[How does peritoneal fluid flow influence anatomical distribution of endometriotic lesions?].

Endometriosis is a common disease in gynecology. Many theories were proposed to explain the endometriosis pathogenesis. The distribution of the endometriosis lesions seems to be interesting in order to understand the endometriosis pathogenesis.

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.

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.

Low dose recombinant FSH treatment may reduce multiple gestations caused by controlled ovarian hyperstimulation and intrauterine insemination.

Objective: To evaluate the rate of multiple pregnancies in intrauterine insemination cycles stimulated with a minimal dose of recombinant follicle stimulating hormone (rec-FSH).

Design: Retrospective study.

Setting: University Medical Center.

Accuracy of rectal endoscopic ultrasonography and magnetic resonance imaging in the diagnosis of rectal involvement for patients presenting with deeply infiltrating endometriosis.

Objective: To compare the accuracy of rectal endoscopic ultrasonography (REU) and magnetic resonance imaging (MRI) for predicting rectal wall involvement in patients presenting histologically proven deeply infiltrating endometriosis (DIE).

Methods: This was a retrospective study of a continuous series of 81 patients presenting histologically proven DIE who underwent preoperative investigations using both REU and MRI. The sonographer and the radiologist, who were unaware of the clinical findings and patient history, but knew that DIE was suspected, were asked whether there was involvement of the digestive wall.

Complications during set-up procedures for laparoscopy in gynecology: open laparoscopy does not reduce the risk of major complications.

Objective: To compare the risk of major complications during the set-up procedures for laparoscopy according to whether the classic technique (creation of the pneumoperitoneum followed by introduction of the optics trocar) or open laparoscopy is used.

Methods: Comparison was made of two retrospective series each carried out in a department promoting one of the two techniques. The setting was a university-affiliated hospital.

[The endoscopic operating room OR 1].

During the last few years, the development of surgical laparoscopy has been the major turning point, and the most important progress in the field of surgery. The specific installation requirements of surgical laparoscopy, as well as the technological progress proper to this surgical technique, justify the need of a new organization of the operating theatre. The new operating room OR 1 is especially designed to fit and satisfy the requirements of a modern operating theatre, where surgical laparoscopy plays a major role.

[Deep pelvic endometriosis: management and proposal for a "surgical classification"].

Deep pelvic endometriosis presents essentially in the form of a painful syndrome dominated by deep dyspareunia and painful functional symptoms that recur according to the menstrual cycle, with the semiology directly correlated with the location of the lesions (bladder, rectum). It is essential to investigate these deep endometriosis lesions and draw up a precise map, which is the only way to be sure that exeresis will be complete. The treatment of first intention remains surgery, and medical treatment is only palliative in the majority of cases.

Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease.

Background: Little is known about the precise nature of the relationship between dysmenorrhoea (DM) and endometriosis. Our aim was to evaluate the relationship between the severity of DM in women with posterior deep infiltrating endometriosis (DIE) and indicators of the extent of their disease.

Methods: Various indicators of the extent of DIE were recorded during surgery in 209 women.

Management of ovarian endometriomas.

The efficiency of medical therapy as a unique treatment for endometrioma has not been demonstrated. Operative laparoscopic management is the 'gold standard' for surgical treatment, and there are no indications to prescribe medical treatment before cystectomy. Post-operative administration of low-dose cyclic oral contraceptives does not significantly affect the long-term recurrence of endometriosis after surgical treatment.

Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol is not detrimental to IVF outcome.

Background: High, normal and poor responders are usually defined by reference to subjectively selected estradiol E2 levels at days 4-6 and the day of hCG administration (d-hCG). The purpose of this study was to use E2 percentile curves from day 5 until d-hCG to determine high, normal and poor responders, and to predict IVF outcome.

Methods: In this retrospective study, 762 patients underwent 905 cycles with a GnRH agonist/recombinant FSH short protocol.

Histologic appearance of endometriosis infiltrating uterosacral ligaments in women with painful symptoms.

Study Objective: To describe the histologic appearance of deep endometriosis infiltrating the uterosacral ligaments (USL).

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

Setting: University-affiliated hospital.

Anatomopathological lesions of bladder endometriosis are heterogeneous.

Objective: To present the anatomopathological characteristics of deep bladder endometriosis.

Design: Descriptive anatomapathological study.

Setting: A university hospital department of gynecological surgery.

Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis.

