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Article ; Online: Role of Magnetic Resonance Imaging in Pelvic Organ Prolapse Evaluation.

Sarpietro, Giuseppe / Foti, Pietro Valerio / Conte, Carmine / Matarazzo, Maria Grazia

2023 Volume 59, Issue 12

Abstract: Background and ... ...

Abstract	Background and Objectives
MeSH term(s)	Humans ; Female ; Prospective Studies ; Quality of Life ; Pelvic Organ Prolapse/diagnostic imaging ; Pelvic Organ Prolapse/surgery ; Magnetic Resonance Imaging ; Pelvic Floor/diagnostic imaging ; Pelvic Floor/surgery
Language	English
Publishing date	2023-11-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59122074
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Article ; Online: Primary vulvar endometriosis in postmenopausal woman: a case report and review of the literature.

Sarpietro, Giuseppe / Matarazzo, Maria G / Vecchio, Giada M / Palermo, Gaia / Cianci, Antonio

Minerva obstetrics and gynecology

2023 Volume 75, Issue 4, Page(s) 387–389

Abstract: Endometriosis is a benign, estrogen-dependent condition that commonly affects women during the reproductive age. Postmenopausal endometriosis is a rare condition because of the absence of estrogenic hormone production. Furthermore, extrapelvic ... ...

Abstract	Endometriosis is a benign, estrogen-dependent condition that commonly affects women during the reproductive age. Postmenopausal endometriosis is a rare condition because of the absence of estrogenic hormone production. Furthermore, extrapelvic endometriosis is a rare and complex phenomenon. For this reason, it is usually a misdiagnosed disease. An 84-year-old female patient with no medical history of endometriosis or dysmenorrhea and no hormone replacement therapy was found to have a 4.4×3 cm tender, mobile mass on the left labium majus detached from the underlying perineal muscle. The patient underwent surgical excision under sedation and local anesthesia. The mass was easily removed intact and was not adherent to the vagina or the perineal muscles. Surgical resection of the lesion should be performed in order to remove the lesion and to confirm the diagnosis histologically. The diagnosis of long-standing endometriotic cyst was made. Primary vulvo-perineal endometriosis is a rare and difficult diagnosis especially in postmenopausal women without previous surgical procedures and no history of endometriosis. A better awareness of symptoms and signs of uncommon locations of extrapelvic endometriosis should be encouraged in order to optimize patient care. Finally, more research is needed to elucidate the pathogenesis of endometriosis in postmenopausal women.
MeSH term(s)	Aged, 80 and over ; Female ; Humans ; Endometriosis/diagnosis ; Endometriosis/surgery ; Endometriosis/pathology ; Muscle, Skeletal/pathology ; Pelvis/pathology ; Postmenopause ; Vulvar Diseases/diagnosis ; Vulvar Diseases/pathology ; Vulvar Diseases/surgery
Language	English
Publishing date	2023-07-17
Publishing country	Italy
Document type	Review ; Case Reports ; Journal Article
ZDB-ID	3062815-5
ISSN	2724-6450
ISSN (online)	2724-6450
DOI	10.23736/S2724-606X.22.05089-8
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Article ; Online: Robotic-assisted laparoscopic cervicouterine anastomosis in a patient with agenesis of the uterine isthmus.

Sareri, Marco Iraci / Bonanno, Giulia M / Sarpietro, Giuseppe / Cianci, Antonio

Fertility and sterility

2021 Volume 117, Issue 2, Page(s) 463–465

Abstract: Objective: To demonstrate the surgical management of agenesis of the uterine isthmus.: Design: Stepwise description of robotic-assisted laparoscopic cervicouterine anastomosis.: Setting: Academic medical center.: Patient(s): A 27-year-old ... ...

