Pelvic floor function after third and fourth degree perineal lacerations: a case-control study on quality of life.

Background: The primary aim of this study was to compare the quality of life between women with obstetric anal sphincter injury (OASI) and women with intact perineum or minor vaginal tears following their first vaginal birth through a validated urogynaecological questionnaire. As a secondary aim, we wanted to identify the specific symptoms for pelvic floor dysfunction after a vaginal birth.

Methods: One hundred thirty-three cases (III- and IV-degree vaginal tears) and 133 controls (intact perineum or I- and II-degree vaginal tear) were asked to fill the PFDI-20 condition-specific and quality of life survey at three and 12 months after vaginal delivery.

Placental Chorangiocarcinoma a Specific Histological Pattern of Uncertain Incidence and Clinical Impact: Systematic Review of the Literature.

Chorangiocarcinoma is a very rare and misdiagnosed placental neoplasm. The unique morphologic features of the lesion distinguish it from other trophoblastic tumors and vascular abnormalities. We present a systematic review of the literature to provide clarity on chorangiocarcinoma entity and biology.

Characteristics of Submucous Myomas and the Risk of Anemia.

Background and Objectives: Uterine fibroids still represent the most common indication for hysterectomy for benign pathologies. In the United States, more than 479,000 hysterectomies are performed annually, 46.6% for myomas and 47.

Laparoscopic monolateral suspension for vaginal vault prolapse: a report of an exit surgical strategy during sacralcolpopexy.

Background: Vaginal vault prolapse is the most frequent long-term complication in patients undergoing hysterectomy and sacralcolpopexy is considered the gold standard. We report our surgical strategy maintaining single-arm mesh when the sacral promontory is not accessible to fix the mesh for an unknown sacral osteophytosis during a laparoscopic sacralcolpopexy. This is significant because, to our knowledge, the bone variant as a procedure limiting factor has never been described before.

Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study.

Background: Recurrence is a frequent complaint of patients with vulvovaginal candidiasis (VVC). Although the pathogenesis of VVC remains a controversial issue, disruption of the balance between the vaginal microbiota may facilitate overgrowth by Candida. Some probiotic bacterial strains can suppress Candida albicans; Lactobacillus plantarum P17630 is able to attach to vaginal epithelial cells and significantly reduce the adhesion of C.

An unusual long-term complication of transobturator polypropylene mesh.

Serious complications associated with surgical mesh for transvaginal repair of POP, as infections, vaginal mesh exposure, painful mesh shrinkage and dyspareunia, are not rare. A 48-year-old woman underwent the Perigee procedure because of a stage 3 anterior wall prolapse. Eleven months after surgery, the patient became suddenly unable to walk because of a strong pain to the left thigh root after running.

The clinical interpretation and significance of electronic fetal heart rate patterns 2 h before delivery: an institutional observational study.

Purpose: To evaluate the clinical significance of intrapartum fetal heart rate (FHR) monitoring in low-risk pregnancies according to guidelines and specific patterns.

Methods: An obstetrician, blinded to neonatal outcome, retrospectively reviewed 198 low-risk cases that underwent continuous electronic fetal monitoring (EFM) during the last 2 h before delivery. The tracings were interpreted as normal, suspicious or pathological, according to specific guidelines of EFM and by grouping the different FHR patterns considering baseline, variability, presence of decelerations and bradycardia.

The effects of uterine fundal pressure (Kristeller maneuver) on pelvic floor function after vaginal delivery.

Purpose: To evaluate the role of uterine fundal pressure during the second stage of labor (Kristeller maneuver) on pelvic floor dysfunction (urinary and anal incontinence, genital prolapse, pelvic floor strength).

Methods: 522 primiparous women, enrolled 3 months after vaginal delivery, were divided in two groups: group A (297 women) identifies the women who received Kristeller maneuvers with different indications (e.g.

[Herth Hope Index--instrument adapted and validated to Portuguese].

This study was aimed at making available the Herth Hope Index adapted and validated into Portuguese in a study carried out with chronic disease patients. The scale is based on the original American instrument, and made possible the existence of an instrument to measure hope, something that did not exist previously in Brazil. For the cultural adaptation and validation were followed the methods that the literature recommends.

Balloon catheter vs. cervical vacuum cup for hysterosalpingography: a prospective, randomized, single-blinded study.

Objective: To compare the use of a balloon catheter device with the use of a cervical vacuum cup device in performing hysterosalpingography (HSG).

Design: Prospective, randomized, single-blinded study.

Setting: Tertiary infertility center.

A new multiparameter flow cytometric method for human semen analysis.

Background: The objectives of this study were (i) to evaluate whether the combined use of Syto 16 and 7-amino-actinomycin-D (7-AAD) allows the detection of sperm apoptosis and (ii) to describe a new multiparameter flow cytometric method to assess simultaneously sperm concentration (SC), viability and apoptosis as well as leukocyte concentration.

Methods: Semen samples from 68 patients were evaluated according to World Health Organization (WHO) criteria (normal, n=26; abnormal, n=42). The detection of activated caspases before and after betulinic acid (BA) incubation was carried out in 13 semen samples by flow cytometry using fluorescein-labelled inhibitors of caspases (FLICA).

Bacterial vaginosis and preterm delivery: an open question.

