International Society for the Study of Vulvovaginal Disease 2019 Presidential Address
No abstract available (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Commentaries Source Type: research

The International Classification of Diseases, 11th Revision: A Step-Back for Women With Vulvodynia?
Conclusions The ICD-11 is not aligned with current vulvodynia diagnostic criteria and terminology, approved by the ISSVD, ISSWSH, and IPPS. Collaboration among the International Association for the Study of Pain Task Force on Classification of Chronic Pain, ICD team, ISSVD, ISSWSH, and IPPS is needed to harmonize terminologies, codes, and clinical approach regarding vulvar pain and vulvodynia classification. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Commentaries Source Type: research

Differences Between Squamous Intraepithelial Lesions of the Vulva and the Cervix
We describe differences between high-grade squamous intraepithelial lesion of the vulva and cervix (vulvar intraepithelial neoplasia and cervical intraepithelial neoplasia), in embryology (arising from ectoderm vs mesoderm), clinical presentations (symptoms or signs due to many vulvar lesions vs abnormal cytology), examination techniques and diagnosis (clinical examination of potentially widely involved areas vs colposcopy of the transformation zone), natural history, management, and follow-up requirements (long-term clinical assessment vs cytology and human papillomavirus testing). We believe that failure to understand th...
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Commentaries Source Type: research

Clinicopathologic Diagnostic Criteria for Vulvar Lichen Planus
Conclusions Clinicopathological correlation yields the most reliable diagnosis of vulvar LP. Disease appearance overlaps with other physiologic, dermatologic, infectious, and neoplastic entities; a low threshold for biopsy at all morphologically distinct areas is recommended. Use of the histopathologic criteria described in this document may reduce the nondiagnostic biopsy rate for clinically diagnosed LP. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vulvovaginal Derm Source Type: research

Anogenital High-Grade Squamous Intraepithelial Lesion Comorbid With Vulvar Lichen Sclerosus and Lichen Planus
Conclusions Histopathologic identification of comorbid HSIL and LS/LP may be challenging because of keratinizing morphology and loss of diagnostic features of LS. Clinicopathologic correlation and use of p16 and p53 are essential to achieve an accurate diagnosis and enact disease-specific management plans. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vulvovaginal Derm Source Type: research

Fat Grafting Improves Fibrosis and Scarring in Vulvar Lichen Sclerosus: Results From a Prospective Cohort Study
Objective The aim of the study was to evaluate the effect of lipotransfer in women presenting with fibrosis and scarring due to lichen sclerosus. Materials and Methods This prospective cohort study included 33 women attending the vulvar clinic of a public hospital. Patients received one lipotransfer treatment. Validated measures were used prospectively to assess the sexual function (Female Sexual Function Index, Female Sexual Distress Scale); symptoms (visual analog scale for itching, burning, soreness), pain (Pain Anxiety Symptoms Scale 20); psychological status and quality of life (Hospital Anxiety and Depression Sc...
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vulvovaginal Derm Source Type: research

Vulvar Lichen Sclerosus: Outcomes Important to Patients in Assessing Disease Severity
Conclusions Future LS severity assessment tools will need to include a combination of patient-rated symptoms, clinical rated signs and anatomical changes, and quality of life measures. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vulvovaginal Derm Source Type: research

Adult Vulvar Lichen Sclerosus: Can Experts Agree on the Assessment of Disease Severity?
Conclusions Global experts were unable to agree on any signs, architectural changes, or an overall global impression to assess vulvar LS disease severity based on analysis of vulvar photographs. Standardized descriptions regarding what constitutes mild, moderate, and severe signs and anatomical changes are required before further scale development can occur. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vulvovaginal Derm Source Type: research

Features of the Vaginal and Vestibular Microbioma in Patients With Vestibulodynia: A Case-Control Study
Objective Our objective was to determine the role of vaginal and/or vestibular microbiota disturbance as an associated factor of symptom characteristic of provoked vestibulodynia (PVD). Study Design In an observational case-control study, the bacterial microbiomes in the vagina and vestibule from 20 women with PVD and 18 healthy controls were compared using a 16S rRNA gene-based molecular analysis. Clinical data were recorded through a 0- to 10-point visual analog scale related to dyspareunia and vulvovaginal pain/burning. Results Comparative assessment of the bacterial taxa (cutoff ≥15%) revealed 105 genera in ...
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vaginal Source Type: research