Abstract	Objective: To demonstrate the surgical management of agenesis of the uterine isthmus. Design: Stepwise description of robotic-assisted laparoscopic cervicouterine anastomosis. Setting: Academic medical center. Patient(s): A 27-year-old nulligravida with primary amenorrhea and cyclic pelvic pain. Intervention(s): The patient underwent a robot-assisted cervicouterine anastomosis using the following surgical steps: adhesiolysis of the right ovary from the rudimentary uterine horn; vesicouterine peritoneal fold dissection and mobilization of the cervical canal; the opening of the cervical canal and dilatation with Hegar dilators; longitudinal incision of the lower third of the anterior uterine wall up to the endometrial cavity; insertion of a 14 Ch Foley catheter, not inflated, fixed to the cervix with a suture and removed after 7 days; and closure of the cervicouterine breach with a double-layer Vicryl suture. Informed consent was obtained from the patient for the use of video and images. Main outcome measure(s): After 3 months, the patency of the anastomosis site was assessed via hysteroscopy. Subsequent follow-up was performed by referring physicians. Result(s): Postoperatively, anatomic continuity was restored and the patient was menstruating with regular monthly cycles; furthermore, cyclic pelvic pain was relieved. Few cases of this condition have been reported in the literature and, currently, surgical treatment of agenesis of the uterine isthmus is controversial, with some treatments including laparoscopic-assisted uterocervical anastomosis using a stent to prevent restenosis, primary cervicouterine anastomosis by laparotomy performed with a Foley catheter in the cervical canal, and anastomosis of the uterine isthmus agenesis. However, to our knowledge, we are the first to use a robotic approach. Preservation of reproductive function and symptom relief represent the goals of the surgery. Therefore, hysterectomy cannot be considered as a treatment option. However, after a cervicouterine anastomosis procedure, the normal uterine morphology cannot be achieved; cyclic abdominal pain may remain after surgical treatment. In this case, an alternative surgical approach, such as hysterectomy, can be considered. Conclusion(s): Robotic-assisted treatment of this uncommon müllerian anomaly is feasible and may be an alternative to hysterectomy in individuals who wish to preserve fertility. Follow-up is needed to evaluate fertility and reproductive function.
MeSH term(s)	Adult ; Anastomosis, Surgical ; Female ; Humans ; Laparoscopy ; Robotic Surgical Procedures ; Treatment Outcome ; Urogenital Abnormalities/pathology ; Urogenital Abnormalities/surgery ; Uterus/abnormalities ; Uterus/pathology ; Uterus/surgery
Language	English
Publishing date	2021-11-19
Publishing country	United States
Document type	Case Reports ; Video-Audio Media
ZDB-ID	80133-1
ISSN	1556-5653 ; 0015-0282
ISSN (online)	1556-5653
ISSN	0015-0282
DOI	10.1016/j.fertnstert.2021.10.001
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Article: Incidental Diagnosis of Pseudomyxoma Peritonei: A Case Report.

Sarpietro, Giuseppe / Iraci Sareri, Marco / Bonanno, Giulia Maria / Matarazzo, Maria Grazia / Cianci, Antonio

Cureus

2022 Volume 14, Issue 3, Page(s) e23425

Abstract: Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by disseminating gelatinous ascites within the peritoneal cavity with mucinous implants on peritoneal surfaces. We present the case of a patient incidentally diagnosed after ... ...

Abstract	Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by disseminating gelatinous ascites within the peritoneal cavity with mucinous implants on peritoneal surfaces. We present the case of a patient incidentally diagnosed after laparoscopy: definitive diagnosis after the histological examination was PMP. A 37-year-old female patient with a medical history of infertility and mild pelvic pain was found to have several collections in the pelvis and an amount of free fluid into the Douglas pouch at ultrasound examination. The patient underwent laparoscopic surgical exploration. Peritoneal biopsies and appendectomy were performed. Histological examination was about a low-grade appendiceal mucinous tumor limited to the mucosa without submucosal infiltration with perforation of the wall and deposit of periappendicular acellular mucin. The patient was discharged in good health and referred to an oncological peritoneal center where cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) were performed. In conclusion, PMP is an uncommon disease within the abdomen, characterized by a mucinous tumor that produces progressive mucinous ascites. It is characterized by various non-specific symptoms and signs and difficult imaging diagnoses. Histological diagnosis is a determinant to establish the therapy that can differ significantly, depending on the stage of the disease.
Language	English
Publishing date	2022-03-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.23425
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Article ; Online: Hereditary Women's Cancer: Management and Risk-Reducing Surgery.

