Skip to main content
SpringerLink
Log in

Gynecologic Disorders in the Older Woman

  • Living reference work entry
  • First Online:
Principles and Practice of Geriatric Surgery

  • 119 Accesses

Abstract

Nonmalignant and malignant genital tract conditions as well as pelvic floor disorders including pelvic organ prolapse and incontinence are common gynecologic problems encountered by the older woman. With the rapidly increasing population of active older American women, physicians can expect to provide evaluation and treatment of these conditions with increasing frequency. These conditions are typically amenable to both medical and surgical therapies making individualization of treatment approaches important. An evidence-based review of evaluation and treatment approaches of benign and malignant gynecologic conditions of the lower and upper genital tract as well as of pelvic floor disorders common in the older woman is presented.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Nelson HD (2008) Menopause review. Lancet 371:760–770

    Article  PubMed  Google Scholar 

  2. Grady D (2006) Clinical practice: management of menopausal symptoms. N Engl J Med 355:2338–2347

    Article  CAS  PubMed  Google Scholar 

  3. Suckling J, Lethaby A, Kennedy R (2003) Local estrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev (4). Art. No:CD0015000. https://doi.org/10.1002/14651858.CD001500.pub2

  4. Green R, Santoro N (2009) Menopausal symptoms and ethnicity: the Study of Women’s Health Across the Nation. Womens Health (Lond Engl) 5(2):127–133. https://doi.org/10.2217/17455057.5.2.127

    Article  Google Scholar 

  5. Rice VM (2005) Strategies and issues for managing menopause-related symptoms in diverse populations: ethnic and racial diversity. Am J Med 118(Suppl 12B):142–147. https://doi.org/10.1016/j.amjmed.2005.09.048

    Article  PubMed  Google Scholar 

  6. Im EO, Lee B, Chee W, Brown A, Dormire S (2010) Menopausal symptoms among four major ethnic groups in the United States. West J Nurs Res 32(4):540–565. https://doi.org/10.1177/0193945909354343

    Article  PubMed  PubMed Central  Google Scholar 

  7. Im EO, Lee SH, Chee W (2010) Black women in menopausal transition. J Obstet Gynecol Neonatal Nurs 39(4):435–443. https://doi.org/10.1111/j.1552-6909.2010.01148.x

    Article  PubMed  Google Scholar 

  8. Simon J, Snabes M (2007) Menopausal hormone therapy for vasomotor symptoms: balancing the risks and benefits with ultralow doses of estrogen. Expert Opin Investig Drugs 16:2005–2020

    Article  CAS  PubMed  Google Scholar 

  9. North American Menopause Society (2012) The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause 19(3):257–271. https://doi.org/10.1097/gme.0b013e31824b970a

    Article  Google Scholar 

  10. Verdier-Sévrain S (2007) Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators. Climacteric 10:289–297

    Article  PubMed  CAS  Google Scholar 

  11. Netter F (1997) Reproductive system. The netter collection of medical illustrations, ed. O. E. vol 2. Elsevier, Philadelphia, p 90

    Google Scholar 

  12. Beers M, Berkow R (2000) Aging and the skin. In: Lane K (ed) The Merck manual of geriatrics, 3rd edn. Merck Research Laboratories, Whitehouse Station, pp 1231–1238

    Google Scholar 

  13. Thomas RH et al (1996) Anogenital lichen sclerosus in women. J R Soc Med 89:694–698

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Goldstein AT et al (2005) Prevalence of vulvar lichen sclerosus in a general gynecology practice. J Reprod Med 50:477–480

    PubMed  Google Scholar 

  15. Meyrick TR, Kennedy C (1986) The development of lichen sclerosus et atrophicus in monozygotic twin girls. Br J Dermatol 114:377–379

    Article  Google Scholar 

  16. Todd P et al (1994) Lichen sclerosus and the Koebner phenomenon. Clin Exp Dermatol 19:262–263

    Article  CAS  PubMed  Google Scholar 

  17. ACOG Practice Bulletin No. 93 (2008) Diagnosis and management of vulvar skin disorders. Obstet Gynecol 111:1243–1253

    Article  Google Scholar 

  18. Birenbaum DL, Young RC (2007) High prevalence of thyroid disease in patients with lichen sclerosus. J Reprod Med 52(1):28–30

    PubMed  Google Scholar 

  19. Carli P et al (1995) Squamous cell carcinoma arising in vulval lichen sclerosus: a longitudinal cohort study. Eur J Cancer Prev 4:491–495

    Article  CAS  PubMed  Google Scholar 

  20. Black MM Ambros-Rudolph C, Edwards L, Lynch PJ (2008) Obstetrics and gynecologic dermatology (Ed: Black M). Moshy Ltd

    Google Scholar 

  21. Cooper SM et al (2004) Does treatment of vulvar lichen sclerosus influence its prognosis? Arch Dermatol 140:702–706

    Article  CAS  PubMed  Google Scholar 

  22. Lorenz B, Kaufman RH, Kutzner SK (1998) Lichen sclerosus. Therapy with clobetasol propionate. J Reprod Med 43:790–794

