Obstetrics and Gynecology Science最新文献

Association between circulating metabolites and endometriosis: a bidirectional two-sample Mendelian randomization study. 循环代谢物与子宫内膜异位症之间的关系：一项双向双样本孟德尔随机研究。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-05-06 DOI: 10.5468/ogs.25180

Lele Pan, Yuying Chen, Yuzhen Cao, Xiaohui Huang, Ying Ma

{"title":"Association between circulating metabolites and endometriosis: a bidirectional two-sample Mendelian randomization study.","authors":"Lele Pan, Yuying Chen, Yuzhen Cao, Xiaohui Huang, Ying Ma","doi":"10.5468/ogs.25180","DOIUrl":"https://doi.org/10.5468/ogs.25180","url":null,"abstract":"Objective: Endometriosis (EM) is a chronic gynecological condition of unclear etiology, with evidence suggesting a link between metabolite levels and EM risk. A two-sample Mendelian randomization (MR) approach was used to explore the association between 233 metabolites and EM.Methods: Using publicly available genetic data, we conducted a bidirectional two-sample MR analysis to assess the associations between metabolites and EM. Sensitivity analyses were performed to test robustness and pleiotropy, with Bonferroni correction applied for significance.Results: MR analysis suggested that genetically elevated diacylglycerol levels were significantly associated with increased EM risk (odds ratio [OR], 1.225; P=1.16×10-7), corresponding to a 22.5% increase in risk per standard deviation increase in genetically predicted diacylglycerol levels, and remained significant after Bonferroni correction. Nominally significant associations were observed for several other metabolites; lower ratios of 3-hydroxybutyrate and saturated fatty acids to total fatty acids and of total cholesterol to total lipids in very low-density lipoproteins were associated with a higher EM risk (OR, 0.863; P=0.015; OR, 0.865; P=0.030; OR, 0.855; P=1.51×10-4). Reverse MR analysis showed that increased levels of conjugated linoleic acid (CLA) and tyrosine and the CLA to total fatty acid ratio exhibited nominal associations with EM (OR, 1.026; P=0.043; OR, 1.036; P=3.33×10-4; OR, 1.026; P=0.045). No significant heterogeneity or pleiotropy was observed.Conclusion: This study provides evidence of an association between specific metabolites, especially diacylglycerol, and EM risk, enhancing our understanding of the metabolic profile associated with EM.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cold coagulation revisited: a strategy for high-grade cervical intraepithelial neoplasia in reproductive-age women. 重访冷凝：育龄妇女高级别宫颈上皮内瘤变的治疗策略。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-05-04 DOI: 10.5468/ogs.25375

Ki Eun Seon, Sujung Kim, Yong Jae Lee, Jung-Yun Lee, Sang Wun Kim, Sunghoon Kim, Young Tae Kim, Eun Ji Nam

{"title":"Cold coagulation revisited: a strategy for high-grade cervical intraepithelial neoplasia in reproductive-age women.","authors":"Ki Eun Seon, Sujung Kim, Yong Jae Lee, Jung-Yun Lee, Sang Wun Kim, Sunghoon Kim, Young Tae Kim, Eun Ji Nam","doi":"10.5468/ogs.25375","DOIUrl":"https://doi.org/10.5468/ogs.25375","url":null,"abstract":"Objective: Cold coagulation, although less commonly used today, offers a less invasive alternative to excisional procedures for high-grade cervical intraepithelial neoplasia (CIN). This study evaluated post-treatment cytologic and virologic negativity rates among reproductive-age women with high-grade CIN.Methods: This retrospective study analyzed the medical records of 151 reproductive-age women diagnosed with CIN 2 or 3 who were treated with cold coagulation at a single tertiary referral hospital between January 2010 and April 2022. Efficacy was assessed using follow-up liquid-based cytology and human papillomavirus (HPV) tests performed 3 months to 3 years after treatment. Statistical analyses included odds ratios and a univariate Cox proportional hazards model to evaluate treatment outcomes and failure rates.Results: At 6 months, cytologic negativity was achieved in 66.7% of patients and virologic negativity in 50.0%; these rates increased to 81.3% and 70.0%, respectively, by 3 years. Treatment failure occurred in 26.5% of patients. However, no significant differences in negative test rates were observed between CIN2 and CIN3 or between HPV16/18 and other high-risk HPV types. Persistent disease occurred in 25.8% of patients, whereas recurrence was observed in 2.6%. Minimal complications were reported, and no cases of progression to cervical cancer were identified.Conclusion: Cold coagulation demonstrated moderate post-treatment cytologic and virologic negativity rates with minimal immediate complications in this retrospective cohort. However, given the substantial rate of persistent disease and the nonstandard role of ablative treatment in settings where excision is available, these findings should be interpreted with caution.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maternal morbidity and cumulative infant mortality among women with disabilities: a nationwide population-based study in Korea, 2013-2022. 残疾妇女的孕产妇发病率和累计婴儿死亡率：2013-2022年韩国全国人口研究

