Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 19;3(3):CD011000.
doi: 10.1002/14651858.CD011000.pub3.

Palliative interventions for controlling vaginal bleeding in advanced cervical cancer

George U Eleje  1 , Ahizechukwu C Eke, Gabriel O Igberase, Anthony O Igwegbe, Lydia I Eleje
Affiliations

Palliative interventions for controlling vaginal bleeding in advanced cervical cancer

George U Eleje et al. Cochrane Database Syst Rev. .

Abstract

Background: This is an updated version of the original Cochrane review published in Issue 5, 2015.Cervical cancer is the fourth most common cancer among women worldwide, with estimated 569,847 new diagnoses and 311,365 deaths per year. However, incidence and stage at diagnosis vary greatly between geographic areas and are largely dependent on the availability of a robust population screening programme. For example, in Nigeria, advanced-stage disease at presentation is common (86% to 89.3% of new cases), whereas in the UK, only 21.9% of women present with International Federation of Gynaecology and Obstetrics (FIGO) stage II+ disease. Women with advanced cancer of the cervix often need palliation for distressing symptoms, such as vaginal bleeding. Vaginal bleeding can be life threatening in advanced disease, with an incidence ranging from 0.7% to 100%. Bleeding is the immediate cause of death in 6% of women with cervical cancer and its management often poses a challenge.Thus, vaginal bleeding remains a common consequence of advanced cervical cancer. Currently, there is no systematic review that addresses palliative interventions for controlling vaginal bleeding caused by advanced cervical cancer. A systematic evaluation of the available palliative interventions is needed to inform decision-making.

Objectives: To evaluate the efficacy and safety of tranexamic acid, vaginal packing (with or without formalin-soaked packs), interventional radiology or other interventions compared with radiotherapy for palliative treatment of vaginal bleeding in women with advanced cervical cancer.

Search methods: The search for the original review was run in 23 March 2015, and subsequent searches for this update were run 21 March 2018. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 3) in the Cochrane Library; MEDLINE via Ovid to March week 2, 2018; and Embase via Ovid to March week 12, 2018. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of review articles, and contacted experts in the field. We handsearched citation lists of relevant studies.

Selection criteria: We searched for randomised and non-randomised comparative studies that evaluated the efficacy and safety of tranexamic acid, vaginal packing (with or without formalin-soaked packs), interventional radiology or other interventions compared with radiotherapy techniques for palliative treatment of vaginal bleeding in women with advanced cervical cancer (with or without metastasis), irrespective of publication status, year of publication or language in the review.

Data collection and analysis: Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. We found no studies for inclusion and, therefore, we analysed no data.

Main results: The search strategy identified 1522 unique references of which we excluded 1330 on the basis of title and abstract. We retrieved the remaining 22 articles in full, but none satisfied the inclusion criteria. We identified only observational data from single-arm studies of women treated with formalin-soaked packs, interventional radiology or radiotherapy techniques for palliative control of vaginal bleeding in women with cervical cancer.

Authors' conclusions: Since the last version of this review we found no new studies. There is no evidence from controlled trials to support or refute the use of any of the proposed interventions compared with radiotherapy. Therefore, the choice of intervention will be based on local resources. Radiotherapy techniques for managing vaginal bleeding are not readily available in resource-poor settings, where advanced cases of cervical cancer are predominant. Thus, this systematic review identified the need for a randomised controlled trial assessing the benefits and risks of palliative treatments for vaginal bleeding in women with advanced cervical cancer.

PubMed Disclaimer

Conflict of interest statement

GE: none known. AE: none known. GI: none known. AI: none known. LE: none known.

