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Veto MM, Chazalon J, Atallah-Seive C, Charles R, Savall A. Speculum self-insertion: an alternative method for gynaecological examination? Fam Pract 2024; 41:147-154. [PMID: 38518797 DOI: 10.1093/fampra/cmae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Speculum examination is an intrusive practice in the clinical care of women. It requires privacy and patients may experience discomfort or anxiety related to the procedure, which can result in delays or avoidance of necessary healthcare. Speculum self-insertion originated in the United States in the 1970s as part of the self-help movement. However, this clinical practice is largely unknown among healthcare providers and has rarely been assessed. AIM This study investigates the women's views and healthcare providers' experiences of the self-insertion method. METHOD A qualitative study was conducted between December 2021 and October 2022, including fieldwork combining semi-structured interviews (10 women) and focus groups associated with individual interviews of 13 healthcare providers. The data collected were independently coded by 2 authors and analysed using an inductive approach and grounded theory method. RESULTS Speculum self-insertion was described as a way to decrease discomfort and facilitate speculum insertion. Self-insertion was proposed as a means of allowing women to participate in the examination, reducing their vulnerability against power imbalances in the doctor-patient relationship. Both patients and healthcare providers have reported that speculum self-insertion is a method that can contribute to improving trust and communication during the examination. CONCLUSION The practice of speculum self-insertion during the consultation is an alternative to traditional practitioner insertion and may be offered to all women by any practitioner who wishes to use this technique.
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Affiliation(s)
- Marie-Morgane Veto
- Department of Education and Research in General Practice, Jean Monnet University, Saint-Etienne, France
| | - Julie Chazalon
- Department of Education and Research in General Practice, Jean Monnet University, Saint-Etienne, France
| | - Corinne Atallah-Seive
- Department of Education and Research in General Practice, Jean Monnet University, Saint-Etienne, France
| | - Rodolphe Charles
- Department of Education and Research in General Practice, Jean Monnet University, Saint-Etienne, France
- Inserm CIC-EC 1408, University Hospital, Saint-Etienne, France
| | - Angélique Savall
- Department of Education and Research in General Practice, Jean Monnet University, Saint-Etienne, France
- Inserm CIC-EC 1408, University Hospital, Saint-Etienne, France
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de Farias ADA, de Siqueira Barbosa LN, Weller M. Factors that Affect Performance of Clinical Breast Examination and Mammography Screening among Brazilian Women. Asian Pac J Cancer Prev 2023; 24:3477-3486. [PMID: 37898853 PMCID: PMC10770697 DOI: 10.31557/apjcp.2023.24.10.3477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/19/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND In the Brazilian health system, community health facilities consist of multidisciplinary teams that focus on family health, whereas health centers treat mainly illnesses of registered patients. In the present study we compared socio-economic factors and performance of mammography screening (MS) and clinical breast exam (CBE), respectively, among women who used both types of public health service centers. METHODS The present study included 180 women aged ≥40 years, who used different health service centers within the same municipal district. Of all 180 women, 110 (41.1%) and 70 (38.9%) used a health center and a community health facility. Logistic regression analysis was performed to calculate odds ratios (ORs) and confidence intervals (CIs) of variables. RESULTS Regression modeling indicated that women who used the community health facility, performed annual MS 9.52 (OR= 0.105; 95%CI: 0.03- 0.36) times more often (p <0.001). In this model retirement and gynecological service use ≤ each second year, increased annual MS performance 8.16 (95%CI: 1.55- 54.32) and 7.78 (95%CI: 2.54- 23.79) times (p <0.001; p <0.001). Among 113 (62.8%) women who reported strong fear of MS, the chance of its performance was 35.71 (OR= 0.028; 95%CI: 0.02- 0.32) times decreased (p= 0.05). In a second model use of gynecological service ≤ each second year, increased chance of annual CBE performance 7.92 (95%CI: 3.25- 19.29) times (p <0.001). Women who used the community health facility performed annual and bi-annual CBE 2.90 (OR= 0.345; 95%CI: 0.14- 0.86) and 2.97 (OR= 0.337; 95%CI: 0.12- 0.92) times more often, compared to women who used the health center (p =0.030). CONCLUSIONS Performance of MS and CBE varied both considerable among women who used different types of health service centers. Gynecological service use, fear and socioeconomic variables, additionally influenced regular performance of MS and CBE.
