The uterus starts shrinking after giving birth and returns to its size prior to pregnancy one month postpartum. However, absence of this natural shrinking is called uterine subinvolution. There are two types of subinvolution : organic and functional. Removal of the cause is the first option for organic subinvolution. Conversely, most cases of functional subinvolution require drug treatment. This study included patients with subinvolution caused by accumulation of lochia with a uterine cavity width of 15 mm or more during a 14-day postpartum checkup. These patients were categorized into the control, keishibukuryogan, and ergometrine maleate groups ; therapeutic intervention was performed. A comparative study was conducted to determine the presence of subinvolution during the 1-month medical screening. There was no difference in the rate of uterine cavity shrinkage between the ergometrine maleate group and the control group. However, the keishibukuryogan group had a significantly higher reduction rate than the ergometrine maleate group. Furthermore, the keishibukuryogan group showed a tendency of higher shrinking rate when compared with the control group (76.1 ± 17.1% vs 65.8 ± 25.4%, 68.3 ± 22.9%, p = 0.0101, p = 0.0709). Additionally, no difference in the reduction rate of the fundal height was noted among the groups. These results suggest that although keishibukuryogan has little effect on reducing the uterine size, however, it has the effect of lochia accumulated within the uterine cavity.

OBJECTIVE: Although radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) are the global standards for adjuvant therapy treatment in cervical cancer, many Japanese institutions choose chemotherapy (CT) because of the low frequency of irreversible adverse events. In this study, we aimed to clarify the trends of adjuvant therapy for intermediate/high-risk cervical cancer after radical surgery in Japan. METHODS: A questionnaire survey was conducted by the Japanese Gynecologic Oncology Group to 186 authorized institutions active in the treatment of gynecologic cancer. RESULTS: Responses were obtained from 129 facilities. Adjuvant RT/CCRT and intensity-modulated RT were performed in 98 (76%) and 23 (18%) institutions, respectively. On the other hand, CT was chosen as an alternative in 93 institutions (72%). The most common regimen of CT, which was used in 66 institutions (51%), was a combination of cisplatin/carboplatin with paclitaxel. CT was considered an appropriate alternative option to RT/CCRT in patients with risk factors such as bulky tumors, lymph node metastasis, lymphovascular invasion, parametrial invasion, and stromal invasion. The risk of severe adverse events was considered to be lower for CT than for RT/CCRT in 109 institutions (84%). CONCLUSION: This survey revealed a variety of policies regarding adjuvant therapy among institutions. A clinical study to assess the efficacy or non-inferiority of adjuvant CT is warranted.
Chemoradiotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Humans ; Japan/epidemiology ; Middle Aged ; Neoplasm Recurrence, Local/prevention & control ; *Practice Patterns, Physicians'/statistics & numerical data ; Risk Assessment ; Risk Factors ; Surveys and Questionnaires ; Uterine Cervical Neoplasms/radiotherapy/*therapy