Uterine artery embolization (UAE) was presented as a treatment for symptomatic uterine fibroids in the early of 1990s, after initially being used as a temporary surgical procedure before the performance of hysterectomy or myomectomy. Although the existence of intraoperative complications is associated with overall survival, plenty of these complications can be prevented. Until recently, surgical management represents the treatment of choice regarding the uterine fibroids. With the arrival of UAE, the percentage of major complications such as intraoperative bleeding, adhesions and ureteral injury is decreasing. The ultimate scope of the problem remains the proper management accompanied by knowledge and experience.
Part of the book: Approaches to Hysterectomy
The annual incidence rate of cancer is estimated to be more than 11,000 patients in the U.K. in the age group of 15–40 years, which corresponds to 4% of all cancer patients. The diagnosis of cancer is followed by devastating consequences for the patients and their families in this age group. Although the treatment of cancer is of crucial significance, it should also examine the impact of the disease on fertility at the time of the diagnosis and the damages caused from the surgical treatment, chemotherapy, or radiotherapy. The gynecological cancer, especially the diagnosis of ovarian cancer, the prevention, and treatment, as well as the fertility preservation in young women, represent the gold standard for all gynecologists. The crucial disadvantage remains the difficulty in primary diagnosis of ovarian cancer and the coexistence with pregnancy, focusing on the fertility preservation and maintaining pregnancy. In the absence of large perspective randomized trials and cohort studies, the therapeutic mapping and optimal management of these patients are difficult. In order to establish detailed guidelines, it is necessary to ensure surgical mapping depending on the cancer staging and the quality of life of the patients.
Part of the book: Obstetrics
Ovarian carcinoma reflects the biggest challenge among the field of gynecologic oncology. It represents the most common death cause of genital carcinomas throughout years. The major classification consists of epithelial and non-epithelial types. Due to the histologic origin, epithelial types of ovarian carcinoma are endometrioid, serous-mucinous, and clear cell types. Due to intense metastatic infiltration and rapid tumor spread, clear cell ovarian carcinoma constitutes type of lesion with the most poor prognosis, decreased overall survival, decreased free survival, and poor quality of life of the patient. The metastatic infiltration is strongly accompanied with all significant prognostic factors. All biochemical pathways at the time of the infiltration are correlated with tumor size, lymphatic spread, staging of the lesion, histologic type, and grade of differentiation of the lesion.
Part of the book: Cancer Metastasis
Leiomyomas represent the most common type of benign tumors of the female genital tract. Assiduous preoperative imaging findings reflect proper therapeutic mapping. In cases of female patients of reproductive age, the ultimate goal remains the fertility preservation and the quality of life of the patient. According to recent bibliography, bizarre leiomyomas remain a controversial issue regarding the preoperative and postoperative therapeutic mapping. Giant cells with pleomorphic nuclei and little or no mitotic activity compose the microscopic analysis of such lesions. Multidisciplinary approach is mandatory in order to establish ultimate diagnosis and treatment. Bizarre leiomyomas still represent a gray scale among the whole scientific community.
Part of the book: Leiomyoma