Uterine sarcoma occurring in a premenopausal patient after uterine artery embolization: a case report and review of the literature.

Objective: We report a case of uterine leiomyosarcoma occurring after uterine artery embolization and review the previously published cases. We estimate the incidence of sarcoma after UAE, the mean diagnostic delay in young women undergoing this procedure and review the potential and limits of preoperative procedures in diagnosing uterine sarcomas.

Case Report: A 35-year-old woman had an early failure after UAE.

Extensive fever workup produces low yield in determining infectious etiology.

Objective: The study was undertaken to evaluate the use of a fever workup in women undergoing benign gynecologic procedures.

Study Design: A retrospective chart review was performed at Jackson Memorial Hospital between 1994 and 2000. Information was abstracted from hospital and clinic records.

Sigmoid impaction secondary to urinary stones: case report and review of literature.

Background: This is the first case report of a Miami pouch sigmoid fistula developing passage of urinary stones resulting in the presentation of constipation secondary to impaction.

Case Report: A 49-year-old woman who developed a recurrence of invasive squamous cell cervical carcinoma 1 year after pelvis radiation. She then underwent anterior pelvic exenteration and creation of a Miami pouch.

Laparoscopic pelvic and paraaortic lymphadenectomy in gynecologic oncology.

In the early 1990s, different authors independently developed techniques for pelvic and paraaortic lymph node sampling. Since then, laparoscopic lymphadenectomy has been demonstrated to yield the same number of nodes when compared with the laparotomic approach. Only one microscopically involved lymph node was lost at laparoscopic lymphadenectomy when a laparotomic control followed immediately after.

Conversion of an incontinent urinary conduit to a continent urinary reservoir (Miami Pouch).

Objective: External urinary or gastrointestinal appliances can impair a patient's quality of life. We report on the feasibility of converting an incontinent colonic urinary diversion to a continent urinary reservoir (Miami Pouch).

Case: We describe the case of a 66-year-old white female with a history of stage Ib(2) cervical cancer treated by radical abdominal hysterectomy and adjuvant radiation therapy.

Continent ileocolonic urinary reservoir (Miami pouch): the University of Miami experience over 15 years.

Objective: A patient with a recurrent central pelvic malignancy after radiation will require urinary diversion as part of the reconstructive phase of the pelvic exenteration. The aim of our study was to assess the result of our 15-year experience with a continent ileocolonic urinary reservoir, which is known as the Miami pouch.

Study Design: Since 1988, all patients who received a continent ileocolonic urinary reservoir in the Division of Gynecologic Oncology, University of Miami School of Medicine, were included in the study.

The safety of incidental appendectomy at the time of abdominal hysterectomy.

Objective: The purpose of this study was to assess the complication rates of incidental appendectomies in women who undergo benign gynecologic procedures.

Study Design: This was a retrospective case-controlled study of patients who did (n=100 women) or did not (n=100 women) undergo incidental appendectomies at the time of an abdominal hysterectomy between June 1995 and January 2001. Information was abstracted from hospital and clinic records and a gynecologic oncology database.

Pelvic exenteration and reconstruction.

For the past six decades, pelvic extenteration has been utilized in the treatment of localized central pelvic recurrences after chemo/radiotherapy. The radicality of the procedure that includes resection of the bladder, vulva/vagina, and rectum, although with curative intent, results in comprehensive changes for the patient. For this reason, all patients should undergo extensive psychosocial counseling to prepare them for the changes in body image and lifestyle.

Recurrent vulvar cancer.

Recurrent vulvar cancer occurs in an average of 24% of cases after primary treatment after surgery with or without radiation. The relatively few primary vulvar cancers, combined with the low proportion of recurrences, has made it difficult to perform randomized studies to document the most appropriate therapeutic modalities. Most reports are small retrospective studies and anecdotal reviews that have emphasized the importance of surgery and have led to new approaches with respect to chemoradiation.