Laparoscopic ovarian transposition in patients with pelvic cancer

2014 ◽  
Vol 20 (4) ◽  
pp. 207-212
Author(s):  
Kastytis Žilinskas ◽  
Živilė Sabonytė-Balšaitienė ◽  
Narimantas Evaldas Samalavičius
Keyword(s):  
Rectal Cancer ◽  
Ovarian Function ◽  
Vena Cava ◽  
Premenopausal Women ◽  
Tumor Stage ◽  
Reproductive Age ◽  
Stage Iii ◽  
Ovarian Transposition ◽  
Hospitalization Period ◽  
Pelvic Cancer

Background. The aim of this study was to evaluate the feasibility of laparoscopic ovarian transposition prior to radiation therapy on the preservation of hormonal function in the treatment of pelvic cancer. Materials and methods. A chart review of premenopausal women diag­nosed with pelvic cancer, who underwent laparoscopic ovarian transposition to paracolic gutters, then received preoperative radiotherapy at the Center of Oncosurgery, Oncology Institute of Vilnius, from January 2010 to July 2013. Results. A total of 14 patients underwent laparoscopic ovarian transposition. Patients were divided into two groups by localisation of can­cer: 2 (14.29%) patients diagnosed with rectal cancer and 12 (85.71%) with cervical cancer. Patients’ age was from 24 to 42  years with a mean age of 33.71 (SD  ±  5.22) years. The average age of the patients in the first group was 26 (SD ±  2.83) years. In the second group women, aged 29 and 42 years with a mean age of 35 (SD ± 4.35) years, were analyzed. Rectal cancer of stage III was diagnosed in both women of the first group. Tumor stage distribution in the second group, respectively: stage I  –  2  cases (16.67%), stage  II  –  3  cases (25%), stage  III  –  7 cases (58.33%). Seven (58.33%) patients of the second group underwent complete endoscopic staging. In these groups of 14 patients there were 2 (14.3%) complications (injury of the inferior vena cava and postoperative abnormal vaginal bleeding). No postoperative exitus occurred. The mean duration of the operation was 2 hours 26 minutes ± 55 minutes (60–245 minutes), respectively, 2  hours 40  minutes  ±  49  minutes (95–245  minutes) when laparoscopic staging and ovarian transposition was performed and 2  hours 12  minutes  ±  1  hour 1  minute (60–245  minutes) when only ovarian transposition was performed. The hospitalization period ranged from 5 to 52 days (average 12 days). Conclusions. Laparoscopic ovarian transposition is a relatively safe and effective procedure for preserving ovarian function. This procedure should be considered in all reproductive age female patients who need to undergo pelvic irradiation as part of pelvic cancer treatment.

Laparoscopic Ovarian Transposition Before Pelvic Cancer Treatment: Ovarian Function and Fertility Preservation

2017 ◽  
Vol 24 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Nash S. Moawad ◽  
Estefania Santamaria ◽  
Alice Rhoton-Vlasak ◽  
Judith L. Lightsey
Keyword(s):  
Cancer Treatment ◽  
Fertility Preservation ◽  
Ovarian Function ◽  
Ovarian Transposition ◽  
Pelvic Cancer

Sonographic Imaging of Surgically Transpositioned Ovaries in the Treatment of Rectal Carcinoma

2021 ◽  
pp. 875647932110465
Author(s):  
Sovereign K. Ortiz
Keyword(s):  
Rectal Carcinoma ◽  
Ovarian Function ◽  
Rectal Adenocarcinoma ◽  
Reproductive Age ◽  
Ovarian Transposition ◽  
Oncological Outcomes ◽  
Sonographic Evaluation ◽  
After Cancer ◽  
Insight Into ◽  
Sonographic Imaging

Pelvic radiation therapy in patients with advanced rectal carcinoma improves oncological outcomes, but often raises infertility concerns in reproductive-age patients. Laparoscopic ovarian transposition is a surgical method which may offer preservation of ovarian function during and after cancer treatment. Sonographic evaluation of the ovaries post transposition gives insight into their condition and the efficacy of ovarian transposition in the continuation of ovarian function after radiation. This case describes how sonography was used to identify and evaluate surgically transpositioned ovaries in a patient with rectal adenocarcinoma.

