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Suzuki Y, Chen L, Ferris JS, St Clair CM, Hou JY, Khoury-Collado F, Pua T, de Meritens AB, Accordino M, Hershman DL, Wright JD. Estrogen replacement therapy and non-hormonal medication use among patients with uterine cancer. Gynecol Oncol 2024; 180:14-23. [PMID: 38041899 DOI: 10.1016/j.ygyno.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE As the prognosis for endometrial cancer is excellent, management of the effects of estrogen deprivation has an important influence on quality of life. We examined the trends in the use of estrogen replacement therapy (ERT) and non-hormonal medications among patients with uterine cancer following surgery. METHODS The MarketScan Database was used to identify patients 18-49 years who underwent hysterectomy plus oophorectomy and those aged 50-75 years who underwent hysterectomy between 2008 and 2020. ERT and non-hormonal treatments of menopause were identified preoperatively and postoperatively. After propensity score balancing, difference-in-differences (DID) analyses were performed to compare the pre-and-postoperative changes in ERT and non-hormonal medication use between groups. The trends in postoperative use of ERT were assessed and tested using Cochran-Armitage trend tests. RESULTS A total of 19,700 patients with uterine cancer and 185,150 controls were identified. Overall, postoperative ERT use decreased for both age groups and for patients with and without uterine cancer. The DID in ERT use between those with uterine cancer and those with benign pathology after hysterectomy was -37.1% (95% CI, -40.5 to -33.6%) for patients 18-49 years of age and - 10.4% (95% CI, -10.9 to -9.9%) for those 50-75 years. The DID for non-hormonal medication use between those with uterine cancer and those with benign pathology after hysterectomy was 11.2% (95% CI, 7.8 to 14.7%) for younger patients and 3.4% (95% CI, 2.9 to 4.0%) for those 50-75 years. The postoperative new ERT use has been declining over time in patients with uterine cancer in those 18-49 years of age (P = .02) and those 50-75 years of age (P < .001). CONCLUSIONS The use of ERT is uncommon and has declined over time in patients with uterine cancer. Conversely, non-hormonal medications are more commonly used among patients with uterine cancer.
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Affiliation(s)
- Yukio Suzuki
- Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Ling Chen
- Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Jennifer S Ferris
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Joseph L. Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Caryn M St Clair
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - June Y Hou
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - Fady Khoury-Collado
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - Tarah Pua
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - Alexandre Buckley de Meritens
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - Melissa Accordino
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - Dawn L Hershman
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Joseph L. Mailman School of Public Health, Columbia University, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States
| | - Jason D Wright
- Columbia University College of Physicians and Surgeons, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States; New York Presbyterian Hospital, New York, NY, United States.
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Ono M, Yamanoi K, Okunomiya A, Sagae Y, Okamoto H, Sunada M, Taki M, Ukita M, Chigusa Y, Horie A, Yamaguchi K, Hamanishi J, Mandai M. A case of solitary lymph node recurrence 9 years after initial treatment for advanced premenopausal endometrioid endometrial cancer; clinical usefulness of hormonal replacement therapy. Int Cancer Conf J 2023; 12:168-172. [PMID: 37251011 PMCID: PMC10212858 DOI: 10.1007/s13691-023-00599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
There is no consensus on the use of hormone replacement therapy (HRT) after treatment of advanced corpus cancer. We report a case of advanced corpus cancer at a young age, in which HRT was initiated 7 years after surgery, and regional lymph node recurrence was later detected. The patient was 35 years old at the time of initial treatment in X year, when she was diagnosed with stageIIIC2 corpus cancer and underwent a hysterectomy with bilateral salpingo-oophorectomy and a retroperitoneal lymphadenectomy. HRT was started at X + 7 years, and at X + 9 years, a 25 × 12-mm-sized mass was found in the hilum of the right kidney. A laparoscopic resection revealed regional lymph node recurrence of the corpus cancer. A retrospective study further revealed that a tumor measuring 12 × 3 mm was found at X + 3 years and grew to 18 × 7 mm in X + 6 years, just before the start of the HRT. We hypothesize that HRT did not induce tumor recurrence; instead, it allowed for long-term follow-up and early diagnosis.
