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Female Genital Diseases HELP
Based on 100,000 articles published since 2008
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These are the 100000 published articles about Genital Diseases, Female that originated from Worldwide during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline [Management of epithelial ovarian cancer. Short text drafted from the French joint recommendations of FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa]. 2019

Lavoue, Vincent / Huchon, Cyrille / Akladios, Cherif / Alfonsi, Pascal / Bakrin, Naoual / Ballester, Marcos / Bendifallah, Sofiane / Bolze, Pierre-Adrien / Bonnet, Fabrice / Bourgin, Charlotte / Chabbert-Buffet, Nathalie / Collinet, Pierre / Courbiere, Blandine / De la Motte Rouge, Thibault / Devouassoux-Shisheboran, Mojgan / Falandry, Claire / Ferron, Gwenal / Fournier, Laure / Gladieff, Laurence / Golfier, François / Gouy, Sébastien / Guyon, Frédérique / Lambaudie, Eric / Leary, Alexandra / Lecuru, Fabrice / Lefrere-Belda, Marie-Aude / Leblanc, Eric / Lemoine, Adrien / Narducci, Fabrice / Ouldamer, Lobna / Pautier, Patricia / Planchamp, François / Pouget, Nicolas / Ray-Coquard, Isabelle / Rousset-Jablonski, Christine / Senechal-Davin, Claire / Touboul, Cyril / Thomassin-Naggara, Isabelle / Uzan, Catherine / You, Benoit / Daraï, Emile. ·CHU de Rennes, hôpital sud, service de gynécologie, 16, boulevard de Bulgarie, 35000 Rennes, France; Chemistry, oncogenesis, stress and signaling, centre Eugène Marquis, Inserm 1242, rue Bataille Flandres-Dunkerque, 35000 Rennes, France. Electronic address: Vincent.lavoue@chu-rennes.fr. · CHI Poissy, service de gynécologie, 78300 Poissy, France. · CHU Strasbourg, hôpital Hautepierre, service de gynécologie, 67000 Strasbourg, France. · Hôpital Saint-Joseph, service d'anesthésie, 75000 Paris, France. · CHU Lyon-Sud, service de chirurgie digestive, Pierre-Bénite, 69000 Lyon, France. · Groupe hospitalier Diaconesses Croix Saint Simon, service de gynécologie, 75000 Paris, France. · AP-HP, institut universitaire de cancérologie Sorbonne université, service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, UMRS-938, 4, rue de La Chine, 75020 Tenon, France. · CHU Lyon-Sud, service de chirurgie gynécologique, Pierre Bénite, 69000 Lyon, France. · AP-HP, hôpital Tenon, service d'anesthésie, 75020 Tenon, France. · CHRU, hôpital Jeanne de Flandres, service de chirurgie gynécologique, 59000 Lille, France. · AP-HM La Conception, pôle Femmes-Parents-Enfants-centre clinico-biologique d'AMP, 147, boulevard Baille, 13000 Marseille, France; Aix-Marseille université, CNRS, IRD, Avignon université, IMBE UMR 7263, 13000 Marseille, France. · Centre Eugène Marquis, service d'oncologie médicale, 35000 Rennes, France. · CHU Lyon-Sud, service d'anatomo-pathologie, hospices civiles de Lyon, Pierre-Bénite, 69000 Lyon, France. · CHU Lyon-Sud, service d'oncogériatrie, hospices civiles de Lyon, Pierre-Bénite, 69000 Lyon, France. · Institut Claudius Regaud, IUCT Oncopole, service d'oncologie chirurgicale, 31000 Toulouse, France. · AP-HP, service de radiologie, hôpital Européen Georges Pompidou, 75015 Paris, France. · Institut Claudius Regaud, IUCT Oncopole, service d'oncologie médicale, 31000 Toulouse, France. · Institut Gustave Roussy, service de chirurgie, 94800 Villejuif, France. · Institut Bergonié, service de chirurgie, 33000 Bordeaux, France. · Institut Paoli Calmette, service de chirurgie, 13000 Marseille, France. · Institut Gustave Roussy, service d'oncologie médicale, 94800 Villejuif, France. · AP-HP, hôpital Européen Georges Pompidou, service de chirurgie gynécologique et oncologique, 75015 Paris, France. · AP-HP, hôpital Européen Georges Pompidou, service d'anatomo-pathologie, 75015 Paris, France. · Centre Oscar Lambret, service de chirurgie, 59000 Lille, France. · CHU de Tours, service de chirurgie gynécologique, 37000 Tours, France. · Institut Bergonié, service de méthodologie, 33000 Bordeaux, France. · Curie (site Saint Cloud), service de chirurgie, 75000 Paris, France. · Centre Léon Bérard, service d'oncologie médicale, 69000 Lyon, France. · CHI de Créteil, service de chirurgie gynécologique, 94000 Créteil, France. · AP-HP, hôpital Tenon, service de radiologie, 75020 Tenon, France. · Institut universitaire de cancérologie, Sorbonne université, hôpital Pitié-Salpêtrière, service de chirurgie et cancérologie gynécologique et mammaire, Inserm U938, 75000 La pitié, France. · Institut de cancérologie des Hospices Civils de Lyon, service d'oncologie médicale, Pierre-Bénite, 69000 Lyon, France. ·Bull Cancer · Pubmed #30850152.

ABSTRACT: Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). In case of ovarian, Fallopian tube or primitive peritoneal cancer of FIGO III-IV stages, thoraco-abdomino-pelvic CT scan with injection (grade B) is recommended. Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A).

2 Guideline Japan Society of Gynecologic Oncology guidelines 2017 for the treatment of uterine cervical cancer. 2019

Ebina, Yasuhiko / Mikami, Mikio / Nagase, Satoru / Tabata, Tsutomu / Kaneuchi, Masanori / Tashiro, Hironori / Mandai, Masaki / Enomoto, Takayuki / Kobayashi, Yoichi / Katabuchi, Hidetaka / Yaegashi, Nobuo / Udagawa, Yasuhiro / Aoki, Daisuke. ·1Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. ebiyas@med.kobe-u.ac.jp. · Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan. · Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan. · Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Tsu, Japan. · Department of Obstetrics and Gynecology, Otaru General Hospital, Sapporo, Japan. · Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. · Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan. · Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan. · Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan. · Fujita Health University School of Medicine, Toyoake, Japan. · Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan. ·Int J Clin Oncol · Pubmed #30291468.

ABSTRACT: The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2017 for the Treatment of Uterine Cervical Cancer are for the purpose of providing standard treatment strategies for cervical cancer, indicating treatment methods currently considered appropriate for cervical cancer, minimizing variances in treatment methods among institutions, improving the safety of treatment and prognosis of diseases, reducing the economic and psychosomatic burden of patients by promoting performance of appropriate treatment, and enhancing mutual understanding between patients and healthcare professionals. The guidelines were prepared through consensus of the JSGO Guideline Committee, based on careful review of evidence gathered through the literature searches and in view of the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise eight chapters and five algorithms. The main features of the 2017 revision are as follows: (1) evidence was collected using a search formula and with cooperation of the Japan Library Association. The bibliographical search formula was placed at the end of the book; (2) regarding clinical questions (CQs) where evidence or clinical inspection in Japan was lacking, opinions of the Guidelines Committee were described as "proposals for future directions"; (3) cervical intraepithelial neoplasia (CIN) 3 and adenocarcinoma in situ (AIS) were treated as a cervical precancerous lesion; (4) the CQs of endoscopic surgery, radical trachelectomy, and sentinel node biopsy were newly added in Chapter 3, "primary treatment for stage IB-II cervical cancer"; and (5) the CQ about hormone replacement therapy after cancer treatment was newly established. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2017 for the Treatment of Uterine Cervical Cancer.

