Size Of Ovarian Cysts Research Articles

Effect of Callisthenic Exercises vs Yoga on Health Related Quality of Life, Lipid Profile, Anthropometric Measurements and ultrasonography Findings in Polycystic Ovarian Syndrome: A Research Protocol

Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder, and individuals with this condition are at a risk of developing complications like metabolic syndromes throughout their lifetime. Not much is known about studies reporting the combined effects of calisthenic exercise with either aerobic exercise or progressive resistive exercises that have shown positive outcomes in PCOS. Need for the study: Extensive literature search has revealed gaps in reporting the individualised effects of calisthenic exercise in PCOS and its comparative effects with yoga. The present research article presents a study protocol comparing calisthenic exercises and yoga protocols prescribed for women with PCOS. Aim of the study: To evaluate and compare the effects of calisthenic exercises and yoga in women with PCOS. Materials and Methods: This research protocol is planned to conduct a randomised clinical trial in Belagavi, Karnataka, India, and will employ a randomised, open-label, parallel-armed, double-blinded clinical experimental design. The duration of the study will be near bout four years, from June 2022 to August 2026. A total of 102 females with PCOS, aged between 18 and 35, will be randomly allocated to either a yoga group (N=51) or a calisthenic exercise group (N=51). For a period of 1½ months (i.e., six weeks), group therapy sessions will be held five times a week. Ultrasonography scans, which will assess ovarian cyst count and size, ovarian volume, and total lipid profile, will be conducted twice (pre- and post-intervention). The PCOS Questionnaire (PCOSQ-26) will be utilised to assess healthrelated quality of life, as well as anthropometric measurements such as waist-hip ratio and Body Mass Index (BMI). These measurements will be assessed prior to the intervention, six weeks following the intervention, and at the 12-week followup. Inferential as well as statistical methods will be used to analyse the gathered data. A test for normal distribution will be conducted, depending on whether parametric tests (Z test and/ or ANOVA) or non-parametric tests (Mann-Whitney U test or Wilcoxon signed-rank test) will be performed. A probability value of less than 0.05 will be considered statistically significant.

Can Tibetan medicine Honghua Ruyi pills relieve endometriosis-associated dysmenorrhea? Protocol for a randomized placebo-controlled trial

ObjectiveTo provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi (HHRY) pills for endometriosis-associated dysmenorrhea. MethodsThis study constitutes a multicenter, randomized, double-blind, placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period. A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio. The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale (VAS) scores and quality of life, whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain, duration of pain episodes (in days), frequency and quantity of the consumption of ibuprofen sustained-release capsules (or other non-steroidal anti-inflammatory drugs), and days off work/study for staff/student due to dysmenorrhea, ovarian cyst, and/or pelvic nodule size. The safety was monitored throughout the treatment period. All the analyses were based on the intention-to-treat principle. For continuous outcomes, simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups, with categorical data expressed as the number and percentage of occurrences. Differences were compared using the chi-square test or Fisher's exact test. The predefined analysis was adjusted for concomitant treatment, a variable considered to be associated with outcomes but unaffected by treatment allocation. Estimates of treatment effects were reported with 95% confidence intervals. Two-tailed P values ≤ .05 were considered statistically significant. ConclusionPositive results from this trial, upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

A successful pregnancy complicated with ovarian cyst torsion in the first trimester

