Journal of minimally invasive gynecology最新文献

{"title":"Twenty-two Years of Minimally Invasive Gynecologic Surgery Fellowship Graduates in the United States and Canada: Geographic Distribution, Accessibility, and Practice Patterns.","authors":"Leigh A Humphries, Christopher X Hong, Annie Apple, Peter R Movilla, Kelly N Wright, Arnold P Advincula, Stephanie N Morris, Jeffrey J Woo","doi":"10.1016/j.jmig.2025.08.018","DOIUrl":"10.1016/j.jmig.2025.08.018","url":null,"abstract":"<p><strong>Study objective: </strong>To describe the geographic distribution, practice characteristics, and academic appointments of graduates of the fellowship in Minimally Invasive Gynecologic Surgery (FMIGS), and to map their practice locations relative to the general population and broader obstetrics and gynecology (OB/GYN) workforce.</p><p><strong>Design: </strong>Retrospective cross-sectional cohort study.</p><p><strong>Setting: </strong>FMIGS programs in the U.S. and Canada.</p><p><strong>Patients: </strong>Graduates from FMIGS-accredited fellowships (2002-2024) were identified from AAGL administration and graduation records. Practice locations and settings (academic, private, or military) were manually abstracted from clinic/university websites in September to October 2024. FMIGS subspecialist counts were tabulated by hospital referral regions (HRRs)-geographic areas with population ≥120,000 containing a major tertiary center. Number and locations of all OB/GYNs were identified through the National Plan and Provider Enumeration System using specialty taxonomy and zip codes. ArcGIS software was used to generate an interactive map of FMIGS locations.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>657 FMIGS subspecialists graduated from 78 programs from 2002-2024. FMIGS subspecialists exhibited very low clinical attrition rates, with 99.7% actively practicing as of 2024. Recent graduates had higher female representation and higher likelihood of working in academic medicine. Geographic analysis revealed clustering of FMIGS subspecialists in major metropolitan regions (New York, Los Angeles, Washington DC), yet many U.S. regions lacked access to any fellowship-trained MIGS subspecialists. While the number of OB/GYNs per HRR was highly correlated with population size (R = 0.96), the number of FMIGS subspecialists per HRR showed a weaker correlation (R = 0.77), with more variability in their distribution across populous regions. The ArcGIS geospatial map illustrated these regional differences.</p><p><strong>Conclusion: </strong>Most FMIGS subspecialists practice in urban areas and increasingly at academic centers with fellowship programs. However, many regions remain underserved by FMIGS-trained subspecialists. The FMIGS map is a valuable resource for assessing regional variation in MIGS fellowship training and facilitating strategic planning and research within the subspecialty.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957582","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":"Different Perspectives of a Case of OHVIRA Syndrome.","authors":"Maria Sakellariou, Alessia Limena, Claire Figuier, Michel Canis","doi":"10.1016/j.jmig.2025.08.017","DOIUrl":"10.1016/j.jmig.2025.08.017","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957654","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":"Endometriosis Involving the Spleen: A Rare Presentation of Extra-pelvic Disease.","authors":"Erin Ferrigni, Zhi Ven Fong, Longwen Chen, Megan Wasson","doi":"10.1016/j.jmig.2025.08.016","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.08.016","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957611","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":"Abdominal Adhesions as an Ectopic Pregnancy Site.","authors":"Shilpa Rajagopal, Karren Lewis","doi":"10.1016/j.jmig.2025.08.015","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.08.015","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957571","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":"Classification Matters: Optimizing Treatment for Cesarean Scar Ectopic Pregnancies.","authors":"Megan S Orlando, Gary N Frishman","doi":"10.1016/j.jmig.2025.08.019","DOIUrl":"10.1016/j.jmig.2025.08.019","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957620","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":"Laparoscopic Management of Cervical Agenesis: A Rare Case Report.","authors":"Victoria L Crofts, Dehlia Moussaoui, Michal Yaron, Jean Dubuisson","doi":"10.1016/j.jmig.