    CAS  PubMed  Google Scholar 

  23. Neill SM, Tatnall FM, Cox NH (2002) Guidelines for the management of lichen sclerosus. Br J Dermatol 147:640–649

    Article  CAS  PubMed  Google Scholar 

  24. Renaud-Vilmer C et al (2004) Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol 140:709–712

    Article  PubMed  Google Scholar 

  25. Virgili A, Bacilieri S, Corazza M (2001) Managing vulvar lichen simplex chronicus. J Reprod Med 46:343–346

    CAS  PubMed  Google Scholar 

  26. Shiohara T (1988) The lichenoid tissue reaction. An immunological perspective. Am J Dermatopathol 10:252–256

    Article  CAS  PubMed  Google Scholar 

  27. Scully C, el-Kom M (1985) Lichen planus: review and update on pathogenesis. J Oral Pathol 14:431–458

    Article  CAS  Google Scholar 

  28. Ramer MA et al (2003) Lichen planus and the vulvovaginal-gingival syndrome. J Periodontol 74:1385–1393

    Article  CAS  PubMed  Google Scholar 

  29. Lee MY, Dalpiaz A, Schwamb R, Miao Y, Waltzer W, Khan A (2015) Clinical pathology of Bartholin’s glands: a review of the literature. Curr Urol 8(1):22–25. https://doi.org/10.1159/000365683

    Article  PubMed  PubMed Central  Google Scholar 

  30. Droegemueller W (1992) Comprehensive gynecology, 2nd edn. Mosby, St. Louis, p 637

    Google Scholar 

  31. Visco AG, Del Priore G (1996) Postmenopausal bartholin gland enlargement: a hospital-based cancer risk assessment. Obstet Gynecol 87:286–290

    Article  CAS  PubMed  Google Scholar 

  32. Bachmann GA et al (2006) Chronic vulvar and other gynecologic pain: prevalence and characteristics in a self-reported survey. J Reprod Med 51:3–9

    PubMed  PubMed Central  Google Scholar 

  33. Moyal-Barracco M, Lynch PJ (2004) 2003 ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med 49:772–777

    PubMed  Google Scholar 

  34. ACOG Committee Opinion No. 345 (2006) Vulvodynia. Obstet Gynecol 108:1049–1052

    Article  Google Scholar 

  35. Arnold LD et al (2007) Assessment of vulvodynia symptoms in a sample of US women: a prevalence survey with a nested case control study. Am J Obstet Gynecol 196(128):e1–e6

    Google Scholar 

  36. Zoubina EV et al (2001) Acute and chronic estrogen supplementation decreases uterine sympathetic innervation in ovariectomized adult virgin rats. Histol Histopathol 16:989–996

    CAS  PubMed  Google Scholar 

  37. Reed BD, Legocki LJ, Plegue MA, Sen A, Haefner HK, Harlow SD (2014) Factors associated with vulvodynia incidence. Obstet Gynecol 123(2 Pt 1):225–231. https://doi.org/10.1097/AOG.0000000000000066

    Article  PubMed  PubMed Central  Google Scholar 

  38. Haefner HK et al (2005) The vulvodynia guideline. J Low Genit Tract Dis 9:40–51

    Article  PubMed  Google Scholar 

  39. Rapkin AJ, McDonald JS, Morgan M (2008) Multilevel local anesthetic nerve blockade for the treatment of vulvar vestibulitis syndrome. Am J Obstet Gynecol 198(41):e1–e5

    Google Scholar 

  40. Hillier S, Lau R (1997) Vaginal microflora in postmenopausal women who have not received estrogen replacement therapy. Clin Infect Dis 25:S123–S126

    Article  PubMed  Google Scholar 

  41. ACOG Practice Bulletin Number 72 (2006) Clinical management guidelines for obstetrician – gynecologists. Obstet Gynecol 107:1195–1206

    Article  Google Scholar 

  42. McEndree B (1999) Clinical application of the vaginal maturation index. Nurs Pract 24(51–52):55–56

    Google Scholar 

  43. Hendrix SL, Cochrane BB, Nygaard IE et al (2005) Effects of estrogen with and without progestin on urinary incontinence. JAMA 293:935–948

    Article  CAS  PubMed  Google Scholar 

  44. Moehrer B, Hextall A, Jackson S (2003) Oestrogens for urinary incontinence in women. Cochrane Database Syst Rev (2). Art. No.:CD 001405. https://doi.org/10.1002/14651858.CD001405

  45. Perrotta C, Aznar M, Mejia R, et al. (2008) Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database Syst Rev (2). Art. No.:CD005131. https://doi.org/10.1002/14651858.CD005131.pub2

  46. Portman DJ, Gass ML, Vulvovaginal Atrophy Terminology Consensus Conference, Panel (2014) Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause 21(10):1063–1068. https://doi.org/10.1097/GME.0000000000000329

    Article  PubMed  Google Scholar 

  47. Pandit L, Ouslander JG (1997) Postmenopausal vaginal atrophy and atrophic vaginitis. Am J Med Sci 314:228

    CAS  PubMed  Google Scholar 

  48. ACOG (2009) The role of transvaginal ultrasonography in the evaluation of postmenopausal bleeding. ACOG Committee Opinion No. 440. Obstet Gynecol 114:409–411

    Article  Google Scholar 

  49. Motta P, Makabe S (2003) An atlas of menopausal aging. Parthenon, New York City

    Google Scholar 

  50. Ferenczy A (2003) Pathophysiology of endometrial bleeding. Maturitas 45:1–14

    Article  CAS  PubMed  Google Scholar 

  51. Gerbaldo D, Ferraiolo A, Croce S et al (1991) Endometrial morphology after 12 months of vaginal oestriol therapy in postmenopausal women. Maturitas 13:269–274

    Article  CAS  PubMed  Google Scholar 

  52. McGurgan P, Taylor LJ, Duffy SR et al (2006) Does tamoxifen therapy affect the hormone receptor expression and cell proliferation indices of endometrial polyps? An immunohistochemical comparison of endometrial polyps from postmenopausal women exposed and not exposed to tamoxifen. Maturitas 54:252–259