Introduction: Ovarian cyst torsion is a rare gynecological emergency characterized by acute abdominal pain due to torsion of the ovarian vascular pedicle. Most cases are associated with several risk factors including pregnancy, ovarian cyst size, and pelvic organ anatomy. Despite the incidence of detected ovarian cysts during pregnancy increasing along with better antenatal care, the clinician needs to consider appropriate management for the safety of the mother and fetus. Case description: A 25-years old woman who was pregnant with a gestational age of 10 weeks was referred to the Emergency Department of Zainoel Abidin General Hospital. The patient complained of sudden abdominal pain at the lower right abdominal quadrant within the last 5 hours before hospital admission. The patient stated the history of the ovarian cyst based on previous ultrasonography assessment on previous antenatal care. Abdominal tenderness on the relevant quadrant was positive during the physical examination. A vaginal examination revealed a regular non-tender cystic mass with a diameter of 5 cm on the right adnexa. The ultrasonographic finding showed the presence of a cystic mass on the right ovary with a size of 6.52 cm x 5.6 cm x 4.06 cm and a positive whirlpool sign. The patient was diagnosed with ovarian cyst torsion in the first trimester of pregnancy. Due to the patient refractoriness to conservative management, the patient was treated surgically by cystectomy laparotomy in an emergency setting. Histopathology examination of the intraoperative specimen revealed a luteoma. The pregnancy was successfully maintained until full-term pregnancy and the baby was delivered by caesarian section due to malposition. Conclusion: Appropriate supportive management was required to maintain pregnancy and prevent fetal loss.

Comparison of the Effect of Honey, Olive, Propolis Combined Vaginal Cream With OCP in the Treatment of Functional Ovarian Cysts in Women of Reproductive Age Referring to Health Centers, Hamadan, Iran 2020-2021

Background: The prevalence of functional ovarian cysts in women is high, and choosing an appropriate, and uncomplicated treatment is necessary. Objective: Compare the effectiveness of honey, olive, and propolis combined vaginal cream with OCP in the treatment of functional ovarian cysts in women of reproductive age in Iran. Methods: This randomized clinical trial study was performed on 40 women of reproductive age referred to Hamadan health centers in 2020. Patients were randomized into two groups, A and B. Group A received oral contraception pills for two consecutive cycles from the seventh day of the menstrual cycle tablets for 21 days after the end of menstruation until the beginning of the next menstruation. Group B received honey, olive, propolis combined vaginal cream. In both groups, the treatment continued for two consecutive cycles. Data was collected through a checklist that included clinical symptoms and ultrasound results. The results were analyzed by Stata-13 and the significance level cut-off was considered less than 0.05. Results: Intra-group comparisons showed that there was a statistically significant (P < 0.05) decrease in cyst size after the intervention in both groups. Intergroup differences were not statistically significant (P ˃ 0.05). Conclusion: Honey, olive, propolis combined vaginal cream (Nika) can be effective like oral contraceptive pills in reducing the size of ovarian cysts. It can be recommended for the treatment of functional ovarian cysts. Clinical Trial Registration Number: IRCT20120215009014N384

The presence of ovarian endometrioma adversely affect ovarian reserve and response to stimulation but not oocyte quality or IVF/ICSI outcomes: a retrospective cohort study

BackgroundThe possible impact of ovarian endometriomas (OMAs) on in vitro fertilization (IVF) outcomes remains controversial. Therefore, this study aimed to assess the impact of OMAs on IVF cycle parameters, including ovarian reserve and response to stimulation, embryo quality and pregnancy outcomes.MethodsThis retrospective cohort study included 2067 patients undergoing their first IVF/ICSI cycles between January 2018 and December 2020. The study group included 154 infertile women who had OMAs. The control group consisted of 1913 women without endometriosis, and finally 305 women were matched according to maternal age, body mass index (BMI), and infertility duration by propensity score matching (PSM). Cumulative live birth rate (CLBR) was set as the primary outcome measure. Logistic regression analysis was conducted on the basis of clinical covariates assessed for their association with CLBRs. Subgroup analyses were performed to evaluate the effect of ovarian surgery, cyst size and laterality on CLBRs.ResultsWomen with OMAs had significantly lower ovarian reserve markers (AMH and AFC), number of follicles, oocytes, embryos, and top-quality embryos than women in the control group (p < 0.05). However, the CLBRs were comparable between the two groups (55.64% versus 54.34%, p = 0.806), regardless of previous history of ovarian surgery. Multivariate analysis revealed association between age (OR = 0.861; 95% CI [0.806–0.921]; p = 0.000), top-quality embryos (OR = 1.829; 95% CI [1.526–2.193]; p = 0.000) and the CLBRs. A negative correlation between OMA size and AFC levels in patients with unoperated OMAs was detected (r = -0.264, p = 0.007). Meanwhile, significant decrease in ovarian reserve with lower AFC, fewer oocytes, embryos and top-quality embryos were observed in patients with OMAs size ≥ 6 cm (p < 0.05). Moreover, ovaries with OMAs had a significantly lower AFC (P = 0.006) but similar number of oocytes when compared with contralateral ovaries without OMAs.ConclusionInfertile women with OMAs were implicated in considerable decreases in ovarian reserve and response to stimulation, but no apparent adverse effects on oocyte quality or clinical outcomes. OMAs surgery and OMAs size may adversely affect ovarian reserve, but not CLBR.

