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A Agostini

Publications and source records attributed to A Agostini.

At least 19 recordsLinked to original sources
PubMed2006

[Vaginoscopic hysteroscopy].

Vaginoscopic hysteroscopy permits to avoid several painful gestures of classical office hysteroscopy. The aim of this article is to describe the advantages such vaginoscopic approach. Six studies were thus selected, dealing with vaginoscopic hysteroscopy. The diameter of the hysteroscope, always a rigid one, was between 3.5 and 5 mm, and CO(2) or saline infusions were indifferently used. Failure rate is inferior to 5%. One study, comparing pain induced by vaginoscopic versus classical hysteroscopy, concluded that vaginoscopic approach was less painful.

Female↗
PubMed2006

[Cervical ripening using misoprostol before hysteroscopy].

Cervical ripening with misoprostol is performed before office or operative hysteroscopy. Aim of this review is to evaluate benefits of cervical ripening with misoprostol before hysteroscopy . Ten studies were selected concerning office or operative hysteroscopy. Cervical ripening with misoprostol seems to be not useful for office hysteroscopy performed with minihysteroscope. Interest of misoprostol in menopausal women with traditional office hysteroscope is debatable. Risk of cervical tear during operative hysteroscopy seems to be reducing with misoprostol. However, interest of misoprostol was not found in all studies. Data were not sufficient to determine adequate dose of misoprostol, time and mode of administration. However, vaginal administration is preferable.

Administration, Intravaginal↗
PubMed2005

[Posthysterectomy prolapse: results of sacrospinous ligament fixation].

OBJECTIVE: To evaluate results of sacrospinous ligament fixation in the treatment of posthysterectomy prolapse. PATIENTS AND METHODS: Between September 1990 and September 2002, 92 women (mean age 64.8 years, range 45 to 92 years) underwent sacrospinous ligament fixation following total hysterectomy (82.6%) or subtotal hysterectomy (17.4%); 96.7% had a menopausal status, and 21.7% used hormone replacement therapy. 48.9% of the patients had a history of surgery for prolapse (and/or urinary incontinence), and 21.7% had associated symptoms of stress urinary incontinence. In all cases, sacrospinous ligament fixation was performed under visual control using conventional stitch. Sacrospinous ligament fixation was combined with the following procedures: anterior vaginal repair (n=31), additional incontinence surgery (n=11), cervical amputation (n=11), levator myorrhaphy (n=61). Main outcome measures were intraoperative complications, postoperative complications, anatomic and functional outcome. RESULTS: Complications were represented by 1 vaginal hematoma (related to sacrospinous fixation), 1 bladder injury, 1 ureteral injury, 3 acute urinary retentions. With a mean follow-up of 47 months (range: 12-156), 12 patients (13.5%) had failure of sacrospinous ligament fixation and 9 required additional procedures, during the first year of follow-up. 14 patients (15.7%) had postoperative cystocele, with 1 case of third-degree cystocele treated with sub-bladder prosthesis by the vaginal route. CONCLUSION: We noted low rates of major complications and sacrospinous ligament fixation in posthysterectomy prolapse appears to give satisfactory long-term results.

Aged↗
PubMed2004

[New insight in physiopathology of preeclampsia and intra-uterine growth retardation: role of inflammation].

Inflammatory response is a major component in physiopathology of preeclampsia and intra-uterine growth retardation. Endothelium is a main connection between placental ischemia and clinical manifestations during vascular pregnancy complications. In this review recent findings concerning inflammatory response and its links with endothelium are reported. Studies concerning isolated intra-uterine growth retardation confirm the hypothesis of a similar pathophysiology with an activation confined to utero-placental bed or at a lower level. Current information on oxidative stress, atherosclerosis, and apoptosis in vascular pregnancy complications are available in this review. These concepts offer innovative possibilities of treatment.

Apoptosis↗
PubMed2004

[Results of hysteroscopic myomectomy].

Main symptoms related to submucous fibroids are menorrhagia, infertility, and postmenopausal bleeding. First experiences of hysteroscopic transcervical resection of fibroids have been published by Neuwirth in the late seventies. Reports with long-term follow-up in patients with abnormal uterine bleeding are available. After a follow-up period of five years and more, results are satisfactory in 70-85% of the patients. Intramural class 2 and larger fibroids (> 4 cm) constitute the limits of the endoscopic technique. Prior to hysteroscopic myoma resection, pretreatment with GnRH agonists may be indicated in selected cases (large myomas, patients suffering from secondary anemia). Repeat resection is an option after failed primary hysteroscopic operation and may reduce the hysterectomy rate. In infertile women with submucosal or intracavitary fibroids, pregnancy and delivery rates are increased after hysteroscopic myomectomy. Operative hysteroscopy is also safe and effective in controlling persistent postmenopausal bleeding. To conclude, hysteroscopic resection is the gold standard for the treatment of symptomatic submucous fibroids.

Female↗
PubMed2004

[Sacrospinous colpopexy complications].

