Facts Views and Vision in ObGyn最新文献

{"title":"The role of pre-operative gonadotrophin-releasing hormone agonists (GnRHa) on pain, bowel and bladder symptoms in rectovaginal/colorectal endometriosis surgery: a multicenter cohort study.","authors":"Munazzah Rafique, Christian Becker, Jonathan Lewin, Arvind Vashisht, Ertan Sarıdoğan, Martin Hirsch","doi":"10.52054/FVVO.2025.39","DOIUrl":"10.52054/FVVO.2025.39","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of medical and surgical treatment of endometriosis-associated pain is a source of ongoing controversy. There is a lack of evidence about gonadotropin-releasing hormone agonists (GnRHa) use on long-term pain control, bladder and bowel symptoms for patients having surgery for deep rectovaginal/colorectal endometriosis.</p><p><strong>Objectives: </strong>To assess the effect of preoperative GnRHa (pre-GnRHa) use on pain, bowel and bladder symptoms for patients undergoing surgery for deep rectovaginal/colorectal endometriosis.</p><p><strong>Methods: </strong>The study evaluated data from the British Society for Gynaecological Endoscopy database, a large international multicentre prospective cohort of patients who underwent deep rectovaginal/colorectal endometriosis surgery between 2009-2021. We included 9433 patients from 101 accredited endometriosis centres. Multivariable logistic regression analysis was used to evaluate the association between pre-GnRHa use and postoperative pain, bowel and bladder symptoms at different time points, controlling for confounders like patient age, body mass index, smoking status, and hysterectomy.</p><p><strong>Main outcome measures: </strong>Rate of cyclical and non-cyclical pelvic and menstrual pain, bowel and bladder symptoms.</p><p><strong>Results: </strong>The mean age of the patients was 36 years (18-55). Pre-GnRHa use was associated with significant postoperative improvement in premenstrual pain [odds ratio (OR): 0.30, 95% confidence interval (CI): -0.57 - -0.034, <i>P</i>=0.02*], menstrual pain (OR: 0.41/10, 95% CI: -0.7 - -0.13, <i>P</i>=<0.001*), non-cyclical pain (OR: 0.27/10, 95% CI: -0.5 - -0.04, <i>P</i>=0.021*) and lower backache (OR: 0.30, 95% CI: -0.532 - -0.087, <i>P</i>=0.006*) up to 12 months postoperatively. Moreover, bladder pain was significantly reduced in the pre-GnRHa group at 12 months (OR: 0.24, 95% CI: -0.451 - -0.039, <i>P</i>=0.01*). Significant improvements were observed in bowel symptoms including frequent bowel movements (OR: 0.10, 95% CI: -0.194 - -0.012, P=0.02*), incomplete emptying sensation (OR: 0.10, 95% CI: -0.196 - -0.023, <i>P</i>=0.01*), cyclical dyschezia (OR: 0.43, 95% CI: -0.724 - -0.142, <i>P</i>=0.003*) and non-cyclical dyschezia (OR: 0.28, 95% CI: -0.504 - -0.075, <i>P</i>=0.008*) up to 12 months.</p><p><strong>Conclusions: </strong>Pre-GnRHa use is associated with a significant reduction in postoperative menstrual pain and non-menstrual pain as well as improved bowel and bladder symptoms lasting up to two years. It is also valuable to improve the quality of life for patients undergoing surgery for deep rectovaginal/colorectal endometriosis.</p><p><strong>What is new?: </strong>This is the largest prospective international study evaluating pre-GnRHa use in deep rectovaginal/colorectal endometriosis surgery. It provides evidence supporting the role of pre-GnRHa as an adjuvant to surgical treatment, to reduce postoperative pai","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"222-231"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The scientific gap.","authors":"Harald Krentel, Rudy Leon de Wilde, Maya Sophie de Wilde","doi":"10.52054/FVVO.2025.260925","DOIUrl":"10.52054/FVVO.2025.260925","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 3","pages":"216-217"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race and ethnicity reporting in endometriosis literature: a systematic review.","authors":"Antonio Raffone, Marisol Doglioli, Alberto Aguzzi, Ludovica Girardi, Lucia De Meis, Daniele Neola, Antonio Travaglino, Matteo Giorgi, Maria Giovanna Vastarella, Luigi Cobellis, Renato Seracchioli, Diego Raimondo","doi":"10.52054/FVVO.2025.153","DOIUrl":"10.52054/FVVO.2025.153","url":null,"abstract":"<p><strong>Background: </strong>Accurate reporting of participants' race and ethnicity is essential for assessing the representativeness of study populations and for identifying potential disparities in diagnosis, treatment, and outcomes.</p><p><strong>Objectives: </strong>To assess the quantity and quality of race and/or ethnicity reporting in the endometriosis literature.</p><p><strong>Methods: </strong>A systematic review of all human studies reporting data about endometriosis as the primary objective published in 2022. Studies were identified from electronic searches of MEDLINE, Google Scholar, Web of Science, Scopus, ClinicalTrials.gov, and the Cochrane Library databases.</p><p><strong>Main outcomes measures: </strong>The frequency and quality of participants' race and/or ethnicity reporting based on compliance with the guidelines set by the ICMJE. Study characteristics that influenced the reporting of race and/or ethnicity were assessed. Publications from journals that followed ICMJE recommendations were compared with those from journals that did not.