Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Acute and chronic pain of the scar following caesarean section, visceral pain, and the possible benefits of physiotherapy.","authors":"Marika Bajerová, Lukáš Hruban","doi":"10.48095/cccg2026232","DOIUrl":"10.48095/cccg2026232","url":null,"abstract":"<p><p>Caesarean section (CS) is one of the most common obstetric surgeries, and the number of CS births has been increasing worldwide. Acute wound pain following a caesarean section can affect the postnatal recovery process, has an impact on the mother's mobility, on the mother-child bonding process, on the quality of breastfeeding, and increases the risk of developing postnatal depression. Chronic pain following CS is related to pain in the scar area (neuropathic pain) and to postoperative intra-abdominal adhesions (visceral pain). Chronic scar and abdominal pain following a caesarean delivery adversely affects a woman's routine daily activities, her psychological state, and motor functions. According to available studies, persistent chronic post-operative pain in the scar area is reported by 10% of women 12 months after caesarean section delivery. Intra-abdominal adhesions are the most common long-term complication associated with caesarean sections and their occurrence is reported in the literature as 24-46% after the first caesarean section and up to 59% after repeated caesarean sections. Currently, there are no unified standards for physiotherapeutic treatment of scars and management of adhesions following a caesarean section delivery. Although scar therapy is generally considered to be effective (aesthetic effect on scar remodeling, reduction in pain intensity, increased elasticity and flexibility of the scar), there is little scientific data in the literature to support this claim. Only a few studies have been published that demonstrate the benefit of physiotherapy in affecting the occurrence of symptoms related to the development of early postoperative adhesions, and studies that deal with approaches leading to the prevention of postoperative adhesions. With regard to the increasing trend of CS births worldwide and in the Czech Republic, and the related rising incidence of acute and chronic post-birth complications caused by CS scarring, it is necessary to create a standardized physiotherapy program focused on the recovery of mothers after a CS birth, including scar care procedures according to evidence-based medicine.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"232-238"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413228","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}

{"title":"Frequency of urogynecological complications after pelvic radiotherapy.","authors":"Pavel Kabele, Petr Hubka, Markéta Polková, Michal Zikán, Karolína Votavová, Tomáš Brtnický","doi":"10.48095/cccg2026239","DOIUrl":"10.48095/cccg2026239","url":null,"abstract":"<p><p>Pelvic radiotherapy is an integral part of treatment of many gynecological and other pelvic malignancies; however, it is associated with a risk of late urogynecological complications that can significantly affect the patients' quality of life. The most common problems include lower urinary tract symptoms, particularly urgency, urinary incontinence, and radiation cystitis, as well as vaginal stenosis, dryness, dyspareunia, lymphedema, and chronic pelvic pain. The incidence of these complications depends on the total radiation dose, radiotherapy technique used, combination with surgical treatment or brachytherapy, and individual patient-related risk factors. The underlying pathophysiology involves post-radiation inflammatory and fibrotic changes, vascular damage, and impaired innervation of irradiated tissues. Diagnosis requires long-term follow-up, targeted medical history taking, physical examination, and the use of functional and imaging methods. Prevention and management are based on modern radiotherapy techniques, patient education, conservative and pharmacological approaches, physiotherapy, and in selected cases, surgical treatment. An essential component of care is also addressing psychosocial consequences, which significantly affect sexuality, partner relationships, and psychological well-being.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"239-244"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413295","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}

