European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Comparison of oxytocin use between singleton and twin pregnancies during induction of labour","authors":"Lisley Konar, Avir Sarkar, Amiya Das, Rituparna Das, Divesh Nitin Maniar, Prathamesh Lanjewar","doi":"10.1016/j.ejogrb.2025.114000","DOIUrl":"10.1016/j.ejogrb.2025.114000","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 114000"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amniotic fluid as a novel delivery route of 3-hydroxybutyrate during fetal brain development","authors":"Takeo Shibata ,&nbsp;Emi Takata ,&nbsp;Masahiro Takakura ,&nbsp;Jia Han ,&nbsp;Sohsuke Yamada ,&nbsp;Takumi Satoh","doi":"10.1016/j.ejogrb.2025.114001","DOIUrl":"10.1016/j.ejogrb.2025.114001","url":null,"abstract":"<div><div>Understanding how fetuses receive essential nutrients during pregnancy is crucial for optimal brain development. We observed significantly higher levels of 3-hydroxybutyrate (3HB) in the amniotic fluid surrounding human fetuses during healthy late pregnancy compared to maternal blood. 3HB concentrations in the maternal blood were 0.12 mmol/L, while those in the amniotic fluid were 0.56 mmol/L. The rate-limiting enzyme of ketogenesis, mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), was highly expressed in the cells of the chorionic plate. The placenta likely plays a crucial role in producing 3HB into the amniotic fluid, via a system involving placental HMGCS2. Here, we propose a novel delivery route for 3HB to the fetus through the amniotic fluid, in addition to the previously known route through umbilical vein. As a potential link to fetal brain development, this study suggests that complementary routes via the amniotic fluid and umbilical vein contribute significantly to the fetal 3HB supply during late pregnancy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"311 ","pages":"Article 114001"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Indonesian version of the Menstrual Distress Questionnaire (MEDI-Q): A reliability study","authors":"Achmad Kemal Harzif ,&nbsp;Muhammad Ikhsan ,&nbsp;Aisyah Retno Puspawardani ,&nbsp;Nafi’atul Ummah ,&nbsp;Amalia Shadrina ,&nbsp;Atikah Sayogo Putri ,&nbsp;Lisa Novianti ,&nbsp;Mila Maidarti ,&nbsp;Gita Pratama ,&nbsp;Kanadi Sumapraja","doi":"10.1016/j.ejogrb.2025.113996","DOIUrl":"10.1016/j.ejogrb.2025.113996","url":null,"abstract":"<div><h3>Background</h3><div>Menstruation is a natural biological process that occurs in women. The menstrual cycle significantly affects women’s physical and psychological well-being. Data obtained from surveys indicates that the burden of menstrual distress resulting from dysmenorrhea should not be underestimated. In a survey conducted with 385 Indonesian women, 79.2% reported experiencing a significant burden on their daily activities due to dysmenorrhea. In light of its considerable impact, it is essential to evaluate the level of distress associated with the menstrual cycle within clinical practice. The Menstrual Distress Questionnaire (MEDI-Q) is an instrument that has been validated for the comprehensive assessment of menstrual-related distress.</div></div><div><h3>Objectives</h3><div>With no validated instruments currently available in Indonesia for measuring menstrual distress, validating the Indonesian version of the MEDI-Q within the Indonesian-speaking population is essential for its wider adoption and utility.</div></div><div><h3>Study design</h3><div>The questionnaire underwent forward and backward translation. The Indonesian version of MEDI-Q is distributed to women aged 19–49. Participants were recruited using a consecutive sampling method and completed the questionnaire twice, with a two-week interval between each completion. Test-retest reliability is evaluated using the Intraclass Correlation Coefficient (ICC), while internal consistency is determined using Cronbach’s alpha.</div></div><div><h3>Results</h3><div>The study included 53 participants, with a mean age of 26.17 ± 4.78. The mean MEDI-Q total scores for the initial and subsequent tests are 8.79 ± 9.11 and 10.64 ± 11.68, respectively. The ICC of the participant’s responses is 0.892, while Cronbach’s alpha coefficient is 0.972.</div></div><div><h3>Conclusion</h3><div>The Indonesian version of MEDI-Q exhibits good test–retest reliability and internal consistency. The results demonstrate that the Indonesian version of the MEDI-Q can be utilized in clinical and research settings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"311 ","pages":"Article 113996"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can contrast-enhanced ultrasound differentiate cervical lesions?","authors":"Yi Zhu ,&nbsp;Chao Zhao ,&nbsp;Huiping Liu,&nbsp;Yi Li,&nbsp;Yue Wang,&nbsp;Jing Geng","doi":"10.1016/j.ejogrb.2025.113998","DOIUrl":"10.1016/j.ejogrb.2025.113998","url":null,"abstract":"<div><h3>Objective</h3><div>Assessment of whether contrast-enhanced ultrasound (CEUS) can be used to differentiate diverse cervical lesions.