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Laparoscopic Shull Technique for Uterine Prolapse and Risk of Recurrences: A Retrospective Comparison with Vaginal Hysterectomy

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INTERNATIONAL UROGYNECOLOGY JOURNAL 2025年第1期36卷 197-203页

作者： ronsini, carlo Vitale, Clorinda Romeo, Paola Sarpietro, Giuseppe Torella, Marco Cianci, Stefano Univ Campania Luigi Vanvitelli Dept Woman Child & Gen & Specialized Surg I-80138 Naples Italy Univ Messina Dept Human Pathol Adult & Childhood G Barresi Gynecol & Obstet Unit Messina Italy

Introduction and Hypothesis The objective was to compare the vaginal and laparoscopic approaches with natural tissue vaginal repair of pelvic organ prolapse (POP) in terms of recurrence rate and complete remission rate (CRR) of symptoms. Materials and Methods This retrospective cohort study analyzed women who underwent hysterectomy for uterine prolapse at two Italian hospitals between October 2021 and March 2023. Group A included 89 patients who received vaginal hysterectomy and colposuspension (VCH), whereas group B included 58 patients who underwent laparoscopic hysterectomy followed by laparoscopic colposuspension sec Shull (LPSS). Results The study included 147 patients with comparable baseline characteristics regarding menopausal age and body mass index. Concerning preoperative data, it is worth mentioning that group A had a higher proportion of patients with more than two previous deliveries and, overall, more severe prolapse stages. Concerning postoperative results, the patients undergoing laparoscopic surgery had longer operation times than group A. Moreover, group B had a higher recurrence rate after surgery (5.6% vs 13%, p = 0.057). Kaplan-Meier analysis indicated a lower rate of prolapse-free patients over time in group B. Cox regression showed a higher hazard ratio for recurrence in the LCSS group than in the VCH group. Complete remission rates for urinary symptoms varied, with group B showing higher CRR for stress incontinence (33% vs 71%, p < 0.001). Conclusion Both VCH and LCSS are effective for POP treatment, with VCH showing better outcomes in terms of symptom remission and shorter operation times. At the same time, LCSS had better CRR for stress incontinence but a higher recurrence rate. Further high-quality prospective studies are needed to confirm these findings and determine the best surgical approach for POP.

关键词： Pelvic organ prolapse Laparoscopic colposuspension sec Shull Vaginal surgery

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Obesity correlates to the microsatellite instability of endometrial cancer: A retrospective observational study

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SEMINARS IN ONCOLOGY 2025年第1期52卷 1-6页

作者： ronsini, carlo Braca, Eleonora Fordellone, Mario Marino, Federica Zito Napolitano, Stefania Raffone, Antonio Cobellis, Luigi De Franciscis, Pasquale Univ Campania Luigi Vanvitelli Dept Woman Child & Gen & Specialized Surg Unit Gynaecol & Obstet Naples Italy Univ Campania Luigi Vanvitelli Dept Mental & Phys Hlth & Prevent Med Med Stat Unit Naples Italy Univ Campania Luigi Vanvitelli Dept Mental & Phys Hlth & Prevent Med Pathol Unit Naples Italy Univ Campania Luigi Vanvitelli Dept Precis Med Med Oncol Unit Naples Italy

Objective: To investigate the relationship between obesity and Microsatellite Instability (MSI) in endometrial cancer (EC), determine which mismatch repair (MMR) protein loss is influenced by obesity, and assess the correlation between BMI and MSI probability. Methods: This retrospective cohort study included 89 endometrial cancer patients treated at the Gynaecologic oncology unit of the University of Campania "Luigi Vanvitelli" from August 2023 to October 2024, and stratified by BMI: normal weight ( n = 26), overweight ( n = 31), obese ( n = 26), and severely obese ( n = 6). Microsatellite instability (MSI) was determined through immunohistochemical assessment of mismatch repair (MMR) protein expression: MLH1, PMS2, MSH2, and MSH6. Tumors were considered MSI if at least one of the four MMR proteins showed loss of expression. Univariate and multivariate logistic regression models were constructed to evaluate the correlation between BMI and MSI Results: 89 patients were enrolled. Obese and severely obese groups showed significantly higher MSI rates (50 % each) compared to normoweight (12 %) and overweight (29 %) groups ( P = .013). MLH1 and PMS2 loss of expression were significantly higher in obese and severely obese women (MLH1: P = .003;PMS2: P = .014). Univariate logistic regression showed a significant positive correlation between BMI and MSI (OR 1.02, 95 % CI 1.01-1.04, P = .007). In multivariate analysis, adjusting for grading, stage, histotype, and age, BMI maintained a significant positive correlation with MSI (OR 1.02, 95 % CI 1.01-1.04, P = .048). Conclusions: This study demonstrates a significant association between obesity and MSI in EC, particularly affecting MLH1 and PMS2 expression. The findings suggest that obesity may contribute to EC development also through MMR deficiency. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： Endometrial Cancer Obesity Microsatellite Instability (MSI) Mismatch Repair Deficiency (MMRd) Body Mass Index (BMI) Immunohistochemistry MLH1/PMS2 Cancer Risk Factors

