Hysteroscopic Management of Complete Vaginal and Uterine Septum with Double Cervix: Tips & Tricks for a Safe Surgery.

Background: The septate uterus is the most common uterine abnormality, comprising 35% of all identified uterine malformations. According to the ESHRE/ESGE 2013 classification, the class U2bC2V1 is a rare congenital malformation characterized by a complete septate uterus with double cervix and nonobstructive longitudinal vaginal septum.

Study Objective: to share the decision-making process, the preoperative ultrasonographic assessment and our step-by-step hysteroscopic surgery technique to manage this complex malformation: including how to access the septate uterine cavity, the resection of the septum and its postoperative management.

Painful sexual intercourse, quality of life and sexual function in patients with endometriosis: not just deep dyspareunia.

Purpose: To evaluate the prevalence of deep and superficial dyspareunia in women with diagnosis of endometriosis. Secondly, to assess the temporal relation between deep and superficial dyspareunia in women reporting both symptoms (concomitant dyspareunia) and the impact on quality of life (QoL) and sexual function.

Methods: This is a cross-sectional cohort study that included fertile women with diagnosis of endometriosis.

"RAIL BIOPSY" A Novel and Useful Technique for Hysteroscopic Endometrial Target Biopsy.

Study Objective: Endometrial biopsy (EB) is one of the most common gynecologic procedures. Office-based EB has replaced procedures involving general/loco-regional anesthesia and cervical dilatation performed in the operating room [1-3]. The Grasp Biopsy seems to be the most appropriate EB technique for reproductive-aged women [1,2,4].

Exploring effects of anesthesia on complexity, differentiation, and integrated information in rat EEG.

To investigate mechanisms underlying loss of consciousness, it is important to extend methods established in humans to rodents as well. Perturbational complexity index (PCI) is a promising metric of "capacity for consciousness" and is based on a perturbational approach that allows inferring a system's capacity for causal integration and differentiation of information. These properties have been proposed as necessary for conscious systems.

Hysteroscopic Transillumination as a Guide for Laparoscopic Excision of Rudimentary Uterine Horn: A Winning Duo.

Study Objective: Anatomic anomalies of the female reproductive genital tract affect approximately 5.5% of women [1]. The hemiuterus or class U4 by the European Society of Human Reproduction and Embryology / European Society for Gynaecological Endoscopy 2013 classification is a rare congenital malformation defined as a unilateral uterine development, with a contralateral part that could be either incompletely formed or absent.

Uterine peristalsis in women affected by adenomyosis: A step towards functional assessment.

Objective: The non-pregnant uterus shows an intrinsic contractility pattern, actively involved in early reproductive processes. Uterine contractility is characterized by endometrial waves that originate from the junctional zone and varies throughout the menstrual cycle due to fluctuations in the concentrations of hormones. The aim of this study was to compare the uterine contractility patterns in the periovulatory phase in a group of patients with isolated adenomyosis and a group of healthy women using transvaginal ultrasound (TVUS).

Not All Bad Comes to Harm: Enhanced Recovery After Surgery for Rectosigmoid Endometriosis.

Study Objective: To assess the impact of implementing an enhanced recovery after surgery (ERAS) protocol on the length of hospitalization in women undergoing laparoscopy for rectosigmoid deep infiltrating endometriosis (DIE).

Design: A retrospective cohort study.

Setting: An academic referral center for endometriosis and minimally invasive gynecologic surgery.

Laminar evoked responses in mouse somatosensory cortex suggest a special role for deep layers in cortical complexity.

It has been suggested that consciousness is closely related to the complexity of the brain. The perturbational complexity index (PCI) has been used in humans and rodents to distinguish conscious from unconscious states based on the global cortical responses (recorded by electroencephalography, EEG) to local cortical stimulation (CS). However, it is unclear how different cortical layers respond to CS and contribute to the resulting intra- and inter-areal cortical connectivity and PCI.

Dienogest alone or dienogest combined with estrogens in the treatment of ovarian endometriomas, that is the question. A retrospective cohort study.

Purpose: to compare the effects of Dienogest 2 mg (D) alone or combined with estrogens (D + ethinylestradiol 0.03 mg, D + EE; D + estradiol valerate 1-3 mg, D + EV) in terms of symptoms and endometriotic lesions variations.

Methods: This retrospective study included symptomatic patients in reproductive age with ultrasound diagnosis of ovarian endometriomas.

Endometriosis in the time of internet: how web navigation affects women with endometriosis.

Objectives: Patients often search for health-related information on the internet allthough this trend may have some benefits, it also has some risks, such as misinformation. The aim of this study is to evaluate how Internet information seeking affect the level of anxiety in patients with endometriosis.

Materials And Methods: This prospective observational study was conducted at our outpatient clinic between March 2019 and December 2020.

Comparison between vaginal and laparoscopic cerclage in women with mid-trimester pregnancy loss or history of spontaneous preterm delivery.

Background: Women with unfavorable obstetric history can benefit from prophylactic cerclage ("history indicated") which can be performed vaginally or transabdominally with laparoscopic techniques. The aim of our study is to evaluate the effectiveness in the prevention of preterm birth of the vaginal technique and of the minimally invasive laparoscopic technique in women with an unfavorable obstetric history.

Methods: This was a retrospective cohort study examining elective cerclages performed in women with adverse obstetrics history.