</div></div><div><h3>Methods</h3><div>A retrospective analysis of ultrasonographic reports was conducted for patients with different cervical lesions, including 18 cases of chronic cervicitis, 28 cases of cervical intraepithelial neoplasia grade I (CIN1), 46 cases of cervical intraepithelial neoplasia grade II (CIN2), 100 cases of cervical intraepithelial neoplasia grade III (CIN3), 7 cases of carcinoma in situ (CIS), and 26 cases of cervical cancer (CC). Timing began with the contrast agent injection via the elbow vein, recorded separately when the myometrium and cervix began to be enhanced. The intensity of enhancement of the cervix was observed and recorded as hyper-enhancement, <em>iso</em>-enhancement, or hypo-enhancement with respect to the myometrium. The rate of regression of the cervix enhancement was also analyzed and classified as fast, synchronous, or slow relative to the myometrium. Quantitative data were analyzed using either one-way ANOVA or the Kruskal-Wallis H test, while qualitative data were analyzed using Fisher’s exact test. Significant differences were further analyzed using post-hoc tests, logistic regression models, and ROC curves.</div></div><div><h3>Results</h3><div>Menopausal status affected longitudinal, anteroposterior, and transverse diameters of the cervix, in addition to cervical volume. Moreover, the time when the myometrium and cervix began to image was also different between the menopause group and the pre-menopause group (P &lt; 0.05), whereas there was no significant variance of pulsatility index (PI), resistance index (RI), enhancement intensity of the cervix, or rate of the cervix fading. The study population was grouped according to their menopausal status, and then we discovered that in the pre-menopausal group, the cervical anteroposterior diameter (APD) differed in the six cervical lesion groups (P = 0.006), especially in CIN1 &amp; CIN2, CIN1 &amp; CIN3, and CIN1 &amp; CC (P = 0.014, 0.045, 0.021, respectively). The enhancement start time (EST) of the cervix differed among the cervical lesion groups (P = 0.02). In particular, there was a significant difference in CC &amp; CIN2 and CC &amp; CIN3 (P = 0.04, 0.03, respectively). The subjects of the study were divided into two groups: those with cervical cancer and those with precancerous lesions. The discrepancy of cervical EST was still significant along with the sensitivity of 0.62, the specificity of 0.76 using a cutoff of 14.895 s, and the accuracy was 0.74.</div></div><div><h3>Conclusion</h3><div>The cervical EST can serve as an indicator of malignancy, and CEUS can be a complementary tool for cervical cancer screening. However, it should be noted that qualitative CEUS analysis alone was unable to differentiate among various precancerous lesions.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113998"},"PeriodicalIF":2.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated cardiometabolic index as a potential risk factor for female Urinary incontinence","authors":"Jiameng Wang ,&nbsp;Boyu Wang ,&nbsp;Chengjia Li ,&nbsp;Tianwei Meng ,&nbsp;Yue Zhou ,&nbsp;Jia Chen ,&nbsp;Huifang Cong","doi":"10.1016/j.ejogrb.2025.113990","DOIUrl":"10.1016/j.ejogrb.2025.113990","url":null,"abstract":"<div><h3>Background</h3><div>Urinary incontinence (UI) is closely related to metabolic conditions. The cardiometabolic index (CMI) is a novel and easily obtainable indicator used to assess metabolic status. This study aims to explore the potential relationship between CMI and female UI.</div></div><div><h3>Methods</h3><div>Data from the NHANES spanning seven consecutive survey cycles from 2005 to 2018 were used, including adult women who self-reported UI and had complete CMI calculation information. The CMI calculation formula is triglycerides(TG)/high-density lipoprotein cholesterol (HDL-C) × waist-to-height ratio (WHtR, WHtR = waist circumference/height). A multivariate logistic regression model was used to examine the linear relationship between CMI and UUI, SUI, and MUI, and subgroup analyses were conducted to explore potential influencing factors. Additionally, RCS curves were used to plot and analyze nonlinear relationships and threshold effects.</div></div><div><h3>Results</h3><div>A total of 6,628 adult women were enrolled in this study. Multivariate logistic regression showed that in the fully adjusted model, compared to subjects with the lowest CMI, those with the highest CMI had an increased association with UUI, SUI, and MUI by 1.14 times (OR = 2.14; 95 % CI, 1.83–2.50, <em>P</em> &lt; 0.0001), 0.38 times (OR = 1.38; 95 % CI, 1.17–1.63, <em>P</em> = 0.0001), and 0.83 times (OR = 1.83; 95 % CI, 1.49–2.23, <em>P</em> &lt; 0.0001), respectively. Subgroup analysis revealed significant interaction between multiple subgroups and UUI, SUI, and MUI. Additionally, the association between CMI and UUI, SUI, and MUI was nonlinear, with inflection points at 2.98, 3.21, and 2.98, respectively.</div></div><div><h3>Conclusions</h3><div>Elevated CMI levels are closely associated with UI and suggest that CMI may serve as a useful reference indicator for assessing UI risk; however, larger prospective cohort studies are needed to validate these findings and clarify the causal relationship between CMI and UI to advance its potential clinical application.