Gement of pelvic/ovarian masses. cheap generic viagra [article in english, french] le t, giede c, salem s, lefebvre g, rosen b, bentley j, kupets r, power p, renaud mc, bryson p, davis db, lau s, lotocki r, senikas v, morin l, bly s, butt k, cargill ym, denis n, gagnon r, hietala-coyle ma, lim ki, ouellet a, raciot mh; society of obstetricians and gynaecologists of canada. viagra headquarters canada picture Abstract objectives: to optimize the management of adnexal masses and to assist primary care physicians and gynaecologists determine which patients presenting with an ovarian mass with a significant risk of malignancy should be considered for gynaecologic oncology referral and management. cheap generic viagra Options: laparoscopic evaluation, comprehensive surgical staging for early ovarian cancer, or tumour debulking for advanced stage ovarian cancer. Outcomes: to optimize conservative versus operative management of women with possible ovarian malignancy and to optimize the involvement of gynaecologic oncologists in planning and delivery of treatment. Evidence: published literature was retrieved through searches of pubmed or medline, cinahl, and the cochrane library, using appropriate controlled vocabulary and key words. generic viagra india 100 mg Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. viagra vs viagra pulmonary hypertension Grey (unpublished) literature was identified by searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Recommendations: 1. Primary care physicians and gynaecologists should always consider the possibility of an underlying ovarian cancer in patients in any age group who present with an adnexal or ovarian mass. (ii-2b) 2. what is viagra used for yahoo Appropriate workup of a perimenopausal or postmenopausal woman presenting with an adnexal mass should include evaluation of symptoms and signs suggestive of malignancy, such as persistent pelvic/abdominal pain, urinary urgency/frequency, increased abdominal size/bloating, and difficulty eating. In addition, ca125 measurement should be considered. generic viagra online (ii-2b) 3. Transvaginal or transabdominal ultrasound examination is recommended as part of the initial workup of a complex adnexal/ovarian mass. order viagra (ii-2b) 4. Ultrasound reports should be standardized to include size and unilateral/bilateral location of the adnexal mass and its possible origin, thickness of septations, presence of excrescences and internal solid components, vascular flow distribution pattern, and presence or absence of asc. generic viagra
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