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Article: Endometriosis-associated infertility: From pathophysiology to tailored treatment.

Bonavina, Giulia / Taylor, Hugh S

2022 Volume 13, Page(s) 1020827

Abstract: Despite the clinically recognized association between endometriosis and infertility, the mechanisms implicated in endometriosis-associated infertility are not fully understood. Endometriosis is a multifactorial and systemic disease that has pleiotropic ... ...

Abstract	Despite the clinically recognized association between endometriosis and infertility, the mechanisms implicated in endometriosis-associated infertility are not fully understood. Endometriosis is a multifactorial and systemic disease that has pleiotropic direct and indirect effects on reproduction. A complex interaction between endometriosis subtype, pain, inflammation, altered pelvic anatomy, adhesions, disrupted ovarian reserve/function, and compromised endometrial receptivity as well as systemic effects of the disease define endometriosis-associated infertility. The population of infertile women with endometriosis is heterogeneous, and diverse patients' phenotypes can be observed in the clinical setting, thus making difficult to establish a precise diagnosis and a single mechanism of endometriosis related infertility. Moreover, clinical management of infertility associated with endometriosis can be challenging due to this heterogeneity. Innovative non-invasive diagnostic tools are on the horizon that may allow us to target the specific dysfunctional alteration in the reproduction process. Currently the treatment should be individualized according to the clinical situation and to the suspected level of impairment. Here we review the etiology of endometriosis related infertility as well as current treatment options, including the roles of surgery and assisted reproductive technologies.
MeSH term(s)	Female ; Humans ; Endometriosis/complications ; Endometriosis/therapy ; Infertility, Female/etiology ; Infertility, Female/therapy ; Reproductive Techniques, Assisted/adverse effects ; Ovarian Reserve ; Causality
Language	English
Publishing date	2022-10-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2022.1020827
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Article ; Online: Opportunistic salpingectomy at the time of vaginal hysterectomy: A systematic review and meta-analysis.

Bonavina, Giulia / Busnelli, Andrea / Salmeri, Noemi / Cavoretto, Paolo I / Salvatore, Stefano / Candiani, Massimo / Bulfoni, Alessandro

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2024

Abstract: Background: Despite the rising rates of opportunistic salpingectomy at the time of surgery for non-malignant conditions, salpingectomy is not widely adopted during vaginal hysterectomy (VH) and has not been extensively investigated.: Objectives: The ... ...

Abstract	Background: Despite the rising rates of opportunistic salpingectomy at the time of surgery for non-malignant conditions, salpingectomy is not widely adopted during vaginal hysterectomy (VH) and has not been extensively investigated. Objectives: The aim of the primary study was to determine the feasibility of bilateral opportunistic salpingectomy at the time of VH. Secondary aims included surgical outcomes, factors associated with patient selection, and the prevalence of incidental tubal malignancies. Search strategy: In this systematic review and meta-analysis we searched Pubmed, Embase and ClinicalTrials.gov databases from inception to September 1, 2023, using relevant keywords. Selection criteria: Original articles with no language restriction reporting outcomes of women undergoing planned VH with opportunistic salpingectomy, were considered eligible. Studies including patients undergoing VH with and without opportunistic salpingectomy were also included. Data collection and analysis: The Newcastle-Ottawa scale was used to assess quality of observational studies. DerSimonian-Laird random effects meta-analysis was performed and pooled effect estimates and proportions with corresponding 95% confidence intervals were computed. Heterogeneity was assessed using the I Results: Seven observational cohort studies including 4808 women undergoing opportunistic salpingectomy at the time of VH and 10 295 patients undergoing VH alone were selected. The pooled proportion of success was 81.83 per 100 observations (95% CI: 75.35-87.54). Opportunistic salpingectomy at the time of VH, when feasible, was associated with a significant reduction in intraoperative complications (OR 0.06, 95% CI: 0.01, -0.37, P = 0.03) and total operative time (95% CI: -17.80, -1.07, P = 0.03) compared to those where it failed. Successful salpingectomy was significantly hindered by nulliparity (OR 0.12, 95% CI: -17.69, -1.21, P < 0.001) and favored by pelvic organ prolapse (OR 3.20, 95% CI: 1.35, 7.55, P = 0.008). Immunohistochemical tubal abnormalities were found in 13/579 (2.1%) patients. The overall quality of the evidence, according to the GRADE assessment, was low. Conclusion: Opportunistic salpingectomy is safe, effective, and feasible at the time of VH. Nulliparity and pelvic organ prolapse are factors potentially influencing surgical outcomes.
Language	English
Publishing date	2024-01-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.15386
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Zs.A 355: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Effect of type III female genital mutilation on obstetric outcomes: A systematic review and meta-analysis.

