Endometrial Cancer General Perspectives, Epidemiology
AbstractPurpose of ReviewThis paper focuses on the epidemiologic factors that are effective on the pathology of the endometrial malignancy. Based on previous reviews and recent articles on endometrial cancer, we sought to define risk factors and related diseases to endometrial malignancies.Recent FindingsPrevious studies have shown that phosphoinositide 3-kinase (PI3K) activity is stimulated by diverse oncogenes and growth factor receptors, and elevated PI3K signaling is considered a hallmark of cancer. A major antagonist of PI3K activity is phosphatase and tensin homolog (PTEN), a tumor suppressor which is often mutated o...
Source: Current Obstetrics and Gynecology Reports - October 14, 2019 Category: OBGYN Source Type: research

Robotic Surgery in Endometrial Cancer
AbstractPurpose of ReviewThe number of minimal invasive gynecological oncological operations performed especially for endometrial cancer is increasing rapidly parallel with the increase in robotic systems in hospitals. This paper focuses on evaluating the studies comparing robotic surgery with laparoscopic and open surgery in patients with endometrial cancer in light of current literature.Recent FindingsWhen the current literature is examined, it is seen that the results of robotic surgery have similar results to laparoscopy such as length of hospital stay, postoperative pain, recovery in a short time, and less blood vesse...
Source: Current Obstetrics and Gynecology Reports - September 3, 2019 Category: OBGYN Source Type: research

The Role of Interventional Radiology in the Management of Placenta Accreta Spectrum Disorders
AbstractPurpose of ReviewPlacenta accreta spectrum disorders encompass a heterogeneous group of conditions classified according to the degree of invasion of the trophoblastic tissue trough the myometrium and uterine serosa with a detrimental effect on maternal outcomes, including life-threatening hemorrhage, need for blood transfusion, damage to adjacent organs, and eventually death, and this highlights the need of additional procedures to improve surgery. The present review aims to provide an up to date on the role of interventional radiology procedures in affecting the outcome of women undergoing surgery for PAS disorder...
Source: Current Obstetrics and Gynecology Reports - August 28, 2019 Category: OBGYN Source Type: research

Contemporary Challenges and Developments: Antenatal Corticosteroid Therapy
AbstractPurpose of ReviewThe purpose of this review is to (i) provide an update to the current challenges surrounding the use of antenatal corticosteroids (ACS) and (ii) to provide a brief synthesis of recent findings relating to work to optimize the efficacy and safety and of ACS therapy to better understand its short- and long-term impacts on the developing foetus.Recent FindingsThere are numerous human and experimental animal studies describing the impact of ACS exposure on foetal growth and programming, in particular, changes to the cardiovascular, endocrine and central nervous systems. Moreover, recent studies have re...
Source: Current Obstetrics and Gynecology Reports - August 21, 2019 Category: OBGYN Source Type: research

Correction to: Updates in Minimally Invasive Approaches to Apical Pelvic Organ Prolapse Repair
The original version of this article unfortunately contained mistake at Conflict of Interest. This section should be corrected and presented as follows: (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - August 9, 2019 Category: OBGYN Source Type: research

Prenatal Ultrasound Imaging for Placenta Accreta Spectrum (PAS): a Practical Guide
AbstractPurpose of ReviewPlacenta accreta spectrum (PAS) is a rare pregnancy complication with an increasing incidence worldwide. PAS can cause serious maternal morbidity and even mortality at delivery. Ultrasound (US) is an excellent imaging modality for the diagnosis of PAS, but it must be used correctly and there is little standardised training in placental imaging available. The aim of this paper is to discuss US screening for PAS and provide practical advice on its use for antenatal diagnosis.Recent FindingsScreening for PAS in a high-risk population (history of previous caesarean delivery (CD) and an anterior low-lyi...
Source: Current Obstetrics and Gynecology Reports - July 16, 2019 Category: OBGYN Source Type: research

