Publications by authors named "Anne Cecile Pizzoferrato"

Aims: Ultrasound is used in the delivery room to assess fetal head position, engagement during labor, and anal sphincter injuries in the immediate postpartum period. The transperineal approach allows for direct visualization of the structures of interest without altering anatomical landmarks. Various ultrasound measurements during labor have been described in the literature, and their use varies widely across maternity units.

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Introduction: Numerous anatomical theories have been developed to explain women stress urinary incontinence (SUI) and improve its management. The transperineal ultrasound is an efficient and non-invasive exam that perfectly studies the bladder neck movement and the urethral anatomy. The measurement of the static portion of the distal urethral length, considered as the functional urethral length (FUL), and of the posterior urethral closure angle (PUCA) have not been studied before and could be of interest.

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Aims: The Antwerp Pelvic Floor Knowledge Questionnaire (APFK-Q) is a self-administered tool used for assessing women's knowledge of the pelvic floor, an essential element of pelvic health education initiatives. The aim of this study was to validate the French version of the APFK-Q and to assess its psychometric properties.

Methods: Acceptability of the cultural adaptation of APFK-Q in French (translation/back-translation) was assessed in two groups of women: one group not working in the healthcare sector (non-healthworkers, n = 112), and another of student midwives (n = 29).

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Objective: Pelvic floor health education workshops for women appear to improve women's knowledge and pelvic floor symptoms. Our aim was to obtain expert consensus on the content and format of a pelvic floor health education program using the Delphi method.

Material And Methods: A two-round Delphi study was conducted involving French-speaking multidisciplinary experts in pelvic floor dysfunction management.

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Background: Recent recommendations from the French High Authority of Health on pelvic organ prolapse (POP) management underline the value of a pelvic examination.

Objectives: The aim of this paper was to analyze the literature and identify the best evidence available regarding pelvic examination for women presenting prolapse-associated symptoms in terms of diagnosis and predictability of treatment success.

Search Strategy: The databases were queried similarly using Medical Subject Headings (MeSH) and non-MeSH terms broadly related to pelvic examination and POP management.

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Objective: To evaluate the health status and recovery of women after mid-urethral sling (MUS) revision in response to complications.

Design: Cross-sectional study using a questionnaire sent to women from a registry.

Setting: Twenty-two French surgical centres.

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Background: Midurethral slings are the gold standard for treating stress urinary incontinence, but their complications may raise concerns. Complications may differ by the approach used to place them.

Objective: This study aimed to compare serious complications and reoperations for recurrence after midurethral sling procedures when using the retropubic vs the transobturator route for female stress urinary incontinence.

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Article Synopsis
  • The study aimed to assess the effectiveness of group pelvic floor education workshops on participants' knowledge, satisfaction, and changes in urinary and digestive habits, while also comparing healthcare providers' knowledge to that of the general population.
  • The workshops were conducted online from May 2021 to June 2022 and included discussions on pelvic floor anatomy, physiology, risk factors for pelvic floor disorders, and preventive measures; participants filled out questionnaires before and after to measure changes in knowledge and behavior.
  • Results indicated a significant increase in pelvic floor knowledge for both healthcare providers and non-providers, with many participants reporting improved understanding and a willingness to change their urinary and digestive behaviors after the workshops.
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Introduction: The number of deliveries by forceps decreases significantly in favour of the vacuum. Now, when the use of forceps is necessary, physicians less experimented with this procedure are likely to induce serious and preventable perineal or foetal injuries. Training therefore becomes essential.

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Background: Incontinence occurs frequently in the postpartum period. Several theoretical pathophysiological models may underlie the hypothesis that different types of management of the active phase of the second stage of labor have different effects on pelvic floor muscles and thus perhaps affect urinary and anal continence.

Objective: This study aimed to evaluate the impact of "moderate pushing" on the occurrence of urinary or anal incontinence compared with "intensive pushing," and to determine the factors associated with incontinence at 6 months postpartum.

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Article Synopsis
  • The objective of the guidelines is to standardize the pelvic clinical exam for gynecology and obstetrics, ensuring practices are evidence-based.
  • A committee of 45 experts, including patient representatives, developed these guidelines independently, focusing on high-quality recommendations using the GRADE® system.
  • They formulated 40 questions into a PICO format, yielding 27 recommendations, with differing levels of agreement, while highlighting the need for more research in areas lacking evidence.
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(1) Background: Pelvic organ prolapse (POP) can be managed using a vaginal pessary. However, the decision-making process whereby health professionals choose the right pessary is unclear. The objective of this study was to focus on the experience of experts in pessary use and to propose an algorithm.

