Transobturator adjustable tape (TOA) in female stress urinary incontinence associated with low maximal urethral closure pressure.

Purpose: To determine the success rate of transobturator adjustable tape (TOA, Agency for Medical Innovations, A.M.I.

Bowel preparation before laparoscopic gynaecological surgery in benign conditions using a 1-week low fibre diet: a surgeon blind, randomized and controlled trial.

Purpose: The aim of this randomized, surgeon-blind, controlled study was to evaluate the role of a 7 days minimal-residue (low fibre intake) pre-operative diet compared with a mechanical bowel preparation in laparoscopic benign gynaecological surgery.

Methods: This was a randomized, surgeon-blind, controlled study. The study included 83 women scheduled to undergo diagnostic or operative laparoscopy for various gynaecological benign conditions.

Prophylactic bilateral oophorectomy during vaginal hysterectomy for benign pathology.

Objective: The aim of this study was to assess the feasibility and safety of vaginal removal of ovaries at the time of vaginal hysterectomy.

Materials And Methods: All patients candidate to hystero-salpingo-oophorectomy by transvaginal approach, between 1 March 2004 and 28 February 2007, were admitted in the study.

Results: Of the 472 women included in the study, 432 (91.

Safety and efficacy of vaginal hysterectomy in the large uterus with the LigaSure bipolar diathermy system.

Objective: This study was undertaken to assess safety and efficacy of vaginal hysterectomy in case of large uterine size (> or = 250 g) using the LigaSure bipolar diathermy (Valleylab, Boulder, CO).

Study Design: In a retrospective study, medical records of 102 patients who underwent vaginal hysterectomy and who had uterine weight (evaluated after surgery) 250 g or greater were reviewed. All hysterectomies were performed by using the LigaSure vessel sealing system to secure vascular pedicles (uterosacral-cardinal, uterine and ovarian and round ligaments).

Rising use of synthetic mesh in transvaginal pelvic reconstructive surgery: a review of the risk of vaginal erosion.

Recently, the use of surgical mesh in pelvic floor surgery has become increasingly popular. While the reduction of surgical failure rates in vaginal reconstructive surgery is of critical importance, the addition of graft materials must be shown to improve anatomical outcomes and at least maintain, if not improve, lower urinary tract, bowel, and sexual function, as well as quality of life for the patient. Synthetic materials still have several disadvantages including vaginal erosion.

Outcomes of the first midwife-led birth centre in Italy: 5 years' experience.

Objective: To assess the experience of the first 5 years of the first midwife-led birth centre (MLBC) in Italy.

Study Design: Data were prospectively collected to analyse the first 5 years' experience of the MLBC. MLBC is located alongside a University hospital maternity unit and it offers care to women with a straightforward pregnancy and midwives take primary professional responsibility for care.

Ureteral suspension facilitates surgery for deep pelvic endometriosis.

This study describes a technique that facilitates the identification of the ureter during radical excision of endometriosis. After dissection of the ureter, a biocompatible silicone sling is introduced into the pelvis through the trocar; the sling is applied around the ureter and the two ends of the sling are pulled until adequate traction on the ureter is obtained. Ureteral suspension was performed in 126 consecutive women with endometriotic lesions involving the ovarian fossa and/or the uterosacral ligaments.

Does water delivery affect pelvic floor? Ultrasound evaluation of perineal function.

Objective: The aim of the study is to analyse urethral mobility and excursion of the pubo-rectal angle, using perineal ultrasound, after normal vaginal delivery and water delivery.

Materials And Methods: A total of 52 primiparous women were enrolled: 25 who had delivery in water (W Group), 27 who had delivery without using water (NW Group). Every woman underwent perineal ultrasound assessment at 6 months after having given birth.

Transfascial vaginal tape (TFT): a simple, safe and cost-effective procedure for stress urinary incontinence. A preliminary study.

Objective: To analyse prospectively the effectiveness of a new simple, minimally invasive, and cost-effective technique for the treatment of female urinary stress incontinence: the transfascial vaginal tape (TFT).

Materials And Methods: In a prospective study, we enrolled 45 women undergoing TFT with or without hysterectomy and/or another pelvic reconstructive procedure between 1st December 2003 and 31st December. TFT consists of a tension-free urethrosuspension using a sling located at the mid-urethral level and placed laterally in the endopelvic fascia previously perforated.

The efficacy of 2002 CDC guidelines in preventing perinatal group B Streptococcal vertical transmission: a prospective study.

Objectives: The aim of the current study is to evaluate the differences in the rate of perinatal group B streptococcal vertical transmission between women who correctly underwent the CDC 2002 guidelines and women who did not.

Methods: Two study groups: women who correctly underwent the CDC 2002 guidelines (study group 1) and women who did not (study group 2). Intrapartum chemoprophylaxis (IC) was administered to all pregnant women identified as GBS carrier.

A randomized comparison of suturing techniques for episiotomy and laceration repair after spontaneous vaginal birth.

Study Objective: To compare the continuous knotless technique of perineal repair with the interrupted method after spontaneous vaginal birth

Design: A randomized controlled trial.

Design Classification: Canadian Task Force Classification I.

Setting: This study was undertaken in a university hospital with more than 2200 deliveries per year.

Transfascial vaginal tape for surgical treatment of stress urinary incontinence.

