Best Practice & Research Clinical Obstetrics & Gynaecology最新文献_第4页

Hormonal Therapies before in vitro fertilization in women with endometriosis: The Minotaur's Labyrinth and the Ariadne's Thread 子宫内膜异位症妇女体外受精前的激素治疗：弥诺陶洛斯的迷宫和阿里阿德涅的丝线

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102500

Antoine Naem , Harald Krentel , Gaby Moawad , Joelle Naem , Renato Venezia , Andrea Etrusco , Sanja Terzic , Antonio Simone Laganà

{"title":"Hormonal Therapies before in vitro fertilization in women with endometriosis: The Minotaur's Labyrinth and the Ariadne's Thread","authors":"Antoine Naem , Harald Krentel , Gaby Moawad , Joelle Naem , Renato Venezia , Andrea Etrusco , Sanja Terzic , Antonio Simone Laganà","doi":"10.1016/j.bpobgyn.2024.102500","DOIUrl":"10.1016/j.bpobgyn.2024.102500","url":null,"abstract":"<div><p>Endometriosis-related infertility is one of the most debated topics in reproductive medicine. In recent years, prolonged pre-cycle hormonal regimens gained attention as a mean of improving the assisted reproduction technologies (ART) success rates in endometriosis patients. GnRH agonists, dienogest, medroxyprogesterone acetate, and aromatase inhibitors are the most studied medications. Conflicting results and a high risk of bias exist in almost all of the conducted studies in the field. However, current evidence suggests that pre-cycle treatment with GnRH agonists may be beneficial for patients with stage III/IV endometriosis. Dienogest and medroxyprogesterone acetate-based progestin-primed ovarian stimulation protocol was shown to be comparable to the prolonged GnRH agonists protocol. Finally, aromatase inhibitors seem to be of limited benefit to the assisted reproductive outcomes of endometriosis patients. Although it is challenging to draw any clinical conclusions, pre-cycle hormonal treatments seem to be best indicated in endometriosis patients who had previously failed ART treatment.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102500"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of single port robotic surgery in gynecology 单孔机器人手术在妇科中的作用。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102497

F. Massimello, V. Cela

引用次数: 0

Entrapped by pain: The diagnosis and management of endometriosis affecting somatic nerves 被疼痛所困：影响躯体神经的子宫内膜异位症的诊断和治疗。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102502

Peter Thiel , Anna Kobylianskii , Meghan McGrattan , Nucelio Lemos

{"title":"Entrapped by pain: The diagnosis and management of endometriosis affecting somatic nerves","authors":"Peter Thiel , Anna Kobylianskii , Meghan McGrattan , Nucelio Lemos","doi":"10.1016/j.bpobgyn.2024.102502","DOIUrl":"10.1016/j.bpobgyn.2024.102502","url":null,"abstract":"<div><p>Somatic nerve entrapment caused by endometriosis is an underrecognized and often misdiagnosed issue that leads to many women suffering unnecessarily. While the classic symptoms of endometriosis are well-known to the gynaecologic surgeon, the dermatomal-type pain caused by endometriosis impacting neural structures is not within gynecologic day-to-day practice, which often complicates diagnosis and delays treatment. A thorough understanding of pelvic neuroanatomy and a neuropelveologic approach is required for accurate assessments of patients with endometriosis and nerve entrapment. Magnetic resonance imaging is the preferred imaging modality for this presentation of endometriosis. Surgical management with laparoscopic or robotic-assisted techniques is the preferred approach to treatment, with excellent long-term results reported after nerve detrapment and endometriosis excision. The review calls for increased awareness and education on the links between endometriosis and the nervous system, advocating for patient-centered care and further research to refine the diagnosis and treatment of this challenging condition.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102502"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000488/pdfft?md5=53d61f8171b75589158dd1d69ef673e9&pid=1-s2.0-S1521693424000488-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Keep your attention closer to the ureters: Ureterolysis in deep endometriosis surgery 将注意力集中在输尿管上：深部子宫内膜异位症手术中的输尿管溶解术

