Reviews in Gynaecological Practice最新文献

{"title":"Non-surgical management of urinary stress incontinence","authors":"Zeenat Eva Khan,&nbsp;Javed Rizvi","doi":"10.1016/j.rigp.2005.07.002","DOIUrl":"10.1016/j.rigp.2005.07.002","url":null,"abstract":"<div><p>This article reviews the non-surgical approach to urinary stress incontinence. As the cost of medical care increases and the waiting lists for surgical operations grow bigger, non-surgical management of incontinence takes on importance. The cure rates or improvement of quality of life with conservative management of urinary stress incontinence are not as good as with the surgical approach but it is an option which may be used in selected patients. Whenever a patient or the health care provider embarks upon the non-surgical options, consideration should be given to the success rates of the modality, either used alone or in combination. The motivation and compliance of patient is important, individuals who have realistic expectations from non-surgical management of urinary stress incontinence usually have the best result.</p><p>Recent literature was reviewed and an attempt has been made to present an objective assessment for all the modalities currently available for the incontinent woman. It is necessary to stress the need for the use of a combination of modalities for better results when non-surgical approach is used as the first line option. It is also important to be empathetic and supportive of such women as they usually have an extremely poor self esteem, are depressed and reclusive.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 4","pages":"Pages 237-242"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74459188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical management of menorrhagia","authors":"Amanda J. O’Leary ,&nbsp;Harsit Tejura","doi":"10.1016/j.rigp.2005.06.003","DOIUrl":"https://doi.org/10.1016/j.rigp.2005.06.003","url":null,"abstract":"<div><p>Menorrhagia is a common complaint and accounts for 12% of referrals to gynaecology clinics. Prevalence increases with age and peaks just prior to menopause.</p><p>It has been estimated that the treatment of menorrhagia accounts for up to 1% of all healthcare costs.</p><p>Effective medical treatments do exist, but clinicians are poor prescribers of the most effective treatments.</p><p>The main classes of drugs employed for the medical treatment of menorrhagia are non-hormonal (inhibitors of prostaglandin synthesis, antifibrinolytic agents and haemostatic agents) and hormonal therapies.</p><p>First-line management of menorrhagia consists of prostaglandin inhibitors, antifibrinolytic agents, oral contraceptive pill, high dose progestogens and progesterone intra-uterine systems, which can reduce menstrual blood loss by 25%, 50%, 50%, 85% and 90%, respectively. Second-line treatment consists of danazol and GnRH agonists which reduce menstrual loss by 50% and 100%. These treatments are second line as these use is limited by side-effects and or limited duration of use.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Pages 159-165"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91681515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline ovarian tumours: Current concepts and management","authors":"Ahmed Sekotory M. Ahmed,&nbsp;Frank Grang Lawton","doi":"10.1016/j.rigp.2005.05.003","DOIUrl":"10.1016/j.rigp.2005.05.003","url":null,"abstract":"<div><p>Since borderline ovarian tumours came into light in the early 1970s, they continued to present a challenge to doctors and patients equally. The majority of affected women present with an early stage disease, and they are usually 10–15 years younger than those with ovarian cancer. Most ovarian borderline tumours are either serous or mucinous. In general, borderline ovarian tumours have a very good prognosis; however, this is much dependant on the histological subtype, disease stage and the presence or absence of invasive implants. The micropapillary serous pattern is often associated with invasive implants and unfavourable outcome; this emphasises the importance of adequate surgical staging as a prognostic indicator. Mucinous borderline ovarian tumours demonstrate an overwhelmingly benign course. It is now established that cases of pseudomyxoma peritonei are all related to gastrointestinal primary either occult or obvious. So far, no pre-operative test can identify ovarian cyst as borderline with a high degree of certainty. Therefore, maintaining a high index of suspicion, arrangement for frozen section and thorough examination of the abdominal cavity are indispensable, as well as adequate counselling. Conservative surgery in younger patients with stage I disease is a reasonable option; fertility outcome is favourable, however, there is a relatively higher risk of recurrence. This option can even be considered in advanced stages but without invasive implants; fortunately most recurrences can be salvaged surgically. It is now well established that patients with treated stage I disease do not required any adjuvant chemotherapy in view of the excellent long term survival of nearly 100%. Prospective trials are needed for those with advanced stage especially in the presence of invasive implants before a conclusion can be reached. Regular follow up is necessary for early detection and successful management of recurrences, particularly in those who were inadequately staged, managed conservatively or demonstrate high risk histological features.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Pages 139-151"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87635271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI in gynaecology","authors":"T. Bhattacharjya,&nbsp;N.R. Moore","doi":"10.1016/j.rigp.2005.04.005","DOIUrl":"10.1016/j.rigp.2005.04.005","url":null,"abstract":"<div><p>Transabdominal and transvaginal ultrasound are the first line imaging investigations used to assess the female pelvis. In the majority of disorders they provide a diagnosis. However, ultrasound has limitations in staging malignant disease and other imaging options to assess the pelvis in such situations include computed tomography (CT) and magnetic resonance imaging (MRI).