Katsuya Mine

Recurrence of ovarian endometrioma after laparoscopic excision: Risk factors and prevention

The aim of this study was to assess the cut‐off age of the risk factors for postoperative recurrence of ovarian endometriomas and to evaluate the end‐points of follow‐up after laparoscopic excision of ovarian endometriomas.

Gonadotropin regulation and role of ovarian osteopontin in the periovulatory period

Osteopontin (OPN), a secreted glycoprotein, has multiple physiological functions. This study investigated the regulation and roles of OPN in the mouse ovary during the periovulatory stages. Immature female mice were treated with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) to simulate follicle maturation and ovulation. In situ hybridization and real-time RT-PCR were performed to assess expression of Opn in the periovulatory ovary. Granulosa cells (GCs) from PMSG-primed immature mice were cultured with or without hCG in the presence or absence of OPN, and effects on expression of Opn, progesterone synthesis, and vascular endothelial growth factor (VEGF) signaling were assessed by real-time RT-PCR, ELISA, and western blotting analysis. Opn transcripts were significantly upregulated 3 h after hCG treatment, followed by a peak at 16 h, and the transcripts localized to GCs. Incubation with hCG significantly increased quantities of Opn transcripts in GCs and OPN levels in the culture medium at 12 and 24 h. Furthermore, OPN treatment caused a significant increase in the levels of Star protein, P 450 cholesterol side-chain cleavage enzyme (p450scc), 3-beta-hydroxysteroid dehydrogenase (Hsd3b), and progesterone in the culture medium. OPN treatment promoted Vegf expression in GCs, which was significantly suppressed by a phosphoinositide 3-kinase (PI3K) inhibitor. In addition, OPN treatment stimulated phosphorylation of AKT, a downstream PI3K signaling molecule. In conclusion, expression of Opn was upregulated in mouse ovarian GCs in response to a gonadotropin surge through epidermal growth factor receptor signaling, which enhances progesterone synthesis and Vegf expression during the early-luteal phase.

Rapid and transient upregulation of CCL11 (eotaxin-1) in mouse ovary during terminal stages of follicular development.

This study aimed to investigate the regulation of expression, localization and physiological role of the CCL11/CCR3 axis in mouse ovary during the periovulatory period.

Novel hybrid laparoscopic sacrocolpopexy for pelvic organ prolapse with a severe paravaginal defect

Abdominal sacrocolpopexy is the gold standard for treating pelvic organ prolapse (POP) because of safety and durable good results. More recently laparoscopic sacrocolpopexy (LSC), a less invasive approach, has become popular. Although these surgeries are versatile and can treat almost all patients with POP, these techniques have shortcomings. Specifically, reinforcement of lateral vaginal defects are not very strong, thus patients with POP and a severe paravaginal defect are not good candidates for abdominal or laparoscopic sacrocolpopexy. To overcome this problem, we developed a novel type of LSC, which can reinforce severe paravaginal defects by using a reversed T‐shaped anterior mesh combining the advantage of transvaginal mesh surgery. We refer to this novel surgery as ‘hybrid LSC’. Thus far, eight patients have successfully undergone this surgery. Hybrid LSC is a simple and secure method, and is an alternative treatment for POP with a severe paravaginal defect.

Gasless laparoscopically assisted myomectomy using a wound retraction system

Introduction: The purpose of this study was to elucidate the feasibility of gasless laparoscopically assisted myomectomy (LAM) using a wound retraction system. This method treats symptomatic uterine myomas by combining laparoscopy with a mini‐laparotomy to enucleate myoma nodules and to close the uterine myometrium.

Retrospective cohort study of the risk factors for secondary infertility following hysteroscopic metroplasty of the uterine septum in women with recurrent pregnancy loss

A hysteroscopic metroplasty was performed for women with recurrent pregnancy loss owing to a uterine septum, following which some women became infertile. The aim of this study was to elucidate the risk factors of secondary infertility 1 year after hysteroscopic metroplasty for a uterine septum.

Surgical Treatment Outcomes in Patients With Recurrent Pregnancy Loss Attributed to Septate Uterus

adenomyosis, 3 had fibroids and 5 had endometriosis. In the 28 patients with pain and bleeding, 11 had adenomyosis, 11 had fibroids and 3 had endometriosis. In the new onset pain group, 9 of the 16 patients had postablative fibrosis and scarring noted on the pathology report. In the pain and bleeding group there were 7 reports of these changes. Conclusion: Bleeding was the most common reason for Novasure failure. Although one quarter of the women who went on to hysterectomy had some component of new onset pain the majority had some additional pathology consistent with development of pain. In only 3 patients (0.1%) with new onset pain was there no obvious pathology. The finding of postablative scarring and fibrosis was not found universally in the patients with new onset pain, nor was it consistently noted in those patients with a bleeding component, which makes it difficult to attribute it as a consistent or common cause of the pain.

An Easy and Safe Approach to the Minimally Invasive Laparoscopic Treatment of Dermoid Cysts: The Mimic Laparoscopic Surgery With Bathtub Method

Study Objective: Uterine perforation after Intrauterine device (IUD) insertion is a rare but serious complication. It is recommended that all intraperitoneal IUDs are removed, even in asymptomatic women. Conventional laparoscopy is the current surgical method of choice for IUD removal. A literature review found no cases describing the use of single-site laparoscopy for IUD removal. We present a case in which a 30 year-old female underwent successful single-site laparoscopic (SSL) IUD removal in the setting of recent uterine perforation. Design: Case Report. Setting: Lenox Hill Hospital, New York. Patients: We report a 30 year-old G3P3 with one prior cesarean section and 2 vaginal births after cesarean section who presented to our clinic with intermittent pelvic pain in the setting of recent Mirena IUD placement. Pelvic and sterile speculum exam were unremarkable with no IUD strings visualized or palpated. Abdominal and Pelvic ultrasound and CT scan demonstrated IUD in the left upper quadrant with omental implantation overlying the small intestine. Intervention: A 12 mm incision was made below the umbilicus. Entry was done under direct visualization with a Hassan Trocar. The IUD was entangled in the omentum overlying small bowel. The IUD was dissected off the omentum through the initial incision. Hemostasis was achieved following a careful abdominal survey. Measurements and Main Results: There was minimal blood loss. The patient was discharged 1 hour after the procedure. The patient followed-up 7 days post-op with no complications and a well-healed incision site.

Device for Safely Removing a Placed Mesh for Pelvic Organ Prolapse.

Study Objective: To determine the prevalence of silent voiding dysfunction in morbidly obese patients (BMI>35 kg/m) before and after bariatric surgery. Design: This is a prospective, single-center based study. Setting: Private bariatric surgical group office. Patients: Data were collected from fifteen morbidly obese female patients, candidates for bariatric surgery. Intervention: All patients underwent laparoscopic gastric sleeve surgery. Measurements and Main Results: Age, BMI and point reduction in BMI after surgery were compared using unpaired T test, while Fisher exact test was used for other demographic data like history of hysterectomy, urinary tract infection, kidney stones and smoking. Prevalence of silent voiding dysfunction before bariatric surgery was 76% and dropped to 54% after, showing that 45% of patients had improvement in their symptoms. There were no significant demographic differences in obese patients with and without voiding dysfunction. There was so significant difference in point reduction in BMI in obese patients who had improvement in voiding dysfunction symptoms and who did not. Conclusion: Weight reduction surgery has significant impact on the improvement of silent voiding dysfunction symptoms but larger prospective and case control studies are required to establish this effect.