OBJECTIVE: To evaluate complications of sacrospinous ligament fixation. DESIGN: Monocentric retrospective study. SETTING: Department of Obstetrics & Gynecology, La Conception University Hospital, Marcella. PATIENTS AND METHODS: Between January 1991 and September 2002, 277 women (mean age 64.9 years, range 37 to 92 years) underwent a sacrospinous ligament fixation; 91% had a menopausal status, and 15.5% used hormone replacement therapy. 33.2% of the patients had prior hysterectomy, 28.9% had a history of surgery for prolapse, and 18.8% had associated symptoms of stress urinary incontinence. In all cases, sacrospinous ligament fixation was performed under visual control using conventional stitch. Sacrospinous ligament fixation was combined with the following procedures: anterior vaginal repair (N =137), additional incontinence surgery (N =31), vaginal hysterectomy (N =137), levator myorraphy (N =203). MAIN OUTCOME MEASURES: Intraoperative complications, postoperative complications, long-term painful symptoms. RESULTS: Intraoperative complications were represented by 1 case of vascular wound and four rectal injuries. Main postoperative complications were vaginal haematomas (N =6) and abscesses (N =2). Long-term symptoms were perineal pain, sciatic neuralgia, and dyspareunia. DISCUSSION AND CONCLUSION: There was no surgical mortality, and we noted low rates of major complications. Sacrospinous ligament fixation assumes high priority in our therapeutic regimen.

Adult↗
PubMed2003

Port site metastasis after laparoscopy for uterine cervical carcinoma.

BACKGROUND: Aim of this study was to review cases reported of port-site recurrence (PSR) after laparoscopy for uterine cervical carcinoma. METHODS: A Medline computer database search from January 1980 to September 2002. RESULTS: We reported 13 cases published of PSR after laparoscopy for cervical carcinoma. The majority of them were squamous carcinoma (9/13 at least, 69%) and initial staging of disease was Ib (7/13 (54%)). Median of interval between laparoscopy and diagnostic of PSR was 7 months (min 1.5 month, max 48 months). Of 10 cases of laparoscopy with lymphadenectomy, in three cases (30%) nodes were not involved. PSR developed at the port through which tissues was extracted in four cases (30.1%) or another port in five cases (38.5%). At the time of PSR, five patients (38.5%) were free of disease. CONCLUSIONS: PSR were reported after laparoscopy for lymphadenenectomy with or without hysterectomy and with or without node involvement. In some cases, umbilical metastases should not be systematically diagnosed as PSR and a diagnosis of Sister Mary Joseph's nodule may be discussed.

Adenocarcinoma↗
PubMed2003

[Complications of operative hysteroscopy].

OBJECTIVES: Assess the prevalence and severity of the various complications of operative hysteroscopy, the context in which they occur and the treatments proposed. METHOD: A single-center observational study from 1/1/90 to 1/1/99 including 2,116 surgical hysteroscopies (resection of a fibroma (782) or polyp (422), section of a septate uterus (199), synechia uteri (90) and endometrectomy (623)). RESULTS: There were 74 complications (3.5%). The most frequent was uterine perforation (34 cases (1.61%)). There were 13 cases of haemorrhage (0.61%), 16 cases of post-surgical fever (0.76%) and 11 metabolic complications (0.47%). Synechia uteri was the surgical intervention with the greatest risk of complications. CONCLUSIONS: The complications of surgical hysteroscopy are rare and relatively benign. Uterine perforation appears to predominate. In our study, the risk of complication was enhanced in the case of synechia uteri.

Endometrium↗
PubMed2003

[Atypical hyperplasia of endometrium and hysteroscopy].

OBJECTIVE: To evaluate the risk of discovering an endometrial cancer when atypical hyperplasia was diagnosed by either endometrial samples using the pipelle device or hysteroscopic resection products. PATIENTS AND METHODS: A retrospective monocentric study from january 1990 to july 2000. Twenty-three patients with atypical hyperplasia were included. Initial endometrial status was provided by endometrial biopsyduring diagnosis hysteroscopy (12 cases) or by operative hysteroscopic resection products (11 cases). For 23 patients, operative hysteroscopy and analyse of products resected were performed. For all patients, there was no hysteroscopical aspect evocative of adenocarcinoma. For 23 patients, histopathological analysis of the hysterectomy piece precised the final diagnosis. RESULTS: Among the 23 hysterectomy pieces, 7 adenocarcinomas were diagnosed (30.4%). Risk for discovering adenocarcinoma when atypical hyperplasia was diagnosed by means of the pipelle biopsy device was 50% (6/12). Risk for discovering adenocarcinoma when atypical hyperplasia was diagnosed by means of operative hysteroscopy resection products was 5.9 % (1/17). DISCUSSION AND CONCLUSION: Atypical endometrial hyperplasia evidenced by pipelle biopsy device is often associated with adenocarcinoma. Diagnosis hysteroscopy however does not show evident pathological aspect of adenocarcinoma in such cases. Operative hysteroscopy allows in most cases correction of endometrial status. Risk of omitting adenocarcinoma when atypical hyperplasia is discovered on hysteroscopic resection pieces is low.

Adenocarcinoma↗