Primary invasive vaginal carcinoma

Article Abstract:

One to 2 percent of cancers affecting the female genital tract are due to primary invasive carcinoma of the vagina. Two main factors influencing survival, the stage of the disease and effectiveness of treatment, were assessed by reviewing 91 cases diagnosed at the Medical University of South Carolina between January 1970 and December 1989. There were 76 squamous carcinomas, a cancer of the flat, scaly, epithelial cells lining the surface of the vagina; 12 adenocarcinomas, a cancer of the glandular cells of the vagina; and three undifferentiated carcinomas, or cancers of cells that have remained in the embryonic stage. Staging is a method of classifying tumors by the extent of their development. The modified version of the International Federation of Gynecology and Obstetrics staging system was used to evaluate these cases of primary invasive vaginal carcinoma. There were 25 patients with stage I disease, 39 with stage II, 15 with stage III, and 12 with stage IV disease. The percentage of patients surviving up to five years was 73 percent for stage I, 39 percent for stage II, 38 percent for stage II, and 25 percent for stage IV disease. Sixteen percent of patients had been previously treated with radiation of the pelvis, and 21 percent also had invasive cancer of the cervix, the opening of the uterus. The cancer was detected during routine examination of vaginal cells in 17 percent of patients. In 10 percent of the women the cancer was without symptoms, but was diagnosed after discovery of a mass. A mass, along with symptoms was found in 72 percent of the patients. Radiation treatment was performed in 87 percent of patients. The factors associated with increased survival included younger age, less advanced disease, and absence of symptoms at diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Identification and classification, Cancer, Cancer treatment, Radiotherapy, Tumors, Vaginal cancer

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Been there - done that: surgical challenges

Article Abstract:

A gynecologic surgeon with 37 years of experience at a teaching hospital gives tips on how to manage difficult gynecologic conditions. Included are tips on pelvic relaxation, enterocele, uterine or vaginal prolapse, rectovaginal fistula, cervical fibroid, peritoneal inclusion, ovarian remnant, vaginal endometriosis, myomectomy at cesarean section, and severe uterine atony. Surgeons must have complete knowledge of the anatomy and blood supply of the reproductive organs and their relationship to other structures.

Methods, Gynecology, Operative, Gynecological surgery

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The changing tides in obstetrics and gynecology

Article Abstract:

The president of the American Gynecological and Obstetrical Society documents the changes in medicine and in obstetrics and gynecology since he entered medical school in 1955. Many of the changes have not been positive ones.

Medicine, History, History of medicine

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