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To assess the efficacy of HIFU treatment on gynecologic, digestive symptoms and quality of life at 3 months in a double-blind comparative study compared with a sham intervention group. Prospective, multicenter, randomized, controlled, double-blind study. 9 reference endometriosis centers in France. Patients under anesthesia, treated by HIFU or in Sham intervention group. 60 patients randomized in two arms, presenting with rectal endometriosis visible on preoperative imaging, and suffering from acute pelvic pain with a score higher than 3 despite potential hormonal treatment. endorectal HIFU probe operating treatment or in sham setting, in the operating room, under anesthesia. The efficacy of HIFU treatment will be assessed by comparing changes in the level of acute pelvic pain assessed by visual analog scale (VAS), at 3 months, compared with the pre-treatment pain level in the HIFU group versus the sham intervention group. Quality of life and other symptoms related to endometriosis will be assessed as secondary criteria, using questionnaires at 1 and 3 months: gynecological and digestive symptoms (VAS), health status (MOSSF-36), fecal incontinence (WEXNER), constipation (KESS) and overall sexual health (FSFI). Change of lesion volume based on MRI will also be analysed. Today, the sixty patients have been included and the 3 months follow-up is completed for all the patients. Unblinding is planned in June 2024 and the results will be available for the coming AAGL congress (it will be the first presentation in a congress). The results of the safety study had already been presented in last AAGL congress in Nashville during a surgical tutorial session. We feature here a unique design of clinical trial, with a French multicenter randomized double-blind clinical study to assess the efficacy of HIFU treatment compared with a sham intervention group. [ABSTRACT FROM AUTHOR]

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Designing multifunctional landscapes requires accurate indicators to assess the effect of landscape structure on the provision on ecosystem services. Biological pest control relying on natural enemies is an important ecosystem service considered as a sustainable alternative to chemical control. The aim of this study was to measure and compare the accuracy of landscape indicators computed at various spatial scales to predict pollen beetle infestations and successful biological control in northwestern France. The sensitivity, specificity, and probability of correctly ranking fields were estimated for each indicator based on a survey of 42 fields using the receiver operating characteristic procedure. For pest infestation, the proportion of woodland and the proportion of semi-natural habitats were found to be informative indicators with good discriminatory abilities. For biological control, the proportion of woodland, the proportion of semi-natural habitats and the proportion of the previous year''s oilseed rape fields with reduced soil tillage were found to be informative indicators with good discriminatory abilities. By using indicator values and optimal thresholds we were able to compute maps of areas at risk for pest infestation and those displaying successful biological control at the regional scale. This study provides tools that could help extension services, landscape planners, and policy makers in optimizing landscape structure according to the provision of a key ecosystem service. The results of this study also provide new grounds for understanding trophic interactions at the regional scale as well as the ambivalent effect of landscape complexity on pest and natural enemy populations. [Copyright &y& Elsevier]

The aim of our study is to test a combination of biological markers differentially expressed in samples from women with or without endometriosis. Methods ENDOSEARCH is a prospective multicentric international clinical trial registered with Clinical Trial.gov. 20 renowned specialized centers in Europe, USA, Canada, and the Indian Ocean, granted by the European Union aiming to validate a cluster of biomarkers. 1000 patients. The Patient Group includes women between 18 and 45 with suspected endometriosis undergoing laparoscopy. Patients with predominant adenomyosis and/or fibroids diagnosed by imaging, chronic, malignant, infectious, metabolic or endocrine diseases are excluded. The Control Group includes patients of same age group without any endometriosis-related clinical sign, with planned laparoscopic surgery for other indications. Samples of endometriosis lesions and endometrial biopsies for both groups are sent to a unique center (Endodiag, Paris, France) to be tested with the cluster of biomarkers. Laparoscopy for endometriosis or benign conditions (Control group). 40% of the patients recruited in the Endometriosis group have already had at least one and up to 4 previous laparoscopies for endometriosis. Almost 50% of the patients had an AFS score of III or IV. 14% of the patients suspected of endometriosis had negative pathology while 2% of the patients in the control group had severe endometriosis at laparoscopy and were excluded. We present the first large prospective multicentric international clinical trial aiming to test a cluster of biomarkers to diagnose endometriosis by recruiting over 1000 patients all around Europe, the US and Canada. Even in major referral centers almost 14% of the pre-op diagnosis were negative at pathology while 2% of the control group had severe endometriosis. Those preliminary results with others show the necessity of development of accurate biological tests to diagnose endometriosis and avoid unnecessary laparoscopies. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness and safety of using a liquid adhesive solution for prosthetic bonding during laparoscopic sacrocolpopexy. Multicenter observational prospective study conducted in three French gynecological surgery centers between June 2015 and February 2017. The effectiveness of the intervention was assessed by means of validated symptom and quality of life questionnaires (PFDI-20 including POPDI-6, CRADI-8 & UDI-6, and PISQ-12) and a clinical examination one year after surgery. The medical device used was a compound of pure, fluid, translucent and sterile n-hexyl cyanoacrylate monomers (IFABOND, Peters Chirurgical, France). The glue is applied by means of a cannula. 45 patients were included from June 2015 to February 2017, with stage 2-4 genital prolapse according to the Pelvic Organ Prolapse Quantification (POP-Q) classification. A modified laparoscopic sacrocolpopexy using a liquid adhesive solution to fix the prosthesis to the vagina and to the levator ani was performed. Two non-absorbable sutures were performed to attach the anterior prosthesis to the isthmus and promontory. The average operating time was 102.5 minutes (40-210 min) and the average hospitalization time was 2.6 days (0-5 days). At one year, clinical examination and questionnaires were available for 33 and 37/45 patients, respectively (73.3 and 82.2%). The analysis of the PFDI 20 questionnaire revealed an improvement in quality of life with an overall score of 41.5/300 one year after surgery vs 106.3/300 preoperatively (p<0.001). No complications occurred during the procedure or prosthetic exposure during the one-year follow-up. The one-year anatomical success rate (POP-Q < 2) was 29/33 (87.9%). The overall satisfaction rate at one was 93.5%. The use of a liquid adhesive solution for prosthetic bonding during sacrocolpopexy appears safe and effective at one year with an improvement in the patient's satisfaction and overall quality of life. [ABSTRACT FROM AUTHOR]