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.08.008","url":null,"abstract":"<p><strong>Objectives: </strong>To present the successful laparoscopic management of a rare case of congenital obstructive Mullerian anomaly, identified as partial vaginal aplasia and cervical agenesis.</p><p><strong>Methods: </strong>Surgical technique description.</p><p><strong>Participant: </strong>A 13-year-old girl was referred for management of cyclic pelvic pain. Despite not having reached menarche, she exhibited secondary sexual characteristics. Magnetic resonance imaging revealed the presence of a uterus with a 6.4×5.2cm hematometra. However, imaging could not conclusively confirm the presence of a proximal vagina and a cervix. Both ovaries and kidneys were observed to be in their normal positions. Due to the failure of hormonal and analgesic therapy to alleviate her pain, the patient underwent a mini-invasive surgical procedure.</p><p><strong>Intervention: </strong>Under general anesthesia, the external genitalia appeared normal. A 2cm vaginal cul-de-sac was identified with the absence of the upper two-thirds of the vagina. Laparoscopy revealed endometriotic peritoneal lesions with widespread deposits of hemosiderin throughout the abdominal cavity. An enlarged uterus with a dilated isthmic portion(hematometra) was confirmed. In this video presentation, we describe the surgical steps involved in performing a direct laparoscopic utero-vaginal anastomosis to restore continuity of the genital tract.</p><p><strong>Results: </strong>The patient experienced immediate relief post-operatively. Two months later, an elective vaginoscopy revealed a 3cm long vagina with a permeable opening at the level of the anastomosis. Hysteroscopy indicated an endocervical canal, still dilated, with the presence of mucus. Passage through the endocervix allowed visualisation of a uterus presenting a partial septum. Repeated hysteroscopy at 5 months showed no stenosis and patient reported regular and painless menstrual cycles after 2-year follow-up. Long-term follow-up is crucial to monitor for vaginal stenosis, prevent recurrence of pain and secondary amenorrhea. Fertility prognosis remains uncertain, as the functionality of the cervical anastomosis to sustain pregnancy is unknown. Nonetheless, pregnancy remains possible given the resolution of obstruction. Careful obstetrical monitoring will be required and caesarean delivery recommended.</p><p><strong>Conclusions: </strong>Cervical agenesis can be effectively managed conservatively, with long-term success achievable using a direct laparoscopic utero-vaginal anastomosis. This case highlights the importance of a multidisciplinary approach involving pediatricians, gynecologists, and radiologists in the management of complex and rare Müllerian anomalies.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957632","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":"Female Dyspareunia and the Relationship to Neurophysiologic Mechanisms: A Scoping Review.","authors":"Elizabeth Cook, Amanda Yunker, Rachel Lane Walden, Ella Barrett-Chan, Hargun Dhillon, Avonae Gentles, Mahfuza Sreya, William Zhu, Sawsan As-Sanie, Paul J Yong","doi":"10.1016/j.jmig.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.07.018","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aims to evaluate recent studies that examine the relationship between dyspareunia and neurophysiologic factors, and to synthesize their results as it pertains to the development and treatment of introital/vulvar dyspareunia and deep dyspareunia DATA SOURCES: A comprehensive search was conducted in PubMed (NLM), Embase (Elsevier), CINAHL (EBSCOhost), Web of Science (Clarivate), Psycinfo (ProQuest), and Cochrane Library (Wiley) to find peer reviewed studies written in English published in 2000 or later that discussed how neurophysiology is related to dyspareunia. Search terms: dyspareunia; painful intercourse; genito-pelvic pain; penetration disorder; neuropsychology; central nervous system sensitization; neur; central sensitization.</p><p><strong>Methods of study selection: </strong>1101 studies were screened and 108 were included in the review. Abstract and full text screening were performed by 4 authors. Articles were also excluded if they did not include an objective diagnostic tool or objective treatment outcome of dyspareunia. We included original peer reviewed published research in the form of randomized control trials, cohort studies, case control studies, case series of greater than 20 participants, and systematic reviews.