Down Syndrome and Van Wyk-Grumbach Syndrome: A Rare Presentation

Van Wyk-Grumbach Syndrome (VWGS) is presented by juvenile hypothyroidism, delayed bone age and isosexual precocious puberty. All of the features will be reversed with treatment of the underlying thyroid hormone deficiency. It has been described, a 3- year-old girl with Down Syndrome who presented with per vaginal bleeding. Physical examination showed typical morphologic features of Down Syndrome and hypothyroidism. Pubertal developments in tanner stages were: breast at stage II and pubic hair at stage I. Serum TSH level was very high. Serum FSH, LH and Estrogen level were also high for her age. On radiological examination her bone age was 2 years. Her pelvic sonogram revealed enlarged uterus with ovarian cysts. These findings confirmed the diagnosis of VWGS. Treatment with Levothyroxine, her vaginal bleeding did not recur and ovarian cyst size decreased after 4 weeks and disappeared after 2 months. In conclusion, thyroid hypo-function must be investigated in children who have precocious puberty with multicystic enlarged ovaries. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 97-99

Rare Case: Ovarian Cysts in Child

An ovarian cyst is a sac filled with liquid or semiliquid material that arises in an ovary. Those cysts were mostly found in women aged 20-50 years. The incidence is 10: 100.000 women. This report reports a case of a child patient aged two years who came to Arifin Achmad Hospital with a chief complaint there is a mass in the lower abdomen area. From the physical examination, the lump in the lower abdomen area was obtained. We performed, laparotomy exploration with cystectomy and found a left ovarian cyst size 12 x 12 x 15 cm.

Diagnostic failures in ovarian torsion during childhood: The effect of ovarian cyst size on the diagnostic accuracy of Doppler ultrasonography.

AbstractPurposeTo determine the diagnostic accuracy of Doppler ultrasonography (US) in pediatric ovarian torsion (OT) and the effect of ovarian cyst size on the effectiveness of Doppler US in pediatric OT.MethodsWe retrospectively reviewed of the data of 84 patients (4–17 years) operated with the preliminary diagnosis of OT from January 2007 to December 2019. Patients' demographic characteristics, clinical signs and symptoms, laboratory and radiologic findings, operative management, histopathological results, and postoperative complications were recorded.ResultsOT was surgically confirmed in 53 (63%) patients. In 30 patients without ovarian cyst, Doppler US suggested OT in 16 out of 22 patients with surgically confirmed OT. In 12 patients with ovarian cysts &lt;5 cm, Doppler US suggested OT in 7 out of 8 patients with surgically confirmed OT. In 42 patients with ovarian cysts ≥5 cm, Doppler US suggested OT in 13 out of 23 patients with surgically confirmed OT. Accuracy of Doppler US in these groups were found to be 73%, 83%, and 47%, respectively.ConclusionGray scale and Doppler US have better performance in patients without ovarian cysts and with cysts smaller than 5 cm and help improve the diagnosis of OT. In patients with ovarian cyst ≥5 cm, accuracy of Doppler US is low. Thus, in the presence of ovarian cyst ≥5 cm and the clinical findings compatible with OT, laparoscopy must be strongly considered.