Conte, Carmine / Pelligra, Silvia / Sarpietro, Giuseppe / Montana, Giuseppe Dario / Della Corte, Luigi / Bifulco, Giuseppe / Martinelli, Canio / Ercoli, Alfredo / Palumbo, Marco / Cianci, Stefano

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 2

Abstract: Hereditary women's syndromes due to inherited mutations result in an elevated risk of developing gynecological cancers over the lifetime of affected carriers. The BRCA 1 and 2 mutations, Lynch syndrome (LS), and mutations in rare hereditary syndromes ... ...

Abstract	Hereditary women's syndromes due to inherited mutations result in an elevated risk of developing gynecological cancers over the lifetime of affected carriers. The BRCA 1 and 2 mutations, Lynch syndrome (LS), and mutations in rare hereditary syndromes increase this risk and require more effective management of these patients based on surveillance and prophylactic surgery. Patients need counseling regarding risk-reducing surgery (RRS) and the time required to perform it, considering the adverse effects of premenopausal surgery and the hormonal effect on quality of life, bone density, sexual activity, and cardiological and vascular diseases. Risk-reducing salpingo-oophorectomy (RRSO) is the gold standard for BRCA-mutated patients. An open question is that of endometrial cancer (EC) risk in patients with BRCA1/2 mutation to justify prophylactic hysterectomy during RRSO surgical procedures. RRS provides a 90-95% risk reduction for ovarian and breast cancer in women who are mutation carriers, but the role of prophylactic hysterectomy is underinvestigated in this setting of patients. In this review, we evaluate the management of the most common hereditary syndromes and the benefits of risk-reducing surgery, particularly exploring the role of prophylactic hysterectomy.
MeSH term(s)	Female ; Humans ; Quality of Life ; Syndrome ; Salpingo-oophorectomy/methods ; Hysterectomy/methods ; Mutation ; Endometrial Neoplasms ; Breast Neoplasms/genetics ; Ovarian Neoplasms/epidemiology ; Genetic Predisposition to Disease
Language	English
Publishing date	2023-02-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59020300
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Article: Laparoendoscopic single-site surgery for the assessment of peritoneal carcinomatosis resectability in patients with advanced ovarian cancer.

Rossetti, D / Vitale, S G / Gulino, F A / Rapisarda, A M C / Valenti, G / Zigarelli, M / Sarpietro, G / Frigerio, L

European journal of gynaecological oncology

2018 Volume 37, Issue 5, Page(s) 671–673

Abstract: Purpose of investigation: To evaluate the feasibility, safety, and effectiveness of laparoendoscopic single site surgery (LESS) for the assessment of peritoneal carcinomatosis resectability in patients with advanced stage ovarian cancer (AOC).: ... ...

Abstract	Purpose of investigation: To evaluate the feasibility, safety, and effectiveness of laparoendoscopic single site surgery (LESS) for the assessment of peritoneal carcinomatosis resectability in patients with advanced stage ovarian cancer (AOC). Materials and methods: The authors retrospectively reviewed the medical records of patients affected by advanced stage ovarian cancer who underwent LESS for operative work-up. A standard cytoreductive laparotomy surgery (CRS) was performed. Results: Fifty-two women affected by AOC underwent LESS for operative work-up. The peritoneal cancer score was completed in 49 (94%) patients by use of LESS; 34/37 (92%) patients considered with a resectable disease were effectively optimally debulked and 15/52 (28%) patients considered with an unresectable disease received before neoadjuvant chemotherapy (NACT) and then underwent surgery. Conclusion: LESS is feasible, safe, and is an alternative minimally invasive procedure to assess the resectability of AOC patients.
MeSH term(s)	Aged ; Female ; Humans ; Laparoscopy ; Middle Aged ; Neoplasm Staging ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Peritoneal Neoplasms/surgery ; Retrospective Studies
Language	English
Publishing date	2018-05-14
Publishing country	China
Document type	Journal Article
ZDB-ID	604589-3
ISSN	0392-2936
ISSN	0392-2936
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Article: P16INK4a as a progression/regression tumour marker in LSIL cervix lesions: our clinical experience.