Laparoscopic Ovarian Transposition Before Pelvic Irradiation: A Saudi Tertiary Center Experience

2010 ◽  
Vol 20 (6) ◽  
pp. 1082-1086 ◽  
Author(s):  
Ismail A. Al-Badawi ◽  
Murad Al-Aker ◽  
Jamal AlSubhi ◽  
Hany Salem ◽  
Alaa Abduljabbar ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Medical Center ◽  
Gynecologic Oncology ◽  
Follicle Stimulating Hormone ◽  
Premenopausal Women ◽  
Pelvic Irradiation ◽  
Ovarian Transposition ◽  
Tertiary Center ◽  
Stimulating Hormone

Objective:To report the authors' experience with laparoscopic ovarian transposition and ovarian function preservation in women who require pelvic irradiation as part of their cancer therapy.Design:Cohort study.Setting:The gynecologic oncology service in a referral tertiary/quaternary medical center in Saudi Arabia.Patients:Twenty-three premenopausal patients treated with radiotherapy for a pelvic malignancy.Interventions:Laparoscopic ovarian transposition to paracolic gutters with uterine conservation.Main Outcome Measures:Preservation of ovarian function assessed by patients' symptoms and serum follicle-stimulating hormone level.Results:Bilateral laparoscopic ovarian transposition was performed in 23 patients: 15 with cervical cancer, 4 with rectal cancer, 3 with Ewing sarcoma, and 1 with Hodgkin lymphoma. No immediate intraoperative or postoperative complications were observed. Three patients were lost to follow-up. Ovarian preservation was achieved in 13 (65%) of 20 patients. Seven patients with low follicle-stimulating hormone levels had regular uterine bleeding at follow-up.Conclusions:Laparoscopic ovarian transposition is a safe and effective procedure for preserving ovarian function. This procedure should be considered in all premenopausal women who need to undergo pelvic irradiation as part of their cancer treatment.

scholarly journals Endocrine Markers of Fertility Potential in Reproductive Age Women with Idiopathic Hyperprolactinemia

2020 ◽  
pp. 71-77
Author(s):  
Alina Valerievna Atalyan ◽  
Leonid Fedorovich Shelokhov ◽  
Lyubov Ilinichna Kolesnikova
Keyword(s):  
Ovarian Function ◽  
Premenopausal Women ◽  
Thyroid Stimulating Hormone ◽  
Reproductive Age ◽  
Free Triiodothyronine ◽  
Reproductive Ability ◽  
Study Results ◽  
Gynecological Disorder ◽  
Fertile Women ◽  
Stimulating Hormone

Background: Hyperprolactinemia (HP) is a common endocrine gynecological disorder in women of reproductive age manifested with menstrual irregularity and sterility subfertility among the majority of women with this disorder. Objective: The aim of this study was to assess the endocrinal markers of inferility in premenopausal women with idiopathic hyperprolactinemia. Materials and Metahodology: The study included 82 women: 27 healthy women, 22 fertile women with idiopathic HP and 33 patients with endocrine sub fertility with idiopathic HP.  All women underwent a standard history taking, clinical examinations.  Lab tests were performed in all women and included the detection of the concentrations of prolactin, thyroid-stimulating hormone, thyroxine, triiodothyronine, cortisol, gonadotrophic hormones, testosterone, and estradiol by ELISA method.   Results: The study results demonstrated that subfertile women with HP are characterized by an increase of follicle-stimulating hormone and free triiodothyronine and a decrease of estradiol and cortisol when compared with fertile patients with HP and Healthy patients. Conclusion: The better glucocorticoid and ovarian function of fertile women with HP supposed to be an essential issue in their reproductive ability.

scholarly journals Imaging of Subcutaneous Ovarian Transposition and Its Rare Complications—A Pictorial Assay

2021 ◽  
Author(s):  
Thara Pratap ◽  
K. Chithratara ◽  
Muhammed Jasim Abdul Jalal ◽  
Dhanya Jacob ◽  
A.K. Vishnu
Keyword(s):  
Cervical Cancer ◽  
Ovarian Function ◽  
Premenopausal Women ◽  
Ct Imaging ◽  
Imaging Findings ◽  
Common Indication ◽  
Anatomical Position ◽  
Ovarian Transposition ◽  
Early Cervical Cancer ◽  
Normal Ultrasound