    Article  CAS  PubMed  Google Scholar 

  53. Shushan A, Revel A, Rojansky N (2004) How often are endometrial polyps malignant? Gynecol Obstet Investig 58:212–215

    Article  Google Scholar 

  54. Van Bogaert LJ (1991) Clinicopathologic findings in endometrial polyps. Obstet Gynecol 77:954–956

    Google Scholar 

  55. Karlsson B, Granberg S, Wikland M et al (1995) Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding – a Nordic multicenter study. Am J Obstet Gynecol 172:1488

    Article  CAS  PubMed  Google Scholar 

  56. Sylvestre C, Child TJ, Tulandi T et al (2003) A prospective study to evaluate the efficacy of two- and three-dimensional sonohysterography in women with intrauterine lesions. Fertil Steril 79:1222–1225

    Article  PubMed  Google Scholar 

  57. de Azevedo JM, de Azevedo LM, Freitas F, Wender MC (2016) Endometrial polyps: when to resect? Arch Gynecol Obstet 293(3):639–643. https://doi.org/10.1007/s00404-015-3854-3

    Article  PubMed  Google Scholar 

  58. Lev-Sagie A, Hamani Y, Imbar T, Hurwitz A, Lavy Y (2005) The significance of intrauterine lesions detected by ultrasound in asymptomatic postmenopausal patients. BJOG 112(3):379–381. https://doi.org/10.1111/j.1471-0528.2004.00444.x

    Article  PubMed  Google Scholar 

  59. Ben-Arie A, Goldchmit C, Laviv Y et al (2004) The malignant potential of endometrial polyps. Eur J Obstet Gynecol Reprod Biol 115:206–210

    Article  PubMed  Google Scholar 

  60. Adams Hillard PJ (2007) Benign diseases of the female reproductive tract. In: Berek JS (ed) Berek & Novak’s gynecology, 14th edn. Lippincott Williams & Wilkins, Philadelphia, pp 431–504

    Google Scholar 

  61. Leibsohn S, d’Ablaing G, Mishell DR Jr et al (1990) Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 162:968–974

    Article  CAS  PubMed  Google Scholar 

  62. Herbst AL (2001) Neoplastic diseases of the uterus. In: Stenchever MA, Droegemuller W, Herbst AL et al (eds) Comprehensive gynecology, 4th edn. Mosby, Inc, St. Louis, pp 921–927

    Google Scholar 

  63. ACOG (2015) Endometrial intraepithelial neoplasia. Committee Opinion No. 631. Obstet Gynecol 125:1272–1278

    Article  CAS  Google Scholar 

  64. Salman MC, Usubutun A, Boynukalin K, Yuce K (2010) Comparison of WHO and endometrial intraepithelial neoplasia classifications in predicting the presence of coexistent malignancy in endometrial hyperplasia. J Gynecol Oncol 21(2):97–101. https://doi.org/10.3802/jgo.2010.21.2.97

    Article  PubMed  PubMed Central  Google Scholar 

  65. Bump RC, Friedman CI, Copeland WE Jr (1988) Non-neuromuscular determinants of intraluminal urethral pressure in the female baboon: relative importance of vascular and nonvascular factors. J Urol 139:162–164

    Article  CAS  PubMed  Google Scholar 

  66. Rovner ES (2007) Urethral diverticula: a review and an update. Neurourol Urodyn 26(7):972–977

    Article  PubMed  Google Scholar 

  67. Anveden-Hertzberg L, Gauderer MW, Elder JS (1995) Urethral prolapse: an often misdiagnosed cause of urogenital bleeding in girls. Pediatr Emerg Care 11:212–214

    Article  CAS  PubMed  Google Scholar 

  68. Redman JF (1982) Conservative management of urethral prolapse in female children. Urology 19:505–506

    Article  CAS  PubMed  Google Scholar 

  69. Wright M (1987) Urethral prolapse in children – alternative management. S Afr Med J 72:551–552

    CAS  PubMed  Google Scholar 

  70. Kleinjan JH, Vos P (1984) Strangulated urethral prolapse. J Urol 132:732–733

    Article  Google Scholar 

  71. Park DS, Cho TW (2004) Simple solution for urethral caruncle. J Urol 172:1184–1185

    Google Scholar 

  72. Willett GD, Lack EE (1990) Periurethral colonic-type polyp simulating urethral caruncle. A case report. J Reprod Med 35:1017–1018

    CAS  PubMed  Google Scholar 

  73. Atalay AC, Karaman MI, Basak T et al (1998) Non-Hodgkin’s lymphoma of the female urethra presenting as a caruncle. Int Urol Nephrol 30:609–610

    Article  CAS  PubMed  Google Scholar 

  74. Lopez JI, Angulo JC, Ibañez T (1993) Primary malignant melanoma mimicking urethral caruncle. Case report. Scand J Urol Nephrol 27:125–126

    Article  CAS  PubMed  Google Scholar 

  75. Foley CL, Greenwell TJ, Gardiner RA (2011) Urethral diverticula in females. BJU Int 108(Suppl 2):20–23

    Article  PubMed  Google Scholar 

  76. Aspera AM, Rackley RR, Vasavada SP (2002) Contemporary evaluation and management of the female urethral diverticulum. Urol Clin North Am 29:617–624

    Article  PubMed  Google Scholar 

  77. Thomas AA, Rackley RR, Lee U et al (2008) Urethral diverticula in 90 female patients: a study with emphasis on neoplastic alterations. J Urol 180(6):2463–2467

    Article  PubMed  Google Scholar 

  78. Chou CP, Levenson RB, Elsayes KM et al (2008) Imaging of female urethral diverticulum: an update. Radiographics 28(7):1917–1930

    Article  PubMed  Google Scholar 

  79. Shobeiri SA, Rostaminia G, White D et al (2013) Evaluation of vaginal cysts and masses by 3-dimensional endovaginal and endoanal sonography. J Ultrasound Med 32(8):1499–1507

