Surgical treatment: Myomectomy and hysterectomy; Endoscopy: A major advancement.

Uterine fibroids affect 25% of women worldwide. Symptomatic women can be treated by either medical or surgical treatment. Development of endoscopic surgery has widely changed the management of myoma.

Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis.

Background: The objective of this study was to evaluate the significance of severe preoperative pain for patients presenting with ovarian endometrioma (OMA).

Methods: Three hundred consecutive patients with histologically proven OMA were enrolled at a single university tertiary referral centre between January 2004 and May 2010. Complete surgical excision of all recognizable endometriotic lesions was performed for each patient.

Total laparoscopic hysterectomy for benign uterine pathologies: obesity does not increase the risk of complications.

Background: This study was designed to investigate the intra-operative characteristics and the risk of intra- and post-operative complications in cases of total laparoscopic hysterectomy (TLH) in overweight, obese and non-obese patients.

Methods: This cohort study includes all patients undergoing TLH for benign pathologies between January 1993 and June 2007 in Cochin university hospital (Paris). Demographic and surgical data were analysed.

Incidence and risk factors of bladder injuries during laparoscopic hysterectomy indicated for benign uterine pathologies: a 14.5 years experience in a continuous series of 1501 procedures.

Background: Laparoscopic hysterectomy is indicated as an alternative to laparotomy when the vaginal route is potentially difficult because of an immobile uterus and a poor vaginal accessibility. The aim of this study was to evaluate the rate, the risk factors for bladder injuries in a series of 1501 laparoscopic hysterectomies indicated for benign uterine pathologies.

Methods: This study was conducted retrospectively from January 1993 to 2000 and prospectively from 2001 to July 2007.

Surgical management of cervical intraepithelial neoplasia in HIV-infected women.

Objective: Rates higher than 50% of positive margin after surgical treatment of cervical intraepithelial neoplasia (CIN) have been reported in HIV-infected women. We evaluated the efficacy of two excisional procedures, loop excision of the transformation zone (LLETZ) and electrosurgical conisation, in obtaining complete excision of CIN in HIV-infected patients.

Study Design: Eighty HIV-infected women with CIN or suspicion of cervical cancer underwent 86 surgical excisions.

Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis.

Objective: To investigate whether an associated ovarian endometrioma is a marker for severity of deep infiltrating endometriosis (DIE).

Design: Observational study between June 1992 and December 2005.

Setting: University tertiary referral center.

Ureteral complications from laparoscopic hysterectomy indicated for benign uterine pathologies: a 13-year experience in a continuous series of 1300 patients.

Background: The aim of this study was to evaluate the risk of ureteral injuries and to discuss how to avoid their occurence after laparoscopic hysterectomy indicated for benign uterine pathologies.

Methods: This observational study covers the period from January 1993 to December 2005 (retrospective study from 1993 to 2000 and prospective from 2001). We reviewed incidence, methods of diagnosis and management of ureteral injuries.

Relation between severity of dysmenorrhea and endometrioma.

Background: To evaluate the relationship between the severity of dysmenorrhea and endometrioma.

Methods: Descriptive study with prospective design. Two hundred and thirty-nine women with histologically proved endometriomas.

Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution.

Background: To investigate whether knowledge of the anatomical distribution of histologically proven deeply infiltrating endometriosis (DIE) lesions contributes to understanding the pathogenesis.

Methods: Observational study between June 1992 and December 2004 (retrospective study between 1992 and 2000; prospective study between 2001 and 2004). Continuous series of 426 patients suffering from pelvic pain who underwent complete surgical exeresis of DIE.

Mobile uterine retroversion is associated with dyspareunia and dysmenorrhea in an unselected population of women.

Objective: To determine if isolated retroversion is a cause of pelvic pain symptoms.

Study Design: One hundred and eleven premenopausal women consulting for routine examination in the gynecology department of two hospitals and two gynecologic private practices were evaluated for chronic pelvic pain symptoms with a self-administered questionnaire. Uterine position and mobility was assessed by pelvic examination.

Total laparoscopic hysterectomy: preoperative risk factors for conversion to laparotomy.

Study Objective: To identify the preoperative factors affecting the risk of conversion to laparotomy during total laparoscopic hysterectomy (TLH) indicated for benign conditions (surgery performed in cases of genital prolapse and/or urinary stress incontinence was excluded).

Design: Retrospective comparative study (Canadian Task Force classification II-2).

Setting: University tertiary referral center for gynecologic endoscopic surgery.

High rate of recurrence of cervical intraepithelial neoplasia after surgery in HIV-positive women.

Objective: Our study investigated the rate of recurrence of cervical intraepithelial neoplasia (CIN) in HIV-positive women after surgery in the era of highly active antiretroviral therapy (HAART).

Methods: One hundred twenty-one HIV-positive women were followed-up with cytology, colposcopy, and histology after surgery for CIN. We conducted univariate and multivariate analyses to determine the relation between recurrence of CIN and risk factors using Cox proportional hazard models with left truncation.

Operative management of deeply infiltrating endometriosis: results on pelvic pain symptoms according to a surgical classification.

Study Objective: To assess the results of complete surgical excision for patients with painful functional symptoms in a context of histologically proven deeply infiltrating endometriosis (DIE).

Design: Retrospective analysis (Canadian Task Force classification II-2).

Setting: University-affiliated hospital.

Surgical management of deeply infiltrating endometriosis: an update.

Deeply infiltrating endometriosis (DIE) manifests itself mainly in the form of pain, predominantly deep dyspareunia, and painful functional symptoms that are aggravated monthly during menstruation, with the semiology being directly correlated with the location of the lesions (bladder, rectum). A workup to assess the extent of the disease is necessary to establish an accurate map of the DIE lesions, which is the essential condition to perform complete exeresis. The treatment of first intention is surgical, because medical treatments are only palliative in the majority of cases.