</p><p><strong>Results: </strong>648/2054 (31.6%) articles met the inclusion criteria. Sixty-five studies (10.0%) reported participants' race and/or ethnicity, and the overall quality of this reporting was poor. The frequency of reporting did not differ between journals adhering to ICMJE guidelines and those that did not (24, 11% vs. 41, 9.5%; <i>P</i>=0.52), between studies involving national versus international populations (60, 92.3% vs. 5, 7.7%; <i>P</i>=0.28), or between male and female authors (33, 50.8% vs. 32, 49.2%; <i>P</i>=0.38) respectively. Race and/or ethnicity were reported more often in prospective than in retrospective studies (37, 56.9% vs. 18, 27.7%; <i>P</i><0.001), and in multicentre compared to single-centre studies (44, 67.7% vs. 21, 32.3%; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>The reporting of race and/or ethnicity in human-based endometriosis research remains both infrequent and inconsistent, including in journals claiming adherence to ICMJE standards. These results highlight the need for improved and uniform documentation of racial and ethnic data in endometriosis research.</p><p><strong>What is new?: </strong>Human-based articles focusing on endometriosis have a low frequency and quality of race and/or ethnicity reporting, even in journals claiming to follow ICMJE recommendations.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 3","pages":"263-270"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Pre-operative GnRH agonists in deep endometriosis: insights beyond the current evidence.","authors":"Munazzah Rafique, Ertan Sarıdoğan, Justin Clark, Martin Hirsch","doi":"10.52054/FVVO.2025.010925","DOIUrl":"10.52054/FVVO.2025.010925","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"300-301"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative laparoscopic technique for #ENZIAN C3 intestinal endometriotic nodule and concurrent uterine fibroids: NOSES.","authors":"Lucia Chaul, Ramiro Cabrera Carranco, Ana Gabriela Sierra Brozon, Eder Gabriel Rivera Rosas, Armando Menocal Tavernier, William Kondo, Alvaro Ovando, Jhanneth Chura Paco","doi":"10.52054/FVVO.2025.46","DOIUrl":"10.52054/FVVO.2025.46","url":null,"abstract":"<p><strong>Background: </strong>Deep infiltrating endometriosis (DIE) is a severe condition which requires innovative surgical approaches to address complex anatomical distortions, reduce operative risks, and enhance outcomes.</p><p><strong>Objectives: </strong>To demonstrate the effectiveness of integrating three advanced surgical techniques-reverse laparoscopic technique, natural orifice specimen extraction surgery (NOSES), and advanced intraoperative bleeding control strategies-in managing a complex case of DIE.</p><p><strong>Participant: </strong>A 29-year-old nulligravida patient presented with hypermenorrhea, dysmenorrhea, urinary symptoms, and bowel dysfunction. Magnetic resonance imaging revealed a 3.3 cm #ENZIAN C3 intestinal nodule, bilateral ovarian endometriomas and multiple uterine fibroids.</p><p><strong>Intervention: </strong>Advanced techniques reverse laparoscopic technique, associated with intraoperative bleeding control strategies such as vasopressin injection, temporary ligation of uterine arteries, and infundibulopelvic ligaments; combined with NOSES for specimen extraction. Patient included in this video gave consent for the publication of this video article and its online posting, including social media, journal's website, scientific literature websites, and other applicable sites. Operative time, estimated blood loss, preservation of anatomical structures, postoperative recovery time, symptom resolution, and complications were assessed. Surgery was completed in 180 minutes, with minimal blood loss (40 cc). The patient tolerated a general anti-inflammatory diet by postoperative day two and was discharged without complications. One month postoperatively, the patient showed significant symptom improvement.</p><p><strong>Conclusions: </strong>The combination of different techniques in the same surgery can clearly lead to favourable results and outcomes, ensuring optimal recovery with superior cosmetic and functional outcomes, particularly in fertility-preserving surgeries.</p><p><strong>What is new?: </strong>The combination of NOSES, the reverse laparoscopic technique, and advanced bleeding control strategies ensures optimal management for complex procedures in DIE surgeries with fertility preservation.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"285-288"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal symptoms after hysterectomy with opportunistic salpingectomy: a pilot study.","authors":"Anne-Sophie Maryns, Tjalina Hamerlynck, Bart De Vree, Anne-Sophie Verboven, Amin P Makar, Philippe Tummers, Wiebren Tjalma","doi":"10.52054/FVVO.2025.40","DOIUrl":"10.52054/FVVO.2025.40","url":null,"abstract":"<p><strong>Background: </strong>Opportunistic salpingectomy during hysterectomy with ovarian preservation may reduce the risk of ovarian cancer, but concerns remain that adding salpingectomy to hysterectomy could affect ovarian vascularisation and subsequent function.</p><p><strong>Objectives: </strong>To assess the feasibility of a full-scale trial to evaluate changes in menopausal symptoms based on the menopause rating scale (MRS) six months following hysterectomy, with and without opportunistic salpingectomy.