Figures

1
1
Study flow diagram.
See this image and copyright information in PMC

Update of

References

References to studies excluded from this review

Adewuyi 2010 {published data only}
    1. Adewuyi SA, Shittu OS, Rafindadi AH, Zayyan MS, Samaila MO, Oguntayo AO. Cisplatin chemotherapy for haemostasis in bleeding cervical cancer: experience from a resource-poor setting. Nigerian Postgraduate Medical Journal 2010;17(2):122-7. [PMID: ] - PubMed
Ahmedov 2013 {published data only}
    1. Ahmedov O, Yuldasheva N, Saidova K, Nekova G. In: The effectiveness of embolization and chemoembolization in cervix cancer with bleeding complications. Proceedings of the European Journal of Cancer; 2013 Sep 27-Oct 1; Amsterdam. 2013.
Banaschak 1985 {published data only}
    1. Banaschak A, Stösslein F, Kielbach O, Bilek K, Elling D. Therapeutic vascular embolization in life-threatening gynecologic hemorrhages [in German]. Zentralblatt für Gynäkologie 1985;107(17):1050-6. - PubMed
Biswal 1995 {published data only}
    1. Biswal BM, Lal P, Rath GK, Mohanti BK. Hemostatic radiotherapy in carcinoma of the uterine cervix. International Journal of Gynaecology and Obstetrics 1995;50(3):281-5. [PMID: ] - PubMed
Ermolov 2003 {published data only}
    1. Ermolov AS, Belozerov GE, Tichomirova NI, Beliakov GA, Oleinikova ON. Embolization of uterine arteries in gynecological patients with uterine bleeding of various etiology [Embolizatsiia matochnykh arterii u ginekologicheskikh bol'nykh s matochnymi krovotecheniiami razlichnoi razlichnoi etiologii]. Vestnik Rentgenologii i Radiologii 2003;4:60-2. [PMID: ] - PubMed
Fletcher 2002 {published data only}
    1. Fletcher HM, Wharfe GH, Mitchell SY, Simon T. Treatment of intractable vaginal bleeding with formaldehyde soaked packs. Journal of Obstetrics and Gynaecology 2002;22(5):570-1. - PubMed
Grigsby 2002 {published data only}
    1. Grigsby PW, Portelance L, Williamson JF. High dose ratio (HDR) cervical ring applicator to control bleeding from cervical carcinoma. International Journal of Gynecological Cancer 2002;12(1):18-21. [PMID: ] - PubMed
Ishikawa 1986 {published data only}
    1. Ishikawa M, Nakayama K, Dehaeck CM. Transcatheter embolization of pelvic vessels to stop intractable hemorrhage. Gynecologic Oncology 1986;24(1):9-16. - PubMed
Kim 2013 {published data only}
    1. Kim DH, Lee JH, Ki YK, Nam JH, Kim WT, Jeon HS, et al. Short-course palliative radiotherapy for uterine cervical cancer. Radiation Oncology Journal 2013;31(4):216-21. [PMID: ] - PMC - PubMed
Konski 2005 {published data only}
    1. Konski A, Feigenberg S, Chow E. Palliative radiation therapy. Seminars in Oncology 2005;32(2):156-64. - PubMed
Kraiphibul 1993 {published data only}
