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Bielefeld, Germany

Kalder M.,University of Marburg | Muller T.,Agaplesion Markus Krankenhaus | Fischer D.,Klinik fur Gynakologie und Geburtshilfe | Muller A.,Frauenklinik | And 16 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2016

In recent years complementary and alternative medicine (CAM) has increasingly been the focus of international research. Numerous subsidised trials (7903) and systematic reviews (651) have been published, and the evidence is starting to be integrated into treatment guidelines. However, due to insufficient evidence and/or insufficient good quality evidence, this has mostly not translated to practice recommendations in reviews by the Cochrane collaboration gynaecology group. There is nevertheless a not insignificant number of CAM providers and users. The percentage of oncology patients who use CAM varies between 5 and 90%. Doctors have been identified as the main providers of CAM. Half of gynaecologists offer CAM because of personal conviction or on suggestion from colleagues. This must be viewed in a critical light, since CAM is mostly practiced without appropriate training, often without sufficient evidence for a given method-and where evidence exists, practice guidelines are lacking-and lack of safety or efficacy testing. The combination of patient demand and lucrativeness for doctors/alternative medicine practitioners, both based on supposed effectiveness CAM, often leads to its indiscriminate use with uncertain outcomes and significant cost for patients. On the other hand there is published, positive level I evidence for a number of CAM treatment forms. The aim of this article is therefore to review the available evidence for CAM in gynaecological oncology practice. The continued need for research is highlighted, as is the need to integrate practices supported by good evidence into conventional gynaecological oncology. © 2016 Georg Thieme Verlag KG Stuttgart · New York. Source

Fleisch M.C.,Universitats Frauenklinik Dusseldorf | Fleisch M.C.,Universitatsklinikum | Bremerich D.,Klinik fur Anasthesiologie | Schulte-Mattler W.,University of Regensburg | And 11 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2015

Purpose: Official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). Positioning injuries after lengthy gynecological procedures are rare, but the associated complications can be potentially serious for patients. Moreover, such injuries often lead to claims of malpractice and negligence requiring detailed medical investigation. To date, there are no binding evidence-based recommendations for the prevention of such injuries. Methods: This S1-guideline is the work of an interdisciplinary group of experts from a range of different professions who were commissioned by DGGG to carry out a systematic literature search of positioning injuries. Members of the participating scientific societies develop a consensus in an informal procedure. Afterwards the directorate of the scientific society approves the consensus. The recommendations cover. © Georg ThiemeVerlag KG Stuttgart · New York. Source

Petry K.U.,Zentrum fur Frauenheilkunde | Rinnau F.,Zentrum fur Frauenheilkunde | Bohmer G.,Zentrum fur Frauenheilkunde | Hollwitz B.,Zentrum fur Frauenheilkunde | And 4 more authors.
BMC Cancer | Year: 2013

Background: Primary human papilloma virus (HPV) screening is more effective than cytology in reducing the risk of cervical cancer, but screening intervals should be extended in HPV-negative women. However, some Markov models predicted that long intervals are associated with an excess risk of cervical cancer. The aim of this analysis was to estimate the real-life risks and benefits of annual Papanicolaou (Pap) screening in HPV-negative women with normal cytology.Methods: Women with negative Hybrid Capture 2 (HC2) results and normal cytology at the time of inclusion in the Hannover HPV screening trial underwent annual Pap smears for 5 years. A subgroup was randomly selected for retesting with cytology, HC2, and colposcopy 60-68 months after recruitment.Results: Of 4236 women included, 3406 had at least one Pap smear, but only 1185 attended all five annual screening visits. The proportion of women with at least one abnormal smear was 14.4% in 60 months. The probability of abnormal smears increased continuously over time. No case of ≥ CIN2+ was observed during 5 years. Of 605 women selected for subgroup analysis, 292 agreed to be retested (48.3%). The rate of high-risk HPV at 60-68 months was 3.0% (9/296).Conclusions: The long-term risk of high-grade neoplasia after an initial negative HC2 test and normal cytology result was low, while the rate of false-positive abnormal Pap smears was significant and increased constantly over time. Pap smear screening of HPV-negative women more frequently than every 5 years could be potentially harmful and seems to be of little clinical value. © 2013 Petry et al.; licensee BioMed Central Ltd. Source

Volz J.,Zentrum fur Frauenheilkunde | Volz-Koster S.,Zentrum fur Frauenheilkunde | Klibavicius A.,Zentrum fur Frauenheilkunde
Gynakologische Praxis | Year: 2010

Advances in minimal invasive surgery in gynecology increasingly replace abdominal and vaginal hysterectomy. In this article different laparoscopic techniques are described like laparoscopic supracervical hysterectomy (LASH), laparoscopic assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH). Up to 90% of all hysterectomies on the basis of benign indication are performed using endoscopic techniques. Source

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