1
|
Delacroix C, Martis S, Allegre L, Fatton B, De Tayrac R, Wagner L. ["Do uro-gynecology multidisciplinary team meeting modify therapeutic management?"]. Fr J Urol 2024; 34:102587. [PMID: 38367348 DOI: 10.1016/j.fjurol.2024.102587] [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: 09/24/2023] [Revised: 12/12/2023] [Accepted: 01/06/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Since the banning of trans-vaginal meshes for pelvic organ prolapse treatment by the FDA in 2019, French authorities have been gradually regulating the use of prosthetic materials in urogynecology. The decision to fit a mid-urethral sling or a reinforcement implant for the cure of prolapse, as well as the management of complex genital prolapse and serious post-implant complications, must be the subject of multidisciplinary consultation and a shared medical decision. To comply with these regulations, multidisciplinary team meetings (MDTMs) have been set up. The aim of the study was to evaluate the impact of these meetings on patient management. MATERIAL We carried out a retrospective study in a tertiary hospital in France on all cases presented in MDTM of urogynecology over the year 2022. MDTMs were held weekly, with a "Prosthesis MDTM" focusing on slings, sacrocolpo/hysteropexies and prosthetic complications, lead by the urology team, and a "Prolapse MDTM" focusing on pelvic organ prolapse and complex prolapses, lead by the gynecology team. We compared the initial proposal of the patient's referring physician versus the final proposal of the MDTM. RESULTS Three hundred and seventy-five cases were presented in our center in 2022: 188 in Prosthetic MDTM and 187 in Prolapse MDTM. The Prosthetic and Static MDTMs agreed with the initial proposal in 83 and 64% of cases respectively, while the therapeutic strategy was questioned in 12 and 36% of cases respectively. CONCLUSION For almost a quarter (24%) of patients, the MDTM of urogynecology opted for a different management from that proposed by the referring physician. The presentation of cases to the MDTM is a legal obligation in specific indications. It also plays an educational role, enabling shared decision-making and responsibility, which is an asset in functional surgery. LEVEL OF EVIDENCE: 4
Collapse
|
2
|
Al Salehi A, Zemmache MZ, Allegre L, Fatton B, de Tayrac R. Functional and sexual outcomes following surgical vaginal introital reduction. Prog Urol 2023:S1166-7087(23)00107-0. [PMID: 37263901 DOI: 10.1016/j.purol.2023.05.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/13/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Surgical introital reduction procedures are commonly performed for the treatment of vaginal laxity (VL), yet poorly studied. The aim of this study was to assess clinical outcomes following surgical vaginal introital reduction for VL. METHODS This was an ambidirectional cohort study conducted in a single urogynecology center. All sexually active women who had vaginal introital surgical reduction for VL between March 2015 and September 2020 were included in this study. VL was defined as a genital hiatus distance ≥4cm according to the POP-Q classification, associated with symptoms of laxity. The primary endpoint was sexual health assessed by the Pelvi-Perineal Surgery Sexuality Questionnaire (PPSSQ), while the secondary endpoints included postoperative pain, perioperative complications, rate of dyspareunia, patient satisfaction and success rate based on the Patient Global Improvement Index (PGI-I) and Vaginal Laxity Questionnaire (VLQ). RESULTS Of the 27 patients sent the questionnaires, 23 sexually active patients returned the completed ones and were included in the study. Participants had a mean age and BMI of 41 years (range 24-74) and 21.3 (range 17.6-31.9) respectively. The most prevalent preoperative symptom was feeling of VL in 82.6% followed by bulging sensation in 47.8%. Preoperative dyspareunia was reported in 8/23 (34.8%). Surgical interventions involved perineorrhaphy with (n=14) or without (n=9) levator ani plication. The PPSSQ mean sexual health score was 86.7/100 (SD 5.8; range 16.7-93.3) and the mean discomfort and pain score was 27.5/100 (SD 26.0; range 0-80). Postoperative sexuality was reported to better, identical or worse in 16 (69.6%), 2 (8.7%) and 5 (21.7%) patients respectively. On PGI-I, patients reported feeling much better, better, slightly better and no change in 10 (43.5%), 5 (21.7%), 5 (21.7%) and 3 (13.0%) respectively. None of the women reported feeling worse. The overall post-operative complication rate was 3/23 (13.0%), including a perineal hematoma, and two cases of reoperation for narrow introitus. De novo dyspareunia was reported by 11/18 (61.1%) patients, occurring often or more in 4/18 (22.2%) patients, due to narrow introitus (n=2), enlarge introitus (n=1) and vaginal dryness (n=1). CONCLUSION Vaginal introital reduction surgery is a viable treatment option for symptoms of vaginal laxity after failure of conservative measures. However, patients should be made aware of the risk of de novo dyspareunia. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Asma Al Salehi
- Obstetrics and Gynecology Department, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Mohammed Zakarya Zemmache
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Lucie Allegre
- Obstetrics and Gynecology Department, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Brigitte Fatton
- Obstetrics and Gynecology Department, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Renaud de Tayrac
- Obstetrics and Gynecology Department, Nîmes University Hospital, University of Montpellier, Nîmes, France.
