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Bertogli H, Lucot JP, Lafourcade J, Warembourg S, Detchev R, Nguyen-Ba E, Dubernard G, Philip CA. [Laparoscopic ultrasound-guided radiofrequency ablation of uterine fibroid : a retrospective study]. Gynecol Obstet Fertil Senol 2024:S2468-7189(24)00191-0. [PMID: 38604536 DOI: 10.1016/j.gofs.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Objective : To assess clinical and radiological efficacy and safety of laparoscopic ultrasound-guided radiofrequency ablation of uterine leiomyomas. Material and Methods : Thirty-three patients with symptomatic uterine leiomyomas FIGO type 2 to 7, have undergone a laparoscopic ultrasound-guided radiofrequency ablation at Croix Rousse university hospital center (Hospices Civils de Lyon) and at Saint-Vincent de Paul hospital in Lille, between june 2020 and december 2022. The characteristics of each myoma and the symptoms were assessed with pelvic MRI and with Higham score, SSS and HRQL scores preoperatively and at 6 months. Results : A total of 54 fibroids have been treated in 33 patients. We observed a significant decrease of the volume 6 months after the surgery, on average 21ml (55,97 ml vs 74,37 ml, 95%CI [7,13 - 34,88], p=0.001). The maximum diameter of each fibroid was also significantly reduced on average 11,78mm (41,89 vs 52,06, IC 95% [8,83 - 14,73], p<0,05). We noticed a significant decrease of the NRS for dysmenorrhea on average 2.79 points (2,1 vs 4,89, 95%CI [1,14-4,42], p<0,05). There was also a trend to improvement of menorrhagia, assess by Higham score. Indeed, 70,8% of the patients had menorrhagia. Menorrhagia was improved of 108,3 points with an average Higham score before surgery of 197,3versus 87,9 after surgery (IC 95% [47,9-168,8], p=0,001). Concerning UFS-QOL score: the symptom severity score (SSS) decreased on average 33 points, testifying of symptom improvement (27,04 vs 60,89, 95%CI [22,92 - 43,39], p<0,001) and the HRQL score increased on average 20 points testifying quality of life improvement (65,57 vs 42,7, 95%CI [15,83-37,85], p<0,001). No severe adverse event has been reported. Conclusion : In this first French study about radiofrequency ablation, we confirm its efficiency for improvement of symptoms and quality of life, but other study are mandatory to confirm the safety of this procedure in particular in patients with a wish to conceive.
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Affiliation(s)
- H Bertogli
- Croix Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - J P Lucot
- Saint-Vincent-de-Paul Hospital, 59000 Lille, France
| | - J Lafourcade
- Saint-Vincent-de-Paul Hospital, 59000 Lille, France
| | - S Warembourg
- Croix Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - R Detchev
- Saint-Vincent-de-Paul Hospital, 59000 Lille, France
| | - E Nguyen-Ba
- Croix Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - G Dubernard
- Croix Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - C A Philip
- Croix Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.
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Declas E, Verdun S, Fauconnier A, Lucot JP. Risk factors for postoperative pain after cystocele repair with mesh. Int Urogynecol J 2023; 34:771-775. [PMID: 36063194 DOI: 10.1007/s00192-022-05285-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Prolapse is a common condition seen in women and its therapeutical management consists first and foremost of surgery. Postoperative pain is one of the most common side effects seen after surgery. The objective of this study was to identify risk factors for postoperative pain after cystocele repair with mesh. METHODS This is a secondary analysis of the multicenter randomized trial PROSPERE, which compared cystocele repair with mesh according to the vaginal or laparoscopic approach. The presence of postoperative pain was assessed by a pain-specific self-reported questionnaire (Questionnaire de Baudelocque). The statistical analysis is based on the Wilcoxon, Chi-squared, and Fisher's tests. RESULTS The prevalence of postoperative pain (pain persisting more than 6 months) was 39% (80 out of 205, 95% CI 32.4-46.1), with 6.3% (13 out of 205) of chronic pain reports. Preoperative pain was the only statistically significant risk factor OR = 2.32 (p = 0,007; 95% CI 1.24-4.36). CONCLUSIONS Surgeons must be careful with preoperative painful prolapse and should inform their patient of the risk of developing postoperative chronic pain.
