OBJECTIVES: Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors. This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: Data from female participants in NHANES 2003-2018 were analyzed. Using R software, datasets (DEMO, BMX, etc.) were merged, and complete cases were retained by intersecting row names, yielding a total of 2 999 participants. After applying strict exclusion criteria, 2 802 participants were included: 83 with gynecologic cancer (cancer group) and 2 719 without (control group). Demographic, reproductive health, and urinary cadmium and arsenic data were collected. Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk. RESULTS: High urinary cadmium and arsenic levels were risk factors for gynecologic cancers, with odds ratios (ORs) of 1.623 (95% CI 1.217 to 2.166) and 1.003 (95% CI 1.001 to 1.005), respectively. After propensity score matching (PSM), the trend remained; cadmium was still a statistically significant risk factor with an OR of 2.182 (95% CI 1.343 to 3.545), while arsenic's association, though not statistically significant, still trended toward risk (OR=1.004, 95% CI 0.999 to 1.009). Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer (OR=1.745, 95% CI 1.178 to 2.586 and OR=1.005, 95% CI 1.002 to 1.008, respectively); these associations persisted after PSM. Additionally, cadmium increased the risk of endometrial cancer (OR=1.617, 95% CI 1.109 to 2.356). CONCLUSIONS Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers. These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.
Humans ; Female ; Cadmium/urine* ; Arsenic/urine* ; Genital Neoplasms, Female/urine* ; Middle Aged ; Nutrition Surveys ; Adult ; Risk Factors ; Environmental Exposure/adverse effects* ; Aged

Primary female genital system lymphoma(PFGSL)is a rare subtype of extranodal lymphoma and patients commonly present in the department of gynecology.At present,there is a lack of uniform standards for the treatment of PFGSL.Although the classification of lymphoid neoplasmas was updated by the World Health Organization classification of haematolymphoid tumors in 2016,PFGSL was still not elaborated in sufficient detail.Most cases of PFGSL are non-Hodgkin lymphoma,involving the ovary and cervix.In some cases,involvement of uterine corpus,vagina,and vulva is reported.In this article,we report two cases of non-Hodgkin lymphoma in the female genital system,one from the uterus and the other from the ovary.By presenting the diagnosis and treatment of the two cases and reviewing the literature,we aim to provide a reference for clinicians in recognizing and treating rare cases.
Female ; Humans ; Genital Neoplasms, Female/diagnosis* ; Lymphoma, Non-Hodgkin/diagnosis* ; Ovarian Neoplasms

Originating but free from chromosomal DNA, extrachromosomal circular DNAs (eccDNAs) are organized in circular form and have long been found in unicellular and multicellular eukaryotes. Their biogenesis and function are poorly understood as they are characterized by sequence homology with linear DNA, for which few detection methods are available. Recent advances in high-throughput sequencing technologies have revealed that eccDNAs play crucial roles in tumor formation, evolution, and drug resistance as well as aging, genomic diversity, and other biological processes, bringing it back to the research hotspot. Several mechanisms of eccDNA formation have been proposed, including the breakage-fusion-bridge (BFB) and translocation-deletion-amplification models. Gynecologic tumors and disorders of embryonic and fetal development are major threats to human reproductive health. The roles of eccDNAs in these pathological processes have been partially elucidated since the first discovery of eccDNA in pig sperm and the double minutes in ovarian cancer ascites. The present review summarized the research history, biogenesis, and currently available detection and analytical methods for eccDNAs and clarified their functions in gynecologic tumors and reproduction. We also proposed the application of eccDNAs as drug targets and liquid biopsy markers for prenatal diagnosis and the early detection, prognosis, and treatment of gynecologic tumors. This review lays theoretical foundations for future investigations into the complex regulatory networks of eccDNAs in vital physiological and pathological processes.
Male ; Female ; Animals ; Humans ; Swine ; DNA, Circular/genetics* ; Genital Neoplasms, Female ; Semen ; DNA ; Reproduction

Biomarkers ; Biomarkers, Tumor ; Circulating Tumor DNA/genetics* ; Female ; Genital Neoplasms, Female/diagnosis* ; Humans ; Prognosis

Female ; Genital Neoplasms, Female ; surgery ; Humans ; Laparoscopy ; methods ; Pelvic Exenteration ; methods ; Postoperative Complications ; Robotic Surgical Procedures ; methods

The levonorgestrel-releasing intrauterine system (LNG-IUS) was originally developed as a method of contraception and was first marketed in Finland in 1990. In Korea, the only LNG-IUS approved for non-contraceptive use is Mirena, a T-shaped device with a vertical stem containing a reservoir of 52 mg of levonorgestrel, which releases 20 µg of levonorgestrel per day. The device's strong local effects on the endometrium benefit women with gynecological conditions such as heavy menstrual bleeding, dysmenorrhea, leiomyoma, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen therapy and in the treatment of endometrial hyperplasia without atypia and, possibly, early endometrial cancer. Because of its effectiveness, safety, and high patient satisfaction, the LNG-IUS will continue to provide important benefits in women's reproductive health.
Adenomyosis ; Contraception ; Dysmenorrhea ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometriosis ; Endometrium ; Estrogens ; Female ; Finland ; Genital Diseases, Female ; Hemorrhage ; Humans ; Korea ; Leiomyoma ; Levonorgestrel ; Menorrhagia ; Methods ; Patient Satisfaction ; Reproductive Health

ObjectiveHuman papilloma virus (HPV) is a necessary cause of cervical cancer and is also closely related to penile cancer, oropharyngeal cancer, and anal cancer in males. However, few studies are reported on male HPV. This study aimed to investigate HPV infection of the external genitalia in men whose female partners have cervical HPV infection.

