Journal of minimally invasive gynecology最新文献

{"title":"A Systematic Review and Meta-Analysis of Energy-Based Devices for Postmenopausal Sexual Dysfunction.","authors":"Fiona Li, Akshara Shyamsunder, Erin Nesbitt Hawes, Rebecca Deans, Jason Abbott","doi":"10.1016/j.jmig.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.019","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of energy-based treatments in the management of sexual dysfunction in postmenopausal women and guide evidence-based practice, highlighting quality and evidence gaps.</p><p><strong>Data sources: </strong>We performed a systematic review of available data to December 2024 from PubMed, Embase and Scopus.</p><p><strong>Methods of study selection: </strong>Two independent reviewers screened 954 possible manuscripts for inclusion using title and abstract with full text extraction as appropriate. All randomized controlled trials (RCT) with sham or placebo control investigating an energy-based vaginal treatment in postmenopausal women that assessed severity of sexual dysfunction or dyspareunia were included in this study. Meta-analyses were performed for any comparable measures of the primary outcome.</p><p><strong>Tabulation, integration, and results: </strong>From 9 included sham or placebo RCT's, 610 participants were enrolled, with 5/9 (55%) trials (including 248 participants in total) using a double-blind methodology. 6 studied carbon dioxide laser, 3 studied radiofrequency treatment, 1 studied erbium-aluminum laser and 1 studied hybrid frequency laser. Pooled data from 6 studies with high heterogeneity suggest significant improvement in sexual function as measured by Female Sexual Function Index with a mean change of 4.25/36 [95% CI: 2.96, 5.53] and improvement in dyspareunia assessed by visual analogue scale out of 10 from 4 studies with a mean change of -5.15 [95% CI-5.97, -4.43].</p><p><strong>Conclusion: </strong>Data from both blinded and unblinded RCT's suggest that energy-based treatments may be beneficial for treatment of sexual dysfunction and dyspareunia. High heterogeneity and variability in outcomes despite similar protocols suggests considerable uncertainty of the results and requires caution when interpreting these data.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285002","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":"Author's Reply.","authors":"Liangrong Wang, Xiaoyao Li","doi":"10.1016/j.jmig.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.017","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266350","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":"Regarding \"Cheek Acupuncture Reduces Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Gynecological Surgery: A Randomized Controlled Trial\".","authors":"Guan Fu, Haimeng Liu, Fangming Liu","doi":"10.1016/j.jmig.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.018","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248314","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":"The Osmolality of Sex-the Science of Vaginal Moisturizers and Lubricants.","authors":"Jon F Pennycuff","doi":"10.1016/j.jmig.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.016","url":null,"abstract":"<p><p>More than half of women report using vaginal lubricants during their lifetime. Despite such ubiquitous use, most healthcare providers don't ask about their use and may not feel comfortable counseling a patient about how to choose the best product. The purpose of this review is to explain the difference between different vaginal products, address the factors that affect the efficacy of vaginal products, and provide evidence on the use of these products for masturbation and the use of sex toys, penile-vaginal intercourse, anal intercourse, and for couples seeking to become pregnant.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248315","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":"A Case of Struma Ovarii in an Adolescent Female.","authors":"Michelle E Darko, Beth W Rackow","doi":"10.1016/j.jmig.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.014","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248313","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":"Transrectal Excision of a Leiomyoma: A Rare Surgical Approach.","authors":"Stephanie Bernard, Dhruvi S Patel, Katrin Arnolds, Michael Sprague","doi":"10.1016/j.jmig.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.015","url":null,"abstract":"<p><p>A 33-year-old woman presented to colorectal surgery with significant chronic constipation, pelvic pain, bleeding per rectum with bowel movements, and a history of BRCA2 gene mutation. Colonoscopy was performed with normal findings. Due to ongoing symptoms, an MRI of the pelvis was ordered which revealed an expansile lobulated mass extending along the mesorectum without uterine involvement. Flexible sigmoidoscopy showed no intraluminal abnormalities with normal rectal biopsies. Pelvic ultrasound demonstrated a heterogenous, vascular soft tissue mass involving the vagina measuring 9.19 × 5.03 × 4.6 cm. Gynecology was then consulted for multidisciplinary management.