| |
Collapse
|
3
|
Leborne P, de Tayrac R, Zemmache Z, Serrand C, Fabbro-Peray P, Allegre L, Vintejoux E. Incidence of obstetric anal sphincter injuries following breech compared to cephalic vaginal births. BMC Pregnancy Childbirth 2023; 23:317. [PMID: 37142944 PMCID: PMC10161470 DOI: 10.1186/s12884-023-05595-5] [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: 12/27/2022] [Accepted: 04/11/2023] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Obstetric anal sphincter injuries (OASIs) at the time of childbirth can lead to serious consequences including anal incontinence, dyspareunia, pain and rectovaginal fistula. These types of lesions and their incidence have been well studied after cephalic presentation deliveries, but no publications have specifically addressed this issue in the context of vaginal breech delivery. The goal of our study was to evaluate the incidence of OASIs following breech deliveries and compare it with cephalic presentation births. METHODS This was a retrospective cohort study involving 670 women. Of these, 224 and 446 had a vaginal birth of a fetus in the breech (breech group) and cephalic (cephalic group) presentations respectively. Both groups were matched for birthweight (± 200 g), date of delivery (± 2 years) and vaginal parity. Main outcome of interest was to evaluate the incidence of OASIs following breech vaginal birth compared to cephalic vaginal births. Secondary endpoints were the incidence of intact perineum or first-degree tear, second-degree perineal tear and rates of episiotomies in each group. RESULTS There was no statistically significant difference in OASIs incidence between the breech and cephalic groups (0.9% vs. 1.1%; RR 0.802 (0.157; 4.101); p = 0.31). There were more episiotomies in the breech group (12.5% vs. 5.4%, p = 0.0012) and the rate of intact or first-degree perineum was similar in both groups (74.1% vs. 75.3%, p = 0.7291). A sub-analysis excluding patients with episiotomy and history of OASIs did not show any statistically significant difference either. CONCLUSION We did not demonstrate a significant difference in the incidence of obstetric anal sphincter injuries between women who had a breech vaginal birth compared to cephalic.
Collapse
Affiliation(s)
- Perrine Leborne
- Department of Obstetric Gynecology, University Hospital Arnaud de Villeneuve, 371 avenue du Doyen Gaston Giraud - 34000, Montpellier, 34000, France.