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113990"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of endogenous sex hormones with endometrial cancer risk: A systematic review and meta-analysis","authors":"Pengfei Zhu ,&nbsp;Juanjuan Ren ,&nbsp;Jing Sun ,&nbsp;Jingjing Geng,&nbsp;Huan Wang,&nbsp;Mingming Ma","doi":"10.1016/j.ejogrb.2025.113997","DOIUrl":"10.1016/j.ejogrb.2025.113997","url":null,"abstract":"<div><h3>Objectives</h3><div>The role of endogenous sex hormones in the risk of endometrial cancer (EC) remains contradictory across the studies. This meta-analysis was carried out to investigate the relation of circulating concentrations of sex hormones and sex hormone-binding globulin (SHBG) to EC risk.</div></div><div><h3>Methods</h3><div>A search of the PubMed, Web of Science, and Scopus databases was conducted to include relevant studies. We used odds ratios (OR) with 95% confidence intervals (CI) to pool effect sizes using a random effects model.</div></div><div><h3>Results</h3><div>The analysis included 16 studies with 292,695 participants. SHBG levels showed an inverse relationship with EC (OR: 0.67). In contrast, higher circulating levels of total testosterone (OR: 1.70), free testosterone (OR: 1.75), dehydroepiandrosterone sulfate (OR: 1.39), and androstenedione (OR: 1.58) were positively associated with EC risk. Estrogens also demonstrated significant associations, so that estrone (OR: 1.55), unconjugated estrone (OR: 1.86), estradiol (OR: 1.38), unconjugated estradiol (OR: 2.14), estriol (OR: 1.75), and unconjugated estriol (OR: 1.99) were linked to increased EC risk, while conjugated estrogens showed no significant associations. A non-linear dose–response relationship was found for SHBG, estrone, estradiol, and total testosterone. The results were significantly affected by age, cancer type, geographic region, menopausal status, study type, and the level of adjustments for covariates. For all hormones, the significant associations were found only for postmenopausal women.</div></div><div><h3>Conclusions</h3><div>This study found an inverse association between SHBG and EC, while identified a direct relationship between sex hormones, except for conjugated estrogens, and EC risk only in postmenopausal women.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113997"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient preference for treatment of an endometrioma, a qualitative study","authors":"V.B. Veth ,&nbsp;A. Keukens ,&nbsp;A.M.F. Schreurs ,&nbsp;M.Y. Bongers ,&nbsp;V. Mijatovic ,&nbsp;J.W.M. Maas","doi":"10.1016/j.ejogrb.2025.113999","DOIUrl":"10.1016/j.ejogrb.2025.113999","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this qualitative study was to identify considerations, objections, and preferences of women with symptomatic ovarian endometrioma in the shared decision-making process.</div></div><div><h3>Design</h3><div>This study was conducted as a qualitative study, including twenty patients facing or faced therapeutic treatment options for an ovarian endometrioma.</div></div><div><h3>Setting</h3><div>Four focus groups were held between February 2020 and June 2021 in the Netherlands. Two of them were held online due to COVID-19 pandemic.</div></div><div><h3>Population</h3><div>A qualitative study was performed using semi-structured in-depth focus group methodology. All women, aged 27–44 years, suffered from pain.</div></div><div><h3>Methods</h3><div>The focus groups were audio recorded and fully transcribed using ATLAS-ti. Grounded theory methodology was applied for data analysis.</div></div><div><h3>Main outcome measures</h3><div>Outcome measure includes the most important aspects during decision-making process for patients facing or faced therapeutic treatment options for an ovarian endometrioma.</div></div><div><h3>Results</h3><div>A total of twenty Dutch women with an ovarian endometrioma were included. Participants named “relief of pain”, “fertility”, “adverse effects or surgical complications”, “recurrence of pain and lesions”, and “time untill treatment effect occurs” as most important aspects during their decision-making process. In addition, women often felt “unheard”, so more attention should be paid to symptoms of endometriosis.</div></div><div><h3>Conclusion</h3><div>Participants named “relief of pain”, “fertility”, “adverse effects or complications”, “recurrence of pain and lesions”, and “time untill treatment effect occurs” as most important aspects during their decision-making process.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113999"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of longitudinal vaginal septum: A case report and literature review","authors":"Tugba Akcaoglu ,&nbsp;Adeviye Elci Atilgan","doi":"10.1016/j.ejogrb.2025.113992","DOIUrl":"10.1016/j.ejogrb.2025.113992","url":null,"abstract":"<div><div>Vaginal septum is a rare and distinctive entity within the spectrum of Mullerian anomalies, presenting a range of symptoms including amenorrhea, abdominal pain, hematometrocolpos, and difficulty with intercourse. Early diagnosis is crucial to prevent long-term morbidity and potential infertility. Using diagnostic tools such as transvaginal ultrasonography and MRI, clinicians can identify associated reproductive tract and renal abnormalities. Once diagnosed, surgical correction is necessary, with careful consideration of the surgical approach to preserve fertility. In many cases, minimizing manipulation during surgery is critical, as the choice of surgical instruments and methods plays a significant role in preventing complications such as urinary or rectal injury. Given the complexity of these conditions, further research and targeted investigations are required to refine screening protocols and improve outcomes for affected individuals. Hereby, we present a case involving this rare condition, offering a detailed overview of the surgical management employed, along with a review of the current literature on the subject.