Journal of Obstetrics and Gynaecology Research最新文献

{"title":"Evaluation of dysmenorrhea changes in patients undergoing cervical dilatation: Does it work?","authors":"Ilkhan Keskin,&nbsp;Osman Samet Günkaya,&nbsp;Arzu Bilge Tekin,&nbsp;Murat Yassa,&nbsp;Niyazi Tuğ","doi":"10.1111/jog.16170","DOIUrl":"10.1111/jog.16170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To demonstrate that cervical dilation will relieve symptoms in women with primary dysmenorrhea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this retrospective cohort study, 30 patients were included in the study group and 30 patients were included in the control group. Age, sex, occupation, education level, duration of dysmenorrhea, and presence of dyspareunia were recorded for all patients. Dilation and hysteroscopy were performed on indicated patients in the study group. In both groups, pain and dysmenorrhea levels were assessed preoperatively and at 1 and 2 months postoperatively using the “Visual Analog Score,” “Facial Pain Scale,” “Quality of Life Questionnaire,” and “Quality of Life Questionnaire Health Status Scale.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no statistically significant differences in the results of VAS, Facial Pain Scale, Quality of Life Questionnaire, Quality of Life Questionnaire Health Status Scale before the procedure between the two groups (MWU(Z) = −0.354, <i>p</i>: 0.753), (MWU(Z) = −1.680, <i>p</i>: 0.093), (MWU(Z) = −0.787, <i>p</i>: 0.431), (MWU(Z) = −1.557, <i>p</i>: 0.119, respectively). Although there were no statistically significant differences in the control group survey scores in the second survey, the scores in all surveys in the study group were statistically significant (<i>p</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that the complaints of the patients decrease in the short and medium term after cervical dilatation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739821","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":"Remnant ureter abscess linked to obstructed hemivagina and ipsilateral renal anomaly syndrome","authors":"Meika Kaneko,&nbsp;Hiroshi Ishikawa,&nbsp;Takaoki Kaneko,&nbsp;Asuka Sato,&nbsp;Makio Shozu,&nbsp;Kaori Koga","doi":"10.1111/jog.16171","DOIUrl":"10.1111/jog.16171","url":null,"abstract":"<p>Patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome sometimes present with distinct symptoms related to coexisting urogenital abnormalities. We present a case of refractory abscess formation in a blind-ended remnant ureter associated with ipsilateral renal agenesis. A 15-year-old patient with OHVIRA syndrome, who had a blind-ended remnant ureter, underwent obstructed hemivagina opening 18 months after menarche due to heavy genital bleeding and abdominal pain after the end of menstruation. Four years later, the patient presented with recurring fever and abdominal pain due to a refractory abscess in the ureter. Although the continuity between the ureter and the previously opened hemivagina was not identified, the same bacteria were detected in the abscess and vaginal discharge, indicating that an ascending bacterial infection of the vagina may cause refractory abscess formation in a blind-ended remnant ureter. Open ureterectomy with partial bladder resection was needed to resolve the symptoms.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739822","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":"Evaluation of expression of amino acid and fatty acid metabolic transporters in the placenta of pregnant women with glucose intolerance","authors":"Toshihide Sakuragi,&nbsp;Eiji Shibata,&nbsp;Megumi Yamamoto,&nbsp;Shohei Shimajiri,&nbsp;Emi Kondo,&nbsp;Hiroshi Mori,&nbsp;Ryosuke Tajiri,&nbsp;Toshiyuki Nakayama,&nbsp;Kiyoshi Yoshino,&nbsp;Mayumi Tsuji","doi":"10.1111/jog.16163","DOIUrl":"10.1111/jog.16163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Pregnant women with glucose intolerance often have large infants, even with strict glycemic control. We examined the expression of amino and fatty acid metabolic transporters in the placentas of such mothers to clarify the role of factors other than glucose transport resulting in giant infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Deliveries at our hospital between 2017 and 2022 were assessed. Immunohistochemical staining of membrane transporters related to glucose, amino acid, and fatty acid transport was performed using postpartum placental tissue. Stained areas were classified and scored, and compared using the