3 Guideline Vasa Praevia: Diagnosis and Management: Green-top Guideline No. 27b. 2019

Jauniaux, Erm / Alfirevic, Z / Bhide, A G / Burton, G J / Collins, S L / Silver, R / Anonymous2171086. · ·BJOG · Pubmed #30260094.

ABSTRACT: -- No abstract --

4 Guideline [Intrauterine contraception: CNGOF Contraception Guidelines]. 2018

Vidal, F / Paret, L / Linet, T / Tanguy le Gac, Y / Guerby, P. ·Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France. Electronic address: vidal.fabien@chu-toulouse.fr. · Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France. · Service de gynécologie-obstétrique, centre hospitalier Loire-Vendée-Océan, 85300 Challans, France. · Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France. ·Gynecol Obstet Fertil Senol · Pubmed #30429071.

ABSTRACT: OBJECTIVE: To provide national clinical guidelines focusing on intrauterine contraception. METHODS: A systematic review of available literature was performed using Pubmed and Cochrane libraries. American, British and Canadian guidelines were considered as well. RESULTS: Intrauterine contraception (IUC) displays a wide panel of indications, including adolescents, nulliparous, patients living with HIV before AIDS (Grade B) and women with history of ectopic pregnancy (Grade C). Cervical cancer screening should not be modified in women with IUC (Grade B). Bimanual examination and cervix inspection are mandatory before device insertion (Grade B). Patients should not systematically undergo screening for sexually transmitted infections (STI) before device insertion (Grade B). Screening for STI should be preferably done before insertion but it can be performed at the time of device insertion in asymptomatic women (Grade B). Routine antibiotic prophylaxis and premedication are not recommended before insertion (Grade A). A follow-up visit may be offered several weeks after insertion (Professional consensus). Routine pelvic ultrasound examination in not recommended after device insertion (Grade B). In patients with IUC, unscheduled bleeding, when persistent or associated with pelvic pain, requires further investigation to rule out complication (Professional agreement). Suspected uterine perforation warrants radiological workup to locate the device (Professional consensus). Laparoscopic approach should be preferred for elective removal of intrauterine device from abdominal cavity (Professional consensus). In case of accidental pregnancy with intrauterine device in situ, ectopic pregnancy should be excluded (Grade B). In case of viable and desired intrauterine pregnancy, intrauterine device removal is recommended if the strings are reachable (Grade C). Detection of Actinomyces-like organisms on pap smear in asymptomatic patients with intrauterine contraception does not require further intervention (Grade B). Immediate removal of intrauterine device is not recommended in case of STI or pelvic inflammatory disease (Grade B). Device removal should be considered in the absence of clinical improvement after 48 to 72 hours of appropriate treatment (Grade B). CONCLUSION: Intrauterine contraception is a long-acting and reversible contraception method displaying great efficacy and high continuation rate. In contrast, complication rate is low. It should thus be offered to both nulliparous and multiparous women.

5 Guideline [Additional non-contraceptive effects of contraception: CNGOF Contraception Guidelines]. 2018

Amat, L / Bulach, A / Leclercq, M / Mesrine, S / Scheffler, F / Sperandeo, D / Scheffler, M. ·Service de gynécologie-obstétrique, CHRU de Nancy, 10, avenue du Dr-Heydenreich, 54035 Nancy, France. · Service de gynécologie-obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59000 Lille, France. · Service de gynécologie-obstétrique, CHIC d'Amboise, rue des Ursulines, 37403 Amboise cedex, France. · Service de gynécologie-obstétrique, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens, France. · Clinique de Bonneveine, 89, boulevard du Sablier, 13008 Marseille, France. · Service de gynécologie-obstétrique, CHRU de Nancy, 10, avenue du Dr-Heydenreich, 54035 Nancy, France. Electronic address: michele@cglre.org. ·Gynecol Obstet Fertil Senol · Pubmed #30414725.

ABSTRACT: Hormonal and intrauterine contraceptive methods provide women with highly efficient protection against undesired pregnancy. Additional non-contraceptive effects are now well documented. Combined hormonal contraceptives use, either through the oral transdermal and vaginal route, allow a reduction in menorrhagia, dysmenorrhea, functional ovarian cysts, benign breast and uterine disease, endometriosis-related pain and recurrence. A reduction in ovarian cancer risks, including in women with BRCA syndrome, endometrial and colon cancer is documented. This effect is prolonged for years after contraception discontinuation. Non-contraceptive benefits of progestin-only contraceptives are less documented. Use of the levonorgestrel IUD is associated with a reduction in menorrhagia, dysmenorrhea including in case of endometriosis. Copper IUD use is associated with a decrease in cervix and endometrial cancer risk.

6 Guideline [Contraception for adolescent : CNGOF Contraception guidelines]. 2018

Pienkowski, C / Cartault, A. ·Unité d'endocrinologie et de gynécologie médicale, hôpital des Enfants, TSA 70034, Centre de référence de pathologies gynécologiques rares (PGR Toulouse), CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. Electronic address: pienkowski.c@chu-toulouse.fr. · Unité d'endocrinologie et de gynécologie médicale, hôpital des Enfants, TSA 70034, Centre de référence de pathologies gynécologiques rares (PGR Toulouse), CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. ·Gynecol Obstet Fertil Senol · Pubmed #30392989.

ABSTRACT: OBJECTIVE: The goal is to establish dialogue and determine the needs and skill levels of adolescence. This concerns sexuality, the prevention of STIs, the informed choice of contraception to avoid an unplanned pregnancy. MéTHODES: A systematic review based on literature about contraception AND teenagers was performed using Pubmed, Cochrane, national and international recommendations. RESULTS: The surveillance of the teenager contraception must integrate more specifically: global health with a stability of weight and corpulence, a sufficient calcium intake, the prevention of the sexually transmitted infections (STIs) and the vaccination against HPV. The 1st consultations with adolescent girls are an essential moment for dialogue in order to develop sexuality education. Main themes are: prevention of STIs with the use of condoms, detection of situations of precariousness or sexual abuse, and finally adherence to treatment to avoid unplanned pregnancy. Use of condoms associated with regular contraception is essential to assure a barrier against sexually transmitted infections (STIs) (NP1). To preserve the patient confidentiality, the patient is received alone (Grade B). She must be reassured about respect of anonymity and availability of free treatment. Clinical examination collects weight, height, BMI and blood pressure (Grade C). It is important to give them the choice of contraceptive method and provide objective information on the different contraceptive methods (NP2). If there are any contraindications, when the first prescription is a pill, it must be a 1st or 2nd generation pill with levonorgestrel. For some experts, it would be important to prescribe a pill at 30μg EE for better efficacy in case of forgetfulness in very young patients and for the good maintenance of bone mineralization (NP4). Information on long-acting reversible contraceptives, or LARCs, is essential. These contraceptive methods have proved their efficacy and their place in the first intention. (NP1). CONCLUSION: Prescribing contraception to a teenage girl requires the adaptation of the best treatment to her needs to prevent an unwanted pregnancy. This requires good information on prevention of STIs and on different methods of contraception in a confidence climate.