    Article  PubMed  Google Scholar 

  80. Wu JM, Vaughan CP, Goode PS et al (2014) Prevalence and trends of symptomatic pelvic floor disorders in U.S women. Obstet Gynecol 123(1):141–148

    Article  PubMed  PubMed Central  Google Scholar 

  81. Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  CAS  PubMed  Google Scholar 

  82. Nygaard I, Bradley C, Brandt D (2004) Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol 104:489–497

    Article  PubMed  Google Scholar 

  83. Harris S, Lind C, Tennstedt S et al (2007) Care seeking and treatment for urinary incontinence in a diverse population. J Urol 177:680–684S

    Article  PubMed  Google Scholar 

  84. De Lancey JO (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1724

    Article  Google Scholar 

  85. Matthews CA et al (2013) Risk factors for urinary, fecal, or dual incontinence in the Nurses’ Health Study. Obstet Gynecol 122(3):539–545

    Article  PubMed  PubMed Central  Google Scholar 

  86. Markland AD et al (2008) Correlates of urinary, fecal, and dual incontinence in older African-American and white men and women. J Am Geriatr Soc 56(2):285–290

    Article  PubMed  Google Scholar 

  87. Abrams P, Cardozo L, Fall M et al (2002) The standardization of terminology of lower urinary tract function: report from the standardization sub-committee of the international continence society. Am J Obstet Gynecol 187:116–126

    Article  PubMed  Google Scholar 

  88. Weber AM, Richter HE (2005) Pelvic organ prolapse. Obstet Gynecol 106:615–634

    Article  PubMed  Google Scholar 

  89. Clemons JL, Aguilar VC, Tillinghast TA et al (2004) Risk factors associated with an unsuccessful pessary fitting trial in women with pelvic organ prolapse. Am J Obstet Gynecol 190(2):345–350

    Article  PubMed  Google Scholar 

  90. Harris TA, Bent AE (1990) Genital Prolapse with and without urinary incontinence. J Reprod Med 35:792–798

    CAS  PubMed  Google Scholar 

  91. FDA (2011) Urogynecologic surgical mesh: update on the safety and effectiveness of transvaginal mesh placement for pelvic organ prolapse: US Food and Drug Administration. www.fda.gov/downloads/MedicalDevices/Safety/AlertsandNotices/UCM262760.pdf

  92. Olsen AL, Smith VJ, Bergstrom JO et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  CAS  PubMed  Google Scholar 

  93. Clark AL, Gregory T, Smith VJ et al (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267

    Article  PubMed  Google Scholar 

  94. Gerten KA, Markland AD, Lloyd LK, Richter HE (2008) Prolapse and incontinence surgery in older women. J Urol 179:2111–2118

    Article  PubMed  PubMed Central  Google Scholar 

  95. Carey JM, Leach GE (2003) Transvaginal surgery in the octogenarian using cadaveric fascia for pelvic prolapse and stress incontinence: minimal one year results compared to younger patients. Urology 63:665–670

    Article  Google Scholar 

  96. Richter HE, Goode PS, Kenton K et al (2007) The effect of age on short-term outcomes after abdominal surgery for pelvic organ prolapse. J Am Geriatr Soc 55:857–863

    Article  PubMed  Google Scholar 

  97. Barber MD, Brubaker L, Burgio KL et al (2014) Factorial comparison of two transvaginal surgical approaches and of perioperative behavioral therapy for women with apical vaginal prolapse: the OPTIMAL Randomized Trial. JAMA 311(10):1023–1034

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Sung VW, Weitzen S, Sokol ER et al (2006) Effect of patient age on increasing morbidity and mortality following urogynecologic surgery. Am J Obstet Gynecol 194:1411–1417

    Article  PubMed  Google Scholar 

  99. Fitzgerald MP, Richter HE, Bradley CS, For the Pelvic Floor Disorders Network et al (2008) Pelvic support, pelvic symptoms and patient satisfaction after colpocleisis. Int Urogynecol J 19:1603–1609

    Article  CAS  Google Scholar 

  100. Richter HE, Albo ME, Zyczynski HM, Kenton K, Norton PA, Sirls LT et al (2010) Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 362(22):2066–2076

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. Alas A, Chinthakanan O, Espaillat L et al (2017) Are suburethral slings less successful in the elderly? Int Urogynecol J 28(4):553–559

    Article  PubMed  Google Scholar 

  102. Toozs-Hobson P, Devani P, Pick J et al (2016) Does age affect the outcome of suburethral tape surgery? The importance of national registries in answering bigger questions. Int Urogynecol J 27(10):1541–1545

    Article  PubMed  Google Scholar 

  103. Kirchin V, Page T, Keegan PE, Atiemo K, Cody JD, McClinton S (2012) Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev 2:CD003881

    Google Scholar 

  104. Lukacz ES, Segall MM, Wexner SD (2015) Evaluation of an anal insert for the conservative management of fecal incontinence. Dis Colon Rectum 58(9):892–898

    Article  PubMed  Google Scholar 

  105. Richter H, Matthews CA, Muir T, Takase-Sanchez MM, Hale DS, Van Drie D et al (2015) A vaginal bowel-control system for the treatment of fecal incontinence. Obstet Gynecol 125(3):540–547

    Article  PubMed  Google Scholar 

  106. Madoff RD (2005) Surgery for fecal incontinence in women. In: Abrams P (ed) Incontinence. Health Publications Ltd, France, pp 1585–1588

    Google Scholar 

  107. Glasgow SC, Lowry AC (2012) Long-term outcomes of anal sphincter repair for fecal incontinence: a systematic review. Dis Colon Rectum 55(4):482–490

    Article  PubMed  Google Scholar 

  108. George AT, Kalmar K, Goncalves J, Nicholls RJ, Vaizey CJ (2012) Sacral nerve stimulation in the elderly. Color Dis 14(2):200–204

    Article  CAS  Google Scholar 

  109. Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67(1):7–30

    Article  PubMed  Google Scholar 

  110. National Cancer Institute Surveillance Epidemiology and End Results (SEER) Program. Cancer Stat Facts: Endometrial Cancer. May 3, 2017. https://seer.cancer.gov/statfacts/html/corp.html.