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102494

Louisa R. Chatroux, Jon I. Einarsson

{"title":"Keep your attention closer to the ureters: Ureterolysis in deep endometriosis surgery","authors":"Louisa R. Chatroux, Jon I. Einarsson","doi":"10.1016/j.bpobgyn.2024.102494","DOIUrl":"10.1016/j.bpobgyn.2024.102494","url":null,"abstract":"<div><p>Endometriosis surgery involving the ureter poses significant challenges requiring meticulous surgical techniques and vigilant postoperative care. This chapter addresses key aspects of ureterolysis techniques, intraoperative management of ureteral injuries, and postoperative care in the context of endometriosis surgery. Ureterolysis methods aim to isolate and mobilize the ureter while preserving its vascularity. Cold instruments and careful dissection are recommended to prevent thermal injury during surgery. Intraoperative tools such as indocyanine green (ICG) show promise in assessing for vascular compromise. Over half of ureteral injuries are detected postoperatively, necessitating a high index of suspicion. Optimal postoperative care in the case of ureteral injury involves Foley catheterization for decompression, ureteral stenting, and meticulous follow-ups to monitor healing and renal function. While advances have been made in surgical techniques and diagnostic tools, gaps persist in preoperative imaging optimization and predictive models for identifying at-risk patients. This chapter aims to bridge existing knowledge gaps, optimize surgical practices, and enhance the overall care and outcomes of patients undergoing endometriosis surgery involving the ureter.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102494"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conservative surgical treatment for adenomyosis: New options for looking beyond uterus removal 子宫腺肌症的保守手术治疗：除切除子宫外的新选择。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102507

Tommaso Capezzuoli , Federico Toscano , Marcello Ceccaroni , Giovanni Roviglione , Anna Stepniewska , Massimiliano Fambrini , Silvia Vannuccini , Felice Petraglia

{"title":"Conservative surgical treatment for adenomyosis: New options for looking beyond uterus removal","authors":"Tommaso Capezzuoli , Federico Toscano , Marcello Ceccaroni , Giovanni Roviglione , Anna Stepniewska , Massimiliano Fambrini , Silvia Vannuccini , Felice Petraglia","doi":"10.1016/j.bpobgyn.2024.102507","DOIUrl":"10.1016/j.bpobgyn.2024.102507","url":null,"abstract":"<div><p>Adenomyosis is a common benign uterine disorders and patients may present dysmenorrhea, dyspareunia, abnormal uterine bleeding (AUB) and infertility. The treatment is very complex, including medical, surgical or radiological approaches. Hormonal drugs represent the first line therapy of adenomyosis, highly effective on symptoms and uterine volume reduction. Radiological procedures (UAE and HIFU), RFA and hysteroscopy may be proposed in those cases in which medical therapy is ineffective. Considering surgical treatment, hysterectomy remains the only existing definitive treatment but in the last decades the desire of uterus preservation is becoming more and more diffuse. On the other hand, surgical conservative treatments of adenomyosis are very effective in ameliorating AUB and pelvic pain and in reducing uterine volume, with some post-operative risks and obstetrics complications. Cytoreductive surgery for adenomyosis may be very complex, therefore it should be performed by experienced surgeons in dedicated centers, above all in case of concomitant endometriosis.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102507"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000531/pdfft?md5=24985635e4407632a18b475cfdb919cf&pid=1-s2.0-S1521693424000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endometriosis related infertility 与子宫内膜异位症有关的不孕症。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102504

Simone Ferrero (Prof)

引用次数: 0

Impact of surgery for endometriosis on the outcomes of in vitro fertilization 子宫内膜异位症手术对体外受精结果的影响

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102496

Simone Ferrero , Irene Gazzo , Marco Crosa , Francesco Paolo Rosato , Fabio Barra , Umberto Leone Roberti Maggiore