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Affiliation(s)
- Maaya Ono
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Koji Yamanoi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Asuka Okunomiya
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Yusuke Sagae
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Haruko Okamoto
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Masumi Sunada
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Mana Taki
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Masayo Ukita
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Ken Yamaguchi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Junzo Hamanishi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
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Bjørge T, Hjellvik V, Bjørge L, Dos-Santos-Silva I, Furu K, Kvåle R, Engeland A. Incidence and prevalence of drugs used for chronic diseases in survivors of adult-onset gynaecological cancer - A nationwide cohort study. BJOG 2023; 130:770-778. [PMID: 36700296 DOI: 10.1111/1471-0528.17410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 12/12/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate both incidence and prevalence of drugs used for chronic diseases in survivors of adult-onset gynaecological cancer. DESIGN A prospective study. SETTING Population-based registries. POPULATION 1.76 million women, including 17 500 women with gynaecological cancers. METHODS Data from the Cancer Registry of Norway was linked to the Norwegian Prescription Database and other national databases. MAIN OUTCOME MEASURES Prevalence ratios (PRs) and hazard ratios (HRs), with 95% confidence intervals (CIs), of dispensed drugs in gynaecological cancer patients (up to 15 years after diagnosis) were estimated by log-binomial and Cox regression, respectively, with cancer-free women as reference. RESULTS For gynaecological cancer patients, the incidence of drugs used for pain control was higher than in cancer-free women, especially the first 5 years after diagnosis, and the prevalence was high at least 10 years after. The prevalence of sex hormones was high in women with gynaecological cancer at least 10 years after diagnosis (cervical and ovarian cancer PR = 23, 95% CI 18-30 and PR = 29, 95% CI 15-38, respectively), but low in cancer-free women (0.3%). Patients with uterine corpus cancer had a higher prevalence of antidiabetics before and at least 10 years after diagnosis, most pronounced in women diagnosed before age 50 (PR = 10, 95% CI 5.0-21). The prevalence of antidepressants was moderately elevated in women with gynaecological cancers. CONCLUSIONS Gynaecological cancer survivors, particularly cervical and ovarian cancer survivors, had an increased long-term use of drugs for pain control and sex hormones. Survivors of uterine corpus cancer used antidiabetics more often, both before and after diagnosis.
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Affiliation(s)
- Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Cancer Registry of Norway, Oslo, Norway
| | - Vidar Hjellvik
- Norwegian Institute of Public Health, Bergen/Oslo, Norway
| | - Line Bjørge
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Isabel Dos-Santos-Silva
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Kari Furu
- Norwegian Institute of Public Health, Bergen/Oslo, Norway
| | - Rune Kvåle
- Norwegian Institute of Public Health, Bergen/Oslo, Norway.,Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Institute of Public Health, Bergen/Oslo, Norway
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Effects of transdermal versus oral hormone replacement therapy in postmenopause: a systematic review. Arch Gynecol Obstet 2022; 307:1727-1745. [PMID: 35713694 PMCID: PMC10147786 DOI: 10.1007/s00404-022-06647-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/25/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To summarize available evidence comparing the transdermal and the oral administration routes of hormone replacement therapy (HRT) in postmenopausal women. METHODS We performed a systematic review of the literature on multiple databases between January 1990 and December 2021. We included randomized controlled trials and observational studies comparing the transdermal and oral administration routes of estrogens for HRT in postmenopausal women regarding at least one of the outcomes of interest: cardiovascular risk, venous thromboembolism (VTE), lipid metabolism, carbohydrate metabolism, bone mineral density (BMD), and risk of pre-malignant and malignant endometrial lesions, or breast cancer. RESULTS The systematic literature search identified a total of 1369 manuscripts, of which 51 were included. Most studies were observational and of good quality, whereas the majority of randomized controlled trials presented a high or medium risk of bias. Oral and transdermal administration routes are similar regarding BMD, glucose metabolism, and lipid profile improvements, as well as do not appear different regarding breast cancer, endometrial disease, and cardiovascular risk. Identified literature provides clear evidence only for the VTE risk, which is higher with the oral administration route. CONCLUSIONS Available evidence comparing the transdermal and oral administration routes for HRT is limited and of low quality, recommending further investigations. VTE risk can be considered the clearest and strongest clinical difference between the two administration routes, supporting the transdermal HRT as safer than the oral administration route.