{"title":"Epidemiological profile of pregnant women and perinatal outcomes of newborns with gastroschisis from a single reference center in Northeastern Brazil.","authors":"Cinthia Maria Gomes da Costa Escoto Esteche, Edward Araujo Júnior, Beatriz da Costa Escoto Esteche, Liliam Cristine Rolo","doi":"10.48095/cccg202626","DOIUrl":"10.48095/cccg202626","url":null,"abstract":"<p><strong>Objective: </strong>To determine the maternal epidemiological profile and perinatal outcomes of fetuses with gastroschisis at a reference center in Northeastern Brazil.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted between January 2014 and December 2022 using medical records. Inclusion criteria comprised of pregnancies ≥ 24 weeks, with a prenatal diagnosis of gastroschisis confirmed in the postnatal period.</p><p><strong>Results: </strong>During the study period, 1,773 newborns with congenital anomalies were born at the service center, 50 were identified as having gastroschisis and four cases were excluded. Prevalence of gastroschisis was 11.5/10,000. Regarding the maternal sociodemographic profile, the mean age was 21 years, 38/46 (83%) were mixed, 34/46 (74%) had a partner, and 32/46 (70%) had high school education. Regarding associated maternal diseases, only 6/46 (13%) had hypertension, none had pre-existing diabetes mellitus, and 4/46 (8.7%) developed gestational diabetes mellitus. As for gastroschisis type, 33/46 (71%) were classified as simple, 11/46 (23.9%) as complex and 2/46 (4.4%) had no information. In 36/46 newborns with gastroschisis, primary closure was performed in the first surgery. The mean time of use of mechanical ventilation was 13 days, the mean time interval between surgery and ambient air was 8 days, the mean time of use of parenteral nutrition was 35 days, and the mean length of stay in the neonatal intensive care unit (NICU) was 39 days. Clinical complications in newborns with gastroschisis included neonatal infection in 35/46 (76%), blood transfusion in 33/46 (72%), hydroelectrolytic disorders and sepsis in 29/46 (63%), and cholestasis and fungal infection/sepsis in 8/46 (17%). Neonatal death occurred in 16/46 (34.8%).</p><p><strong>Conclusion: </strong>Newborns with gastroschisis presented high rates of surgery with primary closure, blood transfusion and neonatal infection. Furthermore, we identified prolonged use of parenteral nutrition, long stay in the NICU, and prolonged use of antibiotic therapy.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 1","pages":"26-34"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500212","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}

{"title":"Limits of preeclampsia screening and prevention in a population of women after assisted reproductive technologies.","authors":"Michal Michna, Katarína Balasičová, Silvia Toporcerová","doi":"10.48095/cccg2026142","DOIUrl":"10.48095/cccg2026142","url":null,"abstract":"<p><p>Pregnancies resulting from assisted reproductive technologies are associated with an increased risk of developing preeclampsia. Available data indicate that one of the risk factors is frozen embryo transfer in an artificial cycle. Assessment of the pulsatility index of the uterine artery along with maternal factors and serum biomarkers form the basis for preeclampsia screening in the 1st trimester. Current evidence suggests that the method of endometrial preparation for embryo transfer may influence uterine artery pulsatility index values, thereby affecting the estimation of preeclampsia risk.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 2","pages":"142-147"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876056","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}

{"title":"Ectopic adrenal cortical rest in the fallopian tube - a rare incidental finding.","authors":"Alaattin Karabulut, Didem Sezen, Abdurrahman Hamdi İnan","doi":"10.48095/cccg2026326","DOIUrl":"https://doi.org/10.48095/cccg2026326","url":null,"abstract":"<p><p>Ectopic adrenal tissue (EAT) is a rare developmental anomaly most frequently observed along the genitourinary tract, usually in pediatric males. Its persistence into adulthood, particularly within the fallopian tube, is exceedingly uncommon. We present the case of a 43-year--old woman who underwent total laparoscopic hysterectomy and bilateral salpingectomy for symptomatic uterine leiomyomas. Histopathologic examination incidentally revealed a well-circumscribed nodule in the right fallopian tube composed of polygonal cells with clear cytoplasm, morphologically resembling adrenal cortical tissue. Immunohistochemical staining demonstrated strong positivity for inhibin and calretinin, confirming the diagnosis of an ectopic adrenal cortical rest. No clinical or biochemical evidence of hormonal hyperfunction was noted. This rare finding expands the limited body of literature on fallopian tube EAT, emphasizing the importance of recognizing this entity to avoid misdiagnosis with metastatic clear cell lesions.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"326-328"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907672","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}

