Cervical Cancer
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Alternative Treatment Method for Cervical Ectopic Pregnancy Servikal Ektopik Gebelik İçin Alternatif Tedavi Yöntemi
J Kartal TR 2016;27(2):147-149 CASE REPORT doi: 10.5505/jkartaltr.2015.065982 OLGU SUNUMU Alternative Treatment Method for Cervical Ectopic Pregnancy Servikal Ektopik Gebelik İçin Alternatif Tedavi Yöntemi Ali Emre TAHAOĞLU, Mehmet İrfan KÜLAHÇIOĞLU, Ahmet ESER, Cihan TOĞRU Diyarbakır Obstetrics and Child Health Hospital, Diyarbakır, Turkey Summary Özet Cervical ectopic pregnancy is a very rare form of ectopic Servikal ektopik gebelik, tüm ektopik gebelikler arasında çok pregnancy. Cervical ectopic pregnancy can be a cause of se- nadir rastalanan bir ektopik gebelik formudur. Servikal ektopik vere bleeding and it is associated with high morbidity and gebelik ciddi bir hemoraji nedeni olabilir. Ayrıca yüksek morbi- mortality. In recent years, many conservative methods of dite ve mortalite ile ilişkilidir. Son yıllarda fertiliteyi korumak treatment seeking to preserve fertility have been reported. amacı ile farklı birçok konservatif yaklaşım rapor edilmiştir. Presently described is case of pregnant woman at gesta- Kliniğimize yedi hafta dört gün ile uyumlu fetal kardiyak ak- tional age of 7 weeks and 4 days who was admitted to clinic tivitesi olmayan gebe vajinal kanama şikayeti ile başvurdu. with vaginal bleeding. Fetal cardiac activity was negative. Hasta yüksek servikal sütür ve Mcdonald serklaj uygulanarak Patient was successfully treated with high ligation suture başarı ile tedavi edildi. Servikal gebelik tedavisi hala tartışma and McDonald cerclage. There is no consensus yet on best konusudur. Fakat tedavi konusunda henüz kesin bir fikir birliği treatment of cervical ectopic pregnancy, but conservative bulunmamaktadır. Konservatif yaklaşım hastayı histerektomi methods can avoid major surgical procedure such as hyster- gibi büyük bir cerrahiden ve bunun getirdiği kötü sonuçlardan ectomy and its consequences. -
Updates in Uterine and Vulvar Cancer
Management of GYN Malignancies Junzo Chino MD Duke Cancer Center ASTRO Refresher 2015 Disclosures • None Learning Objectives • Review the diagnosis, workup, and management of: – Cervical Cancers – Uterine Cancers – Vulvar Cancers Cervical Cancer Cervical Cancer • 3rd most common malignancy in the World • 2nd most common malignancy in women • The Leading cause of cancer deaths in women for the developing world • In the US however… – 12th most common malignancy in women – Underserved populations disproportionately affected > 6 million lives saved by the Pap Test “Diagnosis of Uterine Cancer by the Vaginal Smear” Published Pap Test • Start screening within 3 years of onset of sexual activity, or at age 21 • Annual testing till age 30 • If no history of abnormal paps, risk factors, reduce screening to Q2-3 years. • Stop at 65-70 years • 5-7% of all pap tests are abnormal – Majority are ASCUS Pap-test Interpretation • ASCUS or LSIL –> reflex HPV -> If HPV + then Colposcopy, If – Repeat in 1 year • HSIL -> Colposcopy • Cannot diagnose cancer on Pap test alone CIN • CIN 1 – low grade dysplasia confined to the basal 1/3 of epithelium – HPV negative: repeat cytology at 12 months – HPV positive: Colposcopy • CIN 2-3 – 2/3 or greater of the epithelial thickness – Cold Knife Cone or LEEP • CIS – full thickness involvement. – Cold Knife Cone or LEEP Epidemiology • 12,900 women expected to be diagnosed in 2015 – 4,100 deaths due to disease • Median Age at diagnosis 48 years Cancer Statistics, ACS 2015 Risk Factors: Cervical Cancer • Early onset sexual activity • Multiple sexual partners • Hx of STDs • Multiple pregnancy • Immune suppression (s/p transplant, HIV) • Tobacco HPV • The human papilloma virus is a double stranded DNA virus • The most common oncogenic strains are 16, 18, 31, 33 and 45. -
16 Non-Delivery Obstetric Procedures
16 Non-delivery Obstetric Procedures Cervical Cerclage ...................... 357 AnestheticOptions.................... 358 Regional Anesthesia .................. 358 General Anesthesia .................. 359 CerclageRemoval.................... 359 Dilation and Evacuation (D&E) .............. 360 AnestheticOptions.................... 360 Postpartum Tubal Ligation ................. 362 TimingofTubalLigation................. 362 Physiologic Changes of Pregnancy in the Postpartum Period ..............363 AnestheticTechniques.................. 363 Epidural Anesthesia .................. 363 Spinal Anesthesia ................... 364 General Anesthesia .................. 365 PostoperativePainRelief................. 