Vitale, S G / Valenti, G / Rapisarda, A M C / Cali, I / Marilli, I / Zigarelli, M / Sarpietro, G / Cianci, A

European journal of gynaecological oncology

2018 Volume 37, Issue 5, Page(s) 685–688

Abstract: Purpose of investigation: The aim of this prospective study was the evaluation of low-grade intraepithelial lesion (LSIL) lesions evolvement in woman with evidence of high risk HPV infection and p 16 4a negative expression.: Materials and methods: ... ...

Abstract	Purpose of investigation: The aim of this prospective study was the evaluation of low-grade intraepithelial lesion (LSIL) lesions evolvement in woman with evidence of high risk HPV infection and p 16 4a negative expression. Materials and methods: 150 women with cytological diagnosis of LSIL were selected to be underwent to three years of follow-up consisting in smear test, colposcopy, and protein p16I4a investigation every six months and HPV-test every 12 months. Result: Final follow-up showed 45 cases of spontaneous lesion regression and 42 cases of persistence with absence of protein p164NK4a in all of them. There were three cases of disease progression to CIN2, two at 18-month follow-up and one at last follow-up. Disease progression was characterized of p16NK4a expression. Conclusion: p16l4a should help to identify which LSIL cases are inclined to the progression of the disease and focalize which patients are eligible for specific treatment.
MeSH term(s)	Adult ; Biomarkers, Tumor/analysis ; Cervical Intraepithelial Neoplasia/diagnosis ; Cyclin-Dependent Kinase Inhibitor p16/analysis ; DNA, Viral/analysis ; Disease Progression ; Female ; Humans ; Middle Aged ; Papillomaviridae/isolation & purification ; Squamous Intraepithelial Lesions of the Cervix/diagnosis ; Squamous Intraepithelial Lesions of the Cervix/virology ; Uterine Cervical Neoplasms/diagnosis
Chemical Substances	Biomarkers, Tumor ; Cyclin-Dependent Kinase Inhibitor p16 ; DNA, Viral
Language	English
Publishing date	2018-05-14
Publishing country	China
Document type	Journal Article
ZDB-ID	604589-3
ISSN	0392-2936
ISSN	0392-2936
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Article ; Online: A decision support system based on radiomics and machine learning to predict the risk of malignancy of ovarian masses from transvaginal ultrasonography and serum CA-125.

Chiappa, Valentina / Interlenghi, Matteo / Bogani, Giorgio / Salvatore, Christian / Bertolina, Francesca / Sarpietro, Giuseppe / Signorelli, Mauro / Ronzulli, Dominique / Castiglioni, Isabella / Raspagliesi, Francesco

European radiology experimental

2021 Volume 5, Issue 1, Page(s) 28

Abstract: Background: To evaluate the performance of a decision support system (DSS) based on radiomics and machine learning in predicting the risk of malignancy of ovarian masses (OMs) from transvaginal ultrasonography (TUS) and serum CA-125.: Methods: A ... ...

