Prevalence and Predictors of Anxiety and Depression among Gynaecological Cancer Patients at a Tertiary Health Facility in Southern Nigeria

Background: Cancer patients frequently suffer from mental health problems because of their reactions to their cancer diagnosis, cancer type, treatment effects, recurrence, fear of the end-of-life, survival, and financial burden. Some hospitals have integrated mental health assessments into cancer care, but our centre has little experience with this practice. Aim and Objectives: To ascertain the prevalence and predictors of anxiety and depression in patients with gynaecological cancer at a tertiary health facility in southern Nigeria. Materials and Methods: This was a facility-based cross-sectional descriptive study of 75 women with histologically confirmed gynaecological cancer managed at the University of Port Harcourt Teaching Hospital, Port Harcourt, from January 1, 2022, to December 31, 2022. Individuals having a history of drug addiction, severe cognitive impairment, non-consenting patients, and those with communication difficulties were excluded from the study. A data collection form was used to obtain socio-demographic, reproductive, and clinical characteristics, while the Hospital Anxiety and Depression Scale (HADS) was used to assess for anxiety and depression. Data was analyzed using descriptive statistics to determine the association of variables with anxiety and depression. Results: Most 27 (36.0%) of the respondents were in 40 - 49 age group with a mean age of 50.4 ± 12.3 years. The study showed that 39 (52.0%) of the respondents exhibited symptoms of anxiety, of which 14 (35.9%) were mild, 20 (51.3%) had moderate anxiety and 5 (12.8%) experienced severe anxiety. In addition, 46 (61.3%) of them showed symptoms of depression, of which 17 (37.0%) were mild, 15 (32.6%) were moderate and 14 (30.4%) experienced severe depression. The ratio of respondents who showed anxiety to those that showed symptoms of depression was 5: 6. The factors associated with anxiety were partner’s educational level (X2 = 4.745, p = 0.029), parity (X2 = 6.651, p = 0.036) and duration of diagnosis (X2 = 8.321, p = 0.004), while partner’s educational level (X2 = 6.810, p = 0.009), parity (X2 = 7.129, p = 0.028), age of coitarche (X2 = 6.512, p = 0.039) and duration of diagnosis (X2 = 4.955, p = 0.026) were significantly associated with depression. Conclusion: More than half of the respondents experienced anxiety, while about two-thirds experienced depression. There is a need to incorporate psychological evaluation into the care of gynaecological cancer patients.

Experience of Patients Who Underwent Scheduled Gynaecological Surgery at the Bogodogo University Hospital, Burkina Faso

Introduction: Surgery can cause anxiety and worry, such as waking up in pain, being physically harmed or dying. This study aimed to assess the experience of patients undergoing planned gynaecological surgery in the Obstetrics Gynaecology and Reproductive Medicine department of the University Hospital Centre of Bogodogo. Patients and methods: This was a cross-sectional study with prospective data collection during the period from June 1 to August 31, 2018. The study population consisted of patients who received scheduled gynaecological surgery during the period. Results: Seventy-six (76) patients underwent scheduled surgery and 62 were included. During discussion with the gynaecologist, 58 patients (93.55%) were satisfied. When the surgery was announced, 41 patients (66.13%) were anxious. At the consultation with the anaesthetist 59 patients (95.16%) were satisfied with the discussions. Fifty-five patients (88.7%) were anxious on admission to the operating theatre. The quality of care was satisfactory for 61 patients (98.39%) and all patients were satisfied with the care team. Conclusion: Periodic evaluation of patients’ experiences should therefore be incorporated into care evaluation policies in health facilities in order to contribute to continuous improvement in the quality of medical and surgical care.

