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Stefano Venturoli

Publications and source records attributed to Stefano Venturoli.

14 recordsLinked to original sources
PubMed2006

Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy.

OBJECTIVE: To assess the risks and outcome of pregnancies and deliveries after laparoscopic myomectomy (LM). DESIGN: Retrospective study. SETTING: Center of Reconstructive Pelvic Endosurgery, Reproductive Medicine Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. PATIENT(S): A total of 514 patients of fertile age that underwent LM at the Center were selected. INTERVENTION(S): All the surgical procedures were performed using the same technique employing a vertical uterine incision and avoiding the use of electrosurgery. MAIN OUTCOME MEASURE(S): Number and outcome of pregnancies achieved after surgery, abortion rate, preterm delivery, gestational age, malpresentation, spontaneous or cesarean delivery, and postpartum hemorrhage. We also paid particular attention to the occurrence of uterine rupture. RESULT(S): A total of 158 pregnancies were achieved. There were 43 (27.2%) spontaneous abortions, 4 (2.6%) ectopic pregnancies, and 1 (0.6%) therapeutic abortion. Only 27 patients (25.5%) had vaginal deliveries, whereas 79 (74.5%) underwent cesarean section. No instances of uterine rupture were recorded. CONCLUSION(S): Our preliminary results confirmed that LM, performed by an expert surgeon, can restore reproductive capacity, allowing patients to have a successful pregnancy.

Adult↗
PubMed2006

Cryopreservation of human ovarian tissue.

New and often aggressive treatment schemes allow the successful healing of many young patients with cancer, but the price the young women have to pay is high: many of them lose ovarian function and fertility. Due to the improved long-term survival of adolescents and young women with malignancies undergoing gonadotoxic chemotherapy, preservation of future fertility has been the focus of recent ubiquitarian interest. A feasible solution is the cryopreservation of ovarian tissue. Ovarian tissue, after thawing, can be used in three different ways: 1. grafted into its normal site (orthotopic); 2. grafted into a site other than its normal position (heterotopic), necessitating recourse to in vitro fertilization (IVF); 3. grown and in vitro matured in order to obtain metaphase II oocytes for an IVF program. It is believed that protein supplementation, in cryopreservation solution, is essential for improving ovarian tissue cryopreservation. The aim of this study was to evaluate the ultrastructural appearance of human ovarian tissue cryopreserved in 1.5 M 1,2 propanediol (PROH), 0.2 M sucrose using different protein sources: fetal calf serum (FCS), plasmanate or syntetic serum substitute (SSS). Fresh and frozen/thawed ovarian tissues were compared by transmission electron microscope (TEM), to evaluate the appearance of stromal and follicle cells as affected by different protein sources. Our data indicate that FCS is a better protein support for ovarian tissue cryopreservation when compared to SSS or Plasmanate. In addition the follicles are more resistant to the cryopreservation with respect to stroma.

Adolescent↗
PubMed2006

Progress with oocyte cryopreservation.

PURPOSE OF REVIEW: This article reviews human oocyte cryopreservation, one of the most stimulating challenges of assisted reproduction technology. Since the first steps in assisted reproduction technology, researchers have pursued this goal, to greatly improve the management of infertility treatments. This present review depicts the present state of research and clinical applications of this methodology. RECENT FINDINGS: Recent literature focuses on the possible mechanisms of oocyte damage caused by temperature and cryoprotectant injury and forecasts possible technological solutions. Several papers illustrate encouraging results in the increasing clinical application of this procedure. SUMMARY: Findings give support to several indications of human female gamete cryostorage. Oocyte cryopreservation might replace embryo freezing. Egg freezing offers an alternative to women at risk of losing their reproductive function, caused by antineoplastic treatments, endometriosis, ovarian surgery or genetic premature ovarian failure. In addition, oocyte storage may contribute to an increase in in-vitro fertilization flexibility. Despite the early disappointing results, recent technical modifications have improved the clinical efficiency greatly, with the birth of several healthy children.

Cell Survival↗
PubMed2004

Oocyte cryopreservation in oncological patients.

The use of chemotherapy and radiotherapy in oncological patients may reduce their reproductive potential. Sperm cryopreservation has been already used in men affected by neoplastic disease. Oocyte cryopreservation might be an important solution for these patients at risk of losing ovarian function. A program of oocyte cryopreservation for oncological patients is also present in our center. From June 1996 to January 2000, 18 patients awaiting chemotherapy and radiotherapy for neoplastic disease were included in our oocyte cryopreservation program. Our experience documents that oocyte storage may be a concrete and pragmatic alternative for oncological patients. The duration of oocyte storage does not seem to interfere with oocyte survival as pregnancies occurred even after several years of gamete cryopreservation in liquid nitrogen.