Abstract	Background: To evaluate the performance of a decision support system (DSS) based on radiomics and machine learning in predicting the risk of malignancy of ovarian masses (OMs) from transvaginal ultrasonography (TUS) and serum CA-125. Methods: A total of 274 consecutive patients who underwent TUS (by different examiners and with different ultrasound machines) and surgery, with suspicious OMs and known CA-125 serum level were used to train and test a DSS. The DSS was used to predict the risk of malignancy of these masses (very low versus medium-high risk), based on the US appearance (solid, liquid, or mixed) and radiomic features (morphometry and regional texture features) within the masses, on the shadow presence (yes/no), and on the level of serum CA-125. Reproducibility of results among the examiners, and performance accuracy, sensitivity, specificity, and area under the curve were tested in a real-world clinical setting. Results: The DSS showed a mean 88% accuracy, 99% sensitivity, and 77% specificity for the 239 patients used for training, cross-validation, and testing, and a mean 91% accuracy, 100% sensitivity, and 80% specificity for the 35 patients used for independent testing. Conclusions: This DSS is a promising tool in women diagnosed with OMs at TUS, allowing to predict the individual risk of malignancy, supporting clinical decision making.
MeSH term(s)	Female ; Humans ; Machine Learning ; Ovarian Neoplasms/diagnostic imaging ; Reproducibility of Results ; Ultrasonography
Language	English
Publishing date	2021-07-26
Publishing country	England
Document type	Journal Article
ISSN	2509-9280
ISSN (online)	2509-9280
DOI	10.1186/s41747-021-00226-0
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Article ; Online: Intravaginal 6.5 mg prasterone administration in postmenopausal women with overactive bladder syndrome: A pilot study.

Matarazzo, Maria Grazia / Sarpietro, Giuseppe / Fiorito, Debora / Di Pasqua, Salvatore / Ingrassano, Simona / Panella, Marco Marzio / Cianci, Antonio / Caruso, Salvatore

European journal of obstetrics, gynecology, and reproductive biology

2021 Volume 263, Page(s) 67–71

Abstract: Objective: The aim of this study was to evaluate the impact of vaginally prasterone administration on postmenopausal women with genitourinary syndrome of menopause (GSM) affected by overactive bladder syndrome (OAB). A secondary aim of this study was to ...

Abstract	Objective: The aim of this study was to evaluate the impact of vaginally prasterone administration on postmenopausal women with genitourinary syndrome of menopause (GSM) affected by overactive bladder syndrome (OAB). A secondary aim of this study was to assess the efficacy of prasterone on VVA and quality of life (QoL). Study design: Thirty-two postmenopausal women with GSM and referred OAB symptoms received treatment with daily intravaginal prasterone 6.5 mg. We assessed urinary symptoms through approved ICIQ-OAB and ICIQ-UI questionnaires on incontinence. Women were also screened by the Vaginal Health Index (VHI) to investigate the vulvovaginal atrophy (VVA). Quality of life (QoL) was assessed by the SF-12 Health Survey. Each questionnaire was administrated at baseline (T0) and after a 12-week treatment (T1). Results: Incontinence questionnaires showed improvement at T1 (from 7.8 ± 2.7 to 2.7 ± 2.2, p < 0.001). Even if women referred an improvement of daily urine although the women reported improvement in daily urine leaks, their urine leak amount did not improve statistically significant [T0 (28.6%) Vs T1 (14.3%), p < 0.16]. Prasterone therapy improved significantly the VHI [T1(21 ± 3.7) Vs T0 (10.8 ± 4.1), p < 0.001]. Finally, women had a statistically significant improvement both in Mental [T1(49.9 ± 11.2) Vs T0 (42 ± 9.2), p < 0.009],) and Physical Health [T1(47.1 ± 9.1) Vs T0 (38.6 ± 8.4), p < 0.006], domains of the SF-12 questionnaire. No women referred side effects. Conclusion: Prasterone is an inactive precursor converted into estrogens and androgens into vaginal tissue. It leads to positive effects on VVA through the activation of the vaginal androgen and estrogen receptors. Empirical evidence in this study suggests that intravaginal 6.5 mg prasterone administration could be an effective treatment for postmenopausal women with GMS affected by OAB.
MeSH term(s)	Administration, Intravaginal ; Atrophy/pathology ; Dehydroepiandrosterone ; Female ; Humans ; Pilot Projects ; Postmenopause ; Quality of Life ; Treatment Outcome ; Urinary Bladder, Overactive/drug therapy ; Vagina/pathology
Chemical Substances	Dehydroepiandrosterone (459AG36T1B)
Language	English
Publishing date	2021-06-12
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2021.06.009
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Article ; Online: Ultralow 0.03 mg vaginal estriol in postmenopausal women who underwent surgical treatment for stress urinary incontinence: effects on quality of life and sexual function.

