Management of high-grade ovarian adenocarcinoma in an intraperitoneal pelvic renal transplant recipient.

Background: Number of organ transplant recipients continues to rise worldwide with increasing accessibility and growing advancements in transplant medicine. Transplant patients have at least a two-to-four fold higher risk of developing cancer compared to the general population. As the prevalence of transplant patients increases, a growing number of these patients are expected to present with concurrent conditions such as cancer, requiring more complex and interdisciplinary care.

Genetic Links between Endometriosis and Endometriosis-Associated Ovarian Cancer-A Narrative Review (Endometriosis-Associated Cancer).

Endometriosis is a frequent, estrogen-dependent, chronic disease, characterized by the presence of endometrial glands and stroma outside of the uterine cavity. Although it is not considered a precursor of cancer, endometriosis is associated with ovarian cancer. In this review, we summarized the evidence that clear-cell and endometrioid ovarian carcinomas (endometriosis-associated ovarian carcinoma-EAOC) may arise in endometriosis.

Pathophysiology and Clinical Implications of Ovarian Endometriomas.

Ovarian endometriomas affect many patients with endometriosis and have significant effects on quality of life, fertility, and risk of malignancy. Endometriomas range from small (1-3 cm), densely fibrotic cysts to large (20 cm or greater) cysts with varying degrees of fibrosis. Endometriomas are hypothesized to form from endometriotic invasion or metaplasia of functional cysts or alternatively from ovarian surface endometriosis that bleeds into the ovarian cortex.

Outcomes of Laparoscopic Cesarean Scar Defect Repair: Retrospective and Observational Study.

Cesarean scar defect, also known as niche, isthmocele, uteroperitoneal fistula and uterine diverticulum, is a known complication after cesarean delivery. Due to the rising cesarean delivery rates, niche has become more common and can present as irregular bleeding, pelvic pain, infertility, cesarean scar pregnancy and uterine rupture. Treatments for symptomatic cesarean scar defect vary and include hormonal therapy, hysteroscopic resection, vaginal or laparoscopic repair, and hysterectomy.

Laparoscopic Diagnosis and Treatment of an Isolated Cervical Diverticulum.

Background: Congenital müllerian anomalies are found in 8.0% of women with infertility and up to 5.5% of women in a general population.

Multidisciplinary Management of Cutaneous Gluteus Vaginal Fistula After Sacrospinous Ligament Fixation.

Introduction: Cutaneous gluteal vaginal fistula is a rare but significant postoperative complication which may present years after sacrospinous ligament fixation (SSLF) surgery There is limited data on the management of cutaneous vaginal fistula following SSLF.

Case Description: This case report describes a 77-year-old who presents twenty years after SSLF with cutaneous gluteal vaginal abscess and fistula. She underwent successful management with CT-guided percutaneous drainage of gluteal abscess and placement of guiding cutaneous vaginal catheter, laparoscopic pelvic wall dissection and evaluation, and transvaginal localization and removal of the infected permanent suture.

A systematic review of the reproductive and oncologic outcomes of fertility-sparing surgery for early-stage cervical cancer.

In this review, we aim to evaluate the current literature on reproductive and oncologic outcomes after fertility-sparing surgery for early-stage cervical cancer (stage IA1-IB1). This is a systematic review of the existing literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist to report on fertility-sparing surgery and its outcomes in early-stage cervical cancer. Outcomes of interest were subsequent clinical pregnancy rate, reproductive outcomes, and cancer recurrence outcomes.

Adnexal masses during pregnancy: diagnosis, treatment, and prognosis.

Adnexal masses are identified in pregnant patients at a rate of 2 to 20 in 1000, approximately 2 to 20 times more frequently than in the age-matched general population. The most common types of adnexal masses in pregnancy requiring surgical management are dermoid cysts (32%), endometriomas (15%), functional cysts (12%), serous cystadenomas (11%), and mucinous cystadenomas (8%). Approximately 2% of adnexal masses in pregnancy are malignant.

Combined Medical and Minimally Invasive Robotic Surgical Approach to the Treatment and Repair of Cesarean Scar Pregnancies.