Adolescent↗
PubMed2004

Laparoscopic treatment of pelvic floor defects in women of reproductive age.

STUDY OBJECTIVE: To evaluate the efficacy of conservative laparoscopic treatment of genital prolapse in women of reproductive age. DESIGN: Retrospective analysis (Canadian Task Force classification II-2). SETTING: University hospital, Center of Reconstrutive Pelivc Endosurgery, Reproductive Medical Unit, S. Orsola Hospital, Bologna, Italy. PATIENTS: Fifteen women of reproductive age with genital prolapse. Interventions. Conservative laparoscopic surgical correction of genital prolapse. Apical prolapse was corrected by sacral colpohysteropexy. Burch colposuspension was always included to treat evident or latent stress urinary incontinence. Anterior compartment defects were treated by laparoscopic paravaginal repair and by the interposition of an intervesicouterine prosthesis. Posterior compartment defects were corrected by a prosthetic reconstruction of the rectovaginal support structure. MEASUREMENTS AND MAIN RESULTS: All patients underwent surgery between January 1998 and December 2000. They were prospectively evaluated for a minimum of 24 months of follow-up. No woman underwent additional surgery during the follow-up period. All women had resolution of the apical prolapse. In one woman, anterior compartment correction (i.e., correction of the anterior part of endopelvic fascia, including correction of bladder and anterior vaginal wall prolapse) was reported. No woman underwent additional prolapse surgery during the follow-up period. Three women became pregnant after surgery: one had an abortion at 8 weeks' gestation; the other two completed term pregnancies and delivered by cesarean section. CONCLUSION: Laparoscopic therapy of genital prolapse is a desirable procedure in patients of reproductive age because it respects the anatomic structures and maintains the function of the organs. Furthermore, laparoscopic treatment is feasible and well-tolerated and produces good results.

Adult↗
PubMed2003

T-helper 2-cytokine levels in women with threatened abortion.

OBJECTIVE: Considering that successful embryo development has been immunologically attributed to a T-helper 2 phenomenon and that threatened abortion is a very frequent but pathogenetically not well-defined clinical entity, our purpose was to investigate serum levels of the main T-helper 2-type cytokines during the evolution of this condition. STUDY DESIGN: Three T-helper 2-type cytokines (interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-13 (IL-13)) were measured by an enzyme-linked immunosorbent assay (ELISA) in serum of 12 women with threatened abortion both at hospital admission and discharge time. Fourteen women with missed abortion, 14 normal pregnant women and 14 normal non-pregnant women represent study control groups. RESULTS: Serum concentrations of the selected T-helper 2-type cytokines showed no significant differences in women with threatened abortion with those of normal pregnant and non-pregnant women, whereas showed significantly lower values in women with missed abortion. CONCLUSION: Our data (a) confirm the concept that first-trimester normal pregnancy is a T-helper 2 phenomenon, (b) show that threatened abortion, when T-helper 2-biased, may tend to a positive evolution of the condition, (c) display that interleukin-10, particularly, may represent a useful diagnostic and prognostic marker for predicting the normal continuance of the pregnancy in threatened abortion, (d) confirm the existence of a T-helper 2-type pattern deficiency in missed abortion, and finally (e) may open the way to new T-helper 2-biased immune therapies in case of difficult first-trimester pregnancies.

Abortion, Missed↗
PubMed2003

Maternal serum levels of pro-inflammatory cytokines in missed and threatened abortion.

PROBLEM: A study of association between pro-inflammatory cytokines, and missed and threatened abortions with good outcome has been performed. METHOD OF STUDY: The presence of pro-inflammatory cytokines, namely interleukin (IL)-8 and IL-12 and the soluble interleukin-2 receptor (SIL-2R) was investigated in maternal serum of 12 patients with threatened abortion twice (at admission and discharge), 14 patients with missed abortion, 14 women with healthy first-trimester pregnancy, and 14 normal non-pregnant women, using specific enzyme-linked immunosorbent assays. RESULTS: SIL-2R and, in particular, IL-12 was detected with significantly higher levels in missed abortion group compared with all other groups. IL-8 was detected with no significant difference among all the groups studied. CONCLUSIONS: In spite of caution due to the small sizes of the subject samples, these results support a role of the immune system in the first trimester pregnancy and hypothesize that missed abortion may be associated with an enhanced Th1 reactivity, whereas threatened abortion with good outcome resembles the normal pregnancy with a non-enhanced Th1 reactivity.