    1. Kraiphibul P, Srisupundit S, Kiatgumjaikajorn S, Pairachvet V. The experience in using whole pelvic irradiation in management of massive bleeding from carcinoma of the uterine cervix. Journal of the Medical Association of Thailand 1993;76 Suppl 1:78-81. [PMID: ] - PubMed
Kramer 1999 {published data only}
    1. Kramer SC, Gorich J, Rilinger N, Heilmann V, Sokiranski R, Aschoff AJ, et al. Interventional treatment of hemorrhages in advanced cervical carcinoma [Interventionelle Behandlungsmoglichkeiten von Blutungen bei fortgeschrittenen Karzinomen der Cervix uteri]. Der Radiologe 1999;39(9):795-8. [PMID: ] - PubMed
Kwawukume 1996 {published data only}
    1. Kwawukume EY, Ghosh TS. Extraperitoneal hypogastric artery ligation in control of intractable haemorrhage from advanced carcinoma of cervix and choriocarcinoma. East African Medical Journal 1996;73(2):147-8. [PMID: ] - PubMed
Mihmanli 2001 {published data only}
    1. Mihmanli I, Cantasdemir M, Kantarci F, Halit Yilmaz M, Numan F, Mihmanli V. Percutaneous embolization in the management of intractable vaginal bleeding. Archives of Gynecology and Obstetrics 2001;264(4):211-4. [PMID: ] - PubMed
Mishra 2005 {published data only}
    1. Mishra SK, Laskar S, Muckaden MA, Mohindra P, Shrivastava SK, Dinshaw KA. Monthly palliative pelvic radiotherapy in advanced carcinoma of uterine cervix. Journal of Cancer Research and Therapeutics 2005;1(4):208-12. [PMID: ] - PubMed
Onsrud 2001 {published data only}
    1. Onsrud M, Hagen B, Strickert T. 10-Gy single-fraction pelvic irradiation for palliation and life prolongation in patients with cancer of the cervix and corpus uteri. Gynecologic Oncology 2001;82(1):167-71. [PMID: ] - PubMed
Pereira 2004 {published data only}
    1. Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist 2004;9:561-70. - PubMed
Ratliff 1992 {published data only}
    1. Ratliff CR. Preventing cervical bleeding with Monsel's solution. Oncology Nursing Forum 1992;19(4):664. [PMID: ] - PubMed
Skliarenko 2012 {published data only}
    1. Skliarenko J, Barnesn EA. Palliative pelvic radiotherapy for gynaecologic cancer. Journal Of Radiation Oncology 2012;1(3):239-44.
Yamashita 1994 {published data only}
    1. Yamashita Y, Harada M, Yamamoto H, Miyazaki T, Takahashi M, Miyazaki K, et al. Transcatheter arterial embolization of obstetric and gynaecological bleeding: efficacy and clinical outcome. British Journal of Radiology 1994;67(798):530-4. [PMID: ] - PubMed
Yanazume 2013a {published data only}
    1. Yanazume S, Douzono H, Yanazume Y, Iio K, Douchi T. New hemostatic method using Mohs' paste for fatal genital bleeding in advanced cervical cancer. Gynecologic Oncology Case Report 2013;4:47-9. - PMC - PubMed
Zeghal 2013 {published data only}
    1. Zeghal Souki D, Touhami O, Rajhi H, Ben Hmid R, Zouari F, Mnif N, et al. Selective arterial embolization in case of bleeding in advanced cervical cancer. La Tunisie Medicale 2013;91(8-9):558-9. [PMID: ] - PubMed

