Sebastiano Bandiera

Quality of life and sexual changes after double transobturator tension-free approach to treat severe cystocele

OBJECTIVES To study the quality of life and sexual function changes of women affected by severe cystocele and treated with the double transobturator tension-free approach. STUDY DESIGN 23 women (mean age 60.6) with third and fourth degree cystocele (according to Baden and Walker classification) were monitored by Short Form-36 (SF-36) and Pelvic Organ Prolapse/Urinary Incontinenece Sexual Questionnaire (PISQ-12) before and 12 months after surgical treatment. Each woman also underwent translabial color Doppler ultrasonography to measure the Resistance Index (RI), Pulsatility Index (PI), Peak Systolic Velocity (PSV), and End-Diastolic Velocity (EDV) of the clitoral arteries, before surgery and 12 months postoperatively. RESULTS SF-36 showed a considerable increase in all of the categories (physical functioning, physical role functioning, bodily pain, general health, vitality, social functioning, emotional role functioning, and mental health) compared to those obtained at baseline (P<0.05). PISQ-12 also showed a considerable increase in the behavioural emotive factor score, in the physical factor score, in the partner-related factor score and, consequently, in the total score compared to that obtained at baseline (P<0.05). Color Doppler measurement showed that the mean Pulsatility Index, Peak Systolic Velocity, Resistance Index and End-Diastolic Velocity were not significantly lower to those obtained at baseline (P=NS). CONCLUSIONS Double transobturator tension-free approach to treat severe cystocele considerably improves quality of life and sexual function, and does not significantly influence clitoral blood flow. Our data could add new information about sexual behaviour after prolapse treatment, particularly about the impact on clitoral blood flow changes.

Umbilical cord blood collection in Cesarean section: a comparison before and after placental delivery.

Abstract Fetal stem cells transplants depend on nuclea-ted cells from fetal blood. This study was a prospective randomized trials to compare the collection of fetal blood by gravity into a bag containing anticoagulant, before and after delivery of the placenta. The obstetric and the newborn characteristics in the two group were not significantly different. The mean volume of fetal blood collected while the placental was still in utero was 74.93±7.1 ml as against 35.78±3.6 ml for collection of fetal blood after delivery of the placenta.

T01-O-08 Effects of surgery for stress urinary incontinence on the clitoral blood flow

Objectives To study the effects of the mini-invasive surgery using the tension free vaginal tape (TVT) procedure and the transobturator tape (TOT) procedure in modifying clitoral blood flow in women affected by stress urinary incontinence (SUI). Methods The setting of the prospective open clinical study was the Urogynecologic Service. Forty-two women (mean age 52.8 ys) and 63 women (mean age 53.9 ys) were treated with TVT and TOT, respectively. Each woman underwent translabial color Doppler sonography to measure the resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV) and end diastolic velocity (EDV) of clitoral arteries, before and 6 months after surgery treatment. Results In the TVT women the mean PI and the mean PSV were significantly lower, and the mean RI was significantly higher compared with pre treatment values (p Conclusions The different vaginal approach for both of the surgical methods influence the clitoral blood-flow. Our data stimulate to study the sexual aspects after incontinence treatment, particularly, the possible impact of clitoral flow changes on sexual function.

Reasons to Eliminate Umbilical Cord Blood Units before Cryopreservation

Hematopoietic stem cells collected from umbilical cord blood (UCB) are widely considered a potential alternative to bone marrow. Research on UCB has now developed with the establishment of cord blood banks throughout the world. The aim of our study is to improve the efficiency of our bank because of the high cost and the administrative effort involved in its organization, finding a correlation between the terms of UCB units discarding, such as the low volume and for the low cell counts, and the obstetrics causes. This process has been made to cut the cost of the research and to improve the final result of each bank. We obtained, in 15 months, 683 cord blood units by blood withdrawal from the placenta. The units were cryopreserved within 24 h of collection, in a volume of at least 60 ml with a nucleated cells total of more than 800 per 106. Specific analyses of the unit blood to exclude bacterial contamination were undertaken. Of the 683 bags collected, 340 (49.75%) were discarded, and 343 were banked. The main reasons for rejecting the UCB units were: low volume; low cell counts; clinical history; bacterial contamination; freezing problems; unit misidentification; and no informed consent. We suggest that regular monitoring of the reasons for the rejection of the UCB units could give a significant effort to the bank organization, and identifying those units that are suitable before the cryopreservation could save precious resources.