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Biomedical subjects

L Muzii

Publications and source records attributed to L Muzii.

51 records · Page 3Linked to original sources
PubMed1991

Salpingoscopy in patients with contralateral ectopic pregnancy.

Patients who experience a tubal pregnancy have a poor prognosis in terms of reproductive potential and are at increased risk of a repeat EP. Salpingoscopy is a new endoscopic technique that allows the detection of abnormalities of the tubal mucosa. In seven patients with a follow-up longer than 6 months, an IUP occurred only in patients with a normal ampullary mucosa, whereas a recurrent tubal pregnancy occurred in the patient that conceived with an abnormal tubal mucosa. These preliminary results suggest that salpingoscopy may constitute an important prognostic factor in these patients.

Adult↗
PubMed1991

Reproductive outcome after ovarian surgery: suturing versus nonsuturing of the ovarian cortex.

The purpose of this study was to ascertain if microsurgical approximation of the ovarian edges after ovarian surgery alters postoperative results, as determined by both adhesion formation and reproductive outcome. Sixteen female white New Zealand rabbits were anesthetized, and the ovaries were exposed. Each ovary was longitudinally bivalved with a scalpel, but only one ovary was reconstructed microsurgically, whereas the contralateral ovary was left open. Four weeks after surgery, the rabbits were mated, and two weeks later, a laparotomy was performed to evaluate postoperative adhesions, the number of corpora lutea in each ovary, and the number of embryos in each uterine horn. The nidation index was calculated. No significant differences were found between the microsurgically sutured and the nonsutured ovaries for all the parameters evaluated. Our data suggest that not closing the ovarian incision does not alter either postoperative adhesion formation or reproductive outcome.

Animals↗
PubMed1991

Reproductive outcome after ovarian surgery: microsurgery versus CO 2 laser.

The present study was undertaken to compare CO 2 laser vs microsurgery in ovarian surgery, evaluating both postoperative adhesion formation and reproductive outcome. Eighteen female white New Zealand rabbits were anesthetized, and the ovaries were exposed. At random, one ovary was longitudinally bivalved with a scalpel and then reconstructed by microsurgery. The contralateral ovary was similarly cut, but with a CO 2 laser set at a superpulsed mode. Four weeks after surgery, the rabbits were mated, and two weeks later, the animals were evaluated for extent of postoperative adhesion formation, number of corpora lutea in each ovary, and number of embryos in each uterine horn. The nidation index was calculated. The present study shows no difference in postoperative adhesion formation or reproductive function following ovarian surgery by microsurgery or CO 2 laser.

Animals↗
PubMed1990

Gonadotrophin releasing hormone agonist (buserelin) in the treatment of endometriosis: changes in the extent of the disease and in CA 125 serum levels after 6-month therapy.

Twenty-two women with endometriosis were treated with the luteinizing hormone-releasing hormone (LHRH) agonist buserelin for 6 months. At second-look laparoscopy the mean score of endometriosis had decreased from 23.1 (SD 17.0) to 17.2 (SD 20.2) (P less than 0.05). CA 125 serum levels decreased from 38.4 (SD 32.2) U/ml at diagnosis to 15.5 (SD 7.0) at second look (P less than 0.005). CA 125 levels correlated at diagnosis with total score of endometriosis (P less than 0.05) and with active score of endometriosis (P less than 0.05), but not with the adhesion score. CA 125 levels were not correlated with endometriosis scores at second look laparoscopy, thus suggesting that mechanisms other than the change in the extent of the disease may be involved in the CA 125 decrease during therapy. CA 125 levels may therefore not be a reliable indicator for monitoring the efficacy of LHRH agonist treatment of endometriosis.

Adult↗
PubMedDate not supplied

Tubal factor infertility.