| | - Renaud de Tayrac
- Department of Obstetric Gynecology, University Hospital of Nimes, Place du Pr R. Debré, NIMES CEDEX9, 30029, France
| | - Zakarya Zemmache
- Statistics department (BESPIM), University Hospital of Nimes, Place du Pr R. Debré, NIMES CEDEX9, 30029, France
| | - Chris Serrand
- Statistics department (BESPIM), University Hospital of Nimes, Place du Pr R. Debré, NIMES CEDEX9, 30029, France
| | - Pascale Fabbro-Peray
- Statistics department (BESPIM), University Hospital of Nimes, Place du Pr R. Debré, NIMES CEDEX9, 30029, France
| | - Lucie Allegre
- Department of Obstetric Gynecology, University Hospital of Nimes, Place du Pr R. Debré, NIMES CEDEX9, 30029, France
| | - Emmanuelle Vintejoux
- Department of Obstetric Gynecology, University Hospital Arnaud de Villeneuve, 371 avenue du Doyen Gaston Giraud - 34000, Montpellier, 34000, France
| |
Collapse
|
4
|
Leborne P, Huberlant S, Masia F, de Tayrac R, Letouzey V, Allegre L. Clinical outcomes following surgical management of deep infiltrating endometriosis. Sci Rep 2022; 12:21800. [PMID: 36526707 PMCID: PMC9758215 DOI: 10.1038/s41598-022-25751-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
The main aim of the study was to evaluate severe post-operative complications following deep endometriosis surgery in a tertiary referral centre. This is a retrospective cohort study that included women who had surgery for deep infiltrating endometriosis between 1st January 2013 and 31st December 2019. Endometriosis was diagnosed based on clinical, imaging and histological parameters. We evaluated the rates of post-operative complications, potential risk factors for such complications and postoperative pregnancy rates. A total of 165 patients were included in the final analysis. The median follow-up was 63 (25-106) months. Thirty-seven patients (22.42%) had hysterectomy, 60 (36.81%) had ureterolysis and 44 (26.67%) had colorectal surgery. The overall and severe rates of post-operative complications were 16.20% (n = 23) and 2.42% (n = 4) respectively. Of the variables assessed, operative time and age were the only statistically significant risk factor for complications on multivariate analysis. Among women operated on for infertility, 34.5% (n = 20/58) got pregnant following surgery with 30% of these spontaneously. This study demonstrates acceptable overall and severe post-operative complications and pregnancy rates after deep endometriosis surgery. This information should help clinicians when counselling women to enable them making an informed choice about their management.
Collapse
Affiliation(s)
- Perrine Leborne
- grid.411165.60000 0004 0593 8241Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France
| | - Stephanie Huberlant
- grid.411165.60000 0004 0593 8241Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France ,grid.121334.60000 0001 2097 0141Department of Artificial Polymers, Max Mousseron Institute of Biomolecules, CNRS UMR 5247, University of Montpellier 1, Montpellier, France
| | - Florent Masia
- grid.411165.60000 0004 0593 8241Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France
| | - Renaud de Tayrac
- grid.411165.60000 0004 0593 8241Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France ,grid.121334.60000 0001 2097 0141Department of Artificial Polymers, Max Mousseron Institute of Biomolecules, CNRS UMR 5247, University of Montpellier 1, Montpellier, France
| | - Vincent Letouzey
- grid.411165.60000 0004 0593 8241Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France ,grid.121334.60000 0001 2097 0141Department of Artificial Polymers, Max Mousseron Institute of Biomolecules, CNRS UMR 5247, University of Montpellier 1, Montpellier, France
| | - Lucie Allegre
- grid.411165.60000 0004 0593 8241Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France
| |
Collapse
|
5
|
Carcel C, Masia F, Marsollier-Ferrer C, de Tayrac R, Allegre L. [How I do… To simply expose myself without a uterine manipulator and to limit the risk of tumor dissemination during a hysterectomy for cancer?]. Gynecol Obstet Fertil Senol 2022; 50:93-97. [PMID: 34800740 DOI: 10.1016/j.gofs.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Affiliation(s)
- C Carcel
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France.