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Affiliation(s)
| | | | - Mathias Weller
- Post Graduate Program in Public Health. State University of Paraíba (UEPB). Campina Grande-Paraíba, Brazil.
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Laschke A, Blaakaer J, Jensen CF, Larsen MB. Danish women's preferences regarding gynecological examination support international recommendations: A cross-sectional study. Int J Gynaecol Obstet 2023; 162:1068-1076. [PMID: 37158417 DOI: 10.1002/ijgo.14828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Gynecological examinations (GEs) are challenging for many women. Several recommendations and guidelines have emerged, partly based on common sense and clinicians' consensus. However, there is a lack of knowledge regarding women's opinions. Therefore, this study aimed to describe women's preferences and experiences in relation to GEs and investigate whether they are dependent on their socioeconomic status. METHODS In Denmark, GEs are typically performed by general practitioners or resident specialists in gynecology (RSGs) in gynecological hospital departments. This cross-sectional questionnaire and register study included approximately 3000 randomly selected patients who visited six RSGs from January 1, 2020, to March 1, 2021. The main outcome measurement involved women's preferences and experiences regarding GEs. RESULTS Overall, 37% of the women thought that a changing room was important, 20% preferred a garment to cover themselves, 18% preferred a separate examination room, and 13% thought that the presence of a chaperone was important. Compared with working and retired women, more women outside the workforce felt insufficiently informed, considered their experience with RSGs unprofessional, and found GEs painful. CONCLUSION Our results support existing recommendations regarding GEs and the related environment, confirming that privacy and modesty are factors to take into consideration as they are of concern for a relatively large group of women. Thus, providers should focus on women outside the workforce, because this group appears to feel vulnerable in this environment.
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Affiliation(s)
- Alexander Laschke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Speciallaegeselskabet Alexander Laschke ApS, Aabenraa, Denmark
| | - Jan Blaakaer
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
| | | | - Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark
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Heredia M F, Díaz C L, Kobylianskii A, Escalona M J, Escalona A, Lemos N. Spontaneous paravaginal venous plexus thrombosis presenting as acute lower pelvic pain: a clinical conundrum. J Obstet Gynaecol Can 2023:S1701-2163(23)00112-3. [PMID: 36870437 DOI: 10.1016/j.jogc.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 03/06/2023]
Abstract
Acute pelvic pain due to venous thrombosis can be encountered in the context of Pelvic Congestion Syndrome (PCS). Some vascular anomalies such as nutcracker syndrome or May-Thurner syndrome may cause left ovarian vein or left iliofemoral vein thrombosis. Smaller parametrial or paravaginal vein thrombi have rarely been reported as etiologies of acute pelvic pain. We present a case of spontaneous paravaginal venous plexus thrombosis presenting as acute lower pelvic pain in which thrombophilia was diagnosed. Small vein thrombosis or an unusual location of thrombus should prompt vascular studies and a thrombophilia work-up.