Additional references

Adebamowo 2000
    1. Adebamowo CA. Topical formalin for management of bleeding malignant ulcers. World Journal of Surgery 2000;24(5):518-20. [PMID: ] - PubMed
Adewuyi 2008
    1. Adewuyi SA, Shittu SO, Rafindadi AH. Sociodemographic and clinicopathologic characterization of cervical cancers in northern Nigeria. European Journal of Gynaecological Oncology 2008;29(1):61-4. [PMID: ] - PubMed
Ajayi 1998
    1. Ajayi IO, Adewole IF. Determinants of utilization of cervical screening facility in a low socioeconomic setting in Nigeria. Journal of Obstetrics and Gynaecology 1998;18:154-8. - PubMed
Asonganyi 2013
    1. Asonganyi E, Vaghasia M, Rodrigues C, Phadtare A, Ford A, Pietrobon R, et al. Factors affecting compliance with clinical practice guidelines for pap smear screening among healthcare providers in Africa: systematic review and meta-summary of 2045 individuals. PloS One 2013;8(9):e72712. [PMID: ] - PMC - PubMed
Attarbashi 2007
    1. Attarbashi S, Faulkner RL, Slade RJ. The use of Monsel's solution and vaginal pack for haemostasis in cold knife cone biopsy. Journal of Obstetrics and Gynaecology 2007;27(2):189. [PMID: ] - PubMed
Ayinde 2004
    1. Ayinde OA, Omigbodun AO, Ilesanmi AO. Awareness of cervical cancer, Papanicolaou's smear and its utilisation among female undergraduates in Ibadan. African Journal of Reproductive Health 2004;8:68-80. - PubMed
Azuike 2019
    1. Azuike EC, Eleje GU, Ndukwu CN. Cochrane workshop. International Hospital 2019;3(1):33-38.
Barbera 2010
    1. Barbera L, Elit L, Krzyzanowska M, Saskin R, Bierman AS. End of life care for women with gynecologic cancers. Gynecologic Oncology 2010;118(2):196-201. - PubMed
Barton 2006
    1. Barton MB, Frommer M, Shafiq J. Role of radiotherapy in cancer control in low-income and middle-income countries. Lancet Oncology 2006;7(7):584-95. - PubMed
Bhatla 2019
    1. Bhatla N, Berek JS, Cuello Fredes M, Denny LA, Grenman S, Karunaratne K, et al. Revised FIGO staging for carcinoma of the cervix uteri. International Journal of Gynaecology and Obstetrics 2019;145(1):129-35. [PMID: ] - PubMed
Bradford 2013
    1. Bradford L, Goodman A. Cervical cancer screening and prevention in low-resource settings. Clinical Obstetrics and Gynecology 2013;56(1):76-87. [PMID: ] - PubMed
Bray 2018
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a Cancer Journal for Clinicians 2018;68(6):394-424. [PMID: ] - PubMed
Bukar 2012
    1. Bukar M, Takai IU, Audu BM. Determinants of utilization of papanicolaou smear among outpatient clinic attendees in north-eastern Nigeria. African Journal of Medicine and Medical Sciences 2012;41(2):183-9. [PMID: ] - PubMed
Chattopadhyay 2010
    1. Chattopadhyay G, Ray D, Chakravartty S, Mandal S. Formalin instillation for uncontrolled radiation induced haemorrhagic proctitis. Tropical Gastroenterology 2010;31(4):291-4. - PubMed
CRASH‐2 Collaborators 2011
    1. The CRASH-2 Collaborators. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet 2011;377(9771):1096-101. - PubMed
Davis 1984
    1. Davis JR, Stein Bronn KK, Graham AR, Dawson BV. Effects of Monsel's solution in uterine cervix. American Journal of Clinical Pathology 1984;82(2):332-335. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629-34. - PMC - PubMed
Ferlay 2019
    1. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Pineros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International Journal of Cancer 2019;144(8):1941-53. [PMID: ] - PubMed
FIGO Committee on Gynecologic Oncology 2014
    1. FIGO Committee on Gynecologic Oncology. FIGO staging for carcinoma of the vulva, cervix, and corpus uteri. International Journal of Gynaecology Obstetrics 2014;125(2):97-8. - PubMed
Gamaoun 2018
    1. Gamaoun R. Awareness and knowledge about cervical cancer prevention methods among Tunisian women. Journal of Preventive Medicine and Hygiene 2018;59(1):E30-5. [PMID: ] - PMC - PubMed
