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OBJECTIVE: To compare attitudes toward self-sampling for human papillomavirus (HPV) testing before and after specimen collection in women undergoing colposcopy. The factors associated with the pre-sampling attitude were also studied. METHODS: This prospective study enrolled women with abnormal cervical cytology and/or positive high-risk HPV who attended colposcopy clinics at 10 cancer centers in Thailand between October 2021 and May 2022. Prior to colposcopy, the attitudes of the women toward self-sampling were surveyed through a questionnaire. Written and verbal instructions for self-sampling were provided before the process and subsequent colposcopy. The attitudes toward self-sampling were reassessed after the actual self-sampling. Factors associated with the attitudes were analyzed. RESULTS: A total of 499 women were included in this study. The mean age was 39.28±11.36 years. A total of 85.3% were premenopause, and 98.8% had sexual experience. With the full score of 45, the attitude score after self-sampling was significantly higher than the attitude score before self-sampling (39.69±5.16 vs. 37.76±5.71; P<0.001). On univariate analysis, the factors associated with attitude before HPV self-sampling were age, menopausal status, sexual activity, education level, income, knowledge regarding HPV, and prior high-grade squamous intraepithelial lesion histology. The remaining significant factor on multivariate analysis was sexual activity within the past year (B=0.105, 95% confidence interval, 0.014-2.870; P=0.048). CONCLUSION: Attitudes toward self-sampling improved after the actual self-sampling process, as evidenced by higher attitude scores. Sexual activity was the only independent factor related to the attitude before self-sampling.

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OBJECTIVE: To investigate the effectiveness and safety of oral etoricoxib administration before colposcopic procedure for pain relief during and after colposcopy. METHODS: A prospective double-blind, randomized controlled trial was conducted at the colposcopy unit of Thammasat University Hospital, Thailand from August 2022 to January 2023. The participants were women undergoing colposcopy. They were allocated into two groups: etoricoxib group and control group. Thirty minutes prior to colposcopy, the participants received etoricoxib or placebo tablet. A numerical rating scale was used to evaluate pain upon speculum insertion, 3% acetic acid application, directed cervical biopsy (CDB), endocervical curettage (ECC), and 10 minutes and 24 hours after colposcopy. RESULT: One hundred and ten women were recruited and were divided equally into study and control groups. The mean age of participants was 42.6 years old. One-fourth of cases (29/110) had cervical intraepithelial neoplasia grade 2 or more histology. Subjects in etoricoxib group had less median pain scores during CDB, ECC, and 10-minute and 24-hour post procedure than the control group with statistical significance. Both groups had comparable side effects. CONCLUSION: Administration of oral etoricoxib 30 minutes before colposcopy could reduce pain during and up to 24-hour post colposcopy with minimal side effects.

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OBJECTIVE: To evaluate predictive factors between serum inflammatory markers and malignancy potential of endometrium. METHODS: This retrospective study was conducted at the gynecological oncology unit, department of obstetrics and gynecology, at the faculty of medicine of Thammasat University. The study period was from 2017 to 2020. Endometrial cancer and benign gynecologic disease cases who underwent hysterectomy (with or without adnexectomy) during the study period were recruited. Demographic characteristics, histopathology reports and serum markers were also collected. RESULTS: The study included a study group of 49 participants with endometrial cancer and a control group consisting of 119 cases of benign uterine disease. The study group had statistically significantly higher mean ages, proportional menopausal status and instances of underlying diseases when compared with the control group. Neutrophil/Lymphocyte ratios (NLR) and Platelet/Lymphocyte ratios (PLR) could not meaningfully predict the malignant potential of endometrium in hysterectomy specimens. NLR and PLR were statistically associated with depth of myometrial invasion (MI) in endometrial cancer cases. NLR equal to or greater than 1.93 predicted MI more than half thickness with sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV) at a percentage of 83.3, 52.8, 37.0, 90.5 and 60.4, respectively. PLR equal to or greater than 134.95 predicted MI of greater than fifty percent thickness with sensitivity, specificity, accuracy, PPV and NPV at 75.0, 55.6, 36.0, 87.0 and 60.4 percent, respectively. CONCLUSION: NLR and PLR have positive associations with myometrial invasion of endometrial cancer.

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Background and Objectives: Clinicians have been using elastic abdominal binder for stabilizing incision site after major abdominal surgery. However, the benefits of that practice have never been formally assessed. The aim of this study was to examine the effects of the use of elastic abdominal binder on postoperative pain and recovery of gynecologic cancer patients. Materials and Methods: One-hundred and nine women diagnosed with cervical, endometrial, or ovarian cancer, who underwent open abdominal surgery were assigned randomly into two groups: intervention (56 patients) and control (53 patients). The women in the intervention group applied abdominal binder from postoperative day 1. For the control group, the women did not wear the binder or similar devices. The primary outcomes were pain and functional recovery. Subgroup analysis on participants age ≥ 50 was also performed. Results: For the entire study cohort, the baseline, postoperative day 1, and postoperative day 2 pain scores in the intervention group were significantly lower than the control group. However, there was no significant difference between the groups for postoperative day 3 pain score and for the change in pain scores from the baseline value. Of note, the age ≥ 50 subgroup represented a more balanced cohort with comparable baseline pain scores between the study groups. For this population, the pain scores for postoperative day 1-3 were significantly lower in the intervention group. The intervention group had a longer six-minute walking distance on postoperative day 3 with a trend toward a smaller difference in the day 3 distance from the baseline. Conclusions: The potential benefits of abdominal binder use in reducing postoperative pain and improving functional recovery after open gynecologic cancer surgery could be demonstrated only in those age ≥ 50.

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OBJECTIVE: The aim of the study was to compare pain, anxiety, and satisfaction between women, who listened to music, and those who did not during loop electrosurgical excision procedure (LEEP). MATERIAL AND METHODS: Participants were randomly assigned into two groups. In group 1 (music), the participants listened to relaxing instrumental music through the stereo headset from the time of arrival at the preoperative waiting room until the procedure completed. For group 2 (control), the participants underwent LEEP without music listening. The women rated pain, anxiety, and satisfaction according to 10-cm visual analog scales. Pain was assessed at the time of speculum insertion (baseline pain) and immediately after the LEEP completed (procedural pain). Anxiety and satisfaction were examined just before starting the LEEP and 10 minutes after the procedure completed. RESULTS: One hundred fifty patients (74 in music group and 76 in control group) participated. Mean baseline pain scores after speculum insertion were comparable between the groups (3.7 in the music group vs. 3.5 in the control group, p = .55). Mean procedural pain scores were not different between the groups (4.7 in the music group vs. 5.2 in the control group, p = .32). The differences of the procedural pain scores from baseline were statistically comparable between the study groups (0.9 in the music group vs. 1.7 in the control group, p = .15). There were no significant differences in anxiety and satisfaction scores at any time points assessed between the groups. CONCLUSIONS: The effects of music listening on reducing pain and anxiety during LEEP could not be demonstrated in this study.

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