Hysteroscopy as an elective tool in abnormal uterine bleeding in perimenopausal women.

Abnormal Uterine Bleeding is a very frequent pathology particularly in perimenopausal age (> or = 45 years). The Authors report the experience of the 2nd Department of Ob/Gyn. of Rome University "La Sapienza" from January 1985 up to September 1991. The hysteroscopic evaluation of 789 patients in perimenopausal age is reviewed. The Authors analyze in detail the main cause of metrorrhagia describing the hysteroscopic aspect and relative incidence. Finally, some considerations concerning the great usefulness that a simple and accurate diagnostic investigation such as hysteroscopy represents in a routine diagnostic procedure, are reported

FIGO Stage I endometrial carcinoma: evaluation of lung metastases and follow-up.

The aim of our study was to evaluate the incidence of lung metastases in the follow-up of women submitted to surgery for endometrial carcinoma, in particular for FIGO Stage I which is the lowest risk stage for this metastatic site. The study was conducted on 210 patients affected by FIGO Stage I endometrial cancer in the years 1990 to 2005 distributed as follows: 35 patients with Stage IA (limited to the endometrium), 150 patients with Stage IB (invasion up to and including half the myometrial thickness), 25 patients with Stage IC (invasion greater than half the myometrial thickness). They underwent follow-up. Only one patient out of the group studied has developed lung metastasis six years after surgery. She was staged as FIGO IB (T1b Mx G1). We are still following the cases and evaluating the biological behavior of this specific endometrial carcinoma and its reaction to further therapies. We are also looking for possible clinical characteristics in disagreement with those reported in the literature, which would thus make it necessary to reconsider the prognosis and therapy of this stage of disease

[LH-RH analogues in the preparation of hysteroscopic resection of uterine fibromyoma].

Ten patients with submucous and/or intracavitary myomas, aged between 40 and 50 years old, underwent preliminary and preoperative (endoscopic resection) treatment with LH-RH. A using a depot formula. The Authors report the results of treatment efficacy (disappearance of symptoms and reduced myoma volume) in relation to an optimal surgical approach using an endoscopic route. This form of treatment allowed both operating times and intraoperative bleeding to be reduced

Cervical pregnancy: a case report.

The case of a patient with cervical pregnancy diagnosed by ultrasound (US) at nine weeks of gestation is described. US showed a cavity of 4.5 x 3.5 cm in diameter located on the right lateral wall of the cervix containing trophoblasts. In order to preserve the patient's fertility conservative treatment was administered: methotrexate (MTX), ligature of the uterine arteries, and hysterosuction. Due to intense bleeding uncontrolled by the use of a Foley's catheter total hysterectomy with conservation of the adnexae was performed

Ovarian cancer: relationship between in vitro chemosensitivity and clinical response.

Thirty-nine samples from 30 patients with epithelial ovarian cancer were collected. Using the method described by A. Hamburger (J. Natl. Cancer Inst. 66, 981 (1981] and P. Salmon et al. (N. Engl. J. Med. 308, 129 (1983], tumor cells were exposed to antineoplastic agents (Adriamycin and cis-platinum) and then cultured in double-layer agar. There were 23 evaluable patients. The percentage of complete and partial responses for patients whose cells were sensitive in vitro, whether or not treated with the same drugs, was 68, vs 44% compared to patients whose cells were resistant in vitro and treated in vivo with therapeutic regimens which may or may not have included drugs used in the test. More patients with residual tumor greater than 2 cm were resistant to chemotherapy

[Hysteroscopy in septate uterus. Diagnostic and therapeutic features].

Personal experience of diagnostic and operative hysteroscopy of septate uterus is reported. The diagnosis of septate uterus is an integrated diagnosis that makes use of hysterosalpingography, echography, hysteroscopy and laparoscopy. Of 545 hysteroscopies carried out between January and December 1993, 29 evidenced uterine septum, complete in 6 cases, incomplete in the remaining 23. Of the 29 patients, 7 underwent resection of the septum by the hysteroscopic route. No intra or postoperative complications worthy of note were observed. At follow-up after one month, the uterine cavity in 5 patients proved completely regular while in the remaining 2 one case of fundic fibrous synechia and one of small persistent fibrous bridge, of little importance within the context of the cavity, were observed. The purpose of the present paper is to demonstrate the twofold role of hysteroscopy with regard to the septate uterus; is that hysteroscopy is a diagnostic and a precise operative technique that is atraumatic, fast and of low cost

An overview of adolescents breast disorders.

Our investigation has confirmed the low incidence of mammarian pathology in adolescents and the near absence of malignant neoplastic pathology. Programs of breast control in this age can be valid only by aiming at health education prevention and correction of eventual risk factors. The group of adolescents studied by us has allowed us to define the most frequent pathology as the functional one, that is, mastodinia, and among the organic cases single or multiple fibroadenomas are the most frequent lesions. An exact diagnostic profile is necessary in order to reassure the patient in cases of absence of pathology, or to schedule a follow-up or to program an eventual surgical and/or medical treatment