7 Guideline [The French Genetic and Cancer Consortium guidelines for multigene panel analysis in hereditary breast and ovarian cancer predisposition]. 2018

Moretta, Jessica / Berthet, Pascaline / Bonadona, Valérie / Caron, Olivier / Cohen-Haguenauer, Odile / Colas, Chrystelle / Corsini, Carole / Cusin, Véronica / De Pauw, Antoine / Delnatte, Capucine / Dussart, Sophie / Jamain, Christophe / Longy, Michel / Luporsi, Elisabeth / Maugard, Christine / Nguyen, Tan Dat / Pujol, Pascal / Vaur, Dominique / Andrieu, Nadine / Lasset, Christine / Noguès, Catherine / Anonymous7380963. ·Institut Paoli-Calmettes, oncogénétique clinique, département d'anticipation et de suivi des cancers, 232, boulevard Sainte-Marguerite, 13009 Marseille, France. Electronic address: morettaj@ipc.unicancer.fr. · Centre François-Baclesse, oncogénétique clinique, département de biopathologie, 14000 Caen, France. · Centre Léon-Berard, unité clinique d'oncologie génétique, 69008 Lyon, France; Université Lyon 1, CNRS, LBBE UMR 5558, 69622 Villeurbanne, France. · Gustave-Roussy hôpital universitaire, département de médecine, 94800 Villejuif, France. · GH Saint-Louis-Lariboisière-Fernand-Widal, oncogénétique, 75010 Paris, France. · Institut Curie, oncogénétique, 75005 Paris, France. · CHRU de Montpellier, hôpital Arnaud de Villeneuve, service d'oncogénétique, 34090 Montpellier, France. · Hôpital Pitié-Salpêtrière-Charles-Foix, service de génétique, 75013 Paris, France. · ICO-Centre René-Gauducheau, unité d'oncogénétique, 44800 Nantes, France. · Centre Léon-Berard, unité clinique d'oncologie génétique, 69008 Lyon, France. · Unicancer, 75654 Paris France. · Institut Bergonié, oncogénétique, Inserm U 1218, 33000 Bordeaux, France. · CHR de Metz Thionville, oncogénétique, 57100 Metz, France. · CHU de Strasbourg, oncogénétique clinique, oncogénétique moléculaire, évaluation familiale et suivi, laboratoire d'oncobiologie, 67000 Strasbourg, France. · Institut Jean-Godinot, oncogénétique, 51100 Reims, France. · Centre François-Baclesse, laboratoire de biologie et de génétique du cancer, 14000 Caen, France. · Inserm, U900, Institut Curie, PSL Research University, Mines ParisTech, 75005 Paris, France. · Université Lyon 1, CNRS, LBBE UMR 5558, 69622 Villeurbanne, France; Centre Léon Bérard, département de santé publique, unité de prévention et épidémiologie génétique, 69008 Lyon, France. · Institut Paoli-Calmettes, oncogénétique clinique, département d'anticipation et de suivi des cancers, 232, boulevard Sainte-Marguerite, 13009 Marseille, France; Aix-Marseille université, Inserm, IRD, SESSTIM, 13000 Marseille, France. ·Bull Cancer · Pubmed #30268633.

ABSTRACT: INTRODUCTION: Next generation sequencing allows the simultaneous analysis of large panel of genes for families or individuals with a strong suspicion of hereditary breast and/or ovarian cancer (HBOC). Because of lack of guidelines, several panels of genes potentially involved in HBOC were designed, with large disparities not only in their composition but also in medical care offered to mutation carriers. Then, homogenization in practices is needed. METHODS: The French Genetic and Cancer Group (GGC) - Unicancer conducted an exhaustive bibliographic work on 18 genes of interest. Only publications with unbiased risk estimates were retained. RESULTS: The expertise of each 18 genes was based on clinical utility criteria, i.e. a relative risk of cancer of 4 and more, available medical tools for screening and prevention of mutation carriers, and pre-symptomatic genetic tests for relatives. Finally, 13 genes were selected to be included in a HBOC diagnosis gene panel: BRCA1, BRCA2, PALB2, TP53, CDH1, PTEN, RAD51C, RAD51D, MLH1, MSH2, MSH6, PMS2, EPCAM. The reasons for excluding NBN, RAD51B, CHEK2, STK11, ATM, BARD1, BRIP1 from the HBOC diagnosis panel are presented. Screening, prevention and genetic counselling guidelines were detailed for each of the 18 genes. DISCUSSION: Due to the rapid increase in knowledge, the GGC has planned a yearly update of the bibliography to take into account new findings. Furthermore, genetic-epidemiological studies are being initiated to better estimate the cancer risk associated with genes which are not yet included in the HBOC diagnosis panel.

8 Guideline The polycystic ovary syndrome: a position statement from the Polish Society of Endocrinology, the Polish Society of Gynaecologists and Obstetricians, and the Polish Society of Gynaecological Endocrinology. 2018

Milewicz, Andrzej / Kudła, Marek / Spaczyński, Robert Z / Dębski, Romuald / Męczekalski, Błażej / Wielgoś, Mirosław / Ruchała, Marek / Małecka-Tendera, Ewa / Kos-Kudła, Beata / Jędrzejuk, Diana / Zachurzok, Agnieszka. ·Katedra i Klinika Endokrynologii, Diabetologii i Leczenia Izotopami Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu. diana.jedrzejuk@umed.wroc.pl. ·Endokrynol Pol · Pubmed #30209800.

ABSTRACT: Polycystic ovary syndrome (PCOS) diagnosis and therapy still arouse a lot of controversy. Each year brings new information, so, having collected the experience of three scientific societies, we present contemporary recommendations concerning PCOS diagnostics and treat-ment. In adult female diagnosis, we still use the Rotterdam criteria, which is two out of three of the follwing characteristics: a) ovulation abnormality, b) clinical or biochemical hyperandrogenism, and c) polycystic ovaries. In the case of teenagers, diagnostic criteria are as follows: menstruation disturbances two years after menarche and clinical or biochemical hyperandrogenism. The presence of polycysti-cally abnormal ovaries is not necessary. The consensus paper presents the threats resulting from imperfect diagnostic methods applied in PCOS (hyperandrogenism diagnostics, ultrasound examination of ovaries). Suggested therapy includes personalised schemes according to the dominant PCOS phenotype, i.e. metabolic, hyperandrogenic, or reproductive ones.

9 Guideline Screening for Syphilis Infection in Pregnant Women: US Preventive Services Task Force Reaffirmation Recommendation Statement. 2018

Anonymous2951075 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Kemper, Alex R / Kubik, Martha / Kurth, Ann E / Landefeld, C Seth / Mangione, Carol M / Phipps, Maureen G / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health & Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · Yale University, New Haven, Connecticut. · University of Alabama at Birmingham. · University of California, Los Angeles. · Brown University, Providence, Rhode Island. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #30193283.

ABSTRACT: Importance: Untreated syphilis infection in pregnant women can be transmitted to the fetus (congenital syphilis) at any time during pregnancy or at birth. Congenital syphilis is associated with stillbirth, neonatal death, and significant morbidity in infants (eg, bone deformities and neurologic impairment). After a steady decline from 2008 to 2012, cases of congenital syphilis markedly increased from 2012 to 2106, from 8.4 to 15.7 cases per 100 000 live births (an increase of 87%). At the same time, national rates of syphilis increased among women of reproductive age. Objective: To update the US Preventive Services Task Force (USPSTF) 2009 recommendation on screening for syphilis infection in pregnant women. Evidence Review: The USPSTF commissioned a reaffirmation evidence update to identify new and substantial evidence sufficient enough to change its prior recommendation. Given the established benefits and practice of screening for syphilis in pregnant women, the USPSTF targeted its evidence review on the direct benefits of screening on the prevention of congenital syphilis morbidity and mortality and the harms of screening for and treatment of syphilis infection in pregnant women. Findings: Using a reaffirmation process, the USPSTF found that accurate screening algorithms are available to identify syphilis infection. Effective treatment with antibiotics can prevent congenital syphilis and significantly decrease adverse pregnancy outcomes, with small associated harms, providing an overall substantial health benefit. Therefore, the USPSTF reaffirms its previous conclusion that there is convincing evidence that screening for syphilis infection in pregnant women provides substantial benefit. Conclusions and Recommendation: The USPSTF recommends early screening for syphilis infection in all pregnant women. (A recommendation).

