Ruolo ed evoluzione della chirurgia nerve-sparing nel trattamento della endometriosi severa

Ruolo ed evoluzione della chirurgia nerve-sparing nel trattamento della endometriosi severa

Marcello CeccaroniOrcid, Roberto Clarizia1, Giovanni Roviglione1, Francesco Bruni1, Daniele MautoneOrcid, Giacomo RuffoOrcid

1- Dipartimento di Ostetricia e Ginecologia, Oncologia Ginecologica e Chirurgia Pelvica Mini – Invasiva, International School of Surgical Anatomy, IRCCS Ospedale “Sacro Cuore – Don Calabria”, Negrar di Valpolicella, Verona

2 – Dipartimento di Chiurgia Generale, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Verona

Autore di riferimento: Marcello Ceccaroni

marcello.ceccaroni@sacrocuore.it


DOI: 10.53146/lriog1202140

Abstract

Nerve-Sparing (NS) surgery is a technique which, in the last decades, has shown to be highly effective in order to significantly reduce intestinal, vesical and sexual dysfunctions without reducing surgical results in eradicating Deep Infiltrating Endometriosis (DIE). Following a correct and standardized anatomo-surgical approach, NS technique for DIE can be reproducible by the pelvic surgeon who desires to face surgery for DIE and can lead, for what is possible in severe cases, to an optimal preservation of the majority of the visceral nerve fibers of the pelvis. This approach has shown not to have a negative impact over recurrence rates, which are similar to those related to the classical technique, such as the rates of efficacy over chronic pelvic pain.

Keywords: deep infiltrating endometriosis; laparoscopy; nerve-sparing; radical surgery; surgical anatomy.


Presente in LRIOG Nr.3 – 2021

e-ISSN: 1824-0283


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Laser rigenerativo vulvo – vaginale

Laser rigenerativo vulvo – vaginale: quando, come e perchè

Filippo Murina – Orcid

Servizio di Patologia del Tratto Genitale Inferiore, Ospedale V. Buzzi – Università degli Studi di Milano

filippomurina577@gmail.com


DOI: 10.53146/lriog1202114

Abstract

The use of lasers to treat gynaecological conditions including genitourinary syndrome of the menopause (GSM) has become increasingly popular over recent years. The evidence suggests laser therapy may be beneficial as a non-hormonal treatment in GSM. However, we do not know what the optimum treatment regime or interval is or what the role is for sexual hormones either before or in addition to laser treatment. It was demonstrated that a combination regimen of laser and ospemifene may improve clinical effectiveness. Application of the regenerative laser to the vestibule for vulvar pain and dyspareunia is a promising and safe treatment option in postmenopausal women with the use of appropriate parameters. Clinicians need to be aware of the limitations, risks and outcomes of laser therapy as well as the need for careful evaluation of women to ensure appropriate patient selection. Patients also need to be advised and counselled about realistic expectations of outcomes. Indiscriminate treatment of patients with little evaluation and assessment and counselling will lead to poor satisfaction outcomes and morbidity.

Keywords: laser; genitourinary syndrome of the menopause; dyspareunia; vulvar pain.


Presente in LRIOG Nr.1 – 2021

e-ISSN: 1824-0283


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