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Affiliation(s)
- E Declas
- Obstetrics and Gynecology Department, Saint Vincent de Paul Hospital, Groupe des hôpitaux de l'institut catholique de Lille (GHICL), Boulevard de Belfort, 59000, Lille, France.
| | - S Verdun
- Lille Catholic hospitals, Biostatistics Department-Delegation for Clinical Research and Innovation, Lille Catholic University, Lille, France
| | - A Fauconnier
- Department of Gynecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, 10 rue du Champ Gaillard, BP 3082, 78300, Poissy Cedex, France
| | - J P Lucot
- Obstetrics and Gynecology Department, Saint Vincent de Paul Hospital, Groupe des hôpitaux de l'institut catholique de Lille (GHICL), Boulevard de Belfort, 59000, Lille, France
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Abstract
Extra-uterine leiomyomatosis is a rare pathology defined by the presence of benign smooth uterine muscle cells in unusual localizations, including different entities. It mainly affects premenopausal women with a medical history of uterine myoma with or without surgical treatment. Three main types are discribed: intraveinous leiomyomatosis, benign metastatisizing leiomyoma and leiomyomatosis peritonealis disseminata. The diagnosis may be complex with many differential diagnosis, and relies on histology. The treatment depends on multiple factors such as age, localization, size, symptoms and associated comorbidities. It is based on surgical resection and hormonal privation, surgical (adnexectomy) or medical (hormonotherapy). There is a high risk of recurrence. Some malignant evolutions have been reported, mostly leiomyosarcoma following peritoneal disseminated leiomyomatosis. Long term follow-up of these patients is mandatory. A particular manifestation of extra-uterine leiomyomatosis is the hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome. It is an autosomal dominant disorder which confers an increased risk of cutaneous and uterine leiomyomas and renal cell cancer, with a poor prognosis due to the urologic tumor.
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Affiliation(s)
- E Declas
- Service de gynécologie-obstétrique, hôpital Saint-Vincent-de-Paul, groupe des hôpitaux de l'institut catholique de Lille (GHICL), boulevard de Belfort, 59000 Lille, France.
| | - J P Lucot
- Service de gynécologie-obstétrique, hôpital Saint-Vincent-de-Paul, groupe des hôpitaux de l'institut catholique de Lille (GHICL), boulevard de Belfort, 59000 Lille, France
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Vignolle J, Lefebvre C, Lucot JP, Rubod C. About a case of traumatic separation of the cervix from the uterine corpus, diagnosed in a context of infertility. J Gynecol Obstet Hum Reprod 2018; 47:257-260. [PMID: 29574053 DOI: 10.1016/j.jogoh.2018.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/09/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
This article reports a case of cervico-isthmic disjunction unnoticed during childhood, diagnosed in a context of primary infertility and endometriosis, and surgically treated. It is an uncommon condition. The diagnosis is most often made as part of an assessment of primary amenorrhea in a young woman with a history of severe pelvic trauma. It is suspected after imaging assessment and confirmed intraoperatively. The treatment consists in an anastomosis between the cervix and the uterine body, after individualizing these two structures, around a drain guiding healing. After this surgery, multiple pregnancies have been successfully carried out.
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Affiliation(s)
- J Vignolle
- Service de gynécologie chirurgicale, pôle Femme-Mère-Nouveau-né, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
| | - C Lefebvre
- Service de procréation médicalement assistée, pôle Femme-Mère-Nouveau-né, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - J P Lucot
- Service de gynécologie chirurgicale, pôle Femme-Mère-Nouveau-né, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - C Rubod
- Service de gynécologie chirurgicale, pôle Femme-Mère-Nouveau-né, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Faculté de médecine Henri Warembourg. Université de Lille, France
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Giraudet G, Lucot JP, Sanz F, Rubod C, Collinet P, Cosson M. Outpatient vaginal hysterectomy: Comparison of conventional suture ligature versus electrosurgical bipolar vessel sealing. J Gynecol Obstet Hum Reprod 2017; 46:399-404. [PMID: 28934083 DOI: 10.1016/j.jogoh.2017.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/17/2017] [Accepted: 03/23/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of our study was to evaluate the feasibility of vaginal hysterectomy in an ambulatory care system and the best way to perform it between conventional and bipolar vessel sealing system ligatures. PATIENTS AND METHODS This was a prospective study of 32 patients with vaginal hysterectomy at Lille University Hospital between December 2013 and May 2015. Two surgical techniques were compared: conventional suture ligature (CSL) and electrosurgical bipolar vessel sealing (BVS). Patients stayed in classical hospitalization but were managed how if they were in an ambulatory unit to evaluate their capacity to come back home the same evening of the surgery. The evaluation of same-day discharge was based on Post Anesthetic Discharge Scoring System (PADSS) score?9/10 and Visual Analogic Scale (VAS) score?4/10. Other data collected were: operative time, uterus weight, peroperative bleeding, PADSS score at the 8th postoperative hour, VAS score at the 4th, 6th, 8th, 12th and 24th postoperative hours, the presence of postoperative nausea/vomiting and rehospitalization. RESULTS In the BVS group, 93.8% of patients validated the combined score (PADSS+VAS) on the evening of the intervention against 50% of patients in the CSL group (P<0.05). Hundred percent of BVS group patients were discharged on the day after surgery against 87.5% in the CSL group. The VAS was significantly lower in the BVS group at the 8th (1.4), 12th (1.2) and 24th (1.3) postoperative hours. Operative time was significantly shorter in the BVS group. We found more events such as nausea/vomiting in the CSL group. CONCLUSION Vaginal hysterectomy is feasible in an ambulatory care system most of times. By reducing postoperative pain, electrosurgical bipolar vessel sealing would promote outpatient hospitalization.
