OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganism in pelvic inflammatory disease (PID). In this infection tubal obstruction, infertility, tubal pregnancy and recurrent pelvic infection has involved. Also, perinatal infection, spontaneous abortion and preterm labor of pregnant women increased in chlamydia infection. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis in symptomatic women. METHODS: From March, 2003 to March, 2004, in OB-Gyn development, endocervical swab were obtained in 218 patients (137 impatients of PID and 81 outpatients) by Amplicor Chlamydia Transfer Kits and Human papilloma virus kit. They were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. Also, in this study we investigated the prevalence of human papilloma virus and N. gonorrhea in the Chlamydia infection group. RESULTS: The prevalence rate of Chlamydia trachomatis was 27.5% (61/218) in pelvic inflammatory disease. As regarding the age distribution of Chlamydia trachomatis positive group was the high prevalence rate in twenties (52.8%). Chlamydia infection was related to the history of artificial abortion, oral contraception, occupation status, history of gynecologic disease (PID, Ectopic pregnancy). Women with chlamydial infection were 2.5 times greater risk of coincidal HPV infection and 2 times greater risk of coincidal N. gonorrhea infection and both were statistically significant. CONCLUSION: The prevalence rate of Chlamydia infection is higher than any other sexually transmitted disease and Chlamydia infection has serious complication on reproduction. It appears weak symptom and detection is difficult. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Abortion, Spontaneous ; Age Distribution ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Contraception ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Gonorrhea ; Humans ; Infertility ; Mass Screening ; Obstetric Labor, Premature ; Occupations ; Papilloma ; Pelvic Infection ; Pelvic Inflammatory Disease* ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Pregnant Women ; Prevalence ; Reproduction ; Sexually Transmitted Diseases

Levonorgestrel-releasing intrauterine system (LNG-IUS: Mirena(R)) have many important and potential gynecologic applications beyond its role in contraception. This article describes the evidence and results of clinical applications of use of Mirena(R) for gynecologic diseases such as idiopathic menorrhagia, endometriosis, leiomyoma, adenomyosis, endometrial hyperplasia and early endometrial cancer is reviewed.
Adenomyosis ; Contraception ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometriosis ; Female ; Genital Diseases, Female ; Leiomyoma ; Menorrhagia

The levonorgestrel-releasing intrauterine system (LNG-IUS), originally designed for contraception, has since been applied to various gynecologic diseases. This article summarizes the current status of clinical applications of LNG-IUS to the treatment of gynecologic diseases such as heavy menstrual bleeding, endometriosis, leiomyoma, adenomyosis, endometrial hyperplasia, and early-stage endometrial cancer.
Adenomyosis ; Contraception ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometriosis ; Female ; Genital Diseases, Female ; Hemorrhage ; Leiomyoma ; Menorrhagia

OBJECTIVE: One of the most common causative microorganisms in pelvic inflammatory disease (PID) is the chlamydia trachomatis. In many cases chlamydia trachomatis infection has weak and nearly absent symptom, but it's endocervical infection usually disseminates into upper genital tract. In this infection tubal obstruction, infertility, tubal pregnancy, and recurrent pelvic infection has involved. In this study, we investigated the prevalance of chlamydia trochoma infections in symptomatic and asymptomatic women and its relation with Human Papilloma infection. METHODS: From Jan, 1999 to July, 2003, in St. Vincet's Hospital, The Catholic University of Korea, endocervial swabs were obtained in 3416 patients (1137 in Heath Promotion Center, 2226 in OPD) by Amplicor Chlamydia Trahomatis Kits (STD swab specimen collection transprt kits). Chlamydia trachomatis DNA was extracted and amplified by PCR assays to investigate the prevalence. Also in this study we investigated the prevalence of human papilloma virus by hybrid capture method. Women who visted Hospital were received routine gynecologic examination, history taking, and physical examination and information on potential risk factors was obtained by questionnaire. RESULTS: The prevalence rate of Chlamydia trachomatis in symptomatic women was 12.6% and there was a high peak prevalence among the early twenties (66%). The prevalence rate of Chlamydia in asymtomatic women was 8.2% but there was no peak in early twenties. In asymptomatic woman, asymptomatic chlamydia infection can be statistically anticipated by 1) Economic status, 2) Occupation status, 3) Alcohol intake, 4) History of Gynecologic disease, 5) History of STD. Women with chlamydia infection was 1.5 times greater risk of coincidal HPV infection and was statistically significant. CONCLUSION: The prevalence rate of chlamydia infection is higher than any other developed country, especially in asymptomatic women. Although symptoms are weak, the rate of prevalence and complications can be reduced by the screening of chlamydial infection.
Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Developed Countries ; DNA ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Humans* ; Infertility ; Korea ; Mass Screening ; Occupations ; Papilloma* ; Pelvic Infection ; Pelvic Inflammatory Disease ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Prevalence* ; Surveys and Questionnaire ; Risk Factors ; Specimen Handling