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Additional Risk Factors Lead to a Measurable Inflammatory Response in Stage I Endometrial Cancer-A Prospective Multicentric Observational Study

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INDIAN JOURNAL OF SURGICAL ONCOLOGY 2025年 1-8页

作者： ronsini, carlo Iavarone, Irene Vastarella, Maria Giovanna Corte, Luigi Della Andreoli, Giada Bifulco, Giuseppe Cobellis, Luigi de Franciscis, Pasquale Univ Campania Luigi Vanvitelli Dept Woman Child & Gen & Specialized Surg Largo Madonna Grazie 1 I-80138 Naples Italy Univ Naples Federico II Sch Med Dept Neurosci Reprod Sci & Dent I-80138 Naples Italy

The objective of the study is to explore the correlation between inflammation indices (NLR, MLR, PLR) and prognostic factors (myometrial infiltration, LVSI, grading) in FIGO 2023 stage I endometrial carcinoma. From August 2023 to March 2024, a prospective study was conducted on 163 women diagnosed with stage I endometrial cancer. The research methods were established a priori and authorized through evaluation by the Ethics Committee of the individual centers (IRB 30661/2022 of 31/03/2022). The study was then registered on the *** platform under NCT05657483. Blood samples were collected preoperatively to measure the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR). Histopathological data on myometrial infiltration, LVSI, and grading were also analyzed. NLR values were 2.07, 2.35, and 2.68 for no infiltration, < 50%, and >= 50% myometrial infiltration, respectively (p = 0.033). MLR values were 0.20, 0.23, and 0.26 for the same categories (p = 0.029). PLR values were 119, 140, and 146 (p = 0.043). For LVSI, NLR was 2.17 in negative and 3.23 in diffuse (p = 0.010), while MLR showed 0.20 vs 0.24 (p = 0.054), and PLR showed 125 vs 141 (p = 0.033). Multivariate analysis indicated myometrial infiltration had the strongest correlation with inflammation indices (beta 0.07, CI 95% 0.01-0.13, p = 0.041). Inflammation indices (NLR, MLR, PLR) significantly correlate with myometrial infiltration, LVSI positivity, and higher grading in early-stage endometrial carcinoma, with myometrial infiltration showing the strongest association. These findings suggest that inflammation indices could aid in the prognostic evaluation of endometrial carcinoma. Further research is needed to understand the prognostic implications fully.

关键词： Endometrial carcinoma Myometrial infiltration Lymphovascular space invasion (LVSI) Inflammation indices Diagnosis

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Therapeutic management in women with a diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials

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FERTILITY AND STERILITY 2025年第3期123卷 457-476页

作者： Conforti, Alessandro Carbone, Luigi Di Girolamo, Raffaella Iorio, Giuseppe Gabriele Guida, Maurizio Campitiello, Maria Rosaria Ubaldi, Filippo Maria Rienzi, Laura Vaiarelli, Alberto Cimadomo, Danilo ronsini, carlo Longobardi, Salvatore D'Hooghe, Thomas Esteves, Sandro C. Alviggi, carlo Univ Naples Federico II Dept Neurosci Reprod Sci & Odontostomatol Via Sergio Pansini 5 I-80131 Naples Italy Univ Naples Federico II Dept Publ Hlth Naples Italy ASL Salerno Dept Obstet & Gynecol & Physiopathol Human Reprod Salerno Italy GENERA IVIRMA Global Res Alliance Clin Valle Giulia Rome Italy Univ Urbino Carlo Bo Dept Biomol Sci Urbino Italy Univ Campania Luigi Vanvitelli Dept Woman Child & Gen & Specialized Surg Naples Italy Merck Serono SpA Rome Italy Merck KGaA Darmstadt Germany Univ Leuven KU Leuven Biomed Sci Grp Dept Dev & Regenerat Leuven Belgium Androl & Human Reprod Clin ANDROFERT Campinas SP Brazil Aarhus Univ Fac Hlth Aarhus Denmark