  111. Pignon T et al (1997) Age is not a limiting factor for radical radiotherapy in pelvic malignancies. Radiother Oncol 42(2):107–120

    Article  CAS  PubMed  Google Scholar 

  112. Moore KN, Fader AN (2011) Uterine papillary serous carcinoma. Clin Obstet Gynecol 54(2):278–291

    Article  PubMed  Google Scholar 

  113. American College of Obstetricians and Gynecologists (2009) ACOG Committee opinion no. 440: the role of transvaginal ultrasonography in the evaluation of postmenopausal bleeding. Obstet Gynecol 114(2 Pt 1):409–411

    Google Scholar 

  114. Trimble CL et al (2006) Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer 106(4):812–819

    Article  PubMed  Google Scholar 

  115. Lacey JV Jr et al (2010) Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia. J Clin Oncol 28(5):788–792

    Article  PubMed  PubMed Central  Google Scholar 

  116. Walker JL et al (2012) Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group LAP2 Study. J Clin Oncol 30(7):695–700

    Article  PubMed  PubMed Central  Google Scholar 

  117. Rossi EC et al (2017) A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study. Lancet Oncol 18(3):384–392

    Article  PubMed  Google Scholar 

  118. Fishman DA et al (1996) Radiation therapy as exclusive treatment for medically inoperable patients with stage I and II endometrioid carcinoma with endometrium. Gynecol Oncol 61(2):189–196

    Article  CAS  PubMed  Google Scholar 

  119. Shenfield CB et al (2009) The management of inoperable Stage I endometrial cancer using intracavitary brachytherapy alone: a 20-year institutional review. Brachytherapy 8(3):278–283

    Article  PubMed  Google Scholar 

  120. Lewin SN et al (2010) Comparative performance of the 2009 international federation of gynecology and obstetrics’ staging system for uterine corpus cancer. Obstet Gynecol 116(5):1141–1149

    Article  PubMed  Google Scholar 

  121. Keys HM et al (2004) A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 92(3):744–751

    Article  PubMed  Google Scholar 

  122. Nout RA et al (2010) Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet 375(9717):816–823

    Article  CAS  PubMed  Google Scholar 

  123. Randall ME et al (2006) Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol 24(1):36–44

    Article  CAS  PubMed  Google Scholar 

  124. Fleming GF et al (2004) Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol 22(11):2159–2166

    Article  CAS  PubMed  Google Scholar 

  125. Huh WK et al (2007) Salvage of isolated vaginal recurrences in women with surgical stage I endometrial cancer: a multiinstitutional experience. Int J Gynecol Cancer 17(4):886–889

    Article  CAS  PubMed  Google Scholar 

  126. Carlson MJ, Thiel KW, Leslie KK (2014) Past, present, and future of hormonal therapy in recurrent endometrial cancer. Int J Women’s Health 6:429–435

    Google Scholar 

  127. Lin JF, Slomovitz BM (2008) Uterine sarcoma. Curr Oncol Rep 10(6):512–518

    Article  PubMed  Google Scholar 

  128. Giuntoli RL 2nd et al (2003) Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 89(3):460–469

    Article  PubMed  Google Scholar 

  129. McCluggage WG (2002) Uterine carcinosarcomas (malignant mixed Mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer 12(6):687–690

    Article  CAS  PubMed  Google Scholar 

  130. Park JY et al (2008) Prognostic factors and treatment outcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989–2007. J Cancer Res Clin Oncol 134(12):1277–1287

    Article  PubMed  Google Scholar 

  131. Leitao MM et al (2003) Incidence of lymph node and ovarian metastases in leiomyosarcoma of the uterus. Gynecol Oncol 91(1):209–212

    Article  PubMed  Google Scholar 

  132. HensleyML, et al (2013) Adjuvant therapy for high-grade, uterus-limited leiomyosarcoma: results of a phase 2 trial (SARC 005). Cancer 119(8):1555-1561.

    Article  CAS  PubMed  Google Scholar 

  133. National Comprehensive Cancer Network, NCCN clincial practice guidelines in oncology: uterine neoplasms version 2. 2017

    Google Scholar 

  134. Reed NS et al (2008) Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 44(6):808–818

    Article  CAS  PubMed  Google Scholar 

  135. National Cancer Institute Surveillance Epidemiology and End Results (SEER) Program. Cancer Stat Facts: Ovarian Cancer. May 4, 2017. https://seer.cancer.gov/statfacts/html/ovary.html.