Endometriosis is an estrogen dependent disease in reproductive age. Endometriosis is a chronic inflammatory gynecologic disease. Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. Postmenopausal endometriosis is rare; however, postmenopausal endometriosis is infrequently associated with cancer, thus management is most important for gynecologists. We present two cases of endometriosis associated with postmenopausal women who were not receiving menopausal hormone therapy with a retrospective review of the medical records and a brief review of the literature.
Dysmenorrhea ; Dyspareunia ; Endometriosis ; Estrogens ; Female ; Genital Diseases, Female ; Humans ; Infertility ; Medical Records ; Postmenopause ; Retrospective Studies

Endometriosis is estrogen dependent disease in reproductive age. Endometriosis is a chronic inflammatory gynecologic disease. Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. Postmenopausal endometriosis is rare. Also, malignant transformation in endometriosis is rare. There is no report in Korea about serous adenocarcinoma arising from endometriosis after menopause. The authors present a case of serous adenocarcinoma arising from endometriosis after menopause with brief review of the literature.
Adenocarcinoma ; Dysmenorrhea ; Dyspareunia ; Endometriosis ; Estrogens ; Female ; Genital Diseases, Female ; Infertility ; Korea ; Menopause

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

OBJECTIVE: To assess the advantages, disadvantages, applicability, and complications of laparoscopy in gynecologic diseases. MATERIALS AND METHODS: A retrospective case series which includes 1711 patients who underwent laparoscopic surgery at Department of Obstetrics and Gynecology, Ajou University Hospital from June, 1994 to August, 2001 for gynecologic diseases. RESULTS: The patient's ages ranged from 11 to 77 years, and their mean age was 31.5 years. The indications of laparoscopy were ectopic pregnancy in 626 cases (36.6%), endometriosis, ovarian tumor, secondary infertility, tubal obstruction, primary infertility, myoma of the uterus, pelvic adhesion, and pelvic inflammatory disease in order. The operations performed were salpingectomy in 589 cases (34.4%), diagnostic laparoscopy, ovarian cystectomy, fulguration, salpingo-oophorectomy, laparoscopic-assisted vaginal hysterectomy, fimbrioplaty, oophorectomy, and myomectomy in order. Operation times were from 5 to 260 minutes (mean: 60.6 minutes). Postoperative hospital stays were from 0 day to 29 days (mean: 2.3 days). There were 18 surgical complications including 1 trocar site hematoma, 3 incision site infections, 9 postoperative fever, 2 postopertive ileus and 3 patinets underwnet expolatory laparotomy because of severe adhesion. CONCLUSION: We conclude that operative laparoscopy is useful in gynecologic diseases but need development of laparoscopic equipments, research of operative method, extension of operative indications, and skilled laparoscopic surgeons.
Cystectomy ; Endometriosis ; Fallopian Tube Diseases ; Female ; Fever ; Genital Diseases, Female ; Gynecology ; Hematoma ; Humans ; Hysterectomy, Vaginal ; Ileus ; Infertility ; Laparoscopy* ; Laparotomy ; Length of Stay ; Myoma ; Obstetrics ; Ovariectomy ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Salpingectomy ; Surgical Instruments ; Uterus