Gassibe 1997
    1. Gassibe EF, Gassibe E. Laparoscopic ligation of hypogastric arteries using the Hulka clip to arrest massive vaginal bleeding due to stage IIb cervical carcinoma. Journal of the American Association of Gynecologic Laparoscopists 1997;4(2):259-61. [PMID: ] - PubMed
Glick 2013
    1. Glick JB, Kaur RR, Siegel D. Achieving hemostasis in dermatology – Part II: topical hemostatic agents. Indian Dermatology Online Journal 2013;4(3):172-6. [PMID: ] - PMC - PubMed
GLOBOCAN 2012
    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer 2015;136(5):E359-86. - PubMed
Godoy‐Ortiz 2018
    1. Godoy-Ortiz A, Plata Y, Alcaide J, Galeote A, Pajares B, Saez E, et al. Bevacizumab for recurrent, persistent or advanced cervical cancer: reproducibility of GOG 240 study results in 'real world' patients. Clinical and Translational Oncology 2018;20(7):922-7. [PMID: ] - PubMed
Green 2005
    1. Green J, Kirwan J, Tierney J, Vale C, Symonds P, Fresco L, et al. Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No: CD002225. [DOI: 10.1002/14651858.CD002225.pub2] - DOI - PMC - PubMed
Harbord 2006
    1. Harbord RM, Egger M, Sterne JA. A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25(20):3443-57. - PubMed
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Hunt 2015
    1. Hunt BJ. The current place of tranexamic acid in the management of bleeding. Anaesthesia 2015;70 Suppl 1:50-3, e18. [PMID: ] - PubMed
Hyacinth 2012
    1. Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T. Cervical cancer and PAP smear awareness and utilization of pap smear test among Federal civil servants in North Central Nigeria. PloS One 2012;7(10):e46583. [PMID: ] - PMC - PubMed
IAEA 2008
    1. International Atomic Energy Agency (IAEA). Division of Human Health, Setting up a Radiotherapy Programme: clinical, medical physics, radiation protection and safety aspects, 2008. www-pub.iaea.org/MTCD/publications/PDF/pub1296_web.pdf (accessed 27 April 2015).
Ikechebelu 2010
    1. Ikechebelu JI, Onyiaorah IV, Ugboaja JO, Anyiam DC, Eleje GU. Clinicopathological analysis of cervical cancer seen in a tertiary health facility in Nnewi, south-east Nigeria. Journal of Obstetrics and Gynaecology 2010;30(3):299-301. - PubMed
Jetmore 1993
    1. Jetmore AB, Heryer JW, Conner WE. Monsel's solution: a kinder, gentler hemostatic. Diseases of the Colon and Rectum 1993;36(9):866-7. - PubMed
Ker 2014
    1. Ker K, Roberts I. Tranexamic acid for surgical bleeding. BMJ (Clinical Research Ed.) 2014;349:g4934. [PMID: ] - PubMed
Kobara 2015
    1. Kobara H, Mori H, Rafiq K, Fujihara S, Nishiyama N, Morishita A, et al. Application of endoscopic hemostatic forceps for uterine cervical bleeding. Gastrointestinal Endoscopy 2015;81(1):234-5. [PMID: ] - PubMed
Lorusso 2014
    1. Lorusso D, Petrelli F, Coinu A, Raspagliesi F, Barni S. A systematic review comparing cisplatin and carboplatin plus paclitaxel-based chemotherapy for recurrent or metastatic cervical cancer. Gynecologic Oncology 2014;133(1):117-23. [PMID: ] - PubMed
Luna‐Pérez 2002
    1. Luna-Pérez P, Rodríguez-Ramírez SE. Formalin instillation for refractory radiation-induced hemorrhagic proctitis. Journal of Surgical Oncology 2002;80:41-4. - PubMed
Manca 1997
    1. Manca DP. Stopping cervical bleeding. Canadian Family Physician 1997;43:2121. - PMC - PubMed
Mishra 2011
    1. Mishra K. Gynaecological malignancies from palliative care perspective. Indian Journal of Palliative Care 2011;17(Suppl):S45-51. - PMC - PubMed
Mohs 1941
    1. Mohs F. Chemosurgery: a microscopically controlled method of cancer excision. Archives of Surgery 1941;42:279-96.
Mukakalisa 2014
    1. Mukakalisa I, Bindler R, Allen C, Dotson J. Cervical cancer in developing countries: effective screening and preventive strategies with an application in Rwanda. Health Care for Women International 2014;35(7-9):1065-80. [PMID: ] - PubMed
