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Female Pelvic Medicine & Reconstructive... Jun 2020The aim of the study was to determine whether measures of muscular strength and fitness are associated with pelvic floor muscle (PFM) force 1-year postpartum in a...
OBJECTIVE
The aim of the study was to determine whether measures of muscular strength and fitness are associated with pelvic floor muscle (PFM) force 1-year postpartum in a population of primiparous women who delivered vaginally.
METHODS
This cross-sectional analysis is an ancillary study to an ongoing prospective cohort study and includes 203 primiparous women. Procedures collected 1-year postpartum included maximal PFM force, grip strength, trunk flexor muscle endurance, percent body fat, intra-abdominal pressure during trunk flexor endurance testing, intra-abdominal pressure during strain, and self-reported physical activity.
RESULTS
The mean (SD) age was 29.8 (5.0) years and the mean (SD) body mass index was 24.5 (5.2) kg/m. Nineteen percent were of Hispanic ethnicity. The median (interquartile range) PFM force was 5.05 (2.86-7.94) N. The median (interquartile range) trunk flexor endurance time was 146.0 (78.0-267.0), whereas the mean (SD) grip strength and percent fat were 32.4 (6.4) kg and 29.4% (10.0), respectively.There were no statistically significant associations between PFM force and any of the measures tested on analyses unadjusted or adjusted for self-report of doing PFM exercises. Of other factors evaluated, non-Hispanic ethnicity, increasing age, self-reported family history of pelvic organ prolapse or urinary incontinence, and normal and obese body mass index (both compared with overweight) were associated with lower PFM force.
CONCLUSIONS
In primiparous women 1-year postpartum, we found no associations between PFM force and measures of strength and fitness. This study's results are consistent with existing literature that specific, targeted, and consistent pelvic floor exercises are the best way to improve PFM strength.
Topics: Adult; Cross-Sectional Studies; Exercise; Female; Humans; Muscle Contraction; Muscle Strength; Pelvic Floor; Physical Fitness; Postpartum Period; Prospective Studies; Surveys and Questionnaires
PubMed: 30921083
DOI: 10.1097/SPV.0000000000000718 -
Scientific Reports Jun 2023Previous research on the effects of body mass on the pelvic girdle focused mostly on adult females and males. Because the ontogenetic plasticity level in the pelvis...
Previous research on the effects of body mass on the pelvic girdle focused mostly on adult females and males. Because the ontogenetic plasticity level in the pelvis remains largely unknown, this study investigated how the association between body mass index (BMI) and pelvic shape changes during development. It also assessed how the large variation in pelvic shape could be explained by the number of live births in females. Data included CT scans of 308 humans from infancy to late adulthood with known age, sex, body mass, body stature, and the number of live births (for adult females). 3D reconstruction and geometric morphometrics was used to analyze pelvic shape. Multivariate regression showed a significant association between BMI and pelvic shape in young females and old males. The association between the number of live births and pelvic shape in females was not significant. Less plasticity in pelvic shape in adult females than during puberty, perhaps reflects adaptation to support the abdominopelvic organs and the fetus during pregnancy. Non-significant susceptibility to BMI in young males may reflect bone maturation accelerated by excessive body mass. Hormonal secretion and biomechanical loading associated with pregnancy may not have a long-term effect on the pelvic morphology of females.
Topics: Adult; Male; Pregnancy; Female; Humans; Infant; Pelvis; Lower Extremity; Body Mass Index; Body Size; Puberty
PubMed: 37322042
DOI: 10.1038/s41598-023-36703-2 -
Taiwanese Journal of Obstetrics &... Nov 2022We report a case of an ovarian solitary fibrous tumor (SFT), which rarely occurs in the female genital system.
OBJECTIVE
We report a case of an ovarian solitary fibrous tumor (SFT), which rarely occurs in the female genital system.
CASE REPORT
A 63-year-old postmenopausal woman resorted to the tertiary center seeking management for an intra-abdominal mass. Physical examination disclosed a local abdominal distention. Ultrasound revealed an 18-cm complex mass with inner neovascularization. A whole abdominal computed scan (CT) demonstrated an 18-cm abdominal tumor. The woman then underwent a left salpingo-oophorectomy. Histological examination and immunohistochemical stains of the tumor confirmed the diagnosis of SFT. The patient recovered uneventfully and remained free of recurrence 6 months postoperatively.
CONCLUSION
SFTs in the female genital system are extremely rare and not fully understood. The metastatic risk of the patient was intermediate, according to the modified four-variable risk models based on the World Health Organization (WHO) classification of soft tissue tumors. Close monitoring with clinical evaluation and imaging studies will be conducted.
Topics: Humans; Female; Middle Aged; Ovary; Solitary Fibrous Tumors; Pelvis; Abdominal Neoplasms; Ultrasonography
PubMed: 36427978
DOI: 10.1016/j.tjog.2022.02.051 -
Diagnostics (Basel, Switzerland) Jan 2023Calcified subserous leiomyoma is a rare benign tumor commonly seen in the postmenopausal age group. Cases with severely calcified degeneration all over the mass are...