Multidisciplinary Teams in the Management of Placenta Accreta Spectrum Disorders
AbstractPurpose of ReviewThe three-fold purpose of this review is to summarize recent evidence supporting the use of a multidisciplinary team (MDT) approach in patients with placenta accreta spectrum (PAS), to describe essential members and processes of the PAS MDT, and to highlight necessary resources for both planned and unexpected cases of PAS.Recent FindingsMaternal outcomes in women with PAS are improved when an antenatal diagnosis occurs and referral is made to centers with MDT specialization and experience in treating PAS. New guidelines unequivocally recommend referral to higher-volume, experienced PAS centers of e...
Source: Current Obstetrics and Gynecology Reports - July 11, 2019 Category: OBGYN Source Type: research

Managing Placenta Accreta Spectrum Disorders (PAS) in Middle/Low-Resource Settings
AbstractPurpose of ReviewThe purpose of this review is to describe the technical issues associated with managing the placenta accreta spectrum (PAS) disorders in a low-resource setting and to provide insight on how to improve the outcome under these conditions.Recent FindingsThe available literature recommends managing PAS in a specialized center with a multidisciplinary team (MDT), but there are no standardized management strategies that would help reduce maternal and neonatal morbidity and mortality in a low-resource setting. The increase in the incidence of PAS has been mainly in middle/low-income countries due to high ...
Source: Current Obstetrics and Gynecology Reports - June 27, 2019 Category: OBGYN Source Type: research

Paternal Environmental Toxicant Exposure and Risk of Adverse Pregnancy Outcomes
AbstractPurpose of ReviewCurrent clinical efforts to predict and prevent preterm birth are primarily focused on the mother and have made minimal progress in improving outcomes. However, recent data indicate that paternal factors can also influence timing of birth. Herein, we will review recent human and murine data examining the contribution of the father to pregnancy outcomes with an emphasis on environmental exposures that can negatively impact fertility and the timing of birth.Recent FindingsHuman epidemiology studies now clearly indicate that a variety of paternal factors (age, race, weight, smoking status) can influen...
Source: Current Obstetrics and Gynecology Reports - June 22, 2019 Category: OBGYN Source Type: research

Is There a Role for MRI in the Management of Placenta Accreta Spectrum?
AbstractPurpose of ReviewThe diagnosis of placenta accreta spectrum (PAS) is based on evaluation of risk factors and imaging findings. Ultrasound (US) is widely available and relatively cheap; magnetic resonance imaging (MRI) is expensive and not universally available. We review performance, interpretation, accuracy, and pitfalls of MRI, and whether it has a role in the management of PAS.Recent FindingsRecent meta-analyses showed excellent diagnostic accuracy in depth of placental invasion. Specific MRI features (intraplacental T2 dark bands, myometrial disruption, uterine bulge, and uteroplacental or parametrial hypervasc...
Source: Current Obstetrics and Gynecology Reports - June 22, 2019 Category: OBGYN Source Type: research

Broad Band Ligament Hernia Revisited (85 Cases of Allen-Master ’s Syndrome; History and Perspectives)
AbstractPurpose of ReviewThe purpose of this review is to update readers on the characteristics and pathogenesis of internal hernia secondary to a defect of broad ligament of the uterus.Recent FindingsThe etiopathogenesis of the disease is controversial. There are two main hypotheses to explain the generation of the defect in the ligament. The first of them would explain this entity as a result of obstetric trauma, an inflammatory pelvic disease, or gynecological surgery. However, in the absence of them, the second hypothesis would speak of congenital defects due to rupture of cysts of the ligament itself. In either case, ...
Source: Current Obstetrics and Gynecology Reports - June 4, 2019 Category: OBGYN Source Type: research

Management of Induced Menopause in Gynaecological Cancers and Their Challenges
AbstractPurpose of ReviewThe consequence of treatment for gynaecological cancers can cause sudden onset of intense menopausal symptoms, such as vasomotor symptoms, sexual dysfunction and emotional instability. Hormone replacement therapy (HRT) is often effective and can overcome these unpleasant and severe symptoms. However, data regarding its safety remains controversial. The big question therefore is whether HRT in gynaecological cancer survivors is possible. This is due to the fear of disease relapse. So, the purpose of this study was to review the evidence regarding cancer recurrence or death following use of HRT in su...
Source: Current Obstetrics and Gynecology Reports - May 25, 2019 Category: OBGYN Source Type: research

