{"title":"High-Intensity Focused Ultrasound Treatment for Rectal Endometriosis: A New Tool in Minimally Invasive Approaches?","authors":"G Dubernard, A Mazard, C-A Philip, P Rousset","doi":"10.1016/j.jmig.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.021","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Petya Tanovska, Nicolas Samartzis, Maria Themeli Zografou, Laurin Burla, Markus Eberhard, Dimitrios Rafail Kalaitzopoulos, Brigitte Leeners
{"title":"Association between endometriosis and congenital uterine malformations: A single-center retrospective study.","authors":"Petya Tanovska, Nicolas Samartzis, Maria Themeli Zografou, Laurin Burla, Markus Eberhard, Dimitrios Rafail Kalaitzopoulos, Brigitte Leeners","doi":"10.1016/j.jmig.2024.12.022","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.022","url":null,"abstract":"<p><strong>Study objective: </strong>The association between endometriosis and congenital uterine anomalies (CUAs) has been discussed for decades, but existing evidence about this association is scarce. The aim of our study is to evaluate the prevalence of CUAs in women with endometriosis and to identify specific characteristics in women with both CUAs and endometriosis in a large cohort of patients.</p><p><strong>Design: </strong>This is a retrospective single-center observational study conducted between January 2006 and June 2021.</p><p><strong>Setting: </strong>Swiss tertiary hospital PATIENTS: Women with histologically confirmed endometriosis at laparoscopy.</p><p><strong>Interventions: </strong>All women included in this study underwent a preoperative 2D ultrasound by an experienced sonographer. In cases of suspected intrauterine pathology, bleeding disorders, or infertility, an additional hysteroscopy was performed.</p><p><strong>Measurements and main results: </strong>Out of 1566 women with histologically confirmed endometriosis, 93 were diagnosed with CUAs (5.9%). The most frequent malformations were U1c (arcuate uterus) (41/93, 44.1%), U2a (partial septate uterus) (19/93, 20.4%), U3b (complete bicorporeal uterus) (17/93, 18.3%) and U3a (partial bicorporeal uterus) (10/93, 10.8%). Women with both CUAs and endometriosis were more frequently diagnosed with endometriosis rASRM stage IV (p=0.017) and presence of dysmenorrhea (p=0.019) in comparison to women with endometriosis and a morphologically normal uterus.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the largest endometriosis population examined for the prevalence of CUAs. According to our findings, the prevalence of CUAs in women with endometriosis does not appear to be higher than in the general population. However, women with CUAs and endometriosis are more likely to suffer from severe endometriosis (rASRM stage IV) and dysmenorrhea compared to endometriosis patients without CUA.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Minimally invasive retrieval of a mature jaw bone and teeth from a dermoid cyst.","authors":"Houyu Yang, Yuanjunzi Shi, Gang Ji","doi":"10.1016/j.jmig.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.014","url":null,"abstract":"<p><p>The manuscript showcases images of an extensive ovarian dermoid cyst harboring a mandibular structure containing three teeth. To date, only six case reports have described teeth within a mandibular structure in a dermoid cyst. To the best of our knowledge, this represents the first documented instance of a dermoid cyst with a mandibular structure containing teeth managed through transumbilical laparoendoscopic single-site surgery.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Miquel, Aubert Agostini, Anderson Loundou, Salima Daoud, Elisabetta Mazza, Malcolm G Munro, Patrice Crochet
{"title":"Reliability of an electronic uterine diagram to standardize intrauterine adhesion scoring.","authors":"Laura Miquel, Aubert Agostini, Anderson Loundou, Salima Daoud, Elisabetta Mazza, Malcolm G Munro, Patrice Crochet","doi":"10.1016/j.jmig.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.016","url":null,"abstract":"<p><strong>Study objective: </strong>To study the inter-rater reliability of an electronic complementary uterine diagram (eAFS) in comparison to the conventional American Fertility Society intrauterine adhesions (IUA) scoring system (cAFS). As a secondary aim we wanted to assess the intra-rater reliability of these tools.</p><p><strong>Design: </strong>This was an observational cross over study with a nested test re-test design.