  136. Lengyel E (2010) Ovarian cancer development and metastasis. Am J Pathol 177(3):1053–1064

    Article  PubMed  PubMed Central  Google Scholar 

  137. Eckert MA et al (2016) Genomics of ovarian cancer progression reveals diverse metastatic trajectories including intraepithelial metastasis to the fallopian tube. Cancer Discov 6(12):1342–1351

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  138. Andrews L, Mutch DG (2017) Hereditary ovarian cancer and risk reduction. Best Pract Res Clin Obstet Gynaecol. pii: S1521-6934(17)30001-9. https://doi.org/10.1016/j.bpobgyn.2016.10.017

    Article  Google Scholar 

  139. Walsh T et al (2011) Mutations in 12 genes for inherited ovarian, fallopian tube, and peritoneal carcinoma identified by massively parallel sequencing. Proc Natl Acad Sci U S A 108(44):18032–18037

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  140. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology genetic/familial high-risk assessment: breast and ovarian version 2. 2017. https://nccn.org/professionals/physician_gls/pdf/genetics_screening.pdf

  141. Gates MA et al (2010) Risk factors for epithelial ovarian cancer by histologic subtype. Am J Epidemiol 171(1):45–53

    Article  PubMed  Google Scholar 

  142. Pearce CL et al (2012) Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies. Lancet Oncol 13(4):385–394

    Article  PubMed  PubMed Central  Google Scholar 

  143. Ness RB et al (2002) Infertility, fertility drugs, and ovarian cancer: a pooled analysis of case-control studies. Am J Epidemiol 155(3):217–224

    Article  PubMed  Google Scholar 

  144. Cibula D et al (2011) Tubal ligation and the risk of ovarian cancer: review and meta-analysis. Hum Reprod Update 17(1):55–67

    Article  CAS  PubMed  Google Scholar 

  145. Victora CG et al (2016) Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 387(10017):475–490

    Article  PubMed  Google Scholar 

  146. Cannistra SA (1993) Cancer of the ovary. N Engl J Med 329(21):1550–1559

    Article  CAS  PubMed  Google Scholar 

  147. Goff BA et al (2000) Ovarian carcinoma diagnosis. Cancer 89(10):2068–2075

    Article  CAS  PubMed  Google Scholar 

  148. Carlson KJ, Skates SJ, Singer DE (1994) Screening for ovarian cancer. Ann Intern Med 121(2):124–132

    Article  CAS  PubMed  Google Scholar 

  149. Wethington SL et al (2008) Improved survival for fallopian tube cancer: a comparison of clinical characteristics and outcome for primary fallopian tube and ovarian cancer. Cancer 113(12):3298–3306

    Article  PubMed  Google Scholar 

  150. McGuire WP et al (1996) Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 334(1):1–6

    Article  CAS  PubMed  Google Scholar 

  151. Fader AN, Rose PG (2007) Role of surgery in ovarian carcinoma. J Clin Oncol 25(20):2873–2883

    Article  PubMed  Google Scholar 

  152. Vergote I et al (2010) Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med 363(10):943–953

    Article  CAS  PubMed  Google Scholar 

  153. Kehoe S et al (2015) Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 386(9990):249–257

    Article  PubMed  Google Scholar 

  154. Markman M (2008) Predictive value of neoadjuvant chemotherapy for the clinical utility of subsequently performed major cancer surgery. Curr Oncol Rep 10(6):447–448

    Article  PubMed  Google Scholar 

  155. Chi DS, Schwartz PE (2008) Cytoreduction vs. neoadjuvant chemotherapy for ovarian cancer. Gynecol Oncol 111(3):391–399

    Article  PubMed  Google Scholar 

  156. Ozols RF et al (2003) Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol 21(17):3194–3200

    Article  CAS  PubMed  Google Scholar 

  157. Pujade-Lauraine E et al (2014) Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: The AURELIA open-label randomized phase III trial. J Clin Oncol 32(13):1302–1308

    Article  CAS  PubMed  Google Scholar 

  158. Bristow RE, Puri I, Chi DS (2009) Cytoreductive surgery for recurrent ovarian cancer: a meta-analysis. Gynecol Oncol 112(1):265–274

    Article  PubMed  Google Scholar 

  159. Thigpen T et al (1993) Age as a prognostic factor in ovarian carcinoma. The Gynecologic Oncology Group experience. Cancer 71(2 Suppl):606–614

    CAS  PubMed  Google Scholar 

  160. Alberts DS et al (1993) Analysis of patient age as an independent prognostic factor for survival in a phase III study of cisplatin-cyclophosphamide versus carboplatin-cyclophosphamide in stages III (suboptimal) and IV ovarian cancer. A Southwest Oncology Group study. Cancer 71(2 Suppl):618–627

    CAS  PubMed  Google Scholar 

  161. Uyar D et al (2005) Treatment patterns by decade of life in elderly women (> or =70 years of age) with ovarian cancer. Gynecol Oncol 98(3):403–408

    Article  PubMed  Google Scholar 

  162. von Gruenigen VE et al (2017) Chemotherapy completion in elderly women with ovarian, primary peritoneal or fallopian tube cancer – an NRG oncology/Gynecologic Oncology Group study. Gynecol Oncol 144(3):459–467

    Article  Google Scholar 

  163. GLOBOCAN cancer fact sheets: cervivcal cancer. May 2, 2017. http://globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp

  164. National Cancer Institute Surveillance Epidemiology and End Results (SEER) Program. Cancer Stat Facts: Cervix Uteri Cancer. May 2, 2017. https://seer.cancer.gov/statfacts/html/cervix.html

  165. Venkatesulu BP, Mallick S, Rath GK (2017) Patterns of care of cervical cancer in the elderly: a qualitative literature review. J Geriatr Oncol 8(2):108–116

    Article  PubMed  Google Scholar 

  166. Sharma C et al (2012) Patterns of care and treatment outcomes for elderly women with cervical cancer. Cancer 118(14):3618–3626

    Article  PubMed  Google Scholar 

  167. Walboomers JM et al (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189(1):12–19

    Article  CAS  PubMed  Google Scholar 

  168. Li N et al (2011) Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: Variation by geographical region, histological type and year of publication. Int J Cancer 128(4):927–935

