Pascale Jadoul

• Catholic University of Louvain

Background Cervicitis, an infectious or noninfectious inflammation of the cervix, encompasses a wide range of clinical conditions, from asymptomatic infections to severe lesions, making its diagnosis difficult. Acute cervicitis may develop into pelvic inflammatory disease. In patients with cervicitis, current guidelines recommend testing for herpes...

Introduction: Surgery is the cornerstone of ovarian cancer treatment. However, surgery and perioperative inflammation have been described as potentially pro-metastagenic. In various animal models and other human cancers, intraoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) appears to have a positive impact on patient outc...

Objective In Belgium there is no centralization of surgery for ovarian cancer, with more than 100 centers treating around 800 cases per year. In 2017 a network with several collaborating hospitals was established to centralize surgery for ovarian cancer (UCLouvain Network of Gynecological Oncology; UNGO) following publication of the European Societ...

Research question: How are markers of cell death, invasiveness and progesterone signalling expressed in endometrium and ectopic lesions from adenomyosis patients? Design: Formalin-fixed paraffin-embedded tissue was collected from 15 control and 15 adenomyosis participants . To assess cell survival capacity, caspase 3 and microtubule-associated p...

Background: Hydatidiform Mole (HM) is the most common form of gestational trophoblastic disease. Dilatation and curettage is the classical treatment of this affection. Hysteroscopic resection (HsR) is an alternative for the treatment of intra-uterine pathology. Objective: To describe the feasibility of HsR for the management of HM. Result: Case ser...

Study Objective Assess efficacy, safety, fertility outcomes and recurrence after laparoscopic resection of bladder endometriosis (BE) using a CO2 laser. Design Retrospective cohort study Settings University gynecological surgery unit, referral center for endometriosis. Patients Two hundred and seven women having undergone laparoscopic BE excisio...

Study question To evaluate fertility outcomes after laparoscopic bladder endometriosis (BE) excision in patients presenting with a post operative pregnancy wish or pre-operative infertility. Summary answer Surgical excision of BE is followed by high pregnancy rates, with a significant proportion of spontaneous conceptions, even in the infertile po...

Objective: To describe the available knowledge on vulvo-perineal endometriosis including its diagnosis, clinical management and recurrence rate. Methods: We followed the PRISMA guidelines for Systematic Reviews and our study was prospectively registered with PROSPERO (CRD42020202441). The terms “ Endometriosis” and “ Perineum” or “ Vulva” were used...

Objective: Ectopic pregnancy within Cesarean section scars is a rare condition. Late diagnosis carries significant risk of bleeding with poor prognosis for survival. There is no consensus on the management of this type of pregnancy. Historically, our facility offered an intra-muscular injection of methotrexate that resulted in a significant failure...

Objective: To evaluate the feasibility of hysteroscopic resection (HsR) for primary surgical management of missed abortion. Reproductive outcomes and potential benefit of this technique will be compared to traditional dilatation and curettage (D&C). Design: Retrospective cohort study in two Departments (Gynecology and Obstetrics) of a tertiary med...

Objective: To evaluate the feasibility of hysteroscopic resection (HsR) for primary surgical management of missed abortion. Reproductive outcomes and potential benefit of this technique will be compared to traditional dilatation and curettage (D&C). Design: Retrospective cohort study in two Departments (Gynecology and Obstetrics) of a tertiary medi...

Objectives: To evaluate the efficacy and safety of gonadotropin-releasing hormone (GnRH) agonist after endometrial resection in women suffering early stage endometrial carcinoma (EC) and/or endometrial intra-epithelial neoplasia (EIN). Design: A retrospective review of clinical files between January 1999 and December 2016. Setting: University hospi...

Study question: How effective is ovarian tissue cryopreservation (OTC)? Summary answer: In our cohort of patients who underwent OTC, premature ovarian failure (POF) rates, return rates and pregnancy rates after autotransplantation were 31.5, 4.4 and 33%, respectively. What is known already: OTC for fertility purposes has been performed for >20...

In women, chemotherapy and radiotherapy can be harmful to the ovaries, causing loss of endocrine and reproductive functions. When gonadotoxic treatment cannot be delayed, ovarian tissue cryobanking is the only way of preserving fertility. This technique, however, is not advisable for patients with certain types of cancer, because of the risk of rei...

Objective: To study the pregnancy rate after ulipristal acetate (UPA) therapy for fibroids. Design: Retrospective analysis of a series of 52 patients prospectively included in the PGL4001 (ulipristal acetate) Efficacy Assessment in Reduction of Symptoms Due to Uterine Leiomyomata (PEARL) II and III trials. Setting: Academic hospital. Patient(s): Am...

