Mr Moiad Alazzam is a recognised expert in complex gynaecological surgery both open and minimally-invasive, including laparoscopy, robotics and hysteroscopic surgery. The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage. Women with recurrent early pregnancy loss, uterine septum diagnosed and one subsequent pregnancy. Septum incision was performed until the underlying myometrial tissue. https://doi.org/10.3390/jcm11123290, Subscribe to receive issue release notifications and newsletters from MDPI journals, You can make submissions to other journals. Please tick how youd like to receive marketing information. Hysterosalpingography and/or 2D transvaginal ultrasound were used as the initial screening. Roberto Tozzi 1 and Amerigo Vitagliano 1 1 Unit of Gynecology and Obstetrics, Department of Women and Childrens Health, University of Padua, 35100 Padua, Italy 2 Unit of Gynecology Oncology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities (PROMISE), University of Palermo, 90127 Palermo, Italy 3 The strategies for electronic search were the following combined search: Uterine septum OR Septate uterus OR Metroplasty AND Pregnancy rate OR Live birth rate OR Spontaneous miscarriage OR infertility OR preterm delivery. For postmenopausal women with PMB, at low risk, and ET < 4 mm, a follow-up scan could be offered, and for women with ET 4 mm, office hysteroscopyguided endometrial sampling is recommended independently of ET results. ; Loizzi, V.; Di Spiezio Sardo, A.; Campo, R.; Cicinelli, E.; Bettocchi, S. Resectoscopic Metroplasty with Uterine Septum Excision: A Histologic Analysis of the Uterine Septum. John, B.M. Uterine Septum with or without Hysteroscopic Metroplasty: Impact on Fertility and Obstetrical OutcomesA Systematic Review and Meta-Analysis of Observational Research. Bookshelf Find Roberto Tozzi's email address, contact information, LinkedIn, Twitter, other social media and more. This website uses text-to-speech software called ReachDeck to read and / or translate its content. They have specific specialist knowledge and experience of patients diagnosed with a gynaecological cancer. In five studies, SA was higher in women with subseptate uterus vs. controls (OR 4.40, 95% CI 2.94 to 6.57; In four studies, SA was not different in women with complete septate uterus vs. subseptate uterus (OR 0.87, 95% CI 0.44 to 1.71; In five studies reporting data from infertile patients, SA was higher in women with septate uterus vs. controls (OR 7.56, 95% CI 3.38 to 16.93; In two studies reporting data from recurrent abortion, SA was higher in women with septate uterus vs. controls (OR 2.29, 95% CI 1.32 to 3.99; In five studies with medium/high quality, SA was higher in women with septate uterus vs. controls (OR 5.13, 95% CI 3.33 to 7.92; SA during the first trimester of pregnancy was investigated in five studies [. Choe, J.K.; Baggish, M.S. Reproductive Outcome Analysis of 286 Women Who Underwent Hysteroscopic Septum Resection for Complete and Partial Septum of the Uterus. Grimbizis, G.F.; Camus, M.; Tarlatzis, B.C. There are some scans, tests and treatments that arent available at our facilities in Sevenoaks, however if you need additional care including surgery, you can choose to be treated at KIMS Hospital in Maidstone. Reproductive outcomes after resection of intrauterine septum. Curr Opin Obstet Gynecol. Freud, A.; Harlev, A.; Weintraub, A.Y. Moreover, the impact of septum resection on the prevention of preterm labor cannot be determined. WebPosted in Dr. Tozzi's Blog, HC Update, News (201) Family Magazine Names Dr. Robert J. Tozzi One of NY-Metro Areas Top Family Doctors, 2016 Comments Off on (201) Family and transmitted securely. In three studies reporting data from infertile patients, preterm labor was not different in women who had their uterine septum removed vs. not removed (OR 1.05, 95% CI 0.34 to 3.21; In six studies reporting data from recurrent abortion, preterm labor was not different in women who had their uterine septum removed vs. not removed (OR 0.74, 95% CI 0.26 to 2.15; In seven studies with medium/high quality, preterm labor was not different in women who had their uterine septum removed vs. not removed (OR 0.72, 95% CI 0.30 to 1.74; In the third section we analyzed nineteen manuscripts including a total of 1920 patients. Patients with: Rokitansky syndrome, hypoplastic, arcuate, bicornuate, didelphis, unicornuate uterus. The team comprises doctors, nurses and other healthcare professionals who manage the treatment of gynaecological cancers in Oxfordshire and is the tertiary referral centre for the Thames Valley Cancer Network. 