Clinical Usefulness of Mohs' Paste for Genital Bleeding from the Uterine Cervix or Vaginal Stump in Gynecologic Cancer

Yanazume, Yumi; Douzono, Haruhiko; Yanazume, Shintaro; Iio, Kazuto; Kojima, Noriaki; Mukaihara, Keika; Douchi, Tsutomu

doi:10.1089/jpm.2012.0219

Cited by 15 publications

(3 citation statements)

References 11 publications

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“…Yanazume et al [27] reported the clinical usefulness of Moh's paste for genital bleeding from the cervix or vaginal stump in 8 patients with recurrent gynaecological cancer. Moh's paste, made up of a 20% mixture of zinc chloride paste, was first used in the 1930s by Frederic F. Mohs for the chemical fixation of a cutaneous tumour [28].…”

Section: Local Treatment Of Vaginal Bleedingmentioning

confidence: 99%

The management of vaginal bleeding in advanced cervical cancer

Olejniczak,

Zasowska-Nowak

2023

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Cervical cancer is the fourth most diagnosed malignancy worldwide. This narrative review aimed to assess various treatment methods for reducing or completely stopping vaginal bleeding, which is one of the most common and alarming complaints reported by women with cervical cancer. The treatment of bleeding depends on its intensity, potential causes (reversible and irreversible), stage of the disease, and prognosis. In advanced-stage patients receiving palliative care, interventional methods such as embolization or surgical ligation of internal iliac vessels, or epigastric or uterine arteries are usually not possible due to the patient's poor general condition. The treatment of choice is conservative therapy, which includes the performance of vaginal tamponade (usually using sterile gauze, haemostatic gauze, or cellulose sponges), the use of anti-haemorrhagic drugs (tranexamic acid, vitamin K), and, in selected clinical situations, palliative radiotherapy. The literature on the subject points to reports on the effectiveness of topical 4% formalin solution, Mohs paste, Monsel's solution, thrombin, or epinephrine in inhibiting vaginal bleeding. However, these are not supported by data from randomized clinical trials. Data available in databases on the alleviation of cervical vaginal bleeding are limited, so there is a need for further clinical research on this topic.

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Section: Local Treatment Of Vaginal Bleedingmentioning

confidence: 99%

The management of vaginal bleeding in advanced cervical cancer

Olejniczak,

Zasowska-Nowak

2023

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“…Anecdotal case studies exist regarding the topical application of Mohs’ paste (zinc chloride) and Monsel solution (ferric subsulphate) [76]. Although studies mention the use of oral tranexamic acid, no dedicated studies to support this recommendation were found [77,78].…”

Section: Recommendations For Management Of Site-specific Bleedingmentioning

confidence: 99%

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Sood¹,

Mancinetti

Betticher³

et al. 2020

Annals of Medicine and Surgery

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BackgroundPalliative care patients, those suffering from at least one chronic lifelong medical condition and hospice care patients, those with a life expectancy less than 6 months, are regularly hospitalised in general internal medicine wards. By means of a clinical case, this review aims to equip the internist with an approach to bleeding in this population. Firstly, practical advice on platelet transfusions will be provided. Secondly, the management of bleeding in site-specific situations will be addressed (from the ENT/pulmonary sphere, gastrointestinal - urogenital tract and cutaneous ulcers). Finally, an algorithm pertaining to the management of catastrophic bleeding is proposed.MethodsElectronic databases, including EMBASE, Pubmed, Google Scholar and the Cochrane Library were studied as primary resources, in association with local guidelines, to identify papers exploring platelet transfusions and alternative management of site-specific bleeding in palliative care patients.ResultsHaemorrhagic complications are frequent in palliative care patients in the internal medicine ward. Current guidelines propose a therapeutic-only platelet transfusion policy. Nonetheless, prophylactic and/or therapeutic transfusion remains a physician-dependent decision. Site-specific therapeutic options are based on expert opinion and case reports. While invasive measures may be pertinent in certain situations, their application must be compatible with patient goals. Catastrophic bleeding requires caregivers' comforting presence; pharmacological management is secondary.ConclusionLiterature is lacking regarding management of bleeding in the palliative care population hospitalised in an acute medical setting. Recommendations are of limited quality, the majority based on case reports or expert opinion. Further studies, exploring for example the impact on patient quality of life, are desirable to improve the management of this frequently encountered complication.

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“…The 3-month interval, referred to above, was chosen because of its precedent in defining the success of interventions in other cancer settings. 5,19,20 The decision to seek information on the morbidities of coronary artery disease and bleeding diathesis was based on a high likelihood of lowering the thresholds of transfusion and bleeding, respectively. Finally, overall survival, as calculated from the time of vaginal bleeding to death, was also reported.…”

Section: Medical Record Reviewmentioning

confidence: 99%

Causes and Palliation of Transfusion-Associated Vaginal Bleeding in Patients With Metastatic Cancer

Jackson¹,

Stephens

Jatoi

2014

International Journal of Gynecological Cancer

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PURPOSE The current study was undertaken 1) to capture a clinically relevant, systematically-collected series of patients with metastatic cancer and transfusion-associated vaginal bleeding and 2) to provide insight into how best to palliate this bleeding. METHODS/RESULTS As part of a single-institution review, 46 patients with metastatic cancer and transfusion-associated vaginal bleeding were identified. In a minority, 14 (30%), the cancer itself was directly responsible for the bleeding, and, under these circumstances, a gynecological cancer was the most frequent cause. In 13 patients (28%), more than one palliative intervention was attempted. Of all the interventions, a hysterectomy was used most frequently and was successful in 11 patients. The use of ablation or embolization procedures was rarely tried but successful in 4 patients. However, 2 patients died from the vaginal bleeding, despite multiple palliative procedures to control bleeding, including tumor embolization in one. CONCLUSIONS Transfusion-associated vaginal bleeding in patients with metastatic cancer can arise from non-malignant causes, often assumes an uneventful course, but can, at times, be serious and difficult to control.

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Clinical Usefulness of Mohs' Paste for Genital Bleeding from the Uterine Cervix or Vaginal Stump in Gynecologic Cancer

Abstract: The use of Mohs' paste is safe and convenient for massive genital bleeding from the uterine cervix or vaginal stump due to recurrent gynecologic cancer. However, our study does have some limitations including the small number of enrolled subjects and heterogeneous cancer types.

Cited by 15 publications

References 11 publications

The management of vaginal bleeding in advanced cervical cancer

The management of vaginal bleeding in advanced cervical cancer

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Causes and Palliation of Transfusion-Associated Vaginal Bleeding in Patients With Metastatic Cancer

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