Among the wide variety of contraceptive methods, including hormonal pills, patches, vaginal rings, intrauterine devices and subcutaneous implants, making the right choice may not always be easy. This choice must be based on a correct knowledge of the efficacy and contraindications of the different methods. It is also essential to anticipate the pat...

To assess follicular development after long-term xenotransplantation and exogenous stimulation of cryopreserved prepubertal ovarian tissue. Pilot study. Gynecology research unit in a university hospital. Cryopreserved ovarian fragments were obtained from five prepubertal patients aged 7.2-12.2 years. Xenografting of frozen-thawed prepubertal ovaria...

Purpose: To review 15 years of activities in ovarian tissue cryobanking from medical database files, including patient indications, histological evaluation and clinical characteristics. Methods: Retrospective longitudinal analysis of data from an ovarian tissue bank in an academic hospital. Five hundred and eighty-two patients had their ovarian...

Herein we describe laparoscopic repair of uterine scar defects after cesarean section and pregnancy outcomes in a series of 13 patients. Defects and the residual anterior uterine wall were evaluated using ultrasound and magnetic resonance imaging (MRI). Patients' clinical symptoms were recorded. Pregnancy outcomes were investigated after laparoscop...

To define the role of surgery in the treatment of endometriomas, we review the literature available via PubMed and cross-reference the published data. We analyze the arguments in favor of and against surgical treatment of endometriomas and compare surgical techniques. Pain relief and pregnancy rates of more than 50% after surgery are the most impor...

To report the restoration of ovarian function and pregnancy in a woman after bilateral oophorectomy for benign disease after autotransplantation of cryopreserved ovarian cortex. Case report. Gynecology research unit in a university hospital. A 28-year-old woman who underwent bilateral adnexectomy for ovarian abscesses at the age of 18 years. We per...

"This letter concerns two manuscripts published in Human Reproduction: ‘Restoration of ovarian function after allografting of ovarian cortex between genetically non-identical sisters’ and ‘Livebirth after allografting of ovarian cortex between genetically non-identical sisters’. We wish to draw to the attention of the journal's readership, two poin...

The need for practice guidelines for fertility preservation in young women with hematological malignancies has been increased. To develop recommendations, publications relevant to fertility preservation and hematological cancers were identified through a PubMed database search and reviewed systematically, focusing on the effects of oncological trea...

This article sets out to review the literature on gonadal toxicity of bone marrow transplantation (BMT) in women, and preventive and curative actions available for girls and women facing BMT and infertility. The real incidence of ovarian damage after BMT is difficult to assess. Series reporting ovarian function and pregnancies after BMT vary greatl...

The purpose of this study was to analyze complication and recurrence rates after deep endometriotic nodule surgery. A total of 3,298 cases of deep endometriotic nodules were analyzed. The shaving technique was used, avoiding bowel resection. Laparoscopic nodule resection was performed successfully in all cases. Major complications included: (1) rec...

Endometriosis is one of the most frequently encountered benign diseases in gynecology. Complete resolution of endometriosis is not yet possible, but therapy has essentially three main objectives: (1) to preserve and improve fertility, (2) to reduce pain, and (3) to delay recurrence for as long as possible. The aim of this paper is to focus on ferti...

To report the restoration of ovarian function in a woman with Turner syndrome by allografting ovarian cortex from her monozygotic twin. Case report. Gynecology research unit in a university hospital. A 37-year-old woman with Turner syndrome who had suffered premature ovarian failure (POF) at the age of 15. In this woman, we performed ovarian cortex...

To evaluate which factors determine premature ovarian failure after bone marrow transplantation (BMT) during childhood and adolescence. Cross-sectional study. Academic teaching hospital. Thirty-five women with previous allogeneic (n = 19) or autologous (n = 16) BMT for benign (n = 12) or malignant disease (n = 23). Mean age at BMT was 9.8 ± 5.2 yea...

Premature ovarian failure (POF) and loss of reproductive function usually occur in women with cancer following the use of aggressive chemotherapy and radiotherapy. The options available to preserve fertility in such patients include oocyte cryopreservation, embryo cryopreservation, and ovarian tissue cryopreservation. When none of these options are...

Aggressive chemotherapy generally results in the loss of both endocrine and reproductive functions. If the patient has not undergone previous oocyte, embryo or ovarian tissue cryopreservation, orthotopic allotransplantation of fresh ovarian tissue from a genetically non-identical sister may be considered. Here, we describe a case report. The patien...

