Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi.

OBJECTIVE: This is a randomized clinical trial comparing estroprogestin (E/P) pill given for 12 months vs. gonadotrophin releasing hormone agonist (GNRHa) given for 4 months followed by E/P pill treatment for 8 months in the relief of endometriosis-related pelvic pain. METHODS: Eligible for the study were women with laparoscopically confirmed endometriosis and pelvic pain lasting 3-12 months after diagnosis. Eligible women were randomly assigned to treatment with E/P pill (gestroden 0.75 mg and ethynlestradiol 0.03 mg) for 12 months (47 patients) vs. tryptorelin 3.75 mg slow release every 28 days for 4 months followed by E/P pill for 8 months (55 patients). RESULTS: At baseline, dysmenorrhea was reported in 46 women allocated to E/P pill only (97.9%), and in all the 55 women allocated to GNRHa+E/P pill. The corresponding value at the 12 months follow-up visit was 14 subjects (35.9%) and 16 subjects (34.8%). The baseline median values of the multidimensional and analog scale were for dysmenorrhea 4 and 6 in the EP only and 3 and 6 in the GNRHa+E/P group. The corresponding value at the 12 months follow-up visit were 2 and 6 and 0 and 5. Non-menstrual pain was reported, respectively, at baseline and 12 month visit by 46 (97.9%) and 15 (38.5%) subjects in the E/P pill group and 49 (89.1%) and 17 (37.0%) of the GNRHa+E/P pill one. The baseline median values of the multidimensional and analog scale were for non-menstrual pain 3 and 5 in the E/P only and 2 and 6 in the GNRHa+E/P group. The corresponding values at the 12 month follow-up visit were 0 and 4 and 0 and 4. These differences between the two groups were not statistically significant. CONCLUSIONS: 1 year after randomization, the two treatment schedules show similar relief of pelvic pain in women with endometriosis.

[Colpocytology in patients on hormonal contraceptives]. / Colpocitologia in pazienti in contraccezione ormonale.

In this paper, the authors analyse retrospectively 737 colpocytologic examinations done on patients on hormonal contraception, on IUD contraception and in a control group. A careful examination of data revealed no statistically relevant differences among the various groups.

[Fibroma in pregnancy]. / Attualità sui fibromi in gravidanza.

In this paper, the authors discuss 51 cases of uterine fibromatosis complicating pregnancy. From resulting data, and from an evaluation of the literature data, there emerges the present tendency to effect a conservative therapy of fibromas complicating a pregnancy.

[Ovarian tumors in menopausal patients]. / Tumefazioni ovariche in pazienti in menopausa.

In this paper, the authors discuss 22 cases of ovarian tumefaction in post menopausal age examining them clinically vaginal echography and dosages of CA 125 and 19.9, finding a good correlation between this routine diagnosis and the suspician of ovarian neoplasia.

[Diagnosis of omphalocele by transvaginal echography]. / Diagnostica dell'onfalocele con ecografia transvaginale.

In this paper, the authors discuss the utility of the trans-vaginal probe for an early diagnosis of fetal malformation, and specifically for the omphalocele.

[Report of a case of subcutaneous endometriosis]. / Descrizione di un caso di endometriosi sottocutanea.

In this paper, the authors report a case of subcutaneous endometriosis and analyze the main etiopathogenetic theories to give a reason for this anomalous localization.

[Chlamydia trachomatis and sterility]. / Chlamydia trachomatis e sterilità.

The infection caused by Chlamydia is one of the sexually transmitted diseases and the correlation between Chlamydia infection and sterility has long been known. In this work, the authors discuss how frequent the isolation of Chlamydia is in women with organic tubal damage, a datum supporting the hypothesis which sees tubal damage as secondary to the rooting of Chlamydia in the tube itself.

[The Cytobrush and Ayre spatula in taking cervical-vaginal specimens]. / Cytobrush e spatola di Ayre nel prelievo cervico-vaginale.

The authors prepare 131 cervicovaginal cytologic specimens with Ayre and Cytobrush spatulas and 94 with only the Ayre spatula and results are tested evaluating the percentage of specimens containing cells from the transformation area. The results of such tests show that the sampling methods with Cytobrush and the Ayre spatulas together is to be preferred to the use of the Ayre spatula alone for the higher presence in these specimen of cells from the transformation area, and consequently with the reduction in the number of tests to be repeated and the increase in the percentage of positive diagnoses and decrease of false negatives.

[Beta interferon in clinical practice]. / Il beta interferone nella pratica clinica.

Intramuscular interferon beta determines a positive therapeutic effect on the moderate dysplasia of the when associated with infection by HPV. The therapeutic effect is expressed mainly by progressive viral regression. Also our results show a satisfactory answer to the treatment with intramuscular interferon beta: in fact, the patients we treated had a positive reaction in terms of regression of the infection distinctly superior to what is the spontaneous regression of the infection itself.

[Screening of endometrial carcinoma]. / Lo screening del carcinoma dell'endometrio.

The Authors analyse the characteristics of the carcinoma of the endometrium concluding that this neoplasia has the necessary requirements to undergo a screening by means of endometrial cytology. The Authors believe that this test should be combined with those carried out to prevent cervical and mammary neoplasia, applying a total screening to the gynaecological neoplasia.

[Use of panoramic hysteroscopy in the differential diagnosis of abnormal uterine bleeding]. / Impiego dell'isteroscopia panoramica nella diagnosi differenziale dell' "abnormal uterine bleeding".

The usefulness of Hamou's microcolpohysteroscope in the evaluation of submucous myomas, endometrial polyps, hyperplasia of endometrium, atrophic endometrium, in order to obtain a more accurate diagnosis and a more proper therapeutic management, is underlined.

[Hysteroscopy and infertility. First data from a brief study]. / Isteroscopia ed infertilità. Primi dati ricavati da una breve esperienza.

On the basis of short-term experience with hysteroscopy, objective evaluation of the usefulness of the technique in the diagnosis of infertility is attempted and comparison made with other techniques. An attempt is also made to pinpoint the most suitable moment in the diagnostic procedure for its use.