From Etiopathology to Management of Accreta Placentation
AbstractPurpose of ReviewTo review the etiopathology of the different grades of accreta placentation and evaluate its impact on management strategies and outcomes.Recent FindingsAccreta placentation is essentially the consequence of prior uterine surgery, mainly multiple cesarean deliveries which often result in large scar defects with absence of re-epithelialization by the endometrium. Invasive placentation is associated with high maternal morbidity and if undiagnosed before delivery can lead to massive obstetric hemorrhage leading to maternal death. The clinical symptoms of an adherent placenta accreta are very similar t...
Source: Current Obstetrics and Gynecology Reports - May 20, 2019 Category: OBGYN Source Type: research

Broad Band Ligament Hernias: A Case Report
AbstractPurpose of reviewInternal hernias account for 1% of all mechanical obstructions. However, internal hernias by defect of the broad ligament of the uterus are uncommon. This review aims to update our knowledge regarding this unusual pathology in order to understand its etiology and symptoms, and to aid in early diagnosis and management.Recent findingsSince the end of the nineteenth century, fewer than 100 cases of internal hernias secondary to a defect of the broad ligament have been described. It is known that this defect in the broad uterine ligament can be congenital or acquired, leading to symptoms such as chroni...
Source: Current Obstetrics and Gynecology Reports - April 3, 2019 Category: OBGYN Source Type: research

Vaginal Birth and Pelvic Floor Trauma
AbstractPurpose of ReviewOver the last two to three decades, a growing body of research has shown that vaginal childbirth is more traumatic to mothers than generally assumed. Apart from obstetric anal sphincter tears which have been extensively studied, trauma to the levator ani muscle is a form of maternal injury that is less well recognised and often undiagnosed. In the context of an increasing push towards vaginal birth, this article will review the recent literature to better inform health care providers regarding the significance of pelvic floor trauma.Recent FindingsImaging studies have shown that levator avulsion, w...
Source: Current Obstetrics and Gynecology Reports - March 18, 2019 Category: OBGYN Source Type: research

Updates in Minimally Invasive Approaches to Apical Pelvic Organ Prolapse Repair
AbstractPurpose of ReviewThe purpose of this article is to review and comment on the recent medical evidence regarding minimally invasive procedures for apical pelvic organ prolapse repair.Recent FindingsSacrocolpopexy remains the “gold standard” repair for apical prolapse for those who desire to maintain sexual function, and minimally invasive approaches offer equal efficacy with lower risk than open sacrocolpopexy. Similar to the impact on hysterectomy rates, the introduction of robotic technology has converted a large number of open abdominal sacrocolpopexy procedures to a minimally invasive approach in the ...
Source: Current Obstetrics and Gynecology Reports - March 16, 2019 Category: OBGYN Source Type: research

Endocrine Disruptors and Pregnancy Loss
AbstractPurpose of ReviewIn modern society, we are exposed to a wide variety of manufactured chemical compounds, called “endocrine-disrupting chemicals” (EDCs). EDCs interact with hormone receptors and have a detrimental effect on reproduction, a complex and hormonally regulated process. Two widely prevalent groups of EDCs are bisphenols and phthalates. This review aims to evaluate and summarize current research on EDCs and their proposed relationship with increased rates of pregnancy loss.Recent FindingsMost research focuses on one of many bisphenols, bisphenol A or BPA. Studies of BPA in animals have shown a ...
Source: Current Obstetrics and Gynecology Reports - March 11, 2019 Category: OBGYN Source Type: research

