Przeglad Menopauzalny最新文献

Isolated fallopian tube anomalies are a rare group of disorders, usually observed in otherwise asymptomatic patients. If symptomatic, the patients may present with infertility or unspecified abdominal pains. Various aetiologies have been proposed to explain this phenomenon, ranging from congenital to vascular events. Diagnosis is very challenging because in most cases those abnormalities are not easily seen on ultrasound, computed tomography, or even magnetic resonance imaging. The most objective and certain diagnosis, however, can be obtained through laparoscopy with an associated histopathological examination performed if necessary. Management of this rare group of disorders remains unclear - because the number of cases is relatively small, there is no consensus on treatment. We present a case of a 22-year-old woman with no relevant clinical history and no sexual activity with large bilateral hydrosalpinx that developed as a result of bilateral distal fallopian tube segmental absence with associated occlusion and concomitant endometriotic implants in the vicinity of the left ovarian fossa and the peritoneum of the rectouterine pouch. To our best knowledge, only a few similar cases have been described in the literature. We summarise the available descriptions of this group of pathologies, present theories that have been proposed to explain this phenomenon, and provide various classifications of those disorders.

This review looks at the use of botulinum toxin in the gynaecological field with the aim of determining what needs to be further investigated to achieve a standardized application. Numerous studies have been conducted to explore how botulinum toxins (BoNT) can be applied, and it is becoming popular for treating various disorders such as chronic pelvic pain, vestibulodynia, and vaginism. However, the exact dosage and ideal location for injections still need to be clarified. The objective of this study is to point out which aspects need to be more carefully studied to ensure a consistent use of BoNT in gynaecology.

The gold standard of treatment for patients with early-stage cervical cancer is radical hysterectomy, in agreement with the entire scientific community. During the last decade, growing evidence has supported the minimally invasive approach. Several studies have suggested that the minimally invasive approach could improve surgical and perioperative outcomes. Because of these findings, ESCO/ESTRO/ESP guidelines state that a "minimally invasive approach is favoured" in comparison with open surgery, as a grade B recommendation. Because of the lack of a grade A recommendation, this randomized Laparoscopic Approach to Cervical Cancer trial evaluated open vs. minimally invasive approach in the early stage. It demonstrated an increase in mortality among patients treated with minimally invasive surgery, revolutionizing current thinking on the primary surgical approach to early cervical cancer. The aim of this study is to analyse which is the best treatment for early cervical cancer and which approach is the most effective at the moment. Further studies are needed to state with certainty the appropriateness of the treatments offered to patients with early cervical cancer.

Ovarian cancer is a complex disease, mostly observed in postmenopausal women, and is associated with poor survival rates. It is the sixth most common cancer and the fifth most common cause of death due to cancer among women in developed countries. Thus, despite representing less than one third of all gynaecologic cancers, deaths due to ovarian cancer account for more than two thirds of deaths due to gynaecologic cancers. Its prevalence is higher in Western Europe and Northern America than Asia and Africa. In sub-Saharan Africa, there is a considerably lower prevalence of ovarian cancer than other parts of Africa. Ovarian cancer is multifaceted, involving many factors, complex biological processes and unpredictable consequences. Unlike other female cancers that have early warning symptoms, ovarian cancer's symptoms are non-specific. As a result, ovarian cancers are normally undetected until advanced stages (III or IV). The major risk factors for ovarian cancer include older age, genetics, family history, hormone replacement therapy, nulliparity, and dietary fat. Controversial factors include obesity, infertility, talc powder, radiation exposure, fertility medications and in vitro fertilization. The current review discusses the aetiology, epidemiology and risk factors for ovarian cancer. Nevertheless, identification of the main risk factors for ovarian cancer may increase the awareness among women of the general population. This should help to decrease the incidence rate of ovarian cancer and increase the five-year survival rate.

Introduction: Communication skills help people have a better life. Due to the changes caused by menopause and their effects on interpersonal communication, it is essential to reinforce communication skills during this period. This study aimed to investigate the effect of communication skills training (CST) using the transactional analysis (TA) approach on menopausal women's marital adjustment.

Material and methods: This quasi-experimental study with a parallel design was performed by the availability sampling method with participation of 46 married menopausal women. Participants were randomly assigned to two groups. The intervention group participated in eight CST sessions with a TA approach. The control group did not receive any psychosocial or educational services. Participants completed the demographic information, Queen Dam communication skills, and Spinner's marital adjustment questionnaire before, at the end of, and one month after the training period. Data were analyzed by descriptive and analytical tests with SPSS22 software.