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Affiliation(s)
- G Giraudet
- Department of Gynecological Surgery, Jeanne-de-Flandre Hospital, Regional University Hospital of Lille, avenue Eugène-Avinée, 59000 Lille, France.
| | - J P Lucot
- Department of Gynecological Surgery, Jeanne-de-Flandre Hospital, Regional University Hospital of Lille, avenue Eugène-Avinée, 59000 Lille, France; Department of Gynecology and Obstetrics, Hospital of Bethune, 27, rue Delbecque, 62131 Verquigneul, France
| | - F Sanz
- Department of Anesthesiology in Obstetrics, Gynecology and Reproductive Medicine, Jeanne-de-Flandre Hospital, avenue Eugène-Avinée, 59000 Lille, France; Department of anesthesia, groupement des hôpitaux de l'institut catholique de Lille, hôpital Saint-Philibert, rue du Grand-But, 59160 Lomme, France
| | - C Rubod
- Department of Gynecological Surgery, Jeanne-de-Flandre Hospital, Regional University Hospital of Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - P Collinet
- Department of Gynecological Surgery, Jeanne-de-Flandre Hospital, Regional University Hospital of Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - M Cosson
- Department of Gynecological Surgery, Jeanne-de-Flandre Hospital, Regional University Hospital of Lille, avenue Eugène-Avinée, 59000 Lille, France
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Lepage J, Merlot B, Lucot JP. Bulky fibroid and pregnancy: myomectomy is possible during pregnancy. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3075.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Doucède G, Giraudet G, Lucot JP, Marcelli F, Cosson M. Ureteral kinking during cystocele correction trough UpHold(®) subvesical mesh: case report. Eur J Obstet Gynecol Reprod Biol 2016; 203:334-5. [PMID: 27401695 DOI: 10.1016/j.ejogrb.2016.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 02/28/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
Affiliation(s)
- G Doucède
- Department of Obstetrics and Gynecology, Hôpital Jeanne de Flandre, CHRU Lille, Avenue Eugène Avinee, 59037 Lille Cedex, France.
| | - G Giraudet
- Department of Obstetrics and Gynecology, Hôpital Jeanne de Flandre, CHRU Lille, Avenue Eugène Avinee, 59037 Lille Cedex, France
| | - J P Lucot
- Department of Obstetrics and Gynecology, Hôpital Jeanne de Flandre, CHRU Lille, Avenue Eugène Avinee, 59037 Lille Cedex, France
| | - F Marcelli
- Department of Urology, Hôpital Claude Huriez, CHRU Lille, Street Michel Polonovski, 59037 Lille Cedex, France
| | - M Cosson
- Department of Obstetrics and Gynecology, Hôpital Jeanne de Flandre, CHRU Lille, Avenue Eugène Avinee, 59037 Lille Cedex, France
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Kerbage Y, Debarge V, Lucot JP, Clouqueur E, Rubod C. Simulation training to teach postpartum hemorrhage surgery to residents. Eur J Obstet Gynecol Reprod Biol 2016; 201:27-30. [PMID: 27042768 DOI: 10.1016/j.ejogrb.2016.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Description of the aims, the framework and the results of a postpartum hemorrhage surgery workshop for residents. STUDY DESIGN This article is the first publication to describe a simulation workshop for the surgical management of maternal hemorrhage. Training was divided into both theoretical and practical workshops. Four obstetrician-gynecologists supervised residents who performed all the surgical procedures on a cadaver. This training course included the oldest residents at the Faculty of Medicine of Lille and was evaluated by participants using pre-test and post-test questionnaires. Medical knowledge was also evaluated. RESULTS The pre-test questionnaire showed that medical knowledge for the treatment of postpartum hemorrhage was acceptable but that real practice was lacking. Eighty-six percent of the residents responded that they were not able deal with the situation correctly and most considered it stressful. The post-test questionnaire showed that training greatly improved the participants' theoretical knowledge and technical skills as well as significantly improving self-confidence. CONCLUSIONS Based on these positive results this workshop will be included in the resident training program and also be extended to professionals as a part of the continuing medical education program.