Various studies demonstrated that there is no close correlation between the intratubal damage and the extent and type of pelvic adhesions. Moreover, the results of prospective studies on the prognostic value of salpingoscopy showed that the tubal mucosal status is the most important prognostic factor in terms of reproductive outcome. Salpingoscopy has modified the management of patients with tubal infertility, since the accurate evaluation of the tubal mucosa permits the selection of patients with a normal mucosa (34-42% of the patients with hydrosalpinx and 76-80% of those with periadnexal adhesions) who can benefit from tubal reconstructive surgery. In these patients the term pregnancy rate is 60% in case of hydrosalpinx and 70% in case of periadnexal adhesions.

Fallopian Tube Diseases↗
PubMedDate not supplied

Endometriosis externa and interna: endoscopic diagnosis.

Endometriosis is defined as the presence of the endometrium outside the endometrial cavity. If the ectopic mucosa is located within the endometrium, the disease is defined as endometriosis interna, or adenomyosis, whereas the localization of the endometrium outside the uterus is defined as endometriosis externa, or pelvic endometriosis. The diagnosis of pelvic endometriosis requires invasive techniques, such as laparoscopy or laparotomy, with histologic confirmation on the surgical specimen. The diagnosis of adenomyosis should be based on histology of hysterectomy specimen, since the endoscopic diagnosis is still too inaccurate. Laparoscopy allows the visualization of the different aspects of pelvic endometriosis, i.e. superficial implants, deep lesions, and associated adhesions. Staging is based on a score attributed to each location in order to establish a prognosis in terms of the patient's reproductive performance.

Endometriosis↗
PubMedDate not supplied

Operative laparoscopy.

Operative laparoscopy has replaced the conventional approach by laparotomy to the treatment of most benign gynecological diseases (benign adnexal cysts, ectopic pregnancy, tubal infertility, polycystic ovarian disease, endometriosis, myomas), with advantages in terms of shorter hospital stay, less discomfort and complications for the patient, minor social costs due to the early resumption of normal working activities, and comparable results in terms of reproductive outcome.

Female↗
PubMedDate not supplied

Incidence of genital tuberculosis in infertile patients submitted to diagnostic laparoscopy: recent experience in an Italian university hospital.

The incidence of genital tuberculosis is decreasing in industrialized countries. The authors report their experience in 254 patients with primary or secondary infertility. Out of 101 patients with a tubal factor of infertility, two patients were diagnosed as having tuberculosis by both endometrial biopsy and endometrial culture. In a third patient, even in the presence of laparoscopic findings suggesting genital tuberculosis Mycobacterium tuberculosis was isolated only from the urine.

Adult↗
PubMedDate not supplied

Evaluation of the correlation between endometriosis extent, age of the patients and associated symptomatology.

Two-hundred-and-six patients newly diagnosed to have endometriosis at laparoscopy were evaluated in order to see if endometriosis-associated symptoms are proportional to the extent of the disease, as assessed using the Revised American Fertility Society Classification, and if the extent worsens with age. At hospital admission 81% of the patients complained of dysmenorrhea, 54% of chronic pelvic pain and 27% of dyspareunia. At laparoscopy, 39% of the patients had stage I endometriosis, 13% stage II, 35% stage III and 13% stage IV. At statistical analysis, no significant differences were found in total endometriosis scores, in active scores or in adhesion scores in different age groups. Although a difference in prevalence rate for dysmenorrhea and dyspareunia stage I versus III was found, a trend of increasing severity of symptoms with more widespread disease was not evident. There was not a significant difference in prevalence rate of symptoms for different aspects of endometriosis (implants, cysts or adhesions). Our data show that the American Fertility Society classification does not reflect the intensity of endometriosis-associated symptoms, probably underestimating the most active forms of this disease, and does not allow to follow a possible natural progression of the disease.

Abdominal Pain↗
PubMedDate not supplied

Perlaparoscopic salpingoscopy in the evaluation of the tubal factor in infertile women.