To evaluate the safety of conservative management of early cervical cancer. Case report and analysis of literature guidelines. Academic teaching hospital. A 35-year-old, nulliparous woman treated by simple trachelectomy and pelvic lymphadenectomy for a well-differentiated, 12-mm squamous cell carcinoma infiltrating to a depth of 3 mm (stage Ib1) wi...

To report a live birth after orthotopic transplantation of cryopreserved ovarian tissue. Case report. Department of Gynecology, Cliniques Universitaires Saint-Luc, Brussels. Woman with metastatic cancer who had her ovarian tissue cryopreserved in 2001 before undergoing chemotherapy and hematopoietic stem cell transplantation, resulting in premature...

Aggressive chemotherapy generally results in the loss of both endocrine and reproductive functions. For some women, however, oocyte, embryo or ovarian tissue cryopreservation were not proposed at the time. For three such women, orthotopic allotransplantation of fresh ovarian tissue from their genetically non-identical sister was performed. Three wo...

Introduction According to previous reports, around 700 000 new cancers are expected every year in the female population in the USA and 8% of these women will be under 40 years of age. By 2010, it is estimated that 1 in every 250 people in the adult population will be a survivor of childhood cancer. Advances in the diagnosis and treatment of childho...

In prepubertal and adolescent girls, fertility may be impaired by gonadotoxic treatments, repeat ovarian surgery or genetic disorders. Cryopreservation of ovarian cortex is an existing option to preserve fertility in these young girls at risk of premature ovarian failure (POF). The efficacy, feasibility and risks of ovarian cryopreservation in chil...

Advances in the diagnosis and treatment of childhood, adolescent and adult cancer have greatly increased the life expectancy of premenopausal women with cancer. The ovaries are very sensitive to cytotoxic treatment, especially to alkylating agents. The only established method of fertility preservation is embryo cryopreservation according to the Eth...

To describe and evaluate a new technique of laparoscopic treatment of endometriomas that combines excisional and ablative surgery. Descriptive and prospective study. Gynecology research unit in a university hospital. Fifty-two women under 35 years of age presenting for infertility and/or pelvic pain with endometriomas larger than 3 cm were included...

We report the first case of complete mesh expulsion after laparoscopic subtotal hysterectomy associated with sacral suspension of the cervix for pelvic organ prolapse.

The aim of this study was to evaluate the complication rate after laparoscopic total hysterectomy and laparoscopic subtotal hysterectomy (LASH) in case of benign disease. All complications were prospectively recorded at the time of surgery and analysed retrospectively. University hospital. Among 4505 hysterectomies performed by the same team using...

To report a case of uterine fistula arising after laparoscopic myomectomy after a uterine artery embolization. Case report. A university hospital center. A 38-year-old woman with a uteroperitoneal fistula after laparoscopic myomectomy after a uterine artery embolization. Laparoscopic excision of the fistula and repair of the myometrial defect with...

Cryopreservation of ovarian tissue is currently proposed to young cancer patients before chemo- or radiotherapy to preserve their fertility. In this study, ovarian cortex was removed by laparoscopy from five women and cryopreserved before chemotherapy. After chemotherapy, they all experienced amenorrhoea due to premature ovarian failure and request...

To propose a new laparoscopic technique for repair of scar dehiscence after cesarean section. The dehiscent scars were evaluated by ultrasound, hysterography, hysteroscopy, and magnetic resonance imaging. The results were correlated with those after laparoscopic repair. University hospital. Three patients underwent cesarean section and presented wi...

The development of new accessories and improved technology has enabled gynecologists to perform hysterectomy by laparoscopy. Reich and colleagues 1 described the technique of laparoscopic hysterectomy for the first time in 1989.

Ovarian remnant syndrome is a rare but known complication of bilateral salpingo-oophorectomy associated or not with hysterectomy. This complication is frequently related to a history of multiple surgery, pelvic inflammatory disease, or endometriosis. Here we report the eighth documented case of a primary ovarian adenocarcinoma developing in an ovar...

We report the occurrence of a small cell carcinoma of pulmonary type developed within a large borderline mucinous cystic tumor of the ovary, with another focus of microinvasive mucinous adenocarcinoma, in a 32-year-old woman. The small cell carcinoma expresses several neuroendocrine markers, thyroid transcription factor 1 and parathyroid hormone. C...

Aggressive chemotherapy and radiotherapy generally result in the loss of both endocrine and reproductive functions. In 1990, a woman aged 20 years, presenting with β-thalassemia major, underwent chemotherapy (busulfan and cyclophosphamide) and total body irradiation (TBI) before bone marrow transplantation (BMT), the donor being her 17-year-old HLA...

