P. De Iaco

Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging.

To compare the accuracy of transvaginal sonography (TVS) and magnetic resonance imaging (MRI) in the preoperative staging of endometrial carcinoma.

Behaviour of ovarian tumors of low malignant potential treated with conservative surgery

OBJECTIVE Fertility-sparing surgery has been proposed for the treatment of borderline ovarian tumors. The aim of this study was to evaluate the outcome of patients submitted to cystectomy (CYS) compared with patients treated by unilateral salpingo-oophorectomy (USO) or bilateral salpingo-oophorectomy with/without total hysterectomy (radical surgery, RS). METHODS We reviewed retrospectively the data of patients treated in 3 institutions for borderline ovarian tumors. One hundred and sixty-eight patients underwent laparoscopic or laparotomic surgical treatment from 1985 to 2006. Tumor recurrence rate, disease-free survival and site of recurrences were evaluated. Specific prognostic factors, such as stage, histology, micropapillary subtype, exophytic tumor growth, intraoperative spillage, endosalpingiosis, staging procedures, and route of surgery were analysed. RESULTS Thirty-five patients underwent cystectomy, 50 unilateral salpingo-oopohorectomy, and 83 radical surgery. Twelve patients in the CYS group (34.3%), 10 in the USO group (20.0%), and 5 (6.0%) in RS group relapsed. Five-year progression-free survival (PFS) was 59.6%, 78.4%, and 93.5% in CYS, USO and RS groups, respectively. None of the relapsed patients died of disease. CONCLUSIONS Cystectomy is an effective surgical strategy for patients with borderline ovarian tumor. The higher risk of local relapses is not associated with a reduction in the overall survival. The procedure should be offered to young patients with bilateral tumors and to very young ones, considering the higher risk of local relapse.

Paraovarian/paratubal cysts: comparison of transvaginal sonographic and pathological findings to establish diagnostic criteria

To describe the sonographic features of paraovarian cysts and to compare these features with pathological findings in order to define the best treatment options (surgical vs. conservative).

Transvaginal sonographic appearance of peritoneal pseudocysts

To describe the sonographic features of peritoneal pseudocysts (PPCs) in order to determine the particular aspects that distinguish them from true ovarian cysts.

Transvaginal sonographic features of peritoneal carcinomatosis

Peritoneal carcinomatosis involves the dissemination of intra‐abdominal tumor tissue often associated with gynecological malignancies. The objective of this study was to describe the transvaginal sonographic appearance of this condition.

Transdermal HRT and Doppler findings in normotensive and hypertensive postmenopausal patients

To evaluate the effects of transdermal hormone replacement therapy (HRT) on plasma viscosity, serum levels of thromboxane B2 (TXB2) and vascular impedance in the uterine, bladder wall, internal carotid and ophthalmic arteries in normotensive and hypertensive postmenopausal patients.

Three‐dimensional power Doppler imaging of uterine artery pseudoaneurysm treated unsuccessfully with selective embolization

A 24-year-old primigravida underwent a scheduled Cesarean delivery at 39 weeks’ gestation for breech presentation. Five weeks after the Cesarean section she presented to our emergency department with sudden onset of heavy vaginal bleeding and abdominal pain. Transvaginal ultrasound examination (Accuvix XQ, Medison Corp, Seoul, Korea) showed a hypoechoic area, measuring 14.4 × 8.8 mm, located at the level of the lower uterine segment, adjacent to the Cesarean suture, which involved the majority of the myometrial wall on the right side of the uterus (Figure 1a). Color Doppler sonography confirmed bidirectional systolic and diastolic flow (peak systolic velocity, 0.70 m/s; resistance index, 0.53) within the area, which appeared to be connected to the right uterine artery, findings consistent with a pseudoaneurysm of this vessel (Figure 1b). The patient underwent pelvic angiography and embolization of the pseudoaneurysm. Selective hypogastric arteriography using a 5-F cobra shaped catheter was performed and multiple metallic coils of 3 mm in diameter were deployed across the origin of the pseudoaneurysm from the uterine artery, followed by pledgets of gelatine sponge. Repeat ultrasound

Dermoscopic findings of vulvar intraepithelial neoplasia: a series of four cases

Vulvar intraepithelial neoplasia (VIN) is a subtype of in situ squamous cell carcinoma (SCC). The diagnosis is clinical and histopathological. Dermoscopy of VIN has been scarcely reported. Herein we describe the dermoscopic features in 4 female patients. This article is protected by copyright. All rights reserved.

Female precocious puberty, obesity and polycystic‐like ovaries

To evaluate the characteristics of obese girls with gonadotropin releasing hormone‐dependent precocious puberty with and without polycystic‐like ovaries.

Uterine vascularization and pregnancy outcome in patients undergoing intracytoplasmatic sperm injection: The role of nitric oxide

AbstractPurpose: To evaluate whether, after pituitary desensitisation, the impedance to flow in the uterine vessels may be an indicator of an ICSI programme outcome, and to test the relationship between intrafollicular nitric oxide and oocyte/embryo quality. Methods: Thirty-eight women, on the basis of impedance to flow at the level of uterine artery, evaluated on the first day of COH, were divided in patients with normal (Pulsatility Index—PI, ≤2.5; Group I, n=11) and elevated (PI > 2.5; Group II, n=27) PI values. The patients were submitted to hormonal, ultrasonographic and Doppler evaluations. Plasma and follicular fluid concentrations of nitrites/nitrate (NO2−/NO3−) were assayed. Results: In the Group I, the impedance to flow remained lower than in Group II and was associated to good quality embryos and to a higher pregnancy rate. Follicular fluid NO2−/NO3− levels were inversely correlated with the embryo quality. The uterine artery PI and the pregnancy rate were inversely correlated. The PIs analysed on the day 1 of stimulation, were positively correlated with those registered on day 8 and on the day of ovum pick-up. Conclusions: A Doppler analysis done on day 1 of controlled ovarian hyperstimulation may be an useful indicator of ART outcome.