Endoscopic evaluation of tubal mucosa during tubal reconstructive microsurgery has been shown to be an important prognostic factor in predicting the probability of a subsequent intrauterine pregnancy. Recent reports have described the use of this technique during laparoscopy in order to evaluate the tubal factor in infertility. We report our experience with this new diagnostic procedure. We utilized a flexible fiberscope with an outer diameter of 3.8 mm for endotracheal intubation. The fiberscope was passed through the operating channel of the laparoscope in order to evaluate the tubal mucosa in patients with primary and secondary infertility associated with tubes patent at the distal end. We encountered abnormalities of the infundibulum or of the ampullary mucosa in 24% of the tubes considered normal at HSG and in 27% of the tubes judged normal at laparoscopy. On the contrary, 44% of the tubes with abnormalities at HSG and 58% of the tubes with abnormalities at laparoscopy presented normal mucosa at salpingoscopy. Our results, in addition to those published in the literature, demonstrate that salpingoscopy is an important and valuable diagnostic procedure for an accurate evaluation of infertile patients. With this technique it is also possible to select patients with a favorable prognosis for tubal microsurgery.

Endoscopes↗
PubMedDate not supplied

Salpingoscopy in patients with endometriosis-associated infertility.

Endoscopic evaluation of the tubal mucosa has been shown to be an important prognostic factor in predicting the probability of a subsequent intrauterine pregnancy. A recent classification of the tubal mucosa lesions allows uniformity of evaluation, permitting comparison of results in prospective studies. It has been suggested that endometriosis may be associated with intratubal abnormalities. In this prospective study we evaluated 35 patients with endometriosis-associated infertility. No intraluminal abnormalities were found, and all the patients that subsequently conceived had an intrauterine pregnancy.

Adult↗
PubMedDate not supplied

Absorbable versus non-absorbable sutures in ovarian microsurgery: experimental results in the rabbit model.

Microsurgery has been shown to reduce the risk of adhesion formation when compared to conventional surgery in cases of benign ovarian pathology. However, the microsurgeons have contrasting opinions concerning the use of absorbable versus non-absorbable suture materials. In the present study we compared nylon versus vicryl sutures for ovarian surgery using the rabbit as an experimental model. No differences were found in terms not only of post-operative adhesions but also in terms of post-operative reproductive outcome for the sutures analyzed.

Animals↗
PubMedDate not supplied

GnRH analogs versus expectant management in minimal and mild endometriosis-associated infertility.

The aim of the present study is to compare the outcome of GnRH analog treatment versus expectant management in infertile patients with minimal and mild endometriosis. From January 1987 to December 1990, 14 patients with stage I and II endometriosis underwent a six-month course of the GnRH analog buserelin, whereas 38 patients underwent expectant management. The two groups were comparable as to mean age of the patients, mean length of infertility prior to diagnosis and mean scores of endometriosis. No major tubal or male factor of infertility was present in any patient. Cumulative pregnancy rates at 12 months were comparable in the two groups (48% for GnRH analog treatment and 42% for expectant management). Expectant management should therefore be considered the most cost-effective option in the management of mild endometriosis-associated infertility.

Buserelin↗
PubMedDate not supplied

Reproductive performance in women with bicornuate uterus.

The medical records of 21 patients with bicornuate uterus were analyzed. Thirteen patients did not undergo corrective surgery, whereas eight underwent metroplasty. The pregnancies in patients who did not undergo surgery, and the outcome evaluated. The outcome of pregnancies after corrective surgery was also analyzed. The cumulative pregnancy rates at 12 and 24 months were 67% and 95% in patients without surgical correction and 63% and 88% in patients after surgical correction. The probability of giving birth to a live-born infant with no corrective surgery was 30%, 58% and 79% for the first, second and third pregnancy respectively; the probability of giving birth to a live-born infant after corrective surgery was 71% for the first and 86% for the second pregnancy. Fertility is not impaired in patients with bicornuate uterus, but gestational capacity is. A prognostic estimate of the likelihood of giving birth to a live-born infant can be formulated according to the number of pregnancies and/or surgical correction.

Adult↗