Caruso, Salvatore / Cianci, Antonio / Sarpietro, Giuseppe / Matarazzo, Maria Grazia / Panella, Marco / Cianci, Stefano

Menopause (New York, N.Y.)

2019 Volume 27, Issue 2, Page(s) 162–169

Abstract: Objective: To evaluate the efficacy of low-dose, intravaginal estriol ovules in postmenopausal women with stress urinary incontinence (SUI) before and after transobturator tape (TOT) placement, assessing vaginal health, quality of life (QoL), and sexual ...

Abstract	Objective: To evaluate the efficacy of low-dose, intravaginal estriol ovules in postmenopausal women with stress urinary incontinence (SUI) before and after transobturator tape (TOT) placement, assessing vaginal health, quality of life (QoL), and sexual function. Methods: Ninety-six postmenopausal women affected by SUI and scheduled for TOT placement were enrolled. Women were randomized and divided into two groups through 1:1 at baseline (T0): study group (group A, n = 48) and control group (group B, n = 48). Group A was treated daily for 16 weeks with an intravaginal ovule containing 0.03 mg estriol. Vaginal epithelium maturation, QoL, and sexual function were investigated by using the Vaginal Maturation Index (VMI), Short Form-36 (SF-36) questionnaire, and Female Sexual Function Index (FSFI) questionnaire at baseline (T0), before surgery (T1), and 8 weeks after surgery (T2), respectively. Results: Thirty-six women from group A and 44 women from group B completed the study. The VMI improved in group A at T1 (T1 [43.1] vs T0 [38.1]; P = 0.04) and T2 (T2 [47.8] vs T0 [38.1]; P = 0.001). The physical index score of the QoL improved only after surgery in group A (T2 [49.4] vs T0 [39.7]; P = 0.001). On the contrary, the mental index score improved at T1 [T1 (41.9) vs T0 (37.9), (P = 0.02)] and at T2 [T2 (49.6) vs T0 (37.9), P = 0.001]. Group B had improvement of the physical (45.6 vs 39.4; P = 0.001) and mental (43.6 vs 38.9; P = 0.002) index scores at T2. Sexual function improved in group A at T1 (13.9 vs 18.6; P = 0.001) and at T2 (13.9 vs 25.2; P = 0.001), and in group B at T2 (14 vs 17.2; P = 0.001). Moreover, it improved after TOT placement more in group A than in group B (P = 0.001). Conclusions: Ultralow-dose topical vaginal ovules containing 0.03 mg estriol administrated before and after TOT placement could improve the vaginal epithelium maturation of postmenopausal women affected by SUI. Moreover, vaginal estriol ovules also improved the surgical outcome investigated by SF-36 and FSFI.
MeSH term(s)	Administration, Intravaginal ; Estriol/administration & dosage ; Female ; Humans ; Middle Aged ; Postmenopause ; Postoperative Complications/drug therapy ; Postoperative Complications/etiology ; Postoperative Complications/psychology ; Postoperative Period ; Quality of Life ; Sexual Dysfunction, Physiological/drug therapy ; Sexual Dysfunction, Physiological/etiology ; Sexual Dysfunction, Physiological/psychology ; Suburethral Slings/adverse effects ; Surveys and Questionnaires ; Treatment Outcome ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/surgery ; Vagina/pathology
Chemical Substances	Estriol (FB33469R8E)
Language	English
Publishing date	2019-12-10
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1205262-0
ISSN	1530-0374 ; 1072-3714
ISSN (online)	1530-0374
ISSN	1072-3714
DOI	10.1097/GME.0000000000001446
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