Importance: The clinical management of women with diminished ovarian reserve (DOR) is a challenge in the field of medically assisted reproduction. Several therapeutic strategies have been proposed, but with mixed results, mainly because the definition of DOR used was inconsistent among trials. Objective: To investigate adjuvant treatments and protocols involving only women with DOR according to POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) criteria. Data Sources: We conducted a systematic search using the MEDLINE (PubMed), EMBASE, and ISI Web of Knowledge databases to identify relevant studies published up to June *** review protocol was registered at http://***/PROSPERO/ (registration number: CRD42022346117). Study Selection and Synthesis: After duplication removal, the titles and abstracts of 4,806 articles were scrutinized, and 124 full-text articles were assessed for eligibility. In total, 38 randomized controlled trials were included in the qualitative/quantitative analysis. The following interventions were evaluated: dehydroepiandrosterone (n- 1,336);testosterone (n- 418);high- vs. low-dose gonadotropin (n- 957);delayed-start protocol with gonadotropin hormone-releasing hormone antagonist (n- 398);letrozole (n- 612);clomiphene citrate (1,113);growth hormone (311);luteal phase stimulation (n- 57);dual triggering (n- 139);dual stimulation (168);luteinizing hormone (979);oestradiol pretreatment (n- 552);and corifollitropin alfa (n- 561). Main Outcomes: The primary outcome was live birth rate or ongoing pregnancy if data on live birth were unavailable. Secondary outcomes were number of oocytes retrieved, number of metaphase II oocytes, clinical pregnancy rate and miscarriage rate. Results: Testosterone supplementation is associated with higher live birth rates compared with nonsupplemented women among all interventions evaluated (odds ratio: 2.19, 95% confidence interval [CI]: 1.11-4.32, four studies, 368 pati

关键词： Ovarian reserve ART POSEIDON criteria IVF diminished ovarian reserve poor response poor responders poor ovarian reserve

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Up-regulated microRNAs in blastocoel fluid of human implanted embryos could control circuits of pluripotency and be related to embryo competence

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JOURNAL OF ASSISTED REPRODUCTION AND GENETICS 2025年 1-15页

作者： Battaglia, Rosalia Caponnetto, Angela Ferrara, Carmen Fazzio, Anna Barbagallo, Cristina Stella, Michele Barbagallo, Davide Ragusa, Marco Vento, Maria Elena Borzi, Placido Scollo, Paolo Carli, Luca Feichtinger, Michael Kasapi, Evangelia Tsakos, Elias Palini, Simone Sierka, Wojciech Pecorino, Basilio Campitiello, Maria Rosaria ronsini, carlo Purrello, Michele Valerio, Domenico Longobardi, Salvatore D'Hooghe, Thomas Di Pietro, Cinzia Univ Catania Dept Biomed & Biotechnol Sci Sect Biol & Genet G Sichel I-95123 Catania Italy Univ Enna Kore Dept Med & Surg I-94100 Enna Italy Cannizzaro Hosp IVF Unit Catania Italy Wunschbaby Inst Feichtinger Vienna Austria EmbryoClin IVF Thessaloniki Greece Cervesi Hosp IVF Unit Cattolica Italy Gyncentrum Sp Zelazna 1 PL-40851 Katowice Poland ASL Salerno Dept Obstet & Gynecol & Physiopathol Human Reprod Salerno Italy Univ Campania Luigi Vanvitelli Dept Woman Child & Gen & Specialized Surg Naples Italy Inst Genet Res IRG I-80143 Naples Italy Merck Serono SpA Global Clin Dev Rome Italy Merck KGaA Darmstadt Germany KU Leuven Univ Leuven Dept Dev & Regenerat Biomed Sci Grp Leuven Belgium

