A comparison of sacral neuromodulation vs. transvaginal electrical stimulation for the treatment of refractory overactive bladder: The impact on quality of life, body image, sexual function, and emotional well-being

Overactive bladder syndrome (OAB) is defined by the presence of urinary urgency, with or without urge incontinence, usually accompanied by an increase in urinary frequency and nocturia in the absence of urinary tract infections (UTI) or other diseases. The overall prevalence of OAB symptoms in the female population is reported to be 16.6% and increases with advancing age and menopause. The aetiology of OAB is not fully understood and is likely to affect a heterogeneous population of patients due to changes to their central and peripheral nervous systems. Although OAB is frequently associated with female sexual dysfunction (FSD), its real impact on sexual function in women has been evaluated only in a few studies. The first line of treatment for OAB includes behavioural modification and physical therapy, either as monotherapies or in combination. Many patients who have not had success in managing their symptoms with more conservative therapies may decide to resort to third-line treatments for refractory OAB. These treatments include neuromodulation therapies, particularly transvaginal electrical stimulation (TES) and sacral neuromodulation (SN). The aim of this short commentary is to provide an overview of the effectiveness of these treatments and of their impact on quality of life, body image, sexual function, and emotional well-being

European trends in ovarian cancer mortality, 1990–2020 and predictions to 2025

Introduction: Over the last decades, ovarian cancer mortality in Europe has been decreasing, but disparities in trends were observed. In this paper, we analysed ovarian cancer mortality trends in Europe over the period 1990–2020 and predicted the number of deaths and rates by 2025. Methods: We extracted population and death certification data from ovarian cancer in women for 31 European countries, between 1990 and 2020 from the World Health Organization database. We computed age-standardised mortality rates (ASMR) per 100,000 women-years, based on the world standard population. We also obtained predictions for 2025 using a joinpoint regression model and calculated the number of avoided deaths over the period 1994–2025. Results: Over the observed period, mortality from ovarian cancer showed a favourable pattern in most countries. In the EU-27, rates declined by 5.9% from 2010–2014 to 2015–2019, reaching an ASMR of 4.66/100,000. During the same period, the decline in ovarian cancer mortality was more pronounced in the EU-14 countries (−7.0%) compared to Transitional countries (−2.1%). Declines were also observed in the United Kingdom, to reach an ASMR of 5.29. Decreases in mortality from ovarian cancer are predicted until 2025, to 4.17/100,000 for the EU-27. Conclusions: Favourable trends in ovarian cancer mortality are expected to persist in Europe and can be mainly attributed to the increased use of oral contraceptives in subsequent generations of European women. Decreased use of menopausal Hormone Replacement Therapy and improved diagnosis and management may also have played a role

European trends in ovarian cancer mortality, 1990-2020 and predictions to 2025

Favorable trends in ovarian cancer mortality are expected to persist in Europe and can be mainly attributed to the increased use of oral contraceptives in subsequent generations of European women. Decreased use of menopausal Hormone Replacement Therapy (HRT) and improved diagnosis and management may also have played a rol

Spatial Overlap and Habitat Selection of Corvid Species in European Cities

Understanding habitat and spatial overlap in sympatric species of urban areas would aid in predicting species and community modifications in response to global change. Habitat overlap has been widely investigated for specialist species but neglected for generalists living in urban settings. Many corvid species are generalists and are adapted to urban areas. This work aimed to determine the urban habitat requirements and spatial overlap of five corvid species in sixteen European cities during the breeding season. All five studied corvid species had high overlap in their habitat selection while still having particular tendencies. We found three species, the Carrion/Hooded Crow, Rook, and Eurasian Magpie, selected open habitats. The Western Jackdaw avoided areas with bare soil cover, and the Eurasian Jay chose more forested areas. The species with similar habitat selection also had congruent spatial distributions. Our results indicate that although the corvids had some tendencies regarding habitat selection, as generalists, they still tolerated a wide range of urban habitats, which resulted in high overlap in their habitat niches and spatial distributions

Hysteroscopic treatment of submucosal fibroids in perimenopausal women: when, why, and how?