{"title":"Experience with intrauterine application of platelet-rich plasma in women with recurrent implantation failure.","authors":"Petra Mrvková, Vladimíra Balogová, Hana Višňová, Renata Hüttelová","doi":"10.48095/cccg2026336","DOIUrl":"https://doi.org/10.48095/cccg2026336","url":null,"abstract":"<p><strong>Introduction: </strong>Intrauterine administration of platelet-rich plasma (PRP) is a technique currently under intensive investigation. PRP therapy has the potential to play a complementary role in treatment protocols for women with a thin endometrium or a history of recurrent implantation failure (RIF). The principle of PRP is based on the release of multiple biologically active factors (e. g., cytokines, growth factors) following administration, which initiate reparative processes such as the synthesis of new connective tissue or revascularization. A major advantage of PRP therapy is its favorable safety profile, as no serious adverse effects have been reported to date. In the following study, we summarize our clinical experience with intrauterine PRP administration at our IVF center. The aim of this study was to evaluate the effect of PRP on the clinical pregnancy rate in women with recurrent implantation failure.</p><p><strong>Materials and methods: </strong>A retrospective data analysis was performed. Between January 2021 and December 2024, intrauterine PRP was administered to 45 women with a history of recurrent implantation failure. PRP was applied intrauterinely via a catheter with a volume of 0.5-1 mL using two different protocols. Protocol A consisted of a single intrauterine PRP administration performed 2-5 days prior to embryo transfer. Protocol B included two administrations: the first on days 21-23 of the preceding cycle and the second on days 7-10 of the preparation cycle. The control group comprised of patients with RIF who underwent treatment at our clinic between January 2015 and December 2018 using a standard frozen embryo transfer protocol without PRP administration.</p><p><strong>Results: </strong>Among the 45 women with RIF treated with PRP, clinical pregnancy was confirmed by ultrasound in 23 patients (51.1%). In the control group of 35 women, 10 clinical pregnancies were achieved (28.6%). Statistical analysis using a Pearson's Chi-square test demonstrated a P-value of 0.042, indicating statistical significance. Our findings therefore suggest that intrauterine PRP administration in patients with RIF is associated with a significantly higher clinical pregnancy rate compared to the standard protocol without PRP. These results indicate a potential beneficial effect of this adjunctive therapy on endometrial receptivity.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"336-340"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907691","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}

{"title":"Ethanol sclerotherapy for ovarian endometrioma - a systematic review and narrative synthesis.","authors":"Ondřej Malchar, Radovan Pilka","doi":"10.48095/cccg2026211","DOIUrl":"10.48095/cccg2026211","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this review was to evaluate the efficacy and safety of ethanol sclerotherapy (EST) for ovarian endometriomas, regarding the risk of recurrence, impact on ovarian reserve, and comparison with laparoscopic cystectomy. Additionally, we evaluated whether the available studies assessed the impact of this method on the patients' quality of life using validated questionnaires.</p><p><strong>Methods: </strong>A total of 27 studies (2009-2025; N = 1,936) were included, consisting of two randomized controlled trials (RCTs) and 25 observational studies. Risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. The primary outcomes were recurrence rate and quality of life; the secondary outcome was the change in anti-Müllerian hormone (AMH) levels.</p><p><strong>Results: </strong>Recurrence rate (0-48.6%) varied according to follow-up duration and treatment technique. Data suggest a benefit of the retention protocol (exposure ≥ 10 minutes) compared to simple irrigation. In the single RCT comparing EST and cystectomy, no significant difference in recurrence was found after 12 months (48.6 vs. 42.9%). Although surgery resulted in a decline in AMH levels, these remained largely stable following sclerotherapy (reported in 15 studies). No study evaluated quality of life using validated tools. The quality of evidence was limited by the predominance of observational studies with a risk of bias.</p><p><strong>Conclusion: </strong>EST represents a promising alternative to surgery, with a more favorable impact on ovarian reserve. The efficacy of recurrence prevention is variable depending on the duration of ethanol exposure. Given the methodological limitations and absence of quality of life data, findings must be interpreted with caution. Further RCTs, including quality of life assessment, are necessary to confirm clinical benefit.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"211-225"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413253","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}

