With the increasing number of births by Caesarean section a new pathology has made its presence felt, linked to the scarring of the low uterine transverse incision. It was found that after the birth by caesarean section some patients presented postmenstrual prolonged bleeding, spotting, pelvic pain and infertility. First described in 1995, the isthmocele is a healing defect in the anterior wall of the lower uterine segment at the caesarean hysterotomy site. This faulty scarring could be attributed to physiological peculiarities of the patient, to the suturing technique or ascribed to tissue reaction specifically to the type of suture material used. We found that it may be a correlation between the suture materials used and the appearance of the isthmocele. There are no large studies that asses the long-term outcome of C-section scar on prolonged menstrual bleeding, spotting and infertility and no comparison on the rate of appearance of this pathology by account of the suture material.
Quality of life improvement stands as one of the main goals of the medical sciences. Increasing cancer survival rates associated with better early detection and extended therapeutic options led to the specific modeling of patients’ choices, comprising aspects of reproductive life that correlated with the evolution of modern society, and requires better assessment. Of these, fertility preservation and ovarian function conservation for pre-menopause female oncologic patients pose a contemporary challenge due to procreation age advance in evolved societies and to the growing expectations regarding cancer treatment. Progress made in cell and tissue-freezing technologies brought hope and shed new light on the onco-fertility field. Additionally, crossing roads with general fertility and senescence studies proved highly beneficial due to the enlarged scope and better synergies and funding. We here strive to bring attention to this domain of care and to sensitize all medical specialties towards a more cohesive approach and to better communication among caregivers and patients.
In the present environment of staggering technical innovations and increasing expectations of quality healthcare it is evident that we need to fine tune our diagnostic abilities in order to fulfil patients� demands for more efficient therapies and augmented quality of life. We are looking for current trends in clinical gynecology that make use of Liquid chromatography tandem mass spectroscopy, technology not yet employed in Romanian laboratories for the clinical practice but that is rapidly becoming the worldwide method of choice for accurate characterization of the hormonal milieu essential for the requirements of women healthcare.
Stress incontinence is a major social and health problem for middle-aged and elderly women, with an increasing prevalence as life expectancy increases. Reconstructive surgery techniques using vaginal mesh slings of polypropylene (synthetic grafts) have diversified in recent years, but at the same time various postoperative complications have been reported, among the frequent ones being pelvic pain, thigh pain and dyspareunia. The pain mechanism is not fully understood, but pathophysiological theories describe the pain as closely related to the structure, density, size and elasticity of the vaginal mesh, and the inflammatory response of the host.
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