Topic Review
Estro-Progestins and Pain Relief in Endometriosis
Endometriosis is a benign, hormone-responsive chronic disease that affects women of reproductive age; long-term treatment to balance satisfactory tolerability with clinical efficacy is necessary for these patients. The first-line therapy for endometriosis is predominantly medical treatment, in order to improve symptoms or prevent post-surgical disease recurrence. Multiple factors including age and women preference, pain severity, and endometriosis stage must be considered in the choice of the most suitable therapy. Estrogen-progestogins are generally used as first-line hormone therapies among different medical options currently effective for endometriosis management. Several studies have shown that they are able to improve pain symptoms in most patients, are well tolerated, and are inexpensive. Combined hormonal contraception treatment, administered cyclically or continuously, with different types of hormones and route of administration, results in clinically noticeable decrease in dysmenorrhea, noncyclic pelvic pain, dyspareunia, and recurrence rate after surgery, and also in quality of life improvement.
  • 39
  • 29 Jun 2022
Topic Review
Animal Models and Endometrioma-Related Infertility
Endometrioma (OMA) is the most common subtype of endometriosis, in which the endometriotic lesions are implanted in the ovary. Women with OMA are usually associated with infertility, presenting with reduced ovarian reserve, low oocyte quantity and quality, and poor fertility outcomes. However, the underlying pathological mechanisms in OMA-related infertility are still unclear. Due to the limitations and ethical issues of human studies in reproduction, animal models that recapitulate OMA characteristics and its related infertility are critical for mechanistic studies and subsequent drug development, preclinical testing, and clinical trials. 
  • 37
  • 29 Jun 2022
Topic Review
Cervical Cancer and Treatment
The premalignancy of the uterine cervix is preventable and treatable if neoplasia is detected early. “Screen-and-treat” is a commonly adopted clinical management for precancerous lesions. In general, the standard curative options for precancers include large loop excision of the transformation zone (LLETZ) or loop electrosurgical excision procedure (LEEP), cryotherapy, and cold knife conization, while for locally advanced cervical cancer, hysterectomy, radiotherapy, chemotherapy, and radiotherapy with concurrent chemotherapy and immunotherapy are offered to the patients.
  • 34
  • 28 Jun 2022
Topic Review
Reconstructive Surgery in Distal Tubal Disease
Tubal factor infertility is one of the most frequent causes of female infertility. Despite the rising usage of artificial reproductive technologies, surgery remains an important therapy option among this group of patients. However, the effectiveness of tubal reconstructive surgery against another treatment approaches has not been appropriately evaluated. There are no randomized controlled trials that compare surgery versus IVF or expectant management. Clinical practice is guided on the basis of observational studies. Researchers use different classifications and inclusion criteria. Surgical techniques are not uniform. As a result, published data differ substantially and interpreting of outcomes is consequently made more difficult. 
  • 47
  • 21 Jun 2022
Topic Review
Maternal and Fetal Intima-Media Thickness Assessment in Perinatology
Intima-media thickness (IMT) measurement is a non-invasive method of arterial wall assessment. An increased IMT is a common manifestation of atherosclerosis associated with endothelial dysfunction. In the course of pregnancy, various maternal organs, including the endothelium, are prepared for their new role. However, several pre-gestational conditions involving endothelial dysfunction, such as diabetes, chronic hypertension, and obesity, may impair the adaptation to pregnancy, whereas vascular changes may also affect fetal development, thus, influencing the fetal IMT. In fact, data indicate that following the delivery, the endothelial dysfunction persists and influences the future health of the mother and the newborn. 
  • 35
  • 16 Jun 2022
Topic Review
Treatment of Vulvovaginal Atrophy
Vulvovaginal atrophy (VVA) is a chronic progressive disease involving the female genital apparatus and lower urinary tract. This condition is related to hypoestrogenism consequent to menopause onset but is also due to the hormonal decrease after adjuvant therapy for patients affected by breast cancer. Considering the high prevalence of VVA and the expected growth of this condition due to the increase in the average age of the female population, it is easy to understand its significant social impact. VVA causes uncomfortable disorders, such as vaginal dryness, itching, burning, and dyspareunia, and requires constant treatment, on cessation of which symptoms tend to reappear. 
  • 86
  • 14 Jun 2022
Topic Review
Fertility after Cancer
Approximately one million new cases of cancer are diagnosed in women of reproductive age every year. In the last few decades, advances in early diagnosis and treatment have improved the survival rate. However, the adverse effects of anticancer therapy on the ovaries and uterus have a significant impact on future fertility and may affect the quality of life of cancer survivors. Impaired fertility in cancer survivors is a growing issue that is complicated by an increasing number of women delaying childbearing.
  • 124
  • 10 Jun 2022
Topic Review
The Role of Cancer-Associated Fibroblasts in Ovarian Cancer
Ovarian cancer is a lethal gynecologic tumor and is generally resistant to conventional treatments. Stable cancer-associated fibroblasts (CAFs) are important cellular components in the ovarian cancer tumor microenvironment and may provide novel resources for future treatment strategies. Different subtypes of CAFs display specific functions in tumor pathogenesis and various CAF markers suggest potential treatment targets. Several clinical or preclinical trials have targeted stromal fibroblasts and focused on the properties of CAFs to enhance ovarian cancer treatment efficacy. 
  • 76
  • 01 Jun 2022
Topic Review
Fournier’s Gangrene Therapy in Gynecological Patients
Fournier’s gangrene (FG) is a serious pathology of the soft tissues and fascia of the perineum and genital region with a high morbidity and mortality rate. In recent years, the SGLT-2 inhibitor oral antidiabetic has been related to this entity. According to the new warnings from the main drug agencies, a compilation of cases has been initiated to establish or deny a possible causal relationship. Most of these cases have been reported in men. However, it is important not to underestimate this entity in the gynecological field, since it is extremely serious and requires intense and rapid aggressive treatment based on surgery and empiric antibiotherapy. Later, some cares are needed to involve surgical reconstruction of the defects introduced by debridement. As a result of the low incidence of FG, clinical trials’ data may be insufficient to robustly assess this issue because of the limited numbers of participants. Real-world evidence may help to clarify the association between SGLT2i and FG. 
  • 50
  • 26 May 2022
Topic Review
Cervical Regeneration after Loop Electrosurgical Excision Procedure
Cervical intraepithelial neoplasia (CIN) is a precursor of cervical cancer, and the most common CIN treatment is a loop electrosurgical excision procedure (LEEP). Advantages include patient compliance, outpatient setting, low cost, ease of learning for professionals, and availability of removed tissue for histological assessment, providing information on CIN severity and excision margins. At the same time, there are data that women after LEEP are predisposed to obstetrical complications including preterm birth. More efforts have to be made to study the pathogenic mechanism that leads to preterm birth.
  • 55
  • 25 May 2022
  • Page
  • of
  • 15