10 Guideline Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. 2018

Anonymous2871075 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Kemper, Alex R / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Phipps, Maureen G / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health & Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · Brown University, Providence, Rhode Island. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #30140884.

ABSTRACT: Importance: The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening and has declined from 2.8 to 2.3 deaths per 100 000 women from 2000 to 2015. Objective: To update the US Preventive Services Task Force (USPSTF) 2012 recommendation on screening for cervical cancer. Evidence Review: The USPSTF reviewed the evidence on screening for cervical cancer, with a focus on clinical trials and cohort studies that evaluated screening with high-risk human papillomavirus (hrHPV) testing alone or hrHPV and cytology together (cotesting) compared with cervical cytology alone. The USPSTF also commissioned a decision analysis model to evaluate the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies. Findings: Screening with cervical cytology alone, primary hrHPV testing alone, or cotesting can detect high-grade precancerous cervical lesions and cervical cancer. Screening women aged 21 to 65 years substantially reduces cervical cancer incidence and mortality. The harms of screening for cervical cancer in women aged 30 to 65 years are moderate. The USPSTF concludes with high certainty that the benefits of screening every 3 years with cytology alone in women aged 21 to 29 years substantially outweigh the harms. The USPSTF concludes with high certainty that the benefits of screening every 3 years with cytology alone, every 5 years with hrHPV testing alone, or every 5 years with both tests (cotesting) in women aged 30 to 65 years outweigh the harms. Screening women older than 65 years who have had adequate prior screening and women younger than 21 years does not provide significant benefit. Screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer provides no benefit. The USPSTF concludes with moderate to high certainty that screening women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer, screening women younger than 21 years, and screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer does not result in a positive net benefit. Conclusions and Recommendation: The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. (A recommendation) The USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with hrHPV testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) in women aged 30 to 65 years. (A recommendation) The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation) The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. (D recommendation) The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion or cervical cancer. (D recommendation).

11 Guideline Surgery in ovarian cancer - Brazilian Society of Surgical Oncology consensus. 2018

Tsunoda, A T / Ribeiro, R / Reis, R J / da Cunha Andrade, Cem / Moretti Marques, R / Baiocchi, G / Fin, F / Zanvettor, P H / Falcao, D / Batista, T P / Azevedo, Brb / Guitmann, G / Pessini, S A / Nunes, J S / Campbell, L M / Linhares, J C / Carneiro, V / Coimbra, Fjf. ·Gynaecological Oncology Department, Hospital Erasto Gaertner, Curitiba, Brazil. · Albert Einstein Hospital, São Paulo, Brazil. · Positivo University, Curitiba, Brazil. · Hospital Erasto Dorneles e Hospital Mãe de Deus, Porto Alegre, Brazil. · Brazilian Lutheran University, Porto Alegre, Brazil. · Gynaecological Oncology Department, Barretos Cancer Hospital, Barretos, Brazil. · Paulo Prata Medical University, Barretos, Brazil. · Oncology Department, Albert Einstein Hospital, São Paulo, Brazil. · Gynaecological Oncology Department, AC Camargo Cancer Centre, Sao Paulo, Brazil. · Gynaecological Oncology Department, Hospital São Vicente, Curitiba, Brazil. · Faculdade Evangélica de Curitiba, Curitiba, Brazil. · Gynaecological Oncology Department, Aristides Maltez Hospital, Salvador, Brazil. · AMO Clinic, Salvador, Brazil. · Surgery Department, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil. · Hospital São Vicente, Curitiba, Brazil. · Instituto de Hemato Oncologia do Paraná, Curitiba, Brazil. · Brazilian National Cancer Institute, Rio de Janeiro, Brazil. · Americas Hospital, Rio de Janeiro, Brazil. · Gynaecological Oncology Department, Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. · Hospital Erasto Gaertner, Curitiba, Brazil. · Instituto de Oncologia do Paraná, Curitiba, Brazil. · Santa Lucia Cancer Centre, Brasilia, Brazil. · Hospital de Câncer de Pernambuco, Recife, Brazil Instituto de Medicina Integral Professor Fernando Figueira NeoH - Núcleo Especializado em Oncologia e Hematologia D'OR, Recife, Brazil. · AC Camargo Cancer Centre, Sao Paulo, Brazil. · Brazilian Society of Surgical Oncology 2016/2017, Sao Paulo, Brazil. ·BJOG · Pubmed #29900651.

ABSTRACT: Surgical management in epithelial ovarian cancer (EOC) has a significant impact in overall survival and progression-free survival. The Brazilian Society of Surgical Oncology (BSSO) supported a taskforce of experts to reach a consensus: experienced and specialised trained surgeons, in cancer centres, provide the best EOC surgery. Laparoscopic and/or radiological staging prognosticates the possibility of complete cytoreduction (CC0) and helps to reduce unnecessary laparotomies. Surgical techniques were reviewed. Multidisciplinary input is essential for treatment planning. Quality assurance criteria are proposed and require national consensus. Genetic testing is mandatory. This consensus states the final recommendations from BSSO for management of EOC. TWEETABLE ABSTRACT: Brazilian Society of Surgical Oncology consensus for surgery in epithelial ovarian cancer patients.

12 Guideline Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil. 2018

Zeferino, Luiz Carlos / Bastos, Joana Bragança / Vale, Diama Bhadra Andrade Peixoto do / Zanine, Rita Maria / Melo, Yara Lucia Mendes Furtado de / Primo, Walquíria Quida Salles Pereira / Corrêa, Flávia de Miranda / Val, Isabel Cristina Chulvis do / Russomano, Fábio. ·Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. · Universidade Federal do Paraná, Curitiba, Paraná, Brazil. · Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. · Universidade de Brasília, Brasília, Distrito Federal, Brazil. · Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Rio de Janeiro, Brazil. · Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil. · Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, da Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil. ·Rev Bras Ginecol Obstet · Pubmed #29874685.

ABSTRACT: Evidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPV-DNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.

13 Guideline Practice guidelines for management of ovarian cancer in Korea: a Korean Society of Gynecologic Oncology Consensus Statement. 2018

Suh, Dong Hoon / Chang, Suk Joon / Song, Taejong / Lee, Sanghoon / Kang, Woo Dae / Lee, Sun Joo / Roh, Ju Won / Joo, Won Duk / Yoon, Joo Hee / Jeong, Dae Hoon / Kim, Hee Seung / Lee, Sung Jong / Ji, Yong Il / Kim, Hyun Jung / Lee, Jeong Won / Kim, Jae Weon / Bae, Duk Soo. ·Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. · Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea. drchang@ajou.ac.kr. · Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. · Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea. · Department of Obstetrics and Gynecology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea. · Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Korea. · Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea. · Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. · Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea. · Busan Paik Hospital, Paik Institute for Clinical Research, Inje University, Busan, Korea. · Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. · Department of Obstetrics and Gynecology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea. · Department of Obstetrics and Gynecology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. · Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea. · Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ·J Gynecol Oncol · Pubmed #29770626.