Oral Intake of Lactobacilli Can Be Helpful in Symptomatic Bacterial Vaginosis: A Randomized Clinical Study
Conclusions Oral intake of L. crispatus LMG S-29995, L. brevis, and L. acidophilus can significantly decrease percent of recurrences of BV in recently treated women and prolong time to recurrence of the disease. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vaginal Source Type: research

Five Percent Monolaurin Vaginal Gel for the Treatment of Bacterial Vaginosis: A Randomized Placebo-Controlled Trial
Conclusions Monolaurin was no more clinically or microbiologically effective than placebo in curing BV. Future research should explore whether monolaurin may be used to increase Lactobacilli species. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Vaginal Source Type: research

Management of Malignant Vulval Melanoma: A Retrospective Case Series and Review of the Literature
Conclusions This retrospective multicenter study highlights the high recurrence rate and poor prognosis of vulval melanoma. Lymph node surgery did not make any difference to recurrence-free survival or overall survival. The presence of microsatellites was associated with a statistically increased risk of death. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Other Neoplasia Source Type: research

Predictive Value of an Alternative Strategy for Measuring Depth and Size of Stage 1 Vulvar Squamous Cell Carcinoma
Conclusions Patients downstaged using alternative measurement techniques lacked nodal disease/recurrence; one-third of those with nodal sampling experienced postoperative morbidity. Our data suggest that the use of alternative depth and cumulative extent of invasion could safely allow some conventional stage IB vulvar SCC patients to avoid groin surgery, thereby reducing treatment-related morbidity. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Other Neoplasia Source Type: research

Cervical Stratified Mucin-Producing Intraepithelial Lesion: A Systematic Review of Diagnosis and Management
Conclusions Stratified mucin-producing intraepithelial lesion is a rare lesion with a paucity of research on necessary cytology and IHC stains for diagnosis, but p16 and Ki-67 IHC stains can be performed to rule out benign lesions. The lesion is associated with high risk of concurrent high-grade squamous intraepithelial lesion, adenocarcinoma in situ, and invasive carcinoma, but studies on the risk of pursuing fertility-preserving management are needed. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Management Source Type: research

Risk of Recurrence After Treatment for Cervical Intraepithelial Neoplasia 3 and Adenocarcinoma In Situ of the Cervix: Recurrence of CIN 3 and AIS of Cervix
Conclusions Recurrence risk of CIN 3 and AIS is related to age, histology, and posttreatment cytology, which should assist with discharge planning from colposcopy. Definitive treatment with hysterectomy should be considered in women older than 45 years with additional risk factors for recurrence. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Management Source Type: research

Risk of High-Grade Histopathology Diagnosed by Cervical Conization in Endocervical Curettage Cervical Intraepithelial Neoplasia 1: A Case-Control Study
Objective The aim of the study was to estimate risks of cervical intraepithelial neoplasia 2+ (CIN 2+) on loop electrosurgical excisional procedure (LEEP) specimens with the diagnosis of endocervical curettage (ECC) CIN 1 compared with biopsy CIN 1. Materials and Methods We performed a retrospective computer-based search for subjects enrolled in the Obstetrics and Gynecology Hospital of Fudan University. The case group comprised women with an ECC CIN 1 (ECC results of CIN 1 with colposcopy-directed biopsy results ≤CIN 1), and the control group comprised women with a biopsy CIN 1 (colposcopy-directed biopsy results ...
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Management Source Type: research

Evaluation of Liquid Versus Dry Specimen Transport With a Newly Validated Isothermal Amplification High-Risk Human Papillomavirus Assay
Conclusions Endocervical specimens transported dry have similar proportion of positive HR-HPV tests as those transported in liquid media. Dry brush transport of endocervical samples paired with the special characteristics of AmpFire HR-HPV may become an important addition to population based cervical cancer screening. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Screening Source Type: research

Retrospective 15-Year Review of Anal Cytology Screening in Women at Mayo Clinic Rochester, Minnesota
Conclusions High-risk women should be screened on a periodic basis for anal cancer. Anal cytology is one possible modality that can be used. Further insight into AIN progression, regression, recurrence, and outcome after treatment will help direct future screening recommendations. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Screening Source Type: research