AbstractOvarian transposition, as the name implies, is transpositioning the ovary from its normal anatomical position to another location. This procedure is usually done to preserve the ovarian function. The most common indication of ovarian transposition is early cervical cancer in young premenopausal women to preserve fertility. Subcutaneous ovarian transposition can also be done for benign conditions such as adenomyosis and severe endometriosis in young premenopausal women. We discuss our experience with ovarian transposition in 9 cases, normal ultrasound and CT imaging findings in transposed ovaries, and rare complications which occurred in 2 cases.

Foetal steroid binding protein in British and Japanese women

1987 ◽  
Vol 114 (4) ◽  
pp. 584-588 ◽  
Author(s):  
M. Jawed Iqbal ◽  
Alastair Forbes ◽  
Mark L. Wilkinson ◽  
John W. Moore ◽  
Roger Williams ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Binding Protein ◽  
Premenopausal Women ◽  
Japanese Women ◽  
Sex Hormone Binding Globulin ◽  
Partial Purification ◽  
Enzyme Linked Immunosorbent Assay ◽  
Binding Characteristics ◽  
Steroid Binding ◽  
Steroid Binding Protein

Abstract. In order to examine the newly-discovered sex-steroid binding protein, foetal steroid binding protein (FSBP) in different populations, its binding characteristics and its level were studied by two-tier column ligand binding assay and enzyme-linked immunosorbent assay (ELISA) respectively. In 10 Japanese premenopausal women, analysis of 5α-dihydrotestosterone (DHT) binding in the Cibacron Blue 3GA-Sepharose 6B portion of the column showed a rising plateau pattern with a mean maximum binding of 31.1 ± 7.41%, whereas of 9 similar British women, 8 displayed unsaturable, non-cooperative binding of 11.6 ± 8.22% (P < 0.01). After partial purification of FSBP in these samples, the protein exhibited saturable binding kinetics, median binding 25 (interquartiles 23–34) and 19 (13–25) nmol DHT/l in Japanese and British women, respectively (P < 0.05). By analyzing FSBP by ELISA in 56 Japanese (45 premenopausal) and 59 British (25 premenopausal) women, higher levels were obtained in the whole Japanese group (P = 0.0016) and in the premenopausal Japanese women (P = 0.018) than in their British counterparts. In both nationalities, FSBP levels were higher in premenopausal women, and there was a significant negative correlation of FSBP with age in both populations, particularly in postmenopausal women. FSBP levels did not correlate with weight, parity, sex hormone binding globulin or albumin levels. The influence of FSBP on free steroid levels remains unclear, but some relationship with ovarian function seems a possibility.

Endocrine Treatment of Breast Cancer: Current Perspectives, Future Directions

2017 ◽  
Vol 8 (03) ◽  
Author(s):  
Tazia Irfan ◽  
Mainul Haque ◽  
Sayeeda Rahman ◽  
Russell Kabir ◽  
Nuzhat Rahman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Endocrine Therapy ◽  
Ovarian Function ◽  
Premenopausal Women ◽  
New Drugs ◽  
Effective Control ◽  
Endocrine Treatment ◽  
Estrogen Production ◽  
Hormone Sensitive