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-04-29 DOI: 10.5468/ogs.25402

Kyung Ju Lee, Seokmin Lee, Inhye Kim, Jinah Park

{"title":"Maternal morbidity and cumulative infant mortality among women with disabilities: a nationwide population-based study in Korea, 2013-2022.","authors":"Kyung Ju Lee, Seokmin Lee, Inhye Kim, Jinah Park","doi":"10.5468/ogs.25402","DOIUrl":"https://doi.org/10.5468/ogs.25402","url":null,"abstract":"Objective: This nationwide population-based descriptive study examined differences in fertility trends, infant mortality, and maternal morbidity between women with and without disabilities in Korea using linked National Health Insurance Service (NHIS) data from 2013 to 2022.Methods: The study included women of reproductive age (15-49 years) with live births, identified through NHIS eligibility files, claims data, mortality records, and the maternal-neonatal linked database. Disability status was categorized as physical, internal, or mental. Annual birth trends, cumulative mortality among live-born infants at 1 and 5 years, and maternal morbidity during the antepartum, intrapartum, and postpartum periods were compared between women with and without disabilities.Results: Among 2,861,120 mothers, births among women with disabilities declined more steeply than those among women without disabilities, accompanied by a shift in peak fertility from ages 30-34 to 35-39 years. Infants born to women with disabilities experienced consistently higher cumulative mortality throughout follow-up, with disparities widening over time. Across all perinatal periods, women with disabilities had lower overall maternal morbidity than women without disabilities, with morbidity occurring more frequently during pregnancy and delivery than during the postpartum period in both groups.Conclusion: These findings highlight important differences in reproductive patterns and infant health outcomes that warrant comprehensive, disability-informed maternal care spanning the antepartum period through enhanced postpartum recovery services. Further research linking administrative data with clinical and social datasets is needed to characterize the morbidity burden more accurately and identify modifiable gaps in care.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The value of platelet rich plasma in women with intrauterine adhesions. A systematic review and meta-analysis. 富血小板血浆在宫内粘连患者中的价值。系统回顾和荟萃分析。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-04-28 DOI: 10.5468/ogs.26001