ABSTRACT: Since after 2006 when the first edition of practice guidelines for gynecologic oncologic cancer treatment was released, the Korean Society of Gynecologic Oncology (KSGO) has published the following editions on a regular basis to suggest the best possible standard care considering updated scientific evidence as well as medical environment including insurance coverage. The Guidelines Revision Committee was summoned to revise the second edition of KSGO practice guidelines, which was published in July 2010, and develop the third edition. The current guidelines cover strategies for diagnosis and treatment of primary and recurrent ovarian cancer. In this edition, we introduced an advanced format based on evidence-based medicine, collecting up-to-date data mainly from MEDLINE, EMBASE, and Cochrane Library CENTRAL, and conducting a meta-analysis with systematic review. Eight key questions were raised by the committee members. For every key question, recommendations were developed by the consensus meetings and provided with evidence level and strength of the recommendation.

14 Guideline The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. 2018

Cibula, David / Pötter, Richard / Planchamp, François / Avall-Lundqvist, Elisabeth / Fischerova, Daniela / Haie Meder, Christine / Köhler, Christhardt / Landoni, Fabio / Lax, Sigurd / Lindegaard, Jacob Christian / Mahantshetty, Umesh / Mathevet, Patrice / McCluggage, W Glenn / McCormack, Mary / Naik, Raj / Nout, Remi / Pignata, Sandro / Ponce, Jordi / Querleu, Denis / Raspagliesi, Francesco / Rodolakis, Alexandros / Tamussino, Karl / Wimberger, Pauline / Raspollini, Maria Rosaria. ·Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. Electronic address: dc@davidcibula.cz. · Department of Radiotherapy, Medical University of Vienna, Austria. · Institut Bergonié, Bordeaux, France. · Linkoping University, Sweden. · Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. · Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France. · Asklepios Hambourg Altona and University of Cologne, Medical Faculty, Department of Gynecology, Germany. · University of Milan Bicocca, Monza, Italy. · General Hospital Graz Sued-West, Austria. · Department of Oncology, Aarhus University, Denmark. · Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. · Lausanne University, Switzerland. · Department of Pathology, Belfast Health and Social Care Trust, United Kingdom. · University College Hospital London, United Kingdom. · Queen Elizabeth Hospital, Gateshead, United Kingdom. · Department of Radiation Oncology, Leiden University, The Netherlands. · Istituto Nazionale per lo Studio e la Cura dei Tumori "FondazioneG Pascale," IRCCS, Naples, Italy. · University Hospital of Bellvitge (IDIBELL), Barcelona, Spain. · Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. · Athens University, Greece. · Medical University of Graz, Austria. · Dresden University, TU Dresden, Germany. · University Hospital, Careggi, Florence, Italy. ·Radiother Oncol · Pubmed #29728273.

ABSTRACT: BACKGROUND: Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. OBJECTIVE: The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. METHODS: The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. RESULTS: The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

15 Guideline The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients with Cervical Cancer. 2018

Cibula, David / Pötter, Richard / Planchamp, François / Avall-Lundqvist, Elisabeth / Fischerova, Daniela / Haie-Meder, Christine / Köhler, Christhardt / Landoni, Fabio / Lax, Sigurd / Lindegaard, Jacob Christian / Mahantshetty, Umesh / Mathevet, Patrice / McCluggage, W Glenn / McCormack, Mary / Naik, Raj / Nout, Remi / Pignata, Sandro / Ponce, Jordi / Querleu, Denis / Raspagliesi, Francesco / Rodolakis, Alexandros / Tamussino, Karl / Wimberger, Pauline / Raspollini, Maria Rosaria. ·Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Kateřinská 32, 121 08, Prague, Czech Republic. dc@davidcibula.cz. · Department of Radiotherapy, Medical University of Vienna, Vienna, Austria. · Institut Bergonié, Bordeaux, France. · Linkoping University, Linkoping, Sweden. · Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Kateřinská 32, 121 08, Prague, Czech Republic. · Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France. · Medical Faculty, Department of Gynecology, Asklepios Hambourg Altona and University of Cologne, Hamburg, Germany. · University of Milan Bicocca, Monza, Italy. · General Hospital Graz Sued-West, Graz, Austria. · Department of Oncology, Aarhus University, Aarhus, Denmark. · Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. · Lausanne University, Lausanne, Switzerland. · Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK. · University College Hospital London, London, UK. · Queen Elizabeth Hospital, Gateshead, UK. · Department of Radiation Oncology, Leiden University, Leiden, The Netherlands. · Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G. Pascale," IRCCS, Naples, Italy. · University Hospital of Bellvitge (IDIBELL), Barcelona, Spain. · Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. · Athens University, Athens, Greece. · Medical University of Graz, Graz, Austria. · Dresden University, TU Dresden, Dresden, Germany. · University Hospital, Careggi, Florence, Italy. ·Virchows Arch · Pubmed #29725757.

ABSTRACT: BACKGROUND: Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. OBJECTIVE: The European Society of Gynecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. METHODS: The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. RESULTS: The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

16 Guideline ACR Appropriateness Criteria 2018

Anonymous1331079 / Brown, Douglas L / Packard, Ann / Maturen, Katherine E / Deshmukh, Sandeep Prakash / Dudiak, Kika M / Henrichsen, Tara L / Meyer, Benjamin J / Poder, Liina / Sadowski, Elizabeth A / Shipp, Thomas D / Simpson, Lynn / Weber, Therese M / Zelop, Carolyn M / Glanc, Phyllis. ·Principal Author, Mayo Clinic, Rochester, Minnesota. Electronic address: brown.douglas@mayo.edu. · Research Author, Mayo Clinic, Rochester, Minnesota. · Panel Chair, University of Michigan, Ann Arbor, Michigan. · Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · Mayo Clinic, Rochester, Minnesota. · Hendricks Regional Health, Danville, Indiana. · University of California San Francisco, San Francisco, California. · University of Wisconsin, Madison, Wisconsin. · Brigham & Women's Hospital, Boston, Massachusetts; American Congress of Obstetricians and Gynecologists. · Columbia University, New York, New York; American Congress of Obstetricians and Gynecologists. · University of Alabama at Birmingham, Birmingham, Alabama. · Valley Hospital, Ridgewood, New Jersey and NYU School of Medicine, New York, New York; American Congress of Obstetricians and Gynecologists. · Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. ·J Am Coll Radiol · Pubmed #29724428.

ABSTRACT: Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention. Less common causes of first trimester vaginal bleeding include gestational trophoblastic disease and arteriovenous malformations. Pulsed methods of Doppler US should generally be avoided in the first trimester when there is a normal, or a potentially normal, IUP. Once a normal IUP has been excluded, Doppler US may be useful when other diagnoses such as retained products of conception or arteriovenous malformations are suspected. MRI may occasionally be helpful as a problem-solving tool. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

17 Guideline ACR Appropriateness Criteria 2018

Anonymous1271079 / Kang, Stella K / Reinhold, Caroline / Atri, Mostafa / Benson, Carol B / Bhosale, Priyadarshani R / Jhingran, Anuja / Lakhman, Yulia / Maturen, Katherine E / Nicola, Refky / Pandharipande, Pari V / Salazar, Gloria M / Shipp, Thomas D / Simpson, Lynn / Small, William / Sussman, Betsy L / Uyeda, Jennifer W / Wall, Darci J / Whitcomb, Bradford P / Zelop, Carolyn M / Glanc, Phyllis. ·Principal Author, New York University Medical Center, New York, New York. Electronic address: stella.kang@nyumc.org. · Panel Chair, McGill University, Montreal, Quebec, Canada. · Toronto General Hospital, Toronto, Ontario, Canada. · Brigham & Women's Hospital, Boston, Massachusetts. · University of Texas MD Anderson Cancer Center, Houston, Texas. · Memorial Sloan Kettering Cancer Center, New York, New York. · University of Michigan, Ann Arbor, Michigan. · State University of New York Upstate Medical University, Syracuse, New York. · Massachusetts General Hospital, Boston, Massachusetts. · Brigham & Women's Hospital, Boston, Massachusetts; American Congress of Obstetricians and Gynecologists. · Columbia University, New York, New York; American Congress of Obstetricians and Gynecologists. · Stritch School of Medicine Loyola University Chicago, Maywood, Illinois. · The University of Vermont Medical Center, Burlington, Vermont. · Mayo Clinic, Rochester, Minnesota. · Tripler Army Medical Center, Honolulu, Hawaii; Society of Gynecologic Oncology. · Valley Hospital, Ridgewood, New Jersey, and NYU School of Medicine, New York, New York; American Congress of Obstetricians and Gynecologists. · Specialty Chair, Sunnybrook Health Sciences Centre Bayview Campus, Toronto, Ontario, Canada. ·J Am Coll Radiol · Pubmed #29724422.