Ovarian Cysts Management Following Laparoscopic Surgery

Objective: To analyze diagnostic and surgical outcomes in patients with extremely large ovarian cysts treated by laparoscopic surgery.&#x0D; Methods: A total of 120 cases of large adnexal masses and suspected for malignancy were treated laparoscopically at the at general surgery department of Liaquat University of Medical &amp; Health Sciences. Under endotracheal anesthesia, all surgeries were performed using nasogastric tubes in the stomach. An incision of approximately 1.5 centimeter was made at the supraumbilical or umbilical region and peritoneal cavity was approached. The intra-abdominal approach in all cases was cautiously standardized. The resection of the adnexal mass was performed as per routine method.&#x0D; Results: 12 females were premenopausal and 8 were postmenopausal. 12 women presented with the signs of urinary retention, urinary urgency and abdominal pain. Incidental sonography detected cysts in 8 patients which were asymptomatic. The average volume of the resected cystic fluid was 3000ml (range 900 to 9000 ml). The specimens of frozen section were obtained within the surgical procedure in all patients except 2 patients having para-ovarian cysts. The histopathology presented mucinous benign cystadenoma. There was no blood loss and related other complications reported in all operations.&#x0D; Conclusion: Laparoscopic management of large ovarian cyst observed to a effective, feasible and less complicated surgical option. However accurate selection and diagnosis of the patients, the any ovarian cyst size can be treated easily via laparoscopic surgery.

Benign Ovarian Cysts with Raised CA-125 Levels: Do We Need to Evaluate the Fallopian Tubes?

Objectives It is not clearly known whether some benign (simple) ovarian cysts can convert into cancerous cysts. Size of cyst and wall abnormalities do predict the potentiality of malignancy. Not many studies have been done to explore the malignant potential of large-sized (> 5 cm) unilocular ovarian cysts without wall abnormalities. This study evaluated the correlation between ultrasonographic size of benign ovarian cysts and carbohydrate antigen 125 (CA-125) levels. Methodology Sixty (60) premenopausal women were recruited for the study preoperatively, based on transvaginal ultrasound (TVUS) findings present in the case record sheet received along with the CA-125 sample in the biochemistry laboratories. Those cases with elevated CA-125 levels were selected, where patients had unilocular ovarian cysts without wall abnormalities. CA-125 was done using ECLIA methodology (Cobas e411, Germany). Statistical correlation was calculated between the ovarian cyst size and CA-125 levels using Spearman’s Rho coefficient. Results Mean age group of subjects were 29.7 ± 7.3 years and mean value of CA-125 (normal < 35 IU/mL) was found to be increased: 118.0 ± 147.1 IU/mL so was the mean diameter of cysts (cut off ≤ 5 cm): 48.6 ± 59.8 cm. No correlation was found between CA-125 levels and volume of ovarian cyst ( r = 0.005, p = 0.680) for all subjects. Conclusions The lack of correlation between size of ovarian cysts and CA-125 levels provides a hint that the ovarian cyst epithelium does not directly express CA-125 and it may come from sites like the fallopian tube. Thus, raised level of CA-125 in benign ovarian cyst should be followed-up more closely, demanding assessment of fallopian tubes for early diagnosis of ovarian cancer. Also, algorithms can be explored to include size of ovarian cyst and CA 125 levels to predict ovarian cancer.