To describe the technique of laparoscopic ovariectomy with a view to cryopreservation of a whole ovary with its vascular pedicle. Descriptive study. Gynecology research unit in a department of gynecology in a university hospital. Women with indications for chemotherapy or radiotherapy who are at high risk of premature ovarian failure. Laparoscopic...

To analyze the prevalence of an unexpected complication due to morcellation and to describe the appearance of this complication on magnetic resonance imaging, as well as its therapy. A well-designed controlled trial without randomization (Canadian Task Force classification II-1). Academic hospital. One thousand four-hundred five patients who underw...

A late consequence of ureteral endometriosis is the silent loss of renal function caused by progressive "enclosure" of the lower part of the ureter by the endometriosis. In our experience, in cases of severe loss of renal function with cortical atrophy and residual kidney function (evaluated by Tc99 DMSA scintigraphy) of less than 15%, removal of t...

We report the case of a young girl with uterus didelphys, obstructed vagina and ipsilateral renal agenesis treated by diagnostic laparoscopy and resection of the vaginal septum by a vaginal approach in order to drain the distended uterus. Despite classic surgery, the myometrium on the treated side never recovered its normal function, with subsequen...

The surgical treatment of vaginal vault prolapse and cervical or uterine prolapse is a major challenge to the surgeon, especially when preservation of sexual function is sought. In patients with surgical contraindications, the placement of a vaginal pessary may offer great relief from symptoms without any surgical risk. But when surgery is possible...

Five years after laparoscopic subtotal hysterectomy and morcellation, pelvic magnetic resonance imaging demonstrated the presence of an irregular and heterogeneous pelvic mass measuring 40 x 40 x 30 mm. Histologic examination confirmed smooth muscle hyperplasia infiltrated by numerous endometrial glands (adenomyosis).

The review covers current options for ovarian tissue cryopreservation and transplantation and provides a systematic review of the existing literature from the last 10 years, taking into account all previously published reviews on the subject. The different cryopreservation options available for fertility preservation in cancer patients are embryo c...

Ovarian function after orthotopic transplantation of cryopreserved ovarian tissue has been restored in women with malignant disease. Here the techniques are adapted for a non-cancer patient. In 1999, right oophorectomy was performed in a 21 year old woman before chemotherapy, prior to bone marrow transplantation. Ovarian cortex was frozen, accordin...

This chapter describes two forms of endometriosis involving the urogenital system. It should be pointed out that the prevalence of both ureteral and bladder endometriosis has dramatically and significantly increased in recent years. According to the findings of one of our last studies, environmental toxins could be responsible for this increase.1....

To report two cases of orthotopic transplantation of fresh ovarian tissue. Academic hospital. Two patients with severe endometriosis, who underwent left oophorectomy for recurrent endometriosis. Ovarian cortex was reimplanted in the heterolateral orthotopic site. Biopsies of the grafted tissue were taken 3 months after reimplantation. Viable primor...

We describe an unusual case of ascites caused by the rupture of a large endometrioma.

The lifesaving treatment endured by cancer patients leads, in many women, to early menopause and subsequent infertility. In clinical situations for which chemotherapy needs to be started, ovarian tissue cryopreservation looks to be a promising option to restore fertility. In 1997, biopsy samples of ovarian cortex were taken from a woman with stage...

The efficacy of medical and surgical treatment of endometriosis-associated infertility and pelvic pain is a source of ongoing controversy. Complete resolution of endometriosis is not yet possible and current therapy has three main objectives: (1) to reduce pain; (2) to increase the possibility of pregnancy; and (3) to delay recurrence for as long a...

EDITOR—Garry et al conducted two parallel randomised studies to evaluate the effects of laparoscopic hysterectomy compared with abdominal and vaginal hysterectomy.1 The major bias of their method led them to the wrong conclusion. The primary end point was the occurrence of major complications, which was as high as 11.1% in the laparoscopic hystere...

Taking a relevant history that includes pelvic inflammatory disease or exposure to sexually transmitted diseases is not obsolete.

Magnetic resonance imaging and laparoscopy demonstrated the presence of a myoma in a woman with Rokitansky syndrome.

To evaluate whether an alternative treatment to radical hysterectomy exists for young women with endometrial adenocarcinoma. A review of the literature (70 articles) plus personal results. University hospital. Women with atypical endometrial hyperplasia or adenocarcinoma. The recurrence rate and the pregnancy rate after conservative therapy. Conser...

