Italian multicenter mid-term analysis of laparoscopic lateral suspension in women with pelvic organ prolapse: clinical, sexual and Quality of Life assessment after surgical intervention.

BACKGROUND: The aim of this study was to evaluate effectiveness and safety of laparoscopic lateral suspension in women affected by high grade uterine prolapse associated to anterior defect. The secondary endpoint is to evaluate mid-term impact on Quality of Life and sexual function. METHODS: A multicenter retrospective study on women undergoing laparoscopic lateral suspension for uterine prolapse ≥III stage was performed. We included 174 women, but due to exclusion criteria, 134 patients were enrolled for this study. Preoperative evaluation consisted of an urogynecological interview, clinical exam, 3-day voiding diary and urodynamic testing; the prolapse Quality of Life Questionnaire was used to quantify the impact of prolapse symptoms on Quality of Life and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form, the Female Sexual Function Index and the Female Sexual Distress Scale were administered to evaluate sexual function before surgical intervention and at median follow-up of 3.8 years. RESULTS: We included 134 women with uterine prolapse ≥III stage. All patients underwent laparoscopic lateral suspension, 8 also posterior colporrhaphy and 5 also transobturator tape insertion. POP-Q classification score for anterior and apical compartment showed a significant average decrease. The surveys administered to patients showed an improvement in Quality of Life, an increase in the number of monthly intercourses and a significant improvement in sexual life after surgery. CONCLUSIONS: Laparoscopic lateral suspension for pelvic organ prolapse correction is a safe and effective technique for uterine and anterior associated defect. Quality of Life and sexual function significantly improved after surgery.

Hypochromic microcytic anemia as a clinical presentation of celiac disease.

To determine the prevalence of celiac disease in patients with hypochromic microcytic anemia and to evaluate if and how celiac disease influenced the outcome of anemia, 207 women with hypochromic microcytic anemia were enrolled. Multivariate statistical analysis showed significant differences for the values of hemoglobin comparing the celiac group with the other groups. Comparison of the clinical complications showed an evident statistical significance. Our study showed that among patients with iron deficiency anemia there was a high prevalence of celiac disease. Delayed diagnosis can lead to long-term chronic anemia and various clinical complications. We therefore believe that an early diagnosis prevents and minimizes the complications related to celiac disease, and that serologic screening should become routine in the diagnostic protocol for hypochromic microcytic anemia.