P16/Ki-67 Immunostaining in the Triage of Postmenopausal Women With Low-Grade Cytology Results
Conclusions Dual p16/Ki-67 immunostaining is a useful additional method in postmenopausal patients with low-grade cytology. Considering the high specificity and negative predictive value in our study, we believe that it could be helpful in avoiding unnecessary referrals to colposcopy and thus reduce the cost of the program. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - June 23, 2020 Category: OBGYN Tags: Screening Source Type: research

Health Care for Transgender Men: What Is Missing in OB/GYN Care?
Conclusions It is important for TGM who have a vagina, cervix, and/or uterus to have routine gynecological screenings. However, the lack of gender inclusive care in OB/GYN clinics presents a barrier for many TGM and the recommendations emphasized in this commentary will increase sensitivity for the TGM patient population and decrease their marginalization in health care settings. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Commentary Source Type: research

Vestibulovaginal Sclerosis in a Transgender Man on Testosterone
No abstract available (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Vulvovaginal Disease Source Type: research

Fractionated CO2 Laser as Therapy in Recalcitrant Lichen Sclerosus
Conclusions The fractionated CO2 laser may be a helpful approach for managing LS that is unresponsive to traditional treatment options. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Vulvovaginal Disease Source Type: research

Allergic Contact Dermatitis of the Anogenital Region in Men and Women
Conclusions The top positive and relevant allergens seen were in concordance with other reports from Australia and the rest of the world. Fragrances and medicaments are common allergens, and it is recommended that products used on anogenital skin be fragrance free. Testing patients own products is imperative. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Vulvovaginal Disease Source Type: research

Interactive Learning Modules With Visual Feedback Improve Resident Learning in Colposcopy
Conclusions Learning outcomes improved after introduction of a novel teaching intervention. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Management HPV Assoc Conditions Source Type: research

The Effect of Forced Cough to Minimize Pain and Discomfort at the Time of Colposcopy-Guided Cervical Biopsy
Conclusions We observed a trend that cough reduced pain associated with the colposcopy-guided cervical biopsy but did not reach statistical significance. A similar outcome was observed in anxiety level, where anxiety was reduced in the cough group but was not statistically significant as compared with the no cough group. Further studies are necessary to assess various modalities in reducing pain and anxiety associated with colposcopy-guided cervical biopsy. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Management HPV Assoc Conditions Source Type: research

Role of Oral Tramadol 50 mg in Reducing Pain During Colposcopy-Directed Cervical Biopsy: A Randomized Controlled Trial
Conclusions Oral tramadol 50 mg significantly reduces pain perception during colposcopy-guided ectocervical biopsy, ECC, endocervical brushing, and 10 minutes after colposcopy with tolerable adverse effects. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Management HPV Assoc Conditions Source Type: research

Loop Electrosurgical Excision Procedure or Cervical Conization to Exclude Cervical Cancer Before Simple Hysterectomy
Conclusions After colposcopy, women with ECC of CIN 2 or CIN 3, cervical biopsy of CIN 3, or colposcopic impression of CIN 2+ require LEEP or cone before simple hysterectomy. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Management HPV Assoc Conditions Source Type: research

High-Risk Human Papillomavirus Identification in Precancerous Cervical Intraepithelial Lesions
Conclusions Human papillomavirus tests are a critical component for cervical cancer screening, and understanding of these tests helps test results interpretation and patients' triage. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Management HPV Assoc Conditions Source Type: research

The Utility of Digital Anal Rectal Examinations in a Public Health Screening Program for Anal Cancer
Conclusions The mildly invasive nature of DARE, limited likelihood of adverse procedure-related events, cost-effectiveness and patient acceptability, as well as wide availability of DARE support consideration of its integration into screening for populations at high risk of anal cancer, especially HIV-positive men who have sex with men. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Screening HPV Assoc Conditions Source Type: research

Challenges Associated With Cervical Cancer Screening and Management in Obese Women: A Provider Perspective
Conclusions Cervical cancer screening and management are more challenging in obese compared with normal weight women. Major barriers to cervical sampling and visualization included lack of adequately sized equipment and lack of education and training. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Screening HPV Assoc Conditions Source Type: research

