• Title/Summary/Keyword: gynecological examination

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Effect of Pre-Procedural State-Trait Anxiety on Pain Perception and Discomfort in Women Undergoing Colposcopy for Cervical Cytological Abnormalities

  • Baser, Eralp;Togrul, Cihan;Ozgu, Emre;Esercan, Alev;Caglar, Mete;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4053-4056
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    • 2013
  • Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.

Prevalence of Cervical Human Papilloma Virus Infection Among Married Women in Vietnam, 2011

  • Vu, Lan T.H.;Bui, Dieu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.37-40
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    • 2012
  • The burden of cervical cancer is increasing in Vietnam in the recent years, infection with high risk HPV being the cause. This study aimed to examine the prevalence of HPV and the distribution of HPV specific types among the general population in 5 big cities in Vietnam. Totals of 1500 women in round 1 and 3000 in round 2 were interviewed and underwent gynecological examination. HPV infection status, and HPV genotyping test were perfoirmed for all participants. Results indicated that the prevalence of HPV infection in 5 cities ranged from 6.1% to 10.2% with Can Tho having highest prevalence. The most common HPV types in all 5 cities were HPV 16, 18 and 58. Most of the positive cases were infected with high risk HPV, especially in Hanoi and Can Tho where more than 90% positive cases were high risk HPV. Furthermore, in Can Tho more than 60% of women were infected with multiple HPV types. The information from this study can be used to provide updated data for planning preventive activities for cervical cancer in the studied cities.

The Pap-Smear Test Experience of Women in Turkey: A Qualitative Study

  • Arabaci, Zeynep;Ozsoy, Suheyla
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5687-5690
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    • 2012
  • Objective: The study was planned with the purpose of examining the attitude of women who have pap-smear test for the early diagnosis of cervical cancer, factors affecting their decisions and their feelings and experiences during this period. Materials and Methods: A phenomenological method was used. Data were collected between March 2012 and April 2012 using standard and purposive samplings from 17 women. A detailed interview with women were held in their houses and recorded. The data collection tool consisted of two parts, one of which is information form with 17 questions identifying sociodemographic and cervical cancer risk factors of women and the second part is made up of semi-structured interview form with 15 alternative questions taking literature and the pap-smear test into consideration. Collected data were put into a written document. Content analysis was held by loading the documents into NVIVO 8 Statistical Programme. Results: The study comprised themes such as cervical risk factor, decision of taking pap-smear test, taking pap-smear test, knowledge about pap-smear test, relieving factors during pap-smear test, obstructive factors during pap-smear test, gynecological examination and feelings of women during and after pap-smear test while waiting for the results. Conclusions: As women perceive gynaecological examinations differently from other examinations, they have different feelings in each process of the Pap smear test. Medical staff should advise women more clearly on the nature and advantages of the Pap-smear test.

A case of ovarian enterobiasis

  • Hong, Sung-Tae;Choi, Min-Ho;Chai, Jong-Yil;Kim, Young-Tak;Kim, Mi-Kyung;Kim, Kyu-Rae
    • Parasites, Hosts and Diseases
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    • v.40 no.3
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    • pp.149-151
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    • 2002
  • A 36-year old Korean woman consulted a clinic for a regular gynecological examination, and a mass was noticed in her pelvis. She was referred to the Asan Medical Center, Seoul where transvaginal ultrasonography confirmed a pelvic mass exceeding 10cm in diameter. She received total abdominal hysterectomy and bilateral salpingoophorectomy, and a borderline serous neoplasm with micropapillary features involving the left ovary and right ovarian serosa was histopathologically confirmed. In addition, a section of a nematode with numerous eggs was found in the parenchyma of the left ovary. The worm had degenerated but the eggs were well-preserved and were identified as those of Enterobius vermicularis. She is an incidentally recognized case of ovarian enterobiasis.

Endometrial Cancer in Hospital Universiti Sains Malaysia

  • Wan-Nor-Asyikeen, Wan Adnan;Siti-Azrin, Ab Hamid;Jalil, Nur Asyilla Che;Othman, Nor Hayati;Zain, Anani Aila Mat
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2867-2870
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    • 2016
  • Background: Endometrial cancer is the most common gynecological malignancy among females worldwide, approximately 320,000 women being diagnosed with the disease each year and 76,000 dying. To date, there is limited knowledge of endometrial cancer in Malaysia. Objectives: To identify the epidemiological profile and prognostic factors of survival. Materials and Methods: A list of endometrial cancer patients in 2000-2011 was obtained from the hospital Record Department. Only cases confirmed by histopathology examination were included. We excluded those with incomplete medical records or referral cases. Simple and multiple Cox regression approaches were used for data analysis. Results: Only 108 cases were included with a mean (SD) age of 62.7 (12.3) years, with 87.0% Malay ethnicity. Grade of cancer was: 29.1% grade 1, 43.7% grade 2 and 27.2% grade 3. The majority of patients had non-endometrioid type (60.2%), with myometrial invasion (82.2%) and lymphovascular invasion (57.3%). The significant prognostic factors were age (HR 1.05; 95% CI: 1.02, 1.08, p=0.002) and having lymphovascular invasion (HR 2.15; 95% CI: 1.08, 4.29; p=0.030). Conclusions: Endometrial cancer patients should be diagnosed earlier to reduce the risk of mortality. The public should be given education on the signs and symptoms of the disease.

