When ovarian cysts become a cause for concern

At some point in their lives, most women do develop ovarian cysts — small, fluid-filled sacs that typically form during ovulation, and are located in or on the ovary. 

More often than not, these cysts are harmless and painless, and will go away on their own without the need for treatment. However, it becomes a problem when it does not go away or grows bigger. 

While most ovarian cysts do not present any symptoms, it might be time to schedule a medical check-up if you experience bloating or swelling of the abdomen, constipation or pain during bowelmovements, irregular menstrual periods, as well as lower abdominal or pelvic pain before or during your menstrual cycle. 

Severe cases might be accompanied by nausea and vomiting. In such a scenario, your doctor may order an emergency pelvic ultrasound to rule out ovarian cancer. 

TYPES OF OVARIAN CYSTS

Dr Cindy Pang, obstetrician and gynae-oncologist from Mount Elizabeth Novena Hospital, says there are different types of cysts.

Functional cysts occur as part of the menstrual cycle. These can cause problems sometimes in women in the reproductive age group. In the first half of the cycle – the follicle – which contains the developing egg, can grow up to 2cm before ovulation. After ovulation, the corpus luteal cyst or the egg shell will persist till the start of the next menstrual cycle. If all is good, this process goes on monthly. However, some patients may have hormonal problems leading to the follicle increasing in size, or there could be bleeding into the corpus luteal cyst. This can lead to water cysts and blood cysts forming.

Benign pathological cysts due to processes not related to ovulation can also form. For example, dermoid cyst – which contains hair or sebum and other tissue – can develop from the cells on the ovaries. Another example is endometriotic cyst, which are blood filled cysts due to the lining of the uterus growing on the ovary. These can increase in size and grow independent of the menstrual cycle. 

And then there are cancerous cysts. The lifetime risk of a woman getting ovarian cancer is one in 74 — or about 1.3 per cent. It can affect women of any age, but those who are older, have had breast cancer previously or have a family history of ovarian cancer, may be at a higher risk of developing the disease. The ultrasound will usually show sinister features like solid areas in the cyst and increase blood supply. 

The symptoms of cysts can be vague. A slowly growing cyst can cause symptoms with bloating or swelling of the abdomen, constipation or pain during bowel movements. There could be irregular menstrual periods, as well as lower abdominal or pelvic pain before or during your menstrual cycle.

If the cyst is leaking or twisting at the blood supply, which is medically known as ovarian cyst torsion, the presentation can be sudden with severe lower abdominal pain with nausea and vomiting. This is called an ovarian cyst accident. Surgical intervention is usually needed on an emergency basis as delay can cause the ovary and its surrounding tissue will be damaged, which may affect fertility.

For more information regarding the session on Gynecology Congress 2020 at San Francisco, USA During April 27-29, 2020

PS: https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email: gynecologycongress@frontierscongress.com

Trichomoniasis

Trichomoniasis is a common sexually transmitted infection caused by a parasite. In women, trichomoniasis can cause a foul-smelling vaginaldischarge, genital itching and painful urination.

Men who have trichomoniasis typically have no symptoms. Pregnant women who have trichomoniasis might be at higher risk of delivering their babies prematurely.

To prevent reinfection with the organism that causes trichomoniasis, both partners should be treated. The most common treatment for trichomoniasis involves taking one megadose of metronidazole (Flagyl) or tinidazole (Tindamax). You can reduce your risk of infection by using condoms correctly every time you have sex.

Symptoms

Many women and most men with trichomoniasis have no symptoms, at least not at first. Trichomoniasis signs and symptoms for women include:

·        An often foul-smelling vaginal discharge — which might be white, gray, yellow or green

·        Genital redness, burning and itching

·        Pain with urination or sexual intercourse

Trichomoniasis rarely causes symptoms in men. When men do have signs and symptoms, however, they might include:

·        Irritation inside the penis

·        Burning with urination or after ejaculation

·        Discharge from the penis

Causes

Trichomoniasis is caused by a one-celled protozoan, a type of tiny parasite that travels between people during sexual intercourse. The incubation period between exposure and infection is unknown, but it's thought to range from five to 28 days.