Purpose The paper aims to investigate the biological role of microRNAs secreted by preimplantation embryo into the blastocoel fluid and to detect a distinctive molecular signature for identifying embryos with the highest implantation potential. Methods We carried on a multicenter retrospective study involving five European IVF centers. We collected 112 blastocoel fluid samples from embryos on day 5 post-fertilization, cultured individually, along with data on blastocyst grade and embryo transfer outcomes. Using a custom TLDA Array, we compared the expression levels of 89 miRNAs between 33 fluids from high-quality implanted embryos and 30 fluids from high-quality not-implanted embryos. Expression differences were assessed using SAM and t-test. Additionally, correlation and function enrichment analysis and network construction were conducted to identify the biological roles of deregulated microRNAs. Results We identified six up-regulated microRNAs in the blastocoel fluid from implanted embryos, significantly and positively correlated across all samples (r >= 0.7;P <= 0.05). They could take part in pluripotency circuits, regulating and being regulated by transcription factors associated with stemness, cell growth, and embryo development. The ROC curve analysis confirmed the potential of these miRNAs as implantation classifiers. Conclusion The six miRNAs up-regulated in blastocoel fluid from implanted embryos may represent a functional molecular signature for evaluating blastocyst quality and identifying the most competent embryos. Their evaluation associated with non-invasive preimplantation genetic testing, integrating epigenetic and genomic analyses, could enhance implantation grade and allow for identification of the euploid embryo not able to implant.

关键词： Blastocoel fluid Embryo development Embryo implantation Human blastocyst MicroRNAs

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Assessing quality, reliability and accuracy of polycystic ovary syndrome-related content on TikTok: A video-based cross-sectional analysis

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INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 2025年第0期 2025 Feb 10页

作者： Riemma, Gaetano Carotenuto, Raffaela Maria Casolari, Camilla ronsini, carlo Della Corte, Luigi La Verde, Marco Unfer, Vittorio De Franciscis, Pasquale Lagana, Antonio Simone Etrusco, Andrea Univ Campania Luigi Vanvitelli Dept Woman Child & Gen & Specialized Surg Obstet & Gynecol Unit Naples Italy Univ Naples Federico II Sch Med Dept Neurosci Reprod Sci & Dent Naples Italy Experts Grp Inositol Basic & Clin Res PCOS EGOI PC Rome Italy UniCamillus St Camillus Int Univ Hlth Sci Dept Gynecol Rome Italy Univ Palermo Paolo Giaccone Hosp Dept Hlth Promot Mother & Child Care Internal Med Unit Obstet & Gynecol Palermo Italy

ObjectiveSocial networks share medical content with no peer-review or fact-checking. In the present study we aimed to assess the quality, reliability, and level of misinformation in TikTok videos about polycystic ovary syndrome (PCOS). MethodsWe performed a cross-sectional analysis of TikTok videos retrieved using "PCOS" as the search term and analyzed using patient education materials assessment tool for audio-visual content (PEMAT A/V), modified DISCERN (mDISCERN), global quality scale (GQS), video information and quality index (VIQI) and misinformation assessment were employed. ResultsA total of 180 videos were included. Most videos were partially accurate (containing 25%-50% of false information) or uninformative (more than 50%) (56.7% and 6.6%, respectively) with a significantly higher proportion of inaccurate or uninformative videos from PCOS-patients than healthcare professionals (14.4% vs. 0%;P < 0.001) as well as for partially accurate videos (78.4% vs. 37.5%;P < 0.001). PEMAT A/V scores for understandability and actionability were 50% (interquartile range [IQR]: 33%-58%) and 25% (IQR: 25%-50%), respectively with significantly higher understandability for healthcare professionals (54% [IQR: 42%-71%] vs. 33% [IQR: 25%-50%], P < 0.001). Median mDISCERN was 2 (IQR: 1-3) (low degree of reliability), with videos by healthcare professionals scoring significantly higher than those by patients (2 [IQR: 2-3] vs. 1 [IQR: 0-2];P = 0.001). Intermediate-low overall video quality was reported in VIQI with median score of 12 (IQR: 10-15) and significantly lower scores for patients (9 [IQR: 5-12] vs. 13 [IQR: 12-17];P < 0.001). Similarly, median GQS score was overall intermediate for degree of usefulness (median 3 [IQR: 2-4]), but patient-created videos were of significantly lower quality (median 2 [IQR: 2-3] vs. 4 [IQR: 3-4];P < 0.001). ResultsA total of 180 videos were included. Most videos were partially accurate (containing 25%-50% of false information) or uninformativ

关键词： adolescents misinformation PCOS quality assessment social network TikTok

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Exploring The Relationship Between Microsatellite Instability And Immunitary System In Endometrial Cancer

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International Journal of Gynecological Cancer 2025年第2期35卷

