Pelvic exenteration is a highly morbid operation and remains one of the most catastrophic surgical procedures in gynecological oncology. We would like to present the case of total pelvic exenteration for vaginal cancer after radiotherapy for endometrial cancer as a secondary cancer. A 62-year-old woman, whose gravida: 3, parity: 2, body mass index: 35.9 kg/m2, presented with complaints of vaginal bleeding. She had undergone a surgery because of a stage IB grade 2 endometrioid-type adenocarcinoma seventeen years previously. Following the surgery, she had external pelvic radiotherapy and brachytherapy. A palpable, solid and ulcerative mass was detected extending from the vaginal cuff area to the vestibulum vagina on the left postero-lateral wall of the vagina. The 5-cm vaginal mass was seen at vaginal examination. A punch biopsy from a pathological examination of the tumoral lesion was reported as a squamous cell carcinoma. Pelvic exenteration was performed and ileo-perineal fistula occurred after six months this surgery. In conclusion, we considered that this malignancy was a secondary malignancy induced by radiotherapy.

Objective: Colposcopic biopsy is a discomfortable procedure. Additionally, it creates negative influence on sexuality. This study aimed to investigate the relationships among tenaculum, pain perception, and biopsy size during colposcopy. Methods: In total, 228 patients who underwent colposcopy-directed biopsy were included, and randomized into 4 groups based on whether analgesic and tenaculum were used and replaced (tenaculum with n=58/without analgesic n=56, no tenaculum replacement with n=57/without analgesic n=57). Lidocaine hydrochloride (40 mg) plus adrenaline (0.025 mg) was administered in the analgesic groups. The pain was assessed using a linear visual analog scale. The biopsy specimen size was measured in millimeters. Results: The mean age of the patients was 42.85±8.88 years. The most frequent colposcopy indications were atypical squamous cells of undetermined significance and human papilloma virus-positive results on cervical cytology (30.2%; n=69). Low- and high-grade intraepithelial lesions were noted in 14.91% (n=34) and 10.96% (n=25) women through colposcopy-directed biopsy results, respectively. Tenaculum replacement increased pain perception in the without analgesic group; however, no statistically significant differences were noted between of the groups with and without tenaculum replacement with analgesic. The size and number of biopsy specimens were not associated with tenaculum replacement and analgesic use. Conclusion Administration of analgesics decreased discomfort and pain in patients. Tenaculum replacement aided colposcopists in manipulating the cervix. Additionally, administration of analgesics relieved pain in the tenaculum replacement group.Trial RegistrationClinicalTrials.gov Identifier: NCT03279666

Objective: Colposcopic biopsy is a discomfortable procedure. Additionally, it creates negative influence on sexuality. This study aimed to investigate the relationships among tenaculum, pain perception, and biopsy size during colposcopy. Methods: In total, 228 patients who underwent colposcopy-directed biopsy were included, and randomized into 4 groups based on whether analgesic and tenaculum were used and replaced (tenaculum with n=58/without analgesic n=56, no tenaculum replacement with n=57/without analgesic n=57). Lidocaine hydrochloride (40 mg) plus adrenaline (0.025 mg) was administered in the analgesic groups. The pain was assessed using a linear visual analog scale. The biopsy specimen size was measured in millimeters. Results: The mean age of the patients was 42.85±8.88 years. The most frequent colposcopy indications were atypical squamous cells of undetermined significance and human papilloma virus-positive results on cervical cytology (30.2%; n=69). Low- and high-grade intraepithelial lesions were noted in 14.91% (n=34) and 10.96% (n=25) women through colposcopy-directed biopsy results, respectively. Tenaculum replacement increased pain perception in the without analgesic group; however, no statistically significant differences were noted between of the groups with and without tenaculum replacement with analgesic. The size and number of biopsy specimens were not associated with tenaculum replacement and analgesic use. Conclusion Administration of analgesics decreased discomfort and pain in patients. Tenaculum replacement aided colposcopists in manipulating the cervix. Additionally, administration of analgesics relieved pain in the tenaculum replacement group.Trial RegistrationClinicalTrials.gov Identifier: NCT03279666

Objective: The authors present a surgical film for vulvar cancer surgery, which was performed via video endoscopy. Methods: An 88-yearold woman with squamous cell carcinoma of the vulva and who underwent radical vulvectomy was treated with sentinel lymph node (SLN) and bilateral inguinofemoral lymphadenectomy, which is preferably performed via video endoscopic surgery with a near-infrared fluorescence video endoscopy system. SLN mapping was performed using indocyanine green and near-infrared fluorescence mapping. Results: SLNs were detected in the left superficial inguinal area. The surgeons performed bilateral inguinofemoral lymphadenectomy. Conclusion No postoperative early or late complications developed, and the patient was discharged 7 days after surgery. Stage 1B vulvar cancer was identified.