Abortion, Missed↗
PubMed2002

Total laparoscopic hysterectomy compared with abdominal hysterectomy in the presence of a large uterus.

STUDY OBJECTIVE: To evaluate in a prospective series whether, even in presence of a large uterus, total laparoscopic hysterectomy is feasible and safe, and may be substituted for abdominal hysterectomy. DESIGN: Randomized comparison (Canadian Task Force classification I). Setting. Center for Reconstructive Pelvic Endosurgery, Bologna, Italy. PATIENTS: One hundred twenty-two women with large uterus (>14 wks' gestation) caused by myomas. INTERVENTION: Total laparoscopic hysterectomy and total abdominal hysterectomy. MEASUREMENTS AND MAIN RESULTS: Sixty women underwent laparoscopic hysterectomy (group 1) and 62 abdominal hysterectomy (group 2). Mean longitudinal diameter of the uterus, mean number and diameter of myomas, operating time, and average drop in hemoglobin were similar in the groups. One conversion to laparotomy was necessary because of a bowel injury in a patient with severe pelvic adhesions. Cystotomy occurred in one woman in group 2 and was immediately repaired. Febrile morbidity was statistically more frequent in group 2 than in group 1. Postoperative hospitalization and convalescence were statistically shorter in group 1. CONCLUSION: Laparoscopic hysterectomy is safe and feasible even in the presence of large uterus, and is a valid alternative to abdominal hysterectomy when the vaginal route is contraindicated.

Adult↗
PubMed2002

Cystoscopy-assisted laparoscopic resection of extramucosal bladder endometriosis.

BACKGROUND AND PURPOSE: Involvement of the bladder is seen in only 1% to 2% of patients with endometriosis. The diagnosis of vesical endometriosis is difficult to formulate, and it should be confirmed by cystoscopy with biopsy. However, this examination is often insufficient because of the submucosal-transmural location of the lesion. Therefore, laparoscopic examination represents the gold standard for the diagnosis of pelvic endometriosis. We describe a case of recurrent bladder endometriosis treated by a combined endoscopy technique. CASE REPORT: A 43-year-old woman presented with pelvic pain, dysmenorrhea, and persistent cystitis. The endometriotic lesion on the posterior wall of the bladder consisted in a 2.5-cm nodule growing into the vesical muscularis and raising the overlying peritoneum. We performed laparoscopic resection employing a cystoscopy-assisted technique in order to preserve the integrity of the vesical mucosa. Resection was carried out and monitored from inside the bladder with the cystoscope and laparoscope lights turned on during the whole procedure ("light-to-light" technique). CONCLUSION: This minimally invasive combined endoscopic procedure could represent a good alternative to partial cystectomy for muscle-infiltrating bladder endometriosis that does not involve the vesical mucosa.

Adult↗
PubMed2002

Adjuvant L-arginine treatment in controlled ovarian hyperstimulation: a double-blind, randomized study.

BACKGROUND: Enhanced vascularization appears to be important for follicular selection and maturation in both spontaneous and stimulated IVF cycles. Nitric oxide, formed in vivo from L-arginine, may play a key role in follicular maturation and ovulation. METHODS: To evaluate the role of L-arginine supplementation in controlled ovarian hyperstimulation, 37 IVF patients were divided into two groups according to ovarian stimulation protocols: group I, GnRH agonist plus pure (p)FSH plus oral L-arginine (n = 18); and group II, GnRH agonist plus pFSH plus placebo (n = 19). Hormonal, ultrasonographic and Doppler evaluations were performed, and plasma and follicular fluid nitrite/nitrate concentrations were monitored. RESULTS: Thirty-two patients completed the study. In group I (n = 16), plasma L-arginine concentrations increased from (basal) 87 +/- 12 micromol to 279 +/- 31 micromol (P = 0.002) on the day of beta-HCG administration. In this group, pFSH treatment was shorter (P = 0.039) than in group II (n = 16). The number of the follicles > or =17mm was lower (P = 0.038) in group I than group II. The "good quality" embryos were fewer in number (P = 0.034) and pregnancy rate, both per patient (P = 0.024) and per embryo transfer (P = 0.019), was lower in group I. In the L-arginine group, an increased follicular fluid concentration of nitrite/nitrate was observed. On day 8 of the cycle, elevated plasma estradiol levels were associated with decreased blood flow resistances of perifollicular arteries. Follicular fluid concentrations of nitrite/nitrate were inversely correlated with embryo quality (r = -0.613; P = 0.005) and perifollicular artery pulsatility index (r = -0.609; P = 0.021). CONCLUSIONS: L-Arginine supplementation may be detrimental to embryo quality and pregnancy rate during controlled ovarian hyperstimulation cycles.