ABSTRACT: In the management of epithelial ovarian cancers, imaging is used for cancer detection and staging, both before and after initial treatment. The decision of whether to pursue initial cytoreductive surgery for ovarian cancer depends in part on accurate staging. Contrast-enhanced CT of the abdomen and pelvis (and chest where indicated) is the current imaging modality of choice for the initial staging evaluation of ovarian cancer. Fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT and MRI may be appropriate for problem-solving purposes, particularly when lesions are present on CT but considered indeterminate. In patients who achieve remission, clinical suspicion for relapse after treatment prompts imaging evaluation for recurrence. Contrast-enhanced CT is the modality of choice to assess the extent of recurrent disease, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT is also usually appropriate, as small metastatic foci may be identified. If imaging or clinical examination confirms a recurrence, the extent of disease and timing of disease recurrence then determines the choice of treatments, including surgery, chemotherapy, and radiation therapy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

18 Guideline ACR Appropriateness Criteria 2018

Anonymous1241079 / Knuttinen, M-Grace / Stark, Gregory / Hohenwalter, Eric J / Bradley, Linda D / Braun, Aaron R / Gipson, Matthew G / Kim, Charles Y / Pinchot, Jason W / Scheidt, Matthew J / Sella, David M / Weiss, Clifford R / Lorenz, Jonathan M. ·Principal Author, Mayo Clinic, Phoenix, Arizona. Electronic address: mgk600@hotmail.com. · Research Author, University of Illinois at Chicago, Chicago, Illinois. · Panel Chair, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin. · Cleveland Clinic, Cleveland, Ohio; American Congress of Obstetricians and Gynecologists. · St. Elizabeth Regional Medical Center, Lincoln, Nebraska. · Radiology Imaging Associates, Englewood, Colorado. · Duke University Medical Center, Durham, North Carolina. · University of Wisconsin, Madison, Wisconsin. · Central Illinois Radiological Associates, Peoria, Illinois. · Mayo Clinic, Jacksonville, Florida. · Johns Hopkins Bayview Medical Center, Baltimore, Maryland. · Specialty Chair, University of Chicago Hospital, Chicago, Illinois. ·J Am Coll Radiol · Pubmed #29724419.

ABSTRACT: Uterine fibroids, also known as leiomyomas, are the most common benign tumor in women of reproductive age. When symptomatic, these patients can present with bleeding and/or bulk-related symptoms. Treatment options for symptomatic uterine leiomyomas include medical management, minimally invasive treatment such as uterine artery embolization, and surgical options, such as myomectomy. It is important to understand the role of these treatment options in various clinical scenarios so that appropriate consultation is performed. Furthermore, patients should be presented with the outcomes and complications of each of these treatment options. A summary of the data and clinical trials of the treatment options for symptomatic uterine leiomyomas is outlined in this article. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

19 Guideline The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer. 2018

Cibula, David / Pötter, Richard / Planchamp, François / Avall-Lundqvist, Elisabeth / Fischerova, Daniela / Haie Meder, Christine / Köhler, Christhardt / Landoni, Fabio / Lax, Sigurd / Lindegaard, Jacob Christian / Mahantshetty, Umesh / Mathevet, Patrice / McCluggage, W Glenn / McCormack, Mary / Naik, Raj / Nout, Remi / Pignata, Sandro / Ponce, Jordi / Querleu, Denis / Raspagliesi, Francesco / Rodolakis, Alexandros / Tamussino, Karl / Wimberger, Pauline / Raspollini, Maria Rosaria. · ·Int J Gynecol Cancer · Pubmed #29688967.

ABSTRACT: BACKGROUND: Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. OBJECTIVE: The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. METHODS: The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. RESULTS: The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

20 Guideline [Recommendations for biomarker testing in epithelial ovarian cancer. A national consensus statement by the Spanish Society of Pathology and the Spanish Society of Medical Oncology]. 2018

Oaknin, Ana / Guarch, Rosa / Barretina, Pilar / Hardisson, David / González-Martín, Antonio / Matías-Guiu, Xavier / Pérez-Fidalgo, Alejandro / Vieites, Begoña / Romero, Ignacio / Palacios, José. ·Departamento de Oncología Médica, Hospital Vall d'Hebron, Vall d́Hebron Institute of Oncology (VHIO), Barcelona, España. · Departamento de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España. · Departamento de Oncología Médica, ICO Girona, Hospital Universitario Doctor Josep Trueta, Gerona, España. · Departamento de Anatomía Patológica, Hospital Universitario La Paz, IdiPAZ, Madrid, España. · Departamento de Oncología Médica, MD Anderson Cancer Center, Madrid, España. · Departamento de Anatomía Patológica, Hospital Universitario de Bellvitge, Barcelona, CIBERONC, Barcelona, España. · Departamento de Oncología Médica, Hospital Clínico Universitario de Valencia, Valencia, CIBERONC, Valencia, España. · Departamento de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, España. · Departamento de Oncología Médica, Instituto Valenciano de Oncología, Valencia, España. · Departamento de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS y Universidad de Alcalá, CIBERONC, Madrid, España. Electronic address: jose.palacios@salud.madrid.org. ·Rev Esp Patol · Pubmed #29602379.

ABSTRACT: Advances in the understanding of the histological and molecular characteristics of ovarian cancer now allow 5subtypes to be identified, leading to a more refined therapeutic approach and improved clinical trials. Each of the subtypes has specific histological features and a particular biomarker expression, as well as mutations in different genes, some of which have prognostic and predictive value. CA125 and HE4 are examples of ovarian cancer biomarkers used in diagnosis and follow-up. Currently, somatic or germinal mutations on BRCA1 and BRCA2 genes are the most important biomarkers in epithelial ovarian cancer, having prognostic and predictive value. In this article, a group of experts from the Spanish Society of Medical Oncology and the Spanish Society of Pathology review the histological and molecular characteristics of the 5subtypes of ovarian cancer and describe the most useful biomarkers and mutations for diagnosis, screening and tailored treatment strategy.

21 Guideline Prevention and management of genital herpes simplex infection during pregnancy and delivery: Guidelines from the French College of Gynaecologists and Obstetricians (CNGOF). 2018

Sénat, Marie-Victoire / Anselem, Olivia / Picone, Olivier / Renesme, Laurent / Sananès, Nicolas / Vauloup-Fellous, Christelle / Sellier, Yann / Laplace, Jean-Pierre / Sentilhes, Loïc. ·Service de Gynécologie-Obstétrique, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, Université Paris Sud, France. Electronic address: marie-victoire.senat@aphp.fr. · Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, APHP, France. · Service de Gynécologie Obstétrique, Hôpital Louis Mourier, Hôpitaux Universitaires Paris Nord, Colombes, and Université Paris-Diderot, Paris, France. · Service de Néonatalogie, Soins intensifs, Maternité, CHU Bordeaux, Bordeaux, France. · Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. · Service de Virologie, Hôpitaux universitaires Paris Sud, AP-HP, Villejuif, Université Paris Sud, France. · Collège National des Sages femmes de France, Paris, France. · Gynerisk, Toulouse, France. · Service de Gynécologie-Obstétrique, CHU Bordeaux, Bordeaux, France. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #29571124.