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248316","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":"Use of indocyanine green for intraoperative ureteral identification in difficult hysterectomies for gynecologic malignancies.","authors":"Francesca Falcone, Marina Coppola, Alessandra DI Giovanni, Mario Malzoni","doi":"10.1016/j.jmig.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.012","url":null,"abstract":"<p><strong>Objective: </strong>To show the use of indocyanine green (ICG) for intraoperative ureteral identification (UI) during a difficult laparoscopic hysterectomy (LH) for endometrial cancer (EC).</p><p><strong>Design: </strong>Stepwise demonstration of the technique with narrated video footage.</p><p><strong>Setting: </strong>In patients who are surgically staged/treated for malignant tumors, the occurrence of perioperative complications results in medical and psychosocial implications potentially compromising oncologic outcomes. Although the potential risk of ureteral damage during hysterectomy has been estimated <1% [1-2], it is reasonable to assume that the greater the complexity of hysterectomy, the higher the risk of ureteral injury. UI may be challenging in women undergoing LH for treatment of gynecologic malignancies diagnosed after previous extensive pelvic surgeries. To date, there is paucity of data concerning the use of ICG for UI during surgeries for gynecologic cancers [3].</p><p><strong>Interventions: </strong>The patient was a 59-year-old woman diagnosed with apparent uterine-confined low-grade endometrioid EC. At 30, she underwent fertility-sparing surgery for FIGO₂₀₁₄ stage IA grade 2 endometrioid ovarian cancer (OC). Surgical staging for OC was performed via open laparotomy and included left salpingo-oophorectomy, omentectomy, systematic para-aortic and left-sided pelvic lymphadenectomy. To stage EC, we performed hysterectomy along with salpingo-oophorectomy and sentinel node removal on the right hemi-pelvis, using a 4K-3D near-infrared/ICG videoendoscope. During surgery, the left ureter, which was hard to identify in white-light mode, was instilled with ICG. For intraureteral instillation, a 5-Fr open-ended ureteral catheter was inserted via rigid cystoscopy. Five milliliters of 2.5-mg/mL ICG was injected as the catheter was slowly withdrawn from 15 cm down to the ureteral orifice. Neither intra- nor post-operative complications occurred. Final pathology showed a FIGO₂₀₂₃ stage IB_mNSMP low-grade endometrioid EC.</p><p><strong>Conclusion: </strong>This video may contribute to the standardization of a procedure to be used in cases of difficult UI to maximize the safety of surgery needed to stage/treat gynecologic malignancies.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234382","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":"A randomized controlled trial evaluating the use of a multimedia video to improve consent in patients undergoing total laparoscopic hysterectomy.","authors":"Avelyn Wong, Taylor Hodge, Helen C McNamara, Emma Readman, Debjyoti Karmakar, Stephanie Potenza, Lenore Ellett","doi":"10.1016/j.jmig.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.013","url":null,"abstract":"<p><strong>Study objective: </strong>To evaluate whether a supplementary multimedia video improves surgery-related knowledge in patients undergoing total laparoscopic hysterectomy for benign indications. Secondary outcomes included anxiety and satisfaction levels.</p><p><strong>Design: </strong>Randomized controlled trial SETTING: A tertiary teaching hospital in Melbourne, Australia.</p><p><strong>Patients: </strong>Patients on the surgical waitlist for a total laparoscopic hysterectomy (TLH) for a benign indication, aged 18 years or above, and English speaking.</p><p><strong>Interventions: </strong>An 11-minute multimedia educational video regarding TLH.</p><p><strong>Measurements: </strong>Patient comprehension of the surgery was measured by knowledge scores in a 14-point TLH knowledge questionnaire. This knowledge questionnaire was administered at 3 separate time points: baseline (T₁) upon study entry, post-intervention (T₂), and 4 weeks post-intervention (T₃). The primary outcome was knowledge scores at T₂ following randomization and intervention.</p><p><strong>Main results: </strong>43 patients were randomized from July 2022 to December 2023: 21 patients in the control arm and 22 patients in the video arm. There were no significant differences in baseline patient characteristics between groups. At baseline (T₁), the median score on the TLH knowledge questionnaire was equal for both groups at 5.0. Following the intervention at T₂, the video group scored significantly higher than the control group (median score of 10.0 vs. 8.0, p< 0.001). At 4 weeks (T₃), knowledge scores declined in both groups but remained significantly above baseline in the video group. Anxiety levels assessed using the 6-item Spielberger State-Trait Anxiety Inventory were not significantly different between groups.</p><p><strong>Conclusion: </strong>Our study demonstrates that the use of a supplementary multimedia video improves informed consent for patients planned to undergo a total laparoscopic hysterectomy reflected in increased knowledge of the procedure, without increasing patient anxiety levels.