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Medicina
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Constant Updated in the Tailored Treatment of Gynecological Diseases
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Constant Updated in the Tailored Treatment of Gynecological Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 4015

Special Issue Editor

Prof. Dr. Marco Torella

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy
Interests: gynecologic oncology; gynecological surgery; obstetrics; reproductive medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Incessant improvements in both the theory and technology of medicine encourage us to constantly modernize and renovate the current clinical practice. In particular, gynecology is a developing area, where constant updates and awareness upon novel criticalities refine clinical practice guidelines. Above all, we highlight the importance of new tailored approaches towards different categories of patients in order to treat old pathologies through personalized procedures, both considering technology and surgery. Furthermore, the progress from a biological aspect paves the way for early diagnosis of oncological diseases and enlightens the necessity to perform precision and conservative therapeutic regimens. In parallel, the outbreak of oncological affections during pregnancy forces us to set up novel protocols in order to let the clinicians adapt to different scenarios. Nowadays, the scientific community is experiencing a fortunate chapter of evidence, ending in a remarkable improvement in clinical practice. The present Special Issue was created to collect novel evidence in those fields. Therefore, authors are invited to contribute with their latest manuscripts, in terms of case-reports, original articles, review articles, and meta-analyses.

Prof. Dr. Marco Torella
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gynecologic oncology
  • gynecological surgery
  • obstetrics
  • reproductive medicine

Published Papers (3 papers)

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Research

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12 pages, 784 KiB  
Article
Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes
by Fathi Mraihi, Giovanni Buzzaccarini, Antonio D’Amato, Antonio Simone Laganà, Jihene Basly, Chaima Mejri, Montasar Hafsi, Dalenda Chelli, Zaineb Ghali, Bianca Bianco, Fabio Barra and Andrea Etrusco
Medicina 2024, 60(1), 186; https://doi.org/10.3390/medicina60010186 - 21 Jan 2024
Viewed by 1067
Abstract
Background and Objectives: Cornual pregnancies (CPs) are rare forms of ectopic pregnancy. When abortion does not occur, it can be a life-threatening condition for the mother and can also impair future fertility. We present our experience in the diagnosis and management of [...] Read more.
Background and Objectives: Cornual pregnancies (CPs) are rare forms of ectopic pregnancy. When abortion does not occur, it can be a life-threatening condition for the mother and can also impair future fertility. We present our experience in the diagnosis and management of CPs. A systematic review was also conducted to investigate the reproductive outcomes after treatment. Materials and Methods: Between January 2010 and December 2022, we performed a retrospective, cross-sectional, single-center, and descriptive data collection and analysis (ClinicalTrial ID: NCT06165770). The search for suitable articles published in English was carried out using the following databases (PROSPERO ID: CRD42023484909): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Methodology Register), Health Technology Assessment Database, Web of Science, and search register such as ClinicalTrial. Only studies describing the impact of CP treatment on fertility were selected. Results: Two studies were included in the systematic review. Seventeen patients suffering from CPs were selected. In our series, a pelvic ultrasound allowed for the diagnosis of a cornual localization in 35.30% of cases. Thirteen women (76.47%) underwent immediate surgical management. The laparoscopic approach was the most used (76.92%), with a laparotomic conversion rate of 30%. Four patients (23.52%) received medical treatment with methotrexate. After treatment, two patients managed to achieve pregnancy. Conclusions: CP is a rare form of ectopic pregnancy that can quickly become life-threatening for the mother. Ultrasound does not lead to a precise diagnosis in all cases. In the absence of complications and emergencies, laparoscopy is an approach that could be considered valid. For selected asymptomatic patients, medical treatment may be a valid alternative. The data from the studies included in the systematic review, although demonstrating a superiority of medical treatment in terms of future pregnancies, are heterogeneous and do not allow us to reach a definitive conclusion. Full article
(This article belongs to the Special Issue Constant Updated in the Tailored Treatment of Gynecological Diseases)
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Review