Abstract: Trocar site hernia is a known complication after laparoscopic surgery, especially at 10-mm and larger port sites. Only a few cases of herniation through 5-mm port sites are reported in the literature. We describe 2 cases of bowel herniation and bowel obstruction through 5-mm port sites. The patients were 63 and 74 years old; both had endometrial cancer and underwent an uncomplicated hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy with peritoneal drains left at the lateral 5-mm port sites. Each patient presented symptoms of small bowel obstruction after which the drains were removed and were found to have evisceration through a laterally placed 5-mm port site. The bowel was reduced locally, and a segmental bowel resection was needed in 1 case. Bowel herniation can occur through the fascial defect after placement of a 5-mm port, especially if drains have been placed at the port site. [Copyright &y& Elsevier]

Abstract: Study Objective: To evaluate the feasibility and effectiveness of hysteroscopic tubal sterilization in women with an intrauterine device (IUD). Design: Prospective observational study (Canadian Task Force classification II-2). Setting: University hospital. Patients: From January 2005 through January 2006, all women with an IUD who came for a hysteroscopic tubal sterilization consultation were selected to participate. Interventions: Hysteroscopic tubal sterilization in women with IUD. Measurements and Main Results: Feasibility of the procedure, localization of microinserts, and tubal occlusion evaluated by hysterography. Hysteroscopic tubal sterilization was performed in 6 patients. Hysterography showed correct placement of microinserts and bilateral tubal occlusion in all patients. Conclusion: Hysteroscopic tubal sterilization in women with an IUD appears to be a feasible and effective procedure. [Copyright &y& Elsevier]

Abstract: Splenic rupture is a rare and severe complication of laparoscopic surgery. We report a case of delayed splenic rupture as a severe complication of laparoscopy, occurring 5 days after surgery performed on a 52-year-old woman with history of abdominal surgery and with acute pelvic infection. Subcapsular hematoma, resulting in splenic rupture, may have been a result of overlooked puncture by the Veress needle or by tension on splenic adhesions during lysis. The diagnosis should be brought up during postoperative care in case of severe pain with hemodynamic failure, hemoglobin concentration decrease, or both. [Copyright &y& Elsevier]

Résumé Introduction L’examen morpho-constitutionnel d’un calcul est indispensable pour établir la concordance diagnostique des mécanismes lithogènes ayant engendré ce calcul. Ce typage morphologique comporte une analyse visuelle de la surface et la section du calcul. Le CLAFU propose une méthode d’apprentissage de la reconnaissance endoscopique des calculs rénaux. Méthode Un recueil des images de surface et de section des calculs rénaux traités par urétérorénoscopie numérique a été réalisé de juin 2015 à décembre 2016. Le typage morphologique endoscopique, microscopique et l’examen SPIR des calculs a été réalisé par deux experts (biologiste, urologue). Résultats Cette expertise a permis de valider les images des calculs purs (I à VI) et mixtes (IIb + Ia), (IIb + IVa1)c, (IIb + IVa1)i, IIIab + Ia. Conclusion Le CLAFU met à disposition des urologues des planches validées d’aide à la reconnaissance endoscopique des calculs pour une meilleure prise en charge de la maladie lithiasique. Summary Introduction The constitutional morphological examination of urinary stone is indispensable to establish the diagnostic agreement of the lithiasic mechanisms that have produced this stone. This morphological typing involves a visual analysis of the surface and the section of the stone. CLAFU proposes a method of learning the endoscopic recognition of kidney stones. Method A collection of surface and section images of renal stones treated by digital ureteroroscopy was carried out from June 2015 to December 2016. Endoscopic, microscopic morphological typing and FTIR examination of the stones was carried out by two experts (biologist, urologist). Results This expertise allowed to validate the images of the pure kidney stones (I to VI) and mixed (IIb + Ia), (IIb + IVa1) c, (IIb + IVa1) i, IIIab + Ia. Conclusion The CLAFU provides urologists validated boards to aid in the endoscopic recognition of stones for better management of lithiasis. [ABSTRACT FROM AUTHOR]

Abstract: Uterine leiomyomas are common tumors in women, and most of their complications are well known. Rupture of a uterine leiomyoma is an unusual source of severe hemoperitoneum. The cause seems to be spontaneous rupture of a leiomyoma vessel or is secondary to abdominal trauma. Herein, we describe the case of a 46-year-old woman who had a history of uterine myomas and came to the emergency department with acute abdominal pain after she fell while jogging. The patient''s hemodynamic parameters were stable. An ultrasound examination and computed tomography scan showed multiple uterine myomas and free fluid in the peritoneum without signs of splenic rupture. Laparoscopy was performed, which revealed active bleeding from the base of a pedunculated myoma. The patient required transfusion of 2 units of packed red blood cells, and a subtotal hysterectomy via laparotomy was performed, with an uneventful postoperative course. Because surgical management is needed in an emergency, physicians should be aware of this rare but severe complication in patients with known uterine myomas. [Copyright &y& Elsevier]

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)