Risk factors

Risk factors include having:

·        Multiple sexual partners

·        A history of other sexually transmitted infections

·        A previous episode of trichomoniasis

·        Having sex without a condom

Complications

Pregnant women who have trichomoniasis might: 

·        Deliver prematurely

·        Have a baby with a low birth weight

·        Transmit the infection to the baby as he or she passes through the birth canal

Having trichomoniasis also appears to make it easier for women to become infected with HIV, the virus that causes AIDS.

Prevention

As with other sexually transmitted infections, the only way to prevent trichomoniasis is to abstain from sex. To lower your risk, use condoms correctly every time you have sex.

For more details regarding the session on Gynecology Congress 2020 
PS: https://frontiersmeetings.com/conferences/obstetrics-gynecology/  
Email:gynecologycongress@frontierscongress.com

Women Should Be Screened for Cervical Cancer Even as They Age

Half of cervical cancer cases are diagnosed in women after 49 years old. However, regular screening for the disease begins to drop off at age 45, according to recent studyfindings.

The researchers discovered that between ages 45 and 65, screening participation steadily declined. In addition, women with lower levels of education and those who live in rural areas had lower screening rates.

“I was surprised that the screening rates were so low, especially among the rural white women who receive their primary health care from federally qualified health centers,” senior study author Dr. Diane Harper, a professor in the departments of Family Medicine and Obstetrics & Gynecology at the University of Michigan Medical School, said in an interview with CURE®. “I was assuredly surprised that all three federally funded databases indicated the same trends for screening participation.”

Although there are no definitive answers as to why certain women choose to not be screened, Harper hypothesized that as women become menopausal, they are less inclined to seek pelvic exams and they may also perceive other chronic diseases as more life-threatening, such as COPD, emphysema, arthritis, hypertension and high cholesterol. Physicians may also not be comfortable asking older women to disrobe for a pelvic exam, she explained.

Cervical cancer is caused by the human papillomavirus (HPV), according to the American Cancer Society. However, not everyone who gets HPV will develop cervical cancer. “There is much emphasis and information in the public sphere, media and from the institutes that fund research about vaccinating 11 to 13 years olds with Gardasil9 (a vaccine for adults up to age 45 that helps protect against cervical, vaginal, vulvar and anal cancer, as well as genital warts caused by 9 types of HPV) but not much accompanying information that all women need to continue to be screened throughout their lifetime,” Harper said.

To help lower the incidence of cervical cancer, health care professionals must work to engage women in the 45 to 65 age range. “The biggest take away message is that women 45 to 65 years old should be asking their doctors for primary HPV testing every five years,” Harper said. 

Two screening tests can detect for cervical cancer — the Pap test performed during a pelvic exam that can identify pre-cancerous cells and early-stage cancers and directly testing for HPV.

Here is how often women should be screened, according to Harper:

• Women 21 to 29 years old, every three years with a cell sample.
• Women with no prior treatment for CIN 2/3 disease (abnormal cells found on the surface of the cervix) or for cervical cancer, every five years starting at age 30 through 65 with primary high-risk HPV testing.
• Women who have been treated for CIN 2/3 disease, at least 20 years of screening after initial treatment for CIN 2/3.
• Women who have had cervical cancer should discuss screening with their oncologist.

For more details regarding the Gynecology Congress 2020 at San Francisco, USA during April 27-29, 2020 
PS: https://frontiersmeetings.com/conferences/obstetrics-gynecology/
Email: gynecologycongress@frontierscongress.com

Linzagolix reduces heavy menstrual bleeding caused by uterine fibroids

Results from a phase 3 trial of linzagolix showed that the therapy was effective in reducing heavy menstrual bleeding caused by uterine fibroids, according to a press release issued by the manufacturer, ObsEva.

“Women with uterine fibroids need nonsurgical alternatives to reduce the often unbearable effects of heavy menstrual bleeding,” Hugh Taylor, MD, professor and chair of obstetrics and gynecology at Yale University, said in the release. “The prospects for a medical treatment with multiple dosing options would address a need for this diverse population of women.”

The trial, PRIMROSE 2, was conducted in Europe and the United States, and included 535 women with heavy menstrual bleeding caused by uterine fibroids.

Researchers assessed the efficacy and safety of daily oral linzagolix doses of 100 mg and 200 mg with and without hormonal add-back therapy (ABT) in reducing heavy menstrual bleeding, according to the press release.

