Can high histological confirmation rates be achieved for pelvic endometriosis?

This paper aims to determine the correlation between the diagnosis of endometriosis on the basis of the visualisation at laparoscopy and the histological diagnosis. Histological confirmation rates vary in the current literature. We retrospectively reviewed 160 patients over 2 years, who had laparoscopy for pelvic pain or suspected endometriosis.

Total laparoscopic hysterectomy in morbidly obese women with endometrial cancer anaesthetic and surgical complications.

Objective: To assess the feasibility, associated anaesthetic and surgical morbidity in all morbidly obese women with endometrial cancer treated with total laparoscopic hysterectomy bilateral salpingo-oophorectomy (TLHBSO).

Study Design: Data was collected prospectively and analysed retrospectively on all morbidly obese women who had TLHBSO between February 2003 and January 2007.

Results: One case was converted to laparotomy.

Safety and preliminary efficacy data of a novel casein kinase 2 (CK2) peptide inhibitor administered intralesionally at four dose levels in patients with cervical malignancies.

Background: Cervical cancer is now considered the second leading cause of death among women worldwide, and its incidence has reached alarming levels, especially in developing countries. Similarly, high grade squamous intraepithelial lesion (HSIL), the precursor stage for cervical cancer, represents a growing health problem among younger women as the HSIL management regimes that have been developed are not fully effective. From the etiological point of view, the presence of Human Papillomavirus (HPV) has been demonstrated to play a crucial role for developing cervical malignancies, and viral DNA has been detected in 99.

Primary malignant melanoma arising in an ovarian cystic teratoma.

Cystic ovarian teratomas are common tumours. Malignant melanoma developing in a teratoma, however, is an extremely rare diagnosis. A 49-year-old woman with a history of weight loss and abdominal distension was referred to UCLH.

Successful outcome after prenatal treatment of a cardiac diverticulum with massive pericardial effusion.

Congenital ventricular cardiac diverticula are rare. They may occur prenatally in association with a pericardial effusion which, if large enough, can compromise fetal circulatory and lung development. Parental counseling is difficult because some cases resolve in the second trimester and others progress to worsening hydrops and intrauterine death.

Minimal access surgery in adolescent gynaecology.

The benefits of a minimally invasive approach are now well documented in adult women, and thus surgeons have embraced the notion of expanding such expertise in adolescence with measured enthusiasm and a great sense of responsibility. Faster recovery is likely to have a positive impact on schooling, while less adhesion formation may reduce future fertility issues. Gynaecologists performing minimally invasive procedures in adolescents ought to be aware of the steep learning curve required for achieving proficiency with complex laparoscopic surgery.

Gastroschisis: sonographic diagnosis, associations, management and outcome.

Gastroschisis is a defect in the abdominal wall, typically on the right side of a normally inserted umbilical cord through which bowel and other abdominal contents herniate. Classically, no membrane covers the herniated abdominal contents, which distinguishes the defect from exomphalos, an important differential diagnosis. Gastroschisis is usually diagnosed prenatally using ultrasound examination.

Chronic kidney disease in pregnancy.

Pregnant women with chronic renal disease adapt poorly to a gestational increase in renal blood flow. This may accelerate their decline in renal function and lead to a poor pregnancy outcome

Sexual function and genital sensitivity following feminizing genitoplasty for congenital adrenal hyperplasia.

Purpose: Female sex assignment followed by cosmetic genitoplasty to feminize the genitalia in infancy remains standard practice in the clinical management of ambiguous genitalia. The effects of surgery on genital sensitivity have never been objectively evaluated. To our knowledge the current study is the first to evaluate genital sensitivity and sexual function in women with congenital adrenal hyperplasia.

Female genital mutilation: classification and management.

Female genital mutilation is a deeply rooted cultural tradition observed primarily in Africa and among certain communities in the Middle East and Asia. It has considerable health consequences. Women from the practising communities are increasingly seen within healthcare settings but few healthcare professionals are trained to treat their specific healthcare needs.

Race, prematurity and immaturity.

