a 56 year old lady presented with gradual onset left flank pain, rigours and diarrhoea. Her past history was remarkable for an uneventful, elective bilateral laparoscopic oophorectomy one month earlier under the Gynaecology service. She had previously had breast cancer and was BRCA2 positive. On examination she was pyrexial and tender in her left flank. Computerised tomography revealed moderate left sided hydronephrosis, extensive air within her left renal pelvis and a distal left ureterocolic fistula (Figures 1-3). She was initially managed with antimicrobial therapy and stenting but eventually required a ureteric reimplantation....

Breast cancer is the most common cancer and the fifth most common cause of death from cancer in women. Ovarian cancer is the deadliest type of the gynecological cancers. Concerning women with BRCA1 or BRCA2 mutation, surgical alternatives for reducing their risk of developing breast and/or ovarian cancer are prophylactic mastectomy, skin-sparing mastectomy, and prophylactic salpingo-oophorectomy. The arguments of the proponents and opponents regarding prophylactic mastectomy and salpingo-oophorectomy are presented. Prophylactic surgeries are controversial; hence, mandating immediate interventions on the policy level.

Carcinoma of the uterine cervix is a significant cause of mortality because of malignancy in women. Radiotherapy is a major treatment modality for invasive cervical cancer with good treatment outcome in early-stage patients. However, substantial treatment failures still occur in the advanced-stage patients. In this case report a long term follow up of a 58 years old woman with stage II cervical squamous cell carcinoma (SCC), who was considered inoperable due to her general condition, cardiac poor function and ischemic heart disease (IHD) has been reported. After full dose external radiotherapy the patient became disease free till 6 years and after local recurrence, she was treated successfully with total abdominal hysterectomy (TAH) and bilateralsalpingo-oophorectomy (BSO)as well as adjuvant chemotherapy with favorable results during a long term follow up of 14 years. It is concluded that long term favorable outcome may be achieved by intensive radiotherapy of uterine cervix SCC and probable recurrence could be managed successfully by surgical excision.

Background: Osteoporosis is a chronic disease characterized by a decrease in bone mineral density (BMD) and corruption of the microarchitectural structure of bone tissue.Objective: It was investigated whether methylprednisolone had a favorable effect on osteoporotic bone tissue in Oophorectomy induced osteoporotic rats whose endogenous adrenaline levels are suppressed with metyrosine.Materials and Methods: Bone Mineral Density, number of osteoblast-osteoclast, bone osteocalcin levels and alkaline phosphatase (ALP) measurements were performed. Obtained results were compared with that of alendronate.Results: Oophorectomy induced osteoporosis was exacerbated by methylprednisolone. Alentronate prevented ovariectomised induced osteoporosis, but it couldn’t prevent methylprednisolone +ovariectomised induced osteoporosis in rats.Conclusion: Combined treatment with methylprednisolon and metyrosine was the best treatment for preventing osteoporosis but metyrosine alone couldn’t prevent osteoporosis in ovariectomised rats.

Background: Ovarian masses requiring surgical intervention are uncommon in the pediatric population. The aim of this study was to report results of a multicentric Tunisian study concerning the clinical practice and the management of pediatric ovarian masses and to identify the factors that are associated with ovarian preservation. Materials and Methods: Between January 2000 and December 2015, 98 pediatric patients (<14 years) were surgically treated for ovarian masses at the five pediatric surgery departments in Tunisia. Results: Ninety-eight patients were included in this study. The mean age of the patients at time of surgery was 8. 46± 4. 87 years. Sixty-three ovarian masses (64. 3%) were non-neoplastic lesions, 24 (24. 5%) were benign tumors, and 11 (11. 2%) were malignant neoplasms. Conservative surgery (ovarian preserving surgery) was successfully performed in 72. 4% of the benign lesions whereas only three patients (27. 3%) with malignant tumors underwent ovary-sparing tumor resection (p<0. 001). The mean diameter of the tumors in the patients who underwent oophorectomy was significantly larger than that in the patients who underwent conservative surgery (7. 8 ± 3. 9 cm vs. 5. 7 ± 2. 9 cm, respectively, p=0. 001). Conclusion: In the present study, the risk factors for oophorectomy were a malignant pathology and large tumor size. In accordance with the Gynecologic Cancer Intergroup consensus, it is recommended that surgical management of ovarian masses in children should be based on ovarian preserving surgery.

Background: Ovarian torsion as a surgical emergency needs an urgent operation. According to the researches, ovarian saving in ovarian torsion in the adult population has considerable success. But this study has not yet been performed in the pediatric age group in Iran. Methods: This is a prospective study extending from 2017/1/20 to 2018/9/22. In this period 18 patients (4-13 years old) were diagnosed by ultrasonography and abdominal CT scan. In all of the patients, tumor markers were checked preoperatively and detorsion and fixation with ovarian cyst biopsy was done. One of the patients in spite of normal tumor marker had a malignant pathology (dysgerminoma) that was removed from the study. The patients were followed 3 months after operation by ultrasonography. Results: Ultrasonography was useful in the diagnosis of ovarian torsion in 82/4% of cases. Ovarian torsion was more prevalent in the right side and there was no relation between the cyst size, presentation symptom, the number of twistings, reversibility of the discoloration of the ovary and the intraoperative findings. Ultrasonography showed that the volume of the affected ovary reached the noninvolved ovary in 3 months. Conclusions: According to this study detorting and preserving the torsioned ovaries is effective, even in necrotic cases.

Background: Cryopreservation of oocytes is an efficient method of fertility preservation (FP) that can be applied in women suffering from gynecologic conditions that menace their reproductive future. Collection of oocytes becomes challenging in some scenarios, like the possibility of an ovarian cancer, the "ex-vivo" harvest of oocytes for FP, aspirating follicles directly from the ovarian specimen already excised by laparotomy or laparoscopy and it is an option for these cases.Case Presentation: In the present case report, the case of a patient with an adnexal mass suspected to be a recurrent teratoma was described who referred to our Assisted Reproduction Unit in Hospital Quironsalud Malaga for FP counseling. After controlled ovarian hyper stimulation, followed by laparoscopic abdominal examination and oophorectomy, anex-vivo follicular aspiration for oocyte retrieval was performed on the specimen, using a standard ultrasound-guided procedure to ease and improve the process. All the follicles were aspirated and 5 metaphase II oocytes were obtained.Conclusion: This is to our knowledge, the first communication describing the ex-vivo ovarian aspiration of mature oocytes for FP using standard ultrasound guidance. Although this ultrasound guidance is not completely necessary, as other authors demonstrated previously, such a procedure permitted an easy and complete harvest of oocytes in a rare tumor with bizarre cystic formations, which made follicle recognition very difficult.