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Affiliation(s)
- Y Kerbage
- Université de Lille - Faculté de Médecine, F-59000 Lille, France; Service de gynécologie-obstétrique - CHU Lille, F-59000 Lille, France
| | - V Debarge
- Université de Lille - Faculté de Médecine, F-59000 Lille, France; Service de gynécologie-obstétrique - CHU Lille, F-59000 Lille, France
| | - J P Lucot
- Service de gynécologie-obstétrique - CHU Lille, F-59000 Lille, France
| | - E Clouqueur
- Service de gynécologie-obstétrique - CHU Lille, F-59000 Lille, France
| | - C Rubod
- Université de Lille - Faculté de Médecine, F-59000 Lille, France; Service de gynécologie-obstétrique - CHU Lille, F-59000 Lille, France.
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Lepage J, Merlot B, Lucot JP, Subtil D. Bulky fibroid and pregnancy: myomectomy is possible during pregnancy. CLIN EXP OBSTET GYN 2016; 43:887-888. [PMID: 29944245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
When bulky fibroids are discovered during pregnancy, they can become acutely complicated. The question of their resection thus arises. The authors report a case of a woman who was diagnosed at eight weeks' gestation by ultrasound and then by MRI, with a uterine fibroma measuring 22x12x15 cm.
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Moureau D, Laurent N, Rubod C, Lucot JP, Salleron J, Faye N. Evaluation of tubal microinserts position using 3D ultrasound and pelvic X-ray. Diagn Interv Imaging 2015; 96:1133-40. [PMID: 26163222 DOI: 10.1016/j.diii.2014.12.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/30/2014] [Accepted: 12/03/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE To retrospectively compare three-dimensional ultrasonography (3D-US) and pelvic X-rays to assess the position of tubal sterilization microinserts. MATERIAL AND METHODS Forty-four patients who underwent tubal sterilization with Essure(®) microinserts in our institution were included. The microinserts'position was evaluated three months after the procedure using 3D-US and pelvic X-rays. Placement on 3D-US was binary categorized as correct or incorrect and the distance between the two devices was reported. The orientation and symmetric deployment of the microinserts and the distance between the proximal parts of the two devices was assessed on pelvic X-rays. Performance of 3D-US and pelvic X-ray were compared using Mac Nemar test. Comparison of the distance between the two devices measured on pelvic X-rays and 3D-US was made with the paired Student t test. RESULTS 3D-US images showed microinserts in 93% (41/44). Eighty-six percent (38/44) were correctly positioned on 3D-US and 82% (36/44) on pelvic X-rays. No significant differences between the performances of the two imaging techniques were found. No significant differences for the distance between the two devices measured on pelvic X-ray and 3D-US was found. CONCLUSION 3D-US is a simple, non-ionizing technique, which appears as a promising alternate technique to pelvic X-rays to assess the correct position of Essure(®) microinserts.
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Affiliation(s)
- D Moureau
- Women Medical Imaging Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
| | - N Laurent
- Women Medical Imaging Department, Valenciennes Hospital, Lille Nord University, Valenciennes, France
| | - C Rubod
- Gynecology Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - J P Lucot
- Gynecology Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - J Salleron
- Department of Biostatistics, EA2694, UDSL, Lille University, Lille, France
| | - N Faye
- Women Medical Imaging Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
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Hanssens S, Rubod C, Kerdraon O, Vinatier D, Lucot JP, Duhamel A, Collinet P. Pelvic endometriosis in women under 25: a specific management? Minerva Med 2015; 106:123-131. [PMID: 25283258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to describe the characteristics of women under 25 years with pelvic endometriosis and assess their potential for recurrence and fertility after surgery. METHODS In a comparative retrospective study, 108 patients aged less than 25 years who underwent surgery for pelvic endometriosis were included: 49 in the DIE group (deep infiltrating endometriosis) and 59 in the SE group (superficial endometriosis). The main outcome measures were complications, recurrence and fertility. This study received the favorable opinion of the CEROG No 2012-GYN-04-02. RESULTS The diagnosis was made at 21.6 ± 2.8 years, mainly considering clinical signs (78.4%), and on average 4.3 ± 3.7 years after the onset of symptoms; 16.1% of patients had to be reoperated (N.=5/31) due to a recurrence of their endometriosis. There were more recurrent pain (50% vs. 21.7%, P=0.005) and endometriosis (35.7 vs. 19.6%, P=0.08) in the DIE group. 75% (N.=33/44) patients desired pregnancy after surgery and 50% of them became pregnant, with one third thanks to assisted reproductive technology. CONCLUSION In young women, endometriosis is often more severe. The early treatment does not improve the rate of recurrence and fertility, but can reduce pain and thus improve the quality of life.