Profile of Gynaecological Malignancies in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Southeastern Nigeria

Background: Comprehensive estimates of the incidence of gynaecological malignancies reported from Nigeria are very limited due to limitation in record maintenance. Female cancer is a public health problem the world over. The malignancies of the female genital organs are major causes of morbidity and mortality which necessitates data for policy formulation and health planning. Aim: To establish the profile of gynaecologic malignancies reported in our centre, with reference to incidence, histological subtypes and frequency of involvement at various sites and to compare the procured data with those from other national and international centers. Materials and Method: In this descriptive retrospective study, the records pertaining to all the pathological specimens categorized as gynaecological malignancies from January 1st, 2013 to December 31st, 2015 at our facility were studied and compared with the available international data. Data analysis was done using Epi Info software version 7.2.1 (CDC Atlanta Georgia). Result: Two hundred and eleven (211) cases of gynaecological malignancies were seen during the study period and this constituted 13.4% of gynaecological admissions. Cervical malignancies were the commonest constituting 49.2% of all gynaecological malignancies followed by ovarian malignancies (27.8%), endometrial cancers (11.9%), vulva (5.6%), choriocarcina (3.9%) and vagina (1.6%). The data obtained was compared with data from Surveillance, Epidemiology and End Result (SEER) programme in the United States and European Union. All malignancies except cervical cancers affected a younger age group at our centre. Cervical cancers presented at a relatively more advanced stage, Ovarian cancers were more localized, whereas uterine, vulva and vaginal cancers presented at a similar stages as compared to Western data. Conclusion: This study presents a composite data of Gynaecological malignancies from Southeast Nigeria. Advanced stage of presentation of cervical cancers suggests lacunae in screening programmes available. Compared with Western data, ovarian malignancies were more localized at presentation for which environmental or genetic factors may be responsible.

Absence of Dressing versus Dressing in Gynaecological and Obstetrical Surgery at the University Hospital of Brazzaville

Objective: To compare the evolution of the operative site in the presence or absence of an occlusive skin dressing. Patients and methods: Prospective, comparative study that took place at the University Hospital of Brazzaville from January 1st to August 31st, 2016. 120 patients were randomly recruited divided into two groups: A study group consisting of 60 patients without a dressing and a control group consisting of 60 patients. Results: Sociodemographic characteristics were similar in both groups, as well as pre- and intraoperative characteristics. Postoperative complications included parietal infection (3 vs. 4 cases, p > 0.05), one case of disunion, and one case of skin irritation by the plaster in the study group. The duration of healing was shorter in the control group compared to the study group (11 ± 2 days vs. 12 ± 2, p > 0.05). The average cost of care equipment was 3.5 times higher for the group with dressing (5120 FCFA vs. 18620 FCFA, p 0.05). In the study group, only one patient was afraid of seeing her wound. Patients in the control group were less satisfied, indeed they dreaded the time of removal of the plaster because of the pain.

Prevalence of Dyspareunia and Its Effect on Sexual Life among Gynaecological Clinic Attendees in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.

Risk Management of Obese Women Undergoing Major Gynaecological Surgery

Obesity is a big problem which is growing. Thus clinicians and surgeons are likely to treat obese patients more frequently. Obesity can affect medical practice in a number of ways. In order to protect ourselves from potential litigation, we need to focus on risk management efforts on creating a safe environment for patients of all sizes. The aim of our study was to review the risk management strategies of obese women prior to surgery, perioperatively and following surgery. We then identified the strategies and have brought them forward in our article.

Insulin Sensitivity and Gynaecological Features of Infertile Cameroonian Females with Polycystic Ovary Syndrome: A Cross-Sectional Study

Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It is an intriguing pathology that involves the perpetuation of a vicious circle with reproductive, endocrine and metabolic components. We aimed to assess the reproductive features and insulin sensitivity (IS) in infertile women with or without PCOS. Materials and Methods: We carried out a cross-sectional analytic study at the outpatient Obstetrics and Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital, Cameroon from September 1st 2012 to March 31st 2013 giving total study duration of 07 months. Laboratory analyses were carried out at the National Obesity Centre(NOC)of the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam consensus meeting of 2003 and 21 non PCOS subjects as control. PCOS women were younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2 years;p = 0.0004). The majority of the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic findings were typical of PCOS. Hirsutism score was higher in the PCOS group with a median of 9 (7 - 13). Insulin sensitivity was impaired in two-thirds of the study population, with 12 women found to be insulin resistant(6 PCOS, 6 non PCOS), 12 patients had intermediate insulin sensitivity(2 PCOS, 10 non PCOS)and 12 insulin sensitive(7 PCOS, 5 non PCOS). Apart from blood glucose levels (p = 0.007), all other anthropometric and biological parameters were not significant. Spearman’s correlation identified fasting plasma glucose and total cholesterol as factors associated with insulin sensitivity in females with PCOS. Impaired fasting glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common findings in PCOS. Furthermore, our findings suggest that PCOS may be more of systemic metabolic disease than solely a purely gynecologic disorder as described hitherto. Despite normal fasting plasma glucose levels, a good proportion of these women has impaired insulin sensitivity and it is associated with a metabolic syndrome.

Delayed Presentation of Patients with Gynaecological Malignancies in Kano, North-Western Nigeria

The diagnosis and management of gynaecological cancers are still challenging in low- and middle-income countries. In patients with gynaecological malignancies delay at any point increases morbidity and mortality. This study evaluated the factors that may delay presentation, diagnosis and treatment of patients with malignant gynaecological cancers, and described the duration of each delay. It was a prospective cross-sectional study. A total number of 96 patients diagnosed to have gynaecological malignancy were enrolled in the study between the April 2014 and April 2015. The median age was 47.5 years (range of 18 - 84 years). The diagnoses on admission were cervical malignancy 34 (35.42%), ovarian malignancy 32 (33.33%), chorio carcinoma 15 (15.63%), cancers of uterine body (endometrial and leiomyosarcoma) 10 (10.42%) and vulval malignancies 5 (5.2%). Majority of the patients 65 (67.7%) presented late at either stage III or IV. At presentation, 36 patients (37.5%) had severe anaemia;10 patients (10.41%) had obstructive uropathy;3 (3.13%) developed fistula;19 (19.79%) died on admission from complication of their disease. Most patients 61 (63.54%) had delayed presentation of more than 90 days (“patients delay”). Time in decision ranged between 3 days to maximum of 2920 days and median of 150 days. 58 (60.42%) gave a reason for such delay as lack of knowledge of their presenting symptoms, as a warning sign of possible malignancy;80 (83.33%) had delay in diagnosis (“doctor delay”);40 (41.67%) reported that the medical practitioner did not make referral to the center with available gynaecological services;“hospital delay” was observed in 66 (68.75%) of patients. The reason for delayed treatment in 35 (36.46%) of patients was severe patients condition that warrant stabilization (blood transfusion and dialysis) and 29 (30.21%) could not afford the treatment. Late presentation is a great problem in the management of oncological patients in this environment. High cost of care is the major challenge for the patients and gynaecologist in north-western part of Nigeria.

Pattern of Gynaecological Malignancies in a Tertiary Care Hospital

Background: Gynaecological malignancies are the second most common cancer of females after cancer breast. Gynaecological malignancies contribute significantly to cancer burden and have a higher rate of mortality and morbidity. Carcinoma cervix is the commonest gynaecological malignancy in developing countries while in developed countries, ovarian cancer is the commonest. Comprehensive statistics on gynecologic malignancies reported from Bangladesh are deficient. This study was performed to ascertain the profile of gynecologic cancers reported at our center regarding demography, the frequency of involvement at various sites, clinical presentation, incidence, histologic subtypes and stage at presentation. Methods: This is a retrospective study where the records of the Departments of Gynecology and Pathology at Enam Medical College & Hospital, Dhaka, Bangladesh were retrospectively reviewed to identify all cases of Gynecologic malignancies and to determine the pattern of gynaecological malignancies identified between January 2015 and December, 2018. Results: Cervical cancer (53%) was the most common gynaecological malignancy, followed by ovarian cancer (29%), uterine cancer (8%), vulvar cancer (5%) and gestational trophoblastic neoplasm (GTN 5%). In the case of cervical and ovarian cancer the most common age group was 41 - 50 years and gestational trophoblastic neoplasm (GTN). The majority of patients presented at the ages of 31 - 40 years while uterine cancer presented in the elderly (>60 years). Among the patients studied 88% were multiparous. Of the cervical cancer cases, 96.22% was squamous cell carcinoma and commonest presenting complains were contact bleeding (33.96%) and excessive and irregular menstruation (26.41%). Among ovarian tumor cases 69% had epithelial while 31% had non-epithelial cancer and predo&

