RESUMEN
A decrease in vaginal length associated with treatments for gynecological malignancies, particularly pelvic radiotherapy, negatively impacts sexuality. Research into this important problem has been hampered by a lack of instrumentation to measure vaginal length. The Gynecologic Oncology Group recently evaluated the reliability of an instrument, the "vaginal sound," designed to measure vaginal length. Eighty-eight physicians and nurses attended a training session in the use of the vaginal sound that included a clinical practicum with live models. Reliability was assessed at the time of the practicum. The instrument performed well, with vaginal lengths in models without cancer in the upper range of normal as documented by Masters and Johnson. The vaginal sound also appeared to be sensitive to hypothesized changes in vaginal length. Interrater reliability was high with intraclass correlation coefficients of 0.88 among instructors and 0.76 among trainees. In conclusion, the vaginal sound is a simple, yet reproducible measure and adds methodologic rigor to studies of vaginal length.
Asunto(s)
Equipo para Diagnóstico/normas , Ginecología/instrumentación , Vagina/anatomía & histología , Adulto , Femenino , Humanos , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Eight cases of malignant mixed mesodermal tumors and carcinosarcoma of the ovary from our files and 193 cases from the literature were reviewed. An attempt is made to analyze these cases in regard to clinical feature, treatment results, and their outcome. A detailed review of the histogenesis is presented. These tumors grow very rapidly and are usually in advanced stages when diagnosed. Most patients are postmenopausal. Surgery, radiation therapy, and chemotherapy, either alone or in combination, have been used to treat this neoplasm, but 77.6 per cent of the patients are dead of their disease within 1 year. Limited data suggests that patients treated with surgery and combination chemotherapy survive longer. However, further investigation in finding new combination therapy is desired.