ABSTRACT: OBJECTIVE: Identify measures to diagnose, prevent, and treat genital herpes infection during pregnancy and childbirth as well as neonatal herpes infection. MATERIALS AND METHODS: Bibliographic search from the Medline and Cochrane Library databases and review of international clinical practice guidelines. RESULTS: Genital herpes lesions are most often due to HSV-2 (LE2). The risk of HSV seroconversion during pregnancy is 1-5% (LE2). Genital herpes lesions during pregnancy in a woman with a history of genital herpes is a recurrence. In this situation, there is no need for virologic confirmation (Grade B). In pregnant women with genital lesions who report they have not previously had genital herpes, virological confirmation by PCR and identifying the specific IgG type is necessary (professional consensus). A first episode of genital herpes during pregnancy should be treated with aciclovir (200 mg 5 times daily) or valaciclovir (1000 mg twice daily) for 5-10 days (Grade C), and recurrent herpes during pregnancy with aciclovir (200 mg 5 times daily) or valaciclovir (500 mg twice daily) (Grade C). The risk of neonatal herpes is estimated at between 25% and 44% if a non primary and primary first genital herpes episode is ongoing at delivery (LE2) and 1% for a recurrence (LE3). Antiviral prophylaxis should be offered to women with either a first or recurrent episode of genital herpes during pregnancy from 36 weeks of gestation until delivery (Grade B). Routine prophylaxis is not recommended for women with a history of genital herpes but no recurrence during pregnancy (professional consensus). A cesarean delivery is recommended if a first episode of genital herpes is suspected (or confirmed) at the onset of labor (Grade B) or if it occured less than 6 weeks before delivery (professional consensus) or in the event of premature rupture of the membranes at term. When a recurrence of genital herpes is underway at the onset of labor, cesarean delivery is most likely to be considered when the membranes are intact and vaginal delivery in cases of prolonged rupture of membranes (professional consensus). Neonatal herpes is rare and mainly due to HSV-1 (LE3). In most cases of neonatal herpes, mothers have no history of genital herpes (LE3). When neonatal herpes is suspected, various samples (blood and cerebrospinal fluid) for HSV PCR must be taken to confirm the diagnosis (professional consensus). Any newborn with suspected neonatal herpes should be treated with intravenous acyclovir (20 mg/kg 3 times daily) (grade A) before the PCR results are available (professional consensus). The duration of the treatment depends on the clinical form (professional consensus) CONCLUSION: There is no formal evidence that it is possible to reduce the risk of neonatal herpes in genital herpes during pregnancy. However, appropriate care can reduce the symptoms associated with herpes and the risk of recurrence at term, as well as cesarean rate because of herpes lesions.

22 Guideline [First line management without IVF of infertility related to endometriosis: Result of medical therapy? Results of ovarian superovulation? Results of intrauterine insemination? CNGOF-HAS Endometriosis Guidelines]. 2018

Boujenah, J / Santulli, P / Mathieu-d'Argent, E / Decanter, C / Chauffour, C / Poncelet, P. ·Service de gynécologie-obstétrique, CHU Bondy, avenue du 14-Juillet, 93140 Bondy, France; Centre médical du Château, 22, rue Louis-Besquel, 94300 Vincennes, France. Electronic address: jeremy.boujenah@gmail.com. · Service de chirurgie gynécologie obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, département développement, reproduction, cancer, Inserm U1016, université Paris-Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, 75005 Paris, France; GRC6-UPMC : centre expert en endométriose (C3E), hôpital Tenon, 75020 Paris, France. · Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 gamétogenèse et qualité du gamète, CHRU de Lille, 59037 Lille cedex, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. · Service de gynécologie-obstétrique, centre hospitalier Renée-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93022 Bobigny, France. ·Gynecol Obstet Fertil Senol · Pubmed #29551300.

ABSTRACT: INTRODUCTION: Using the structured methodology of French guidelines (HAS-CNGOF), the aim of this chapter was to formulate good practice points (GPP), in relation to optimal non-ART management of endometriosis related to infertility, based on the best available evidence in the literature. MATERIALS AND METHODS: This guideline was produced by a group of experts in the field including a thorough systematic search of the literature (from January 1980 to March 2017). Were included only women with endometriosis related to infertility. For each recommendation, a grade (A-D, where A is the highest quality) was assigned based on the strength of the supporting evidence. RESULTS: Management of endometriosis related to infertility should be multidisciplinary and take account into the pain, the global evaluation of infertile couple and the different phenotypes of endometriotic lesions (good practice point). Hormonal treatment for suppression of ovarian function should not prescribe to improve fertility (grade A). After laproscopy for endometriosis related to infertility, the Endometriosis Fertility Index should be used to counsel patients regarding duration of conventional treatments before undergoing ART (grade C). After laparoscopy surgery for infertile women with AFS/ASRM stage I/II endometriosis or superficial peritoneal endometriosis, controlled ovarian stimulation with or without intrauterine insemination could be used to enhance non-ART pregnancy rate (grade C). Gonadotrophins should be the first line therapy for the stimulation (grade B). The number of cycles before referring ART should not exceed up to 6 cycles (good practice point). No recommendation can be performed for non-ART management of deep infiltrating endometriosis or endometrioma, as suitable evidence is lacking. DISCUSSION AND CONCLUSION: Non-ART management is a possible option for the management of endometriosis related to infertility. Endometriosis Fertilty Index could be a useful tool for subsequent postoperative fertility management. Controlled ovarian stimulation can be proposed.

23 Guideline [Nerve sparing techniques in deep endometriosis surgery to prevent urinary or digestive functional disorders: Techniques and results: CNGOF-HAS Endometriosis Guidelines]. 2018

Rabischong, B / Botchorishvili, R / Bourdel, N / Curinier, S / Campagne-Loiseau, S / Pouly, J L / Canis, M. ·Service de gynécologie-obstétrique et reproduction humaine, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. Electronic address: brabischong@chu-clermontferrand.fr. · Service de gynécologie-obstétrique et reproduction humaine, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. ·Gynecol Obstet Fertil Senol · Pubmed #29551299.

ABSTRACT: OBJECTIVES: To evaluate the feasibility and functional urinary and digestive results of nerve sparing techniques in endometriosis surgery. METHODS: A research on the medline/pubmed database using specific keywords (nerve sparing, endometriosis, pelvic nerves) identified 7 publications among about 50 whose purpose was to describe the feasibility, the techniques and the functional results of nerve preservation in this indication. Among them there are: 2 uncontrolled retrospective studies, 3 prospective non-randomized studies, a meta-analysis and a review of the literature. RESULTS: Nerve preservation requires a perfect knowledge of the anatomy of the pelvic autonomic system. The laparoscopic approach is preferred by the different authors due to its anatomical advantage. The feasibility of this technique seems to be demonstrated despite certain limitations in the different studies and depending of the retroperitoneal extension of the lesions. When feasible, it is likely to significantly improve postoperative urinary function (urinary retention) compared to a conventional technique. It is observed no difference regarding digestive function. CONCLUSIONS: Nerve sparing in this indication is a technique the feasibility of which has been demonstrated and is subject to the topography and extent of the disease. In the absence of invasion or entrapment of pelvic autonomic nerves by endometriosis, this technique improves postoperative voiding function (NP3). During pelvic surgery for endometriosis, it is recommended to identify and preserve autonomic pelvic nerves whenever possible (GradeC).