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Affiliation(s)
- S Hanssens
- Department of Obstetrics and Gynecology, Jeanne de Flandre Hospital, Regional University Hospital Center of Lille (CHRU), Lille cedex, France -
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Fernandez H, Capmas P, Lucot JP, Resch B, Panel P, Bouyer J. Fertility after ectopic pregnancy: the DEMETER randomized trial. Hum Reprod 2013; 28:1247-53. [DOI: 10.1093/humrep/det037] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVE We report two cases of perineal cellulitis due to the surgical treatment of female stress urinary incontinence with a trans-obturator sub-urethral tape of Uratape (Porgés). METHODS Treatment and follow up of their complication were performed at the CHRU of Lille. RESULTS In both cases, this complication is related to prolonged vaginal exposition of the tape. Vaginal erosion always occurs next to the silicon coated section of the tape. CONCLUSION Such a complication has never been described yet. It shows a lack of data concerning human tissue tolerance of sub-urethral tapes constituents. Such examples should call for caution against new materials, all the more so as they have not yet been validated by large scale studies.
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Affiliation(s)
- F Caquant
- Department of Gynaecologic Surgery, Jeanne de Flandre Maternity Hospital, CHRU de Lille, Lille, France.
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Lucot JP, Cosson M, Crepin G. [Surgical treatment of stress incontinence using a new vaginal tissue sling: short-term feasibility and complications]. J Gynecol Obstet Biol Reprod (Paris) 2001; 30:144-50. [PMID: 11319466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVE Many operative techniques have been proposed for urinary stress incontinence, a common finding in women. The goal of operating solely via a vaginal approach using autologous material has led to the development of a sling technique using a band of vaginal tissue. METHODS We described the operative technique and analyzed outcome in the first 35 patients operated with the new vaginal tissue sling technique. RESULTS Mean duration of the procedure was 35 minutes. The procedure was performed in two cases and thus could be used for prolapsus cure. We had no peroperative complications. Postoperative complications were mainly urine retention (50%) lasting a mean 4.4 days. Transfixation of the bladder was observed late in one case with resection of an intravesicular suture. At mean follow-up of 16.9 months, the success rate was 80% with 68.5% of the patients free of urine leakage. In case of sphincter insufficiency, the success rate was 85.7% (64.3% of the patients were free of leakage). Three of the four patients who had undergone prior Burch colpopexy were cured. DISCUSSION Our series demonstrated the feasibility of the new vaginal tissue sling technique. It appears to be an adapted procedure for urinary stress incontinence with sphincter insufficiency and particularly well adapted for low closure pressures and after failure of surgical cure. The final assessment of this technique will require longer follow-up and comparative studies with other methods.
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Affiliation(s)
- J P Lucot
- Hôpital Jeanne de Flandre, Pôle Chirurgie Gynécologique, CHU de Lille, et Pavillon Paul Gellée, CH de Roubaix
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Subtil D, Truffert P, Lucot JP, Massoni F, Dufour P, Puech F. [Managing premature rupture of the membranes before 24 weeks]. J Gynecol Obstet Biol Reprod (Paris) 1999; 28:642-9. [PMID: 10624611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- D Subtil
- Clinique de Gynécologie-Obstétrique-Néonatologie, Hôpital Jeanne de Flandre, Lille
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Durand-Réville M, Robert Y, Dufour P, Lucot JP, Rocourt N, Mizrahi D, Monnier JC. [Ultrasonic diagnosis of placenta percreta. Apropos of a case with hemorrhagic complication]. J Radiol 1997; 78:313-6. [PMID: 9239369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Placenta percreta is a rare but severe disease, which is more and more frequent. The reported case shows that diagnosis can be made with B mode and color Doppler ultrasonography. Extension of high-vascularized placenta to the myometrium, abnormal placental-subplacental complex and vascular flow through the myometrium were suggestive of the diagnosis. Early diagnosis should decrease mortality and morbidity.
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