Francesco Forlani
University of Palermo
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Featured researches published by Francesco Forlani.
Maturitas | 2015
Antonino Perino; Alberto Calligaro; Francesco Forlani; Corrado Tiberio; Gaspare Cucinella; Alessandro Svelato; Salvatore Saitta; Gloria Calagna
OBJECTIVE To evaluate the efficacy and feasibility of thermo-ablative fractional CO2 laser for the treatment of symptoms related to vulvo-vaginal atrophy (VVA) in post-menopausal women. METHODS From April 2013 to December 2013, post-menopausal patients who complained of one or more VVA-related symptoms and who underwent vaginal treatment with fractional CO2 laser were enrolled in the study. At baseline (T0) and 30 days post-treatment (T1), vaginal status of the women was evaluated using the Vaginal Health Index (VHI), and subjective intensity of VVA symptoms was evaluated using a visual analog scale (VAS). At T1, treatment satisfaction was evaluated using a 5-point Likert scale. RESULTS During the study period, a total of 48 patients were enrolled. Data indicated a significant improvement in VVA symptoms (vaginal dryness, burning, itching and dyspareunia) (P<0.0001) in patients who had undergone 3 sessions of vaginal fractional CO2 laser treatment. Moreover, VHI scores were significantly higher at T1 (P<0.0001). Overall, 91.7% of patients were satisfied or very satisfied with the procedure and experienced considerable improvement in quality of life (QoL). No adverse events due to fractional CO2 laser treatment occurred. CONCLUSION Thermo-ablative fractional CO2 laser could be a safe, effective and feasible option for the treatment of VVA symptoms in post-menopausal women.
Acta Obstetricia et Gynecologica Scandinavica | 2013
Antonino Perino; Donatella Mangione; Alessandro Svelato; Francesco Forlani; Fiorella Gargano; Domenico Incandela; Maria Antonietta Coppola; Renato Venezia
Sir, We would like to bring to general attention the case of a 44year-old woman who came to our clinic because of spotting and occasional periods of amenorrhea. She had had menarche at the age of 14 years, followed by regular menstrual cycles. Her medical history revealed that she had one living child, and had subsequently experienced two miscarriages. The patient was human immunodeficiency virus (HIV) and hepatitis C virus positive. In addition, she was suffering from HIV-related chronic renal failure, HIV-related neuropathy and hepatitis C virus-related chronic hepatopathy. Physical and pelvic examinations were unremarkable. Transvaginal ultrasound examination revealed a hyperechogenic area in the uterine cavity measuring 14 mm 9 6 mm. The patient underwent a diagnostic hysteroscopy, which showed a 20 mm 9 10 mm white meshwork of bony spicules arising from the posterior wall, with a hard tactile consistency (Figure 1). A resectoscopic excision was then performed. The histological examination showed trabeculae of woven bone, and was consistent with osseous metaplasia of the endometrium. Concomitant endometrial histology showed a secretory endometrium. Two weeks after surgery, the patient again underwent a second transvaginal ultrasound examination, which revealed no trace of the original, abnormal ultrasound finding. Osseus metaplasia is rarely encountered, with less than 100 cases reported in the international literature (1). There is controversy regarding the pathogenic mechanisms related to the histogenesis of heterotopic bone in the endometrium. A number of theories have been proposed, as follows: continuous and strong endometrial estrogenic stimulation; osteogenesis in the surrounding endometrium, which is promoted by retained fetal bones; implantation of embryonic parts without pre-existing bone after early-stage abortions; dystrophic calcification of retained and necrotic tissues, usually after an abortion; chronic endometrial inflammation, such as endometritis or pyometra; and metastatic calcification and metabolic disorders, such as hypercalcemia, hypervitaminosis D or hyperphosphatemia (1–3). The most recent and accepted theory is metaplasia of the endometrial stromal cells, usually fibroblasts, which change into osteoblasts and thus produce bone in the endometrium. A previous history of abortion is present in most of the reported cases, with osseous changes in the endometrium. Usually, the reproductive age group (between 20 and 40 years of age) is involved, although it has also been reported in the menopausal years (1). In the few reported cases in the literature, the time between the antecedent abortion and discovery of the endometrial ossification varies from eight weeks to 23 years (4). Chronic renal failure is a known cause of abnormal calcium–phosphorous metabolism with metastatic calcifications; this may be the pathway of osseous metaplasia observed in our patient. Ultrasound examination plays a primary role in the diagnosis of patients with osseous metaplasia. The characteristic hyperechogenic pattern is strongly suggestive of osseous tissue within the uterus and should be confirmed by hysteroscopic examination (2). Today, hysteroscopy is accepted as the gold standard for diagnosis and treatment. Bone formation in the endometrium is rare, but can be seen in malignant mixed M€ ullerian tumors and in teratomas, which should be considered in the differential diagnosis (1). Clinicians and pathologists should bear this chance in mind, particularly in light of the fact that an erroneous diagnosis may well result in unnecessary hysterectomy.
