Objective. Uterine myoma is considered the most common gynaecological benign neoplasm occurring in 50-60% of women. Generally, the patients are asymptomatic, but almost a third of women with leiomyomas will require treatment due to symptoms such as heavy uterine bleeding, severe pelvic pain, bulk symptoms, dyspareunia or infertility. Cervical myomas are uncommon, with a prevalence of only 0.6%. Vaginal approach is the classical option for their removal, but when it is impossible, in some cases laparoscopy may be an alternative. This article aims to describe a safe laparoscopic technique for a complete removal of a large cervico-vaginal myoma, the removal of which was impossible with a classical vaginal approach due to its size. Description of the technique. In consideration of the myoma's size, location, characteristics and the impossible vaginal approach, the patient was considered eligible for a laparoscopic myomectomy. Followings are the main surgical steps: set up of surgical view of the intervention field; vertical posterior colpotomy; myoma's peduncle identification and incision; reduction of myoma's size with power morcellation within the vagina; extraction of the fibroid from the vagina to the peritoneal cavity through the colpotomy; completion of the power morcellator and extraction of the whole specimen; colporrhaphy; peritoneal washing. Conclusions. When the vaginal approach is not practicable, laparoscopic management of large myomas in difficult locations such as the cervico-vaginal region seems to be a feasible and a safe surgical option.

To estimate the prevalence of sacroiliac dysfunction during pregnancy in Egypt. Methods: This was a cross-sectional observational study recruiting 861 pregnant women who attended the Obstetrics and Gynecology Department's outpatient clinic at Suez Canal University Hospitals from August 2016 to March 2020. Pain provocation tests were performed, including distraction test, Patrick Faber test, posterior pain provocation test, compression test, and active straight leg raising test. The reference criteria of three or more positive painprovoking tests have high validity for the diagnosis. The primary outcome measurement was the prevalence of sacroiliac dysfunction during pregnancy. Result: 861 pregnant women were involved in this study, with 26.2 ± 6 years. The distraction test, Patrick Faber test, and posterior pain provocation test were the most positive tests (59.1%, 57.1%, and 51%, respectively). Three hundred twenty-four cases were found to have three or more positive pain provocation tests. The prevalence of sacroiliac dysfunction was 37.6%. Conclusion: Sacroiliac dysfunction commonly occurs among pregnant women in Egypt.