Patient Satisfaction after Elective Major Gynaecological Surgery in 2 Reference Hospitals in Yaounde: A Cross-Sectional Study

Introduction: Patient satisfaction is a quality-of-care measure and reveals patients’ appreciation of healthcare delivery. We sought to measure patient satisfaction following major gynaecological surgeries in 2 University Teaching Hospitals in Yaounde, Cameroon. Methods: This study was a cross-sectional, prospective study over 9 months (October 1st, 2018, to June 30th, 2019) at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Surgical Satisfaction Questionnaire (SSQ-8) via phone call 6 months after surgery, we appreciated and scored key aspects linked to patient satisfaction and obtained information on post-operative complications. Data were analysed using Microsoft Excel 18 and SPSS 21 setting significance at p Results: We recruited 72 patients aged 24 to 68 years. Our participants had a mean satisfaction score of 26 ± 7.854 (59.7% satisfied and 40.3% dissatisfied). All aspects tested on the SSQ-8 questionnaire influenced patient satisfaction. Patients who said they were satisfied with pain control after surgery (OR = 0.207 CI = 0.070 - 0.609, p = 0,003), and with surgical results in the SSQ-8 questionnaire (OR = 0.053, CI = 0.011 - 0.254, p < 0.001) achieved statistically significant post-operative satisfaction. Contrarily, patients who were dissatisfied with surgery results (OR = 132.000, CI = 15.256 - 114.131, p < 0.001) and those who developed complications (OR = 7.922, CI = 2.241 - 28.004, p < 0.001) were significantly dissatisfied with surgery. Additionally, 47.2% declared a poor post-operative current health status versus 52.8% who claimed a good post-operative current health status. Following multivariate analysis, satisfaction with the results of surgery (OR = 0.071, CI = 0.008 - 0.657, p = 0.020) and the occurrence of complications (OR = 7.284, CI = 1.146 - 46.273, p = 0.035) were the main determinants of patient satisfaction. Patient current health status evolved similarly to patient satisfaction and especially by satisfaction with time taken to resume work (OR = 0.039, CI = 0.004 - 0.398, p = 0.006) and pre-operative exercise routine (OR = 0.038, CI = 0.002 - 0.678, p-value = 0026). Conclusion: Patient satisfaction with elective gynaecological surgery is low and determined by post-operative experiences and the occurrence of complications. Also, patients self-reported current health status tends to evolve similarly to satisfaction following surgery.

Informed Consent Prior to Elective Gynaecological Surgery in Two Reference Hospitals in Yaoundé, Cameroon: A Mixed Methods Study

Introduction: Informed consent is a process that enshrines respect for patients’ autonomy, their dignity, and their rights to determine what happens to their own bodies. We set out to describe the surgical informed consent process and evaluate its quality in patients undergoing elective gynaecological surgeries in two University Teaching Hospitals in Yaounde, Cameroon. Methods: This was a cross-sectional, prospective study over 9 month period, from October 1st, 2018, to June 30th, 2019 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Brezis questionnaire 48 hours after surgery, we obtained data which enabled us to evaluate and score the informed consent process and obtained written reports of patients’ appreciation of key aspects of the informed consent process prior to surgery. We then called each participant 6 months after their surgery date to obtain information on the occurrence or not of post-operative complications. Results: We recruited 72 patients aged 24 to 68 years old (61 at YGOPH, 11 at YCH). The operating gynaecologist sought patient consent in 65.3% (49/72) of cases, while 61.1% (44/72) of the subjects would have loved to have more information on surgical risks;69.4% (50/72) were satisfied with the consent process;and 56.9% (41/72) could recall and repeat the information they received prior to surgery. While 37.5% (27/72) had poor quality (non-valid consent), 40.3% had good quality consent (valid). Consent administered by the gynaecologist (OR = 0.172;95% CI = 0.060 - 0.049) was a strong determinant of valid consent. Also, patients with non-valid consent significantly reported more complications (OR = 4.469;95% CI = 1.412 - 14.147) than those with valid consent. Conclusion: Informed consent prior to elective gynaecological surgeries in our study was poor. The timing of the consent process, as well as the person involved in the process affect the validity of the consent.