</p><p><strong>Setting: </strong>Self-identified gynecologists who performed diagnostic hysteroscopy as part of their routine practice were asked to score IUA on 7 preselected videos using both cAFS and eAFS tools in two separate rounds. The order of use of tools was determined at random. Gynecologists who agreed to be involved in a 3<sup>rd</sup> round were asked to use the tool they were allocated to in the first round to assess intra-rater variability.</p><p><strong>Patients: </strong>No patients were recruited for the purpose of this study.</p><p><strong>Measurements: </strong>Inter-rater agreement between evaluators when using eAFS and cAFS for IUA scoring.</p><p><strong>Main results: </strong>Overall, the inter-rater agreement was fair (0.25 [CI 0.17 - 0.34] for cAFS and moderate (0.53 [CI 0.48 -0.58] for the eAFS tool. The biggest difference between both tools was seen in the \"extent of cavity involved\" component, which was fair (0.28 [CI 0.21 - 0.35]) vs. substantial (0.71 [CI 0.64 - 0.78]) for cAFS vs. eAFS respectively. Moreover, agreement coefficients were comparable amongst \"expert\" and \"non-expert\" evaluators with the use of the eAFS tool. Moreover, intra-rater perfect agreement was higher with the use of eAFS compared to cAFS (38% vs 32.5%).</p><p><strong>Conclusion: </strong>The current AFS IUA scoring system has fair inter-rater agreement. However, using a complementary electronic uterine diagram increased this agreement from fair to moderate overall and from fair to substantial in the \"extent of adhesions\" domain of the tool. Use of the electronic diagram also improved inter-rater agreement amongst non-experts making it comparable to that of experts.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr Rajesweri P, Dr Surakshith Battina, Dr Sarat Battina
{"title":"\"Pregnancy in a non-communicating rudimentary uterine horn managed with laparoscopy in the first trimester\".","authors":"Dr Rajesweri P, Dr Surakshith Battina, Dr Sarat Battina","doi":"10.1016/j.jmig.2024.12.020","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.020","url":null,"abstract":"<p><p>A 23-year-old woman, conceived by ovulation induction presented at 10 weeks amenorrhea with abdominal pain and a positive urinary Beta HCG. 2D ultrasound suggested a right-sided ectopic pregnancy. On 3D ultrasound imaging, an unicornuate uterus with a right rudimentary horn pregnancy of size 6 cm was diagnosed [Figure 1]. At laparoscopy, the left tube was normal. Still, on the right, there was only a fibrous streak entering a uterine horn [Figure 2], with the pregnancy in the non-communicating rudimentary horn of an unicornuate uterus (class IIB). The right rudimentary horn, pregnancy, and tube were excised, [Figure 3], and postoperative recovery was uneventful. Histopathological examination confirmed the presence of trophoblastic tissue, consistent with a rudimentary horn pregnancy. Rudimentary horn pregnancy is uncommon with an incidence of 1 in 75,000 to 150,000 pregnancies causing uterine rupture in 50% of cases with an estimated maternal mortality rate of 0.5% [1]. The pregnancy in a non-communicating horn that has no connection with the cervix is due to the transperitoneal migration of sperm to the contralateral rudimentary horn, fertilizing the ova on that side [2]. Diagnosis can be made on 2D ultrasound with accuracy being only 26% [3]. 3D ultrasound improves accuracy rates. Laparoscopic surgery is favored due to its minimally invasive nature, reduced recovery times, and lower risk of infection [4,5].</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alireza Hadizadeh, Henry H Chill, Angela Leffelman, Claudia Paya-Ten, Cecilia Chang, Jungeun Lee, Roger P Goldberg, Ghazaleh Rostaminia
{"title":"Assessment of peri- and post-operative outcomes following apical prolapse repair in octogenarians: A retrospective cohort study.","authors":"Alireza Hadizadeh, Henry H Chill, Angela Leffelman, Claudia Paya-Ten, Cecilia Chang, Jungeun Lee, Roger P Goldberg, Ghazaleh Rostaminia","doi":"10.1016/j.jmig.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.015","url":null,"abstract":"<p><strong>Objective: </strong>To assess the risk of postoperative complications and unanticipated healthcare encounters in octogenarians compared to younger patients following apical prolapse repair.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>University-affiliated academic tertiary hospital center.</p><p><strong>Intervention: </strong>Surgery for pelvic organ prolapse PATIENTS: Patients who underwent apical prolapse repair between 2009 and 2024. The cohort was divided into two groups: 1) Patients over the age of 80 (octogenarians); 2) Patients aged 18-79 (younger cohort). Patients who underwent obliterative procedures or had missing complication data within 30 days post-surgery were excluded.