| | - F Masia
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - C Marsollier-Ferrer
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - R de Tayrac
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - L Allegre
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| |
Collapse
|
6
|
Huberlant S, Leprince S, Allegre L, Warembourg S, Leteuff I, Taillades H, Garric X, de Tayrac R, Letouzey V. In Vivo Evaluation of the Efficacy and Safety of a Novel Degradable Polymeric Film for the Prevention of Intrauterine Adhesions. J Minim Invasive Gynecol 2020; 28:1384-1390. [PMID: 33152532 DOI: 10.1016/j.jmig.2020.10.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/15/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVE To study the safety of a degradable polymeric film (DPF) and its efficacy on reducing the risk of intrauterine-adhesion (IUA) formation in a rat model. DESIGN A series of case-control studies relying on random allocation, where feasible. SETTING University and good practice animal laboratories. ANIMALS The animal models comprised female and male Oncins France Strain A and female Wistar rats. INTERVENTION(S) AND MEASUREMENTS The Oncins France Strain A rats were used for in vivo evaluation of the impact of the DPF on endometrial thickness and its effect on fertility. For in vivo evaluation of the biologic response, 40 Wistar rats were randomly allocated to intervention and control groups, with matched sampling time after surgery. Finally, for the in vivo evaluation of the DPF's efficacy on IUA prevention, a total of 24 Wistar rats were divided into 3 groups: 1 treated with the DPF, 1 treated with hyaluronic acid gel, and a sham group. MAIN RESULTS The DPF did not have a significant impact on endometrial thickness, and there were no significant differences in the number of conceived or prematurely terminated pregnancies, confirming its noninferiority to no treatment. The DPF did not induce irritation at 5 days and 28 days. Finally, the DPF significantly reduced the likelihood of complete IUA formation compared with hyaluronic acid gel- and sham-implanted animals, where only 27% of the animals had their uterine cavity obliterated compared with 80% and 100%, respectively. CONCLUSION The DPF is a safe film that is effective in preventing IUA formation after intrauterine curettage in rats.
Collapse
Affiliation(s)
- Stéphanie Huberlant
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France.
| | - Salome Leprince
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Lucie Allegre
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Sophie Warembourg
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Isabelle Leteuff
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Hubert Taillades
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Xavier Garric
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Renaud de Tayrac
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| | - Vincent Letouzey
- Institut des Biomolécules Max Mousseron, UMR 5247, CNRS, Université Montpellier, ENSCM (Drs. Huberlant, Leprince, Allegre, Warembourg, Leteuff, Garric, de Tayrac, and Letouzey); Experimental Department, University of Montpellier (Mr. Taillades), Montpellier; Department of Gynecology and Obstetrics, CHU Nîmes, University of Montpellier, Nîmes (Drs. Huberlant, Allegre, de Tayrac, and Letouzey); Gynecology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon (Dr. Warembourg), France
| |
Collapse
|
7
|
Larouzee E, Allegre L, Boudy AS, Ilenko A, Selleret L, Zilberman S, Owen C, Gligorov J, Richard S, Thomassin-Naggara I, Chabbert-Buffet N, Darai E, Bendifallah S. Predicting the likelihood of recurrence of pregnancy-associated breast cancer: Nomogram based on analysis of the French cancer network: Cancer Associé à La Grossesse. J Gynecol Obstet Hum Reprod 2020; 50:101766. [PMID: 32325267 DOI: 10.1016/j.jogoh.2020.101766] [Citation(s) in RCA: 1] [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: 01/25/2020] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Pregnancy associated breast cancer (PABC) are defined as breast cancer diagnosed during pregnancy and during the year following delivery. The prediction of poor prognosis events (PPE) such as recurrence is a major medical challenge of management for women with PABC. The aim of this study was to build a nomogram based on selected clinical and histological variables to predict recurrence. STUDY DESIGN This retrospective study included 96 patients with PABC from January 2002 to January 2018. A multivariate Cox analysis of selected risk factors was performed and a nomogram to predict recurrence was built. The nomogram was internally validated. RESULTS The overall recurrence rate was 22% (21/95) and the 3-years recurrence rate was 13% (12/95). Age at diagnosis, histological type, immuno-histological class, tumor stage (TNM), node stage (TNM) were associated with PPE in univariate analysis, and were included in the final Cox model to develop the nomogram. The predictive model had a concordance index of 0.83 (95% Confidence Interval (CI), 0.81-0.85) and 0.78 (95% CI, 0.76-0.80) before and after the 200 repetitions of bootstrap sample corrections, respectively, and showed a good calibration. CONCLUSION Our results support the use of the present nomogram based on 5 clinical and pathological characteristics to predict PPE in PABC with a high concordance. External validation is required to recommend this nomogram in routine practice.