Calcified subserous leiomyoma is a rare benign tumor commonly seen in the postmenopausal age group. Cases with severely calcified degeneration all over the mass are extremely rare. It causes diagnostic confusion with the solid calcified adnexal mass and the large bladder calculi in the pelvis. We hereby present a case of heavily calcified subserous uterine leiomyoma in a 66-year-old postmenopausal woman. An X-ray of the abdomen and pelvis and CT scan showed a pelvic mass with scattered popcorn appearance in the pelvis, representing severely calcified discrete spots all over the mass. Sonographically, different from typical uterine leiomyomas which exhibit recurrent refractory shadowing patterns, our case showed heavy homogeneous acoustic shadow obscuring all structures beneath the mass surface, resulting in a suboptimal ultrasound examination. Accordingly, CT scans, which are usually not a primary tool for the diagnosis of uterine leiomyomas, are helpful to characterize the mass and identify their organ of origin. The case presented here was treated with a hysterectomy with bilateral oophorectomy and was post-operatively confirmed for severely calcified subserous leiomyomas.
PubMed: 36611445
DOI: 10.3390/diagnostics13010154 -
Journal of Surgical Case Reports Jun 2020Multifocal endometriosis found outside of the pelvis is very rare. We present here a case of endometriosis found in the pelvis, appendix and umbilicus. A 52-year-old...
Multifocal endometriosis found outside of the pelvis is very rare. We present here a case of endometriosis found in the pelvis, appendix and umbilicus. A 52-year-old female had a previous umbilical hernia repair, and years later started to develop a recurrent umbilical mass. After a full work-up, it was decided the patient have a diagnostic laparoscopy with wide local excision of umbilical mass to rule out any underlying malignancy. Findings during the procedure included an umbilical mass, dilated appendix and ovoid mass abutting the appendix. Pathology of the umbilical mass was found to be consistent with endometriosis. Umbilical and pelvic endometriosis is a rare condition. Options for diagnosis prior to surgical interventions are limited in endometriosis. In this case, ruling out underlying malignancy took priority, and the mass was removed and she will have less chance of recurrence.
PubMed: 32595921
DOI: 10.1093/jscr/rjaa120 -
BMJ Case Reports Aug 2021Leiomyosarcoma is a rare aggressive malignant mesenchymal tumour, accounting for 1% of all uterine malignancies. It spreads rapidly through the intraperitoneal and...
Leiomyosarcoma is a rare aggressive malignant mesenchymal tumour, accounting for 1% of all uterine malignancies. It spreads rapidly through the intraperitoneal and haematogenous pathways. It is often diagnosed postoperatively following myomectomy, hysterectomy or supracervical hysterectomy for presumed benign disease. It has a predilection for perimenopausal women with a median age of 50 years. Individuals may describe symptoms of vaginal or abdominal pressure. Physical examination may reveal a large palpable pelvic mass, which may haemorrhage. Surgery remains the mainstay of treatment. Hysterectomy and a bilateral salpingo-oophorectomy may be considered, depending on the individual's menopausal status. Ovarian preservation can be considered in young patients. Adjuvant systemic treatment and radiotherapy are of no benefit. Gemcitabine/docetaxel and doxorubicin have shown benefit in the treatment of advanced or recurrent disease. The authors present the case of a 44-year-old woman with lower abdominal pain, vaginal bleeding and a uterine fibroid. Laboratory investigations confirmed a leucocytosis, neutrophilia and a thrombocythaemia. Further investigation with an MRI pelvis showed a very large, heterogeneous, malignant appearing pelvic mass compressing the right ureter and it appeared uterine in nature. Her staging CT showed multiple lung metastases. The diagnosis of uterine leiomyosarcoma was subsequently established. Due to the aggressive behaviour of this sarcoma subtype, novel early detection strategies and targeted therapies are required.
Topics: Adult; Female; Humans; Leiomyoma; Leiomyosarcoma; Middle Aged; Pelvic Neoplasms; Uterine Myomectomy; Uterine Neoplasms
PubMed: 34433536
DOI: 10.1136/bcr-2021-244233 -
Journal of Ovarian Research Mar 2024Mesonephric-like adenocarcinoma is a new class of rare subtypes of the female reproductive system. Its clinical symptoms are similar to other types of ovarian tumors....
Mesonephric-like adenocarcinoma is a new class of rare subtypes of the female reproductive system. Its clinical symptoms are similar to other types of ovarian tumors. The diagnosis is based on pathological and immunohistochemical methods. The main treatment option is surgery combined with chemotherapy. Few cases have been reported at home and abroad. We reported a case of a 45-year-old woman with a cystic solid mass in the left adnexa. The postoperative pathological diagnosis was mesonephric-like adenocarcinoma of the left ovary and mature cystic teratoma (partial infiltration of the small intestine). This case had no specific clinical symptoms. Immunohistochemical findings showed positive results of GATA3, TTF1, CD10, ER, and PR. Paclitaxel and carboplatin chemotherapy were given after the operation. Currently, no specific criteria are available for diagnosis and treatment of the disease. This article aims to improve the understanding of clinicians in this disease and create a basis for clinical diagnosis and treatment.