Uterine fibroids are a common finding in premenopausal women. They considerably reduce the quality of life by provoking abnormal uterine bleeding and consequent anemia and pelvic pain. Over the past 20 years, radical surgery (hysterectomy) for symptomatic fibroids has been partially replaced with minimally invasive surgical procedures that spare the uterus, with lower costs and reduced morbidity. Outpatient and inpatient operative hysteroscopy have been validated as safe and effective minimally invasive treatment options for both submucosal and intramural fibroids. In such a scenario, several technological innovations and the possibility of pharmacological pretreatment have enhanced the hysteroscopic approach. However, the counseling and treatment of perimenopausal women remain a challenge for the gynecologist. The main purpose of this review is to provide an updated guide to the management of submucosal fibroids in perimenopausal women, depicting how, when, and why hysteroscopic treatment is a valuable choice to eliminate symptoms and satisfy the patient’s wish to improve their overall quality of life

Breast cancer mortality in the Americas and Australasia over the period 1980–2017 with predictions for 2025

Substantial progress has been made in the diagnosis, management, and treatment of breast cancer over the last decades. This has affected mortality rates but has also led to inequality in epidemiological trends between different regions of the world. We extracted death certification data for breast cancer from the World Health Organization database. We analyzed trends in breast cancer mortality in selected countries from America, Asia, and Oceania over the 1980–2017 period and predicted numbers of deaths and rates for 2025. In North America, we observed decreased breast cancer mortality, reaching a rate of about 13/100,000 women in 2017. In Latin American countries, breast cancer mortality rates did not consistently decrease. The highest decreases in mortality were observed in Australia. Mortality trends in Asian countries remained among the lowest globally. We have predicted decreased mortality from breast cancer in 2025 for most of the analyzed countries. The epidemiological situation regarding breast cancer mortality is expected to change in the coming years. Advancements in diagnosis and treatment of breast cancer must be extended in various areas of the world to obtain global control of breast cancer mortality

Effectiveness of laparoscopic surgeries in treating infertility related to endometriosis

Introduction Endometriosis is defined as an illness caused by the presence of foci of endometrial tissue outside the uterine cavity. The illness is found in 5–10% of women at reproductive age. In the group of those suffering from endometriosis, the percentage of infertile women amounts to 50%. At higher stages of endometriosis clinical advancement, the suggested treatment is the application of assisted reproductive technology. Objective The aim of the study was assessment of the effectiveness of laparoscopy in treating infertility related to endometriosis among women treated in our clinic in 2009–2012. Material and Methods The clinic is a medical centre focused on advanced minimally invasive surgical treatment, especially laparoscopic surgeries in diseases of the uterus – with a focus on laparoscopic surgeries for patients with endometriosis of the recto-vaginal area. 53 female patients treated for infertility who underwent a laparoscopic surgical procedure to remove the foci of endometriosis in 2009–2012, were analysed retrospectively. After the surgical procedure, the patients were observed over a period of 12 months, during which the frequency of pregnancies (including natural and assisted pregnancies) was assessed in relation to the stage of endometriosis advancement (rAFS). Results In 17 out of 53 (32%) patients who underwent the surgical procedure a clinical pregnancy was diagnosed. 11 out of 53 (20.75%) women became pregnant spontaneously, 6 out of 53 (11.32%) patients became pregnant as a result of assisted reproductive technology (ART) (5 IVF and 1 IUI). The average time from the date of surgical procedure to spontaneous pregnancy amounted to 6 months. Conclusions Laparoscopy is a vital therapeutic method. Operative laparoscopy is an efficient method for treating infertility related to endometriosis, and the procedure seems to be the most effective particularly at stage III rAFS. The period for expectant management after a surgical procedure should last 6 months

Hysteroscopic treatment of submucosal fibroids in perimenopausal women: when, why, and how?

Uterine fibroids are a common finding in premenopausal women. They considerably reduce the quality of life by provoking abnormal uterine bleeding and consequent anemia and pelvic pain. Over the past 20 years, radical surgery (hysterectomy) for symptomatic fibroids has been partially replaced with minimally invasive surgical procedures that spare the uterus, with lower costs and reduced morbidity. Outpatient and inpatient operative hysteroscopy have been validated as safe and effective minimally invasive treatment options for both submucosal and intramural fibroids. In such a scenario, several technological innovations and the possibility of pharmacological pretreatment have enhanced the hysteroscopic approach. However, the counseling and treatment of perimenopausal women remain a challenge for the gynecologist. The main purpose of this review is to provide an updated guide to the management of submucosal fibroids in perimenopausal women, depicting how, when, and why hysteroscopic treatment is a valuable choice to eliminate symptoms and satisfy the patient's wish to improve their overall quality of life