Collapse
Affiliation(s)
- Elise Larouzee
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.
| | - Lucie Allegre
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France
| | - Anne-Sophie Boudy
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France
| | - Anna Ilenko
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France
| | - Lise Selleret
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France
| | - Sonia Zilberman
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France
| | - Clémentine Owen
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France
| | - Joseph Gligorov
- Centre CALG (Cancer Associé à La Grossesse), France; Department of Oncology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France
| | - Sandrine Richard
- Centre CALG (Cancer Associé à La Grossesse), France; Department of Oncology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France
| | - Isabelle Thomassin-Naggara
- Department of Radiology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France
| | - Nathalie Chabbert-Buffet
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France; UMRS-938 Sorbonne University, Paris, France
| | - Emile Darai
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France; UMRS-938 Sorbonne University, Paris, France
| | - Sofiane Bendifallah
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; Centre CALG (Cancer Associé à La Grossesse), France; UMRS-938 Sorbonne University, Paris, France
| |
Collapse
|
8
|
Allegre L, Debodinance P, Demattei C, Fabbro Peray P, Cayrac M, Fritel X, Courtieu C, Fatton B, Tayrac R. Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial. Neurourol Urodyn 2019; 38:2242-2249. [DOI: 10.1002/nau.24125] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/14/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Lucie Allegre
- Department of Obstetrics and GynaecologyNîmes University Hospital Nîmes France
| | | | - Christophe Demattei
- Department of BESPIM (Biostatistics, Epidemiology, Public Health and Innovation in Methodolgy)Nîmes University Hospital Nîmes France
| | - Pascale Fabbro Peray
- Department of BESPIM (Biostatistics, Epidemiology, Public Health and Innovation in Methodolgy)Nîmes University Hospital Nîmes France
| | - Mélanie Cayrac
- Department of Obstetrics and GynaecologyMontpellier University Hospital Montpellier France
| | - Xavier Fritel
- Department of Obstetrics and GynaecologyPoitiers University Hospital Poitiers France
| | | | - Brigitte Fatton
- Department of Obstetrics and GynaecologyNîmes University Hospital Nîmes France
| | - Renaud Tayrac
- Department of Obstetrics and GynaecologyNîmes University Hospital Nîmes France
| |
Collapse
|
9
|
Leprince S, Huberlant S, Allegre L, Warembourg S, Leteuff I, Bethry A, Paniagua C, Taillades H, De Tayrac R, Coudane J, Letouzey V, Garric X. Preliminary design of a new degradable medical device to prevent the formation and recurrence of intrauterine adhesions. Commun Biol 2019; 2:196. [PMID: 31123719 PMCID: PMC6531438 DOI: 10.1038/s42003-019-0447-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/26/2019] [Indexed: 01/22/2023] Open
Abstract
Intrauterine adhesions lead to partial or complete obliteration of the uterine cavity and have life-changing consequences for women. The leading cause of adhesions is believed to be loss of stroma resulting from trauma to the endometrium after surgery. Adhesions are formed when lost stroma is replaced by fibrous tissue that join the uterine walls. Few effective intrauterine anti-adhesion barriers for gynecological surgery exist. We designed a degradable anti-adhesion medical device prototype to prevent adhesion formation and recurrence and restore uterine morphology. We focused on ideal degradation time for complete uterine re-epithelialization for optimal anti-adhesion effect and clinical usability. We developed a triblock copolymer prototype [poly(lactide) combined with high molecular mass poly(ethylene oxide)]. Comparative pre-clinical studies demonstrated in vivo anti-adhesion efficacy. Ease of introduction and optimal deployment in a human uterus confirmed clinical usability. This article provides preliminary data to develop an intrauterine medical device and conduct a clinical trial.
Collapse
Affiliation(s)
- Salome Leprince
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
| | - Stéphanie Huberlant
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
- Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France
| | - Lucie Allegre
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
- Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France
| | - Sophie Warembourg
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
- Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France
| | - Isabelle Leteuff
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
- Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France
| | - Audrey Bethry
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
| | - Cedric Paniagua
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
| | - Hubert Taillades
- Experimental Department, University of Montpellier, Montpellier, 34000 France
| | - Renaud De Tayrac
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
- Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France
| | - Jean Coudane
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
| | - Vincent Letouzey
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
- Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France
| | - Xavier Garric
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France
| |
Collapse
|
10
|
Larouzée E, Allegre L, Boudy A, Darai E, Bendifallah S. Nomogram predicting recurrences in pregnancy-associated breast cancer: analysis from the French cancer network Cancer Associé à La Grossesse (CALG). Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.113] [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: 10/27/2022] Open
|