Compared to white Europeans, Blacks and South Asians have a significantly shorter mean gestational length and a higher incidence of preterm birth. For any given gestational age before 37 weeks, Black and South Asian babies have less risk of respiratory distress syndrome, and the survival rate in Black babies is higher than white Europeans. From 37 weeks of gestation onwards, the perinatal mortality rate in Blacks is higher than in white Europeans, and this appears to be associated with a higher rate of meconium passage and respiratory morbidity.

The risk of recurrence of holoprosencephaly in euploid fetuses.

Objectives: To determine the cause of and devise a management strategy for holoprosencephaly cases seen at a regional tertiary referral fetal medicine unit.

Methods: Holoprosencephaly cases referred to University College London Hospital's Fetal Medicine Unit in the past 15 years were ascertained from a fetal database. We examined maternal, neonatal, genetic, and pathology records for prenatal and postnatal management, outcome, and genetic follow-up.

Requests for cosmetic genitoplasty: how should healthcare providers respond?

Demand for cosmetic genitoplasty is increasing. argue that surgery carries risks and that alternative solutions to women's concerns about the appearance of their genitals should be developed

Practical issues drawn from the implementation of the integrated test for Down syndrome screening into routine clinical practice.

We have evaluated a cohort of women booked for antenatal care at University College London Hospitals. The uptake of screening was 64.4% and was significantly higher (73 versus 46%) in women who booked before 14 weeks.

Primary mucinous carcinoid tumour of the ovary: a case report.

Primary ovarian carcinoid tumours of the ovary are rare and represent less than 0.1% of ovarian malignancy. The evidence to guide treatment and prognosis of these tumours is limited.

Sonographic diagnosis of SEDC and double heterozygote of SEDC and achondroplasia--a report of six pregnancies.

Objective: To define the sonographic features of spondyloepiphyseal dysplasia congenita (SEDC) and the double heterozygote for SEDC and achondroplasia.

Methods: A retrospective review of 6 pregnancies in one family where one parent has achondroplasia and the other SEDC.

Results: There were 4 double heterozygote pregnancies and 2 where the fetus had SEDC.

The reinforcement of invasion in epithelial ovarian cancer cells by 17 beta-Estradiol is associated with up-regulation of Snail.

Objective: The transcription factor Snail, which is implicated in the triggering of epithelial-mesenchymal transitions (EMT), plays an important role in adhesion, invasion and metastasis of tumor cells. In the present study, we assessed 17beta-Estradiol (E2)'s effect on Snail, E-cadherin and MMP-2 expression of epithelial ovarian cancer cell line ES-2 and SKOV3. Then we induced Snail gene silencing by RNA interference to explore the effect of E2 on E-cadherin and MMP-2 expression when Snail gene expression was blocked.

Laparoscopic vaginoplasty: alternative techniques in vaginal reconstruction.

Construction of a neovagina is the next step for women with an absent vagina who have failed vaginal dilator therapy. Traditional operative techniques such as skin grafting or intestinal substitution have major disadvantages including prolonged recovery time and significant scarring. Laparoscopic vaginoplasty is performed widely throughout Europe but has not been available in the UK until now.

Menstrual effluent in endometriosis shows no difference in volume, VEGF-A, MMP2 and MMP9 or sFLT.

Since retrograde menstruation is considered a key event in the aetiology of endometriosis, this study sought to determine whether the menstrual effluent of women with this condition is different from that of those with a normal pelvis. As the amount of blood lost during menstruation is thought to be higher in this group, measured objective menstrual blood loss (MBL) was measured. In addition, factors enhancing both ectopic implantation of endometrium and its subsequent growth (by establishing a neo-vasculature) were chosen for study.

Adult female outcomes of feminising surgery for ambiguous genitalia.

For the last half a century, feminising genital surgery has been routine practice for children with ambiguous genitalia assigned to a female sex of rearing. Due to various factors including the stigma and secrecy associated with intersex and the practical difficulties of paediatricians following-up adult patients, there has been little available outcome data on this policy. Recently however adult peer support groups have expressed dissatisfaction with the results of surgery.