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Special Issue "Diagnosis and Treatment of Gynecological Diseases"

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 20 July 2023 | Viewed by 3248

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Special Issue Editors

Dr. Cristina Secosan

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Guest Editor

Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
Interests: gynecology; minimally invasive surgery; cervical cancer; endometriosis

Prof. Dr. Razvan Ilina

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Guest Editor

Department of Surgery, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
Interests: surgery; oncology; gynecology

Special Issue Information

Dear Colleagues,

Gynecological diseases, both benign and malignant, represent one of the leading causes of female morbidity and mortality worldwide. The diagnosis and treatment of gynecological diseases constitute an ever-evolving topic shaped by changes in technology and scientific developments. The introduction of new diagnostic methods, advances in current imaging and pathology tools, progress in research on molecular and cellular pathologies, and the advent of new medications and surgical techniques attest to the ongoing efforts to identify alternative solutions for the diagnosis and treatment of gynecological pathologies.

We welcome authors to submit manuscripts focusing on the diagnosis and management of gynecological pathologies, either benign or malignant.

The aim of this Special Issue is to present the latest evidence and knowledge in this field of research with respect to the development of new diagnostic tools, advances in gynecological imaging techniques, novel procedures, operative techniques, and materials, anatomical considerations, pre- and/or postoperative management, enhanced recovery after surgery protocols, and other topics that can contribute to improvements in the current standard of care.

Manuscripts submitted should not have been published previously, nor should they be under consideration for publication in another journal. The key types of article that will be considered are original research manuscripts, reviews, and case reports addressing the theme of benign and malignant gynecologic pathologies.

Dr. Cristina Secosan
Prof. Dr. Razvan Ilina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

gynecology
screening
treatment
diagnosis
imaging
markers
cancer
benign pathology
minimally invasive surgery

Published Papers (5 papers)

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Research

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Open AccessArticle

The Role of ROR1 in Chemoresistance and EMT in Endometrial Cancer Cells

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Medicina 2023, 59(5), 994; https://doi.org/10.3390/medicina59050994 - 21 May 2023

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Abstract

Background and Objectives: Receptor tyrosine kinase-like orphan receptor type 1 (ROR1) plays a critical role in embryogenesis and is overexpressed in many malignant cells. These characteristics allow ROR1 to be a potential new target for cancer treatment. The aim of this study was to investigate the role of ROR1 through in vitro experiments in endometrial cancer cell lines. Materials and Methods: ROR1 expression was identified in endometrial cancer cell lines using Western blot and RT-qPCR. The effects of ROR1 on cell proliferation, invasion, migration, and epithelial-mesenchymal transition (EMT) markers were analyzed in two endometrial cancer cell lines (HEC-1 and SNU-539) using either ROR1 silencing or overexpression. Additionally, chemoresistance was examined by identifying MDR1 expression and IC50 level of paclitaxel. Results: The ROR1 protein and mRNA were highly expressed in SNU-539 and HEC-1 cells. High ROR1 expression resulted in a significant increase in cell proliferation, migration, and invasion. It also resulted in a change of EMT markers expression, a decrease in E-cadherin expression, and an increase in Snail expression. Moreover, cells with ROR1 overexpression had a higher IC50 of paclitaxel and significantly increased MDR1 expression. Conclusions: These in vitro experiments showed that ROR1 is responsible for EMT and chemoresistance in endometrial cancer cell lines. Targeting ROR1 can inhibit cancer metastasis and may be a potential treatment method for patients with endometrial cancer who exhibit chemoresistance. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Gynecological Diseases)

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Open AccessArticle

Incidence and Risk Factors of Postoperative Febrile Morbidity among Patients Undergoing Myomectomy

Korrakot Wattanasiri

Worashorn Lattiwongsakorn

Rung-aroon Sreshthaputra

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Theera Tongsong

Medicina 2023, 59(5), 990; https://doi.org/10.3390/medicina59050990 - 20 May 2023

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Abstract

Background and Objectives: To identify the incidence, causes, and independent predictors of postoperative febrile morbidity among patients undergoing myomectomy. Material and methods: Medical records of patients who had undergone myomectomy at Chiang Mai University Hospital between January 2017 and June 2022 were comprehensively reviewed. The clinical variables, including age, body mass index, previous surgery, leiomyoma size and number, the International Federation of Gynecology and Obstetrics (FIGO) fibroid type, preoperative and postoperative anemia, type of surgery, operative time, estimated blood loss, and intraoperative antiadhesive use, were analyzed as a predictive factor of postoperative febrile morbidity. Results: During the study period, 249 consecutive women were reviewed. The mean age was 35.6 years. The majority of women had FIGO fibroid type 3–5 (58.2%) and type 6–8 (34.2%). Febrile morbidity was noted in 88 women (35.34%). Of them, 17.39% had a urinary tract infection and 4.34% had a surgical site infection, whereas the causes in the majority of cases (78.26%) could not be identified. The significant independent risk factors for febrile morbidity were abdominal myomectomy (adjusted odds ratio: aOR, 6.34; 95% CI, 2.07–19.48), overweight women (aOR, 2.25; 95% CI, 1.18–4.28), operation time of more than 180 min (aOR, 3.37; 95% CI, 1.64–6.92), and postoperative anemia (aOR, 2.71; 95% CI, 1.30–5.63). Conclusions: Approximately one-third of women undergoing myomectomy experienced febrile morbidity. The cause could not be identified in most cases. The independent risk factors included abdominal myomectomy, overweight, prolonged operation time, and postoperative anemia. Of them, abdominal myomectomy was the most significant risk factor. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Gynecological Diseases)

Open AccessArticle

Association between Patients’ Self-Judgement, Coagulated Menstrual Blood, and Menorrhagia: Results from a Questionnaire Survey and Blood Test Analysis

