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The Effect of Fertility on Resection Margin in Conization
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Abstracts / Journal of Minimally Invasive Gynecology 22 (2015) S1–S253 3. Clinical assessment indicated improved quality of life such that some patients elected to cancel or delay surgery. 4. Patients with Type 0 myomas (8) had rapid control of bleeding. 185 The Effect of Fertility on Resection Margin in Conization Choi J-Y, Lee J, Suh DH, Kim K, No JH, Kim Y-B. Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-do, Republic of Korea
Figure l. Amenorrhea* – After Three Month UPA 5 mg/d* Spotting or minimal bleeding on the simplified bleeding score
Figure 2. Effect on Fibroid Volume* After 3 Months UPA*Ultrasound
Table 1 Baseline Characteristics UPA Study Characteristic Mean Age Ethic Origin: White Black Other Mean BMI (Kg/SQ) Simplified Bleeding Score-% Heavy Bleeding Volume Largest Fibroid cm 3 Pain Assessment (VAS)
186
39.6 Years 23 (80%) 8 (14.3%) 3 (8.6%) 28.2 95% 48.6 ( 32-97.2) 55.0-77.6mm Mean=68.0
Ulipristal Acetate 5 mg/d/3 months
Table 2 Parameters After UPA Therapy 5 mg/d/3 months Simplified Bleeding Score Hemoglobin Volume Reduction of Largest Myoma VAS mm Average Time to control of bleeding
Study Objective: We aimed to determine whether patient’s fertility affected rate of resection margin positive in conization. Design: Retrospective cohort study. Setting: Seoul National University Bundang Hospital. Patients: Patients undergoing conization performed for cervical disease by gynecologic oncologist between 2006 and 2008. Intervention: Women with low grade squamous intraepithelial lesion(LSIL), high grade squamous intraepithelial lesion(HSIL), atypical squamous cells of undetermined significance(ASC-US), atypical squamous cells – cannot excluded HSIL(ASC-H) diagnosed by pap smear were treated with conization. Measurements and Main Results: Using 4 baseline characteristics, we generated a propensity score to match study and comparison group.(age, cervical disease, gynecologic oncologist). 44 study group and 44 comparison group were propensity score-matched. Study group was comprised of women with no history of marriage or delivery after 20 weeks of gestation. Comparison group was comprised of other women. Study group had more resection margin involvement(case=41%, control=20%, p\0.04), especially in exocervical resection involvement (case=32%, control=14%, p\0.04). There were no differences in specimen volume and 1-year recurrence rate. Conclusion: We found that patient with no history of marriage or delivery after 20 weeks of gestation had more resection margin positive rate in conization. This suggests that practitioners who is concerned about the risk of preterm delivery does smaller cervical conization.
3% Heavy Bleeding Mean 12.0 g/dl 38.1% 33 mm 9.6 days
interventions for symptomatic fibroids resulted in rapid reduction in blood loss and improvement in hemoglobin levels. 2. Ultrasound metrics pre and post therapy showed reduction in the largest myoma volume comparable to the PEARL Trials.
Menstrual Abnormalities and Reproductive Challenges in Women With End Stage Renal Disease on Chronic Dialysis Hawkins E,1 Chudnoff S,1 Levie M,1 Fridman D,1 Mehta S,1 Melamed M.2 1 Obstetrics, Gynecology and Women’s Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; 2Department of Medicine, Division of Nephrology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York Study Objective: To update the literature on menstrual patterns and reproductive challenges of women with end stage renal disease (ESRD), before and after dialysis initiation. Design: Cross sectional analysis. Setting: Urban academic hospital dialysis centers. Patients: Reproductive-aged women requiring dialysis for ESRD. Thirty patients have completed this ongoing protocol. Intervention: Participants completed a survey about pre- and post-dialysis menstrual characteristics, obstetric and gynecologic history. Medical records were referenced. Primary objectives were menstrual characteristics, gynecologic problems and sexual satisfaction. Measurements and Main Results: Average age was 37.5 (10.4) and dialysis duration 5.5 years (3.6). 57% under 55 menstruated. Half experienced at least 6 month menstrual gaps. 43% sought care for abnormal = bleeding, 21% required surgery. Menstrual frequency before renal diagnosis averaged 25 days, lengthened to 40 after renal diagnosis but before dialysis, equalizing to 33 after dialysis initiation. The most significant menstrual changes were in the first year on dialysis and reflected amenorrhea in 36%. For those who continued menstruating approximately half stabilized in frequency, regularity, duration, blood loss and pain. The remaining half had lessening of these parameters.