Nour A El-Goly, Ahmed M Maged, Sally El-Attar, Nada Kamal, Mohamed N Farid

{"title":"The value of platelet rich plasma in women with intrauterine adhesions. A systematic review and meta-analysis.","authors":"Nour A El-Goly, Ahmed M Maged, Sally El-Attar, Nada Kamal, Mohamed N Farid","doi":"10.5468/ogs.26001","DOIUrl":"https://doi.org/10.5468/ogs.26001","url":null,"abstract":"To evaluate the benefits of platelet-rich plasma administration after adhesiolysis in women with intrauterine adhesions. A database search using the keywords (autologous platelet-rich plasma) AND (intrauterine adhesions) and their Medical Subject Headings terms revealed 11 studies with 1,130 participants. Endometrial thickness was reported in four studies with 274 participants. The mean difference effect estimate was 0.53 with a 95% confidence interval (CI) of 0.23, 0.82; P<0.001, and I²=0%. The menstrual pattern after the procedure showed that the odds ratio (OR) effect estimates for amenorrhea, hypomenorrhea, and normal menstruation were 6.47 (0.24, 174.08), 0.84 (0.41, 1.73), and 1.21 (0.51, 2.84), respectively, and the P-values were 0.27, 0.63, and 0.66, respectively. The number of women with adhesions after the procedure showed that the OR effect estimates for grade I, II, and III adhesions were 1.74 (0.41, 7.45), 0.76 (0.21, 2.70), and 0.31 (0.11, 0.88), respectively, and the P-values were 0.46, 0.67, and 0.03, respectively. Changes in the American Fertility Society (AFS) score after the operation were reported in three studies with 276 participants. The mean difference effect estimate was 0.87, with a 95% CI of 0.17, 1.56; P=0.01; I²=0%. The clinical pregnancy rate was reported in five studies involving 506 participants. The OR effect estimate was 1.80 with a 95% CI of 1.18, 2.75; a P-value of 0.006, and I² of 0%. Platelet-rich plasma administration after hysteroscopic adhesiolysis improved endometrial thickness (low evidence), recurrence of grade III adhesions (low evidence), AFS score of adhesions (low evidence), and clinical pregnancy rates (moderate evidence).","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initiating robotic vNOTES: a Beginner's guide. 启动机器人vNOTES：初学者指南。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-04-15 DOI: 10.5468/ogs.25407

Aya Mohr-Sasson, Asha Bhalwal, Alvaro Montealegre

{"title":"Initiating robotic vNOTES: a Beginner's guide.","authors":"Aya Mohr-Sasson, Asha Bhalwal, Alvaro Montealegre","doi":"10.5468/ogs.25407","DOIUrl":"https://doi.org/10.5468/ogs.25407","url":null,"abstract":"Objective: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is associated with reduced postoperative pain and faster recovery compared with conventional laparoscopy. However, its adoption is limited by challenging triangulation, caudal-to-cephalic visualization requiring a learning curve, and restricted instrument length when managing complex pathology. Robotic assistance provides three-dimensional visualization, wristed instrumentation with enhanced dexterity, and surgeon-controlled camera movement, which may help overcome these limitations and expand the role of minimally invasive vaginal surgery. This video aims to demonstrate essential procedural steps and practical tips for surgeons beginning robotic vNOTES hysterectomy.Methods: The first part of the video demonstrates key procedural steps using a simulation model. Following anterior and posterior colpotomy and bilateral detachment of the uterosacral ligaments, an Alexis ring is inserted, as in conventional vNOTES. GelPoint (COMPANY, CITY, STATE, COUNTRY) trocars are arranged in a diamond configuration on the GelSeal cap (COMPANY, CITY, STATE, COUNTRY) and secured to the ring to establish pneumoperitoneum. The patient is placed in Trendelenburg position, the robot is docked, and the camera trocar is inserted first, followed by two additional trocars with appropriate spacing to avoid arm collision. The second part of the video demonstrates application of the technique in a 43-year-old woman who presented with heavy uterine bleeding secondary to multiple fibroids.Results: The patient successfully underwent robotic vNOTES hysterectomy, bilateral salpingectomy, and right ovarian cystectomy, demonstrating translation of simulation-based principles into clinical practice.Conclusion: Robotic vNOTES is a feasible approach that combines robotic advantages with vaginal access, enabling minimally invasive management of complex gynecologic pathology under direct visualization.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The neutrophil-to-lymphocyte ratio: a marker for microbial invasion of the amniotic cavity in preterm prelabor rupture of membranes. 中性粒细胞与淋巴细胞的比率：在早产胎膜破裂中微生物侵入羊膜腔的标志。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-04-01 DOI: 10.5468/ogs.26018

Da Eun Jeong, Min Jung Lee, Eun Ji Oh, Young Mi Jung, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh

{"title":"The neutrophil-to-lymphocyte ratio: a marker for microbial invasion of the amniotic cavity in preterm prelabor rupture of membranes.","authors":"Da Eun Jeong, Min Jung Lee, Eun Ji Oh, Young Mi Jung, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh","doi":"10.5468/ogs.26018","DOIUrl":"https://doi.org/10.5468/ogs.26018","url":null,"abstract":"Objective: This study investigated the relationship between maternal blood neutrophil-to-lymphocyte ratio (NLR), serum C-reactive protein (CRP) levels, and microbial invasion of the amniotic cavity (MIAC) in the context of preterm prelabor rupture of membranes (pPROM).Methods: This retrospective cohort study included 154 women with pPROM between 20+0 and 33+6 weeks of gestation who underwent transabdominal amniocentesis. MIAC was defined as a positive amniotic fluid culture. Maternal blood samples were collected within 24 hours after amniocentesis. CRP levels and leukocyte differential counts were quantified.Results: MIAC was diagnosed in 36.4% of the patients with pPROM. Patients with MIAC had significantly higher median NLR and CRP levels than those without MIAC (NLR, 6.8 vs. 5.0; CRP, 0.58 mg/dL vs. 0.26 mg/dL, both P<0.05). NLR and CRP exhibited comparable areas under the curve 0.67 (95% confidence interval [CI], 0.58-0.75) vs. 0.63 (95% CI, 0.54-0.72); P=0.59. Receiver operating characteristic curve analysis was performed to establish the most effective diagnostic cutoff values for NLR and CRP (6.2 for NLR and 0.7 mg/dL for CRP). The prevalence of MIAC was highest in patients with both elevated NLR and CRP levels (54.3%) and lowest in those with low values of both parameters (18.8%). Intermediate prevalence rates were observed in patients with discordant NLR and CRP values.Conclusion: NLR exhibited a significant positive association with MIAC in patients with pPROM, with a diagnostic performance similar to that of CRP. Nonetheless, the presence of MIAC in 18.8% of the patients with low levels of both parameters highlights the limitations of these measures in ruling out MIAC.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Synergistic effects of melatonin and dienogest on pain relief in endometriosis: a randomized controlled trial. 褪黑素和dienogest对缓解子宫内膜异位症疼痛的协同作用：一项随机对照试验。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-03-31 DOI: 10.5468/ogs.25053

Mahroo Rezaeinejad, Homa Homam, Parand Gheshlaghi, Leila Jafari, Shahed Shoari, Marjan Ghaemi

{"title":"Synergistic effects of melatonin and dienogest on pain relief in endometriosis: a randomized controlled trial.","authors":"Mahroo Rezaeinejad, Homa Homam, Parand Gheshlaghi, Leila Jafari, Shahed Shoari, Marjan Ghaemi","doi":"10.5468/ogs.25053","DOIUrl":"https://doi.org/10.5468/ogs.25053","url":null,"abstract":"Objective: Endometriosis affects 5-10% of reproductive-aged women and is characterized by chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Standard hormonal therapies, such as dienogest, effectively manage symptoms, but are often associated with side effects and high recurrence rates after discontinuation. This study investigated the efficacy of melatonin as an adjunct to dienogest for reducing endometriosis-associated pain.Methods: Ninety-four women with ultrasonography-confirmed ovarian endometrioma were randomized 1:1 to receive melatonin+dienogest or placebo+dienogest for 6 months. Analyses were performed on both per-protocol (PP; n=52) and intention-to-treat bases (ITT; n=94). The primary outcome was dysmenorrhea measured using the visual analog scale. The secondary outcomes included dyspareunia, pelvic pain, dyschezia, quality of life (World Health Organization quality of life-brief version [WHOQOL-BREF]), and clinical symptoms (Biberoglu&Behrman [B&B] scale).Results: Dysmenorrhea scores decreased significantly more in the melatonin arm (Δ=-1.3 points; P=0.011 PP; Δ=-1.2; P=0.014 ITT). No significant between-group differences were observed in dyspareunia, pelvic pain, or dyschezia. WHOQOL-BREF scores improved by 6.5±9.2 points in the melatonin group and 5.9±8.7 in the placebo group (P=0.71). B&B composite pain scores decreased by 4.1±2.9 (melatonin) and 3.8±3.0 (placebo) (P=0.64). No serious adverse events occurred; however, vertigo was more frequent in the melatonin group (53.8% vs. 7.7%).Conclusion: Adjunctive melatonin therapy with dienogest significantly improved dysmenorrhea compared with dienogest alone. However, the addition of melatonin did not yield significant improvements in other pain domains or quality of life indices. These results support the use of melatonin as a targeted adjunct treatment for menstrual pain during endometriosis.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intravaginal magnesium sulfate as an alternative to intravenous dexamethasone for labor acceleration: first direct comparison in a bayesian adaptive trial. 阴道内硫酸镁替代静脉地塞米松加速产程：贝叶斯适应性试验的首次直接比较。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-03-30 DOI: 10.5468/ogs.26002