Caring for Pregnant Women with Opioid Use Disorder
AbstractPurpose of ReviewThe US opioid epidemic continues historic trends of disproportionately affecting women. However, attention to the rise in neonatal opioid withdrawal syndrome (NOWS) and other types of neonatal care often overshadow the urgent need for improved and more wide-ranging maternal treatment in the peripartum period.Recent FindingsThis review aims to highlight the trends in maternal morbidity and mortality related to substance use disorder (SUD), to discuss the under-funding of woman-focused interventions, and to discuss medication-assisted treatment (MAT) options for women with SUD. We found that the rate...
Source: Current Obstetrics and Gynecology Reports - March 6, 2019 Category: OBGYN Source Type: research

Noninvasive Prenatal Diagnostics: Recent Developments Using Circulating Fetal Nucleated Cells
AbstractPurpose of ReviewThe purpose of this review is to highlight recent research advances in noninvasive prenatal diagnostic methods.Recent FindingsRecent studies developing noninvasive prenatal diagnostic (NIPD) methods have been focused on either fetal nucleated red blood cells (fNRBCs) or circulating trophoblasts (cTBs). Enriched cTBs were successfully utilized for whole genome profiling and short tandem repeat (STR) identification to confirm feto-maternal relationship. However, further analysis of isolated fNRBCs remains confined to examining fetal cytogenetics.SummaryInvasive prenatal diagnostic procedures, amnioce...
Source: Current Obstetrics and Gynecology Reports - January 21, 2019 Category: OBGYN Source Type: research

Update on Permanent Contraception for Women
AbstractPurpose of ReviewWe completed this review to update readers on the current literature and controversies surrounding different approaches to permanent female contraception.Recent FindingsPermanent contraception continues to be a popular method of pregnancy prevention. The withdrawal of the Essure ® hysteroscopic approach to permanent contraception from the US market and the increased use of salpingectomy to decrease risk of ovarian cancer have changed options available to women. Current studies support allowing adult women who desire no future pregnancies to access permanent contraception r egardless of age, par...
Source: Current Obstetrics and Gynecology Reports - November 3, 2018 Category: OBGYN Source Type: research

Factors Associated with Adolescents ’ Choice to Use Long Acting Reversible Contraceptives: a Systematic Review
AbstractPurpose of ReviewThis review aims to update the published literature to summarize our understanding about the associated factors with adolescents ’ willingness to use long-acting reversible contraceptives.Recent FindingsLong acting reversible contraception (LARCs), specifically intrauterine devices and implants, have been successful in preventing unintended pregnancy and repeat pregnancy among adolescents. Unfortunately, many misconceptions about eligibility, fears of the insertion procedure, and health effects prevent adolescents from choosing them.SummaryA total of 1316 articles were identified and only nin...
Source: Current Obstetrics and Gynecology Reports - October 29, 2018 Category: OBGYN Source Type: research

A Comprehensive Update on Stillbirth Prevention: from Preconception to Postpartum, Individuals to Public Health Administrations
AbstractPurpose of ReviewStillbirth is a devastating event for the pregnant woman, families, and care providers alike. No preventable stillbirths should be tolerated, no matter how low the incidence is. The rate of reducing stillbirth rate is less than satisfactory and warrants continued efforts. Indeed, massive researches from all specialties bloomed in recent years. Some interventions are with good evidence and feasible to be practiced, while others are preliminary but exciting to be investigated further. The purpose of this review is a comprehensive overview of the recent studies on stillbirth prevention. An emphasis is...
Source: Current Obstetrics and Gynecology Reports - October 23, 2018 Category: OBGYN Source Type: research

Contraception for Women with Epilepsy
AbstractPurpose of ReviewThe purpose of this review is to summarize the current available literature on contraception for women with epilepsy, and to provide recommendations for women with epilepsy on enzyme-inducing anti-seizure drugs and on non-enzyme-inducing anti-seizure drugs.Recent FindingsA recent study has confirmed the safety of the levonorgestrel-containing intrauterine device for women with epilepsy, with no effect on seizure control or anti-seizure drug levels. Other recent studies have found low serum etonogestrel or levonorgestrel levels in women on enzyme-inducing anti-seizure drugs and the etonogestrel or l...
Source: Current Obstetrics and Gynecology Reports - October 17, 2018 Category: OBGYN Source Type: research