Women were considered responders to treatment if they had menstrual blood loss of 80 mL or less at 24 weeks and at least a 50% reduction in menstrual blood loss from baseline.

The responder rate was 93.9% (P < 0.001) among women who received 200 mg of linzagolix with ABT and 56.7% in those who received 100 mg without ABT (P < 0.001). In comparison, the responder rate of those in the placebo group was 29.4% (P < 0.001).

Both doses achieved secondary endpoints of significant rates of amenorrhea, reduced pain and improved quality of life among participants. Researchers also observed a significant improvement in hemoglobin levels with both doses, along with fewer days of bleeding and decreased uterine volume.

Adverse events — the most common of which were headache, anemia, and hot flashes — occurred in less than 5% of patients.

“The excellent responder rates for the 200 mg with ABT and the 100 mg dose without ABT strongly support our dual strategy of development for linzagolix,” Ernest Loumaye, MD, PhD, CEO and co-founder of ObsEva, said in the press release.

Loumaye explained in the release that if the company’s second study of linzagolix, PRIMROSE 1, yields positive results, it would submit a marketing authorization application to the European Medicine Agency by the end of 2020 and a New Drug Application to the FDA in early 2021. – by Erin Michael

Source: Healio Primary Care

For more information on Gynecology Congress 2020 at San Francisco,USA during April 27-29, 2020

PS: https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email: gynecologycongress@frontierscongress.com

Immunotherapy Tolerable after Chemoradiotherapy in Cervical Cancer Patients

A study published in JAMA Oncology assessed the tolerability of sequential immunotherapy following chemoradiotherapy among women with lymph node (LN)–positive cervical cancer.

“Despite standard chemoradiotherapy (CRT), most women with lymph node (LN)–positive cervical cancer experience disease recurrence,” the authors explained. “Immunotherapy is being investigated in the up-front treatment setting.”

This was a prospective phase 1 study that took place in 29 Gynecology Oncology Cooperative Group member institutions. Patients were recruited between Dec. 18, 2012, and Aug. 31, 2016, and had a 14.8-month median follow-up and translational end points. A total of 34 patients with International Federation of Gynecology and Obstetrics stage IB2 to IVA cervical cancer with positive pelvic LNs, para-aortic LNs, or both were initially included in the study, and 13 were excluded because they did not receive ipilimumab. Eligible patients received six weekly doses of cisplatin 40 mg/m² concurrently with radiotherapy. Following chemotherapy, patients received sequential ipilimumab every three weeks for four total doses; ipilimumab was administered in 3 mg/kg and 10 mg/kg doses to determine the maximum tolerated dose. The primary outcome measure was safety; other outcomes included overall and progression-free survival, and exploratory endpoints included human papillomavirus (HPV) genotype, HLA allele status, and PD-1 expression measured in peripheral blood.

There were 32 women in the intent-to-treat analysis, who had a median age of 50 (range, 26 to 61) years; most patients (n = 22, 69%) were white. Twenty-one women received ipilimumab, all of whom had positive pelvic LN; six (29%) had positive para-aortic LNs. All patients finished chemoradiotherapy to completion. The majority of women who received at least two ipilimumab cycles (n = 18, 86%) finished four ipilimumab cycles, and three (14%) completed two cycles. The maximum tolerated dose of ipilimumab was 10 mg/kg. the rate of self-limiting grade 3 toxic effects among the 21 ipilimumab patients was low (n = 2/21, 9.5%); these effects included lipase increase and dermatitis. Overall survival after 12 months was 90%, and progression-free survival was 81%. There were no correlations between HPV genotype and HLA subtype and progression-free or overall survival. PD-1-expresssing T cells were increased following chemoradiotherapy, and were sustained with ipilimumab.

“This study’s findings suggest that the use of immunotherapy after [chemoradiotherapy] for curative-intent treatment of patients with cervical cancer is tolerable and effective,” concluded the authors. “The results indicated that PD-1 was upregulated after [chemoradiotherapy] and sustained with sequential ipilimumab therapy. These immune findings may help guide future therapies to harness the activated T-cell phenotype in patients with node-positive cervical cancer.”