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Choi S, Lee YJ, Jeong JH, Jung J, Lee JW, Kim HJ, Ko BS, Son BH, Ahn SH, Lee Y, Chung IY. Risk of Endometrial Cancer and Frequencies of Invasive Endometrial Procedures in Young Breast Cancer Survivors Treated With Tamoxifen: A Nationwide Study. Front Oncol 2021; 11:636378. [PMID: 34150613 PMCID: PMC8209428 DOI: 10.3389/fonc.2021.636378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/06/2021] [Indexed: 01/31/2023] Open
Abstract
Background Although the guidelines recommend gynecological assessment and close monitoring for symptoms of endometrial cancer in postmenopausal breast cancer survivors taking tamoxifen (TAM), the risk of endometrial cancer in young breast cancer survivors has not yet been fully assessed. This study aimed to investigate the risk of developing endometrial cancer and the frequencies of gynecological examinations in young breast cancer survivors taking TAM in South Korea. Methods A nationwide retrospective cohort study was conducted using the Health Insurance Review and Assessment Service claims data. Kaplan–Meier analyses and log-rank tests were used to assess the probability of endometrial cancer, benign endometrial conditions, and the probability of invasive endometrial procedure. To analyze the risk of endometrial cancer and benign endometrial conditions, we used a multivariable Cox proportional hazards regression model. Results Between 2010 and 2015, 60,545 newly diagnosed female breast cancer survivors were included. The total person–years were 256,099 and 140 (0.23%) patients developed endometrial cancer during the study period. In breast cancer survivors aged ≥60 years [hazard ratio (HR), 5.037; 95% confidence interval (CI), 2.185–11.613], 50–59 years (HR, 4.343; 95% CI, 2.122–8.891), and 40–49 years (HR, 2.121; 95% CI, 1.068–4.213), TAM was associated with an increased risk of endometrial cancer. In subjects aged below 40 years, TAM did not significantly increase the risk of endometrial cancer. However, among the TAM subgroups, breast cancer survivors aged below 40 years [1.61 per 1,000 person–years (PY); HR, 12.460; 95% CI, 2.698–57.522] and aged 40–49 years (2.22 per 1,000 PY; HR, 9.667; 95% CI, 4.966–18.819) with TAM-related endometrial diseases showed significantly increased risks of endometrial cancer. Among the TAM subgroup with benign endometrial conditions, the ratios of the frequency of invasive diagnostic procedures to the incidence of endometrial cancer were higher in subjects under 40 than subjects aged 60 or more. Conclusion Young breast cancer survivors with TAM-related benign endometrial diseases are at a higher risk of developing endometrial cancer. Gynecological surveillance should be tailored to the risk of endometrial cancer in young breast cancer survivors to improve the early detection of endometrial cancer and avoid unnecessary invasive procedures.
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Affiliation(s)
- Soojeong Choi
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young Jae Lee
- Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Jae Ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jinhong Jung
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jong Won Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hee Jeong Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Beom Seok Ko
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Byung Ho Son
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sei Hyun Ahn
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yura Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Il Yong Chung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Drosdzol-Cop A, Fuchs A, Dulska A, Skrzypulec-Plinta V. Recommendations of the Expert Group of the Polish Society of Gynecologists and Obstetricians regarding gynecological examination and treatment of a minor during the SARS-CoV-2 pandemic. Ginekol Pol 2020; 91:488-489. [PMID: 32902849 DOI: 10.5603/gp.2020.0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 11/25/2022] Open
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Demirel G, Ertekin Pinar S, Bilgic D. Anxiety levels and methods of coping with stress of adolescents undergoing their first gynecological examination. J Psychosom Obstet Gynaecol 2020; 41:131-136. [PMID: 31328602 DOI: 10.1080/0167482x.2019.1643314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: The present study was conducted to assess the anxiety levels and the methods of coping with the stress of adolescents who underwent their first gynecological examination.Methods: The sample of this descriptive study consisted of 223 married or single adolescent women who went to a state hospital in Sivas Province in Turkey for their first gynecological examination. The data were collected by face-to-face interviews with the Personal Information Form, the State Anxiety Inventory (SAI) and the Ways of Coping Inventory (WCI).Results: There was a statistically significant negative correlation between the SAI scores, and the self-confident approach (r = -0.305; p = 0.001) and optimistic approach (r = -0.170; p = 0.011) of the WCI subscales. A statistically significant positive correlation was found between SAI scores, and the desperate approach (r = 0.153; p = 0.022) and submissive approach (r = 0.143; p = 0.032).Conclusion: Adolescent women who underwent their first gynecological examination have "moderate" levels of anxiety and their coping with stress styles are ineffective. As anxiety levels increase, they use more ineffective methods.