</p><p><strong>Methods: </strong>A prospective observational pilot study of premenopausal women age 40 to 55 years scheduled for hysterectomy with ovarian preservation was conducted, where participants were counselled and given the option of concomitant salpingectomy or not.</p><p><strong>Main outcome measures: </strong>Forty-six out of 50 women chose opportunistic salpingectomy. It took 17 months to recruit 50 patients. Complete follow-up data was achieved in 43 of the 50 participants.</p><p><strong>Results: </strong>The median MRS score remained unchanged in the opportunistic salpingectomy group at 9 [interquartile range (IQR): 3-14], both before surgery and six months afterwards (n=39). In contrast, the group of women who did not undergo opportunistic salpingectomy had a median MRS score of 11 (IQR: 3-16) preoperatively, which increased to 25 (IQR: 6-32) six months postoperatively (n=4).</p><p><strong>Conclusions: </strong>The majority of patients in our cohort opted for opportunistic salpingectomy. However, no deterioration in menopausal symptoms was observed in this group after six months. A randomised controlled trial comparing hysterectomy with and without opportunistic salpingectomy in this patient population may not be feasible, given the strong patient preference for salpingectomy and slow recruitment.</p><p><strong>What is new?: </strong>The development of subjective menopausal symptoms is evaluated after hysterectomy with opportunistic salpingectomy.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"232-236"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine application of Budesonide-hyaluronic acid gel in patients with recurrent implantation failure and total loss of junctional zone differentiation on magnetic resonance imaging.","authors":"Evy Gillet, Panayiotis Tanos, Helena Van Kerrebroeck, Stavros Karampelas, Marion Valkenburg, Istvan Argay, Alessa Sugihara, Stephan Gordts, Rudi Campo","doi":"10.52054/FVVO.2025.89","DOIUrl":"10.52054/FVVO.2025.89","url":null,"abstract":"<p><strong>Background: </strong>Recurrent implantation failure (RIF) and repeated pregnancy loss remain major challenges in assisted reproductive technology, often without identifiable causes despite high-quality embryo transfers. Emerging evidence suggests that abnormalities in the junctional zone (JZ) of the uterus may impair implantation.</p><p><strong>Objectives: </strong>To evaluate the efficacy of hysteroscopic (HSC) sub-endometrial exploration combined with intrauterine application of budesonide-enriched crosslinked hyaluronic acid (HA) gel on pregnancy outcomes in women with RIF and complete JZ loss on magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>This single-centre observational pilot study included 20 women with RIF and MRI-confirmed loss of JZ differentiation. All patients had excellent cryopreserved blastocysts, either from an egg donation program or derived from their own autologous oocytes (<37 years). Under conscious sedation, patients underwent HSC sub-endometrial exploration with micro-incisions at the lateral walls and fundus, followed by intrauterine instillation of budesonide-enriched HyaRegen^® gel. [BioRegen Biomedical (Changzhou) Co., Ltd.].</p><p><strong>Main outcome measures: </strong>Clinical pregnancy rate, live birth rate, and maternal/neonatal outcomes.</p><p><strong>Results: </strong>Eighteen of 20 women (90%) conceived. In the donor group, all 9 pregnancies led to live births. In the autologous group, 8 of 9 pregnancies were successful; one was medically terminated at 20 weeks due to foetal malformation. All 17 neonates were healthy at birth and six-month follow-up.</p><p><strong>Conclusions: </strong>Preliminary observations of this novel approach suggest that it may contribute to improving implantation and live birth rates in women with unexplained RIF and JZ abnormalities.</p><p><strong>What is new?: </strong>This study introduces a targeted intrauterine intervention for RIF patients with loss of JZ differentiation, combining HSC exploration and budesonide-HA gel therapy.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"237-244"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative GnRH agonists in deep endometriosis: insights beyond the current evidence.","authors":"Shahar Bano, Hira Shehzad, Sarmad Nazir","doi":"10.52054/FVVO.2025.206","DOIUrl":"10.52054/FVVO.2025.206","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"298-299"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic hysterectomy for deep infiltrating endometriosis: anterior colpotomy first technique.","authors":"Nasuh Utku Doğan, Sefa Metehan Ceylan, Esra Bağcıoğlu, Selen Doğan","doi":"10.52054/FVVO.2025.59","DOIUrl":"10.52054/FVVO.2025.59","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Deep infiltrating endometriosis, particularly involving the rectovaginal space, represents one of the most challenging surgical benign gynaecologic conditions. While hysterectomy is a definitive option in women without fertility desire, these procedures are technically complex and associated with higher risks of complications. The anterior colpotomy first technique