Introduction: In the past decade, two minimally invasive, mid-urethral sling procedures have been developed to correct stress urinary incontinence: the tension-free vaginal tape and the transobturator tape. Using similar surgical principles, we describe the placement of a sling located at the mid-urethral level and placed laterally in the previously perforated endopelvic fascia. This technique was termed transfascial vaginal tape.

Effect of presurgical local infiltration of levobupivacaine in the surgical field on postsurgical wound pain in laparoscopic gynecological surgery.

Background: To maintain a high standard of patient care, it is essential to provide adequate pain management in patients who undergo laparoscopic surgery.

Methods: We randomly enrolled 74 women who underwent laparoscopic surgery for gynecological benign diseases. Patients in the levobupivacaine group (n=37) were injected with 7 ml of 5 mg/ml levobupivacaine at all incisional areas patients in the control group (n=37) were injected with an equal volume of physiologic saline solution.

Tension-free obturator tape (Monarc Subfascial Hammock) in patients with or without associated procedures.

The aim of the present study was to evaluate the safety and efficacy of the tension-free obturator tape (TOT) procedure in patients having concomitant hysterectomy and/or pelvic reconstructive surgery. A chart review from August 2002 to December 2004 identified 341 consecutive female patients with stress urinary incontinence who had undergone a TOT procedure alone (Monarc only group) or a TOT procedure associated with hysterectomy or other pelvic reconstructive surgery (Monarc + other surgery group). Intraoperatively, three cases of hemorrhage occurred.

A prospective, randomized trial comparing immediate versus delayed catheter removal following hysterectomy.

Background: A prospective, randomized study was used to assess whether the immediate removal of an in-dwelling catheter after hysterectomy affects the rate of recatheterization, symptomatic urinary tract infections, time of ambulation, and hospital stay.

Methods: We randomly assigned 96 women who underwent hysterectomy [44 vaginal hysterectomy (VH), 37 abdominal hysterectomy, and 15 laparoscopic assisted VH) to three groups. The in-dwelling catheter was removed immediately (group A), at 6 hr (group B), or at 12 hr (group C) after the operation.

Topical diclofenac patch for postoperative wound pain in laparoscopic gynecologic surgery: a randomized study.

Study Objective: To compare pain management of standard analgesic and standard analgesic plus diclofenac transdermal patch in patients who undergo laparoscopic gynecologic surgery.

Design: Randomized prospective study (Canadian Task Force classification I).

Setting: University hospital.

Randomized study of laparoscopic versus minilaparotomic myomectomy for uterine myomas.

Study Objective: To compare the postoperative recovery of patients undergoing laparoscopic and minilaparotomic myomectomy.

Design: Randomized study (Canadian Task Force classification I).

Setting: University hospital.

Vaginal ultrasonographic and hysterosonographic evaluation of the low transverse incision after caesarean section: correlation with gynaecological symptoms.

Aim: We investigated whether there is a correlation between morphological changes of the lower uterine segment after caesarean section (CS), visualized by means of either a transvaginal sonography (TVS) or a sonohysterography (SHG), and the frequency of abnormal uterine bleedings reported by the women.

Methods: By means of a random selection of our population, anamnesis, medical records, and TVS and SHG images of the lower uterine segment were collected in 217 women (116 with previous CS and 101 with previous vaginal birth), and an observational case-control study was performed.

Results: The uterine incision was identified in almost all women after CS (102/116) using TVS.

Transvaginal sonohysterographic evaluation of uterine malformations.

Objective: The aim of this study was to assess the diagnostic value and the usefulness of sonohysterography (SHG) in the detection of uterine anomalies, compared with other diagnostic methods.

Study Design: From January 2002 to December 2003, we collected 54 patients with a history of primary or secondary infertility or repeated spontaneous abortion and with a clinically or sonographically suspected abnormal uterus. All patients had previously undergone hysterosalpingography (ISG).

Perineal ultrasound evaluation of the urethrovesical junction angle and urethral mobility in nulliparous women and women following vaginal delivery.

The objective of this study was to demonstrate the differences in the urethrovesical junction angle and urethral mobility by means of perineal ultrasounds in women following vaginal delivery with respect to nulliparous women. We have enrolled 34 women, 12 nulliparous (Group A) and 22 women in the post-partum period (Group B). The ultrasounds were employed to measure the urethrovesical junction angle ("urethro-pelvic" angle) and the urethral mobility.

The value of sonohysterography in detecting intracavitary benign abnormalities.

The aim of this retrospective study was to assess the diagnostic value and the usefulness of sonohysterography in the detection of uterine intracavitary benign abnormalities, compared with other diagnostic methods (transvaginal ultrasonography and diagnostic hysteroscopy). From January 2003 to December 2003, a total of 73 patients (47 premenopausal (middle age 38.9) and 26 postmenopausal women (middle age 60.

Vaginal versus transabdominal hysterectomy: is mode of hysterectomy to influence pelvic statics or is pelvic statics to influence mode of hysterectomy?

Background: To check the hypothesis that the mobility of the urethrovesical junction in the preoperative phase is different in women that will undergo either vaginal, abdominal, or laparoscopic-assisted vaginal hysterectomy.

Methods: Eighty-seven consecutive hysterectomies, carried out between January 1999 and December 2001 in our Department, were retrospectively considered. The type of surgical procedure as well as the approach was decided by the surgeon, according to personal experience.