For more information regarding the session on gynecology congress 2020 at San Francisco, USA during April 27-29, 2020

PS : https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email: gynecologycongress@frontierscongress.com

FDA Pulls Surgical Mesh for Pelvic Organ Prolapse From the Market

The FDA has ordered all manufacturers of surgical mesh for transvaginal repair of anterior compartment prolapse (cystocele) to stop selling their products immediately. According to the agency, the manufacturers Boston Scientific and Coloplast have not provided sufficient evidence that the benefits of these products outweigh their high, class III risks, compared with transvaginal surgical tissue repair without the use of mesh.

Women who have received transvaginal mesh for pelvic organ prolapse (POP) should continue routine care. However, if symptoms arise such as persistent vaginal bleeding or discharge, pelvic or groin pain, or pain with sex, they should promptly inform their health care providers. Patients planning a future prolapse procedure with transvaginal mesh require alternative treatments.

“In order for these mesh devices to stay on the market, we determined [in 2016] that we needed evidence that they worked better than surgery without the use of mesh to repair POP. That evidence was lacking in these premarket applications, and we couldn’t assure women that these devices were safe and effective long term,” Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health, stated in a news release.

Surgical mesh made of synthetic materials can be found in knitted mesh or non-knitted sheets and are absorbable, non-absorbable, or a combination of both. Animal-derived mesh are absorbable.

Source: Renal & Urology News

For more information regarding the session on Gynecology Congress 2020 during April 27-29, 2020 at San-Francisco, USA

PS:https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email: gynecologycongress@frontierscongress.com

Uterine fibroids

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage and can add weight.

Many women have uterine fibroids sometime during their lives. But you might not know you have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

Symptoms

Many women who have fibroids don't have any symptoms. In those that do, symptoms can be influenced by the location, size and number of fibroids.

In women who have symptoms, the most common signs and symptoms of uterine fibroids include:

·        Heavy menstrual bleeding

·        Menstrual periods lasting more than a week

·        Pelvic pressure or pain

·        Frequent urination

·        Difficulty emptying the bladder

·        Constipation

·        Backache or leg pains

Causes

Doctors don't know the cause of uterine fibroids, but research and clinical experience point to these factors:

·        Genetic changes. Many fibroids contain changes in genes that differ from those in normal uterine muscle cells.

·        Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids.

Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.

·        Other growth factors. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

·        Extracellular matrix (ECM). ECM is the material that makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous. ECM also stores growth factors and causes biologic changes in the cells themselves.

For more information regarding the session in Gynecology Congress 2020 At San Francisco, USA during April 27-29, 2020.

PS: https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email: gynecologycongress@frontierscongress.com

Pediatric-Adolescent Gynecology

Gynecology is the area of medicine that specializes in diagnosing, treating, and managing conditions that affect the female reproductive organs. Our pediatric gynecology specialists provide evaluation, treatment, and support tailored to babies, children, and teens.

Our pediatric-adolescent gynecologists have advanced training to understand the unique issues that affect the development and anatomy of growing girls and young women. Our physicians take great care to examine and treat girls in a sensitive manner, and to address their specific needs. We provide specialized care through a joint effort with Children'sMedical Center in Dallas and at Legacy in Plano.

Gynecology Conditions 

Gynecologists have the expertise to treat all kinds of conditions and injuries that affect girls’ reproductive organs. Some of the issues include:

Anomalies of the reproductive organs, such as the uterus, ovaries, fallopian tubes, or cervix

Congenital (present since birth) or acquired (developed after birth) genital anomalies

Contraception

Cysts, masses, or lesions of the reproductive organs

Early or delayed puberty or sexual development

Endometriosis

Menstrual problems caused by other health conditions

Painful periods and heavy bleeding

Pelvic pain

Polycystic ovary syndrome (PCOS)

Sexually transmitted diseases (STDs), such as chlamydia, genital herpes, HIV, human papillomavirus (HPV), pelvic inflammatory disease, and syphilis

Vaginal discharge

Vaginal trauma

Vaginitis (inflammation of the vagina), yeast infections, and other infections

For more details regarding the session on gynecology Congress 2020

PS : https://frontiersmeetings.com/conferences/obstetrics-gynecology/

Email : gynecologycongress@frontierscongress.com