Kobra Hosseini, Mahin Seifi Alan, Leila Asadpoor Asl, Niloofar Seighali, Haniyeh Rashidi, Bita Badehnosh, Hadith Rastad

{"title":"Intravaginal magnesium sulfate as an alternative to intravenous dexamethasone for labor acceleration: first direct comparison in a bayesian adaptive trial.","authors":"Kobra Hosseini, Mahin Seifi Alan, Leila Asadpoor Asl, Niloofar Seighali, Haniyeh Rashidi, Bita Badehnosh, Hadith Rastad","doi":"10.5468/ogs.26002","DOIUrl":"https://doi.org/10.5468/ogs.26002","url":null,"abstract":"Objective: Labor acceleration remains a major challenge in obstetric care. Although intravenous (IV) dexamethasone has been shown to be effective for labor acceleration, its systemic adverse effects limit its use. Intravaginal magnesium sulfate (MgSO4) may offer a potential alternative; however, comparative studies are needed. This study compared the safety and efficacy of these interventions for labor acceleration.Methods: This Bayesian adaptive, three-arm randomized controlled trial enrolled 150 women in latent labor and assigned them to receive intravaginal MgSO4 (50%; 10 mL), IV dexamethasone (8 mg), or usual care. The primary outcomes were labor duration and change in Bishop score; secondary outcomes included Apgar scores.Results: Both active treatments significantly improved Bishop scores compared with control at 6 hours (+3.06 vs. +3.05 points; P<0.001), with no significant difference between them. However, intravaginal MgSO4 reduced labor duration more effectively. It shortened the latent phase by 3.0 hours (95% credible intervals [CrI], 2.2 to 3.9) compared with dexamethasone (1.8 hours; 95% CrI, 1.2 to 2.4) and the active phase by 1.99 hours (95% CrI, 1.03 to 2.99) compared with 1.09 hours (95% CrI, 0.54 to 1.71), with a posterior probability of superiority exceeding 99.9%. All neonates had Apgar scores ≥8.Conclusion: Intravaginal MgSO4 produced cervical effacement and dilation comparable to IV dexamethasone but achieved a significantly greater reduction in labor duration. Given similar neonatal safety outcomes, these findings suggest that intravaginal MgSO4 may be a preferable first-line agent for labor acceleration.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

vNOTES hysterectomy: strategic repositioning of the vaginal route through technological evolution and emerging surgical variants. 子宫切除术：通过技术发展和新出现的手术变体对阴道路径的战略性重新定位。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-03-18 DOI: 10.5468/ogs.25285

Yun Seok Yang, Chul Kwon Lim, Jae Young Kwack, Jun-Hyeok Kang, Seong Hee Kim, Kwan Young Oh