Iatrogenic Lesions of the Ureter Following Obstetric or Gynaecological Surgery Managed at Yalgado Ouedraogo University Hospital: A Series of 14 Cases

Objective: To describe the aetiology, clinical presentation, management and outcomes of a series of patients with iatrogenic lesions of the ureter following obstetric or gynaecological surgery treated at Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso. Methods: This is a case series looking at 14 consecutive patients from 1 January 2011 to 28 February 2017, operated on for urological complications following obstetric and gynaecological surgery. Results: Our study focused on fourteen cases. The average age was 32.9 years (range 20 - 60 years). Thirteen were housewives. Eleven lived in rural areas. The aetiological factor was Caesarian section in seven cases, laparotomy in four cases and hysterectomy in three cases. The type of ureteral injury was bilateral ligation in nine cases. The average time to diagnosis was 16 days (range 2 - 120 days). Anuria was the commonest presenting symptom. Ultrasound in ten patients showed evidence of uretero-hydronephrosis. Eight patients required renal dialysis. Surgical management was uretero-vesical re-implantation in eleven cases, disunion of sutures associated with catheterization in two cases and a termino-terminal ureteral anastomosis in one case. The average hospital stay was 26 days (range 9 - 44 days). The post-operative period was complicated by two cases of vesico-vaginal fistula, one case of parietal suppuration, one case of pyelonephritis and one case of hydronephrosis. No deaths were recorded and a complete cure was ultimately obtained in all patients. Conclusion: Urological complications of obstetric and gynaecological surgery are dominated by ligation of the ureters in our setting. Caesarian section is the commonest cause. Treatment is essentially surgical.

Early discharge after major gynaecological surgery: advantages of fast track surgery

Introduction: Fast Track Surgery (FTS) programs have been adopted by many specialties with documented improved patient outcomes and reduced length of stay (LOS). Methods: We initiated a FTS program in January 2008 and present our experience up to and including November 2010 on patients whose LOS was 2 days. Results: During the study period 242 patients had a laparotomy performed. Overall 54(22.3%) patients were discharged on day 2. In the first year of initiating our FTS program 10% were discharged on day 2, 25% in year 2 and 31% in year 3. Twenty-two patients (41%) had malignant pathology and of these, 16 (73%) had local or regional spread and 6 (27%) had distant spread. Forty patients (74%) had vertical midline incisions (VMI) performed. Surgery was classified as complex in 40 cases (74%) and 6 (11%) patients underwent staging lymph node dissection. Average patient BMI was 26.1 with 44% of patients considered overweight or obese. There were no intraoperative complications recorded. When compared to 188 patients whose LOS was greater than 2 days, the early discharge cohort were more likely to have benign pathology, more likely to be younger, to have a transverse incision, to have received COX II inhibitors, to have a lower net haemoglobin (Hb) change and to tolerate early oral feeding. Conclusions: Increased clinical experience with FTS enables over 31% patients undergoing laparotomy to be safely discharged on day 2 without an increase in the read-mission rate or morbidity.