Enhanced Recovery after Surgery (ERAS) in Gynecologic Surgery —A Review
AbstractPurpose of ReviewThe purpose of this review is to summarize the newly published guidelines on enhanced recovery after surgery (ERAS) in gynecologic oncology and discuss recent studies evaluating the outcomes of ERAS implementation in general gynecology and gynecologic oncology.Recent FindingsERAS guidelines for gynecologic surgery include preoperative diet, preoperative education, multimodal analgesia, early postoperative feeding, early mobilization and urinary catheter removal, avoidance of mechanical bowel preparation and drains, maintenance of normothermia, and minimal fluid shifts. The studies evaluated in this...
Source: Current Obstetrics and Gynecology Reports - September 1, 2018 Category: OBGYN Source Type: research

Postoperative Hormonal Suppression for Prevention of Deeply Infiltrative Endometriosis Recurrence After Surgery
This article reviews the literature of hormonal suppression for the prevention of postoperative recurrence of DIE. Despite the dearth of data, the current evidence suggests the utility of long-term postoperative hormonal suppression after surgery especially in those who underwent incomplete excision of DIE. Longer follow-up studies are greatly needed. (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - September 1, 2018 Category: OBGYN Source Type: research

Natural History of Uterine Fibroids: A Radiological Perspective
AbstractPurpose of ReviewThis review aims to update our understanding of the radiological life cycle of fibroids, so that we may better counsel patients making difficult treatment decisions. Evidence for both pregnant and non-pregnant women have been considered separately.Recent FindingsRecent findings have shown that fibroids can undergo both growth and regression in non-gravid uterus. In pregnant women, fibroid growth is non-linear fashion, with the greatest growth occurring in the first 7  weeks of pregnancy. Growth in the later trimesters was significantly slower.SummaryFibroid growth, both in the intra- and inter...
Source: Current Obstetrics and Gynecology Reports - September 1, 2018 Category: OBGYN Source Type: research

Correction to: In Pursuit of Solving a Global Health Problem: Prototype Medical Device for Autotransfusing Life-Threatening Postpartum Hemorrhage in Resource-Limited Settings
The original version of this article contains an error in the spelling of an author ’s last name. Originally, the name was spelled as Hananeh Esmailbeighi. Her last name should be spelled as Esmailbeigi. (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - August 9, 2018 Category: OBGYN Source Type: research

The Non-neurogenic Overactive Bladder: an Update
The objective of this study was to review the most recent literature to evaluate and analyse new information regarding the evaluation and treatment trends that is available.Recent FindingsThe aetiology and pathophysiology for the non-neurogenic or idiopathic overactive bladder (OAB) remains unclear. Recent functional MRI studies of the brain indicate an age-related decrease in neurological control of continence of urine. Microbiomes in the urogenital tract have also been implicated in the aetiology of the OAB. The diagnosis and initial management should be based on a thorough history, examination and basic investigations t...
Source: Current Obstetrics and Gynecology Reports - August 1, 2018 Category: OBGYN Source Type: research

Enhanced Recovery after Surgery (ERAS) in Gynecologic Surgery —A Review
AbstractPurpose of ReviewThe purpose of this review is to summarize the newly published guidelines on enhanced recovery after surgery (ERAS) in gynecologic oncology and discuss recent studies evaluating the outcomes of ERAS implementation in general gynecology and gynecologic oncology.Recent FindingsERAS guidelines for gynecologic surgery include preoperative diet, preoperative education, multimodal analgesia, early postoperative feeding, early mobilization and urinary catheter removal, avoidance of mechanical bowel preparation and drains, maintenance of normothermia, and minimal fluid shifts. The studies evaluated in this...
Source: Current Obstetrics and Gynecology Reports - July 12, 2018 Category: OBGYN Source Type: research