Atypical endometriosis is related to a higher recurrence rate

ObjectivesThe aims of this study were to evaluate the clinical characteristics and recurrence rate of atypical endometriosis (AE)11AE: Atypical endometriosis, ASRM: American Society of Reproductive Medicine, EAOC: Endometriosis-associated ovarian cancer, RR: Relative risk, TE: Typical endometriosis. compared to typical endometriosis (TE) in addition to the malignant transformation rate among a large cohort. Study designThe medical records of 2681 patients who had undergone surgical treatment of ovarian endometrioma between January 2008 and September 2019 were retrospectively reviewed. The patients were divided into AE (n = 86) and TE (n = 2595) groups. Patients’ characteristics and recurrence rates were evaluated and compared between the two groups. ResultsThe mean size of ovarian cysts was significantly larger in the AE group (7.6 ± 3.5 cm vs 6.7 ± 3.3 cm, p = 0.01) and the proportion of nulliparous women was significantly lower in AE group (65.1 % vs 77.8 %, p = 0.008). Otherwise, there were no statistically significant differences in patient characteristics between the two groups. After Cox regression analyses with IPTW was adjusted, the risk factors for recurrent endometrioma were higher preoperative CA125 level >48 U/mL (hazard ratio [HR] = 2.741; 95 % confidence interval [CI] = 1.517−4.952; p < 0.001), multilocular cyst (HR = 1.909; 95 % CI = 1.128−3.230; p = 0.016), and atypical endometriosis (HR = 2.666; 95 % CI = 1.659−4.284; p < 0.001). The AE group displayed a significantly higher cumulative recurrence rate than the TE group (p = 0.0057, log-rank test). No patients were diagnosed with atypical endometriosis to malignant transformation during the follow-up periods. However, two typical endometriosis patients experienced borderline malignancy and serous carcinoma, respectively. ConclusionRecurrence rates for AE were higher than for TE. Although the AE group included no patient with malignant transformation in this study, considering the higher recurrence as well as the possibility of malignant transformation, long-term close surveillance is warranted.

The relationship of ovarian endometrioma and its size to the preoperative serum anti-Mullerian hormone level.

The aim of this study is to evaluate the impact of ovarian endometrioma according to its size on the serum anti-Mullerian hormone (AMH) levels compared to that of other benign ovarian cysts. The current study retrospectively evaluated preoperative serum AMH level and its association to presenting ovarian cyst size which were measured in clinical setting. Women with surgically diagnosed endometrioma or other benign ovarian cysts were included. All patients underwent transvaginal or transrectal ultrasonography to determine the size of the ovarian cysts. Preoperative serum AMH level was checked and evaluated according to histologic type of the cyst, which were endometrioma or other benign ovarian cysts, respectively. Both groups were classified into ≤ 4 cm, > 4 cm and ≤ 8 cm, > 8 cm and ≤ 12 cm, > 12 cm according to the diameter of cyst and analyzed the difference of mean AMH levels in both groups. There was no significant difference in preoperative serum AMH level between the two groups (3.36 ± 2.3 versus 3.76 ± 2.64, p = 0.331). The difference of preoperative AMH levels according to categorized cyst size also was not statistically significant in both groups. Preoperative serum AMH levels were not statistically different between endometrioma and other benign ovarian cyst groups and were not related to the size of endometrioma.

Efficacy of Virechana, Triphaladi decoction with processed Guggulu in the management of ovarian cyst - A pilot study.

Background:Ovarian cyst is an emerging problem among the women of reproductive age group. Most of the ovarian cyst (80%–85%) are benign, and two-thirds of these occur in women between 20 and 44 years of age. They may be identified in asymptomatic women during routine pelvic examination or may produce symptoms. Management of the ovarian cyst through surgery is available to meet urgent need of the patient, but to establish a satisfactory conservatory medical treatment is the need of the hour. According to Ayurveda, ovarian cysts can be managed on the line of Kaphaja Granthi (nodular/glandular swellings by Kapha Dosha) and Vidradhi (abscess).Aim:The aim of this study was to evaluate the clinical efficacy of Virechana (therapeutic purgation), Triphaladi Kashaya (decoction) with processed Guggulu (Commiphora mukul Engl.) in the management of ovarian cyst.Materials and methods:16 patients were included in this clinical study and among them, 15 patients completed the treatment and one patient was dropped out from the trial. Patients were given Virechana followed by Triphaladi Kashaya (50 ml) with processed Guggulu (1 g) orally twice a day before meal for 60 days. The patients were followed up till 1 month. The assessment was carried out on subjective parameters such as lower abdominal pain, backache, and dysmenorrhea as well as objective parameters such as ovarian cyst size and volume by four-dimensional gray scale and color doppler sonography. Cancer antigen 125 was also assessed before and after treatment. Results were statistically analyzed using Wilcoxon signed-rank test and Student's t-test by sigma statistical tool (version 3.5, Systat Software Inc., United States).Results:Significant results were observed in subjective parameters such as lower abdominal pain (93.11%), backache (81.81) and dysmenorrhea (90.90%) as well as objective parameters such as reduction in size of the cyst (60%) and complete resolution of the cyst (26.66%).Conclusion:Triphaladi Kashaya with processed Guggulu is more effective in hemorrhagic cyst and simple cyst rather than other cyst, due to Shothahara properties which may have effectively curtailed the progress of ovarian cyst.