Diagnostic Indicators for Blood Stasis Syndrome Patients with Gynaecological Diseases

Objective： To investigate the important diagnostic indicators for blood stasis syndrome （BSS） in patients of childbearing age with gynaecological diseases. Methods： A partial least squared-discriminant analysis （PLS-DA） were applied to BSS symptoms data of patients with gynaecological diseases, and the diagnostic indicators used by doctors of Korean medicine （DKMs） among BSS patients with gynaecological diseases were also investigated. Results： A total of 103 patients of childbearing age with gynaecological diseases and 40 healthy controls were enrolled. Among the 103 patients, 63 （61.7%） and 40 （38.8%） were diagnosed with BSS and non-BSS, respectively, and BSS patients exhibited a more severe extent of disease. A score plot of PLS-DA showed clearly different patterns among the 3 groups. Based on the variable importance on projection of PLS-DA model, menstrual pains, dark lumps in the menstrual blood, ileocoecal tenderness and resistance, sharp pains, and sublingual varicosities were selected as the top five most important indicators. Moreover, more than 75% of DKMs chose dark lumps in menstrual blood, menstrual pain, and dark menstrual blood as the diagnostic indicators of BSS in patients with gynaecological diseases, and more than 49% of them also considered sharp pains, dark red tongue, sublingual varicosities, and tendency to bruise easily as diagnostic indicators of BSS. Conclusion： DKMs focused on menstrual symptoms and certain gynaecological symptoms to diagnose BSS patients of childbearing age with female diseases.

Clinical Observation on the Effects of Different Doses of Tramadol lnjection for Preemptive Analgesia in Gynaecological Laparoscopy

Objective: To observe the analgesic effects of tramadol in general anaesthesia for laparoscopic surgery. Methods: To operate 80 laparoscopic surgeries under the circumstance of general anaesthesia. Randomly divide them into 4 groups,with 20 cases in each group and the intravenous injection should be finished before the operation. Group Ⅰ: 2 ml normal saline; Group Ⅱ: 1.5 ml/kg tramadol; Group Ⅲ: 2mg/kg tramadol; Group Ⅳ : 2.5 mg/kg tramadol. Use VAS and Ramsay sedation marking system to assess the degree of pain-feeling and sedation in these circumstances: after pulling out oxygen hose, before leaving the operation room and1, 2, 4, 8, 12, 24 h after the operation. Meanwhile, record such side effects as nausea,vomiting, dizziness, hypersomnia, restless, nightmares, itchy and sweating. Results:The VAS score was significantly lower within postoperative 8 h in Group Ⅱ, Ⅲ andⅣ than that in Group I, while no significant difference was found among GroupⅡ, Ⅲand Ⅳ at each time point. The postoperative Ramsay sedation score was 0-2 in each group. Incidence of postoperative nausea, vomiting, and sweating were more in GroupⅡ, Ⅲ and IV than that in Group I. Group Ⅳ and Group I have statistical differences, in which P<0.05 or P<0.01. However, Group Ⅱ, Ⅲ and Group Ⅳ have no statistical differences. Conclusion: The study suggests that preoperative injection of 1.5-2 mg/kg tramadol provides satisfactory preoperative analgesia in patients undergoing gynaecological laparoscopy, reducing the use of analgesics and the incidence of side effects.

Associated with Knowledge, Attitude, Practice of Women of Childbearing Age towards Gynecological and Breast Cancer in Glazoue, Benin in 2021

Introduction: Gynaecological and breast cancers (GBC) are the most frequent and most serious cancers of women. They are frequent in Benin with an average of 108.5 cases per year. Objective: To identify factors associated with women’s knowledge, attitudes and practices regarding GBC. Methods: This was a cross-sectional, prospective, descriptive and analytical study. Women of childbearing age residing in the commune of Glazoué in Benin for at least six months were included. The WHO cluster sampling technique was used. The Bruno De Finetti postulate and the Likert scale were used to study women’s knowledge, attitudes and practices. Data were collected and analysed using Epi Data 3.1 and Epi info 7.2.2.6 software. Results: A total of 540 women were registered. The mean age was 27.1 ± 8.84 years with extremes of 15 and 49 years. They were married (61.1%), had secondary education (40.2%) and lived in urban areas (61.9%). They had a low level of knowledge (75.4%), an adapted attitude (93.0%) and poor practice (88.9%). Occupation (p = 0.000), level of education (p = 0.007) and place of residence (p = 0.001) significantly influenced knowledge of GBC. The attitude was adequate (93%) and the practice was poor (88.9%). Inappropriate attitude was significantly associated with the level of education (p = 0.006). Conclusion: Women in the commune of Glazoué in Benin have a low level of knowledge of GBC with an adapted attitude and poor practice. Several factors are associated, hence the need to take them into account to facilitate GBC screening.