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Yu J, Hang Y, Sun W, Wang G, Xiong Z, Ai L, Xia Y. Anti-Osteoporotic Effect of Lactobacillus brevis AR281 in an Ovariectomized Mouse Model Mediated by Inhibition of Osteoclast Differentiation. BIOLOGY 2022; 11:biology11030359. [PMID: 35336732 PMCID: PMC8944959 DOI: 10.3390/biology11030359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
Simple Summary Osteoporosis-related fractures are among the most common complications found in postmenopausal adults, which results in considerable economic impacts. Most treatments for osteoporosis increase bone formation or decrease bone resorption. While estrogen replacement therapy may be the gold standard for the treatment of osteoporosis, it also carries an increased risk of cardiac events and strokes in women. Thus, it is important to seek a safe and effective treatment method. Gut homeostasis is demonstrably linked to bone health. Probiotics are widely known to modulate gut microbiota, but with large strain differences. Our findings showed a strain of Lactobacillus brevis AR281 with an anti-osteoporotic property in ovariectomized mice, which may provide a new way to prevent osteoporosis. Abstract Osteoporosis is a global disease characterized by weakened bone microarchitecture, leading to osteoporotic fractures. Estrogen replacement therapy is the traditional treatment for osteoporosis but carries with it an increased risk of cardiac events. In search of a safe and effective treatment, we used Lactobacillus brevis AR281, which has anti-inflammatory properties, to conduct a 7-week experiment, investigating its inhibitory effects on osteoporosis in an ovariectomized (ovx) mouse model. The results demonstrated that AR281 significantly improved bone microarchitecture and biomechanical strength in ovx mice by attenuating bone resorption. AR281 significantly decreased the critical osteoclast activator, the ratio of the receptor activator for nuclear factor kappa B (NF-κB) ligand (RANKL) to osteoprotegerin, and pro-inflammatory osteoclastogenic mediators, such as IL-1, IL-6, and IL-17, which can increase the RANKL expression. Moreover, AR281 modulated intestinal microbiota in ovx mice increased the abundance of Akkermansia, which is responsible for the improvement of gut epithelial barrier integrity. In an in vitro trial, AR281 suppressed the number of osteoclasts differentiated from the osteoclast precursor RAW264.7 cells caused by RANKL through the tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6)/NF-κB/nuclear factor of activated T cells c1 (NFATc1) pathway. Therefore, AR281 may be a natural alternative for combating osteoporosis.
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Sourouni M, Kiesel L. Hormone Replacement Therapy After Gynaecological Malignancies: a Review Article. Geburtshilfe Frauenheilkd 2021; 81:549-554. [PMID: 34035549 PMCID: PMC8137272 DOI: 10.1055/a-1390-4353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022] Open
Abstract
Rapid advances in oncology have led to an increased survival rate in cancer patients, who live long enough to reach the natural age of menopause or experience the end of gonadal function as a side effect of oncological treatment. Survivors after gynaecological malignancies are a major challenge as these diseases are hormone-dependent and hormone replacement therapy (HRT) possibly increases the risk of recurrence. This article is based on a selective literature search for relevant studies and guidelines regarding HRT after gynaecological malignancies and provides a broad overview of current research. The data for assessing the oncological safety of HRT after gynaecological malignancy are insufficient overall. According to current knowledge, HRT is fundamentally contraindicated after breast and endometrial cancer. After ovarian cancer, HRT can be used after assessment of the risks and benefits, while there is usually no contraindication to HRT after vulvar, vaginal or
cervical cancer.
