Assessing the risk of laparoscopic morcellation of occult uterine sarcomas during hysterectomy and myomectomy: Literature review and the ISGE recommendations.

Objective: This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation.

Study Design: The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment. A literature search within the Medline/PubMed and Cochrane Database was carried out using keywords "morcellation", "uterine fibroids", "uterine sarcoma", "myomectomy" and "hysterectomy".

Resectoscopic myomectomy.

Hysteroscopic myomectomy currently is the "gold standard" procedure for treating submucous myoma and represents an effective and safe solution to abnormal uterine bleeding and infertility myoma-related. Several studied have shown that, in the case of submucous myomas, resectoscopic myomectomy has several advantages compared with the traditional surgical treatment of myomectomy by laparotomy, in terms of reduced myometrial trauma, shorter hospitalization times and decreased risk of postoperative adhesion formation. The aim of this paper was to describe the alternative techniques, currently available, of resectoscopic myomectomy.

Life-threatening urinary retention after haemorrhoidectomy and internal sphincterotomy.

Postoperative urinary retention (UR) is a common complication following haemorrhoidectomy. This report presents a female patient who developed long-lasting UR after haemorrhoidectomy and internal sphincterotomy, which progressed to renal failure. The precipitating cause was represented by a non-healing anal ulcer and excruciating anal pain at evacuation.

Sources of clinical referrals to an urban coloproctology unit in Italy.

Prompt and appropriate referrals to colorectal surgeons result in better clinical and more cost-effective outcome: the question that then arises is how patients with large bowel diseases get in contact with the specialist. The aim of the present research was to investigate the sources of clinical referrals of 1000 patients attending a dedicated coloproctology unit. One thousand consecutive new patients attending the private Coloproctology Unit of Rome were prospectively evaluated from May 1995 through December 1999.

Anal continence after rectocele repair.

Introduction: Rectocele may be associated with both chronic constipation and anal incontinence. Several different surgical procedures have been advocated for rectocele repair. The aim of the present study was to evaluate anorectal function and clinical outcome in a consecutive series of patients who underwent selected endorectal or transperineal surgery for rectocele for whom operative treatment was determined by clinical and proctographic features.

Mucosal changes in ileal pouches after restorative proctocolectomy for ulcerative and Crohn's colitis.

Purpose: Inflammation and dysplasia may affect the ileal pouch after restorative proctocolectomy and ileal pouch-anal anastomosis. The aim of this prospective study was to evaluate the morphologic changes and the risk of dysplasia within the pouch after ileal pouch-anal anastomosis.

Methods: Thirty-seven patients with ileal pouch-anal anastomosis underwent endoscopies and biopsies of the pouch: 21 patients were affected by ulcerative colitis and 16 by Crohn's colitis.

Psychologic aspects in proctalgia.

Purpose: One of the main problems in coloproctology is chronic idiopathic anal pain. The aim of this study was to investigate the psychosomatic components of proctalgia to identify which, if any, component is associated with this pain and to what extent.

Methods: Twenty patients with proctalgia were observed (mean age, 46 years).