Kathiane Lustosa Augusto

Endometriosis and Ovarian Cancer: an Integrative Review (Endometriosis and Ovarian Cancer)

Despite being initially considered a benign disease, it is widely thought nowadays that endometriosis and especially ovarian endometriomas are neoplastic conditions with the potential to become malignant. This review was conducted to summarize, in a concise and systematic manner, the available scientific data relating endometriosis to ovarian cancer, published in the past five years. After reading abstracts and applying our predefined inclusion and exclusion criteria, a final list of 11 scientific papers was obtained and subjected to review. Endometriosis is associated with an increased risk of developing epithelial ovarian cancer (EOC), mainly of endometrioid and clear cell subtypes. This might be by virtue of the high estrogen concentration with the disease, which leads to malignant proliferation of endometriotic cysts, or be due to mutations in the ARID1A gene and consequent loss of BAF250a expression. The iron produced in the fluid of endometriotic cysts promotes oxidative stress, which in turn may cause genetic mutations and malignant progression of ovarian cysts.

Defecatory dysfunction and fecal incontinence in women with or without posterior vaginal wall prolapse as measured by pelvic organ prolapse quantification (POP-Q)

INTRODUCTION AND HYPOTHESIS Pelvic Floor Dysfunction is a complex condition that may be asymptomatic or may involve a loto f symptoms. This study evaluates defecatory dysfunction, fecal incontinence, and quality of life in relation to presence of posterior vaginal prolapse. METHODS 265 patients were divided into two groups according to posterior POP-Q stage: posterior POP-Q stage ≥2 and posterior POP-Q stage <2. The two groups were compared regarding demographic and clinical data; overall POP-Q stage, percentage of patients with defecatory dysfunction, percentage of patients with fecal incontinence, pelvic floor muscle strength, and quality of life scores. The correlation between severity of the prolapse and severity of constipation was calculated using ρ de Spearman (rho). RESULTS Women with Bp stage ≥2 were significantly older and had significantly higher BMI, numbers of pregnancies and births, and overall POP-Q stage than women with stage <2. No significant differences between the groups were observed regarding proportion of patients with defecatory dysfunction or incontinence, pelvic floor muscle strength, quality of life (ICIQ-SF), or sexual impact (PISQ-12). POP-Q stage did not correlate with severity of constipation and incontinence. General quality of life perception on the SF-36 was significantly worse in patients with POP-Q stage ≥2 than in those with POP-Q stage <2. CONCLUSIONS The lack of a clinically important association between the presence of posterior vaginal prolapse and symptoms of constipation or anal incontinence leads us to agree with the conclusion that posterior vaginal prolapse probably is not an independent cause defecatory dysfunction or fecal incontinence.

The impact of chronic pelvic pain and its associated symptoms on women’s quality of life in a tertiary care hospital in Brazil

Introduction Chronic pelvic pain (CPP) is a common manifestation of multiple diseases, and might be related to gynecological, musculoskeletal and gastrointestinal causes. CPP is often associated with reduced quality of life (QOL). Objective To investigate whether pain intensity correlates negatively with the QOL in Brazilian women with CPP. Methods We recruited women with CPP referred to our outpatient service from December 2014 to December 2015. QOL was assessed using the Short Form Health Survey (SF-36) while clinical and demographic data were obtained using a standardized form. Statistics included Spearmans rank coefficient test and chi-square test. Results The total SF-36 score correlated negatively with pain intensity as measured by visual analog scale (rho = -0.46). Significant correlations were seen in the role-physical (rho = -0.596), physical functioning (rho = -0.463), role-emotional (rho = -0.402) and bodily pain (rho = -0.471) domains, but not in the other SF-36 domains. There was a positive association between presence of acyclic chronic pain and history of being at emergency rooms for pain control (p = 0.026, chi-square test). Conclusions Pain intensity correlates negatively with QOL in Brazilian women with CPP, but different QOL domains are affected in a heterogeneous fashion. Further research is needed in order to determine the specific reasons behind such differences.