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Affiliation(s)
- Marina Sourouni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Münster, Germany
| | - Ludwig Kiesel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Münster, Germany
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Wang L, Huang Q, Lin Q, Chen L, Shi Q. Knockdown of long non-coding RNA small nucleolar RNA host gene 9 or hexokinase 2 both suppress endometrial cancer cell proliferation and glycolysis. J Obstet Gynaecol Res 2021; 47:2196-2203. [PMID: 33821518 DOI: 10.1111/jog.14777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/02/2021] [Accepted: 03/13/2021] [Indexed: 01/19/2023]
Abstract
AIM Endometrial cancer (EC) is a common type of malignant gynecological cancer. Small nucleolar RNA host gene 9 (SNHG9) has been discovered to serve a role in several types of cancer; however, the role of SNHG9 in EC remains unclear. The present study aimed to investigate the effects of lncRNA SNHG9 on cell proliferation and glycolysis in EC cells. METHODS SNHG9 and hexokinase 2 (HK2) mRNA expression levels were measured by reverse transcription-quantitative PCR. Glucose consumption and lactate production were detected by the glycolysis cell-based assay kit. Cell Counting Kit-8 and colony formation assays were conducted to detect cell proliferation. The knockdown experiments of SNHG9 and HK2 were carried out by transfection of corresponding small interference RNAs (siRNA). The SNHG9-overexpressed plasmid was transfected into the cells to upregulate SNHG9. HK2 protein levels were analyzed by western blotting assay. RESULTS SNHG9 expression levels were significantly upregulated in EC tissues and cells. The knockdown of SNHG9 subsequently effectively attenuated cell proliferation and glycolysis in vitro, while SNHG9 overexpression reported the opposite effects. Notably, the transfection of 2-DG partially reversed the promoting effect of SNHG9 on glycolysis. Downregulation of HK2 markedly decreased cell proliferation and glycolysis in EC cells antagonized SNHG9. CONCLUSION Either downregulation of SNHG9 or HK2 inhibits EC cell proliferation and glycolysis via repressing EC cell proliferation and glycolysis.
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Affiliation(s)
- Lianhua Wang
- Department of Gynecology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qiming Huang
- Department of Imaging, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qingqing Lin
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Lvxuan Chen
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qiyang Shi
- Department of Gynecology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Brzozowska M, Lewinski A. Hormonal replacement therapy in women with a history of internal genital organ malignancy. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2021; 20:34-39. [PMID: 33935618 PMCID: PMC8077805 DOI: 10.5114/pm.2021.104572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/21/2021] [Indexed: 11/17/2022]
Abstract
Sudden cessation of ovary activity as a result of bilateral oophorectomy or chemo- or radiotherapy in premenopausal women is linked with more serious consequences that bear no comparison to natural menopause - to name just a few: higher rate of mortality, higher rate of colorectal and lung cancer, circulatory system diseases, cognitive disorders, Parkinson's disease, psychological disorders, osteoporosis, and sexual disorders. The prolonged period of estrogens deficit in premenopausal age is connected with worsened quality of life. The progress in oncological care means that in many malignant diseases, also in the case of gynaecological malignancies, the percentage of survivors increases. This makes improving the quality of life more and more important. The purpose of this review is to establish, based on EBM data, the answer to whether replacement hormonal therapy, being the most effective treatment of menopause symptoms, can be recommended for women who have undergone bilateral oophorectomy because of gynaecological cancer. On the basis of collected data, derived from meta-analysis, and studies which have been published within the last 20 years, it seems that the use of the appropriate type of hormonal replacement therapy (HRT) in properly selected gynaecological cancer survivors (epithelial ovarian cancer - EOC, endometrial cancer, squamous cell carcinoma of the cervix) is safe and effective. It seems that benefits connected with better quality of life that stem from the use of appropriate HRT in gynaecological cancer survivors predominate the unfounded fear of disease recurrence in selected patients' groups.