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Medicina 2023, 59(5), 874; https://doi.org/10.3390/medicina59050874 - 01 May 2023

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Abstract

Background and Objectives: Menorrhagia is defined as a blood loss of more than 80 mL, which is significant enough to cause anemia. Previously known methods for evaluating menorrhagia, such as the alkalin-hematin method, pictograms, and measuring the weight of sanitary products, were all impractical, complex, and time-consuming. Therefore, this study aimed to determine which item among menstrual history taking was most associated with menorrhagia and devised a simple evaluating method for menorrhagia through history taking that can be applied clinically. Materials and Methods: The study was conducted from June 2019 to December 2021. A survey was conducted on premenopausal women who underwent outpatient treatment or surgery and those who underwent a gynecologic screening test, and their blood tests were analyzed. The presence of iron deficiency anemia was identified with a Hb level of less than 10 g/dL with microcytic hypochromic anemia on a complete blood count performed within one month of the survey. A questionnaire survey was conducted on six items related to menorrhagia to investigate whether each item was related to “significant menorrhagia”. Results: There were 301 participants in the survey during the period. In univariate analysis, the results revealed a statistically significant association between significant menorrhagia and the following items: self-judgement of menorrhagia; menstruation lasting over 7 days; total pad counts in a single menstrual period; Number of sanitary products changed per day; and leakaging of menstrual blood and presence of coagulated menstrual blood. In multivariate analysis, only the “self-judgement of menorrhagia” item showed a statistically significant result (p-value = 0.035; an odds ratio = 2.217). When the “self-judgement of menorrhagia” item was excluded, the “passage of clots larger than one inch in diameter” item showed a statistically significant result (p-value = 0.023; an odds ratio = 2.113). Conclusions: “Patient self-judgement of menorrhagia” is a reliable item for evaluating menorrhagia. Among several symptoms indicating menorrhagia, determining the presence of the “passage of clots larger than one inch in diameter” during the menstrual period is the most useful item for evaluating menorrhagia in clinical history taking. This study suggested using these simple menstrual history taking items to evaluate menorrhagia in real clinical practice. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Gynecological Diseases)

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Open AccessCase Report

A Rare Case Report of Successful Laparoscopy-Guided Reduction of Non-Puerperal Uterine Inversion

Seongmin Kim

Sanghoon Lee

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Jae-Yun Song

Medicina 2023, 59(4), 793; https://doi.org/10.3390/medicina59040793 - 19 Apr 2023

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Abstract

Non-puerperal uterine inversion is an extremely rare and potentially dangerous condition. Cases are poorly described in the literature, and their actual incidence is unknown. A 34-year-old nulliparous female patient visited the emergency department following a loss of consciousness. She had experienced continuous vaginal bleeding over the preceding two months, with a two-day history of worsening symptoms. The patient showed signs of hypovolemic shock secondary to unceasing vaginal bleeding. Ultrasound and computed tomography revealed an inverted uterus and a large hematoma inside the patient’s vaginal cavity. An emergency explorative laparoscopy was performed, which confirmed uterine inversion. Initially, Johnson’s maneuver was attempted under laparoscopic visualization, but this failed to achieve uterine reduction. Following the unsuccessful performance of Huntington’s maneuver, a re-trial of the manual reduction allowed the uterus to recover to its normal anatomy. The patient’s vaginal bleeding was dramatically reduced after successful uterine reduction. The pathologic report conducted confirmed endometrioid adenocarcinoma. Laparoscopic visualization is a feasible and safe procedure for achieving uterine reduction in cases of non-puerperal uterine inversion with an unconfirmed pathology. Uterine malignancies should be considered in patients with non-puerperal uterine inversion. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Gynecological Diseases)

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Open AccessCase Report

Papillary Squamotransitional Cell Carcinoma of the Uterine Cervix with Atypical Presentation: A Case Report with a Literature Review

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Mariela Vasileva-Slaveva

Medicina 2022, 58(12), 1838; https://doi.org/10.3390/medicina58121838 - 14 Dec 2022

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Abstract

Introduction: Cervical cancer is the fourth most prevalent malignancy and the fourth leading cause of cancer-related death in women around the world. Histologically, squamous cell carcinoma (SCC) is the most common form of cervical cancer. SCC has several subtypes, and one of the rarest is papillary squamotransitional cell carcinoma (PSCC). In general, PSCC is believed to have a similar course and prognosis to typical SCC, with a high risk of late metastasis and recurrence. Case report: We discuss the case of a 45-year-old patient diagnosed with PSCC who was admitted to our department in December 2021. The clinical manifestations were pelvic discomfort and lymphadenopathy throughout the body. On admission, all laboratory values, with the exception of C-Reactive Protein (CRP) at 22.35 mg/L and hemoglobin (HGB) at 87.0 g/L, were normal. The clinical and ultrasound examination revealed a painful formation with indistinct borders in the right portion of the small pelvis. Following dilation and curettage, a Tru-Cut biopsy of the inguinal lymph nodes was performed. The investigation histologically indicated PSCC. MRI of the small pelvis showed an endophytic tumor in the cervix with dimensions of 35/26 mm and provided data for bilateral parametrial infiltration; a hetero-intensive tumor originating from the right ovary and involving small intestinal loops measuring 90/58 mm; and generalized lymphadenopathy and peritoneal metastases in the pouch of Douglass. The FIGO classification for the tumor was IVB. The patient was subsequently referred for chemotherapy by the tumor board’s decision. Discussion: Despite the generally good prognosis of SCC, PSCC is a rare and aggressive subtype. It is usually diagnosed at an advanced stage and has a poor prognosis. Conclusions: PSCC is a rare subtype of SCC, and its diagnosis and treatment are challenging. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Gynecological Diseases)

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