</p><p><strong>Integration and results: </strong>Multiple study types were noted: 22 randomized control trials, 9 prospective cohort studies, 3 retrospective cohort studies, 30 case control, 16 case series, 17 cross sectional, and 11 systematic reviews. Of these articles, 72 focused on introital/superficial dyspareunia, 23 focused on deep dyspareunia, and 13 on both. Data was synthesized in text and table format, separating by type of dyspareunia (introital vs deep) and either etiology/diagnosis or treatment.</p><p><strong>Conclusion: </strong>There are complex neurophysiologic mechanisms that influence both introital and deep dyspareunia, highlighting the roles of peripheral and central sensitization, nerve fiber density, and neuroplasticity in this condition. There are several promising treatments, including TENS, botulinum toxin A, physical therapy, and various multimodal approaches; but further research is needed to establish standardized therapeutic guidelines.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957657","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":"International Societies","authors":"","doi":"10.1016/S1553-4650(25)00268-7","DOIUrl":"10.1016/S1553-4650(25)00268-7","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 9","pages":"Page A2"},"PeriodicalIF":3.3,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858110","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":"Post-cesarean versus primary bladder endometriosis and coexistent pelvic endometriosis: a systematic review.","authors":"Noemi Salmeri, Camilla Buffo, Alessia Ragusi, Edgardo Somigliana, Paola Viganò, Paolo Vercellini","doi":"10.1016/j.jmig.2025.08.012","DOIUrl":"10.1016/j.jmig.2025.08.012","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence of coexisting pelvic lesions in post-cesarean bladder endometriosis (BE) and primary BE. If women with post-cesarean BE exhibit a lower prevalence of coexistent endometriosis, it could be hypothesized that peritoneal damage of the vesicouterine fold, coupled with surgical dissemination of decidual fragments may be sufficient per se for lesion development.</p><p><strong>Data sources: </strong>Systematic search conducted in PubMed, Embase, and Scopus up to March 20th, 2025.</p><p><strong>Methods of study selection: </strong>Eligibility was defined using the PICOS framework: women with post-cesarean BE (Population); full pelvic assessment with surgical or imaging-based confirmation of endometriosis (Intervention); women with primary BE and no prior cesarean section (CS) (Comparator); presence of endometriosis beyond the bladder (Outcome); and case reports or series providing sufficient clinical/surgical details (Study type). Studies were evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. The review followed PRISMA 2020 guidelines. No formal analysis was performed due to the descriptive nature of the data, but crude proportions were compared using Fisher's exact test.</p><p><strong>Tabulation, integration, and results: </strong>Of 7,378 records identified, 4,499 were screened and 374 full texts assessed. Eighty-one studies were included, accounting for 117 women with BE (26 post-cesarean, 91 primary). Coexistent pelvic endometriosis was significantly less frequent in post-cesarean BE (19.2%) than primary BE (79.1%) (p<0.0001). The odds of concomitant pelvic endometriosis were approximately 16 times lower in post-cesarean BE compared to primary BE (OR 0.06; 95% Confidence Interval, 0.02-0.20). In the limited number of post-cesarean cases with coexistent pelvic endometriosis, lesions were restricted to few 2021 #Enzian compartments.</p><p><strong>Conclusion: </strong>Peritoneal injury followed by iatrogenic dissemination of endometrial fragments during CS may be sufficient per se to cause BE, regardless of individual predisposition. Therefore, adopting surgical techniques that potentially reduce the risk of this long-term post-cesarean complication should be recommended.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873641","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":"Board Of Directors-Ed Calendar","authors":"","doi":"10.1016/S1553-4650(25)00267-5","DOIUrl":"10.1016/S1553-4650(25)00267-5","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 9","pages":"Page A1"},"PeriodicalIF":3.3,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858109","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}