Peritoneal endometriosis is probably caused by the implantation of regurgitated menstrual cells. The ovarian endometrioma is the consequence of non-hormone-regulated bleeding from intraovarian epithelial inclusions after they have undergone metaplasia into endometrial-like tissue. Rectovaginal adenomyosis is, in fact, an adenomyotic lesion and can...

To compare the use of a new antiestrogen fulvestrant with goserelin in reducing uterine fibroid growth before hysterectomy. An international, multicenter, randomized, placebo-controlled study. Departments of obstetrics and gynecology. Premenopausal women (n = 307) diagnosed with uterine fibroids requiring hysterectomy. Over a 12-week period, patien...

The efficacy of medical and surgical treatment of endometriosis-associated infertility and pelvic pain is a source of questions and controversies. Complete resolution of endometriosis is not yet possible, but therapy has essentially three main objectives: (1) to reduce pain, (2) to increase the possibility of pregnancy, and (3) to delay recurrence...

To assess the safety of fertility-sparing treatment and the remaining chance of childbearing after surgery. Retrospective clinical study. Gynecology department of a university teaching hospital. Seventy-five women underwent surgical management in our institution between 1986 and 2001 for borderline tumors of the ovary. Fifty-nine patients were trea...

Objective: 1) To describe a new instrument (GyneLase®), a new approach (ELITT™ Endometrial Laser Intra-uterine Thermal Therapy) in the treatment of menorrhagia. 2) To evaluate the efficacy of this new technique in the management of dysfunctional uterine bleeding (DUB). Design: Prospective study. One hundred patients followed for one year. Patients:...

The diagnosis of peritoneal endometriosis at the time of laparoscopy is often made by the observation of typically puckered black or bluish lesions. There are also numerous subtle appearances of peritoneal endometriosis. The lesions are frequently non-pigmented. Red flame-like lesions, glandular excrescences, and subovarian adhesions must be consid...

The endoscopic technique for the management of uterine septa was first proposed by Eström and Fernström in 1970,1 but the method has only become widely used in recent years.2

The incidence of myomas in infertile women without any obvious cause of infertility is estimated to be between 1 and 2.4%. The relationship between leiomyomas and infertility remains a subject of debate. To address this issue, we have tried to evaluate the impact of myomas on fertility and pregnancy outcome in different conditions where myomas are...

In order to evaluate the relationship between leiomyomas and infertility, which remains a subject of debate, we have tried to evaluate the impact of myomas on fertility and pregnancy outcome in different conditions where myomas are implicated. Medline research was conducted of publications appearing between January 1988 and August 2001 on the subje...

This article is a review of the efficacy of medical and surgical treatment of endometriosis-associated infertility and pelvic pain. Endometriosis is the cause of pelvic pain (dysmenorrhea, dyspareunia) and infertility in more than 35% of women of reproductive age. Complete resolution of endometriosis is not yet possible but therapy has essentially...

This manuscript is a review of new ideas regarding the pathogenesis of peritoneal endometriosis, ovarian endometriosis, and retroperitoneal adenomyosis. Peritoneal endometriosis, the different aspects of which (black, red and white) represent distinctive steps in the evolutionary process, can be explained by the transplantation theory. Red lesions...

The objective of this study was to analyse the histological and immunohistochemical characteristics of cultured explants of human endometrium transplanted into nude mice. Biopsies of eutopic endometrium were taken from six patients during laparoscopic surgery and classified according to the phase of the cycle. All the explants were cultured with oe...

Open exploration and endoscopic sphincterotomy (ES) remain the preferred treatment of common bile duct stones (CBDS). The recent spread of laparoscopy has worsened the dilemna of choosing between surgical and endoscopic treatment of CBDS. The aim of this study was to critically evaluate the results of our preliminary experience with laparoscopic co...

Gallbladder duplication is a rare congenital condition, which can now be detected preoperatively by imaging studies. We report a case of duplicated gallbladder with symptomatic unilobar gallstones. Appropriate biliary workup (ultrasound, oral cholecystography, and intravenous cholangiography) allowed a correct preoperative diagnosis. Laparoscopic t...

The aim of this study was to evaluate the immediate and long-term results in a retrospective series of patients with highly symptomatic adult polycystic liver disease (APLD) treated by extensive fenestration techniques. A classification of APLD was developed as a stratification scheme to help surgeons conceptualize which operation to offer to patie...

Open surgery is the standard approach for splenectomy in hematologic disorders, but a few cases of successful laparoscopic splenectomy have been reported. Thirty-one patients (18 adults, group 1; and 13 children, group 2) underwent laparoscopic splenectomy. Indications for surgery included idiopathic thrombocytopenic purpura (25 patients), congenit...