{"title":"vNOTES hysterectomy: strategic repositioning of the vaginal route through technological evolution and emerging surgical variants.","authors":"Yun Seok Yang, Chul Kwon Lim, Jae Young Kwack, Jun-Hyeok Kang, Seong Hee Kim, Kwan Young Oh","doi":"10.5468/ogs.25285","DOIUrl":"https://doi.org/10.5468/ogs.25285","url":null,"abstract":"Vaginal hysterectomy remains the least invasive approach for benign gynecologic diseases, but has steadily declined due to limited surgical exposure during residency. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as an innovative technique that combines endoscopic advantages with those of the vaginal route. This review systematically evaluates the clinical outcomes, emerging technological advancements, and global feasibility of vNOTES hysterectomy with a particular focus on its potential to strategically reposition the vaginal route as the primary minimally invasive option in gynecologic surgery. A comprehensive literature review was performed to assess comparative studies, surgical variants, perioperative outcomes, and learning curves of vNOTES, including advanced forms of total NOTES hysterectomy (TNH), isobaric vNOTES (iNH), and robotic vNOTES (RvNH). vNOTES hysterectomy consistently demonstrates favorable perioperative outcomes, such as reduced operative time, lower blood loss, decreased postoperative pain, and shorter hospital stay, compared with laparoscopic hysterectomy. vNOTES provides particular advantages in complex cases, including large uteri, obesity, nulliparity, and pelvic adhesions. Emerging variants such as TNH, iNH, and RvNH show promising feasibility but require further validation. The relatively short learning curve of vNOTES supports its broad clinical adoption. vNOTES hysterectomy is a transformative advancement that complements existing minimally invasive techniques and offers a strategic opportunity to revive the declining vaginal route. The versatility, evolving technical adaptations, and potential for global scalability of vNOTES make it a key modality in gynecologic surgery. Successful dissemination relies on structured training, standardized guidelines, device development, and long-term safety data.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Three-year post-recurrence survival outcome by leukopenia grade 2+ during systemic chemotherapy in recurrent cervical cancer. 复发性宫颈癌全身化疗期间白细胞减少2+级的3年生存率。

IF 1.9

Obstetrics and Gynecology Science Pub Date : 2026-03-17 DOI: 10.5468/ogs.26032

Pornpawee Wangsatidtongbai, Rakchai Buhachat, Ekasak Thiangphak

{"title":"Three-year post-recurrence survival outcome by leukopenia grade 2+ during systemic chemotherapy in recurrent cervical cancer.","authors":"Pornpawee Wangsatidtongbai, Rakchai Buhachat, Ekasak Thiangphak","doi":"10.5468/ogs.26032","DOIUrl":"https://doi.org/10.5468/ogs.26032","url":null,"abstract":"Objective: This study aimed to evaluate the association between grade ≥2 chemotherapy-induced leukopenia (CIL) and 3-year post-recurrence survival (PRS) in patients with recurrent cervical cancer (CC) undergoing systemic chemotherapy.Methods: We conducted a retrospective comparative cohort study of patients with recurrent CC who received ≥3 cycles of systemic chemotherapy at a tertiary referral center between January 2000 and June 2022. Complete serial blood counts were performed for each cycle. Patients were classified according to the development of grade ≥2 leukopenia (white blood cell count <3,000 cells/μL) within the first 3 cycles. Three-year PRS was analyzed using Kaplan-Meier estimates and Cox proportional hazards models.Results: Among 164 patients (mean age 52.4±11.0 years), leukopenia G2+ occurred in 29 patients (17.7%). Median 3-year PRS was significantly longer in the leukopenia G2+ group than in the non-leukopenia G2+ group (28.9 vs. 17.5 months). The 3-year PRS rates were 38.8% and 16.9%, respectively (P=0.022). On univariate analysis, longer intervals from complete clinical remission to recurrence, platinum regimens, and grade ≥2 leukopenia were associated with improved survival. Multivariate analysis confirmed that leukopenia conferred a 47% reduction in mortality risk (hazard ratio, 0.53; 95% confidence interval, 0.31-0.91; P= 0.021).Conclusion: CIL during early treatment cycles was independently associated with superior survival in patients with recurrent CC. In the absence of infectious complications, leukopenia may reflect adequate pharmacodynamic drug exposure and host treatment response. It should be interpreted as a post-hoc prognostic indicator, supporting its potential role as a pragmatic surrogate marker of chemotherapy efficacy.","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0