Breast cancer remains one of the major causes of death in women, and endocrine treatment is currently one of the mainstay of treatment in patients with estrogen receptor positive breast cancer. Endocrine therapy either slows down or stops the growth of hormone-sensitive tumors by blocking the body’s capability to yield hormones or by interfering with hormone action. In this paper, we intended to review various approaches of endocrine treatments for breast cancer highlighting successes and limitations. There are three settings where endocrine treatment of breast cancer can be used: neoadjuvant, adjuvant, or metastatic. Several strategies have also been developed to treat hormone-sensitive breast cancer which include ovarian ablation, blocking estrogen production, and stopping estrogen effects. Selective estrogen-receptor modulators (SERMs) (e.g. tamoxifen and raloxifene), aromatase inhibitors (AIs) (e.g. anastrozole, letrozole and exemestane), gonadotropin-releasing hormone agonists (GnRH) (e.g. goserelin), and selective estrogen receptor downregulators (SERDs) (e.g. fulvestrant) are currently used drugs to treat breast cancer. Tamoxifen is probably the first targeted therapy widely used in breast cancer treatment which is considered to be very effective as first line endocrine treatment in previously untreated patients and also can be used after other endocrine therapy and chemotherapy. AIs inhibit the action of enzyme aromatase which ultimately decrease the production of estrogen to stimulate the growth of ER+ breast cancer cells. GnRH agonists suppress ovarian function, inducing artificial menopause in premenopausal women. Endocrine treatments are cheap, well-tolerated and have a fixed single daily dose for all ages, heights and weights of patients. Endocrine treatments are not nearly as toxic as chemotherapy and frequent hospitalization can be avoided. New drugs in preliminary trials demonstrated the potential for improvement of the efficacy of endocrine therapy including overcoming resistance. However, the overall goals for breast cancer including endocrine therapy should focus on effective control of cancer, design personalized medical therapeutic approach, increase survival time and quality of life, and improve supportive and palliative care for end-stage disease.

Cardiovascular Risk in Perimenopausal Women

2019 ◽  
Vol 17 (6) ◽  
pp. 591-594 ◽  
Author(s):  
John C. Stevenson ◽  
Sophia Tsiligiannis ◽  
Nick Panay
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ovarian Function ◽  
Density Lipoprotein ◽  
Premenopausal Women ◽  
Therapeutic Interventions ◽  
Additional Risk Factor ◽  
Chd Risk ◽  
Perimenopausal Women ◽  
Chd Risk Factors

Cardiovascular disease, and particularly coronary heart disease (CHD), has a low incidence in premenopausal women. Loss of ovarian hormones during the perimenopause and menopause leads to a sharp increase in incidence. Although most CHD risk factors are common to both men and women, the menopause is a unique additional risk factor for women. Sex steroids have profound effects on many CHD risk factors. Their loss leads to adverse changes in lipids and lipoproteins, with increases being seen in low density lipoprotein (LDL) cholesterol and triglycerides, and decreases in high density lipoprotein (HDL) cholesterol. There is a reduction in insulin secretion and elimination, but increases in insulin resistance eventually result in increasing circulating insulin levels. There are changes in body fat distribution with accumulation in central and visceral fat which links to the other adverse metabolic changes. There is an increase in the incidence of hypertension and of type 2 diabetes mellitus, both major risk factors for CHD. Oestrogens have potent effects on blood vessels and their loss leads to dysfunction of the vascular endothelium. All of these changes result from loss of ovarian function contributing to the increased development of CHD. Risk factor assessment in perimenopausal women is recommended, thereby permitting the timely introduction of lifestyle, hormonal and therapeutic interventions to modify or reverse these adverse changes.

scholarly journals The Modern Landscape of Endocrine Therapy for Premenopausal Women with Breast Cancer

Breast Care ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. 312-315 ◽  
Author(s):  
Lorenzo Rossi ◽  
Olivia Pagani
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Ovarian Function ◽  
Treatment Options ◽  
Endocrine Resistance ◽  
Premenopausal Women ◽  
New Drugs ◽  
Fine Tuning ◽  
Individual Risk ◽  
Ovarian Function Suppression

The optimal endocrine therapy for premenopausal women with early and advanced breast cancer still remains an important and controversial issue. For over 30 years, tamoxifen has been the gold standard in the adjuvant setting. New therapeutic options, such as the addition of ovarian function suppression to oral endocrine therapy (either tamoxifen or aromatase inhibitors), can improve outcomes over tamoxifen alone in well-selected patients. Treatment duration has also been revisited, and extended therapy is becoming a new standard of care, especially in high-risk patients. Endocrine therapy for advanced disease still represents a challenge and a research priority. New drugs and combinations able to overcome endocrine resistance are at the horizon, and their role in premenopausal women should be better elucidated. Side effects and quality of life (including family planning considerations) play an important role in treatment selection and in the patients' treatment adherence and should always be discussed before start of treatment. The paper will specifically focus on how to integrate all new treatment options in the current armamentarium of endocrine therapy of premenopausal women, with the aim of best fine-tuning treatment selections according to the individual risk/benefit evaluation.

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