Subtotal hysterectomy reviewed: a stable or aperture for stump cervical malignancy. A referral hospital experience

Fram, Kamil; Saleh, Shawqi; Fram, Farah; Fram, Rand; Muhidat, Nadia; Abdaljaleel, Maram; Sweis, Narjes; Khouri, Zaid; Al-Qudah, Farah

doi:10.5114/pm.2022.124016

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Vaccinations against cervical cancer must be kept in mind, and they are an important target to address because 600 women (91.6%) had no idea about the vaccine or its purpose, and even though 35 women (5.3%) were aware of this vaccine, they were not happy to be vaccinated; and only 20 women (3.1%) had taken the vaccine before [22][23][24]. Early diagnosis of cancerous diseases gives a recovery opportunity for the patient, especially by employing therapeutic skills, especially the surgical skills that come to the fore in the surgical steps [25].…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer screening in Jordan; a review of the past and an outlook to the future – facts and figures

Fram¹,

Fram²,

Saleh³

et al. 2023

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Introduction: This study aims to assess the attitude, knowledge, and behaviour of Jordanian women toward cervical cancer screening and its phenomenal role in preventing the disease, and to identify the defects and obstacles in the national screening programs for early detection of this manageable kind of malignancy.Material and methods: A prospective study via a questionnaire that included the demographic data, knowledge, behaviour, and attitude among Jordanian women about the cervical screening program using face-to-face interviews.Results: Among 655 women who responded to the questionnaire, 340 (51.9%) reported having no idea about the smear, 350 (53.4%) had completed higher education, 84 (12.84%) were not happy to be screened, and 53 (8.09%) were afraid of the result being positive for malignancy. The shocking and scandalous upshots reported that 600 women (91.6%) had no idea about the role of vaccination against this threatening disease.Conclusions: Screening programs occupy a limited space among the health care provider's priorities. The health education and national awareness strategy regarding cervical cancer should be adopted and implemented in primary health care units. The media with its different facets and platforms must take responsibility and share this national cancer education battle. The once-in-a-lifetime screening test should be adopted urgently, being the most important step, because it represents the minimum correct starting point to lessen the future burden on the national healthcare system and benefit the health of the target groups.

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Section: Discussionmentioning

confidence: 99%

Cervical cancer screening in Jordan; a review of the past and an outlook to the future – facts and figures

Fram¹,

Fram²,

Saleh³

et al. 2023

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“…Nevertheless, recent publications have contradicted these assertions and revealed that, compared with total abdominal hysterectomy, subtotal hysterectomy did not improve outcomes in terms of urinary or sexual function. Not surprisingly, women who underwent subtotal hysterectomy were more likely to experience postoperative vaginal bleeding from the cervical stump until one year after surgery compared with women who underwent total abdominal hysterectomy [25][26][27]. The potential development of carcinoma on the cervical stump is a further cause of concern.…”

Section: Introductionmentioning

confidence: 99%

“…The potential development of carcinoma on the cervical stump is a further cause of concern. The presence of cancer can be determined with relative accuracy only during the procedure [25].…”

Section: Introductionmentioning

confidence: 99%

“…Although subtotal hysterectomy is easier to perform and involves less extensive surgery, shorter operating times, and less perioperative bleeding [25], it does bear the risk of persistent pain and repeat surgery [22,[28][29][30]. Several studies advise against subtotal hysterectomy in women with endometriosis, pelvic pain, or dysmenorrhea [22,28,29].…”

Section: Introductionmentioning

confidence: 99%

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Total or Subtotal Hysterectomy for the Treatment of Endometriosis: A Review

Alkatout

Mazidimoradi

Salehiniya

et al. 2023

JCM

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Objective: The purpose of the review was to evaluate and compare outcomes after total or subtotal hysterectomy in women with endometriosis or adenomyosis. Methods: We searched four electronic databases: Medline (PubMed), Scopus, Embase, and Web of Science (WoS). The first aim of the study was to compare outcomes after total and subtotal hysterectomy in women with endometriosis, and the second aim was to compare the two procedures in women with adenomyosis. Publications that reported short- and long-term outcomes after total and subtotal hysterectomy were included in the review. The search was not subject to any limitation in terms of time or method. Results: After screening 4948 records, we included 35 studies published from 1988 to 2021; the studies were based on various methodologies. With regard to the first aim of the review, we found 32 eligible studies and divided these into the following four categories: postoperative short- and long-term outcomes, recurrence of endometriosis, quality of life and sexual function, and patient satisfaction after total or subtotal hysterectomy in women with endometriosis. Five investigations were deemed eligible for the second aim of the review. No differences were seen in terms of postoperative short- and long-term outcomes after subtotal or total hysterectomy in women with endometriosis or adenomyosis. Conclusions: Preservation or removal of the cervix in women with endometriosis or adenomyosis appears to have no effect on short- or long-term outcomes, recurrence of endometriosis, quality of life and sexual function, or patient satisfaction. Nevertheless, we lack randomized blinded controlled trials on these aspects. Such trials will be needed to enhance our comprehension of both surgical approaches.

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Justification of the necessity, value, and role of diagnostic hysteroscopy in the management plan for abnormal uterine bleeding. A teaching hospital experience

Fram,

Fram

et al. 2024

OGIJ

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Aims: The crucial purpose of this study is to pay thoughtfulness to the filmic inspection of the uterine cavity and circumstantial operative amenities have provided the gynecologist with the perfect 'diagnostic' tool, making it conceivable to inspect the cavity and biopsy distrusted areas under direct visualization for patients presented with abnormal uterine bleeding AUB in the perimenopausal or postmenopausal periods. Materials and methods: We retrospectively reviewed the medical records of 123 perimenopausal and postmenopausal women who presented with abnormal uterine bleeding (AUB) at Jordan University Hospital (JUH) between January 1, 2022, and August 1, 2024. Participants underwent diagnostic hysteroscopy followed by endometrial biopsy. The hysteroscopic findings were compared with the final histopathological diagnoses to evaluate diagnostic accuracy. Results: In this study of 123 women, clinical indications for hysteroscopy differed by menopausal status, with heavy menstrual bleeding being the most common indication among premenopausal women (74.6%), while postmenopausal bleeding was predominant in postmenopausal women (80.8%). Hysteroscopy revealed a regular uterine cavity in 92.7% of cases, with endometrial abnormalities such as thickened or thin endometrium observed in a significant number of women. Histopathological analysis found normal endometrium in 47.2% of cases, with endometrial polyps (16.3%) and other conditions such as hormonal imbalance and endometritis also frequently noted. A significant relationship was observed between menopausal status and both uterine cavity condition (p = .025) and endometrial state (p = .002), with postmenopausal women more likely to exhibit a thin or abnormal endometrium. The diagnostic value of hysteroscopy was high for fibroids (100% detection) but lower for endometrial polyps (50% detection). Conclusion: Hysteroscopy must be used as the second-line diagnostic tool after vaginal ultrasound assessment for evaluating the endometrial status in cases of AUB and a necessary step before the decision of surgical removal of the uterus. However, hysteroscopy is not very reliable for ruling out endometrial hyperplasia or cancer in women who have postmenopausal bleeding. Because of this, an endometrial biopsy is crucial for an accurate diagnosis.

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Subtotal hysterectomy reviewed: a stable or aperture for stump cervical malignancy. A referral hospital experience

Cited by 3 publications

References 26 publications

Cervical cancer screening in Jordan; a review of the past and an outlook to the future – facts and figures

Cervical cancer screening in Jordan; a review of the past and an outlook to the future – facts and figures

Total or Subtotal Hysterectomy for the Treatment of Endometriosis: A Review

Justification of the necessity, value, and role of diagnostic hysteroscopy in the management plan for abnormal uterine bleeding. A teaching hospital experience

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