    Article  CAS  PubMed  Google Scholar 

  169. Howlader N, Noone NA, Krapcho M, Miller D, Bishop K, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Cronin KA (2017) SEER cancer statistics review, 1975–2014. https://seer.cancer.gov/csr/1975_2014

  170. International Collaboration of Epidemiological Studies of Cervical Cancer (2007) Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. Int J Cancer 120(4):885–891

    Article  CAS  Google Scholar 

  171. Massad LS et al (2013) 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol 121(4):829–846

    Article  PubMed  Google Scholar 

  172. Mota F (2003) Microinvasive squamous carcinoma of the cervix: treatment modalities. Acta Obstet Gynecol Scand 82(6):505–509

    Article  PubMed  Google Scholar 

  173. Sedlis A et al (1999) A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol 73(2):177–183

    Article  CAS  PubMed  Google Scholar 

  174. Landoni F et al (1997) Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet 350(9077):535–540

    Article  CAS  PubMed  Google Scholar 

  175. Nezhat FR et al (2008) Robotic radical hysterectomy versus total laparoscopic radical hysterectomy with pelvic lymphadenectomy for treatment of early cervical cancer. J Soc Laparoendosc Surg 12(3):227–237

    Google Scholar 

  176. Obermair A et al (2008) A phase III randomized clinical trial comparing laparoscopic or robotic radical hysterectomy with abdominal radical hysterectomy in patients with early stage cervical cancer. J Minim Invasive Gynecol 15(5):584–588

    Article  PubMed  Google Scholar 

  177. Holman LL, Levenback CF, Frumovitz M (2014) Sentinel lymph node evaluation in women with cervical cancer. J Minim Invasive Gynecol 21(4):540–545

    Article  PubMed  PubMed Central  Google Scholar 

  178. Peters WA 3rd et al (2000) Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol 18(8):1606–1613

    Article  CAS  PubMed  Google Scholar 

  179. Whitney CW et al (1999) Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol 17(5):1339–1348

    Article  CAS  PubMed  Google Scholar 

  180. Rose PG et al (1999) Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 340(15):1144–1153

    Article  CAS  PubMed  Google Scholar 

  181. Tewari KS et al (2014) Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 370(8):734–743

    Article  CAS  PubMed  Google Scholar 

  182. Judson PL et al (2006) Trends in the incidence of invasive and in situ vulvar carcinoma. Obstet Gynecol 107(5):1018–1022

    Article  PubMed  Google Scholar 

  183. Akhtar-Danesh N, Elit L, Lytwyn A (2014) Trends in incidence and survival of women with invasive vulvar cancer in the United States and Canada: a population-based study. Gynecol Oncol 134(2):314–318

    Article  PubMed  Google Scholar 

  184. ACOG (2016) Committee opinion No.675: management of vulvar intraepithelial neoplasia. Obstet Gynecol 128(4):e178–e182

    Article  CAS  Google Scholar 

  185. Preti M et al (2014) Vulvar intraepithelial neoplasia. Best Pract Res Clin Obstet Gynaecol 28(7):1051–1062

    Article  PubMed  Google Scholar 

  186. Del Pino M, Rodriguez-Carunchio L, Ordi J (2013) Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma. Histopathology 62(1):161–175

    Article  PubMed  Google Scholar 

  187. Halec G et al (2017) Biological relevance of human papillomaviruses in vulvar cancer. Mod Pathol 30(4):549–562

    Article  CAS  PubMed  Google Scholar 

  188. van Esch EM et al (2013) Clinical characteristics associated with development of recurrence and progression in usual-type vulvar intraepithelial neoplasia. Int J Gynecol Cancer 23(8):1476–1483

    Article  PubMed  Google Scholar 

  189. Wallbillich JJ et al (2012) Vulvar intraepithelial neoplasia (VIN 2/3): comparing clinical outcomes and evaluating risk factors for recurrence. Gynecol Oncol 127(2):312–315

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  190. Homesley HD et al (1991) Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (a Gynecologic Oncology Group study). Am J Obstet Gynecol 164(4):997–1003. discussion 1003-4

    Article  CAS  PubMed  Google Scholar 

  191. Rauh-Hain JA et al (2014) Management and outcomes for elderly women with vulvar cancer over time. BJOG 121(6):719–727;discussion 727

    Article  CAS  PubMed  Google Scholar 

  192. Hacker NF, Van der Velden J (1993) Conservative management of early vulvar cancer. Cancer 71(4 Suppl):1673–1677

    Article  CAS  PubMed  Google Scholar 

  193. Homesley HD et al (1993) Prognostic factors for groin node metastasis in squamous cell carcinoma of the vulva (a Gynecologic Oncology Group study). Gynecol Oncol 49(3):279–283

    Article  CAS  PubMed  Google Scholar 

  194. Stehman FB et al (1992) Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy: a prospective study of the Gynecologic Oncology Group. Obstet Gynecol 79(4):490–497

    CAS  PubMed  Google Scholar 

  195. Van der Zee AG et al (2008) Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol 26(6):884–889

    Article  PubMed  Google Scholar 

  196. de Hullu JA et al (2000) Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva. J Clin Oncol 18(15):2811–2816

    Article  PubMed  Google Scholar 

  197. Homesley HD et al (1986) Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol 68(6):733–740

    CAS  PubMed  Google Scholar 

  198. Gill BS et al (2015) Impact of adjuvant chemotherapy with radiation for node-positive vulvar cancer: a National Cancer Data Base (NCDB) analysis. Gynecol Oncol 137(3):365–372

    Article  PubMed  Google Scholar 

  199. Moore DH et al (1998) Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys 42(1):79–85

    Article  CAS  PubMed  Google Scholar 

  200. Montana GS et al (2000) Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 48(4):1007–1013

    Article  CAS  PubMed  Google Scholar 

  201. Moore DH et al (2012) A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a gynecologic oncology group study. Gynecol Oncol 124(3):529–533