Korean Red Ginseng alleviates dehydroepiandrosterone-induced polycystic ovarian syndrome in rats via its antiinflammatory and antioxidant activities

BackgroundBeneficial effects of Korean Red Ginseng (KRG) on polycystic ovarian syndrome (PCOS) remains unclear. MethodsWe examined whether pretreatment (daily from 2 hours before PCOS induction) with KRG extract in water (KRGE; 75 and 150 mg/kg/day, p.o.) could exert a favorable effect in a dehydroepiandrosterone (DHEA)-induced PCOS rat model. ResultsPretreatment with KRGE significantly inhibited the elevation of body and ovary weights, the increase in number and size of ovarian cysts, and the elevation of serum testosterone and estradiol levels induced by DHEA. Pretreatment with KRGE also inhibited macrophage infiltration and enhanced mRNA expression levels of chemokines [interleukin (IL)-8, monocyte chemoattractant protein-1), proinflammatory cytokines (IL-1β, IL-6), and inducible nitric oxide synthase in ovaries induced by DHEA. It also prevented the reduction in mRNA expression of growth factors (epidermal growth factor, transforming growth factor-beta (EGF, TGF-β)) related to inhibition of the nuclear factor kappa-light-chain-enhancer of activated B cell pathway and stimulation of the nuclear factor erythroid–derived 2-related factor 2 pathway. Interestingly, KRGE or representative ginsenosides (Rb1, Rg1, and Rg3(s)) inhibited the activity of inflammatory enzymes cyclooxygenase-2 and iNOS, cytosolic p-IkB, and nuclear p–nuclear factor kappa-light-chain-enhancer of activated B in lipopolysaccharide-induced RAW264.7 cells, whereas they increased nuclear factor erythroid–derived 2-related factor 2 nuclear translocation. ConclusionThese results provide that KRGE could prevent DHEA-induced PCOS via antiinflammatory and antioxidant activities. Thus, KRGE may be used in preventive and therapeutic strategies for PCOS-like symptoms.

Effects of Fertility Massage and Conventional Exercises In Poly Cystic Ovarian Syndrome

We determined the effects of fertility massage and conventional exercises in reducing the waist hip ratio, ovarian cyst size and stress level among women with poly cystic ovarian syndrome. Study included 30 females who are diagnosed with poly cystic ovarian syndrome. Each group consists of 15 participants who were assessed for waist hip ratio, ovarian cyst size and perceived stress level with an intervention of 6 weeks. Comparison between Fertility Massage Group A and Conventional Exercises Group B, shows the waist hip ratio measurements have significant difference between the groups with the P value (0.0293), Perceived stress level between the group also shows significant changes in the post test with a P value (0.0351) and Ovarian Cyst Size was decreased in posttest when compared to pretest scores with a P value (0.0001) Thereby the post test scores of Group A is lesser than the Group B. Therefore from this study it is concluded that fertility massage along with conventional exercises is more effective than conventional exercises in treating women with poly cystic ovarian syndrome.

The effects of sclerotherapy with 5% trichloroacetic acid on the cyst diameter and ovarian tissue in the rat ovarian cyst model