Fetal Diagnosis and Therapy | 2017
Giuseppe Cali; F. D'Antonio; Francesco Forlani; Ilan E. Timor-Tritsch; José M. Palacios-Jaraquemada
Vascular control is a fundamental step in the surgical management of morbidly adherent placenta (MAP), and this implies a precise knowledge of the vascular supply in the lower part of the genital tract. High degrees of MAP are sometimes characterised by the presence of a rich vascular anastomotic system between the bladder, uterus, and vagina involving the superior, medial, and inferior vaginal and the lower vesical arteries. This brief report shows that prenatal ultrasound assessment of bladder-uterovaginal anastomoses in MAP is feasible.
Gynecological Surgery | 2014
Antonio Perino; Francesco Forlani; Antonio Lo Casto; Giuseppe Cali; Gloria Calagna; Stefano Rotolo; Gaspare Cucinella
To comment on the prevalence, diagnosis, and treatment of the septate uterus, with special reference to hysteroscopic metroplasty and its effect on reproductive outcome, we searched publications in PubMed and Embase. Original articles, meta-analysis, reviews, and opinion articles were selected. The studies suggest that the prevalence of the septate uterus is increased in women with repeated pregnancy loss and infertility. Reliable diagnosis depends on accurate assessment of the uterine fundal contour and uterine cavity by means of magnetic resonance and three-dimensional ultrasound. Pertinent published data comparing pregnancy outcome before and after hysteroscopic metroplasty indicated a marked improvement after surgery. Magnetic resonance and three-dimensional ultrasound represent the gold standard for diagnosis of septate uterus. Hysteroscopic metroplasty with its simplicity, minimal postoperative sequelae, and improved reproductive outcome is the gold standard for treatment, not only in patients with recurrent pregnancy loss and premature labor but also in patients with infertility, especially if in vitro fertilization is being contemplated.
Acta Obstetricia et Gynecologica Scandinavica | 2018
Giuseppe Cali; Francesco Forlani; Ilan Timor-Trisch; José M. Palacios-Jaraquemada; Francesca Foti; Gabriella Minneci; Maria Elena Flacco; Lamberto Manzoli; Alessandra Familiari; G. Pagani; Giovanni Scambia; F. D'Antonio
The aim of this study was to assess the diagnostic accuracy of ultrasound in detecting the depth of abnormally invasive placenta in women at risk.
Journal of Clinical Obstetrics, Gynecology & Infertility | 2017
Antonio Maiorana; Emanuela Ognibene; Giovanni Parisi; Walter Alio; Domenico Incandela; Francesco Forlani
Ultrasound in Medicine and Biology | 2015
Ilan E. Timor-Tritsch; Giuseppe Cali; Ana Monteagudo; Robert W. Berg; Francesco Forlani
ITALIAN JOURNAL OF GYNAECOLOGY & OBSTETRICS | 2014
Antonino Perino; Fabio Fiorino; Francesco Forlani; Alessandro Svelato; Gloria Calagna; Antonio Ragusa; Roberta Spinoso
Giornale Italiano di Ostetricia e Ginecologia | 2013
Antonino Perino; Francesco Forlani; Gaspare Cucinella; Gloria Calagna; Stefano Rotolo; Maria Margherita Triolo; null Trapani; null Minnella
ITALIAN JOURNAL OF GYNAECOLOGY & OBSTETRICS | 2012
Antonino Perino; Donatella Mangione; Domenico Incandela; Francesco Forlani; Alessandro Svelato; Alessandra Muraglia; Maria Francesca Guarneri; Laura Lo Verso; Fawzia Habib; Mohamed A. Alkabalawy; Amr K. Elfayomy