366 Cervical Cerclage Cervical incompetence complicates up to 1% of all pregnan- cies. It is characterized by premature dilation of the internal cervical os and shortening of the cervix from the internal os to the uterine cavity. It is associated with early pregnancy loss and premature birth. Cervical cerclage is a procedure performed at least 23,000 times annually in the United States.1 There are three techniques in use at the present time: McDonald transvaginal approach, Shirodkar transvaginal approach, and the abdominal cerclage. The first two techniques are technically easier and much more popular. All cerclage pro- cedures involve a circumferential suture or band tied around the cervical os to strengthen and support the cervix and prevent further dilation. The McDonald technique is simpler and is sim- ply a purse-string suture placed in the neck of the cervix as high S. Datta et al., Obstetric Anesthesia Handbook, DOI 10.1007/978-0-387-88602-2_16, C Springer Science+Business Media, LLC 2006, 2010 358 Non-delivery Obstetric Procedures in the vagina as possible. The Shirodkar involves dissection of the bladder and rectum away from the anterior and posterior aspects of the cervix to allow a imbedded band to be placed higher on the cervix, closer to the internal os. -
Treating Cervical Cancer If You've Been Diagnosed with Cervical Cancer, Your Cancer Care Team Will Talk with You About Treatment Options
cancer.org | 1.800.227.2345 Treating Cervical Cancer If you've been diagnosed with cervical cancer, your cancer care team will talk with you about treatment options. In choosing your treatment plan, you and your cancer care team will also take into account your age, your overall health, and your personal preferences. How is cervical cancer treated? Common types of treatments for cervical cancer include: ● Surgery for Cervical Cancer ● Radiation Therapy for Cervical Cancer ● Chemotherapy for Cervical Cancer ● Targeted Therapy for Cervical Cancer ● Immunotherapy for Cervical Cancer Common treatment approaches Depending on the type and stage of your cancer, you may need more than one type of treatment. For the earliest stages of cervical cancer, either surgery or radiation combined with chemo may be used. For later stages, radiation combined with chemo is usually the main treatment. Chemo (by itself) is often used to treat advanced cervical cancer. ● Treatment Options for Cervical Cancer, by Stage Who treats cervical cancer? Doctors on your cancer treatment team may include: 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 ● A gynecologist: a doctor who treats diseases of the female reproductive system ● A gynecologic oncologist: a doctor who specializes in cancers of the female reproductive system who can perform surgery and prescribe chemotherapy and other medicines ● A radiation oncologist: a doctor who uses radiation to treat cancer ● A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer Many other specialists may be involved in your care as well, including nurse practitioners, nurses, psychologists, social workers, rehabilitation specialists, and other health professionals. -
ICD~10~PCS Complete Code Set Procedural Coding System Sample
ICD~10~PCS Complete Code Set Procedural Coding System Sample Table.of.Contents Preface....................................................................................00 Mouth and Throat ............................................................................. 00 Introducton...........................................................................00 Gastrointestinal System .................................................................. 00 Hepatobiliary System and Pancreas ........................................... 00 What is ICD-10-PCS? ........................................................................ 00 Endocrine System ............................................................................. 00 ICD-10-PCS Code Structure ........................................................... 00 Skin and Breast .................................................................................. 00 ICD-10-PCS Design ........................................................................... 00 Subcutaneous Tissue and Fascia ................................................. 00 ICD-10-PCS Additional Characteristics ...................................... 00 Muscles ................................................................................................. 00 ICD-10-PCS Applications ................................................................ 00 Tendons ................................................................................................ 00 Understandng.Root.Operatons..........................................00 -
Term Pregnancy in a Bicornuate Uterus: Complications, Diagnostic and Therapeutic Challenges in a Low Resource Setting (Douala, Cameroon)
