Take it or leave it: oophorectomy at the time of benign hysterectomy.

Purpose Of Review: Previous modeling data suggest ovarian conservation up to age 65 for women without adnexal disease and at average risk of ovarian cancer because of an increase in mortality associated with ovarian removal. Recent modeling data challenges this practice. This review of recent literature will update providers regarding consideration for oophorectomy at time of benign hysterectomy.

Adenomyosis and fertility: does adenomyosis impact fertility and does treatment improve outcomes.

Purpose Of Review: Adenomyosis has recently been associated with infertility. Relief of bleeding and pain has been demonstrated with medical and surgical therapy. Less is known about reproductive outcomes after treatment.

Contained tissue extraction using power morcellation: prospective evaluation of leakage parameters.

Background: Safe tissue removal is a challenge for minimally invasive procedures such as myomectomy, supracervical hysterectomy, or total hysterectomy of a large uterine specimen. There is concern regarding disruption or dissemination of tissue during this process, which may be of particular significance in cases of undetected malignancy. Contained tissue extraction techniques have been developed in an effort to mitigate morcellation-related risks.

Minimally invasive specialists and rates of laparoscopic hysterectomy.

Background And Objective: Despite the prevalence of hysterectomy for treatment of benign gynecologic conditions, providers nationwide have been slow to adopt minimally-invasive surgical techniques. Our objective is to investigate the impact of a department for minimally invasive gynecologic surgery (MIGS) on the rate of laparoscopic hysterectomy at an academic community hospital without robotic technology.

Methods: This retrospective observational study included all patients who underwent hysterectomy for benign indications from January 1, 2004, through December 31, 2012.

Molecular network analysis of endometriosis reveals a role for c-Jun-regulated macrophage activation.

Clinical management of endometriosis is limited by the complex relationship between symptom severity, heterogeneous surgical presentation, and variability in clinical outcomes. As a complement to visual classification schemes, molecular profiles of disease activity may improve risk stratification to better inform treatment decisions and identify new approaches to targeted treatment. We use a network analysis of information flow within and between inflammatory cells to discern consensus behaviors characterizing patient subpopulations.

Women's preferences for minimally invasive incisions.

Study Objective: To determine whether traditional, robotic, or single-site laparoscopic incisions are more appealing to women.

Design: Descriptive study using a survey (Canadian Task Force classification III).

Setting: Single-specialty referral-based gynecology practice.

Fertility preservation: nonsurgical and surgical options.

Improved surveillance and treatment regimens have resulted in decreased mortality rates among cancer patients, allowing these women to focus on survival and quality of life, including the ability to preserve their fertility. The treatments that have improved survival among both adults and children diagnosed with cancer are often gonadotoxic, especially those that employ high doses of alkylating agents and radiation therapy directed near or toward the pelvis. The impact on the ovarian reserve is related to the accelerated depletion of the primordial germ cell pool resulting from these therapies.

Effects of lifetime exercise on the outcome of in vitro fertilization.

Objective: To estimate whether exercise before the first cycle of in vitro fertilization (IVF) affects cycle outcomes.

Methods: A total of 2,232 patients were prospectively enrolled before undergoing their first cycle of IVF for the treatment of infertility from 1994-2003 at three IVF clinics in the greater Boston area. The primary IVF outcomes of interest included successful live birth and four points of cycle failure: cycle cancellation, failed fertilization, implantation failure, and pregnancy loss.

Benign vaginal villi noted at time of defibulation of female genital cutting.

Background: Female genital cutting is a cultural practice in Africa and the Middle East. As more patients who have undergone this procedure are seen in the United States and undergo surgical revision of the scarred labia, new clinical findings will arise.

Case: At the time of surgical revision of female genital cutting, small clusters of villi were noted on the vaginal and labial mucosa of 3 patients.

Exercise during pregnancy: a critical appraisal of the literature.

To review the effects of exercise during pregnancy on fetal and maternal outcomes, a selective literature search was performed using MEDLINE, the Cochrane Database and bibliographies from relevant articles to identify additional references. The data on exercise during pregnancy are limited but suggest that moderate exercise during a low-risk pregnancy does not lead to adverse outcomes for the fetus or mother and improves overall maternal fitness and well-being. The data examining the impact of exercise on labor outcomes, maternal weight gain and fetal weight are conflicting.