Bonavina, Giulia / Lina Spinillo, Silvia / Sotiriadis, Alexandros / Bulfoni, Alessandro / Kaltoud, Randa / Salvatore, Stefano / Candiani, Massimo / Ivo Cavoretto, Paolo

Heliyon

2024 Volume 10, Issue 8, Page(s) e29336

Abstract: Background: Controversial evidence suggests a potential association between female genital mutilation (FGM/C) and adverse obstetric outcomes, with type III FGM/C (infibulation) carrying the greatest risk. The aim of this systematic review and meta- ... ...

Abstract	Background: Controversial evidence suggests a potential association between female genital mutilation (FGM/C) and adverse obstetric outcomes, with type III FGM/C (infibulation) carrying the greatest risk. The aim of this systematic review and meta-analysis was to assess current rate of adverse obstetric outcomes in women with type III female genital mutilation and cutting (FGM/C; infibulation) delivering across different settings worldwide. Methods: We searched Results: 14 observational studies including 15,320 type III FGM/C women and 59,347 controls were eligible. The risk for postpartum haemorrhage was significantly increased in type III FGM/C, in the main analysis (OR 1.83, 95 % CI 1.03 to 3.24, I Conclusions: These results consistently show an increased risk of adverse obstetric outcomes in women with FGM/C type III. Infibulation substantially increases the risk for PPH, particularly in nulliparae.
Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e29336
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Article ; Online: Vesicouterine Fistula After Cesarean Delivery at Full Cervical Dilation.

Bulfoni, Alessandro / Bonavina, Giulia / Acerboni, Stefano / Schirripa, Irene / Casale, Paolo / Busnelli, Andrea

Urogynecology (Philadelphia, Pa.)

2023 Volume 29, Issue 12, Page(s) 974–979

Abstract: Importance: Vesicouterine fistula (VUF) is an iatrogenic consequence of cesarean section in the vast majority of cases. The worldwide increase of cesarean delivery rates is likely to be accompanied by a rise of this complication, and surgery is the ... ...

Abstract	Importance: Vesicouterine fistula (VUF) is an iatrogenic consequence of cesarean section in the vast majority of cases. The worldwide increase of cesarean delivery rates is likely to be accompanied by a rise of this complication, and surgery is the mainstay treatment. Objective: The aim of the study is to assess current evidence on VUF pathogenesis and management. Study design: The study is a case report and literature review on PubMed and Embase spanning over the past 2 decades. Results: An early VUF developed after a cesarean section at full cervical dilation and concurrent incidental bladder injury. A transabdominal extravesical repair was performed 3 months after cesarean delivery. Both the cystotomy and hysterotomy were repaired in a double-layer fashion with no interposition flap. A contemporary literature review including 25 patients showed that VUF was repaired transabdominally in 21 patients (84%), and an open approach was adopted in 18 patients (85.7%). In most patients, the uterine side was closed with a single-layer suture and an interposition flap was used to reinforce the repair. Concomitant hysterectomy was performed in 6 patients (24%). Overall, successful term pregnancies were reported in 2 patients after VUF repair. Conclusions: Vesicouterine fistula is a rare event and is commonly associated with cesarean sections, especially those with a concurrent bladder injury. Careful and meticulous surgical technique may prevent the occurrence of this condition. Delayed repair and double-layer closure of both bladder and uterus, with or without an interposition flap, are recommended.
MeSH term(s)	Female ; Humans ; Pregnancy ; Abdominal Injuries/complications ; Cesarean Section/adverse effects ; Dilatation ; Fistula/etiology ; Urinary Bladder Diseases/complications ; Urinary Bladder Fistula/etiology ; Uterine Diseases/etiology
Language	English
Publishing date	2023-07-29
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ISSN	2771-1897
ISSN (online)	2771-1897
DOI	10.1097/SPV.0000000000001398
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Article ; Online: Surgical repair of post-cesarean vesicouterine fistula: A systematic review and a plea for prevention.

Bonavina, Giulia / Busnelli, Andrea / Acerboni, Stefano / Martini, Alberto / Candiani, Massimo / Bulfoni, Alessandro

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2023

Abstract: Background: Vesicouterine fistula (VUF) is a iatrogenic injury in the vast majority of cases. The worldwide increase of cesarean delivery rates is expected to lead to increased complications.: Objectives: To assess current evidence on VUF ... ...