Effectiveness of emergency contraception in women after sexual assault

  • Choi, Dong Seok;Kim, Miran;Hwang, Kyung Joo;Lee, Kyoung Mi;Kong, Tae Wook
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.3
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    • pp.126-130
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    • 2013
  • Objective: To assess the effectiveness of emergency single-dose levonorgestrel contraception in preventing unintended pregnancies among woman who visited the emergency department (ED) due to sexual assault (SA). Methods: We conducted a retrospective chart review in a university hospital in South Korea. Cases from November 10, 2006 to November 9, 2009 were enrolled. Information from the initial visit to the ED and subsequent follow-up visits to the gynecology outpatient clinic was collected. Results: In total, 1,179 women visited the ED due to SA. Among them, 416 patients had a gynecological examination and 302 patients who received emergency contraception (EC) (1.5 mg single-dose levonorgestrel) at the ED due to SA were enrolled. Ten patients did not return for follow-up examinations. In follow-up visits at the outpatient clinic, two pregnancies were confirmed, which showed the failure rate of the EC to be 0.68%. Conclusion: Single-dose levonorgestrel EC is extremely effective at preventing pregnancy among victims of SA.

Concurrent Chemoradiation with Weekly Paclitaxel and Cisplatin for Locally Advanced Cervical Cancer

  • Kalaghchi, Bita;Abdi, Robab;Amouzegar-Hashemi, Farnaz;Esmati, Ebrahim;Alikhasi, Afsaneh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.287-291
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    • 2016
  • Cervical cancer is one of the most common gynecological cancers in Iranian women. This study was initiated to assess whether the combination of paclitaxel and cisplatin with radiation might feasible for these patients. The aim was to assess tumor response and toxicity of weekly cisplatin and paclitaxel along with radiotherapy in the treatment of cervical cancer. Women with primary untreated squamous cell carcinoma of the cervix with FIGO stages IB2 to IIIB were treated with weekly injections of cisplatin 30 mg/m2 and paclitaxel 35 mg/m2 for 5-6 weeks along with radiotherapy. A total of 25 patients were enrolled in this study who completed the intended treatment. Disease was assessed prior to treatment by pelvic examination and contrast enhanced MRI of the abdomen and pelvis. Response was assessed 1 month after completion of treatment by physical examination and 3 months after also by MRI.Toxicity was assessed and was graded using RTOG grading. There was a complete response rate of 84% after 3 months. The major toxicity was grade 1 and 2 anemia (92%). The mean duration of treatment was 58 days. In conclusion, combination chemotherapy with cisplatin and paclitaxel along with radiotherapy in patients with locally advanced squamous cell carcinoma of cervixwas well tolerated, in contrast to other studies, but it seems that there was no increase in tumor response and progression free survival with this treatment regimen.

Design of a New Applicator for High-Dose Rate Vaginal Brachytherapy (고선량율 질강 근접조사를 위한 새로운 적용구의 제작)

  • Shin, Sei One
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.123-128
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    • 2000
  • Purpose: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. Methods: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). Results: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. Conclusions: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

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Knowledge about Cervical Cancer Risk Factors and Pap Smear Testing Behavior among Female Primary Health Care Workers: A Study from South Turkey

  • Coskun, Savas;Can, Huseyin;Turan, Sercan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6389-6392
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    • 2013
  • Background: Cervical cancer is one of the ten most frequent cancers in Turkey. We here examined knowledge about cervical cancer in relation to Papanicolaou (Pap) testing among female primary health care workers in Hatay, a city is located in the south of Turkey. Materials and Methods: The study was completed on 261 women healthcare workers who were or had been sexually active and who accepted to participate to the study. The participants gave verbal informed consent and thereafter questionnaires prepared by the investigators were administered by personal interview. Results: Only 30.3% (n=79) of the participants regularly had a gynecologic examination. While 87.4% (n=228) of the participants reported that they had already heard about the Pap smear test, only 45.2% (n=118) had undergone this test. It was determined that had undergone an average of $1.66{\pm}0.89$ times (1-4) within the last five years. Some 56.0% (n=117) of the participants were well informed about the Pap smear test (p<0,001) and 81.1% (n=63) of the participants who regularly had gynecological examinations (p<0,001) had this test. Conclusions: For the early diagnosis of the cervical cancer, regularly having a Pap smear test is crucial. Healthcare workers should also demonstrate sensitivity about this issue. We think that the importance of the issue should be re-highlighted by organizing in-service training for female primary healthcare workers. Studies are warranted to determine the psychosociological factors that cause individuals to not have the test.

Diagnostic Accuracy of Magnetic Resonance Imaging versus Clinical Staging in Cervical Cancer

  • Shirazi, Ahmad Soltani;Razi, Taghi;Cheraghi, Fatemeh;Rahim, Fakher;Ehsani, Sara;Davoodi, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5729-5732
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    • 2014
  • Background: Cervical cancer is the third most common gynecological cancer and a widespread malignancy in women, accounting for a large proportion of the cancer burden in developing countries. We compared accuracy of MRI staging with clinical staging and also concordance between the two methods for newly diagnosed patients with cervical cancer, using clinical staging as the reference. Materials and Methods: This prospective study was conducted on 27 newly diagnosed patients with cervical cancer from Imam Khomeini hospital from June 2012 to Feb 2014. New cases of cervical cancer with positive PAP test were staged separately with a clinical exam based on the FIGO system by a gynecologist, oncologist and also with MRI by an expert radiologist. Then we compared the predicted stage for each patient with the two methods. Results: Based on clinical staging 9 patients (33%) were observed at stage 1. MRI staging was in coordination with clinical staging in eight of them and for one patient MRI accorded stage 2B (88% concordance). Conclusions: MRI is a reliable noninvasive method with high accuracy for cervical cancer staging. Also presently it is easily obtainable, so we recommend using this technique along with clinical examination for staging cervical cancer patients. We also recommend to radiologists and residents of radiology to get experience with this method of staging.