Colposcopic Principles and Tissue Basis

Mehta, Sumita; Khatuja, Ritu

doi:10.1007/978-981-13-3438-2_11

Cited by 3 publications

(11 citation statements)

References 14 publications

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“…A family history of endometrial cancer increases the risk of this disease two to three times higher [6], [19]. Phosphatase and tensin homolog (PTEN) germline mutations in autosomal dominant syndrome/Cowden syndrome encode a phosphatase involved in the signaling pathway Phosphoinositide 3-kinase (PI3K/Akt) cells that influence proliferation, apoptosis, and energy metabolism [19], [20].…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged exposure to estrogen without resistance from progesterone triggers endometrial cancer [4], [5]. A high increase in the incidence of endometrial cancer has been linked to multiple studies that have found a relationship between estrogen exposure factors and obesity, nulliparity, early menarche, menopausal status, anovulation or oligo ovulation, polycystic ovary syndrome (PCOS), and a family history of endometrial and colorectal cancer [6], [7]. Genetic mutations linked to Lynch syndrome, Cowden syndrome, and polymerase prof-reading polyposis are among the genetic variables that are also risk factors for endometrial cancer [8].…”

Section: Introductionmentioning

confidence: 99%

“…The high incidence coincides with several lifestyle factors such as increasing obesity, increasing age and older age at first birth [9]. The growth of endometrial cancer can also be caused by hyperinsulinemia and increased levels of the insulin hormone growth factor in patients with diabetes mellitus, resulting in increased endometrial proliferation [6].…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors Analysis of Endometrial Cancer at DR Soetomo Hospital in Surabaya, Indonesia

Dwi Irnasih,

Sandhika,

Dwi Jayanti

2024

IJRP

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Endometrial cancer is a common gynecological cancer that occurs frequently in perimenopausal and postmenopausal women. Several factors influence the incidence of endometrial cancer, such as age, family history of cancer, Body Mass Index, parity, diabetes mellitus, age at menarche, menopausal status, and age at first birth. This study aims to determine the risk factors associated with endometrial cancer in Dr. Soetomo's hospital in Surabaya. This research uses an analytical observational design with a case-control approach. The subjects were chosen by convenience sampling, and 70 patients in the case group and 69 in the control group were obtained. Bivariate analysis using Mann-Whitney and Chi-square, then multivariate analysis using the logistic regression test with significance p<0.05. The results showed that age, family history of cancer, diabetes mellitus, menopausal status, and age at first birth were related to endometrial cancer. Body mass index, parity, and age at menarche are variables not associated with endometrial cancer. Diabetes mellitus is the most dominant factor in increasing endometrial cancer incidence with Odd Ratio (OR)= 7.085 (95% CI; 1. 299-38.637). This research provides information about what factors are related to and influence the incidence of endometrial cancer. The development of these findings needs to be carried out in a larger sample size and using a cohort study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk Factors Analysis of Endometrial Cancer at DR Soetomo Hospital in Surabaya, Indonesia

Dwi Irnasih,

Sandhika,

Dwi Jayanti

2024

IJRP

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“…Lateral vaginal wall collapse is an issue well-known to those frequently performing gynecologic care and is often presented in educational materials teaching new trainees how to perform exams [4,[18][19][20][21][22][23][24][25][26][27]. However, the peer-reviewed, published literature characterizing the issue is limited.…”

Section: Introductionmentioning

confidence: 99%

“…A survey of the members of American Society of Colposcopy and Cervical Pathology showed that 73% of clinicians use this technique, which is more common than sidewall retractors (59%), tenacula (72%), and patient positioning (62%) [7]. Despite their frequent use, to the authors' knowledge, there is only one peer-reviewed article [42] published on PubMed thus far describing how to use these ad hoc solutions and none that rigorously compare the methods, though it is mentioned in passing by some other articles [4,7,[18][19][20] and books [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Improving visualization of the cervix during pelvic exams: A physical model and a steppingstone to reducing disparities in gynecological cancers

