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Introduction Today, approximately half of the patients in gynecological malignancies are in the reproductive period at the time of diagnosis (Letourneau et al. 2012). in addition to the treatment stress [...], Agents to reduce the gonadotoxic effects of chemotherapeutics are still under investigation. in this context, we aimed to investigate the protective effect of sildenafil against chemotherapeutic-induced gonadotoxicity in a rat model. A total of 62 female rats were divided into eight groups as control, sildenafil (1.4 mg/kg, orally), doxorubicin (3 mg/kg, i.p.), cisplatin (5 mg/kg, i.p.), cyclophosphamide (200 mg/kg, i.p.), doxorubicin+sildenafil, cisplatin+sildenafil, and cyclophosphamide+sildenafil (1.4 mg/kg orally sildenafil in addition to the same dose of chemotherapeutics). The groups were compared in terms of follicle count, ovarian size, and anti-mfillerian hormone (AMH) levels. Use of sildenafil with cyclophosphamide was effective only in preserving primary follicle count (p = 0.026) and had no significant change in the secondary follicle count, ovarian size, or AMH level. Adding sildenafil to cisplatin had a significant protective effect on primary follicle count (p = 0.011), secondary follicle count (p = 0.009), and ovarian size (p = 0.001), but this effect could not be demonstrated at AMH level. Sildenafil was not effective on any parameter in the doxorubicin group. Sildenafil may be effective in reducing the gonadotoxicity associated with the use of cisplatin and cyclophosphamide. Key words: cisplatin, cyclophosphamide, doxorubicin, sildenafil, rat. Les agents permettant de reduire les effets gonadotoxiques de la chimiotherapie sont toujours a l'etude. Dans ce contexte, nous avons vise a etudier l'effet protecteur du sildenafil dans un modele de gonadotoxicite provoquee par la chimiotherapie chez le rat. Nous avons reparti 62 rates dans les huit groupes suivants : temoin, sildenafil, doxorubicine, cisplatine, cyclophosphamide, doxorubicine + sildenafil, cisplatine + sildenafil et cyclophosphamide + sildenafil. Nous avons administre par voie intraperitoneale de la doxorubicine a 3 mg/kg dans le groupe doxorubicine, du cisplatine a 5 mg/kg dans le groupe cisplatine, de la cyclophosphamide a 200 mg/kg dans le groupe cyclophosphamide, avec du sildenafil a 1,4 mg/kg en association avec les memes doses d'agents chimiotherapeutiques dans les autres groupes. Nous avons procede a des comparaisons entre les groupes quant au nombre de follicules, a la taille des ovaires et aux taux d'hormone anti-mullerienne (HAM). L'utilisation du sildenafil avec la cyclophosphamide a ete efficace uniquement pour la preservation du nombre de follicules primaires (p = 0.026), sans entrainer de variation marquee quant au nombre de follicules secondaires, a la taille des ovaires et aux taux d'HAM. L'ajout du sildenafil au cisplatine a eu un effet protecteur notable quant aux nombres de follicules primaires (p = 0.011) et secondaires (p = 0.009) de meme qu'a la taille des ovaires (p = 0.001), mais nous n'avons pas pu observer cet effet quant aux taux d'HAM. Le sildenafil n'a eu d'effet sur aucun des parametres dans le groupe doxorubicine. En conclusion, le sildenafil pourrait etre efficace pour la reduction de la gonadotoxicite associee avec l'utilisation du cisplatine et de la cyclophosphamide. Mots-cles: cisplatine, cyclophosphamide, doxorubicine, sildenafil, rat.

Objectives: The present study aimed to analyze of uterine smooth muscle tumors of uncertain malignant potential (STUMP) and the outcomes of patients with STUMP. Material and methods: In this retrospective study, the data of patients diagnosed with STUMP in a single tertiary center between January 2005--January 2020 were reviewed. We assessed the demographic variables, treatment outcomes, time until recurrence, disease-free and overall survival of the patients. Results: Twenty-five patients diagnosed with STUMP were included in the study. The mean age of the patients was 43.2 ± 10.3 years. Thirteen of the 25 patients (52%) were treated by myomectomy, others received diagnoses following hysterectomy. The median follow-up time was 45.2 months. Recurrence was observed in three cases (12%), two of which were followed up without hysterectomy, and the third patient died by peritonitis carcinomatosa 60 months after diagnosis although she received cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) treatment. Conclusions: This study evaluates the data of patients with STUMP. Our results reveal a STUMP recurrence of 12%, like those previously reported in the literature. Despite the possibility of malignant recurrence, fertility-preserving treatment with close follow-up should be tried, because of the relatively early age at diagnosis. [ABSTRACT FROM AUTHOR]

Background: Spontaneously exfoliated benign-appearing endometrial cells (BEC) on a Papanicolaou smear might indicate endometrial pathology in postmenopausal women, necessitating further investigation. A cut-off age of 40 years was included in the Bethesda System 2001 based on studies of clinical significance of endometrial cells in Pap smears in Western countries., Aims: The purpose of this study was to determine the significance of age subgroup for women with a cytological diagnosis of BEC, regardless of menopausal status, in a retrospective cohort of Turkish women., Materials and Methods: Between October 2006 and November 2011, 41 patients with a BEC diagnosis and 64 patients with a cytological diagnosis of normal smear (NS) were enrolled; regardless of menopausal status, these women were 40 years and older and for whom follow-up endometrial biopsies had been performed., Results: On subsequent histopathologic evaluation, no malignant lesion was detected in women aged 40-50 years compared to three endometrioid-type adenocarcinomas in women older than 50 years with cytological diagnosis of BEC. There was a significant difference between women older than 50 years with cytologic diagnosis of BEC and NS in relation to premalignant lesions on histopathologic evaluation; however, this was not the case for women aged 40-50 years., Conclusions: According to our study, reporting BEC for women aged between 40 and 50 years has minor clinical significance but is significant for women older than 50 years, regardless of menopausal status. Larger sample size would be appropriate to confirm the results of the current study.