The involution of the female genital tract seems to reflect a built-in biological life expectancy, inter-related with the hypothalamic-hypophyseal-ovarian axis. Lower levels of oestradiol have a number of adverse effects, including on the lower urinary tract. The major universal change is vaginal atrophy. The vaginal mucosa becomes thinner and dry, which can produce vaginal discomfort, dryness,...

INTRODUCTION High-intensity focused ultrasound (HIFU) is an ablative treatment undergoing assessment for the treatment of benign and malignant disease. We describe the first reported intracavitary HIFU ablation for recurrent, unresectable and symptomatic cervical cancer. CASE DESCRIPTION A 38 year old woman receiving palliative chemotherapy for metastatic cervical adenocarcinoma was offered a...

OBJECTIVES : Surgery for pelvic organ prolapse (POP) is common with increasing high-quality evidence to guide surgical practice. Yet many important basic questions remain, including the optimal timing for POP surgery, the optimal preoperative evaluation of urinary tract function, and the postoperative outcome assessment. This manuscript reviews traditional surgical approaches for POP. METHODS...

The optimal route for delivery of preterm breech-presenting fetuses remains a clinical dilemma. Available data from the literature are largely based on retrospective cohort studies, and randomised controlled trials are considered impossible to conduct. Consistently however, large population-based surveys have shown that planned caesarean sections for these fetuses were associated with better ne...

Nanopharmaceuticals have the potential to revolutionise medical treatment by permitting the design of more potent, less toxic "smart" therapeutics, ultimately leading to personalised medicine. This review summarises the challenges and potential uses of nanodelivery system for the topical drug therapy of vaginal diseases. The vaginal route of drug administration remains a challenge in the develo...

BACKGROUND Oral cavity has been proposed as an important reservoir of H.pylori, being implicated in bacterial transmission through oral-oral route. However, some investigators believe that the newborn acquires H.pylori from mother through vaginal delivery. In this study, oral and vaginal yeasts were examined for the intracellular occurrence of H.pylori and their possible role in bacterial trans...

A case of persistent fetal bradycardia first detected at 32 weeks of gestational age is described. The diagnosis of atrial ectopic beats was made by means of M-mode echocardiography. Since the fetus was normally grown and showed no signs of distress, the vaginal route of delivery was allowed, also because continuous M-mode echocardiographic monitoring was possible during labour.

Hysterectomy is one of the most frequently performed surgical procedures in the United States. Selection of the route of hysterectomy for benign causes can be influenced by the size and shape of the vagina and uterus; accessibility to the uterus; extent of extrauterine disease; the need for concurrent procedures; surgeon training and experience; average case volume; available hospital technolog...

Our objective was to investigate the first-pass effect to the uterus of progesterone gel administered vaginally. This was a prospective, randomized study of 32 postmenopausal women, attending our menopause clinic. All women used transdermal estradiol (50 microg/day, a patch each week) for 2 weeks. They used either vaginal progesterone gel or intramuscular progesterone in oil 50 mg after 24 h to...

OBJECTIVE To assess the feasibility and safety of performing vaginal hysterectomy on enlarged uteri the equivalent of 14 to 20 weeks of gestation in size. DESIGN A prospective observational study. SETTING The Royal Free Hospital, London. PARTICIPANTS Fourteen consecutive women undergoing vaginal hysterectomy for uterine fibroids up to 20 weeks in size. INTERVENTIONS Vaginal hysterectomy...