作者： Eleonora Braca Stefania Napolitano Caterina De Rosa Luisa Amato Annalisa Ariano Erica Perri Luigi Cobellis carlo ronsini Department of Women Children and General and Specialist Surgery Università degli Studi della Campania Napoli Italy Department of Precision Medicine Università degli Studi della Campania Napoli Italy

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Cytoreductive surgery followed by HIPEC repetition for secondary ovarian cancer recurrence

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UPDATES IN SURGERY 2019年第2期71卷 389-394页

作者： Cianci, Stefano ronsini, carlo Vizzielli, Giuseppe Tropea, Alessandro Biondi, Antonio Scambia, Giovanni Fagotti, Anna Fdn Policlin Univ A Gemelli IRCCS Dipartimento Sci Salute Donna & Bambino Unita Operat Ginecol Oncol Rome Italy Univ G dAnnunzio Dept Med & Aging Sci Chieti Italy Univ Pittsburgh Med Ctr Italy Ist Mediterraneo Trapianti & Terapie Alta Special Dept Treatment & Study Abdominal Dis & Abdominal IRCCSISMETT Palermo Italy Univ Catania Dept Gen Surg & Med Surg Specialties Catania Italy Univ Cattolica Sacro Cuore Fdn Policlin Univ A Gemelli Dipartimento Sci Salute Donna & Bambino IRCCSUnita Operat Ginecol Oncol Rome Italy

Secondary and tertiary cytoreductive surgery was associated with improved overall survival in platinum-sensitive recurrent ovarian cancer (ROC). Hyperthermic intraoperative intra-peritoneal chemotherapy (HIPEC) is considered an attractive method in the treatment of ROC to deliver chemotherapy with enhanced effect directly at the tumor site. However, another deserving aspect is the feasibility and the oncologic role of HIPEC repetition. Twelve patients affected by secondary ovarian cancer recurrence previously submitted to cytoreduction followed by HIPEC were enrolled for the present study to receive tertiary cytoreduction followed by HIPEC repetition. The median operative time, including time for HIPEC procedure, was 360min (range 240-540). Average EBL was 325ml (from 100 to 500ml). The median hospital stay was of 5days, from 4 to 10. Low-grade post operatory complications occurred in 2 patients (16.6%) and high-grade complication in 1 case (8.3%). Our study report encouraging data about safety of HIPEC repetition in ovarian cancer treatment.

关键词： HIPEC HIPEC repetition Ovarian cancer Loco-regional treatment Carcinosis Chemotherapy Cytoreduction

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Robotic isolated lymphnodal debulking of the pelvic side wall in a secondary ovarian recurrence

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INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 2022年第11期32卷 1477-1478页

作者： Di Donna, Mariano Catello Cucinella, Giuseppe Zaccaria, Giulia ronsini, carlo Scambia, Giovanni Chiantera, Vito Univ Palermo ARNAS Civ Dept Gynecol Oncol I-90100 Palermo Italy Univ Palermo Dept Surg Oncol & Oral Sci Di Chir On S Palermo Italy Univ Campania Luigi Vanvitelli Sch Med & Surg Dept Woman Child & Gen & Specialized Surg Naples Italy Fdn Policlin Univ A Gemelli IRCCS Dipartimento Sci Salute Donna & Bambino Rome Italy

Localized lymph node recurrence is suitable for minimally invasive surgery, providing better perioperative and long term outcomes, but highly advanced surgical skills and experience are required. 2 3 We present the case of a 59-year-old patient with a second high grade serous epithelial ovarian cancer recurrence treated with robotic surgery. The robotic approach represents a technological advance over traditional laparoscopy, allowing radical surgery even in a complex case of ovarian recurrence involving the pelvic side wall.4 Robotic surgery may be considered for highly selected recurrent ovarian cancer cases in referral oncological centers with extensive experience in minimally invasive surgery. Ethics approval This study involves human participants but in our center, institutional review board approval was not required because the study involved analysis of existing data.

关键词： Ovarian Cancer Neoplasm Recurrence Local Lymph Nodes Laparoscopes Cytoreduction surgical procedures

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Regarding "Laparoscopic Approach for Shull Repair of Pelvic Floor Defects" Reply

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JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY 2019年第2期26卷 371-+页

作者： Restaino, Stefano Lucidi, Alessandro Finelli, Angelo ronsini, carlo Iacovelli, Antonia Fanfani, Francesco Hosp G Bernabeo Ortona Italy Univ G dAnnunzio Chieti Italy

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