Search

Assess efficacy, safety, fertility outcomes and recurrence after laparoscopic resection of bladder endometriosis (BE) using a CO laser. Retrospective cohort study. University gynecologic surgery unit, referral center for endometriosis. A total of 207 women having undergone laparoscopic BE excision between January 1998 and January 2019. None. Intra- and postoperative complication rates. Disease recurrence and fertility outcomes in patients with a minimum 1-year follow-up (n = 176) for "isolated" and "non-isolated" BE groups. Forty-three patients presented with isolated BE. Bladder "shaving" without mucosae opening was performed in 50.7% cases. No intraoperative complications were noted. One postoperative grade 3 complication was related to BE excision: a bladder breach requiring closure by repeat laparoscopy. Mean (± SD) follow-up was 7.05 (± 4.65) years. In patients wishing to conceive (n = 132), the total pregnancy rate (PR) was 75% (48.5% spontaneous), 76.19% in the isolated BE group (56.3% spontaneous). Among the 94 patients with previous infertility, 74.5% conceived, 50% spontaneously. No statistical difference was found in PR and need for in vitro fertilization between isolated and nonisolated BE groups. BE recurrence rate was 3.4%. No difference was observed between groups with full-thickness bladder resection (4/88) and shaving (2/88) (p = .406). Age at surgery (hazard ratio 0.91 [0.84-0.98], p = .016) and postoperative pregnancy (hazard ratio 0.07 [0.01-0.91], p = .042) showed influence on disease recurrence. The study demonstrates that laparoscopic BE removal is feasible with very low complications rates and was associated with high PR (both spontaneous and in vitro fertilization), even in patients with previous infertility. BE recurrence is lower than for other endometriosis locations. Bladder endometriosis; Laparoscopy; Deep infiltrating endometriosis; Fertility; Partial bladder resection.

Assess efficacy, safety, fertility outcomes and recurrence after laparoscopic resection of bladder endometriosis (BE) using a CO laser. Retrospective cohort study. University gynecologic surgery unit, referral center for endometriosis. A total of 207 women having undergone laparoscopic BE excision between January 1998 and January 2019. None. Intra- and postoperative complication rates. Disease recurrence and fertility outcomes in patients with a minimum 1-year follow-up (n = 176) for "isolated" and "non-isolated" BE groups. Forty-three patients presented with isolated BE. Bladder "shaving" without mucosae opening was performed in 50.7% cases. No intraoperative complications were noted. One postoperative grade 3 complication was related to BE excision: a bladder breach requiring closure by repeat laparoscopy. Mean (± SD) follow-up was 7.05 (± 4.65) years. In patients wishing to conceive (n = 132), the total pregnancy rate (PR) was 75% (48.5% spontaneous), 76.19% in the isolated BE group (56.3% spontaneous). Among the 94 patients with previous infertility, 74.5% conceived, 50% spontaneously. No statistical difference was found in PR and need for in vitro fertilization between isolated and nonisolated BE groups. BE recurrence rate was 3.4%. No difference was observed between groups with full-thickness bladder resection (4/88) and shaving (2/88) (p = .406). Age at surgery (hazard ratio 0.91 [0.84-0.98], p = .016) and postoperative pregnancy (hazard ratio 0.07 [0.01-0.91], p = .042) showed influence on disease recurrence. The study demonstrates that laparoscopic BE removal is feasible with very low complications rates and was associated with high PR (both spontaneous and in vitro fertilization), even in patients with previous infertility. BE recurrence is lower than for other endometriosis locations. Bladder endometriosis; Laparoscopy; Deep infiltrating endometriosis; Fertility; Partial bladder resection.

OBJECTIVE: To describe the available knowledge on vulvo-perineal endometriosis including its diagnosis, clinical management and recurrence rate. METHODS: We followed the PRISMA guidelines for Systematic Reviews and our study was prospectively registered with PROSPERO (CRD42020202441). The terms “Endometriosis” and “Perineum” or “Vulva” were used as keywords. Cochrane Library, Medline/Pubmed, Embase and Clinicaltrials.gov were searched. Papers in English, Spanish, Portuguese, French or Italian from inception to July 30, 2020 were considered. Reference lists of included articles and other literature source such as Google Scholar were also manually scrutinized in order to identify other relevant studies. Two independent reviewers screened potentially eligible studies according to inclusion criteria. RESULTS: Out of 539 reports, 90 studies were eligible including a total of 283 patients. Their mean age was 32,7±7,6 years. Two hundred sixty-three (95,3%) presenting with vulvo-perineal endometriosis have undergone either episiotomy, perineal trauma or vaginal injury or surgery. Only 13 patients (4,7%) developed vulvo-vaginal endometriosis spontaneously i.e. without any apparent condition favoring it. The reasons that motivated the patients to take medical advice were vulvo-perineal cyclical pain increasing during menstruations (98,2% of the patients, n=278). Out of the 281 patients for whom a clinical examination was described, 274 patients (97,5%) showed a vulvo-perineal nodule, mass or swelling while 6 presented with bluish cutaneous lesions (2,1%) and 1 with bilateral polyps of the labia minora (0,4%). All but one patients underwent surgical excision of their lesions but only 88 patients (28,1%) received additional hormonal therapy. The recurrence rate was 10,2% (29 patients) considering a median follow-up period of 10 months (based on 61 studies). CONCLUSION: Vulvo-perineal endometriosis is poorly reported with only approximately 300 cases identified in the literature

