Luigi Fedele

Prevention of the recurrence of post-operative endometriosis is crucial for future fertility. The incidence of disease relapse can be influenced by major demographic changes and by the use of long-term adjuvant medical treatment. Decrease i…

Women with endometriosis have a substantial increase in risk of deep dyspareunia with respect to the general female population of corresponding age. This symptom has personal and intimate implications, including unfavorable emotional impact…

BACKGROUND: There is growing and consistent evidence showing that ovarian reserve is affected following surgical excision of ovarian endometriomas. Of particular concern is the risk of severe ovarian damage leading to unresponsiveness to ov…

PURPOSE OF REVIEW: To evaluate the efficacy of second-line surgery in the management of recurrent endometriosis. RECENT FINDINGS: Long-term probability of pain recurrence after repeat conservative surgery for recurrent endometriosis varies…

BACKGROUND: Umbilical endometriosis represents the most common site of cutaneous endometriosis. Although its treatment is typically surgical, in literature the approach used is variable and extends from diathermocoagulation to omphalectomy.…

Conservative surgical treatment for symptomatic endometriosis is frequently associated with only partial relief of pelvic pain or its recurrence. Therefore, medical therapy constitutes an important alternative or complement to surgery. Howe…

OBJECTIVE: To evaluate modifications in bladder sensitivity and function after ureteroneocystostomy with bladder psoas hitch for hydronephrosis due to deep pelvic endometriosis. DESIGN: Prospective study. SETTING: Center for the Treatment…

OBJECTIVE: To detect a direct transition from a haemorrhagic corpus luteum to an endometriotic cyst by serial transvaginal ultrasonographic scans. DESIGN: Prospective observational study. SETTING: An academic tertiary care and referral ce…

Chronic pelvic pain (CPP), defined as non-cyclic pain of 6 or more months, is a frequent disorder that may negatively affect health-related quality of life. In women several causes are recognised, although in a not negligible proportion of …

BACKGROUND: The hormonal milieu that characterizes pregnancy may determine profound modifications of ovarian endometriomas leading to lesions mimicking malignancy. In this study, we report on our experience and perform a review of the liter…

The objective of this study was to determine whether delaying attempts to conceive after surgery for endometriosis impacts on reproductive prognosis. Patients operated on for endometriosis who were not seeking pregnancy at the time of surge…

Material & Methods: This study aimed to examine the biological implications of progesterone receptor subunits A (PRA) and B (PRB) mRNA expressions by analyzing the pattern of PRB/PRAB ratio in endometrial cells from women with pelvic endome…

BACKGROUND: A growing body of evidence suggests that ovarian reserve is damaged after excision of ovarian endometriomas. However, it may not be excluded that gonadal damage is at least partly caused by the very presence of an endometrioma p…

Several causes of chronic pelvic pain (CPP) are recognised, but in many women a definite diagnosis cannot be made. Few randomised controlled trials on treatment of CPP have been conducted. In a Cochrane systematic review, only medroxy-proge…

BACKGROUND: Rectovaginal endometriosis usually causes distressing pain. Surgical treatment may be effective but is associated with a high risk of morbidity and major complications. Information on the effect of medical alternatives for pain …

OBJECTIVE: To describe two rare cases of multiple extrauterine adenomyomas, their clinical management, and their response to surgical and hormone therapy with GnRH agonist. DESIGN: Case report and review of the English-language scientific …

OBJECTIVE: To assess whether routine renal ultrasonography may be recommended in all patients with pelvic endometriosis, in order to avoid silent ureteral involvement of the disease. DESIGN: Retrospective descriptive study. SETTINGS: Tert…

In spite of the increasing number of operative laparoscopies performed for endometriosis associated pelvic pain, postoperative symptomatic recurrences are very common. Reoperation is often considered the best treatment option, but the exten…

BACKGROUND: Deep endometriosis is usually associated with severe symptoms and constitutes a complex treatment challenge. METHODS: The available evidence has been revisited with the aim of defining an effective diagnostic workup and a safe …

Estimates of endometriosis recurrence after primary surgery are around 10% per annum during the first postoperative quinquennium. The aim of this study was to define the effect of reoperation in women seeking conception. A MEDLINE and PubMe…

BACKGROUND: Surgery is often considered the best treatment option in women with symptomatic endometriosis. However, extent and duration of the therapeutic benefit are still poorly defined. METHODS: The best available evidence on surgery fo…

After repetitive surgery for recurrent endometriosis, 20 of 89 (22%) women achieved spontaneous pregnancy, compared with 165 of 411 (40%) after first-line procedure (adjusted incidence rate ratio, 0.51; 95% confidence interval, 0.32 to 0.82…

We report 2 case of an atypical variant of unicornuate uterus in 2 adolescent patients with severe dysmenorrhea. Pelvic ultrasonography and magnetic resonance imaging identified a normal uterine contour. On the right side within the uterine…