1996-2023 MDPI (Basel, Switzerland) unless otherwise stated. Jourdain, O.; Dabysing, F.; Harle, T.; Lajus, C.; Roux, D.; Dallay, D. Management of septate uterus by flexible hysteroscopy and Nd:YAG laser. Any disagreement over the eligibility of a study was resolved through discussion with a third external collaborator (AV). ; et al. ; Grimbizis, G.F. Clinical implications of congenital uterine anomalies: A meta-analysis of comparative studies. Data sources: a literature search of relevant papers was conducted using electronic bibliographic databases (Medline, Scopus, Embase, Science direct). National Institute for Health and Care Excellence. ; Xu, W.M. 2003 Aug;15(4):309-14. doi: 10.1097/01.gco.0000084242.09900.13. This involves the freezing of ovarian or testicular tissue for reimplantation later in life. Concomitantly the incidence of obesity The role of HOX genes in human implantation. Spontaneous abortion rate (SAdefined as fetal loss prior to the completed 23th week of gestation; Preterm labour (PLdefined as a delivery before 37 weeks of gestation). Would you like email updates of new search results? Raga, F.; Bauset, C.; Remohi, J.; Bonilla-Musoles, F.; Simn, C.; Pellicer, A. Venetis, C.A. ; Berlin, J.A. ; Aoki, K.; Maruyama, T.; Nakatsuka, M.; Ozawa, N.; Sugi, T.; Takeshita, T.; Nishida, M. Does surgery improve live birth rates in patients with recurrent miscarriage caused by uterine anomalies? Visit our dedicated information section to learn more about MDPI. ; Var, T.; Batioglu, S. Hysteroscopic metroplasty in patients with a uterine septum and otherwise unexplained infertility. WebOxford Gynaecological Cancer Centre Lead Clinician - Mr Roberto Tozzi. Comparators: (i) Women with untreated uterine septum versus women without septum (controls); (ii) Women with treated uterine septum versus women with untreated septum (controls); (iii) Women before and after septum removal. -, Rafii A, Stoeckle E, Jean-Laurent M, Ferron G, Morice P, Houvenaeghel G, et al. Outcome definitions: Pregnancy rate (PRdefined as the presence of a gestational sac on transvaginal ultrasound; Live birth rate (LBRdefined as the delivery of one or more living and viable infants). Lead Specialist Nurse - Margaret Instone. Outcome of assisted reproduction in women with congenital uterine anomalies: A prospective observational study. ; data curation, J.C. and M.S. (Apr 2022), Carlo Saccardi, Giulia Spagnol, Giulio Bonaldo, Matteo Marchetti, Roberto Tozzi, Marco Noventa Department of Women and Childrens Health, University of Padua, Padua, ItalyCorrespondence: Giulia Spagnol, Obstetrics and Gynecology Clinic, Department of Women and Childrens Health, University of Padua, 3 Via Giustiniani, Padua 35128, Italy, Tel +39 347 359-8173, Email [emailprotected]: Transvaginal ultrasound (TVUS) represents an accurate and noninvasive technique to investigate endometrial thickness (ET) in the early diagnosis of endometrial cancer (EC). -, Chi DS, Eisenhauer EL, Zivanovic O, Sonoda Y, Abu-Rustum NR, Levine DA, et al. Author links open overlay panel Roberto Tozzi a The surgery is mainly practised in ; Isaacson, K.B. "Vaginal-Laparoscopic Repair (VLR) of Primary and Persistent Vesico-Vaginal Fistula: Description of a New Technique and Surgical Outcomes" Journal of Clinical Medicine 12, no. Email: [emailprotected] Tel: 01865 235362 Fax: 01865 235676. The Gynaecological Oncology Multidisciplinary Team (MDT) is a well-established group of experts with a specialist role in the diagnosis, treatment and management of women with gynaecological cancers. WebOxford Gynaecological Cancer Centre Lead Clinician - Mr Roberto Tozzi. We excluded from the analysis narrative or systematic reviews and case reports. ; Cocksedge, K.A. Maneschi, F.; Zupi, E.; Marconi, D.; Valli, E.; Romanini, C.; Mancuso, S. Hysteroscopically detected asymptomatic mllerian anomalies. ; Macones, G.A. ; validation, A.V., C.S., A.S.L. She was appointed as a Consultant Clinical Oncologist at the Cancer Centre in 2006. WebAdd your review of Mr Roberto Tozzi Share your experience to help others. 12 with electro-surgery. Laparoscopic surgery for gynaecological oncology. doi: 10.1016/j.placenta.2011.06.017. Reproductive outcome following resectoscope metroplasty in women having a complete uterine septum with double cervix and vagina. 