{"title":"Clinically relevant histopathological features and biomarkers in endometrial cancer.","authors":"Borek Sehnal, Jana Drozenová, Lukáš Vaněk, Munachiso Onyedikachi Ndukwe, Michael J. Halaška, Martin Hruda, Lukáš Rob, Radoslav Matěj","doi":"10.48095/cccg2026131","DOIUrl":"10.48095/cccg2026131","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of the most important histopathological characteristics and biomarkers of endometrial carcinoma that have clinical relevance for prognosis, prediction of treatment response, and decision-making regarding adjuvant therapy.</p><p><strong>Methods and results: </strong>Endometrial carcinoma represents the most common malignancy of the female reproductive tract in developed countries. Disease prognosis is determined not only by the anatomical extent, but also by a number of non-anatomical factors. The histological tumour type, presence of lymphovascular space invasion, and specific patterns of myometrial invasion (such as the MELF pattern) play major roles. Current molecular classification divides endometrial carcinomas into four groups (POLEmut, MMRd, NSMP, and TP53mut), which differ in prognosis as well as in therapeutic response. Additional clinically applicable biomarkers include oestrogen and progesterone receptors, L1CAM, HER2, CA125, and HE4. Emerging research focuses on novel biomarkers such as TROP2, circulating tumour DNA (ctDNA), circular RNA (circRNA), tumour- -infiltrating lymphocytes (TILs), and folate receptor alpha (FRa). These markers enable more precise risk stratification and identification of patients suitable for targeted therapies. Integration of multiple biomarkers with clinicopathological parameters further enhances the accuracy of risk assessment and prediction of treatment response.</p><p><strong>Conclusion: </strong>Incorporating histopathological features and biomarkers into routine clinical practice allows for a more accurate estimation of prognosis and a more rational selection of adjuvant therapy. An increasing number of non-anatomical biomarkers are becoming an integral part of the decision-making algorithm in endometrial carcinoma management.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 2","pages":"131-141"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876003","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}

{"title":"Impact of angiogenic factors and maternal endothelial dysfunction on pregnancy outcome.","authors":"Martina Piklová, Adam Eschner, Jana Klicnarová, Miloš Velemínský","doi":"10.48095/cccg202689","DOIUrl":"10.48095/cccg202689","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the relationship between the fibroblast growth factor soluble receptor 1 (sFlt-1/PlGF) ratio and adverse perinatal outcomes.</p><p><strong>Materials and methods: </strong>Patients admitted between 22+0 and 34+6 weeks of gestation from February 2024 to June 2025 were included. The sFlt-1/PlGF ratio was measured and its relationship to pregnancy outcome was evaluated. We assessed whether patients with increased sFlt-1/PlGF ratios developed conditions leading to preterm birth (spontaneous or iatrogenic).</p><p><strong>Results: </strong>A total of 78 patients were included, of whom 47 delivered before 37 weeks of gestation and 31 after 37 weeks. The sFlt-1/PlGF ratio appeared significant in relation to the risk of preterm birth. Almost all women with an sFlt-1/PlGF ratio above 100 delivered before 37 weeks. Based on the collected data, we developed a model to estimate the probability of delivery within 3 or 7 days. The model showed low sensitivity (0.32 and 0.53), but high specificity (0.91 in both cases). It accurately identified patients who would not deliver within 3 or 7 days.</p><p><strong>Conclusion: </strong>The sFlt-1/PlGF ratio is a useful tool in assessing the further course of pregnancy.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 2","pages":"89-95"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876084","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}

{"title":"The frail patient - frailty as a critical factor in surgical risk and postoperative outcomes.","authors":"Markéta Polková, Pavel Kabele, Jana Matějíčková, Tomáš Brtnický","doi":"10.48095/cccg2026245","DOIUrl":"10.48095/cccg2026245","url":null,"abstract":"<p><p>Frailty is a multidimensional syndrome characterized by reduced physiological reserve and increased vulnerability to stressors, significantly elevating the risk of postoperative complications, morbidity, and mortality. As the population ages, prevalence of frailty among surgical patients is rising. This article summarizes current knowledge on frailty as a key predictor of surgical risk, introduces validated tools for its assessment, and discusses their application in clinical practice. Furthermore, it highlights prehabilitation as an effective intervention to improve the patients' baseline condition and reduce postoperative complications. Based on available evidence, frailty is a modifiable condition whose early identification and targeted interventions have the potential to significantly influence surgical outcomes and overall patient prognosis. The article calls for routine integration of frailty assessment into perioperative clinical care.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"245-249"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413408","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}