Adjuvants, Pharmaceutic↗
PubMed2002

Polycystic ovaries in childhood: a common finding in daughters of PCOS patients. A pilot study.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a controversial endocrine pathology and, recently, it has been suggested that the condition is hereditary. The aim of this study was to prospectively determine in daughters of patients with PCOS, by ultrasonographic (US) and colour Doppler analyses, the incidence of polycystic ovaries and search any correlation with specific hormonal parameters. METHODS: Fifteen prepubertal offspring (Group I) of patients with PCOS and 10 normal control prepubertal girls (Group II) were submitted to clinical, auxological, and basal hormonal assay. In addition all patients were submitted to US and colour Doppler ovarian and uterine evaluation. RESULTS: Among Group I girls the prevalence of polycystic ovaries was 93%, whereas no subjects among Group II had polycystic ovaries. The ovarian volume (2.76 +/- 1.21 ml versus 0.87 +/- 0.46 ml; P < 0.001) and the number of small sized follicles (5.36 +/- 2.2 versus 0.75 +/- 0.92; P < 0.001) were significantly higher in Group I than Group II patients. In addition, a normal stromal score and an absent stromal vascularization was observed in the control group. The hormone levels did not differ between the two groups. CONCLUSION: In conclusion we speculate that polycystic ovaries in childhood may be considered a sign of genetic predisposition to PCOS and that environmental factors may express the adult clinical and hormonal presentation of the syndrome.

Age of Onset↗
PubMed2002

Isolated premature pubarche: ultrasonographic and color Doppler analysis--a longitudinal study.

Twenty-seven girls with premature pubarche were studied by ultrasonographic and color Doppler analyses to determine the incidence of polycystic ovaries (PCO), to longitudinally assess their evolution, and to search for any hormonal correlation. The girls were submitted to auxological, clinical, and hormonal evaluation, and 21-hydroxylase deficiency was ruled out by an ACTH test. Furthermore, the girls underwent ultrasonographic and color Doppler ovarian and uterine analyses. Among girls with premature pubarche, the prevalence of PCO was 41%. Advanced skeletal maturation, tall stature, and increased hair distribution were constant in these patients. In patients with ultrasonographic and color Doppler evidence of PCO, the ovarian volume, the number of small-sized subcapsular follicles, the stromal echogenicity, and the ovarian stromal vascularization progressively increased during the study. In the whole studied population, ovarian volume correlated with the number of small-sized follicles (r = 0.719; P < 0.0001). Furthermore, a slight and inverse correlation has been found between ovarian volume and ovarian stromal artery pulsatility index (r = -536; P = 0.048). In conclusion, we affirm that PCO are greatly represented among girls with premature pubarche and progressively evolve.

Arteries↗
PubMedDate not supplied

Is total laparoscopic surgery for endometrial carcinoma at risk of local recurrence? A long-term survival.

BACKGROUND: Loco-regional recurrences after laparotomic surgery for early endometrial carcinoma have an incidence of 3-8%. This study examined the pattern of recurrences and survival after full laparoscopic hysterectomy. PATIENTS AND METHODS: Between January 1997 and December 2002, 113 consecutive patients with pre-operative Stage I endometrial cancer, self-referred to two different surgical teams, were treated by the laparoscopic approach by one team and by the laparotomic approach by the other team. RESULTS: Nineteen patients were treated by total laparoscopic hysterectomy (TLH) by the endoscopic group, and 94 were treated by total abdominal hysterectomy (TAH) by the oncologic group. Sixteen patients (84.2%) in the laparoscopic group and 79 patients (84.0%) in the laparotomic group had Stage I disease. The mean age and mean weight did not differ in the two groups. With a mean follow-up of 52.2 months for the TLH group and 43.6 months for the TAH group, one recurrence (5.3%) was observed in the former group and 9 recurrences (10.6%) in the latter group. No significative differences were observed for disease-free survival and overall survival. CONCLUSION: Total laparoscopic hysterectomy does not increase the risk of local recurrence and does not affect survival for patients with early stage endometrial carcinoma.

Adult↗