Epidemiology and Clinical Signs of Gynecological Cancers in an African Country South of the Sahara: Case of the Republic of Benin in 2022

Introduction: Gynaecological cancers are the deadliest of the women’s cancers in the Republic of Benin. Late diagnosis is the most common reason. Objective: This paper aims to describe the epidemiological characteristics, and clinical and pathological signs of gynaecological cancers treated in the Republic of Benin between 2018 and 2022. Patients and Methods: This was a cross-sectional, descriptive, retrospectively collected study of patient data treated between 2018 and 2022 in two university gynaecology departments in Cotonou. All gynaecological cancers that have histological evidence were included. The epidemiological, clinical and pathological characteristics of the cancers were assessed. Results: Cervical, endometrial and ovarian cancers were the most common in the proportions of 62.0%, 24.1%, 12.0% and 1.8% respectively. The mean age at diagnosis was 54 years. The victims were uneducated and had low economic power in 81% and 85% of cases, respectively. The consultation was late in 82.1% of cases. Metrorrhagia, postmenopausal metrorrhagia and pelvic cluster headache were the common reasons for consultation for cervical, endometrial and ovarian cancer, respectively. Diagnosis was late in 66.7% (n = 71). The most common histological types were squamous cell carcinoma, endometrioid adenocarcinoma, and serous cystadenocarcinoma for cervical, endometrial, and ovarian cancers, respectively. Conclusion: Gynaecological cancers were common and their consultation time was delayed. The diagnosis was made at the advanced stage and there were several reasons for this.

Evolution of radical hysterectomy for cervical cancer along the last two decades: single institution experience

Background： The radical hysterectomy （RH） surgical technique has improved along the years. It is used for the treatment of cervical cancer, endometrial cancer when affecting the cervix, and upper vaginal carcinomas. Our aim was to describe the historical evolution of the technique after the introduction of laparoseopy at our institution. Methods： We performed a retrospective review of medical records of patients who underwent RH, grouped in three periods according to the year of surgery： 1990-1999, 2000-2009 and 2010-2013. Patients＇ characteristics, pathologic details, intraoperative and postoperative complications were analyzed and comoared throughout the time periods. Results： A total of 102 cases of RH were performed at our center during the study period. Among all data collected, the presence of necrosis, age, number of lymph nodes, surgery route, operating time, hospital stay, blood loss and transfusion requirement were statistically significant different among groups. Conversion to laparotomy rate was 19% for the second period compared to the absence of cases in the last one. No significant differences （P=0.124） were observed in the adjuvant treatment received among the three different groups. At the time of the last contact the patients free of disease were 12 （85.7%）, 53 （91.3%） and 26 （86.6%） respectively （P=0.406）. Regarding the disease-free interval, we found significant better outcomes in the group of laparotomy compared to laparoscopy （P=0.015）.Conclusions： Laparoscopic RH is an acceptable surgery with advantages like magnified vision of the operation＇s field, lower surgical complications, shorter hospital stay and earlier resumption to daily activities.

Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou

Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.

Oxidative stress and female reproductive disorder: A review

Oxidative stress arises from an imbalance between the body’s pro-oxidants and antioxidants.Recently,oxidative stress has been proven a contributing factor to many female reproductive disorders including infertility,preeclampsia,endometriosis and polycystic ovarian syndrome.Herein,we review the mechanistic role of oxidative stress in inducing the most common female reproductive disorders.The current review has also highlighted the protective role of vitamin C,necessary for certain female reproductive hormone secretion by the antral follicle and corpus luteum and also essential for collagen production in ovarian tissue remodeling after ovulation,in alleviating oxidative stress and thus improving female reproductive outcomes.