Ng 2015
    1. Ng WC, Jerath A, Wasowicz M. Tranexamic acid: a clinical review. Anaesthesiology Intensive Therapy 2015;47(4):339-50. [PMID: ] - PubMed
NHSCSP 2007‐2010
    1. Sasieni P, Castanon A, Louie KS. NHS Cancer Screening Programmes audit of invasive cervical cancer. National report 2007-2010. www.cancerscreening.nhs.uk/cervical/publications/nhscsp-audit-invasive-c... (accessed 27 April 2015).
Obiechina 2009
    1. Obiechina NJ, Mbamara SU. Knowledge attitude and practice of cervical cancer screening among sexually active women in Onitsha, southeast Nigeria. Nigerian Journal of Medicine 2009;18(4):384-7. - PubMed
Orang'o 2017
    1. Orang'o E, Itsura P, Tonui P, Muliro H, Rosen B, Lonkhuijzen L. Use of palliative cisplatinum for advanced cervical cancer in a resource-poor setting: a case series from Kenya. Journal of Global Oncology 2017;3(5):539-44. [PMID: ] - PMC - PubMed
Papp 1989
    1. Papp Z, Murvay K, Szeverenyi M, Peter M. A life-saving hemostatic procedure by ligation of the hypogastric artery in hemorrhage caused by cervix carcinoma [Cervix carcinomabol eredo verzes eletmento csillapitasa az arteria hypogastrica lekotesevel]. Az Orvosi Hetilap Centenáriumi Emlékkönyve 1989;130(32):1715-8. [PMID: ] - PubMed
Pecorelli 2009
    1. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. International Journal of Gynaecology and Obstetrics 2009;105(2):103-4. [PMID: ] - PubMed
Quinn 2019
    1. Quinn BA, Deng X, Colton A, Bandyopadhyay D, Carter JS, Fields EC. Increasing age predicts poor cervical cancer prognosis with subsequent effect on treatment and overall survival. Brachytherapy 2019;18(1):29-37. [PMID: ] - PMC - PubMed
Review Manager 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Rosen 2017
    1. Rosen VM, Guerra I, McCormack M, Nogueira-Rodrigues A, Sasse A, Munk VC, et al. Systematic review and network meta-analysis of bevacizumab plus first-line topotecan-paclitaxel or cisplatin-paclitaxel versus non-bevacizumab-containing therapies in persistent, recurrent, or metastatic cervical cancer. International Journal of Gynecological Cancer 2017;27(6):1237-46. [PMID: ] - PMC - PubMed
Sankaranarayanan 2008
    1. Sankaranarayanan R, Thara S, Esmy PO, Basu P. Cervical cancer: screening and therapeutic perspectives. Medical Principles and Practice 2008;17(5):351-64. - PubMed
Scatchard 2012
    1. Scatchard K, Forrest JL, Flubacher M, Cornes P, Williams C. Chemotherapy for metastatic and recurrent cervical cancer. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No: CD006469. [DOI: 10.1002/14651858.CD006469.pub2] - DOI - PMC - PubMed
Seider 1988
    1. Seider MJ, Peters LJ, Wharton JT, Oswald MJ. Safety of adjunctive transvaginal beam therapy in the treatment of squamous cell carcinoma of the uterine cervix. International Journal of Radiation Oncology, Biology, Physics 1988;14(4):729-35. - PubMed
Shafi 2012
    1. Shafi MI. Premalignant and malignant disease of the cervix. In: Edmund KD, editors(s). Dewhurst’s Textbook of Obstetrics and Gynaecology. 8th edition. London: Wiley-Blackwell, 2012:747–59.
Shapley 2006
    1. Shapley M, Jordan J, Croft PR. A systematic review of postcoital bleeding and risk of cervical cancer. British Journal of General Practice 2006;56(527):453-60. [PMID: ] - PMC - PubMed
Skret 1994
    1. Skret A, Obrzut B, Stachurski J. Laparoscopic ligature of the iliac arteries in treatment of hemorrhage related to uterine cervical cancer [Laparoskopowe podwiazanie tetnic biodrowych wewnetrznych w leczeniu krwotoku ze zmienionej nowotworowo szyjki macicy]. Ginekologia Polska 1994;65(9):527-30. [PMID: ] - PubMed
Skret 1995
    1. Skret A, Obrzut B, Stachurski J. Laparoscopic ligation of the internal iliac artery in bleeding cervix carcinoma [Laparoskopische Ligatur der A. iliaca interna bei einem blutenden Zervixkarzinom]. Zentralblatt fur Gynakologie 1995;117(9):486-90. [PMID: ] - PubMed