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113992"},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the quality of information after an obstetrical anal sphincter injury improves the quality of life for women experiencing anal incontinence","authors":"Venara Aurélien ,&nbsp;Rebmann Emeline ,&nbsp;Helbert Candice ,&nbsp;Lemasson Florine ,&nbsp;Legendre Guillaume ,&nbsp;Hamel Jean-François","doi":"10.1016/j.ejogrb.2025.113989","DOIUrl":"10.1016/j.ejogrb.2025.113989","url":null,"abstract":"<div><h3>Background</h3><div>To compare the information remembered by women about the potential risk of obstetrical anal sphincter injury (OASIS) according to the occurrence of anal incontinence and the time elapsed since the OASIS.</div></div><div><h3>Methods</h3><div>This prospective and observational monocentric cohort study included all the 227 women who had OASIS during a 15-years period. Information was collected using the Fecal Incontinence Quality of Life (FIQL) questionnaire, sent to participants by post, and by a phone interview about women’s memories of the information given.</div></div><div><h3>Results</h3><div>80 patients had at least one episode of anal incontinence (AI) (35.2 %). Patients remembered having received information about the risk of AI in 28.2 % (n = 64) and about the risk of urinary incontinence (UI) in 34.4 % (n = 78). 82.2 % (n = 188) stated that they would be interested in having information about AI and 84.6 % wanted information about UI.</div><div>Patients who received the information ≤ 5 years ago were more able to remember information about AI and UI than other patients. Being able to remember information about the risk of AI was significantly associated with a better quality of life.</div></div><div><h3>Conclusion</h3><div>Patients who had received information ≤ 5 years ago were able to remember more of it. This coincides with the implementation of a specific post-OASIS consultation and therefore advocates for such consultations becoming common practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113989"},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing outcomes in vulvar cancer surgery: A comprehensive approach to complication prevention","authors":"Angel Chimenea ,&nbsp;Ana María Calderón ,&nbsp;Carmen Vargas-Rodríguez ,&nbsp;José Manuel Silván ,&nbsp;María Ángeles Martínez-Maestre","doi":"10.1016/j.ejogrb.2025.113995","DOIUrl":"10.1016/j.ejogrb.2025.113995","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to identify and synthesize strategies that reduce surgical complications in vulvar cancer, focusing on preoperative, intraoperative, and postoperative measures.</div></div><div><h3>Study Design</h3><div>A literature review was conducted by searching PubMed, Scopus, and ScienceDirect databases. Studies from 2000 to 2024 published in English and Spanish language were included. Articles were included if they addressed preoperative assessment, surgical approaches, lymph node management, wound care, or psychosocial support in vulvar cancer patients.</div></div><div><h3>Results</h3><div>Conservative surgical techniques—particularly the triple-incision approach and sentinel lymph node biopsy (SLNB)—demonstrate lower morbidity while maintaining acceptable oncologic control, especially in early-stage disease. Video endoscopic inguinal lymphadenectomy has shown promise in further reducing wound complications, although its adoption is limited to specialized centers with technical expertise. Optimizing patients preoperatively through glycemic control, nutritional support, and smoking cessation can decrease the risk of wound infection and dehiscence. Postoperative interventions such as meticulous wound care, negative-pressure wound therapy, and early lymphatic drainage techniques help prevent chronic lymphedema. Additionally, psychosocial and sexual counseling emerges as crucial for addressing the significant emotional and functional challenges associated with vulvar surgery.</div></div><div><h3>Conclusions</h3><div>A multidisciplinary, patient-centered approach is essential to mitigate the high morbidity traditionally linked to vulvar cancer surgery. Ongoing research into advanced surgical methods, standardized perioperative protocols, and holistic patient support will be key to further improving outcomes, preserving quality of life, and reducing the burden of long-term complications in this rare but challenging malignancy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113995"},"PeriodicalIF":2.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}