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11 pages, 2358 KiB  
Review
Meigs Syndrome and Elevated CA-125: Case Report and Literature Review of an Unusual Presentation Mimicking Ovarian Cancer
by Irene Iavarone, Michela Padovano, Francesca Pasanisi, Luigi Della Corte, Elvira La Mantia and Carlo Ronsini
Medicina 2023, 59(9), 1684; https://doi.org/10.3390/medicina59091684 - 19 Sep 2023
Viewed by 1419
Abstract
Background and Objectives: Meigs syndrome is represented by a benign adnexal tumor, ascites, and hydrothorax. Even though the ovarian mass is often characterized by a fibroma-like origin, cancer antigen-125 (CA-125) serum levels could be elevated as in the development of ovarian cancer. [...] Read more.
Background and Objectives: Meigs syndrome is represented by a benign adnexal tumor, ascites, and hydrothorax. Even though the ovarian mass is often characterized by a fibroma-like origin, cancer antigen-125 (CA-125) serum levels could be elevated as in the development of ovarian cancer. Here, we present the case of a patient with Meigs syndrome and increased CA-125. Materials and Methods: We performed systematic research for articles including similar cases in PubMed, EMBASE, and Scopus in February 2023, adopting the string of idioms: “Meigs syndrome AND Cancer antigen 125”, and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Eligible records were 25. Hydrothorax was right-sided in 10 cases over 25; left-sided in two patients over 25. Concerning ascites, two patients showed more than 6 L of ascitic fluid, whereas three patients had 6 L or less. CA-125 elevation ranged from 149 IU/mL to 3803 IU/mL. Adnexal mass histotypes were: struma ovarii (12 cases), thecomas (two cases), fibrothecomas (five cases), fibromas (five cases), and one sclerosing stromal tumor (SST). Conclusions: In postmenopausal women with elevated CA-125 serum levels and an adnexal mass suspicious for malignancy at ultrasound (US), ascites and pleural effusion, surgery, and histopathological examination are necessary. MS is a diagnostic option, with an excellent prognosis after exeresis of the mass. Full article
(This article belongs to the Special Issue Constant Updated in the Tailored Treatment of Gynecological Diseases)
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Other

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15 pages, 2234 KiB  
Systematic Review
The Efficiency of Sclerotherapy for the Management of Endometrioma: A Systematic Review and Meta-Analysis of Clinical and Fertility Outcomes
by Carlo Ronsini, Irene Iavarone, Eleonora Braca, Maria Giovanna Vastarella, Pasquale De Franciscis and Marco Torella
Medicina 2023, 59(9), 1643; https://doi.org/10.3390/medicina59091643 - 11 Sep 2023
Cited by 2 | Viewed by 1326
Abstract
Background and Objectives: The most common sites of implantation of endometriotic tissue are the ovaries. Endometriomas are present in most cases of endometriosis (up to 45%). Although laparoscopic cystectomy is the standard of care in endometrioma, new strategies have been set up [...] Read more.
Background and Objectives: The most common sites of implantation of endometriotic tissue are the ovaries. Endometriomas are present in most cases of endometriosis (up to 45%). Although laparoscopic cystectomy is the standard of care in endometrioma, new strategies have been set up to minimize iatrogenic injuries to ovarian tissue. Sclerotherapy consists of injecting alcohol into the endometrioma to denature the amino acidic components of its pseudocapsule. The aim of this systematic review and meta-analysis is to compare clinical and pregnancy outcomes in surgery and sclerotherapy. Materials and Methods: Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched PubMed, EMBASE, Scopus, Google Scholar, Clinical-trials.gov, and the Cochrane Central Register of Controlled Trials databases in January 2023, adopting the string “Endometriosis and sclerotherapy”. We made no limitations on the country and year of publication. We included the studies containing Success Rate (SR), Recurrence Rate (RR), Pregnancy Rate (PR) before and after the procedure. We used comparative studies for meta-analysis. Results: A total of 29 studies fulfilled inclusion criteria, 7 retrospective observational studies and 22 prospective studies. Eight comparative studies were enrolled in meta-analysis. Patients were analyzed concerning the number of recurrences and pregnancies in surgery, and compared with sclerotherapy. Four studies showed SR > 80.0%, and only two had SR < 80.0%, of which one consisted of tetracycline instillation. Only 1 study had 100% PR, the other 14 reported PR > 30.0%, whereas six had PR < 30.0%, of which one showed 0.0% PR with ethanol injection at two-thirds of the cyst fluid volume. Meta-analysis highlighted a non-significant lower incidence of recurrence in the surgery group compared to the sclerotherapy group (p = 0.87). In parallel, the surgery group showed a non-significant better PR than the sclerotherapy group (p = 0.08). Conclusions: Despite sclerotherapy having a minor incidence of postoperative complications compared to surgery, the latter is associated with a lower RR and better PR. However, those data assert the importance of a targeted therapy according to preoperative conditions and reproductive potential. Full article
(This article belongs to the Special Issue Constant Updated in the Tailored Treatment of Gynecological Diseases)
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