Sobiczewski 2002
    1. Sobiczewski P, Bidzinski M, Derlatka P. Laparoscopic ligature of the hypogastric artery in the case of bleeding in advanced cervical cancer. Gynecologic Oncology 2002;84(2):344-8. [PMID: ] - PubMed
Soyle 1992
    1. Soyle M, Warwick A, Redman C, Hillier C, Chenoy R, O'Brien S. Does application of Monsel's solution after loop diathermy excision of the transformation zone reduce post operative discharge? Results of a prospective randomised controlled trial. British Journal of Obstetrics and Gynaecology 1992;99(12):1023-4. - PubMed
Spitzer 1996
    1. Spitzer M, Chernys AE. Monsel's solution-induced artifact in the uterine cervix. American Journal of Obstetrics and Gynecology 1996;175(5):1204-7. - PubMed
Symonds 2004
    1. Symonds P, Kirwan J, Williams C, Humber C, Tierney J, Green J, et al. Concomitant hydroxyurea plus radiotherapy versus radiotherapy for carcinoma of the uterine cervix. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No: CD003918. [DOI: 10.1002/14651858.CD003918.pub2] - DOI - PMC - PubMed
Tam 2005
    1. Tam KF, Lee TP, Ngan HY. Hemostasis following cervical punch biopsy using Monsel's solution. International Journal of Gynaecology and Obstetrics 2005;88(2):160-1. [PMID: ] - PubMed
Tangtrakul 1979
    1. Tangtrakul S, Srisupundit S. Hemostasis by cryosurgery in advanced cervical carcinoma: a case report. Journal of the Medical Association of Thailand 1979;62(6):333-7. [PMID: ] - PubMed
Tarney 2014
    1. Tarney CM, Han J. Postcoital bleeding: a review on etiology, diagnosis, and management. Obstetrics and Gynecology International 2014;2014:192087. [PMID: ] - PMC - PubMed
Umezulike 2007
    1. Umezulike AC, Tabansi SN, Ewunonu HA, Nwana EJ. Epidemiological characteristics of carcinoma of the cervix in the Federal capital Territory of Nigeria. Nigerian Journal of Clinical Practice 2007;10(2):143-6. [PMID: ] - PubMed
van Lonkhuijzen 2011
    1. Lonkhuijzen L, Thomas G. Palliative radiotherapy for cervical carcinoma, a systematic review. Radiotherapy and Oncology 2011;98(3):287-91. [PMID: ] - PubMed
Vilardo 2017
    1. Vilardo N, Feinberg J, Black J, Ratner E. The use of QuikClot combat gauze in cervical and vaginal hemorrhage. Gynecologic oncology reports 2017;21:114-6. [PMID: ] - PMC - PubMed
Vyas 2006
    1. Vyas FL, Mathai V, Selvamani B, John S, Banerjee Jesudason SR. Endoluminal formalin application for haemorrhagic radiation proctitis. Colorectal Disease 2006;8(4):342-6. - PubMed
WHO 2011
    1. World Health Organization. Improving health care: individual interventions, 2011. www.who.int/nmh/publications/ncd_report_chapter5.pdf (accessed 20 July 2014).
Yanazume 2013b
    1. Yanazume Y, Douzono H, Yanazume S, Iio K, Kojima N, Mukaihara K, et al. Clinical usefulness of Mohs' paste for genital bleeding from the uterine cervix or vaginal stump in gynecologic cancer. Journal of Palliative Medicine 2013;16(2):193-7. [PMID: ] - PubMed
Yennurajalingam 2009
    1. Yennurajalingam S. Hemorrhage. In: Bruera E, Higginson I, Ripamonti C, Cunten C, editors(s). Textbook of Palliative Medicine. 2nd edition. Boca Raton (FL): CRC Press, 2009:808-16.

References to other published versions of this review

Eleje 2014
    1. Eleje GU, Eke AC, Igberase GO, Igwegbe AO, Eleje LI. Palliative interventions for controlling vaginal bleeding in advanced cervical cancer. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No: CD011000. [DOI: 10.1002/14651858.CD011000] - DOI
Eleje 2015
    1. Eleje GU, Eke AC, Igberase GO, Igwegbe AO, Eleje LI. Palliative interventions for controlling vaginal bleeding in advanced cervical cancer. Cochrane Database of Systematic Reviews 2015, Issue 5. Art. No: CD011000. [DOI: 10.1002/14651858.CD011000.pub2] - DOI - PMC - PubMed

Publication types

MeSH terms