Postoperative Hormonal Suppression for Prevention of Deeply Infiltrative Endometriosis Recurrence After Surgery
This article reviews the literature of hormonal suppression for the prevention of postoperative recurrence of DIE. Despite the dearth of data, the current evidence suggests the utility of long-term postoperative hormonal suppression after surgery especially in those who underwent incomplete excision of DIE. Longer follow-up studies are greatly needed. (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - July 7, 2018 Category: OBGYN Source Type: research

Female Voiding Dysfunction: a Practical Approach to Diagnosis and Treatment
AbstractPurpose of ReviewIn this review, we examined a practical approach to diagnosis and treatment of voiding dysfunction in female patients.Recent FindingsThis field of urogynaecology has been the subject in many studies over the last few decades, but despite that, there is no universally accepted algorithm for diagnosis and treatment of this condition. This is primarily related to a lack of standardised definition of different types of voiding dysfunction. The International continence society (ICS) and International Urogynecology Association (IUGA) have created a joint document on terminology of female pelvic floor dys...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

New Horizons in Fibroid Management
AbstractPurpose of ReviewReview of the latest advances in the treatment of uterine fibroids. Addressing conservative management, medical therapy, interventional radiological procedures (non-surgical alternatives or non-excisional procedures) and conservative or radical endoscopic or open surgery (myomectomy, hysterectomy).Recent FindingsNewer medical therapy relied on the use of selective progesterone receptor modulators (SPRMs) (Esmya/UPA) for management of heavy menstrual bleeding (HMB) associated with fibroids. However, the drug is currently under investigation for a link with hepatic damage associated with its use. Oth...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

An Overview of Surgical Treatment for Female Stress Urinary Incontinence
AbstractPurpose of ReviewWe aimed to present an overview of recent data on the proven surgical techniques for female stress urinary incontinence (SUI) including their efficacy, safety, and adverse events.Recent FindingsSurgical treatment of female SUI is the mainstay of urogynecological surgery, with two accepted gold standard techniques: Burch colposuspension and synthetic midurethral slings (MUS). Thorough understanding of the historical evolution of the surgical techniques before and after the introduction of integral theory is important. This theory enhances our comprehension for the continence mechanism of MUS, which ...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

The Loss of Vaginal Hysterectomy
AbstractPurpose of ReviewThe purpose of this review is to provide an update on evidence to support primary use of the minimally invasive approach provided by vaginal hysterectomy in benign conditions that meet criteria for removal of the uterus. This paper will also serve to discuss why the vaginal approach to hysterectomy has decreased over the last decade and to provide observations and solutions to this problem.Recent FindingsRecent findings continue to support vaginal hysterectomy as the preferred route for hysterectomy as endorsed by position statements by the American College of Obstetrics and Gynecology, the America...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

Endometrial Ablation —Current Evidence for Patient Optimization and Long-Term Outcomes
AbstractPurpose of ReviewEndometrial ablation is a minimally invasive surgical option to treat abnormal uterine bleeding. Here, we summarize the evidence regarding patient optimization prior to endometrial ablation and the long-term outcomes of this procedure. Patient optimization includes preoperative planning, patient selection, and preoperative predictors of postoperative failure. Long-term outcomes include postoperative bleeding patterns, frequency of additional procedures for treatment failure, patient satisfaction, risk of endometrial cancer, and pregnancy outcomes.Recent FindingsEndometrial ablation is a safe proced...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

The Life Cycle of the Uterine Fibroid Myocyte
AbstractPurpose of ReviewUterine fibroids are common benign tumors of women in the USA and worldwide, yet the biological nature and pathogenesis of these tumors remain largely unknown. This review presents our view of the stages in the life cycle of a subset of uterine fibroid myocytes, introduces hypothetical concepts and morphological data to explain these changes, and relates these changes in individual myocytes to the phases of fibroid tumor development.Recent FindingsThe observations gained from light and electron microscopic, immunohistochemical, and morphometric studies in our laboratory have led to the hypothesis t...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