Mann–Whitney <i>U</i> test. Multiple logistic regression analysis was performed for large for gestational age infant as the outcome and maternal age, prepartum body mass index, primipara/multipara, gestational week, and glucose intolerance as confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1725 subjects, 101 met the inclusion criteria and were analyzed (glucose-intolerant [GI] group, <i>n</i> = 61; non-GI group, <i>n</i> = 40). Per unit villus, there was decreased expression of amino acid-related transporters. However, per unit placenta, the immunohistochemical staining scores for glucose, amino acid, and fatty acid transport were significantly higher in the GI than in the non-GI group. Multiple logistic regression analysis showed that L-type amino acid transporter 1 (LAT1, odds ratio [95% confidence interval]: 12.35 [2.93–52.05], <i>p</i> &lt; 0.001) and placenta-plasma membrane fatty acid-binding protein (placenta-FABPpm, 6.27 [1.64–23.88], <i>p</i> = 0.007) were significantly higher in the GI than in the non-GI group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Activation of LAT1 and placenta-FABPpm expressions observed in the placentas of glucose-intolerant women despite glycemic control indicate that nutrients other than blood glucose should also be effectively managed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716418","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":"Annual report of the committee on gynecologic oncology, the Japan Society of Obstetrics and Gynecology: Annual patient report for 2021 and annual treatment report for 2016","authors":"Hiroaki Kajiyama,&nbsp;Satoshi Tamauchi,&nbsp;Fumiaki Takahashi,&nbsp;Kei Kawana,&nbsp;Board members of the 2023 Committee on Gynecologic Oncology of the Japan Society of Obstetrics and Gynecology","doi":"10.1111/jog.16168","DOIUrl":"10.1111/jog.16168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2021 and the Annual Treatment Report for 2016, on the outcomes of patients who started treatment in 2016.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2021 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2016 was analyzed by using the Kaplan–Meier, log-rank, and Wilcoxson tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treatment was initiated in 2021 for 8006 patients with cervical cancer, 13 912 with endometrial cancer, 8337 with ovarian, tubal, and peritoneal cancer, 2375 with ovarian borderline tumors, and with the others (226 vulvar cancer, 161 vaginal cancer, 437 uterine sarcoma, 47 uterine adenosarcoma, 160 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients with cervical cancer were 92.3%, 77.0%, 56.1%, and 30.3% for stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with endometrial cancer were 94.1%, 88.8%, 71.2%, and 24.5% for stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with ovarian cancer (surface epithelial-stromal tumors) were 91.3%, 78.8%, 54.3%, and 36.8% for stages I, II, III, and IV, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716413","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":"Letter to “Outstanding performance of ChatGPT on the obstetrics and gynecology board certification examination in Japan: Document and image-based questions analysis”","authors":"Shigeki Matsubara","doi":"10.1111/jog.16164","DOIUrl":"10.1111/jog.16164","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687184","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":"Japan Society of Obstetrics and Gynecology revised diagnostic criteria for polycystic ovary syndrome: JSOG2024 criteria","authors":"Hiroki Noguchi,&nbsp;Akira Iwase,&nbsp;Takeshi Iwasa,&nbsp;Haruhiko Kanasaki,&nbsp;Fuminori Kimura,&nbsp;Koji Kugu,&nbsp;Kazuki Saito,&nbsp;Tsuyoshi Baba,&nbsp;Tetsuaki Hara,&nbsp;Saki Minato,&nbsp;Rie Yanagihara,&nbsp;Toshiya Matsuzaki,&nbsp;from the subcommittee “Validation of diagnostic criteria for polycystic ovary syndrome in Japan” in Reproductive Endocrine Committee, Japan Society of Obstetrics and Gynecology","doi":"10.1111/jog.16152","DOIUrl":"10.1111/jog.16152","url":null,"abstract":"<p>Japanese patients with polycystic ovary syndrome (PCOS) exhibit distinct body type characteristics, such that the rate of overweight/obese women is remarkably low. In addition, hyperandrogenism is relatively rare among Japanese PCOS patients. Therefore, these factors are considered in PCOS diagnostic criteria used in Japan. Diagnostic criteria for PCOS were recently revised by the Japan Society of Obstetrics and Gynecology based on a