Deeply infiltrating endometriosis: evaluation of retro-cervical space on MRI after vaginal opacification.

Objectives: To prospectively investigate diagnostic value and tolerability of MRI after intra-vaginal gel opacification for diagnosis and preoperative assessment of deeply infiltrating endometriosis.

Methods: Sixty-three women with clinical suspicion of deeply infiltrating endometriosis were previously examined with trans-vaginal ultrasonography and then with MRI pre and post administration of vaginal gel. We evaluated the tolerability of this procedure with a scoring scale from 0 to 3.

Recurrence rate of endometrioma after laparoscopic cystectomy: a comparative randomized trial between post-operative hormonal suppression treatment or dietary therapy vs. placebo.

Objective(s): To assess the recurrence rate of endometrioma after laparoscopic cystectomy plus hormonal suppression treatment or plus dietary therapy compared to post-operative placebo.

Study Design: A randomized comparative trial was conducted on 259 consecutive women who underwent laparoscopic unilateral/bilateral cystectomy for endometrioma. Seven days after surgery, the patients were randomly allocated on the basis of a computer-generated randomization sequence, to one of four post-operative management arms as follows: placebo (n=65) or gonadotrophin-releasing hormone analogue (tryptorelin or leuprorelin, 3.

Laparoscopic myomectomy for very large myomas using an isobaric (gasless) technique.

Objectives: Laparoscopic myomectomy using pneumoperitoneum for large myomas (> or = 8 cm) is hindered by several factors, such as the increased operative time, the risk of perioperative bleeding, and the risk of conversion to laparotomy. With the introduction of isobaric laparoscopy using abdominal wall lifting, this procedure can be performed using conventional surgical instruments introduced through small abdominal incisions. The aim of this study was to evaluate the feasibility, reproducibility, and safety of isobaric laparoscopic myomectomy for very large myomas > or = 10 cm using a subcutaneous abdominal wall-lifting device.

Isobaric (gasless) laparoscopic myomectomy during pregnancy.

We report on the first case of an isobaric (gasless) laparoscopic myomectomy during the second trimester of pregnancy. Our patient had acute abdominal pain that did not respond to medical management. The procedure was performed under spinal anesthesia with conscious sedation.

Office hysteroscopy: comparison of 2.7- and 4-mm hysteroscopes for acceptability, feasibility and diagnostic accuracy.

Objective: To compare 2.7- and 4-mm rigid optics, with 3- and 5-mm outer sheaths, respectively, in office diagnostic hysteroscopy by evaluating pain, patient tolerability, optical view and diagnostic accuracy of the procedure.

Study Design: Three hundred seventy-one consecutive patients undergoing hysteroscopy were included in a prospective, randomized clinical trial, and the outcomes were analyzed.

Gasless laparoscopic myomectomy. Indications, surgical technique and advantages of a new procedure for removing uterine leiomyomas.

Objective: To evaluate the feasibility, safety and reliability of gasless laparoscopic myomectomy (GLM) using a new subcutaneous lifting system (Laparotenser, Lucini L&T, Milan, Italy) for removing subserosal and intramural leiomyomas.

Study Design: A total of 279 women with at least 1 symptomatic subserosal or intramural myoma measuring > 30 mm underwent GLM between April 1997 and July 2001. All procedures were performed by the same surgeons using the same technique.

Transvaginal hydrolaparoscopic ovarian drilling using bipolar electrosurgery to treat anovulatory women with polycystic ovary syndrome.

Study Objective: To verify the value, feasibility, and reliability of transvaginal hydrolaparoscopic ovarian drilling using the bipolar VersaPoint system to treat clomiphene-resistant, anovulatory women with polycystic ovary syndrome.

Design: Prospective clinical study (Canadian Task Force classification II-2).

Setting: University teaching hospital.

Transvaginal hydrolaparoscopy vs. conventional laparoscopy for evaluating unexplained primary infertility in women.

Objective: To verify the usefulness and reliability of transvaginal hydrolaparoscopy (THL) as a screening tool for evaluating infertility in women in comparison with conventional diagnostic laparoscopy.

Study Design: Sixty consecutive women with unexplained primary infertility were prospectively enrolled into the study. After examination of the whole pelvic cavity, tubal patency was evaluated and the uterine cavity studied by hysteroscopy.