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Vulva : Overview, Anatomy, structure and function - Sentelhealth

 Overview : The vulva is a part of the female reproductive system and is also part of the external genitalia. The vulva consists of labia minora, labia majora, mons pubis, clitoris, vestibular bulb, vulval vestibule, urinary meatus the vaginal opening, hymen, and Bartholin's glands. other parts of the vulva include sebaceous glands, urogenital triangle, and pudendal cleft. Pelvic floor muscles support the structures of the vulva and vulva including the entrance to the vagina. Vulva goes through changes during childhood, puberty, menopause, and post-menopause. Structure: A) Mons pubis: it is present in both sexes and act as a cushion during sexual intercourse and is more pronounced in female. the mons pubis is a soft fatty tissue at the front of the vulva in the pubic region covering the pubic bone. the lower part of the mons pubis is divided by a fissure called pudendal cleft. it separates mons pubis and labia majora, the mons pubis, and labia majora get covered by pubic hair at pu...
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Mesothelioma treatment

mesothelioma treatment

mesothelioma can be treated at all stages and there are several treatment options for patients with mesothelioma. though these treatments do not cure the disease but can increase life expectancy and improve the quality of life.
combination of surgery, chemotherapy, and radiotherapy is the most common form of mesothelioma treatment. the overall outcome depends on the stage and the type of mesothelioma.

mesothelioma treatment by type :

1) pleural mesothelioma:
pleural mesothelioma can be treated with 2 surgical options

A)Extrapleural pneumectomy:
This is a treatment option for early-stage mesothelioma with the most promising results amongst all other surgical options for mesothelioma. hence early diagnosis is a crucial step.
this surgery is developed by Dr.David Sugarbaker.

SURGERY:
1) Preoprative traetment 
chemotherapy with cisplatin and pemetrexed prior to surgery is very effective. combination of these two drugs is more effective than either alone.
60% of patients who received this combination lived for at least two years after the initial surgery.

2) Extrapleural pneumonectomy
the surgery removes the affected part of the lung along with the entire pleura, part of the pericardium part of the diaphragm.
due to the removal of all the structures in the early stages metastasis of pleural mesothelioma is limited.

3)Intraoperative chemotherapy sometimes intraoperative chemotherapy with cisplatin can be given after extrapleural pneumectomy.
chemotherapy is heated to 107 degrees and heated chemo wash is placed inside the chest cavity and washed around. The aim of this procedure is to remove any mesothelioma cells that may have been left behind from surgery.

4)Postoperative treatment
postoperative chemotherapy is given in all patients however the medications can be changed depending upon the patient's response. postoperative chemotherapy is helpful in reducing the recurrence of the disease.
radiation therapy may be administered directly to the chest cavity to destroy remaining cancer cells.
Distant recurrence is very common and occurs in almost half of the cases.
multimodal treatment is known to have less recurrence rates.

B)Pleurectomy/Decortication surgery:
It has become a more popular treatment of choice as it is the only lung-sparing surgery for pleural mesothelioma. A higher success rate is achieved in pleurectomy with decortication.
this surgery is created by Dr.Robert Cameron.

SURGERY
It consists of preoperative chemotherapy, surgery followed by postoperative chemotherapy.

1)Preoperative chemotherapy
A standard four weeks chemotherapy is given to the patients to stop the tumor growth. preoperative chemotherapy helps to reduce the size of the tumor making it easy for surgeons to remove more of the diseased tissue.

2)Pleurectomy/decortication 
it involves removing of pleura(lining) of the affected lung in the initial stages of mesothelioma.
This surgery has a lower mortality rate than extrapleural pneumectomy.

3)Postoperative treatment
Cisplatin therapy is typically given for 3 to5 weeks.it helps to kill the cancerous cells left behind by surgery.
postoperative chemotherapy has promising results in reducing recurrence.




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