Topics: Female; Humans; Middle Aged; Ovarian Neoplasms; Adenocarcinoma; Pelvis; Carboplatin
PubMed: 38444000
DOI: 10.1186/s13048-024-01383-7 -
BMC Cancer Nov 2020Chondrosarcoma (CS) most commonly involves the pelvis. This study aimed to analyze differences in clinical characteristics and prognostic factors between primary and...
BACKGROUND
Chondrosarcoma (CS) most commonly involves the pelvis. This study aimed to analyze differences in clinical characteristics and prognostic factors between primary and secondary conventional pelvic CS, and provide reference for clinical diagnosis and treatment.
METHODS
Eighty patients (54 primary cases and 26 secondary cases) with pelvic CS were included in this retrospective study. The tumor site, Enneking stage, soft tissue mass, margin, initial tumor grade, incidence of local recurrence and distant metastasis were evaluated. Kaplan-Meier method was used to calculate the overall survival rate. X test and log-rank test were used for univariate analysis, and Cox test was used in multivariate analysis.
RESULTS
The average age of patients with secondary CS was significantly younger than that of patients with primary CS (P < 0.001). The soft tissue mass of patients with secondary CS was significantly larger than that of patients with primary CS (P = 0.002). There was a significant difference in initial tumor pathologic grade between the two groups (P = 0.002). No statistically significant difference was observed in the local recurrence rate between the two groups. The median recurrence time of patients with primary CS after the first treatment was significantly shorter than that of patients with secondary CS (P < 0.001). The overall survival rate of patients with secondary CS was much higher than that of patients with primary CS (P = 0.003). Cox regression analysis showed that the initial tumor grade was an independent factor in the overall survival rate of patients with CS.
CONCLUSION
There were significant differences in age, soft tissue mass, initial tumor grade, and overall survival rate between the two groups. The overall survival rate of pelvic CS was related to the initial tumor grade of CS.
Topics: Adult; Age Factors; Bone Neoplasms; Chondrosarcoma; Female; Humans; Male; Margins of Excision; Middle Aged; Neoplasm Grading; Pelvic Bones; Prognosis; Regression Analysis; Retrospective Studies; Survival Rate
PubMed: 33138794
DOI: 10.1186/s12885-020-07530-9 -
BMJ Case Reports Jul 2021A 58-year-old asymptomatic woman was referred to our gynecologic oncology unit for the management of a left adnexal mass found during a routine gynecologic examination....
A 58-year-old asymptomatic woman was referred to our gynecologic oncology unit for the management of a left adnexal mass found during a routine gynecologic examination. Her personal history included an emergency splenectomy at the age of 4 years old, following traumatic splenic laceration after a car accident. The patient's work-up (including transvaginal ultrasound and MRI) confirmed a pelvic solid mass, which was reported as suspicious for malignancy and classified as Ovarian-Adnexal Reporting & Data System-MRI 5. An exploratory laparoscopy was performed, showing a reddish blue lesion located at the left broad ligament. Histologic analysis showed the presence of splenic tissue and normal adnexa. The postoperative follow-up was uneventful.Pelvic splenosis is a challenging diagnosis rarely made preoperatively due to concern for malignancy. In the presence of a pelvic mass, the collection of a detailed patient's history, including information about previous splenic rupture, might raise suspicion for pelvic splenosis.
Topics: Adnexal Diseases; Diagnosis, Differential; Female; Humans; Middle Aged; Pelvis; Splenectomy; Splenosis
PubMed: 34257126
DOI: 10.1136/bcr-2021-243505 -
The American Journal of Case Reports Jun 2020BACKGROUND The aim of this study was to report the clinical diagnosis and treatment of a case of pelvic actinomycosis in our hospital and provide a review of recent... (Review)
Review
BACKGROUND The aim of this study was to report the clinical diagnosis and treatment of a case of pelvic actinomycosis in our hospital and provide a review of recent literature. CASE REPORT The patient was a 54-year-old woman who was admitted to our hospital due to "bilateral lower abdominal tenderness accompanied with anorexia and vomiting for 3 months". After admission, a variety of imaging examinations found pelvic space-occupying lesions, which were considered as malignant. She underwent surgery and pelvic actinomycosis was diagnosed by postoperative pathology. Postoperatively, she was treated with a high-dose sufficient course of penicillin (20 million U, iv gtt) for 14 days and she is currently under close follow-up for 1 year, with no recurrent symptoms. CONCLUSIONS Pelvic actinomycosis is rare and often forms mass invasion into the tissue structure around the pelvic cavity, which is easily misdiagnosed as ovarian malignant tumor. The criterion standard for diagnosing an infection is culture, with histopathology aiding the diagnosis.
Topics: Actinomycosis; Anti-Bacterial Agents; Diagnosis, Differential; Female; Genital Diseases, Female; Humans; Intrauterine Devices; Middle Aged; Pelvis; Penicillins
PubMed: 32532952
DOI: 10.12659/AJCR.922601