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Affiliation(s)
- Maria Brzozowska
- Department of Endocrinology and Metabolic Diseases, Medical University, Lodz, Poland Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Andrzej Lewinski
- Department of Endocrinology and Metabolic Diseases, Medical University, Lodz, Poland Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
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Monti M, Fischetti M, Santangelo G, Galli V, Clemente F, Giannini A, Tibaldi V, DI Pinto A, Pecorini F, Perniola G, DI Donato V, Benedetti Panici P. Urinary incontinence in women: state of the art and medical treatment. Minerva Obstet Gynecol 2021; 73:135-139. [PMID: 32744453 DOI: 10.23736/s2724-606x.20.04635-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Urinary incontinence, the involuntary loss of urine, is a common condition that affects approximately 50% of adult women. This condition increases with age, affecting 10% to 20% of all women and up to 77% of elderly women residing in nursing homes. EVIDENCE ACQUISITION Systematic data search performed using PubMed/MEDLINE database up to July 20, 2020. Focus was only for English language publications of original studies on urinary incontinence. EVIDENCE SYNTHESIS Given the basis of published evidence and the consensus of European experts, this study provides an updated overview on clinical applications and surgical procedures of urinary incontinence. CONCLUSIONS Urinary incontinence is an underestimated health problem. Patients need an overview of their health condition through a detailed anamnestic collection and physical examination to identify the type of incontinence and offer the best treatment.
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Affiliation(s)
- Marco Monti
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Margherita Fischetti
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Giusi Santangelo
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy -
| | - Valerio Galli
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | | | - Andrea Giannini
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Valentina Tibaldi
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Anna DI Pinto
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Francesco Pecorini
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Giorgia Perniola
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Violante DI Donato
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Pierluigi Benedetti Panici
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
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Bovbjerg ML. Current Resources for Evidence-Based Practice, September 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:487-499. [PMID: 32805207 PMCID: PMC7428455 DOI: 10.1016/j.jogn.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of “spin” in scientific reporting and its effect on summaries and syntheses of the literature and commentaries on reviews about early versus late amniotomy as part of labor induction protocols and the economic burden associated with maternal morbidity.
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Perineural Spread of Clear Cell Adenocarcinoma of Müllerian Origin Resulting in Neoplastic Lumbosacral Plexopathy. World Neurosurg 2020; 141:323-326. [PMID: 32592970 DOI: 10.1016/j.wneu.2020.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Adenocarcinomas of müllerian origin are malignancies derived from tissues of the proximal third of the vagina, cervix, uterus, and fallopian tubes. These organs develop from the embryologic müllerian ducts. While reports of perineural spread of certain uterine and cervical carcinomas exist in the literature, to our knowledge, no reports of clear cell-type müllerian adenocarcinoma presenting with neural invasion of the lumbosacral plexus exist in the literature. CASE DESCRIPTION A 77-year-old woman with a remote history of hysterectomy and bilateral salpingo-oopherectomy for benign disease presented for evaluation of foot drop. We present clinical, electromyographic, and imaging findings of her condition, which revealed a diffuse intraneural lesion of the ipsilateral lumbosacral plexus. Percutaneous biopsy of the lesion confirmed nerve infiltrating clear cell adenocarcinoma of müllerian origin. CONCLUSIONS We present the first case of adenocarcinoma of müllerian origin with confirmed perineural spread presenting with ipsilateral lower extremity weakness. This case illustrates the importance of recognizing potential perineural spread of gynecologic malignancies to avoid delay in treatment.
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