Fertility Sparing Gynaecological Surgery

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Women's Health Care".

Deadline for manuscript submissions: closed (24 February 2023) | Viewed by 4616

Special Issue Editors


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Guest Editor
Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
Interests: gynaecologic oncology; endometriosis; minimally invasive surgery
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Guest Editor
Clinic of Obstetrics and Gynecology, Dipartimento di Area Medica (DAME), University Hospital of Udine, University of Udine, 33100 Udine, Italy
Interests: gynaecologic oncology; endometriosis; minimally invasive surgery

Special Issue Information

Dear Colleagues,

The advancement of knowledge and the accuracy of diagnostic procedures make it possible today to make an early diagnosis of many gynaecological pathologies, both benign and malignant. Women who receive in adolescence the diagnosis of a benign disease with a high risk of chronicization or a malignant gynaecological disease are promptly referred to a specialist surgical evaluation. This means that many young women undergo early gynaecological surgery, and it is therefore necessary to consider and preserve their reproductive potential. Patients with ovarian cysts, endometriosis, pelvic inflammatory disease, myomas and gynaecological cancers often undergo surgery as a first treatment. Surgery for young women must respect their desire for offspring as much as possible; it must be radical, but at the same time, minimally invasive. The creation of multidisciplinary paths, the sending of patients to high-level centres, and the use of minimally invasive gynaecological surgery techniques allow the preservation of patients’ fertility. The maintenance and implementation of fertility-sparing pathways is necessary to avoid premature iatrogenic infertility.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Systematic reviews and meta-analyses of existing fertility-sparing programmes for benign and malignant gynaecological surgical pathologies.
  • Validation studies of existing fertility-sparing surgical approaches.
  • Comparative studies of different fertility-sparing pathways.

We look forward to receiving your contributions.

Dr. Federica Perelli
Dr. Giuseppe Vizzielli
Guest Editors

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Keywords

  • fertility sparing
  • surgery
  • gynaecological cancer
  • cancer survivors
  • minimally invasive gynaecological surgery
  • pelvic inflammatory disease
  • myomas, endometriosis
  • ovarian cyst
  • surgical approach

Published Papers (2 papers)

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Research

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13 pages, 902 KiB  
Article
Sparing Is Caring: Hormonal Retreatment in Women with Recurrent Endometrial Cancer after Fertility Preservation Management—A Single Centre Retrospective Study
by Ida Pino, Maria Di Giminiani, Davide Radice, Ailyn Mariela Vidal Urbinati, Anna Daniela Iacobone, Maria Elena Guerrieri, Eleonora Petra Preti, Silvia Martella and Dorella Franchi
Healthcare 2023, 11(7), 1058; https://doi.org/10.3390/healthcare11071058 - 6 Apr 2023
Cited by 1 | Viewed by 1508
Abstract
Fertility-sparing treatment (FTS) of endometrial cancer (EC) has a high rate of remission but also a high rate of relapse (10–88%). Many women still wish to conceive at the time of relapse, but results regarding retreatment are still lacking. This study aims to [...] Read more.
Fertility-sparing treatment (FTS) of endometrial cancer (EC) has a high rate of remission but also a high rate of relapse (10–88%). Many women still wish to conceive at the time of relapse, but results regarding retreatment are still lacking. This study aims to evaluate the safety, oncological and pregnancy outcomes of repeated FST in women with recurrent EC. This is a retrospective single-center study that recruited patients who had uterine recurrence after achieving a complete response (CR) with FST for FIGO stage IA, well-differentiated (G1), endometrioid EC. All eligible women underwent a second FST. Among 26 patients with recurrence, 6 decided to receive a hysterectomy and 20 received fertility-sparing retreatment. In total, 17 out of 20 women (85%) achieved a CR in a median time of 6 months. A total of 2/20 women showed a stable disease and continued the treatment for a further 6 months and finally achieved a CR. In total, 1/20 women showed disease progression and underwent demolitive surgery. After relapse and a CR, 14 patients attempted to become pregnant, among whom 7 became pregnant (pregnancy rate 50%—life birth rate 29%). Secondary FST is a safe and effective option for women who desire to preserve fertility after the recurrence of early-stage EC. Full article
(This article belongs to the Special Issue Fertility Sparing Gynaecological Surgery)
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Review

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21 pages, 685 KiB  
Review
Bacterial Vaginosis and Post-Operative Pelvic Infections
by Afroditi Ziogou, Eleftherios Ziogos, Ilias Giannakodimos, Alexios Giannakodimos, Stavros Sifakis, Petros Ioannou and Sotirios Tsiodras
Healthcare 2023, 11(9), 1218; https://doi.org/10.3390/healthcare11091218 - 25 Apr 2023
Cited by 6 | Viewed by 2600
Abstract
Bacterial vaginosis (BV) represents a condition in which the normal protective Lactobacilli, especially those that produce H2O2, are replaced by high quantities of facultative anaerobes, leading to gynecologic and obstetric post-operative complications. BV is an important cause of obstetric [...] Read more.
Bacterial vaginosis (BV) represents a condition in which the normal protective Lactobacilli, especially those that produce H2O2, are replaced by high quantities of facultative anaerobes, leading to gynecologic and obstetric post-operative complications. BV is an important cause of obstetric and gynecological adverse sequelae and it could lead to an increased risk of contracting sexually transmitted infections such as gonorrhea, genital herpes, Chlamydia, Trichomonas, and human immunodeficiency virus. Herein, we reviewed bacterial vaginosis and its association with post-operative pelvic infections. In Obstetrics, BV has been associated with increased risk of preterm delivery, first-trimester miscarriage in women undergoing in vitro fertilization, preterm premature rupture of membranes, chorioamnionitis, amniotic fluid infections, postpartum and postabortal endomyometritis as well as postabortal pelvic inflammatory disease (PID). In gynecology, BV increases the risk of post-hysterectomy infections such as vaginal cuff cellulitis, pelvic cellulitis, pelvic abscess, and PID. BV is often asymptomatic, can resolve spontaneously, and often relapses with or without treatment. The American College of Obstetricians and Gynecologists recommends testing for BV in women having an increased risk for preterm delivery. Women with symptoms should be evaluated and treated. Women with BV undergoing gynecological surgeries must be treated to reduce the frequency of post-operative pelvic infections. Metronidazole and clindamycin are the mainstays of therapy. Currently, there is no consensus on pre-surgery screening for BV; decisions are made on a case-by-case basis. Full article
(This article belongs to the Special Issue Fertility Sparing Gynaecological Surgery)
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