has been developed as an alternative approach to simplify dissection and improve surgical safety in such advanced cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Stepwise video demonstration of laparoscopic hysterectomy for deep infiltrating endometriosis involving rectovaginal space by the anterior colpotomy first technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participant: &lt;/strong&gt;A 47-year-old woman presented with dysmenorrhea, dyspareunia and dyschezia unresponsive to medical treatment. Transvaginal ultrasound and magnetic resonance imaging (MRI) revealed bilateral 5 cm endometriomas, 2 cm endometriotic nodules on both utero-sacral ligaments, and a 4 cm nodule in the Douglas pouch. A further 3 cm superficial endometriotic nodule on the rectosigmoid colon was also revealed on MRI. According to the Enzian classification, the score was A3, B2/2, C3. Laparoscopic hysterectomy, bilateral salpingo-oophorectomy and endometriotic excision of lesions were planned. Operation time was 210 minutes, and blood loss was 50 mL. On the postoperative fourth day patient was discharged. The patient remained pain-free at 25 months follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Surgical steps for anterior colpotomy first technique could be divided into following steps: 1) entry into retroperitoneum, 2) ligation of uterine artery at the branching point from hypogastric artery, 3) development of vesicouterine space, 4) dissection of ureter and transection of lateral parametrium, 5) combining lateral and anterior compartments, 6) anterior colpotomy, 7) developing rectovaginal space from lateral to midline, 8) completion of posterior colpotomy, 9) excision of endometriotic nodule and leaving nodule on rectosigmoid colon, 10) completion of hysterectomy, 11) rectal shaving and resection of endometriotic lesions, 12) Bubble test, assessment of ureteral integrity and ladder filling with saline. In this technique, it is more feasible to do anterior colpotomy first and to develop rectovaginal space from lateral sides towards midline instead of dealing with the posterior compartment at the beginning of surgery. Ultimately endometriotic nodule between the rectosigmoid colon and the uterus is cut, leaving the endometriotic nodule on the rectosigmoid colon.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Laparoscopic hysterectomy with anterior colpotomy first technique makes complicated hysterectomies easier in patients with deep infiltrating endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is new?: &lt;/strong&gt;This video article presents a stepwise demonstration of the anterior colpotomy first technique for laparoscopic hysterectomy in deep","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"281-284"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic management of presacral retroperitoneal haematoma after sacrocolpopexy.","authors":"Giovanni Panico, Sara Mastrovito, Davide Arrigo, Camilla Riccetti, Giuseppe Campagna, Giovanni Scambia, Alfredo Ercoli","doi":"10.52054/FVVO.2025.33","DOIUrl":"10.52054/FVVO.2025.33","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive sacrocolpopexy (SCP) has emerged as the gold standard procedure for pelvic organ prolapse. However, it entails a deep surgical dissection, essential for proper mesh positioning, and is not devoid of intraoperative and postoperative complications, including sporadic cases of potentially life-threatening intraoperative bleeding or postoperative haematomashaematomas. The appropriate management of bleeding complications in this area varies depending on the individual case and presence of hemodynamic instability, from emergency open surgery to a conservative wait-and-see approach.</p><p><strong>Objectives: </strong>To illustrate an effective method for the management of bleeding complications of SCP and raise awareness about this unusual complication.</p><p><strong>Participant: </strong>A 69-year-old woman underwent laparoscopic revision surgery due to evidence of a voluminous presacral haematoma on the second postoperative day after SCP.</p><p><strong>Intervention: </strong>The effectiveness of minimally invasive revision surgery for the management of voluminous presacral haematoma following laparoscopic SCP was assessed. Laparoscopic revision surgery allowed for the complete drainage of the haematoma without complications, resulting in discharge on postoperativeday seven.</p><p><strong>Conclusions: </strong>The video reviews the steps of the laparoscopic approach for performing a successful and safe revision surgery to manage presacral haematomas after SCP, and illustrates the procedure's adaptability, also providing specific tips and tricks to successfully perform this procedure without the need for mesh removal, thereby preserving the best outcome for the patient.</p><p><strong>What is new?: </strong>This is the first description of the surgical management of a retroperitoneal hematoma following colposacropexy. The study's conclusions provide a valuable resource for gynecologists facing patients presenting with a retroperitoneal presacral hematoma after prosthetic surgery for prolapse.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"289-293"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}