Hemostasis Techniques in Myomectomies
AbstractPurpose of ReviewMyomectomy can be associated with significant blood loss, particularly when large and numerous fibroids are removed. Surgeons have incorporated a large number of methods to reduce blood loss, including pre-operative optimization, the use of minimally invasive surgery, and intraoperative techniques. The purpose of this review is to summarize these methods and evaluate the literature supporting those with clinical value.Recent FindingsThe use of minimally invasive surgery has clear benefit in reducing blood loss in myomectomy for appropriately selected patients. Preoperative hormonal treatments reduc...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

Management of Fibroids in Resource-Limited Settings
This article reveals that limited data are available regarding the prevalence, treatment, and extent of the management of uterine fibroids in such settings. Myomectomy is the most common procedure used for fibroids ’ treatment and it can be done during cesarean sections under certain circumstances. Medical treatment and new technologies of fibroids treatment are rarely available for use.SummaryManagement and treatment of fibroids needs continuous efforts in research and innovation into finding cost-effective solutions. Media should play a major rule in increasing the awareness of the problem among women. On the other...
Source: Current Obstetrics and Gynecology Reports - June 1, 2018 Category: OBGYN Source Type: research

New Horizons in Fibroid Management
AbstractPurpose of ReviewReview of the latest advances in the treatment of uterine fibroids. Addressing conservative management, medical therapy, interventional radiological procedures (non-surgical alternatives or non-excisional procedures) and conservative or radical endoscopic or open surgery (myomectomy, hysterectomy).Recent FindingsNewer medical therapy relied on the use of selective progesterone receptor modulators (SPRMs) (Esmya/UPA) for management of heavy menstrual bleeding (HMB) associated with fibroids. However, the drug is currently under investigation for a link with hepatic damage associated with its use. Oth...
Source: Current Obstetrics and Gynecology Reports - May 16, 2018 Category: OBGYN Source Type: research

Natural History of Uterine Fibroids: A Radiological Perspective
AbstractPurpose of ReviewThis review aims to update our understanding of the radiological life cycle of fibroids, so that we may better counsel patients making difficult treatment decisions. Evidence for both pregnant and non-pregnant women have been considered separately.Recent FindingsRecent findings have shown that fibroids can undergo both growth and regression in non-gravid uterus. In pregnant women, fibroid growth is non-linear fashion, with the greatest growth occurring in the first 7  weeks of pregnancy. Growth in the later trimesters was significantly slower.SummaryFibroid growth, both in the intra- and inter...
Source: Current Obstetrics and Gynecology Reports - May 8, 2018 Category: OBGYN Source Type: research

The Loss of Vaginal Hysterectomy
AbstractPurpose of ReviewThe purpose of this review is to provide an update on evidence to support primary use of the minimally invasive approach provided by vaginal hysterectomy in benign conditions that meet criteria for removal of the uterus. This paper will also serve to discuss why the vaginal approach to hysterectomy has decreased over the last decade and to provide observations and solutions to this problem.Recent FindingsRecent findings continue to support vaginal hysterectomy as the preferred route for hysterectomy as endorsed by position statements by the American College of Obstetrics and Gynecology, the America...
Source: Current Obstetrics and Gynecology Reports - May 1, 2018 Category: OBGYN Source Type: research

The Life Cycle of the Uterine Fibroid Myocyte
AbstractPurpose of ReviewUterine fibroids are common benign tumors of women in the USA and worldwide, yet the biological nature and pathogenesis of these tumors remain largely unknown. This review presents our view of the stages in the life cycle of a subset of uterine fibroid myocytes, introduces hypothetical concepts and morphological data to explain these changes, and relates these changes in individual myocytes to the phases of fibroid tumor development.Recent FindingsThe observations gained from light and electron microscopic, immunohistochemical, and morphometric studies in our laboratory have led to the hypothesis t...
Source: Current Obstetrics and Gynecology Reports - April 28, 2018 Category: OBGYN Source Type: research