Yerrabelli

Palsgaard

Hojati

et al. 2022

Preprint

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PURPOSE Pelvic exams are frequently complicated by collapse of the lateral vaginal walls, obstructing the view of the cervix. To overcome this, physicians frequently repurpose a glove or a condom as a sheath placed over the speculum blades to retract the lateral vaginal walls. Despite their regular use in clinical practice, little research has been done comparing the relative efficacy of these methods. Better visualization of the cervix can benefit patients by decreasing examination-related discomfort, improving cancer screening accuracy, and preventing the need to move the examination to the operating room under general anesthesia. METHODS This study presents a physical model that simulates vaginal pressure being exerted around a speculum. Using it, we then compare the efficacy of different condom types, glove materials, glove sizes, and application methods onto the speculum. RESULTS The results show that the best sheath is the middle finger of nitrile-material gloves. They provide adequate lateral wall retraction without significantly restricting the opening of the speculum. In comparison, condoms provide a smaller amount of retraction due to loosely fitting the speculum. They may still be a reasonable option for a different speculum size. However, vinyl-material gloves are an impractical option for sheaths; they greatly restrict speculum opening, occasionally even breaking the speculum, which overcome its retraction benefits. Glove size, condom brand, and condom material (latex vs polyisoprene) had minimal impact. CONCLUSION This study serves as a guide for clinicians as they use easily accessible tools to perform difficult pelvic exams. We recommend that physicians consider nitrile gloves as the preferred option for a sheath around a speculum. Additionally, this study demonstrates proof-of-concept of a physical model that quantitatively describes different materials on their ability to improve cervical access. This model can be used in future research with more speculum and material combinations, including with materials custom-designed for vaginal retraction.

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Improving visualization of the cervix during pelvic exams: A simulation using a physical model of the speculum and human vagina as a steppingstone to reducing disparities in gynecological cancers

Yerrabelli,

Palsgaard,

Hojati

et al. 2023

PLoS ONE

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Pelvic exams are frequently complicated by collapse of the lateral vaginal walls, obstructing the view of the cervix. To overcome this, physicians frequently repurpose a glove or a condom as a sheath placed over the speculum blades to retract the lateral vaginal walls. Despite their regular use in clinical practice, little research has been done comparing the relative efficacy of these methods. Better visualization of the cervix can benefit patients by decreasing examination-related discomfort, improving cancer screening accuracy, and preventing the need to move the examination to the operating room under general anesthesia. This study presents a physical model that simulates vaginal pressure being exerted around a speculum. Using it, we conduct controlled experiments comparing the efficacy of different condom types, glove materials, glove sizes, and techniques to place gloves on the speculum. The results show that the best sheath is the middle finger of nitrile-material gloves. They provide adequate lateral wall retraction without significantly restricting the opening of the speculum. In comparison, condoms provide a smaller amount of retraction due to loosely fitting the speculum. They may still be a reasonable option for a different speculum size. However, vinyl-material gloves are an impractical option for sheaths; they greatly restrict speculum opening, occasionally even breaking the speculum, which overcome its retraction benefits. Glove size, condom brand, and condom material (latex vs polyisoprene) had minimal impact. This study serves as a guide for clinicians as they use easily accessible tools to perform difficult pelvic exams. We recommend that physicians consider nitrile gloves as the preferred option for a sheath around a speculum. Additionally, this study demonstrates proof-of-concept of a physical model that quantitatively describes different materials on their ability to improve cervical access. This model can be used in future research with more speculum and material combinations, including with materials custom-designed for vaginal retraction.

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Colposcopic Principles and Tissue Basis

Cited by 3 publications

References 14 publications

Risk Factors Analysis of Endometrial Cancer at DR Soetomo Hospital in Surabaya, Indonesia

Risk Factors Analysis of Endometrial Cancer at DR Soetomo Hospital in Surabaya, Indonesia

Improving visualization of the cervix during pelvic exams: A physical model and a steppingstone to reducing disparities in gynecological cancers

Improving visualization of the cervix during pelvic exams: A simulation using a physical model of the speculum and human vagina as a steppingstone to reducing disparities in gynecological cancers

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