Surgical Outcomes and Complications of Laparoscopic Hysterectomy for Endometriosis: A Multicentric Cohort Study.

Study Objective: To investigate the postoperative morbidity of laparoscopic hysterectomy (LH) for endometriosis/adenomyosis in terms of operative outcomes and complications.

Design: Retrospective multicentric cohort study.

Setting: Eight European minimally invasive referral centers.

How to Manage Endometriosis in Adolescence: The Endometriosis Treatment Italian Club Approach.

The evaluation of endometriosis in an adolescent girl is a challenging topic. The initial stage of the disease and the limited diagnostic instrument appropriate for the youth age and for its typical features can reduce the ability of the gynecologist. At the same time, missing a prompt diagnosis can delay the beginning of specific and punctual management of endometriosis, which could avoid a postponed diagnosis from 6 to 12 years, typical of adolescent girls complaining of dysmenorrhea.

How much will it hurt? Factors associated with pain experience in women undergoing medication abortion during the first trimester.

Objectives: Few studies have investigated the features associated with pain levels during abortion. We aimed to investigate the risk factors for experiencing pain during medication abortion, focusing on women's psychological distress and anxiety levels.

Study Design: We carried out this observational study at two centers in Bologna, Italy.

Is preoperative ultrasound tumor size a prognostic factor in endometrial carcinoma patients?

Objective: We aimed to assess the prognostic value of preoperative ultrasound tumor size in EC through a single center, observational, retrospective, cohort study.

Methods: Medical records and electronic clinical databases were searched for all consecutive patients with EC, preoperative ultrasound scans available to estimate tumor size, and a follow-up of at least 2-year, at our Institution from January 2010 to June 2018. Patients were divided into two groups based on different dimensional cut-offs for the maximum tumor diameter: 2, 3 and 4 cm.

Postoperative morphologic changes of the isthmocele and clinical impact in patients treated by channel-like (360°) hysteroscopic technique.

Objective: To evaluate the changes in (1) residual myometrial thickness (RMT), (2) cesarean scar defect (CSD) size, and (3) clinical symptoms, before and after channel-like (360°) hysteroscopic resection for the treatment of CSD.

Methods: A single-center, observational, prospective, cohort study was carried out enrolling all symptomatic patients of childbearing age, diagnosed with CSD and routinely scheduled for channel-like (360°) hysteroscopic resection from July 2020 to July 2021 at the Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Univeristaria di Bologna. University of Bologna, Italy.

The social media effect: the impact of fake news on women affected by endometriosis. A prospective observational study.

Objectives: Our purpose was to evaluate women's awareness of endometriosis and their ability to identify fake news about endometriosis on the internet. The second outcome was to identify those characteristics which make women more likely to believe in fake news.

Study Design: This prospective observational study was conducted at our academic outpatient clinic for endometriosis and pelvic pain.

Three-Dimensional Ultrasound Evaluation of Pelvic Floor Muscle Contraction in Women Affected by Deep Infiltrating Endometriosis: Application of a Quick Contraction Scale.

Objectives: Using transperineal 3D/4D ultrasound, we evaluated the prevalence of the various categories of a 4-point pelvic contraction scale among women affected by ovarian endometriosis (OE), deep infiltrating endometriosis (DIE), and healthy controls.

Methods: This prospective study was conducted on nulliparous women scheduled for surgery to remove endometriosis, and nulliparous healthy volunteers who did not show any clinical or sonographic signs of endometriosis, who served as controls. Patients were subjected to 3D/4D transperineal ultrasound obtaining measurements of the antero-posterior diameter (APD), both at rest and during maximal pelvic floor muscle (PFM) contraction (PFMC).

Malignant epithelioid neoplasm of the ileum with ACTB-GLI1 fusion mimicking an adnexal mass.

Background: Malignant epithelioid neoplasm with ACTB-GLI1 fusion are considered different from the more common pericytic lesions, such myopericytoma, because they have a spectrum of different genetic abnormalities. They appear to pursue a benign clinical course in young adults, although in sporadic cases lymph node metastasis were described. The categorization of this new type of tumor may also lead to new therapeutic strategies, because they might be sensitive to SHH pathway inhibitors.

Cost-effectiveness analysis of ovarian tissue cryopreservation and transplantation for preservation of fertility in post-pubertal oncological women submitted to high-risk gonadotoxic chemotherapy.

Objective: To study the economic impact of ovarian tissue cryopreservation and transplantation (OTC) in post-pubertal patients who underwent high-risk gonadotoxic chemotherapy.

Methods: A decision tree model was used to determine the live birth rate and cost-effectiveness of OTC versus non-OTC. The incremental cost-effectiveness ratio (ICER) was calculated.

Prognostic significance of CTNNB1 mutation in early stage endometrial carcinoma: a systematic review and meta-analysis.

Background: In the last years, mutations in the exon 3 of CTNNB1 have emerged as a possible prognostic factor for recurrence in early stage endometrioid endometrial carcinoma, especially in cases with no specific molecular profile (NSMP).

Objective: To define the prognostic value of CTNNB1 mutations in early stage endometrioid endometrial carcinoma, through a systematic review and meta-analysis.

Methods: Electronic databases were searched from their inception to November 2020 for all studies assessing the prognostic value of CTNNB1 mutation in early stage (FIGO I-II) endometrioid endometrial carcinoma.