Objective: To investigate whether specific types of pelvic pain are correlated with the anatomic locations of deeply infiltrating endometriosis (DIE).

Design: Retrospective data analysis.

Setting: University tertiary referral center.

Acceptability of the levonorgestrel-releasing intrauterine system after discontinuation of previous contraception: results of a French clinical study in women aged 35 to 45 years.

This open, noncomparative study evaluated the rate of premature removals of the levonorgestrel-releasing intrauterine system (LNG-IUS) Mirena because of adverse events. To take part in the study, women had to be aged between 35 years and 45 years, and had to change their contraception for poor compliance, poor tolerance, or unfavorable change in the benefit/risk ratio of their previous contraception (oral contraceptives or copper- or progestin-releasing intrauterine device). One removal of Mirena for a wish for pregnancy was excluded from analyses, so that there were 23 removals among 203 women included.

Magnetic resonance imaging and endometriosis: deeply infiltrating endometriosis does not originate from the rectovaginal septum.

The goal of this study was to describe the magnetic resonance (MR) imaging signs of deeply infiltrating endometriosis (DIE) lesions and above all to find out if MR imaging can pinpoint the location of these lesions. We made a retrospective study of 8 patients presenting with histologically proven DIE lesions. The MR imaging results were compared with intraoperative findings.

Routine clinical examination is not sufficient for diagnosing and locating deeply infiltrating endometriosis.

Study Objective: To determine whether routine clinical examination is sufficient for the diagnosis and establishing the location of deeply infiltrating endometriosis (DIE).

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

Setting: University-affiliated hospital.

[Management of endometriosis ovarian cysts].

The efficacy of medical treatment as unique treatment for endometrioma is not demonstrated. Operative laparoscopic management is the gold standard for surgical treatment. There is no indication to prescribe preoperatively medical treatment before cystectomy.

[Laparoscopic treatment of genital prolapse: lateral utero-vaginal suspension with 2 meshes. Results of a series of 47 patients].

We report our experience with a new technique to treat genital prolapse: the laparoscopic lateral suspension with two meshes. This is a prospective longitudinal study of 47 women with genital prolapse. With a mean follow-up of 15.

[Acceptability and value of autoinjection of gonadotropins for ovarian stimulation in intrauterine insemination].

Objectives: To evaluate the acceptability, the personal and economic benefit of subcutaneous self-injections of recombinant FSH within mono-ovulating stimulation for Intra Uterine Insemination (IUI).

Patients And Methods: Women aged < 42 years' old, enrolled for a series of three IIU associated with ovarian stimulation with FSH. All had an infertility > 2 years, at least one patent fallopian tube, and normal FSH and estradiol levels at day three of the cycle.

[Complications of laparoscopy in gynecology].

In the field of surgery the development of operative laparoscopy has been one of the most important steps forward over the past fifteen years. This technique has become the surgical treatment of choice for a number of indications in gynaecology. The advantages of laparoscopy as compared with laparotomy are weil known, and assessment of the risk of complications is essential.

Recurrence of leiomyomata after laparoscopic myomectomy.

Study Objective: To assess recurrence of leiomyomata after laparoscopic myomectomy (LM) and evaluate predictive factors of recurrence.

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

Setting: University hospital.

Management of deep endometriosis.

Deep endometriosis is defined as an endometriotic lesion that penetrates the retroperitoneal space for a distance of > or =5 mm. Deep endometriosis is extremely active, occurs in phase with eutopic endometrium, evolves progressively with age, and is most often located in the pouch of Douglas, the rectovaginal septum, the uterosacral ligaments, and occasionally in the uterovesical fold. These lesions are associated with pelvic pain, the intensity of which is proportional to the depth of penetration.

Laparoscopic myomectomy fertility results.

The appearance of uterine myomas has been linked to infertility. It has been suggested that surgical management of myomas by laparoscopic myomectomy improves fertility rates in these group of patients. In this paper we initially describe specific aspects of the surgical technique of laparoscopic myomectomy including the set-up, precise technique for hysteroromy, enucleation of the myoma, suturing of the uterus, and extraction of the myoma.

Adhesion formation after laparoscopic resection of uterosacral ligaments in women with endometriosis.

Study Objective: To analyze the risk of postoperative adhesions in women who undergo laparoscopic surgical management of deep endometriosis infiltrating the uterosacral ligaments (USL).

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

Setting: University-affiliated hospital.