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Affiliation(s)
- Gulbahtiyar Demirel
- Department of Midwifery, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Sukran Ertekin Pinar
- Department of Midwifery, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Dilek Bilgic
- Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
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Dziobek K, Opławski M, Grabarek BO, Zmarzły N, Kieszkowski P, Januszyk P, Kiełbasiński K, Kiełbasiński R, Boroń D. Assessment of the Usefulness of the SEMA5A Concentration Profile Changes as a Molecular Marker in Endometrial Cancer. Curr Pharm Biotechnol 2020; 21:45-51. [PMID: 31544715 DOI: 10.2174/1389201020666190911113611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/12/2019] [Accepted: 08/18/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Semaphorin 5A (SEMA5A) functions not only in the nervous system but also in cancer transformation where its role has not yet been sufficiently studied and described. OBJECTIVE The aim of the study was to determine the changes in SEMA5A expression in endometrial cancer at various degrees of its differentiation (G1-G3) compared to control. MATERIALS AND METHODS The study group consisted of 45 patients with endometrial cancer at various grades: G1, 17; G2, 15; G3, 13. The control consisted of 15 women without neoplastic changes in the routine gynecological examination. The statistical analysis of immunohistochemical assessment of SEMA5A level was carried out using the Statistica 12 program based on the Kruskal-Wallis test and Dunn's post-hoc test (p<0.05). RESULTS The expression of SEMA5A (optical density) was observed in the control group (Me = 103.43) and in the study group (G1, Me = 140.72; G2, Me = 150.88; G3, Me = 173.77). Differences in expression between each grade and control and between individual grades turned out to be statistically significant (p<0.01). The protein level of SEMA5A expression increased with the decreasing degree of endometrial cancer differentiation. CONCLUSION In our research, we indicated the overexpression of SEMA5A protein in endometrial cancer. It is a valuable starting point for further consideration of the role of SEMA5A as a new supplementary molecular marker in endometrial cancer.
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Affiliation(s)
- Konrad Dziobek
- Center of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Marcin Opławski
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, Kraków, Krakow, Poland
| | - Beniamin O Grabarek
- Center of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.,Katowice School of Technology, The University of Science and Art in Katowice, Katowice, Poland.,Department of Molecular Biology, School of Pharmaceutical in Sosnowiec, Medical University of Silesia in Katowice, Katowice, Poland
| | - Nikola Zmarzły
- Katowice School of Technology, The University of Science and Art in Katowice, Katowice, Poland.,Department of Molecular Biology, School of Pharmaceutical in Sosnowiec, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Piotr Januszyk
- Katowice School of Technology, The University of Science and Art in Katowice, Katowice, Poland.,Faculty of Health Science, Public Higher Medical Professional School in Opole, Opole, Poland
| | | | - Robert Kiełbasiński
- Department of Obstetrics & Gynaecology ward, Health Center in Mikołów, Mikołów, Poland
| | - Dariusz Boroń
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, Kraków, Krakow, Poland.,Katowice School of Technology, The University of Science and Art in Katowice, Katowice, Poland.,Faculty of Health Science, Public Higher Medical Professional School in Opole, Opole, Poland
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Milan B, Sampaio BFB, Silva EVDCE, Leal CRB, Navarro B, Gomes DC. The gynecological examination in Pantaneiro mares. Anim Reprod 2020; 17:e20190031. [PMID: 32399064 PMCID: PMC7212739 DOI: 10.21451/1984-3143-ar2019-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Gynecological examination is essential to assess the reproductive tract of mares and can provide important information about the uterine environment. It includes physical, vaginal, and rectal examination, ultrasound, cytology, culture, and endometrial biopsy. The present study aimed to perform gynecological examination and fertility to assess the fertility prognosis of Pantaneiro mares that have not been reproductively active and to determine their reproductive ability. Eight mares underwent ultrasound and gynecological examination and artificial insemination. Ultrasound revealed changes only in one mare. Histopathological findings were mild, such as periglandular and perivascular inflammatory cell infiltrates, fibrotic areas, glandular dilation, glandular island formation, and edema due to the phase of the estrous cycle. One animal was classified in category I and the others in category IIA. Cytological changes were found in only one mare. Endometrial culture from five mares resulted in isolation of Pseudomonas sp., Bacillus sp., Escherichia coli and Candida sp. Only four mares resulted pregnant through artificial insemination, using the same stallion with fresh semen, which has been proving fertility. Thus, mares with better uterine conditions will not always become pregnant and those with mild changes will not always be barren.