</p><p><strong>Clinical trial registration: </strong>The trial was prospectively registered with the Australian New Zealand Clinical trial registry ACTRN12621001496808 at ANZCTR.org.au https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382805.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208748","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":"Surgical Management of Uterine Fibroids: A Large Retrospective Study.","authors":"Shuangmei Ye, Wenwen Wang, Yan Li, Wei Shen","doi":"10.1016/j.jmig.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.011","url":null,"abstract":"<p><strong>Study objective: </strong>To analyze trends in surgical management of uterine fibroids and identify factors influencing surgical decisions among Chinese women over the past decade.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Four campuses of Tongji Hospital, a tertiary care center in Wuhan, China.</p><p><strong>Patients: </strong>Of 104,430 women screened, 13,344 diagnosed with uterine fibroids who underwent surgical treatment between 2013 and 2022 were included. Exclusion criteria were concurrent adenomyosis, uterine fibroids found unexpectedly during unrelated surgery (e.g., genital cancer), and pregnant women with uterine fibroids.</p><p><strong>Interventions: </strong>Hysterectomy, myomectomy.</p><p><strong>Measurements and main results: </strong>Data from surgical inpatients were analyzed for annual rates of hysterectomies and myomectomies. Univariate and multivariate logistic regression models were used to identify factors associated with choice of surgery. From 2013 to 2022, hysterectomy rates decreased from 42.3% to 33.1%, with the most pronounced decline observed in the 45-49 age group (a 21.1 percentage point decrease), followed by the 40-44 age group (a 15.6 percentage point decrease). Myomectomy rates increased from 57.7% to 66.9%. Factors associated with an increased likelihood of hysterectomy included clinically significant symptoms, lower pre-operative hemoglobin (Hb), multiple uterine fibroids, older age at admission, later age at menarche, and higher body mass index (BMI). Notably, among hysterectomy patients, 34.9% also had oophorectomy, compared to 1.1% in the myomectomy group.</p><p><strong>Conclusions: </strong>Surgical management of uterine fibroids in central China has shifted towards increased utilization of myomectomy over hysterectomy, particularly among women aged 40-49. This transition is critical given potential adverse outcomes associated with hysterectomy in premenopausal women.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208749","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":"Changes in sexual function after minimally invasive hysterectomy in reproductive-aged women: a systematic review and meta-analysis.","authors":"Chensi Ouyang, Alexander Wang, Morgan Briggs, Grace Maszy, Hannah Lewis, Isabel Green, Meryl Alappattu, Georgine Lamvu","doi":"10.1016/j.jmig.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.05.010","url":null,"abstract":"<p><strong>Objective: </strong>One primary concern among patients undergoing minimally invasive hysterectomy (MIH) is post-surgical sexual function. Conflicting evidence exists due to variability in the sexual function measures, the menopause status of patients, and the inclusion of data from laparotomies. The purpose of this systematic review and meta-analysis was to evaluate the effects of MIH on sexual function in premenopausal women while accounting for these confounders.</p><p><strong>Data sources: </strong>Data search was conducted in PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, Scopus, Science Direct, ProQuest, and EBSCO from inception to December 31, 2024.</p><p><strong>Methods: </strong>The initial search yielded 1,124 papers, and eight studies met eligibility criteria. Eligibility criteria included reporting on sexual function using the Female Sexual Function Index (FSFI), MIH for benign and non-urogynecological conditions, and a study population of premenopausal women. MIH routes included laparoscopic and vaginal surgeries. The primary outcome of interest was a change in the total FSFI score and domains pre- and post-surgery.</p><p><strong>Tabulation, integration, and results: </strong>Meta-analysis was performed for each outcome using Cochrane Review Manager 5. Mean differences and 95% confidence intervals (CI) were calculated using pre- and post-surgery FSFI scores. The mean difference between pre- and post-hysterectomy FSFI scores showed a small statistically significant improvement in sexual function after surgery: -1.54 (CI -2.83, -0.25). There were small statistically significant improvements in sexual function in the domains of desire (-0.75, CI -1.34, -0.17), arousal (-0.85, CI -1.46, -0.25), orgasm (-0.46, CI -0.81, -0.12), and satisfaction (-0.69, CI -1.20, -0.18). There were no statistically significant changes in the domains of lubrication and pain. The level of evidence is low, with moderate heterogeneity and risk of bias.</p><p><strong>Conclusion: </strong>After hysterectomy with ovarian preservation, pre-menopausal women report small, yet statistically significant, improvement in overall sexual function, which is not likely clinically significant.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199366","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}