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Article Synopsis
  • Women's preoperative hopes and fears about cystocele repair often differ from those of their surgeons, highlighting a gap in understanding.
  • A study analyzed responses from 265 women, revealing prevalent hopes related to prolapse repair (60%) and fears of prolapse relapse (38%).
  • Surgeons' expectations aligned closely with women's, but only 60% of women reported prolapse repair as a key expectation, suggesting the need for enhanced communication between patients and surgeons regarding individual concerns and goals.
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When a patient presents with symptoms suggestive of pelvic organ prolapse (POP), clinical evaluation should include an assessment of symptoms, their impact on daily life and rule out other pelvic pathologies. The prolapse should be described compartment by compartment, indicating the extent of the externalization for each. The diagnosis of POP is clinical.

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Background: The non-surgical solution for Pelvic Organ Prolapse (POP) typically consists of a pessary fitting. We aimed to assess patient satisfaction and symptom improvement 6 months after a pessary fitting and to identify risk factors associated with pessary failure.

Methods: Six months after a pessary fitting, patient satisfaction was assessed by the PGII score; symptoms and quality of life were assessed using validated questionnaires (PFDI-20, ICIQ-SF, PISQ-12, USP, and PFIQ-7).

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Background: The Clavien-Dindo classification, used to describe postoperative complications, does not take into account patient perception of severity. Our main objective was to assess women's perception of postoperative pelvic floor repair complications and compare it to the classification of Clavien-Dindo.

Methods: Women and surgeons participating in the VIGI-MESH registry concerning pelvic floor repair surgery were invited to quote their perception of complication severity through a survey based on 30 clinical vignettes.

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Article Synopsis
  • Endometriosis is a chronic condition that negatively affects women's fertility, and the study aims to explore the relationship between preoperative Enzian scores and postoperative fertility outcomes after deep pelvic endometriosis surgery.
  • A retrospective study conducted at Rennes University Hospital analyzed data from women who underwent surgery for deep endometriosis, utilizing the ENDOREN database to assess the correlation between MRI-based Enzian scores and live birth rates.
  • Results showed a live birth rate of 35%, identifying the Enzian B score as a positive predictor for live births, while factors like uterine adenomyosis and previous endometriosis surgeries were found to negatively impact fertility outcomes.
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Objective: Uterine fibroids are often associated with lower urinary tract symptoms (LUTS), the exact prevalence of which has been underexplored. Our main objective was to evaluate the effect of surgical treatment of fibroids on LUTS. Our secondary objectives were to assess the prevalence of LUTS in women undergoing fibroid surgery and to analyze the relationship between the characteristics of fibroids and the severity of symptoms.

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Pessary fitting and follow-up for women with pelvic organ prolapse (POP) can be performed by different health care practitioners (HCPs). We aimed to investigate knowledge and current practices among the main HCPs involved in pessary use in France. We sent an electronic questionnaire about pessary use to the members of eight French learned societies between April and October 2020.

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Background: We aimed at developing a core outcome and variables of interest set to investigate the effects of mediolateral episiotomy on Obstetric Anal Sphincter Injury (OASI) during and after operative delivery in nulliparous women in a large-scale one-year observational French study including 15,000 women (INSTRUMODA).

Methods: A list of outcomes and variables of interest was suggested to obstetricians participating in the INSTRUMODA study using online questionnaires divided into 7 categories: the woman's history and course of pregnancy, course of labor, modalities of operative delivery, episiotomy characteristics, immediate maternal morbidity, one-year maternal morbidity, immediate neonatal morbidity. We used a three-round DELPHI method to reach a consensus.

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Objective: Laparoscopic sacrocolpopexy is the standard surgery to correct apical pelvic organ prolapse. It is currently mainly practiced in the context of a conventional hospitalization, but more and more practitioners are developing it as an outpatient procedure. The objective of this study was to evaluate the feasibility of outpatient laparoscopic sacrocolpopexy and patient satisfaction.

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Introduction: Pelvic floor disorders (PFD) are common conditions impacting quality of life and sexuality may worsen after ovarian cancer therapies. Our objective was to describe the prevalence of PFD and sexuality in women with ovarian cancer (OC).

Methods: We reviewed articles indexed in the MEDLINE database until June 2020 and selected articles assessing UI, POP, FI and sexual dysfunction in a population of women with OC.

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Objective: We aimed to assess the impact of an educational program on the symptoms and quality of life of patients undergoing supervised pelvic floor muscle training (PFMT). Secondary objectives included: baseline assessment of patients' knowledge of the pelvic floor; and patient satisfaction and symptom improvement after the entire PFMT program.

Material And Methods: An observational questionnaire-based study in women attending a PFMT program consisting of four educational sessions, one visual feedback session, and five personalized training sessions.

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Article Synopsis
  • The study evaluates the feasibility of same-day surgery for minimally invasive hysterectomies performed on women, focusing on factors contributing to success or failure.
  • Conducted at Caen and Amiens University Hospitals, it included 50 patients under 70 with no major health issues, categorized into "fit" and "unfit" groups based on their recovery scores.
  • The results highlighted that prior laparotomy, pain, and postoperative nausea/vomiting were significant predictors for unsuccessful same-day discharge, but overall, same-day hysterectomy was found to be safe and feasible.
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