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Affiliation(s)
- Bruno Milan
- Faculdade de Medicina Veterinária e Zootecnia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | | | | | - Cassia Rejane Brito Leal
- Faculdade de Medicina Veterinária e Zootecnia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Bruna Navarro
- Faculdade de Medicina Veterinária e Zootecnia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Danilo Carloto Gomes
- Faculdade de Medicina Veterinária e Zootecnia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
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Nunes RD, Cascaes M, Schneider IJC, Traebert J. Effects of using lubricant during the speculum examination for Pap smear collection. Diagn Cytopathol 2018; 46:1040-1044. [PMID: 30284399 DOI: 10.1002/dc.24069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the effect of using lubricant during speculum examination for Pap smear collection. METHODS A cross-sectional study was conducted involving 83 patients attending a medical school clinic. Participants were allocated into two groups: Group 1-Lubricant using; Group 2-No lubricant using. All patients were submitted to two successive collections and after were asked about their level of discomfort. Differences between groups regarding quality, artifacts, cytology, and level of discomfort were observed through chi-squared test. Odds ratios and 95% confidence intervals were also estimated. Statistical significance was set at P < .05. RESULTS No significant differences between groups regarding quality, presence of artifacts, and cytological results were observed. Significant lower discomfort level in Group 1 (lubricant using). CONCLUSION The use of vaginal lubricant did not affect the results of cytology and could be a useful tool to reduce the discomfort during Pap smear collection.
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Affiliation(s)
- Rodrigo Dias Nunes
- Faculty of Medicine, University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil.,Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil
| | - Maisa Cascaes
- Faculty of Medicine, University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil
| | - Ione Jayce Ceola Schneider
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil
| | - Jefferson Traebert
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Santa Catarina, Brazil
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Palacios S, Nappi RE, Bruyniks N, Particco M, Panay N. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric 2018; 21:286-291. [PMID: 29553288 DOI: 10.1080/13697137.2018.1446930] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The primary objective of the European Vulvovaginal Epidemiological Survey (EVES) was to assess, at a country level, the prevalence of postmenopausal women with vulvovaginal atrophy (VVA) confirmed by gynecological clinical assessment among all postmenopausal women attending menopause centers. METHOD Women aged 45-75 years old with their last menstrual period more than 12 months before and who attended menopause or gynecology centers were included. If they had at least one VVA symptom, women filled a number of questionnaires including the EuroQoL-EQ-5D3L and Day-to-Day Impact of Vaginal Aging (DIVA). Then a gynecological examination was performed to confirm the VVA diagnosis. RESULTS A total of 2160 evaluable patients were included in the study. VVA was confirmed in 90% of the patients. Compared with patients without confirmed VVA (n = 206), patients with confirmed VVA (n = 1954) were significantly older (p < 0.001), had more severe symptoms (p < 0.001 for vaginal and vulvar symptoms, p < 0.05 for urinary ones) and had a lower quality of life as assessed by EQ-5D3L (p = 0.012) and DIVA (p < 0.001). CONCLUSION VVA is highly prevalent among postmenopausal women. Gynecological clinical assessment of VVA is associated with severe symptoms and impaired quality of life and therefore should be promoted for appropriate clinical assessment and early therapeutic intervention.
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Affiliation(s)
- S Palacios
- a Palacios Institute of Women's Health , Madrid , Spain
| | - R E Nappi
- b Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause , IRCCS S. Matteo Foundation , Pavia , Italy.,c Department of Clinical, Surgical, Diagnostic and Paediatric Sciences , University of Pavia , Pavia , Italy
| | | | | | - N Panay
- f Imperial College London , London , UK
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