    Article  CAS  PubMed  Google Scholar 

  202. Piura B et al (1993) Recurrent squamous cell carcinoma of the vulva: a study of 73 cases. Gynecol Oncol 48(2):189–195

    Article  CAS  PubMed  Google Scholar 

  203. Salom EM, Penalver M (2002) Recurrent vulvar cancer. Curr Treat Options in Oncol 3(2):143–153

    Article  Google Scholar 

  204. Sugiyama VE et al (2007) Vulvar melanoma: a multivariable analysis of 644 patients. Obstet Gynecol 110(2 Pt 1):296–301

    Article  PubMed  Google Scholar 

  205. Sanchez A et al (2016) Primary genitourinary melanoma: epidemiology and disease-specific survival in a large population-based cohort. Urol Oncol 34(4):166.e7–166.e14

    Article  Google Scholar 

  206. Suwandinata FS et al (2007) Management of vulvar melanoma and review of the literature. Eur J Gynaecol Oncol 28(3):220–224

    CAS  PubMed  Google Scholar 

  207. Moxley KM et al (2011) Malignant melanoma of the vulva: an extension of cutaneous melanoma? Gynecol Oncol 122(3):612–617

    Article  CAS  PubMed  Google Scholar 

  208. van der Linden M et al (2016) Paget disease of the vulva. Crit Rev Oncol Hematol 101:60–74

    Article  PubMed  Google Scholar 

  209. Lloyd J, Flanagan AM (2000) Mammary and extramammary Paget’s disease. J Clin Pathol 53(10):742–749

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  210. Ouldamer L et al (2013) Bartholin’s gland carcinoma: epidemiology and therapeutic management. Surg Oncol 22(2):117–122

    Article  CAS  PubMed  Google Scholar 

  211. Creasman WT, Phillips JL, Menck HR (1998) The national cancer data base report on cancer of the vagina. Cancer 83(5):1033–1040

    Article  CAS  PubMed  Google Scholar 

  212. Hiniker SM et al (2013) Primary squamous cell carcinoma of the vagina: prognostic factors, treatment patterns, and outcomes. Gynecol Oncol 131(2):380–385

    Article  PubMed  Google Scholar 

  213. Beller U et al (2006) Carcinoma of the vagina. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet 95(Suppl 1):S29–S42

    Article  PubMed  Google Scholar 

  214. Di Donato V et al (2012) Vaginal cancer. Crit Rev Oncol Hematol 81(3):286–295

    Article  PubMed  Google Scholar 

  215. Tjalma WA et al (2001) The role of surgery in invasive squamous carcinoma of the vagina. Gynecol Oncol 81(3):360–365

    Article  CAS  PubMed  Google Scholar 

  216. Perez CA et al (1999) Factors affecting long-term outcome of irradiation in carcinoma of the vagina. Int J Radiat Oncol Biol Phys 44(1):37–45

    Article  CAS  PubMed  Google Scholar 

  217. Frank SJ et al (2005) Definitive radiation therapy for squamous cell carcinoma of the vagina. Int J Radiat Oncol Biol Phys 62(1):138–147

    Article  PubMed  Google Scholar 

  218. Tran PT et al (2007) Prognostic factors for outcomes and complications for primary squamous cell carcinoma of the vagina treated with radiation. Gynecol Oncol 105(3):641–649

    Article  PubMed  Google Scholar 

  219. Dalrymple JL et al (2004) Chemoradiation for primary invasive squamous carcinoma of the vagina. Int J Gynecol Cancer 14(1):110–117

    Article  CAS  PubMed  Google Scholar 

  220. Rajagopalan MS et al (2014) Adoption and impact of concurrent chemoradiation therapy for vaginal cancer: a National Cancer Data Base (NCDB) study. Gynecol Oncol 135(3):495–502

    Article  PubMed  Google Scholar 

  221. Stock RG, Chen AS, Seski J (1995) A 30-year experience in the management of primary carcinoma of the vagina: analysis of prognostic factors and treatment modalities. Gynecol Oncol 56(1):45–52

    Article  CAS  PubMed  Google Scholar 

  222. Cosin JK, Olawaiye A (2014) Staging of gynecologic malignancies handbook, 4th edn. Society of Gynecologic Oncology, Chicago, IL

    Google Scholar 

  223. Morse AN, Labin LC, Young SB et al (2004) Exclusion of elderly women from published randomized trials of stress incontinence surgery. Obstet Gynecol 104:498–503

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Alabama at Birmingham, Birmingham, AL, USA

    Isuzu Meyer, Tera F. Howard, Haller J. Smith, Kenneth H. Kim & Holly E. Richter

Authors
  1. Isuzu Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tera F. Howard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haller J. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenneth H. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Holly E. Richter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Holly E. Richter .

Editor information

Editors and Affiliations

  1. VA Connecticut Health Care System, Yale University School of Medicine, West Haven, CT, USA

    Ronnie A. Rosenthal

  2. SUNY Downstate School of Public Health, National Capital Region Johns Hopkins Medicine, Bethesda, MD, USA

    Michael E. Zenilman

  3. Center for Geriatric Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USA

    Mark R. Katlic

Section Editor information

  1. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Jason Johanning

  2. Duke Medicine, Durham, NC, USA

    Sandhya Lagoo-Deenadayalan

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Meyer, I., Howard, T.F., Smith, H.J., Kim, K.H., Richter, H.E. (2019). Gynecologic Disorders in the Older Woman. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20317-1_50-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-20317-1_50-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20317-1

  • Online ISBN: 978-3-319-20317-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation