Journal of Obstetrics, Gynecology and Cancer Research
Volume:1 Issue: 3, Fall 2016

Dermoid cyst is a benign and common ovarian neoplasm affecting women. Sources for this review article were taken from PubMed and other up-to-date databases covering the period from Jan 2010 to Jan 2016. Keywords for the search were “dermoid cyst” and “treatment”. A search of the literature revealed 113 full textmanuscripts, from which 21 were relevant. In addition, another 56 relevant manuscripts identified in the reference lists of the above-mentioned 21 manuscripts were included in the study, although they had been published before 2010. Clinical considerations for dermoid cystmanagement are categorized as follows: 1) selection of the best choice of surgical treatment in dermoid cyst: laparoscopy or laparotomy; 2) procedure to exteriorize a dermoid cyst in laparoscopy; 3) selection of oophorectomy or cystectomy; 4) spillage of the cyst contents: prevention and treatment of the consequences if it does happen; 5) necessity of surgical treatment in dermoid cyst management; 6) ovarian torsion and other complications; 7) Probability of malignancy in dermoid cyst.

Urgency is a characteristic for overactive bladder and is defined by a sudden obligatory need for urination, a feeling that can be hardly stopped. Many methods such as drug therapy and feedback have been used to treat urinary incontinency.

The aim of this study was to assess and compare the effect of medication, biofeedback or biofeedback plus medication on urge- urinary incontinency and quality of life of patients.

This was a case-control randomized clinical trial performed on patients referred to Imam Khomeini hospital in 2014. Patients were divided into three groups of drug (Tolterodine), biofeedback, and biofeedback plus drug. Biofeedback group underwent two sessions of treatment weekly for four weeks, and the drug group received tolterodine (4 mg slow release) for four weeks. The third group received both of them. Quality of life and urinary incontinency symptoms were compared between the three groups and analyzed, using SPSS Version 16 software (IBM, Armonk, USA).

Meaningful differences were observed between the three groups with respect to change in the total score of the questionnaire (P < 0.001). Between the groups, drug therapy had the most effect on improving the total score of the questionnaire, with a mean change of 25.44 ± 1.80. No meaningful difference was observed between drug plus biofeedback and biofeedback group (P = 0.114). By comparing the mean incontinency score, we found a meaningful difference between the drug and biofeedback groups and the biofeedback and biofeedback plus drug groups (P < 0.001 and P < 0.002, respectively); however, no meaningful difference was found between the biofeedback plus drug group and the drug group in mean incontinency score (P = 0.187).

Our study results revealed that tolterodine and biofeedback both increased quality of life indices and decreased the severity of urinary incontinency significantly in our participants. However, drug plus biofeedback treatment improved the severity and quality of urinary incontinency, but did not improve quality of life of the patients. Therefore, physicians should consider improving the quality of life of patients as well.

Progesterone is a smooth muscle relaxant and also has a vasodilator effect on human placental arteries and veins.

The aim of this study was to evaluate the effect of progesterone therapy on fetal Doppler velocimetry in intrauterine growth retardation (IUGR) and preterm fetuses.

Thirty pregnant females with IUGR and thirty pregnant females with threatened preterm labor at 28 to 37 weeks of gestation were enrolled in the clinical trial study. Fetal Doppler velocimetry was investigated before, 24 hours and two weeks after progesterone therapy. Seven patients with IUGR and 9 patients with preterm labor were excluded from the study before completion of the survey due to the termination of pregnancy.

Following progesterone treatment, middle cerberal arterypulsatility index (MCA_PI) significantly decreased after 24 hours in patients with IUGR and after two weeks in patients with preterm labor (P < 0.001). There was not a statistically significant decrease in the pulsatility index of the fetal umbilical artery (UmA) after 24 hours in the IUGR fetuses (P = 0.18). Umbilical artery pulsatility index (UmA_PI) significantly decreased after two weeks in IUGR fetuses (P < 0.004).

Progesterone led to a reduction in the MCA_PI and UmA_PI in IUGR and preterm fetuses. Vasodilatory effect of progesterone on the umbilical artery is mediated by multiple doses in IUGR fetuses.

Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.

The present study aims at achieving the best method of cervical ripening for pregnancy termination to reduce the Csection rate, labor duration, economic burden, and labor pain.

In this regard, the current study examined the effect of hyoscine-N-butylbromide (HBB) on the progression of cervical ripening in normal vaginal delivery. In the current prospective double-blind controlled clinical trial, 60 pregnant females referred to Valiasr hospital (with the mean age of 27.2 years) were randomly divided into 2 groups of experimental and control; HBB and normal saline (placebo) were intravenously administered in the active phase of labor.

The pain reduction in the patients, the duration of drug action until the cervical dilatation, the number of drug use for the full cervical dilatation, the time of the onset of the first, second, and third stages of labor, the length of hospitalization until the delivery, the drug effect on the fetus and mother, and the delivery method were evaluated in both groups. HBB significantly reduced the duration of the first stage of labor; however, it did not affect the second and third stages. Moreover, no negative effects were observed on the mother and fetus health.

According to the obtained results, it can be concluded that the intravenous injection of HBB can be applied as an effective drug for labor progress; however, further clinical studies with larger sample sizes are required to confirm these findings.

Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.

We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented with late PPH. Bilateral uterine artery ligation was done to conserve the uterus, however, the hemorrhage did not cease. In order to control the bleeding, embolization was suggested. During angiography, a pseudoaneurysm of the feeding femoral artery was noticed and embolization was performed to save the patient.

Uterine artery pseudoaneurysm is one of the uncommon causes of secondary postpartum hemorrhage and could lead to a life-threatening situation. Management should be multidisciplinary and the gold standard for treatment and diagnosis is through interventional radiology.

Mesonephric adenocarcinoma of uterine cervix is a rare variant of primary endocervical adenocarcinoma and a few cases have been reported previously. In fact in non-metastatic adenocarcinoma of the cervix, less than 5% possess mesonephric type. Because of the low incidence of mesonephric adenocarcinoma, various methods have been proposed for treatment of mesonephric adenocarcinoma. Nevertheless, there is no unity in treatment approaches.

Here, we present a 45-year woman who had bloody discharge for 6 months period. Hormonal profile such as thyroid stimulating hormon (TSH) and prolactin was normal and all imaging studies showed a cervical fibroma as a mass. Abdominal hysterectomy -bilateral salpingectomy was performed. After pathologic report as a mesonephric adenocarcinoma, she received radiation and then she was candidate for bilateral oophorectomy.

Because of the diversity and an unusual appearance of mesonephric adenocarcinoma with aproblematic case of cervical mass, it is very important to consider mesonephric adenocarcinoma as a type of diagnosis. Numerous differential diagnoses should be considered for management of this type of carcinoma. In order to make a diagnosis, deep biopsy of infiltrative mass of uterine cervix, is mandatory.

One of the rare ovarian neoplasms is sclerosing stromal tumor (SST). The most common age at presentation of sclerosing stromal tumor is the second and third decades of life. Usually this tumor presents with menstrual irregularity and pelvic pain as reported previously. Surgery is mandatory for diagnosis because there is not any distinctive feature to diagnose by imaging techniques.

Our case in this report is a 26-year-old woman presented with pelvic pain. We conducted routine laboratory tests and checked ovarian mass tumor markers preoperatively. Due to her normal hormonal status in physical examination, we did not request more hormonal laboratory tests. However on imaging, we did not suspect benign tumor. Doppler sonography showed low resistance flow in peripheral and center of the mass. Right ovarian mass was resected and diagnosed as ovarian stromal tumor compatible with sclerosing stromal tumor. Unexpectedly at operation, we encountered severe hemorrhage from peritoneal surface so that conservativemanagement such as packing and suturing or cauterization was not helpful. Finally, argon coagulation stopped bleeding. All coagulation laboratory tests requested by a hematologist were normal.

In conclusion, we believe that vascular endothelial growth factor (VEGF) production of tumor is responsible for massive bleeding.