Trends in Patient Demographics and Diagnostic Yield at an Academic Colposcopy Clinic From 2008 to 2018
Objective The aim of the study was to review trends in colposcopy rates and diagnoses of high-grade dysplasia and cancer for the past 10 years at an academic colposcopy clinic. Materials and Methods A registry of patients seen January 2008 to December 2018 at an academic colposcopy clinic was queried to examine trends in patient characteristics, cytology and histology results, and interventions during the study period, which coincided with the implementation of revised national guidelines. Differences in characteristics were examined with analysis of variance and χ2 tests. Trends in diagnoses were examined with lo...
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Screening HPV Assoc Conditions Source Type: research

Incorporating Stakeholder Feedback in Guidelines Development for the Management of Abnormal Cervical Cancer Screening Tests
Conclusions Stakeholder feedback was incorporated into the development of the 2019 ASCCP Risk-Based Management Consensus Guidelines. Proposed recommendations with less than two-thirds agreement in the public comment period were considered for revision. Findings underscore the importance of stakeholder feedback in developing guidelines that meet the needs of patients and providers. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

Reporting and Assessing the Quality of Diagnostic Accuracy Studies for Cervical Cancer Screening and Management
Conclusions The adapted QUADAS-2 will have broad application for researchers, evidence evaluators, and journals who are interested in designing, conducting, evaluating, and publishing studies for cervical cancer screening and management. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

A Systematic Review of Tests for Postcolposcopy and Posttreatment Surveillance
Conclusions Despite a large number of published studies on postcolposcopy and posttreatment surveillance, only few met criteria for abstraction and were included in the meta-analysis. More high-quality studies are needed to evaluate assays and approaches that can improve management of patients with abnormal screening. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

A Study of Partial Human Papillomavirus Genotyping in Support of the 2019 ASCCP Risk-Based Management Consensus Guidelines
Conclusions Identification of HPV 16 clearly mandated consideration in clinical management of new abnormal screening results. HPV 18 positivity must be considered as a special situation because of established disproportionate risk of invasive cancer. More detailed genotyping and use beyond initial management will be considered in guideline updates. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines
Conclusions The new risk-based guidelines present recommendations for the management of abnormal screening test and histology results; the key risk estimates supporting guidelines are presented in this article. Comprehensive risk estimates are freely available online at https://CervixCa.nlm.nih.gov/RiskTables. The 2019 American Society for Colposcopy and Cervical Pathology Risk-Based Management Consensus Guidelines for the management of cervical cancer screening abnormalities recommend 1 of 6 clinical actions (treatment, optional treatment or colposcopy/biopsy, colposcopy/biopsy, 1-year surveillance, 3-year surveillance...
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors
No abstract available (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

2019 ASCCP Risk-Based Management Consensus Guidelines: Methods for Risk Estimation, Recommended Management, and Validation
Conclusions The new risk-based guidelines present management of abnormal cervical screening results. By describing the steps used to develop these guidelines, the methods presented in this article can provide a basis for future extensions of the risk-based guidelines. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

An Introduction to the 2019 ASCCP Risk-Based Management Consensus Guidelines
No abstract available (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - April 1, 2020 Category: OBGYN Tags: Risk Based Guidelines Source Type: research

Early Detection of Anal High-Grade Squamous Intraepithelial Lesion: Do We Have an Impact on Progression to Invasive Anal Carcinoma?
Conclusions Patients with macroscopic histologically proven HSIL at first diagnosis of anal intraepithelial lesion have a significantly higher risk of anal cancer compared with patients with microscopic lesions diagnosed during HRA, but the duration between the first diagnosis of HSIL and cancer does not differ between the 2 groups. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Anal Disease Source Type: research

Assessment of Anal Cancer Screening Tools in Detecting High-Grade Anal Squamous Intraepithelial Lesions in Women
Objective The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing. Materials and Methods A cross-sectional study was done among 128 eligible women who attended the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Center between 2014 and 2019. Kappa (κ) coefficient, sensitivity, specificity, positive predictive value, and negative predictive value we...
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Anal Disease Source Type: research