{"title":"Impact of surgery for endometriosis on the outcomes of in vitro fertilization","authors":"Simone Ferrero , Irene Gazzo , Marco Crosa , Francesco Paolo Rosato , Fabio Barra , Umberto Leone Roberti Maggiore","doi":"10.1016/j.bpobgyn.2024.102496","DOIUrl":"10.1016/j.bpobgyn.2024.102496","url":null,"abstract":"<div><p>This narrative review aims to summarize available evidence on the IVF-associated outcomes after surgery for endometriosis. Only one retrospective study investigated if surgical treatment of superficial/peritoneal endometriosis may modify the outcomes of IVF; therefore, more data are needed to confirm the benefit of surgery for this type of disease for improving ART outcomes, and to be able to support it in routine practice. Solid evidence from several meta-analyses demonstrates that surgical treatment of endometriomas does not enhance the outcomes of IVF. In contrast, surgical treatment of ovarian endometriosis may lead to a reduction in ovarian reserve, especially in cases involving bilateral endometriomas or repeated surgical procedures. Some non-randomized studies have examined if surgical treatment on deep endometriosis may influence IVF outcomes. A systematic review with meta-analysis revealed that patients who underwent surgery before IVF exhibited significantly higher pregnancy rates per patient, pregnancy rates per cycle, and live birth rates per patient compared to those without prior surgery. However, the available data are insufficient to recommend surgical excision of deep endometriosis as the first-line treatment for asymptomatic patients to enhance IVF outcomes.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102496"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000427/pdfft?md5=c125e7d1e9cdcc3fb2f31bf0ab20171d&pid=1-s2.0-S1521693424000427-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tailoring radicality in diaphragmatic surgery for deep endometriosis: A matter of choice 为深部子宫内膜异位症的膈肌手术量身定制根治方案：选择问题。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102499

Marcello Ceccaroni , Gianmarco D'Ancona , Giovanni Roviglione , Sarah Choi , Tommaso Capezzuoli , Andrea Puppo , Ashot Drampyan , Fabio Barra

{"title":"Tailoring radicality in diaphragmatic surgery for deep endometriosis: A matter of choice","authors":"Marcello Ceccaroni , Gianmarco D'Ancona , Giovanni Roviglione , Sarah Choi , Tommaso Capezzuoli , Andrea Puppo , Ashot Drampyan , Fabio Barra","doi":"10.1016/j.bpobgyn.2024.102499","DOIUrl":"10.1016/j.bpobgyn.2024.102499","url":null,"abstract":"<div><p>Diaphragmatic endometriosis (DpE) is a rare disease localization which represents an important clinical challenge. The main criticisms toward the proper DpE management consist of poor consensus on both surgical indications and the choice between different surgical techniques available to treat the disease. Furthermore, only weak recommendations are provided by current guidelines and surgical management is mostly based on surgeon's experience. As consequence, the lack of standardization about the surgical treatment led to the risk of under- or over-treatments in patients suffering from this form of endometriosis.</p><p>The latest evidence-based data suggest to adopt a lesion-oriented surgical approach serving as a guide in daily surgical activities, in order to ensure a tailored radicality and reduce the rate of surgery-related complications.</p><p>Diaphragmatic endometriosis surgery should be performed only by expert surgeons with an extensive oncogynecologic expertise since it represents a technically demanding procedure. A multidisciplinary approach is also mandatory in order to adequately select and treat these patients by minimizing the risk of additional morbidity.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102499"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conservative approaches to postpartum haemorrhage 产后出血的保守治疗方法

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102516

Christian Chigozie Makwe , Kehinde Sharafadeen Okunade

引用次数: 0

Challenges of prenatal diagnosis in obese pregnant women 肥胖孕妇产前诊断面临的挑战

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102470

Farah Siddiqui , Karim Kalache , Badreledeen Ahmed , Justin C. Konje

{"title":"Challenges of prenatal diagnosis in obese pregnant women","authors":"Farah Siddiqui , Karim Kalache , Badreledeen Ahmed , Justin C. Konje","doi":"10.1016/j.bpobgyn.2024.102470","DOIUrl":"10.1016/j.bpobgyn.2024.102470","url":null,"abstract":"<div><p>Obesity rates are increasing world-wide with most of the increase in women of the reproductive age group. While recognised as an important contributor to non-communicable diseases, pregnant women with obesity are particularly at risk of not only maternal and pregnant complications but also have an increased risk of congenital malformations. Furthermore, pregnant obese women are more likely to be older and therefore at a greater risk of aneuploidy. Prenatal diagnosis in these women especially those who are morbidly obese is challenging due not only to their weight but the implications of the increase adiposity on biochemical markers of aneuploidy. In this review we discuss the current challenges in providing prenatal diagnosis for these women including those related to the ergonomics of ultrasound and those inherent in them because of their obesity. Appropriate counselling for these women should include the lower sensitivity of the tests, the difficulties in performing some of the procedures (imaging and invasive testing) as well as the increased risk of structural abnormalities related to their obesity.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102470"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0