Abstract	Background: Vesicouterine fistula (VUF) is a iatrogenic injury in the vast majority of cases. The worldwide increase of cesarean delivery rates is expected to lead to increased complications. Objectives: To assess current evidence on VUF pathogenesis and surgical management. Search strategy: Pubmed and Embase databases were searched from January 2000 to January 2023 using relevant key words. Selection criteria: Only original articles including either transabdominal or transvaginal surgical routes for post-cesarean VUF repair, in English language, were included. Data collection and analysis: Two authors independently screened the references for eligibility, data extraction, and assessment of methodologic quality. All available surgical outcomes were recorded. Main results: Of the 1160 studies retrieved, 67 were selected for analysis. Most of these were case reports, case series, or observational cohort studies including a total of 284 patients. The majority (78.6%) of patients had more than one cesarean section, and approximately 10% of them experienced an overt bladder injury and/or uterine rupture at the time of cesarean delivery. The supratrigonal part of the bladder was most commonly involved (92.5%). The majority of patients (88.8%) underwent delayed VUF repair through laparotomy. Length of stay and blood loss were significantly less in patients treated via a minimally invasive approach (P < 0.001 and P = 0.02, respectively). Most patients had double-layer bladder repair and single-layer uterine repair. The overall success rate was 100% on first attempt for each independent combination of different surgical approaches and techniques. Live birth following VUF repair was reported in 23 patients. Conclusions: Paying close attention to surgical details is crucial to reduce the incidence of this complication and recurrence rates. Double-layer bladder closure and delayed timing of repair of VUF are recommended.
Language	English
Publishing date	2023-12-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.15256
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Zs.A 355: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Female Genital Mutilation and Cutting and Obstetric Outcomes.

Bonavina, Giulia / Kaltoud, Randa / Ruffolo, Alessandro Ferdinando / Candiani, Massimo / Salvatore, Stefano

Obstetrics and gynecology

2022 Volume 140, Issue 1, Page(s) 87–90

Abstract: The aim of this prospective study was to investigate the association of type III female genital mutilation/cutting (FGM/C) and de-infibulation with immediate maternal and neonatal outcomes. Women with type III FGM/C were compared with women with type I ... ...

Abstract	The aim of this prospective study was to investigate the association of type III female genital mutilation/cutting (FGM/C) and de-infibulation with immediate maternal and neonatal outcomes. Women with type III FGM/C were compared with women with type I or II FGM/C or no FGM/C. Only uncomplicated singleton, full-term pregnancies with the fetus in vertex presentation were included. There was a greater frequency of postpartum hemorrhage and the use of mediolateral episiotomy in women with type III FGM/C. Mediolateral episiotomy was associated with a reduced rate of any spontaneous perineal laceration as well as third-degree and fourth-degree lacerations in women with type III FGM/C who underwent de-infibulation.
MeSH term(s)	Circumcision, Female/adverse effects ; Episiotomy/adverse effects ; Female ; Humans ; Infant, Newborn ; Lacerations/complications ; Lacerations/surgery ; Obstetric Labor Complications/etiology ; Obstetric Labor Complications/surgery ; Postpartum Hemorrhage/etiology ; Pregnancy ; Prospective Studies
Language	English
Publishing date	2022-06-07
Publishing country	United States
Document type	Letter
ZDB-ID	207330-4
ISSN	1873-233X ; 0029-7844
ISSN (online)	1873-233X
ISSN	0029-7844
DOI	10.1097/AOG.0000000000004830
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Article ; Online: Burden of Colovesical Fistula and Changing Treatment Pathways: A Systematic Literature Review.

Froiio, Caterina / Bernardi, Daniele / Asti, Emanuele / Bonavina, Giulia / Conti, Andrea / Carmignani, Luca / Bonavina, Luigi

Surgical laparoscopy, endoscopy & percutaneous techniques

2022 Volume 32, Issue 5, Page(s) 577–585

Abstract: Purpose: Colovesical fistula (CVF) is a rare complication of sigmoid diverticulitis causing significant morbidity and quality of life impairment. Aim of this study was to analyze contemporary literature data to appraise the current standard of care and ... ...

Abstract	Purpose: Colovesical fistula (CVF) is a rare complication of sigmoid diverticulitis causing significant morbidity and quality of life impairment. Aim of this study was to analyze contemporary literature data to appraise the current standard of care and changes of treatment algorithms over time. Materials and methods: A systematic review of the literature on surgical management of CVF was conducted through PUBMED, EMBASE, and COCHRANE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. Results: Fourteen papers published between 2014 and 2020 and including 1061 patients were analyzed. One-stage colonic resection with primary anastomosis, with or without loop ileostomy, was the most common surgical procedure. A laparoscopic or robotic approach was attempted in 39.5% of patients, and conversion rate to open surgery was 7.8%. Clavien-Dindo grade ≥3 complication rate, 30-day mortality, and recurrence rate were 7.4%, 1.5%, and 0.5%, respectively. Conclusions: Minimally invasive sigmoidectomy with primary anastomosis is safe and should be the first-choice approach for CVF. Bladder repair is not necessary after a negative intraoperative leak test. A standardized perioperative care can improve clinical outcomes and reduce the length of hospital stay and the duration of Foley catheterization.
MeSH term(s)	Colon, Sigmoid/surgery ; Conversion to Open Surgery ; Diverticulitis, Colonic/surgery ; Humans ; Intestinal Fistula/complications ; Intestinal Fistula/surgery ; Laparoscopy/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Quality of Life ; Treatment Outcome
Language	English
Publishing date	2022-10-01
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000001099
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Article ; Online: Pre-emptive or Preventive Transversus Abdominis Plane Block Analgesia for Laparoscopic Surgery?