Results: There was no significant difference in demographics between the groups (p < 0.05). The mean marital adjustment scores were 53.48 ±12.24, 117.70 ±11.15, and 116.52 ±10.73 before, at the end of, and one month after the intervention, respectively. The marital adjustment scores before the intervention did not differ between the two groups but significantly increased after training and in the follow-up period (p < 0.001).

Conclusions: Communication skills training with a TA approach in postmenopausal women improves marital adjustment. Therefore, it is suggested that midwives use this method in comprehensive health centers as an effective method for improving the lives of postmenopausal women.

Introduction: A paraovarian cyst (POC) is a cyst in the broad ligament or mesosalpinx. Paraovarian cysts have an estimated prevalence of 5-20% amongst the adnexal masses. Despite the high prevalence and availability of advanced imaging modalities, an accurate pre-operative diagnosis of POC is still made in less than 50% of patients.

Case reports: Two females with suspected ovarian torsion underwent laparotomy and had POCs. A 42-year-old hysterectomized female underwent surgery for a suspected POC which turned out to be a mesenteric cyst. Two females underwent laparotomy for suspected mesenteric cysts which turned out to be POCs. A nulliparous female with infertility conceived spontaneously after cystectomy of POC.

Results: Optimal management of an adnexal mass depends on the knowledge of the origin and the exact nature of the mass. No clear-cut guidelines exist for the management of POCs despite their high prevalence. There is a need for further research on this topic to formulate clear-cut guidelines for their management.

Conclusions: Radiologists and gynaecologists need to keep them in mind as differentials for patients with adnexal masses to ensure a correct pre-operative diagnosis in order to achieve an optimal outcome for these females. Gynaecologists need to be aware of the cases which can be managed conservatively and those that need surgery, along with the extent of the surgery required, taking care to protect the ovary at all costs, particularly in benign cases.

Introduction: The aim of the study is to evaluate the correlation between the level of serum oestradiol (E₂) on the day of human chorionic gonadotropin (hCG-day) administration and successful intracytoplasmic sperm injection (ICSI) outcome.

Material and methods: This prospective study was performed during the period from January 2019 to September 2021, at Zagazig Obstetrics and Gynecology Department, and Al-Azhar Obstetrics and Gynecology Department, and private ART centers. One hundred and fifty women attending the infertility clinic for ICSI cycles. All women were divided into 5 groups according to the serum E₂ level on the day of hCG administration: Group A - serum E₂ < 1000 pg/ml; Group B - serum E₂ 1000 to < 2000 pg/ml; Group C - serum E₂ 2000 to < 3000 pg/ml;Group D - serum E₂ 3000 to < 4000 pg/ml; Group E - serum E₂ ≥ 4000 pg/ml.

Results: The highest fertilization rate (58.1%) was among women with E₂ ≥ 4000 pg/ml, while the lowest (37%) was in women with E₂ 1000 to < 2000 pg/ml. Also, the highest pregnancy rate (21.5%) was among women with E₂ > 4000 pg/ml, while the lowest (5.3%) was in women with E₂ < 1000 pg/ml. In the current study the median serum E₂ level on the day of hCG administration was highly significant in women who became pregnant when compared to women who did not. The best cut-off value of serum E₂ at hCG administration was ≥ 3682.3 pg/ml.

Conclusions: this study suggests that the optimal range of E₂ level for achieving a successful pregnancy is > 4000 pg/ml.

Introduction: The aim was to investigate the response of pregnant women when the COVID-19 vaccination policy shifted from restricted to required, and the confusion that ensued during pregnancy, bearing in mind that women undergo unique physiological and immunological changes during pregnancy, making them at risk of developing a more severe course of COVID-19 infection compared to their non-pregnant peers.

Material and methods: A cross-sectional study was carried out at the outpatient clinics at Jordan University Hospital for all pregnant women during the period of the survey from 1^st October 2021 to 31^st December 2021, focusing on the source of information about the vaccine, receiving the vaccine, and the reasons for rejecting the vaccine, especially during pregnancy.

Results: In total, 468 pregnant women were interviewed. The single primary source of information about the COVID-19 vaccine was the traditional media, audio-visual and print media being the most important as reported by 191 women (40.81%), while possible harm to the fetus was the single main reason for refusal of vaccination during pregnancy as reported by 111 women (23.72%).

Conclusions: Reluctance toward vaccination is primarily driven by the fierce media campaign that portrayed its initially ambiguous effects on the pregnancy and fetus in a negative light, in conjunction with the open media platforms that enabled semi-experts to issue medically inaccurate statements and information and further complicated the matter by planting the seed of fear and mistrust of the public in the health care system and providers. More public healthcare awareness regarding the safety of the COVID-19 vaccine is needed.