The aim of this study was to compare the effects of only aspiration with aspiration and 5% trichloroacetic acid (TCA) application on ovarian cyst size and ovarian reserve. The ovarian cysts of 14 rats that were divided into two groups randomly were investigated after total salpingectomy procedure. G1 was the group of saline application after cyst aspiration, while in G2, after aspiration 5% TCA at half amount of aspiration volume was injected into the cyst and re-aspirated after five minutes. The abdomens of the rats were closed and re-explored after 1 month. The cyst diameters of the rats in each group were measured. Ovaries were removed for histopathological examination. There was no significant difference in cyst diameter in G1 before and after aspiration. In G2, there was a significant decrease in cyst size after TCA application. Ovarian follicle counts were not significantly different between the two groups. In conclusion, application of 5% TCA to the ovarian cysts for five minutes significantly reduces the cyst size.Impact StatementWhat is already known on this subject: Minimally invasive therapies come into prominence to avoid surgical complications and diminished fertility in the treatment of ovarian cysts. USG-guided aspiration and sclerosis has been reported as cost-efficient and effective treatment methods for localised benign cysts in other organs such as the thyroid, parathyroid, liver, kidney and spleen. It has been shown that sclerotherapy applied to infertile women with ovarian cysts reduces pelvic pain without affecting the number of follicles, term pregnancy and abortion rates, extracted oocytes, embryo quality or hormonal levels when compared to non-ovarian cystic infertile women. TCA is a chemical agent that is topically applied, not systemically absorptive, which causes denaturation of proteins and structural cell death, resulting in coagulation necrosis after chemical cauterisation. For this reason, we used 5% TCA to treat simple ovarian cysts on a rat model.What the results of this study add: In this experimental study, we showed that the application of 5% TCA into the cyst for five minutes – then aspirated – significantly reduced the size of the ovarian cysts. Five percent TCA application did not affect the ovarian reserve.What the implications are of these findings for clinical practice and/or further research: Our study is original because of the fact that to the best of our knowledge, this is the first study about the use of 5% TCA in treatment of ovarian cysts in the literature.

SR-16234, a Novel Selective Estrogen Receptor Modulator for Pain Symptoms with Endometriosis: An Open-label Clinical Trial.

SR-16234 is a selective estrogen receptor modulator (SERM) structurally different from approved SERM and has been reported to have estrogen receptor (ER) α antagonistic activity and strong affinity with a weak partial agonistic activity to ERβ receptor. SR-16234 showed strong inhibitory effects on transplanted endometrial cysts in the endometriosis model of rat and mouse. In this clinical trial, efficacy and safety of SR-16234 have been evaluated in endometriosis patients. This trial was an open-label single arm clinical trial. Ten patients with dysmenorrhea and pelvic pain associated with endometriosis and adenomyosis were enrolled in this trial, and received 40 mg of SR-16234 once daily for 12 weeks. The primary endpoint was the visual analogue scale (VAS) of pelvic pain. The secondary endpoints included dysmenorrhea score, pelvic pain score, objective observations (stiffness of Douglas' pouch, limitation of uterine movement, size of ovarian chocolate cysts, thickness of endometrium, and serum CA125 concentration) and safety. After oral administration of SR-16234 40 mg for 12 weeks, there were statistically significant decreases in pelvic pain VAS, total pelvic pain score, total dysmenorrhea score, stiffness of Douglas' pouch, limitation of uterine movement compared with the baseline values. The present trial suggested that a selective estrogen receptor modulator could be used for treatment of pain associated with endometriosis for the first time.

Contribución al estudio de los quistes del paraovario

Los quistes del paraovario son tumores de naturaleza benigna que tienen su origen en el órgano de Rosenmüller, epoóforo o paraovario (restos del cuerpo de Wolff) que se encuentra situado entre las hojas del ligamento ancho y cuya etiología no es conocida hasta el momento. En nuestra casuística del Pabellón 5, Sala II del Hospital Arzobispo Loayza, encontramos que de 2,746 ginecópatas 19 eran portadoras de quiste paraovárico, es decir en un 0.69 %. Observamos igualmente que por cada 100 quistes del ovario hay de 7 a 8 quistes del paraovario, lo que nos indica qure no dejan de ser frecuentes. La edad en que se presentaron con más frecuencia oscila entre los 20 a 30 años. Los quistes del paraovario en general son de mediano tamaño, así lo confirma nuestra casuística y nunca alcanzan el tamaño de los grandes quistes del ovario, aunque hay casos excepcionales por su volumen (Forgue, Hummel y Lawson). Los síntomas se presentan cuando el tumor adquiere cierto volumen y en nuestro estudio los síntomas se presentaron, en orden de frecuencia, como sigue: dolor, tumor, adormecimiento de miembros inferiores, náuseas y vómitos, síntomas urinarios y metrorragia. El diagnóstico es muy difícil. Cuando son palpables se confunden por su localización, movilidad y consistencia con los quistes del ovario a tal punto que es casi imposible diferenciarlos. El examen ginecológico puede darnos alto porcentaje de certeza cuando encontramos el ovario separado de la tumoración quística. Como métodos auxiliares de diagnóstico señalamos la pneumoginecografía con histerosalpingografía y la culdoscopía. La complicación más frecuente encontrada por nosotros es la torción del pedículo del quiste. EI tratamiento de los quistes del paraovario es su extirpación quirúrgica, procurando ser conservadores.