International Journal of Medical and Pharmaceutical Case Reports 11(3): 1-4, 2018; Article no.IJMPCR.43964 ISSN: 2394-109X, NLM ID: 101648033 Term Pregnancy in a Bicornuate Uterus: Complications, Diagnostic and Therapeutic Challenges in a Low Resource Setting (Douala, Cameroon) 1,2 1,2 1 3 4* A. A. Tazinya , V. F. Feteh , R. C. Ngu , N. N. Bechem and G. E. Halle-Ekane 1Mboppi Baptist Hospital Douala, Douala, Cameroon. 2Medical Doctors Research Group Douala, Douala, Cameroon. 3Department of Public Health and Epidemiology, Nottingham University, England. 4Department of Obstetrics/ Gynecology, Faculty of Health Sciences, University of Buea, Cameroon. Authors’ contributions This work was carried out in collaboration between all authors. Authors AAT, VFF, NNB and RCN were involved in the management of the patient. Authors AAT and GEHE wrote the first draft of the manuscript. Authors AAT, VFF and NNB managed the literature searches. All authors read and approved the final manuscript. Article Information DOI: 10.9734/IJMPCR/2018/43964 Editor(s): (1) Dr. Erich Cosmi, Director of Maternal and Fetal Medicine Unit, Department of Woman and Child Health, University of Padua School of Medicine, Padua, Italy. Reviewers: (1) Donnette Simms-Stewart, University of the West Indies, Jamaica. (2) Ikobho Ebenezer Howells, Niger Delta University Teaching Hospital, Nigeria. (3) Elisabete Gonçalves, Centro Hospitalar Universitário do Algarve, Portugal. Complete Peer review History: http://www.sciencedomain.org/review-history/26173 Received 16th June 2018 Accepted 5th September 2018 Case Report th Published 10 September 2018 ABSTRACT Severe uterine malformations are usually associated with infertility. Furthermore, a term pregnancy in the case of a severe uterine malformation is rare because spontaneous abortions and uterine ruptures are not uncommon before the third trimester. -
Cervical Stitch
Information for you Published in May 2018 Cervical stitch About this information This information is for you if you want to know about having a cervical stitch, which is also called cervical cerclage. You may also find it helpful if you are a partner, relative or friend of someone who is in this situation. A glossary of all medical terms used is available on the RCOG website at: www.rcog.org.uk/en/patients/ medical-terms. Key points • A cervical stitch may help to keep your cervix closed and may reduce the risk of you giving birth early. • You may be offered a cervical stitch if you are at risk of giving birth early. • A cervical stitch is usually put in between 12 and 24 weeks of pregnancy and then removed at 36–37 weeks unless you go into labour before this. What is a cervical stitch? A cervical stitch is an operation where a stitch is placed around the cervix (neck of the womb). It is usually done between 12 and 24 weeks of pregnancy although occasionally it may be done at later stages in pregnancy. Transabdominal A cervical stitch is more commonly put in Transvaginal vaginally (transvaginal) and less commonly by an abdominal route (transabdominal) 1 Why is it done? Babies born early (before 37 completed weeks of pregnancy) have an increased risk of short- and long-term health problems. You can find out more about this from the NICE guidance on Preterm Labour and Birth, which can be found at: www.nice.org.uk/guidance/ng25/ifp/chapter/About-this-information. -
Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010
Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy, -
WHO Guidelines for Treatment of Cervical Intraepithelial Neoplasia 2–3 and Adenocarcinoma in Situ
WHO guidelines WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ Cryotherapy Large loop excision of the transformation zone Cold knife conization WHO guidelines WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ: cryotherapy, large loop excision of the transformation zone, and cold knife conization Catalogage à la source : Bibliothèque de l’OMS WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ: cryotherapy, large loop excision of the transformation zone, and cold knife conization. 1.Cervical Intraepithelial Neoplasia – diagnosis. 2.Cervical Intraepithelial Neoplasia – therapy. 3.Cervical Intraepithelial Neoplasia – surgery. 4.Adenocarcinoma – diagnosis. 5.Adenocarcinoma – therapy. 6.Cryotherapy – utilization. 7.Conization – methods. 8.Uterine Cervical Neoplasms – prevention and control. 9.Guideline. I.World Health Organization. ISBN 978 92 4 150677 9 (Classification NLM : WP 480) © World Health Organization 2014 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. -
Overview of Surgical Techniques in Gender-Affirming Genital Surgery
