Objective To evaluate the effectiveness of nurse-led telephone follow-up (TFU) for patients with stage-I endometrial cancer.Design Multicentre, randomised, non-inferiority trial.Setting Five centres in the North West of England.Sample A cohort of 259 women treated for stage-I endometrial cancer attending hospital outpatient clinics for routine follow-up.Methods Participants were randomly allocated to receive traditional hospital based follow-up (HFU) or nurse-led TFU.Main outcome measures Primary outcomes were psychological morbidity (State Trait Anxiety Inventory, STAI-S) and patient satisfaction with the information provided. Secondary outcomes included patient satisfaction with service, quality of life, and time to detection of recurrence.Results The STAI-S scores post-randomisation were similar between groups [mean (SD): TFU 33.0 (11.0); HFU 35.5 (13.0)]. The estimated between-group difference in STAI-S was 0.7 (95% confidence interval, 95% CI À1.9 to 3.3); the confidence interval lies above the non-inferiority limit (À3.5), indicating the noninferiority of TFU. There was no significant difference between groups in reported satisfaction with information (odds ratio, OR 0.9; 95% CI 0.4-2.1; P = 0.83). Women in the HFU group were more likely to report being kept waiting for their appointment (P = 0.001), that they did not need any information (P = 0.003), and were less likely to report that the nurse knew about their particular case and situation (P = 0.005).Conclusions The TFU provides an effective alternative to HFU for patients with stage-I endometrial cancer, with no reported physical or psychological detriment. Patient satisfaction with information was high, with similar levels between groups.Keywords Endometrial cancer, gynaecology, oncology, patient satisfaction, psychological, morbidity, telephone follow-up.Tweetable abstract ENDCAT trial shows effectiveness of nurse-led telephone follow-up for patients with stage-I endometrial cancer.

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Caution should be exercised when choosing expectant management in cases of viable CSPs, and if chosen, the patient should be counselled adequately for possible outcomes including loss of pregnancy and hysterectomy. Expectant management is acceptable in CSPs with no foetal cardiac activity. There is a need for prospective research on this topic with adequate reporting on possible prognostic markers, as well as a need to improve on the techniques to prevent loss of fertility during delivery.

Ultrasound-guided transvaginal oocyte retrieval (TVOR) is a relatively simple and atraumatic method with rare complications as well as the possibility of doing it under sedation. It has become the method of choice in most IVF centres, because it results in excellent oocyte yields, with increased speed and excellent follicle and major pelvic vessel visualization, thereby decreasing the probability of vessel puncture [1]. However, the technique is not without risk such as pelvic infection, bleeding secondary a blood vessel puncture or pelvic visceral trauma. Consumption coagulopathy is a serious complication of pelvic infection and sepsis which can be life threatening if not diagnosed and corrected early, especially if surgical intervention is required. We present a case of bilateral ovarian abscesses following transvaginal oocyte retrieval showing early signs of consumption coagulopathy.

Although rare, serious vascular injuries after tension-free vaginal tape (TVT) insertion have been well known. We present a case of external iliac artery injury after TVT insertion, managed successfully by surgical intervention. This article also reviews the literature regarding major vascular injuries and their management. We conclude that clinicians should be able to suspect rare but serious vascular injuries, and patients have to be fully counselled regarding their potential consequences.

Complete excision is both diagnostic and therapeutic. FNAC could be a tool to exclude malignancy and allows a quick diagnosis.

Though, both TOT and TVT-O has been shown not to enter pelvis on anatomical dissection on female cadavers, many cases of bladder injury have been reported. Delorome and De Leval strongly suggest avoiding routine cystoscopy during insertion. Avoidance of cystoscopy means shorter operating time as well as less costly for patients. We recommend that routine cystoscopy at least need to be considered in selected group patients. In cases of associated pelvic surgery or presence of prolapse, previous retropubic surgery or difficult insertion of the tapes, cystoscopy could be considered. Further, large randomised clinical trials are needed to asses TVT, TOT and TVT-O in-order to conclude the question of routine cystoscopy or not.

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