24 Guideline [Management of endometriosis: CNGOF-HAS practice guidelines (short version)]. 2018

Collinet, P / Fritel, X / Revel-Delhom, C / Ballester, M / Bolze, P A / Borghese, B / Bornsztein, N / Boujenah, J / Bourdel, N / Brillac, T / Chabbert-Buffet, N / Chauffour, C / Clary, N / Cohen, J / Decanter, C / Denouël, A / Dubernard, G / Fauconnier, A / Fernandez, H / Gauthier, T / Golfier, F / Huchon, C / Legendre, G / Loriau, J / Mathieu-d'Argent, E / Merlot, B / Niro, J / Panel, P / Paparel, P / Philip, C A / Ploteau, S / Poncelet, C / Rabischong, B / Roman, H / Rubod, C / Santulli, P / Sauvan, M / Thomassin-Naggara, I / Torre, A / Wattier, J M / Yazbeck, C / Canis, M. ·Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France. Electronic address: pierre.collinet@chru-lille.fr. · Service de gynécologie-obstétrique et médecine de la reproduction, Inserm CIC 1402, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France. · Haute Autorité de santé, 5, avenue du Stade-de-France, 93218 La Plaine-Saint-Denis cedex, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. · Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université Claude-Bernard-Lyon 1, 69000 Lyon, France. · Service de chirurgie gynécologie-obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, département développement, reproduction, cancer, Inserm U1016, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. · 29, rue de l'Essonne, 91000 Evry, France. · Service de gynécologie-obstétrique, CHU Bondy, avenue du 14-Juillet, 93140 Bondy, France; Centre médical du Château, 22, rue Louis-Besquel, 94300 Vincennes, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France; Faculté de médecine, Encov-ISIT, UMR6284 CNRS, université d'Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France. · 98, route de Blagnac, 31200 Toulouse, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; GRC-6 centre expert en endométriose (C3E), Sorbonne université, Paris, France; UMR-S938 Inserm Sorbonne université, Paris, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. · 3, rue Pablo-Picasso, 92160 Antony, France. · Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 gamétogenèse et qualité du gamète, CHRU de Lille, 59037 Lille cedex, France. · EndoFrance, BP 50053, 01124 Montluel cedex, France. · Université Claude-Bernard-Lyon 1, 69000 Lyon, France; Clinique gynécologique et obstétricale, hôpital de la Croix-Rousse, groupe hospitalier Nord, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex, France. · Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France; EA 7285 risques cliniques et sécurité en santé des femmes, université Versailles-Saint-Quentin-en-Yvelines, Saint-Quentin-en-Yvelines, France. · Service de gynécologie-obstétrique, CHU Bicêtre, AP-HP, 78, avenue du Général-de-Gaulle, 94275 Le Kremlin-Bicêtre, France; CESP-INSERM, U1018, équipe épidémiologie et évaluation des stratégies de prise en charge, VIH, reproduction, pédiatrie, université Paris-Sud, Paris, France. · Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87042 Limoges, France; UMR-1248, faculté de médecine, 87042 Limoges, France. · Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France. · Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France. · Service de gynécologie-obstétrique, CHU d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France; CESP-Inserm, U1018, équipe 7, genre, santé sexuelle et reproductive, université Paris-Sud, 94276 Le Kremlin-Bicêtre cedex, France. · Service de chirurgie digestive, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75001 Paris, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), hôpital Tenon, Paris, France. · Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 33000 Bordeaux, France. · Service de gynécologie-obstétrique, centre hospitalier de Versailles, 177, route de Versailles, 78157 Le Chesnay cedex, France. · Service d'urologie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 60495 Pierre-Bénite, France. · Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Mère-Enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France. · Service de gynécologie-obstétrique, centre hospitalier Renée-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93022 Bobigny, France. · Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France. · Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France. · Service de gynécologie-obstétrique, CHU Bicêtre, AP-HP, 78, avenue du Général-de-Gaulle, 94275 Le Kremlin-Bicêtre, France. · Service d'imagerie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Sorbonne universités, UPMC université Paris 06, Paris, France; Institut universitaire de cancérologie, Assistance publique, Paris, France. · Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France. · Centre d'étude et traitement de la douleur, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonowski, 59000 Lille, France. · Service de gynécologie-obstétrique, hôpital Foch, AP-HP, 40, rue Worth, 92151 Suresnes, France; Centre d'assistance médicale à la procréation, clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-Sur-Seine, France. ·Gynecol Obstet Fertil Senol · Pubmed #29550339.

ABSTRACT: First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.

25 Guideline [Epidemiology and diagnosis strategy: CNGOF-HAS Endometriosis Guidelines]. 2018

Fauconnier, A / Borghese, B / Huchon, C / Thomassin-Naggara, I / Philip, C-A / Gauthier, T / Bourdel, N / Denouel, A / Torre, A / Collinet, P / Canis, M / Fritel, X. ·Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France; EA 7285 risques cliniques et sécurité en santé des femmes, université Versailles-Saint-Quentin-en-Yvelines, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-le-Bretonneux, France. Electronic address: afauconnier@chi-poissy-st-germain.fr. · Service de chirurgie gynécologie obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, département développement, reproduction, Cancer, Inserm U1016, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. · Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France; EA 7285 risques cliniques et sécurité en santé des femmes, université Versailles-Saint-Quentin-en-Yvelines, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-le-Bretonneux, France. · Service d'imagerie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Sorbonne universités, UPMC université Paris 06, institut universitaire de cancérologie, AP-HP, 21, rue de l'École-de-Médecine, 75006 Paris, Paris, France. · Clinique gynécologique et obstétricale, groupe hospitalier Nord-hôpital de la Croix-Rousse, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex, France. · Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87042 Limoges, France; UMR-1248, faculté de médecine, 87042 Limoges, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France; Encov-ISIT, UMR6284 CNRS, faculté de médecine, université d'Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France. · EndoFrance, BP 50053, 01124 Montluel cedex, France. · Centre Hospitalier Universitairede Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France. · Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France. · Inserm CIC 1402, service de gynécologie-obstétrique et médecine de la reproduction, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France. ·Gynecol Obstet Fertil Senol · Pubmed #29548620.

ABSTRACT: Based on the best evidence available, we have provided guidelines for clinical practice to target the nature of endometriosis as a disease, the consequences of its natural history on management, and the clinical and imaging evaluation of the disease according to the level of care (primary care, specialized or referral). The frequency of endometriosis is unknown in the general population; endometriosis requires management when it causes symptoms (pain, infertility) or when it affect the function of an organ. In the absence of symptom, there is no need for follow-up or screening of the disease. Endometriosis may be responsible for various pain symptoms such as severe dysmenorrhea, deep dyspareunia, painful bowel movements or low urinary tract signs increasing with menstruation, or infertility. A careful evaluation of the symptoms and their impact on the quality of life should be made. The first-line examinations for the diagnosis of endometriosis are: digital examination and pelvic ultrasound. The second-line examinations are: the pelvic exam by an expert clinician, the pelvic MRI and/or the transvaginal ultrasound by an expert. MRI and ultrasound carrying different and complementary information. Other examinations may be considered as part of the pre-therapeutic assessment of the disease in case of specialized care. Diagnostic laparoscopy may be suggested in case of clinical suspicion of endometriosis whereas preoperative examinations have not proved the disease, it must be part of a management plan of endometriosis-related pain or infertility. During management, it is recommended to give comprehensive information on the different therapeutic alternatives, the benefits and risks expected from each treatment, the risk of recurrence, fertility, especially before surgery. The information must be personalized and take into account the expectations and preferences of the patient, and accompanied by an information notice given to the patient.

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