0000000000183319

AUTHOR

Jose Carugno

Uterine cervical stenosis: from classification to advances in management. Overcoming the obstacles to access the uterine cavity

Background: To date hysteroscopy is the gold standard technique for the evaluation and management of intrauterine pathologies. The cervical canal represents the access route to the uterine cavity. The presence of cervical stenosis often makes entry into the uterine cavity difficult and occasionally impossible. Cervical stenosis has a multifactorial etiology. It is the result of adhesion processes that can lead to the narrowing or total obliteration of the cervical canal. Purpose: In this review, we summarize the scientific evidence about cervical stenosis, aiming to identify the best strategy to overcome this challenging condition. Methods: The literature review followed the scale for the q…

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Preventing Persistence of HPV Infection with Natural Molecules

Human papillomavirus (HPV) infection is one the most common sexually transmitted infections worldwide. In most cases, the infection is temporary and asymptomatic; however, when persistent, it may lead to lesions that can evolve into cancer in both women and men. Nowadays, prophylactic vaccination is the primary preventive strategy for HPV infections, but vaccines do not cover all types of HPV strains. Scientific research has uncovered the beneficial role of some natural supplements in preventing persistent HPV infections or treating HPV-related lesions. We review the current insight into the roles of natural molecules in HPV infection with a special focus on epigallocatechin gallate (EGCG),…

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Follow-Up and Relook Hysteroscopy

Intra-uterine adhesions (IUAs) after initial treatment in patients with Asherman’s Syndrome are one of the main challenging issues in the gynecological practice, since its incidence has been increasing over the last few decades, with a reported recurrence rate up to 30%. Asherman syndrome is characterized by variable scarring inside the uterine cavity that can lead to partial or complete dysfunction of the endometrium with impairment of fertility and menstrual pattern (amenorrhea and hypomenorrhea).

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Endometrial biopsy: Indications, techniques and recommendations. An evidence-based guideline for clinical practice

This practice guideline provides updated evidence for the gynecologist who performs endometrial biopsy (EB) in gynecologic clinical practice. An international committee of gynecology experts developed the recommendations according to AGREE Reporting Guideline. An adequate tissue sampling is mandatory when performing an EB. Blind methods should not be first choice in patients with suspected endometrial malignancy. Hysteroscopy is the targeted-biopsy method with highest diagnostic accuracy and cost-effectiveness. Blind suction techniques are not reliable for the diagnosis of endometrial polyps. In low resources settings, and in absence of the capacity to perform office hysteroscopy, blind tec…

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Role of Ovarian Suspension in Preventing Postsurgical Ovarian Adhesions in Patients with Stage III-IV Pelvic Endometriosis: A Systematic Review.

Endometriosis is a benign complex gynecological condition with high morbidity that affects women of reproductive age. Pelvic adhesion formation represents a serious clinical challenge in the management of patients with endometriosis. Several interventions have been proposed over the last few years aiming to reduce post-operative ovarian adhesions formation. The aim of this study is to summarize the evidence of the efficacy of ovarian suspension in the prevention of post-operative ovarian adhesions formation in women undergoing laparoscopic surgery for stage III-IV endometriosis. The research was conducted using electronic databases. A review of the abstracts of all references retrieved from…

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