</p><p><strong>Measurements and main results: </strong>A total of 481 patients were analyzed, including 136 octogenarians and 355 younger patients. Postoperative complications within 30 days were the primary outcome, while secondary outcomes included unanticipated healthcare encounters such as emergency department visits, clinic visits, and readmissions. Octogenarians had significantly higher frequency of comorbidities, such as hypertension (61.5% vs. 28.1%, p < 0.001) and a history of deep vein thrombosis (6.7% vs. 1.7%, p < 0.001), compared to younger patients. However, overall complication frequency within 30 days did not differ significantly between groups (7.4% vs. 7.6%, p = 0.934). Specific complications varied, with octogenarians experiencing higher frequency of postoperative urinary retention (5.2% vs. 0%, p < 0.001), and younger patients showing a higher likelihood of urinary tract infections (5.9% vs. 0.7%, p = 0.013). Multivariate analysis identified prior abdominal surgery (OR: 2.20, 95% CI: 1.05-4.57, p = 0.036) and undergoing anterior repair (OR: 3.36, 95% CI: 1.27-8.89, p = 0.015) as predictors of complications within 30 days. No significant differences were observed in unanticipated healthcare encounters between groups.</p><p><strong>Conclusion: </strong>Apical prolapse repair in octogenarians is safe and feasible, with similar complication frequencies and healthcare encounters compared to younger patients. These findings suggest that age alone should not preclude surgical intervention in this population, though individualized risk assessment remains crucial.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mattia Dominoni, Barbara Gardella, Andrea Gritti, Marianna Francesca Pasquali, Arsenio Spinillo
{"title":"Conservative Treatment Of Uterine Myomas: A Network Meta-analysis Of Randomized Controlled Studies.: NMA For Uterine Myomas Conservative Treatment.","authors":"Mattia Dominoni, Barbara Gardella, Andrea Gritti, Marianna Francesca Pasquali, Arsenio Spinillo","doi":"10.1016/j.jmig.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.012","url":null,"abstract":"<p><strong>Objective: </strong>To comparatively evaluate the effectiveness of uterine artery embolization (UAE), focused ultrasound (HIFU), radiofrequency ablation (RFT), and laparoscopic/laparotomic surgery in the conservative treatment of uterine fibroids DATA SOURCES: The research was performed via electronic databases PubMed, EMBASE, and Cochrane Library, using the PRISMA standards.</p><p><strong>Methods of study selection: </strong>The network included 10 randomized trials between 2000 and 2024 and 1002 randomized subjects.</p><p><strong>Tabulation: </strong>The Network meta-analysis (NMA) was carried out with subroutine netmeta on R. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. The surface under the cumulative ranking curve (SUCRA) was computed by Bayesian NMA.</p><p><strong>Integrations and results: </strong>Integrations and Results: Incidences of reintervention per 100 person/year of follow-up were 4.13 (range 0 to 19.4), 16.1 (6.2 to 32.8), 14.3 (0 to 15.1) and 6 (4.3 to 6.7) for myomectomy, UAE, HIFU and RFT, respectively. The incidence rate ratios compared to myomectomy were 2.45 (95% CI = 1.38-4.37), 5.23 (95% CI = 1.59,17.3), and 4.59 (95% CI= 0.77-27.3, p=0.09) for UAE, HIFU and RFT, respectively. RTF had the highest (SUCRA=1.25% and 3%) while myomectomy had the lowest (SUCRA=98% and 95%) risk of reintervention or hysterectomy during follow-up (median 12 months, range 3-24). The risk of major complications was significantly lower after UAE (OR=0.38,95%CI=0.17-0.85) than myomectomy. The procedure with the lowest likelihood of major complications was HIFU (SUCRA=81.5%). Finally, in the evaluation of QoL at follow-up visits 60 there were no differences between the treatments studied, although the model was highly heterogeneous and inconsistent.</p><p><strong>Conclusion: </strong>In analysis of randomized trials, surgical myomectomy carried the least risk of reintervention and subsequent hysterectomy during a relatively short follow up period. HIFU was the method with the lowest risk of major complications.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary Ovarian Lymphoma Treated with Da Vinci Robotic-Assisted Laparoscopy: A Rare Malignant Tumor of the Ovary.","authors":"Hubin Xu, Haimin Jiang, Lingqian Zhao, Huafeng Shou","doi":"10.1016/j.jmig.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.jmig.2024.12.013","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}