nationwide survey of PCOS and released on December 5, 2023 (JSOG2024). JSOG2024 criteria diagnosed PCOS according to the following three items: (1) irregular menstrual cycle/chronic anovulation, (2) polycystic ovarian morphology or elevated serum anti-Müllerian hormone (AMH) level, and (3) hyperandrogenism or high luteinizing hormone. The presence of all three items is required to diagnose PCOS, after excluding other diseases with symptoms similar to PCOS. We also established AMH cut-off values by age and a system for evaluating ovarian findings useful for both the JSOG2024 and Rotterdam criteria. We anticipate that the JSOG2024 criteria with cut-off values will enhance the treatment of Japanese patients with PCOS and those of other ethnicities with low obesity and hirsutism.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682054","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":"Causes and clinical characteristics of women with primary amenorrhea and ovarian or gonadal disorders at a quaternary hospital","authors":"Krantarat Peeyananjarassri,&nbsp;Satit Klangsin,&nbsp;Apisada Chumkam,&nbsp;Saranya Wattanakumtornkul,&nbsp;Kriengsak Dhanaworavibul,&nbsp;Chainarong Choksuchat,&nbsp;Chatpavit Getpook,&nbsp;Phawat Matemanosak,&nbsp;Chariyawan Charalsawadi,&nbsp;Worathai Maisrikhaww","doi":"10.1111/jog.16165","DOIUrl":"10.1111/jog.16165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the causes and clinical characteristics of primary amenorrhea and ovarian or gonadal disorders in women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The medical records of all women evaluated for primary amenorrhea between January 2002 and December 2023 were retrospectively reviewed. Women with missing data were excluded from the study. Disorders of the ovary or gonads (hypergonadotropic hypogonadism) were defined as increased serum follicle-stimulating hormone (FSH) levels (&gt;40 mIU/mL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a 21-year period, after excluding 1 woman with incomplete data, the study included 87 women who met the inclusion criteria. The median age at presentation was 18 years (interquartile range [IQR], 17–20). The median estradiol level was 5 pg/mL (IQR 5–10.4), and the median FSH level was 80 mIU/mL (IQR 63.1–94.9). The most common cause of primary amenorrhea was Turner syndrome (TS), followed by 46,XX and 46,XY gonadal dysgenesis. The median height was 147 cm (IQR, 140–158.7), and 50 women (57.5%) had karyotypic abnormalities, with TS being the most common abnormality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TS was identified as the most common cause of primary amenorrhea with ovarian or gonadal disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682085","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":"Exploring potential pathways from oxidative stress to ovarian aging","authors":"Hiroshi Kobayashi,&nbsp;Shogo Imanaka","doi":"10.1111/jog.16166","DOIUrl":"10.1111/jog.16166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In developed nations, women have increasingly deferred childbearing, leading to a rise in demand for infertility treatments and the widespread use of assisted reproductive technologies. However, despite advancements in in vitro fertilization (IVF), live birth rates among women over 40 remain suboptimal. Mitochondrial dysfunction is widely recognized as a key factor in the processes driving the age-related deterioration in both the quantity and quality of oocytes. We aim to summarize current insights into ovarian aging, with a particular focus on pathways that impair mitochondrial function, and explore directions for future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic databases were searched for articles published up to June 30, 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ongoing ovulation, luteolysis, and menstruation trigger exogenous reactive oxygen species (ROS)-mediated oxidative stress that damages mitochondrial DNA. This, in turn, reduces nuclear gene expression, compromises mitochondrial oxidative phosphorylation, and diminishes adenosine 5′ triphosphate production. Persistent endogenous ROS further exacerbate mitochondrial DNA damage and aneuploidy, ultimately causing irreversible chromosomal abnormalities, leading to oocyte aging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We have delineated the pathway from oxidative stress to ovarian aging. Early detection and management of ovarian aging present challenges and opportunities to enhance IVF treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687260","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":"Primary splenic ectopic pregnancy: A case report and literature review of a rare issue","authors":"Verrazzo Paolo,&nbsp;Pirozzi Raffaele Emmanuele Maria,&nbsp;Del Sorbo Vivian,&nbsp;Mauriello Claudio,&nbsp;Stradella Cristina,&nbsp;Pirozzi Felice,&nbsp;Stradella Luigi","doi":"10.1111/jog.16154","DOIUrl":"10.1111/jog.16154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Primary splenic pregnancy is a rare form of extratubal ectopic pregnancy, frequently associated with life-threatening abdominal bleeding, with only 51 cases reported in the worldwide literature. The aim of this work, through the proposal of its own index case, is to identify the fundamental steps of the diagnostic process, crucial to reduce the mortality rate, while evaluating the available therapeutic options, through a review of the literature, particularly the more conservative ones, to avoid splenectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present the case of a 22-year-old woman, showing her diagnostic-therapeutic pathway. We searched Pubmed and other sources for all publications in English and all available non-English literature, including historical publications, on this rare topic, to identify the best treatment for these patients. We classified each article by clinical onset, diagnostic and therapeutic strategy, and histological findings, if available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We reviewed all the 43 cases available in the English-language literature (plus another paper in German), finding that 72.7% of patients presented in an emergency setting. Seventy-five percent of patients required splenectomy, 6.8% received pharmacological-only therapy, 11.3% received arterial embolization before definitive treatment. The other ones received non-radical surgical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Primary splenic pregnancy presents challenging diagnostic and therapeutic features. Treatment options (pharmacological, interventional, and/or surgical) should be tailored based on the clinical presentation and hemodynamic status of the patient. Our work would like to stimulate the validation of evidence-based therapeutic strategies validated by clinical experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676090","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":"Optimizing analgesia for endometrial biopsy: A prospective, randomized comparative study","authors":"Enes Serhat Coskun,&nbsp;Ali Selcuk Yeniocak,&nbsp;Havva Betul Bacak,&nbsp;Suleyman Salman","doi":"10.1111/jog.16148","DOIUrl":"10.1111/jog.16148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This prospective, randomized, observational study aimed to compare the efficacy of intrauterine lidocaine, oral dexketoprofen, cervical lidocaine spray, and paracervical block with prilocaine for pain management during outpatient endometrial biopsy (EMB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred ninety-seven women aged 18–75 undergoing EMB were randomly assigned to one of four groups: intrauterine lidocaine (<i>n</i> = 49), oral dexketoprofen (<i>n</i> = 48), cervical lidocaine spray (<i>n</i> = 50), or paracervical block with prilocaine (<i>n</i> = 50). Pain intensity was assessed using a visual analog scale (VAS) immediately post-procedure and at 30 min, with additional analgesia needs recorded at 60 min. Statistical analyses included Kruskal–Wallis, chi-square tests, and post hoc analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intrauterine lidocaine group had the lowest pain scores, while oral dexketoprofen had the highest (<i>p</i> &lt; 0.001). Intrauterine lidocaine and paracervical block scores were significantly lower than those in the lidocaine spray and dexketoprofen groups (<i>p</i> &lt; 0.001). Additional analgesia was needed in 30% of the lidocaine spray group, with none required in other groups. Severe pain (VAS ≥5.8) was more frequent in the dexketoprofen group compared to others (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Intrauterine lidocaine and paracervical block are more effective than lidocaine spray and oral dexketoprofen in reducing procedural pain during EMB, highlighting the importance of appropriate analgesic selection to enhance patient comfort in office-based gynecological procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647438","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}