Abstracts / Journal of Minimally Invasive Gynecology 22 (2015) S1–S253 3. Clinical assessment indicated improved quality of life such that some patients elected to cancel or delay surgery. 4. Patients with Type 0 myomas (8) had rapid control of bleeding. 185 The Effect of Fertility on Resection Margin in Conization Choi J-Y, Lee J, Suh DH, Kim K, No JH, Kim Y-B. Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-do, Republic of Korea
Figure l. Amenorrhea* – After Three Month UPA 5 mg/d* Spotting or minimal bleeding on the simplified bleeding score
Figure 2. Effect on Fibroid Volume* After 3 Months UPA*Ultrasound
Table 1 Baseline Characteristics UPA Study Characteristic Mean Age Ethic Origin: White Black Other Mean BMI (Kg/SQ) Simplified Bleeding Score-% Heavy Bleeding Volume Largest Fibroid cm 3 Pain Assessment (VAS)
186
39.6 Years 23 (80%) 8 (14.3%) 3 (8.6%) 28.2 95% 48.6 ( 32-97.2) 55.0-77.6mm Mean=68.0
Ulipristal Acetate 5 mg/d/3 months
Table 2 Parameters After UPA Therapy 5 mg/d/3 months Simplified Bleeding Score Hemoglobin Volume Reduction of Largest Myoma VAS mm Average Time to control of bleeding
Study Objective: We aimed to determine whether patient’s fertility affected rate of resection margin positive in conization. Design: Retrospective cohort study. Setting: Seoul National University Bundang Hospital. Patients: Patients undergoing conization performed for cervical disease by gynecologic oncologist between 2006 and 2008. Intervention: Women with low grade squamous intraepithelial lesion(LSIL), high grade squamous intraepithelial lesion(HSIL), atypical squamous cells of undetermined significance(ASC-US), atypical squamous cells – cannot excluded HSIL(ASC-H) diagnosed by pap smear were treated with conization. Measurements and Main Results: Using 4 baseline characteristics, we generated a propensity score to match study and comparison group.(age, cervical disease, gynecologic oncologist). 44 study group and 44 comparison group were propensity score-matched. Study group was comprised of women with no history of marriage or delivery after 20 weeks of gestation. Comparison group was comprised of other women. Study group had more resection margin involvement(case=41%, control=20%, p\0.04), especially in exocervical resection involvement (case=32%, control=14%, p\0.04). There were no differences in specimen volume and 1-year recurrence rate. Conclusion: We found that patient with no history of marriage or delivery after 20 weeks of gestation had more resection margin positive rate in conization. This suggests that practitioners who is concerned about the risk of preterm delivery does smaller cervical conization.
3% Heavy Bleeding Mean 12.0 g/dl 38.1% 33 mm 9.6 days
interventions for symptomatic fibroids resulted in rapid reduction in blood loss and improvement in hemoglobin levels. 2. Ultrasound metrics pre and post therapy showed reduction in the largest myoma volume comparable to the PEARL Trials.
Menstrual Abnormalities and Reproductive Challenges in Women With End Stage Renal Disease on Chronic Dialysis Hawkins E,1 Chudnoff S,1 Levie M,1 Fridman D,1 Mehta S,1 Melamed M.2 1 Obstetrics, Gynecology and Women’s Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; 2Department of Medicine, Division of Nephrology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York Study Objective: To update the literature on menstrual patterns and reproductive challenges of women with end stage renal disease (ESRD), before and after dialysis initiation. Design: Cross sectional analysis. Setting: Urban academic hospital dialysis centers. Patients: Reproductive-aged women requiring dialysis for ESRD. Thirty patients have completed this ongoing protocol. Intervention: Participants completed a survey about pre- and post-dialysis menstrual characteristics, obstetric and gynecologic history. Medical records were referenced. Primary objectives were menstrual characteristics, gynecologic problems and sexual satisfaction. Measurements and Main Results: Average age was 37.5 (10.4) and dialysis duration 5.5 years (3.6). 57% under 55 menstruated. Half experienced at least 6 month menstrual gaps. 43% sought care for abnormal = bleeding, 21% required surgery. Menstrual frequency before renal diagnosis averaged 25 days, lengthened to 40 after renal diagnosis but before dialysis, equalizing to 33 after dialysis initiation. The most significant menstrual changes were in the first year on dialysis and reflected amenorrhea in 36%. For those who continued menstruating approximately half stabilized in frequency, regularity, duration, blood loss and pain. The remaining half had lessening of these parameters.