METHODSWe collected the relevant data on the male outpatients whose partners had cervical HPV infection in our Department of Urology and Andrology from August to December 2016. We obtained samples with nylon swabs from the glans penis, corona, inner layer of the prepuce and penile body and detected different types of HPV infection using the Hybribio HPV typing kit, PCR and membrane hybridization.

RESULTSValid data were collected from 140 males, which showed 83.5% of HPV infection of the external genitalia, including 60 cases of HPV6 (43.2%), 27 cases of HPV16 (19.4%), 14 cases of HPV39 (10.1%), 13 cases of HPV18 (9.4%), 13 cases of HPV58 (9.4%), and 13 cases of HPV52 (9.4%). Redundant prepuce was found in 75.5% of the males, but there was no statistically significant difference in the incidence rate of HPV infection between the normal and redundant prepuce groups (P > 0.05).

CONCLUSIONSMen who have the female partners with positive cervical HPV are at high risk of HPV infection and therefore need to be screened and treated so as to reduce HPV infection in both sexes.

Female ; Foreskin ; virology ; Genital Diseases, Female ; virology ; Genital Diseases, Male ; virology ; Human papillomavirus 16 ; isolation & purification ; Humans ; Male ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; Penile Neoplasms ; virology ; Penis ; abnormalities ; virology ; Phimosis ; virology ; Polymerase Chain Reaction ; Sexual Partners ; Specimen Handling ; Uterine Cervical Neoplasms ; virology

OBJECTIVE: To determine the effect of surgeon experience on intraoperative, postoperative and long-term outcomes among patients undergoing pelvic exenteration for gynecologic cancer. METHODS: This was a retrospective analysis of all women who underwent exenteration for a gynecologic malignancy at MD Anderson Cancer Center, between January 1993 and June 2013. A logistic regression was used to model the relationship between surgeon experience (measured as the number of exenteration cases performed by the surgeon prior to a given exenteration) and operative outcomes and postoperative complications. Cox proportional hazards regression was used to model survival outcomes. RESULTS: A total of 167 exenterations were performed by 19 surgeons for cervix (78, 46.7%), vaginal (43, 25.8%), uterine (24, 14.4%), vulvar (14, 8.4%) and other cancer (8, 4.7%). The most common procedure was total pelvic exenteration (69.4%), incontinent urinary diversion (63.5%) and vertical rectus abdominis musculocutaneous reconstruction (42.5%). Surgical experience was associated with decreased estimated blood loss (p < 0.001), intraoperative transfusion (p = 0.009) and a shorter length of stay (p = 0.03). No difference was noted in the postoperative complication rate (p = 0.12–0.95). More surgeon experience was not associated with overall or disease specific survival: OS (hazard ratio [HR] = 1.02; 95% confidence interval [CI] = 0.97–1.06; p = 0.46) and DSS (HR = 1.01; 95% CI = 0.97–1.04; p = 0.66), respectively. CONCLUSION: Patients undergoing exenteration by more experienced surgeons had improvement in intraoperative factors such as estimated blood loss, transfusion rates and length of stay. No difference was seen in postoperative complication rates, overall or disease specific survival.
Cervix Uteri ; Female ; Genital Neoplasms, Female ; Humans ; Length of Stay ; Logistic Models ; Pelvic Exenteration* ; Postoperative Complications ; Pregnancy ; Pregnancy Outcome ; Rectus Abdominis ; Retrospective Studies ; Surgeons ; Urinary Diversion

PURPOSE: This study aimed to develop and evaluate the lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. METHODS: Thirteen web-sites were searched for eligible clinical practice guidelines (CPGs) and eleven databases were searched to identify evidence to develop a lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. RESULTS: Based on the inclusion and exclusion criteria, eight CPGs and ninety-six studies, two guidelines and eight studies were identified as evidence. The protocol development group consisted of ten experts who have at least five years' experience in the related area. A lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment was developed including forty-three recommendations in five domains. Significant differences were found in nurses' pre and post knowledge and confidence on lower extremity lymphedema prevention and management. CONCLUSION: Nurses and other professionals could utilize this evidence based lower extremity lymphedema nursing practice protocol and apply it to patients undergoing gynecologic cancer treatment.
Female ; Genital Neoplasms, Female ; Humans ; Lower Extremity* ; Lymphedema* ; Nursing Assessment ; Nursing*

PURPOSE: The purpose of this study was to investigate the factors associated with the supportive care needs of gynecologic cancer patients, and to provide basic data for patient-centered care. METHODS: The data were collected from 153 patients with ovarian/cervix/uterine cancer in 2016. For the data collection, the Korean version of the Supportive Care Needs Scale-gyne and electronic charts were used. T-test, one-way ANOVA, and logistic regression were used to analyze the data. RESULTS: The standardized scores for the supportive care needs of patients ranged from 19.45 to 35.66. The supportive care need in the psychological domain was the highest, followed by the emotional, physical, and information domains. The ten highest frequency items consisted of 5 items in information, 3 in psychological, 1 item each in the emotional and spiritual domain. Patients under 45 years old have more fear about treatment and disability, and uncertainty about their future. College graduates had higher needs for information about support groups and self-care. Patients with recurrence felt more bored and meaningless. CONCLUSION: Patients with gynecologic cancer have various supportive care needs according to their characteristics. In order to fulfil their needs, a more intensive and patient-centered individualized approach based on the patient's characteristics should be introduced.
Data Collection ; Female ; Genital Neoplasms, Female ; Humans ; Logistic Models ; Needs Assessment ; Patient-Centered Care ; Quality of Life ; Recurrence ; Self Care ; Self-Help Groups ; Uncertainty