OBJECTIVE: To assess the advantages, disadvantages, applicability, and complications of laparoscopy in gynecologic diseases. MATERIALS AND METHODS: A retrospective case series which includes 1711 patients who underwent laparoscopic surgery at Department of Obstetrics and Gynecology, Ajou University Hospital from June, 1994 to August, 2001 for gynecologic diseases. RESULTS: The patient's ages ranged from 11 to 77 years, and their mean age was 31.5 years. The indications of laparoscopy were ectopic pregnancy in 626 cases (36.6%), endometriosis, ovarian tumor, secondary infertility, tubal obstruction, primary infertility, myoma of the uterus, pelvic adhesion, and pelvic inflammatory disease in order. The operations performed were salpingectomy in 589 cases (34.4%), diagnostic laparoscopy, ovarian cystectomy, fulguration, salpingo-oophorectomy, laparoscopic-assisted vaginal hysterectomy, fimbrioplaty, oophorectomy, and myomectomy in order. Operation times were from 5 to 260 minutes (mean: 60.6 minutes). Postoperative hospital stays were from 0 day to 29 days (mean: 2.3 days). There were 18 surgical complications including 1 trocar site hematoma, 3 incision site infections, 9 postoperative fever, 2 postopertive ileus and 3 patinets underwnet expolatory laparotomy because of severe adhesion. CONCLUSION: We conclude that operative laparoscopy is useful in gynecologic diseases but need development of laparoscopic equipments, research of operative method, extension of operative indications, and skilled laparoscopic surgeons.
Cystectomy ; Endometriosis ; Fallopian Tube Diseases ; Female ; Fever ; Genital Diseases, Female ; Gynecology ; Hematoma ; Humans ; Hysterectomy, Vaginal ; Ileus ; Infertility ; Laparoscopy* ; Laparotomy ; Length of Stay ; Myoma ; Obstetrics ; Ovariectomy ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Salpingectomy ; Surgical Instruments ; Uterus

OBJECTIVETo evaluate the effectiveness on comprehensive health education intervention program regarding reproductive tract infections/sexually transmitted diseases (RTIs/STDs) among reproductive age population in the rural areas of China.

METHODSData were generated from the Reproductive Health/Family Planning Project implemented by the State Family Planning Committee and the Ministry of Health from 1998 to 2002, which covered 32 counties in 22 provinces. A quasi-experimental design was used. Six counties were selected from 32 project counties as intervention group, while 6 non-project counties were taken as controls which were similar in number of population and economic level to the counties as selected. Subjects of the study were mothers with children under 3 years and men under 35 years of age. A total number of 675 mothers and men were interviewed using a structured questionnaire by strictly trained investigators. Logistic model was used to compare the difference of knowledge on RTIs/STDs between intervention group and control group. OR value was used to describe the degree of the difference.

RESULTSOver the 18 month intervention period, persons in the intervention group had more knowledge of RTIs/STDs than those in control group. Logistic regression analysis indicated that intervention was significantly associated with better knowledge on factors as transmission, risks, symptoms, management and prevention of RTIs/STDs with 95% CI of OR as 2.4 - 6.4, 2.0 - 4.8, 3.0 - 6.4, 1.9 - 5.7 and 1.8 - 6.8 respectively, after controlling the demographic factors. Level of education was an important factor influencing the subjects to receive knowledge on RTIs/STDs.

CONCLUSIONComprehensive health education intervention programs had significant impact on knowledge about RTIs/STDs among the target population, indicating that the Reproductive Health/Family Planning Project implemented in the rural areas of China had been successful.

Adult ; China ; Female ; Genital Diseases, Female ; prevention & control ; Genital Diseases, Male ; prevention & control ; Health Education ; Humans ; Male ; Rural Health ; Sexually Transmitted Diseases ; prevention & control