</p><p>The use of MRI in gynaecology has been limited by restricted availability of equipment. However, as the resources improve it is envisaged that MRI will have an increasing role in the assessment of gynaecological conditions. The factors that make MRI ideally suited for this role are superb depiction of the anatomy of the pelvic organs, the combination of high-resolution images with wide coverage, the lack of ionising radiation and the ability to use MRI in pregnancy safely.</p><p>This article reviews the current role of MRI in gynaecology.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Pages 172-181"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81885175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of ultrasound in the evaluation of pelvic organ prolapse","authors":"C. Barry, H. Dietz","doi":"10.1016/J.RIGP.2005.06.004","DOIUrl":"https://doi.org/10.1016/J.RIGP.2005.06.004","url":null,"abstract":"","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"1 1","pages":"182-195"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75548239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of ultrasound in the evaluation of pelvic organ prolapse","authors":"Christopher Barry ,&nbsp;Hans Peter Dietz","doi":"10.1016/j.rigp.2005.06.004","DOIUrl":"https://doi.org/10.1016/j.rigp.2005.06.004","url":null,"abstract":"<div><p>Pelvic organ prolapse is a common problem significantly affecting women's quality of life, particularly in later years. Transperineal, two-dimensional ultrasonography can be used for the assessment of female pelvic floor dysfunction for pelvic organ morphology, tissue biomechanics and in vivo properties of prosthetic implants. The role of transperineal ultrasound for the assessment of pelvic organ prolapse is still developing, but with the rapid development of three- and four-dimensional technology may allow dynamic assessment of anatomy in the axial plane. Three-dimensional ultrasound also permits the storage of data volumes for analysis at a later stage, which introduces the ability to independently review images in any plane offline. Further evaluation and research of this imaging tool is required to identify its place in the assessment of women for pelvic organ prolapse and its role in surgical audit.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Pages 182-195"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90129326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelial ovarian cancer and induction of ovulation","authors":"Emma J. Crosbie ,&nbsp;Usha Menon","doi":"10.1016/j.rigp.2005.06.002","DOIUrl":"10.1016/j.rigp.2005.06.002","url":null,"abstract":"<div><p>The possible link between ovulation-inducing agents and ovarian cancer has been the focus of considerable research effort over the past decade. Epidemiological studies addressing this issue have varied in their ability to achieve adequate sample sizes, obtain accurate measures of subfertility and fertility drug use, and eliminate potential bias due to confounding variables. Despite these methodological challenges, nulliparity has consistently been associated with increased rates of epithelial ovarian cancer. An additional modest effect of subfertility has been suggested by some studies, particularly among women who remain childless despite prolonged non-pharmacological attempts to conceive. Type of subfertility may also impact on ovarian cancer risk: ovulatory disorders, endometriosis and unexplained subfertility have all been associated with increased rates of the disease. However, most studies have shown no overall increased risk of epithelial ovarian cancer in women exposed to ovulation-inducing agents, irrespective of the type of fertility drugs used and duration of treatment. While results are generally reassuring, there is a clear need for larger studies employing longer periods of follow-up, detailing precisely the types, doses and duration of treatments patients have received, and controlling for potential confounding reproductive factors. While uncertainties persist, patients undergoing ovulation induction should be informed of the possible increased risk of ovarian cancer following treatment, but it should be emphasised that this risk is doubled at most. Short courses of ovulation induction are probably preferable but there is no evidence for post-treatment screening for ovarian cancer in these patients.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Pages 131-138"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84724989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial ablation—A review of second generation techniques","authors":"Alison M Sambrook ,&nbsp;David E Parkin","doi":"10.1016/j.rigp.2005.03.001","DOIUrl":"10.1016/j.rigp.2005.03.001","url":null,"abstract":"<div><p>Menorrhagia is a common gynaecological complaint. It produces a significant burden upon society accounting for two-thirds of all hysterectomies. Endometrial ablation techniques have been developed and evaluated over the last decade in the hope that some destructive techniques will prove an alternative to hysterectomy. New techniques should be thoroughly evaluated before they are accepted into mainstream practise. With the evidence currently available, the most thoroughly evaluated techniques are microwave endometrial ablation and thermal balloon ablation.</p></div>","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Pages 166-171"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80138060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical management of menorrhagia","authors":"A. O’Leary, H. Tejura","doi":"10.1016/J.RIGP.2005.06.003","DOIUrl":"https://doi.org/10.1016/J.RIGP.2005.06.003","url":null,"abstract":"","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"1 1","pages":"159-165"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83034015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The development of recombinant follicle stimulating hormone (rFSH) for use in the treatment of infertility: new solutions to old challenges” [Rev. Gynaecol. Pract. 4 (2004) 203–210]","authors":"Sigal Klipstein,&nbsp;Wendy D. Latash,&nbsp;Vishvanath C. Karande","doi":"10.1016/j.rigp.2005.05.001","DOIUrl":"10.1016/j.rigp.2005.05.001","url":null,"abstract":"","PeriodicalId":101089,"journal":{"name":"Reviews in Gynaecological Practice","volume":"5 3","pages":"Page 200"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rigp.2005.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"104883265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}