Diagnosing Anal Squamous Intraepithelial Lesions With and Without p16: An Interobserver Variability Study
Conclusions This study highlights the importance of a judicious use of p16 for diagnosis. When there is no need for p16 by the Lower Anogenital Squamous Terminology guidelines, interobserver agreement was substantial to almost perfect with a 2-tiered diagnosis. However, when its use is indicated but it is not performed or reviewed, the agreement is much lower even with a 2-tiered diagnosis. Rational use of p16 will ensure diagnostic accuracy and the best possible patient care. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Anal Disease Source Type: research

The International Society for the Study of Vulvovaginal Disease Surgical Oncological Procedure Definitions Committee “Surgical Terminology for Vulvar Cancer Treatment”
Conclusions This terminology helps avoid confusion and promote better understanding and exchange of experiences among gynecologic oncologists involved in vulvar carcinoma care. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Vulvar Disease Source Type: research

Upcoming Position Papers From the International Society for the Study of Vulvovaginal Disease
No abstract available (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Vulvar Disease Source Type: research

Identification of Specific Tumor Markers in Vulvar Carcinoma Through Extensive Human Papillomavirus DNA Characterization Using Next Generation Sequencing Method
Conclusions Using the NGS-based innovative capture-HPV approach, we established a cartography of HPV 16 DNA in 8 VC cases and identified novel genes targeted by integration that may be used as specific tumor markers. In addition, we established a rationale strategy for optimal characterization of HPV status in VC. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Vulvar Disease Source Type: research

Prognosis and Long-Term Outcome of Women With Idiopathic Recurrent Vulvovaginal Candidiasis Caused by Candida albicans
Conclusions Fluconazole suppression therapy was highly effective in preventing VVC symptoms but was rarely curative and VVC relapse occurred frequently after discontinuation of maintenance therapy. The development of drug resistance in C. albicans isolates after long-term fluconazole maintenance therapy although uncommon is a previously unrecognized complication. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Vaginal Disease Source Type: research

Vaginal Intraepithelial Neoplasia: A Retrospective Study of Treatment and Outcomes Among a Cohort of UK Women
Conclusions Vaginal intraepithelial neoplasia remains an uncommon premalignant condition. It can affect women of all ages and is commoner in those who are immunosuppressed. Observation of low-grade disease is safe and the abnormality often resolves spontaneously. For persistent disease or higher-grade abnormalities, there are many treatment options but laser vaporization is the most commonly used. However, because of the nature of VaIN, recurrence is common even after treatment and further management can be challenging. The overall rate of malignant progression is small but protracted follow-up may be necessary. (Source:...
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Vaginal Disease Source Type: research

Time-Dependent Squamous Cell Carcinoma Antigen in Prediction of Relapse and Death of Patients With Cervical Cancer
Objective The aim of the study was to develop a methodology to identify the best use of a longitudinally measured biomarker in relevance to prognosis. Materials and Methods Data of squamous cell carcinoma antigen (SCC-Ag) from 770 patients with cervical squamous cell carcinoma (SCC) were used. The pretreatment, nadir, and time-dependent SCC-Ag values were analyzed in relevance to disease relapse and death with univariate and multivariate analysis side by side with a variety of available clinicopathologic factors. The predictive power of the significant variates was evaluated by C-index with 5-fold cross validation. R...
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Cervical Disease Source Type: research

Human papillomavirus Posttreatment Clearance Time in Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer
Conclusions Delaying first posttreatment follow-up to 9 months in patients at high risk of noncompliance could potentially reduce burden of cost and repeated clinical visits. This follow-up approach could be consistently applied to all women regardless of age, severity, and extent of disease. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Cervical Disease Source Type: research

Specimen Fragmentation and Loop Electrosurgical Excision Procedure and Cold Knife Cone Biopsy Outcomes
Objective Surgical technique for loop electrosurgical excision procedure (LEEP) and cold knife cone (CKC) emphasizes a uniform specimen, but sequelae of specimen fragmentation are not established. We evaluated outcomes between fragmented and unfragmented excisional biopsy specimens. Materials and Methods Loop electrosurgical excision procedure and CKCs from January 2010 to October 2013 were reviewed. Intraepithelial lesion grade, fragmentation, margin, and Endocervical curettage status were analyzed. Adenocarcinoma in situ and cancer were excluded. Repeat procedures during the study period were included in follow-up. ...
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Cervical Disease Source Type: research