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised some important interrogations on minimally invasive gynaecological surgery. The International Society for Gynecologic Endoscopy (ISGE) has taken upon itself the task of providing guidance and best practice policies for all practicing gynaecological endoscopists. Factors affecting decision making processes in minimal invasive surgery (MIS) vary depending on factors such as the phase of the pandemic, policies on control and prevention, expertise and existing infrastructure. Our responsibility remains ensuring the safety of all health care providers, ancillary staff and patients during this unusual period. We reviewed the current literature related to gynecological and endoscopic surgery during the Coronavirus Disease 19 (COVID-19) crisis. Regarding elective surgery, universal testing for SARS-CoV-2 infection should be carried out wherever possible 40 h prior to surgery. In case of confirmed positive case of SARS-CoV-2, surgery should be delayed. Priority should be given to relatively urgent cases such as malignancies. ISGE supports medical optimization and delaying surgery for benign non-life-threatening surgeries. When possible, we recommend to perform cases by laparoscopy and to allow early discharges. Any procedure with risk of bowel involvement should be performed by open surgery as studies have found a high amount of viral RNA (ribonucleic acid) in stool. Regarding urgent surgery, each unit should create a risk assessment flow chart based on capacity. Patients should be screened for symptoms and symptomatic patients must be tested. In the event that a confirmed case of SARS-CoV-2 is found, every attempt should be made to optimize medical management and defer surgery until the patient has recovered and only emergency or life-threatening surgery should be performed in these cases. We recommend to avoid intubation and ventilation in SARS-CoV-2 positive patients and if at all possibl

The South African Society of Gynaecological Endoscopy (SASGE) is a newly formed society representing the interests of all practicing endoscopists in South Africa, a role previously held by SASREG. It was founded under the leadership of SASOG, SASREG, special interest groups, University representatives and the previous steering committee of SASGE. SASGE is pleased to release this guideline aimed at practitioners performing endoscopy during the COVID-19 global pandemic.

No abstract available

No Abstract available

No abstract available

Objective Soluble fms-like tyrosine kinase-1 (sFlt-1) participates to the physiopathology of pre-eclampsia by complexing the placental growth factor(PlGF) and blunting its biological action. Measurement of sFlt-1 levels contributes to the risk assessment of pre-eclampsia but only few automated assays for sFlt-1 testing are available. The aim of our study was to evaluate the analytical performances of the Thermo Scientific B•R•A•H•M•S sFlt-1 KRYPTOR immunoassay on KRYPTOR® compact PLUS instrument, a recently developed automated immunoassay. Methods Imprecision of the B•R•A•H•M•S sFlt-1 KRYPTOR (Thermo Scientific) immunoassay was determined with three levels of manufacturer’s control materials and seven pools of serum covering a broad spectrum of sFlt-1 concentrations, ran in duplicates two times a day for 5 days. The linearity of the sFlt-1 assay was determined through a 20 points dilution test. Matrix commutability was evaluated in paired EDTA and serum samples collected from second and third trimester pregnant women (n=47). PlGF concentrations were also determined in this set of patient samples with the B•R•A•H•M•S PlGF KRYPTOR immunoassay. Results The between run coefficients of variation (CV) for the quality control materials were 0. 8, 1. 1 and 1. 0% for mean concentrations of 1540,2988 and 9666 pg/mL, respectively. The 20 points dilution test covered a range of concentrations ranging from 92391 to 41 pg/mL anddemonstrated a reduced mean bias of 6. 2%, confirming the linearity of the assay. In the pregnant women samples, the median concentrations of sFlt-1 in serum and EDTA were respectively 1072 pg/mL (range: 166. 3 - 3400) and 1122 pg/mL (326 – 3099). The Spearman correlation coefficient between the 2 matrixes was 0. 97 and Passing and Bablok regression analysis showed a slope of 0. 97 and an intercept of 30. 31. For PlGF, the median concentrations in serum and EDTA were respectively 220. 3 pg/mL (range: 88. 6 – 928. 3) and 214. 5 pg/mL (76. 3 – 948. 4). The S