208 Review Article Overview of surgical techniques in gender-affirming genital surgery Mang L. Chen1, Polina Reyblat2, Melissa M. Poh2, Amanda C. Chi2 1GU Recon, Los Angeles, CA, USA; 2Southern California Permanente Medical Group, Los Angeles, CA, USA Contributions: (I) Conception and design: ML Chen, AC Chi; (II) Administrative support: None; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Amanda C. Chi. 6041 Cadillac Ave, Los Angeles, CA 90034, USA. Email: [email protected]. Abstract: Gender related genitourinary surgeries are vitally important in the management of gender dysphoria. Vaginoplasty, metoidioplasty, phalloplasty and their associated surgeries help patients achieve their main goal of aligning their body and mind. These surgeries warrant careful adherence to reconstructive surgical principles as many patients can require corrective surgeries from complications that arise. Peri- operative assessment, the surgical techniques employed for vaginoplasty, phalloplasty, metoidioplasty, and their associated procedures are described. The general reconstructive principles for managing complications including urethroplasty to correct urethral bulging, vaginl stenosis, clitoroplasty and labiaplasty after primary vaginoplasty, and urethroplasty for strictures and fistulas, neophallus and neoscrotal reconstruction after phalloplasty are outlined as well. Keywords: Transgender; vaginoplasty; phalloplasty; metoidioplasty Submitted May 30, 2019. Accepted for publication Jun 20, 2019. doi: 10.21037/tau.2019.06.19 View this article at: http://dx.doi.org/10.21037/tau.2019.06.19 Introduction the rectum and the lower urinary tract, formation of perineogenital complex for patients who desire a functional The rise in social awareness of gender dysphoria has led vaginal canal, labiaplasty, and clitoroplasty. -
Colposcopy of the Uterine Cervix
THE CERVIX: Colposcopy of the Uterine Cervix • I. Introduction • V. Invasive Cancer of the Cervix • II. Anatomy of the Uterine Cervix • VI. Colposcopy • III. Histology of the Normal Cervix • VII: Cervical Cancer Screening and Colposcopy During Pregnancy • IV. Premalignant Lesions of the Cervix The material that follows was developed by the 2002-04 ASCCP Section on the Cervix for use by physicians and healthcare providers. Special thanks to Section members: Edward J. Mayeaux, Jr, MD, Co-Chair Claudia Werner, MD, Co-Chair Raheela Ashfaq, MD Deborah Bartholomew, MD Lisa Flowers, MD Francisco Garcia, MD, MPH Luis Padilla, MD Diane Solomon, MD Dennis O'Connor, MD Please use this material freely. This material is an educational resource and as such does not define a standard of care, nor is intended to dictate an exclusive course of treatment or procedure to be followed. It presents methods and techniques of clinical practice that are acceptable and used by recognized authorities, for consideration by licensed physicians and healthcare providers to incorporate into their practice. Variations of practice, taking into account the needs of the individual patient, resources, and limitation unique to the institution or type of practice, may be appropriate. I. AN INTRODUCTION TO THE NORMAL CERVIX, NEOPLASIA, AND COLPOSCOPY The uterine cervix presents a unique opportunity to clinicians in that it is physically and visually accessible for evaluation. It demonstrates a well-described spectrum of histological and colposcopic findings from health to premalignancy to invasive cancer. Since nearly all cervical neoplasia occurs in the presence of human papillomavirus infection, the cervix provides the best-defined model of virus-mediated carcinogenesis in humans to date. -
Chapter 9 Management of Cervical Cancer Complicating Pregnancy
Page 91 Chapter 9 Management of Cervical Cancer Complicating Pregnancy Overview In recent years, cervical cancer is being seen increasingly often in younger women. More cervical cancer is detected during pregnancy due to women becoming pregnant later in their lives, in turn the result of later marriage. The basic treatment strategy is the same as for non-pregnant women. However, the treating institution must provide individualized management depending on clinical stage, weeks of gestation, and the patient’s desire to continue the pregnancy. If the cancer is at an early stage, concurrent cervical cancer treatment and continuation of pregnancy is possible in many cases. For advanced cancer, the management will differ depending on whether or not the fetus is at a stage in which it is viable outside the uterus. If the fetus is sufficiently developed, treatment for cervical cancer is promptly performed as soon as the mother delivers the fetus. If the fetus has not reached such a stage, the maternal life should be given priority, and the cancer treated. In recent years, neonatal medicine has rapidly advanced, and social values have become diversified. Accordingly, even if a cancer is found at a stage when the fetus is not viable outside the uterus, some patients and their families have a strong desire to wait to begin treatment until it is viable. There is no consensus on the allowable waiting period, and at present treatment should only be delayed with caution. Page 92 CQ33 How should cervical cancer complicating pregnancy be managed? Recommendations (1) Cone biopsy may be delayed until after delivery as long as a microinvasive or more advanced lesion is not suspected on the results of cytology, colposcopy, or biopsy (Grade C).