Compared with Feeding Infants Breast Milk or Cow-Milk Formula, Soy Formula Feeding Does Not Affect Subsequent Reproductive Organ Size at 5 Years of Age ,

Background: Literature reports suggest that phytochemicals, such as isoflavones found in soybeans, impair reproductive function in animals and raise the possibility that consuming soy infant formula could alter hormonally sensitive organ development in children.Objective: This study compared reproductive organs volumes and structural characteristics in children at age 5 y who were enrolled in the Beginnings study long-term cohort.Methods: Breast bud, uterus, ovaries, prostate, and testes volumes and characteristics were assessed by ultrasonography in 101 children (50 boys and 51 girls) aged 5 y who were breastfed (n = 35) or fed cow-milk formula (n = 32) or soy formula (n = 34) as infants. Analyses were adjusted for race, gestational age, and birth weight.Results: Among girls, no significant differences were found in breast bud, ovarian, or uterine volumes; counts of ovaries with cysts; ovarian cysts numbers; ovarian cyst size; and uterine shape between the diet groups. Among boys, no significant differences were found in breast bud, testes, or prostate volumes or structural characteristics between the diet groups.Conclusions: In this cohort, no early infant feeding effects were found on reproductive organs volumes and structural characteristics in children age 5 y. The follow-up of these children through puberty is planned and should help delineate potential early infant feeding effect on reproductive function later in life. This trial was registered at clinicaltrials.gov as NCT00616395.

The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts.

ObjectivesTo examine the effect of 95% ethanol sclerotherapy (EST) administered over 5 minutes on cyst diameter and ovarian tissue in experimentally induced simple ovarian cysts in a rat model.Materials and methodsIn order to induce ovarian cysts, unilateral total salpingectomy was performed in regularly menstruating adult female Wistar albino rats (n=20) between 12 and 14 weeks of age and weighing between 200 and 220 g. One month after the procedure, the abdominal cavity was opened and 14 rats (70%) were found to have developed macroscopic cysts. Rats with macroscopic cysts (n=14) were assigned into two groups in a prospective and single-blinded manner: group 1 (G1) (n=7), control rats; and group 2 (G2) (n=7), 5-minute EST 95% group. Cyst diameter was measured and recorded for each rat. In G2, after whole cyst fluid was aspirated the cystic cavity was irrigated with 95% ethanol, approximately equal to half of the aspirated cyst volume, after which an interval of 5 minutes was allowed and same amount was re-aspirated and the abdominal cavity was closed. One month after this procedure, abdominal cavities were reopened and intra-abdominal adhesion scoring was performed in both groups. Cyst diameter was measured for each rat, and the right ovary was removed, fixed in 10% formaldehyde, and transported to the laboratory. A histologic assessment of the ovarian tissues was performed under light microscopy following staining with hematoxylin and eosin. Mann–Whitney U-test was used for statistical analysis. A P-level less than 0.05 was considered significant.ResultsIn comparison with G1, there was a statistically significant reduction in the mean ovarian cyst dimensions in G2, while there were no significant differences between the two groups with respect to total number of follicles. Again, a significant increase in apoptotic activity and germinal epithelial degeneration was observed in G2 as compared to G1. The two groups were similar in terms of adhesion formation.ConclusionAlthough 95% EST results in a reduction in the size of simple ovarian cysts, this effect seems to be achieved at the expense of ovarian tissue injury.