Background And Objectives: The rise in cesarean deliveries, has led to increase in maternal complications in subsequent pregnancies such as abnormal placental implantation, uterine rupture, hemorrhage and, less commonly, cesarean scar pregnancies (CSP). Our objective was to describe patient characteristics following a combined medical and surgical treatment approach to first trimester cesarean scar pregnancies.

Methods: This was a case series approved by the Institutional Review Board of cesarean scar pregnancies over a two-year period at a single academic institution.

Conservative management of stage IIB ovarian carcinoma with favorable oncology and fertility outcomes.

•Fertility treatment prior to definitive cancer therapy in stage IIB EOC.•Both fertility and oncologic outcomes were successful.•The role of Multidisciplinary team is critical.

Broad ligament Extraintestinal Gastrointestinal Stromal Tumor (EGIST): Case report and brief overview of EGIST.

•Highly suspicious pelvic mass may require preoperative biopsy for diagnosis.•Neoadjuvant imatinib lowers EGIST tumor burden in extensive disease preoperatively.•EGIST resection aims at complete surgical resection and negative margins.

Robotic Repair of Complicated Vesico-[utero]/Cervicovaginal Fistula after Cesarean Section.

Study Objective: To demonstrate intra- and postoperative steps in a successful management of a complicated vesico-[utero]/cervicovaginal fistula.

Design: Stepwise demonstration of the technique with narrated video footage.

Setting: A urogenital fistula in developed countries mostly occurs after gynecologic surgeries but rarely from obstetric complications.

Fallopian tube endometriosis in women undergoing operative video laparoscopy and its clinical implications.

Objective: To determine the incidence of fallopian tube endometriosis in patients undergoing laparoscopic surgery with a preoperative diagnosis of endometriosis, pelvic pain, infertility, or cystic adnexal mass.

Design: Retrospective cross-sectional study.

Setting: Gynecologic oncology and minimally invasive surgery practice.

Endometriosis and Endometriosis-Associated Ovarian Cancer (EAOC).

Endometriosis is a gynecologic disease that affects over 10% of women of reproductive age causing pelvic pain, dysmenorrhea, and infertility, resulting in significant disability and reduced quality of life. Very recent genetic studies have suggested that endometriosis is a clonal disease in the epithelium and its development is independent of stroma, providing new insight into the genesis of endometriosis. The endometrioid tissue lining may also react by epithelial atypical hyperplasia and even neoplasia, in a manner somehow similar to that in the uterine cavity and under the same hormonal influences.

Endometrial Carcinoma and its Precursors.

This chapter focuses on premalignant and malignant diseases of the endometrium (lining of the uterus). Endometrial carcinoma is the most common gynecologic cancer in the United States. Women have a 1 in 40 lifetime risk of being diagnosed with endometrial cancer, the fourth most common malignancy among women.

Reproductive and oncologic outcomes after fertility-sparing surgery for early stage cervical cancer: a systematic review.

This review sought to evaluate the current literature on reproductive and oncologic outcomes after fertility-sparing surgery for early stage cervical cancer (stage IA1-IB1) including cold-knife conization/simple trachelectomy, vaginal radical trachelectomy, abdominal radical trachelectomy, and laparoscopic radical trachelectomy with or without robotic assistance. A systematic review using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist to evaluate the current literature on fertility-sparing surgery for early stage cervical cancer and its subsequent clinical pregnancy rate, reproductive outcomes, and cancer recurrence was performed. Sixty-five studies were included encompassing 3,044 patients who underwent fertility-sparing surgery, including 1,047 pregnancies with reported reproductive outcomes.

Endometriosis Malignant Transformation Review: Rhabdomyosarcoma Arising From an Endometrioma.

Background: Endometriosis is a widely known benign disease, but 0.5%-1% of cases are associated with malignancy. It has been linked with ovarian neoplasms, particularly endometrioid and clear cell adenocarcinoma histology.

The two Achilles heels of surgical randomized controlled trials: differences in surgical skills and reporting of average performance.

Randomized controlled trials of surgery are fundamentally different from randomized controlled trials of medications because it is difficult to blind or mask a surgical procedure or perform "sham" operations. An additional challenge is the variation in skills and surgical proficiency of participating centers and surgeons. Addressing heterogeneity in surgical proficiency remains of paramount importance, especially when randomized controlled trials involve a new or complex procedure such as minimally invasive radical surgery.