2001;83:286291. Epub 2011 Jul 18. Removal of the septum by hysteroscopy (hysteroscopic metroplasty) would appear to improve the outcome SA, being very close to statistical significance. Unfortunately, a comprehensive updated summary of the current available evidence is missing. This site needs JavaScript to work properly. Mr Soleymani majd started his Obstetrics and Gynaecology career in London, before moving to Oxford and completing his structured postgraduate training programme. Valle, R.F. Trends in timing of prenatal diagnosis and abortion for fetal chromosomal abnormalities. Grimbizis, G.; Camus, M.; Clasen, K.; Tournaye, H.; De Munck, L.; Devroey, P. Hysteroscopic septum resection in patients with recurrent abortions or infertility. 2002;20:12481259. Our dedicated team of physical therapists are here to ensure you receive a timely diagnosis and prompt treatment. 32 with scissors. Lower expression of the homeobox protein Hox-A10 (HOXA10) and Vascular Endothelial Growth factor (VEGF) receptor genes, lower number of glandular and ciliated cells in the endometrial lining of the intrauterine septum and uncoordinated uterine contractility (due to increased content of muscle tissue within the septum) are supposed to be the main factors [, An important effort in summarizing the published data on CUAs and reproductive issues was given by Venetis et al. She completed her specialist training in London after undertaking a period of research at the Institute for Cancer Research and joined the team in Oxford in 2016. Not every subseptate uterus requires surgical correction to reduce poor reproductive outcome. 2Nuffield Department of Women & Reproductive Health, University of Oxford, Oxford, UK. 289 embryo transfers, 1654 embryo transfers as controls. After visualization of the tubal ostia the resection was started from the lower margin of the septum and continued until the muscular component until a normal cavity was obtained and the hysteroscope could be moved freely from one tubal ostium to the other without any intervening obstruction. Please be aware, if you are requesting a diagnostic scan such as an MRI, or CT, you must have a referral from a relevant clinician or Allied Health professional such as a physiotherapist. First, based on our analysis, we can affirm that the presence of a uterine septum could have a detrimental effect, especially on LBR, SA. Verona, Veneto, Italy View. ; Sur, S.; Deb, S.; Clewes, J.S. Full length article. She specialises in the systemic treatment of patients with ovarian and other gynaecological cancers. Epub 2017 Sep 19. See the complete profile on LinkedIn and A literature search of relevant papers was conducted using the electronic bibliographic databases (Medline, Scopus, Embase, Science direct, Cochrane library, Clinicaltrials.gov, Cochrane Central Register of Controlled Trials, EU Clinical Trials Register and World Health Organization International Clinical Trials Registry Platform). Clinical Nurse Specialists (CNS) are senior nurses who work as core members of our team. Sensitivity analyses including only medium and high-quality studies was also performed. ORCID provides an identifier for individuals to use with their name as they engage in research, scholarship, and innovation activities. ; Kapiteijn, K.; et al. WebOthers Named Roberto Tozzi. A random-effects model was used for the calculations to adjust for this heterogeneity. The team meets every Monday to discuss, in confidence, newly referred patients with a suspected or confirmed diagnosis of a gynaecological cancer. In addition, we compare the surgical and survival outcomes of patients who underwent upfront vs. interval surgery. Dr Roux trained in South Africa before embarking on a career in the UK. Soleymani Majd H, Ferrari F, Gubbala K, Campanile RG, Tozzi R. Curr Opin Obstet Gynecol. Women with subseptate uterus and who have experienced recurrent spontaneous abortions (two first- trimester abortions). ; Mathew, S.; Suresh, A. 2016 Mar;140(3):430-5. doi: 10.1016/j.ygyno.2015.12.004. Two main classification systems were developed: the ASRM (AFS) classification initially published in 1988, which was subsequently modified in 2016, and the ESHRE-ESGE classification [, Whether the uterine septum increases the risk of reproductive failure is still uncertain. London, before moving to Oxford and completing his structured postgraduate training programme Ferron,! Without Hysteroscopic metroplasty ) would appear to improve the outcome SA, being very close to significance! 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