Objective: To evaluate the prevalence of bacterial vaginosis in a population of Italian pregnant women and to study its association with adverse pregnancy outcomes, particularly preterm delivery.

Study Design: After giving informed consent, 598 women were consecutively enrolled at their first prenatal visit (13-18 weeks of gestation). The presence of bacterial vaginosis was assessed by Gram's method at 13-18 weeks of gestation (early bacterial vaginosis) and at 28-32 weeks of gestation (late bacterial vaginosis).

First-trimester intrauterine hematoma and outcome of pregnancy.

Objective: To evaluate the outcome of pregnancies complicated by first-trimester intrauterine hematoma.

Methods: An analysis was performed on 248 cases. The pregnancy outcome was correlated with hematoma volume, gestational age (weeks), and maternal age (years).

The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery.

Objective: To evaluate the effect of mediolateral episiotomy on puerperal pelvic floor strength and dysfunction (urinary and anal incontinence, genital prolapse).

Methods: Five hundred nineteen primiparous women were enrolled 3 months after vaginal delivery. Puerperae were divided in 2 groups: group A (254 women) comprised the women who received mediolateral episiotomy and group B (265 women) the women with intact perineum and first- and second-degree spontaneous perineal lacerations.

Impact of highly purified urinary FSH and recombinant FSH on haemostasis: an open-label, randomized, controlled trial.

Background: It has recently been suggested that recombinant FSH administration may result in an increased risk of venous thrombosis. An open-label, randomized, controlled trial was carried out to compare the impact of urinary and recombinant FSH on haemostasis.

Methods: Fifty infertile women were randomized, using a random number generator on a personal computer, to receive either highly purified urinary FSH (u-hFSH) or recombinant human FSH (r-hFSH); a starting dose of 150 IU.

The treatment of Sjögren's syndrome with tibolone: a case report.

We report the successful treatment with tibolone of a postmenopausal woman affected by primary Sjögren's syndrome. One year after the beginning of treatment, the woman does not need artificial tears and vaginal lubricants. This is the first report of an effective pharmacologic treatment for primary Sjögren's syndrome in humans.

Assessment of pelvic floor muscle function after vaginal delivery. Clinical value of different tests.

Objective: To evaluate the efficacy of different tests in identifying pelvic floor dysfunction after vaginal delivery.

Study Design: One hundred ninety-seven primiparae were investigated 2 months after vaginal delivery. They underwent pelvic floor muscle assessment by digital test, vaginal manometry and uroflowmetric stop test.

Prevalence of urinary incontinence in young and middle-aged women in an Italian urban area.

Objective: To investigate by questionnaire the prevalence and characteristics of urinary incontinence (UI) in a female population aged between 18 and 49.

Study Design: Of 44,095 females aged 18-49.9 living in our urban area a sample of 10,000 subjects was sent a questionnaire and 3557 replied.

Effects of epidural analgesia during labor on pelvic floor function after vaginal delivery.

Background: Aims of this study were to determine the rate of symptoms related to perineal trauma (anal and stress urinary incontinence) and to assess pelvic floor muscle function in women who underwent epidural analgesia.

Methods: Comparative design comprising 70 matched pairs of primiparous mothers. Each woman was questioned about urogynecologic symptoms and examined by digital test, vaginal perineometry and uroflowmetric stop test score 3 months after vaginal delivery.

Visual function in menopause: the role of hormone replacement therapy.

Objective: To assess the effects of hormone replacement therapy (HRT) on visual function after menopause.

Design: This study was conducted on 80 postmenopausal women aged 52 to 70 years. Women were randomly divided into two groups: 40 women were treated by oral HRT (equine conjugated estrogens 0.

[Postpartum perineal assessment].

Background: To evaluate the incidence of urogenital and anorectal dysfunctions during puerperium, verify the correlation between obstetric perineal damage observed during labour and puerperal symptoms, test the efficacy of tests to evaluate perineal function in pelvic floor dysfunctions consequent to vaginal birth.

Methods: A total of 693 consecutive puerperae were recruited two months after birth. All completed a clinical and anamnestic questionnaire and underwent clinical urogynecological examination, digital test, vaginal manometry and uroflowmetric evaluation of the voluntary capacity to interrupt micturition.

The urine stream interruption test and pelvic muscle function in the puerperium.

Objectives: This study assesses the role of the uroflowmetric urine stream interruption test (UST) in the evaluation of postpartum pelvic floor muscle function.

Method: Two months after vaginal delivery, 492 women who underwent a digital test, vaginal manometry, and a UST were divided into two groups: continent and incontinent. Variables were subjected to the Student's t-test and to Fisher's exact test to verify the difference between the two groups.

Perineal evaluation in the puerperium. Role of testing with a cotton-tipped swab.

Objective: To verify the applicability and significance of testing with a cotton-tipped swab in postpartum evaluation.

Study Design: One hundred seventy-eight puerperas were examined two months after vaginal delivery and underwent testing with a cotton-tipped swab, digital test, vaginal manometry and uroflowmetric urine stream interruption test. Statistical analysis was performed using Student's t test to evaluate the difference between mean values of continent and incontinent puerperas and the Bravais-Pearson coefficient to test the correlation between all the tests used in the study.