Resta, Marco / Bernardi, Daniele / Bonavina, Giulia / Asti, Emanuele / Bonavina, Luigi

Journal of the American College of Surgeons

2020 Volume 232, Issue 1, Page(s) 114–115

MeSH term(s)	Abdominal Muscles ; Analgesia ; Humans ; Laparoscopy ; Nerve Block
Language	English
Publishing date	2020-11-08
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1016/j.jamcollsurg.2020.10.005
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Article: Delayed presentation of inflammatory breast carcinoma during the COVID-19 pandemic.

Bernardi, Daniele / Asti, Emanuele / Bonavina, Giulia / Luporini, Alberto / Clemente, Claudio / Bonavina, Luigi

European surgery : ACA : Acta chirurgica Austriaca

2021 Volume 54, Issue 4, Page(s) 212–216

Abstract: Background: Breast cancer may present with distinct cutaneous manifestations that may be paraneoplastic or secondary to direct skin infiltration, distant skin metastases, or dermal lymphatic tumor embolization (inflammatory breast carcinoma).: Case ... ...

Abstract	Background: Breast cancer may present with distinct cutaneous manifestations that may be paraneoplastic or secondary to direct skin infiltration, distant skin metastases, or dermal lymphatic tumor embolization (inflammatory breast carcinoma). Case report: A 51-year-old Asian woman visited the emergency care department during the outbreak of COVID-19 in Northern Italy. About 6 months before, she had noted the onset of right breast swelling accompanied by skin redness and itching. She never consulted a physician, and, over time, the local skin condition progressed to a large scaly plaque covering the entire breast surface including the nipple. At presentation, abduction of the right upper limb was impaired due to severe shoulder pain. CT scan showed the presence of bilateral breast masses with necrotic and colliquative features, and multiple skeletal, nodal, pulmonary, and brain images suggestive of metastases. An ultrasound-guided core biopsy of the contralateral breast showed grade 2 non-special type infiltrating carcinoma. The patient was referred to the breast oncology unit and is currently being treated with aromatase inhibitors and chemotherapy. Conclusion: The COVID-19 pandemic has disrupted the entire spectrum of oncological care including breast cancer. Hopefully, telemedicine will contribute to increase patients' confidence and will provide earlier diagnosis and treatment while minimizing the risk of contagion.
Language	English
Publishing date	2021-06-15
Publishing country	Austria
Document type	Journal Article
ZDB-ID	2073941-2
ISSN	1682-4016 ; 1682-8631 ; 1682-1769
ISSN (online)	1682-4016
ISSN	1682-8631 ; 1682-1769
DOI	10.1007/s10353-021-00726-8
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Article: Endometriosis and Impaired Placentation: A Prospective Cohort Study Comparing Uterine Arteries Doppler Pulsatility Index in Pregnancies of Patients with and without Moderate-Severe Disease.

Salmeri, Noemi / Farina, Antonio / Candiani, Massimo / Dolci, Carolina / Bonavina, Giulia / Poziello, Caterina / Viganò, Paola / Cavoretto, Paolo Ivo

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 5

Abstract: The aim of this study was to evaluate if moderate-severe endometriosis impairs uterine arteries pulsatility index (UtA-PI) during pregnancy when compared to unaffected controls. In this prospective cohort study, pregnant women with stage III-IV ... ...

Abstract	The aim of this study was to evaluate if moderate-severe endometriosis impairs uterine arteries pulsatility index (UtA-PI) during pregnancy when compared to unaffected controls. In this prospective cohort study, pregnant women with stage III-IV endometriosis according to the revised American Fertility Society (r-AFS) classification were matched for body mass index and parity in a 1:2 ratio with unaffected controls. UtA-PIs were assessed at 11-14, 19-22 and 26-34 weeks of gestation following major reference guidelines. A General Linear Model (GLM) was implemented to evaluate the association between endometriosis and UtA-PI Z-scores. Significantly higher third trimester UtA-PI Z-scores were observed in patients with r-AFS stage III-IV endometriosis when compared to controls (
Language	English
Publishing date	2022-04-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12051024
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