Endometrial Ablation —Current Evidence for Patient Optimization and Long-Term Outcomes
AbstractPurpose of ReviewEndometrial ablation is a minimally invasive surgical option to treat abnormal uterine bleeding. Here, we summarize the evidence regarding patient optimization prior to endometrial ablation and the long-term outcomes of this procedure. Patient optimization includes preoperative planning, patient selection, and preoperative predictors of postoperative failure. Long-term outcomes include postoperative bleeding patterns, frequency of additional procedures for treatment failure, patient satisfaction, risk of endometrial cancer, and pregnancy outcomes.Recent FindingsEndometrial ablation is a safe proced...
Source: Current Obstetrics and Gynecology Reports - April 25, 2018 Category: OBGYN Source Type: research

An Overview of Surgical Treatment for Female Stress Urinary Incontinence
AbstractPurpose of ReviewWe aimed to present an overview of recent data on the proven surgical techniques for female stress urinary incontinence (SUI) including their efficacy, safety, and adverse events.Recent FindingsSurgical treatment of female SUI is the mainstay of urogynecological surgery, with two accepted gold standard techniques: Burch colposuspension and synthetic midurethral slings (MUS). Thorough understanding of the historical evolution of the surgical techniques before and after the introduction of integral theory is important. This theory enhances our comprehension for the continence mechanism of MUS, which ...
Source: Current Obstetrics and Gynecology Reports - April 23, 2018 Category: OBGYN Source Type: research

Female Voiding Dysfunction: a Practical Approach to Diagnosis and Treatment
AbstractPurpose of ReviewIn this review, we examined a practical approach to diagnosis and treatment of voiding dysfunction in female patients.Recent FindingsThis field of urogynaecology has been the subject in many studies over the last few decades, but despite that, there is no universally accepted algorithm for diagnosis and treatment of this condition. This is primarily related to a lack of standardised definition of different types of voiding dysfunction. The International continence society (ICS) and International Urogynecology Association (IUGA) have created a joint document on terminology of female pelvic floor dys...
Source: Current Obstetrics and Gynecology Reports - April 21, 2018 Category: OBGYN Source Type: research

Hemostasis Techniques in Myomectomies
AbstractPurpose of ReviewMyomectomy can be associated with significant blood loss, particularly when large and numerous fibroids are removed. Surgeons have incorporated a large number of methods to reduce blood loss, including pre-operative optimization, the use of minimally invasive surgery, and intraoperative techniques. The purpose of this review is to summarize these methods and evaluate the literature supporting those with clinical value.Recent FindingsThe use of minimally invasive surgery has clear benefit in reducing blood loss in myomectomy for appropriately selected patients. Preoperative hormonal treatments reduc...
Source: Current Obstetrics and Gynecology Reports - April 21, 2018 Category: OBGYN Source Type: research

Management of Fibroids in Resource-Limited Settings
This article reveals that limited data are available regarding the prevalence, treatment, and extent of the management of uterine fibroids in such settings. Myomectomy is the most common procedure used for fibroids ’ treatment and it can be done during cesarean sections under certain circumstances. Medical treatment and new technologies of fibroids treatment are rarely available for use.SummaryManagement and treatment of fibroids needs continuous efforts in research and innovation into finding cost-effective solutions. Media should play a major rule in increasing the awareness of the problem among women. On the other...
Source: Current Obstetrics and Gynecology Reports - April 17, 2018 Category: OBGYN Source Type: research

The Current Landscape of PARP Inhibitors in Ovarian Cancer
AbstractPurpose of ReviewThe aim of this study is to discuss the background of PARP inhibitors and to provide an overview of the utility of these drugs for treatment of epithelial ovarian cancer.Recent FindingsNumerous phase I –III trials are presented within the manuscript that outline the safety and efficacy of several PARP inhibitors in women with primary and recurrent ovarian cancer. There are now three FDA-approved PARP inhibitors for use in ovarian cancer patients in the USA: olaparib, niraparib, and rucaparib. Th ese drugs have activity both alone and in combination with other agents, including chemotherapy an...
Source: Current Obstetrics and Gynecology Reports - March 3, 2018 Category: OBGYN Source Type: research