Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Cryopreservation of oocytes to preserve female fertility.","authors":"Andrea Nesvadbová, Štěpán Machač, Jiří Bezdíček","doi":"10.48095/cccg202696","DOIUrl":"10.48095/cccg202696","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to obtain information on the possibilities and success rate of cryopreservation of human oocytes. In the Czech Republic, this method is used to prolong women's reproductive health to a limited extent due to low awareness among women and also due to the high cost of this method.</p><p><strong>Materials and methods: </strong>Ninety-three oocyte retrievals were evaluated in women with oocyte retrievals intended for vitrification and long-term storage to extend reproductive age. Clients were divided according to age into two groups: under 35 years old and over 35 years old. At the same time, each age group was divided into two groups according to the number of vitrified oocytes: under 4 oocytes and over 4 oocytes. Furthermore, the success rate of the oocyte vitrification method was compared with the success rate of oocyte vitrification in healthy anonymous donors.</p><p><strong>Results: </strong>In order to obtain information on the success rate of the oocyte vitrification method, we evaluated the survival rate (SR), fertilization rate (FR) and utilization rate (UR) in each group. SR was 61.5-89.3%, with the lowest value in older clients with a low oocyte count. FR was 50.0-80.0%, where the lowest value was again seen in older clients with a low oocyte count. UR was 34.9-75.0%, where the lowest value was seen in the group of older clients with a higher vitrified oocyte count compared to the other groups.</p><p><strong>Conclusion: </strong>In conclusion, the age at the time of oocyte freezing and the number of stored oocytes remain the two key factors that determine the success rate to secure the possibility of having a child in the future.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 2","pages":"96-101"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876136","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":"Junctional zone thickness on magnetic resonance imaging - a non-invasive diagnostic method for adenomyosis and beyond.","authors":"Jule Eriç Horasanl, Fatih Akkuş, Pinar Diydem Yılmaz, Cengiz Kadıyoran, Ecenur Çetinkuş Polat","doi":"10.48095/cccg2026173","DOIUrl":"10.48095/cccg2026173","url":null,"abstract":"<p><strong>Background and objectives: </strong>Adenomyosis is a prevalent gynecologic disorder involving ectopic endometrial tissue within the myometrium. Magnetic resonance imaging (MRI) enables non-invasive diagnosis, yet the role of junctional zone (JZ) thickness in predicting coexisting intrauterine pathologies remains uncertain. This study evaluated the diagnostic and predictive value of MRI-based JZ thickness in hysterectomy-confirmed adenomyosis.</p><p><strong>Materials and methods: </strong>This retrospective study included 420 patients who underwent hysterectomy with preoperative MRI between 2020 and 2025. JZ thickness was measured on sagittal T2-weighted images, and histopathological findings were recorded. Logistic regression analyses were performed to identify independent predictors of intrauterine pathologies. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>The mean JZ thickness was 17.5 ± 3.8 mm. Histopathological evaluation confirmed adenomyosis in 97.1% of cases, with coexisting lesions including myomas (44.5%), endometrial polyps (7.9%), simple hyperplasia (6.2%), atypical hyperplasia (1.9%), and endometrial cancer (2.4%). JZ thickness demonstrated strong positive correlations with polyps (R = 0.46; P < 0.001), simple hyperplasia (R = 0.55; P < 0.001), atypical hyperplasia (R = 0.49; P < 0.001), and myomas (R = 0.38; P < 0.001). Logistic regression identified JZ thickness as the most consistent independent predictor of intrauterine lesions, with an odds ratio of 1.70 for atypical hyperplasia (95% CI 1.11-2.60; P = 0.014). ROC analysis revealed excellent discriminative ability for simple hyperplasia (AUC = 0.842), atypical hyperplasia (AUC = 0.888), and polyps (AUC = 0.840), while predictive performance for myomas was moderate (AUC = 0.661).</p><p><strong>Conclusions: </strong>MRI-based measurement of JZ thickness is a reliable, non-invasive biomarker for adenomyosis, demonstrating an additional predictive value for coexisting premalignant intrauterine pathologies. Incorporating JZ thickness thresholds into routine imaging evaluation may enhance risk stratification, reduce unnecessary invasive procedures, and inform about personalized management strategies in women with adenomyosis.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"173-180"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413337","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":"Ultrasound examination during labor - a prospective pilot comparative study of clinical and ultrasonographic accuracy.","authors":"Lucia Borovska, Jozef Záhumenský, Peter Papcun, Rastislav Dudič, Peter Urdzik","doi":"10.48095/cccg2026285","DOIUrl":"https://doi.org/10.48095/cccg2026285","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this pilot study was to evaluate and compare the diagnostic accuracy of digital vaginal examination versus intrapartum ultrasound (IUS) during the first and second stages of labor in women with cephalic presentation.</p><p><strong>Materials and methods: </strong>This prospective comparative study was conducted at the Department of Gynecology and Obstetrics, L. Pasteur University Hospital in Košice. The cohort included parturients (regardless of parity) with regular uterine contractions, cephalic presentation, and ruptured membranes. To ensure high data quality, all ultrasound examinations were performed by senior obstetricians with at least 8 years of clinical experience. Examining obstetricians were blinded to each other's findings. The assessment focused on fetal position, head position, head station, and progression during labor. IUS included a transabdominal approach (head position) and a transperineal approach, measuring head-perineum distance and angle of progression. In cases of discrepancy, the ultrasound finding was considered the reference standard.</p><p><strong>Results: </strong>A total of 47 patients were included. Agreement between IUS and VE across all parameters was observed in 27 cases (57%). Discrepancies were noted in 20 patients (43%), with the most frequent errors occurring in the assessment of fetal head position. The statistical superiority of ultrasound over digital examination was highly significant (P < 0.0001). Presence of a caput succedaneum was a major confounding factor, which was present in 45% of non-correlated cases. The caesarean section rate in the cohort was 21% (N = 10).</p><p><strong>Conclusion: </strong>While vaginal examination remains the global gold standard in routine obstetrics, it is inherently subjective and prone to inter-observer variability. Our findings suggest that intrapartum ultrasound provides a more objective, accurate, and reproducible assessment. Incorporating IUS into labor management may reduce the need for frequent digital examinations, potentially lowering the risk of chorioamnionitis and enhancing patient comfort while optimizing clinical decision-making.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"285-289"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907655","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":"ESGO/ISUOG guidelines for needle biopsies in gynecologic oncology - the adapted version.","authors":"Renata Poncová, Daniela Fischerová, Filip Frühauf","doi":"10.48095/cccg2026157","DOIUrl":"10.48095/cccg2026157","url":null,"abstract":"<p><p>The aim of this article is to summarize current knowledge on performing biopsies using a core needle, which have become a routine method in gynecologic oncology. The text is based on international guidelines focusing on the selection of imaging techniques for navigation, selection of approach, indications, and contraindications of this method. Additionally, the article addresses recommendations to minimize the risk of bleeding, proper management of anticoagulant or antiplatelet therapy, and provides an overview of the biopsy technique. Finally, it includes recommendations for the required expertise of physicians performing biopsies to ensure maximum safety.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 2","pages":"157-165"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876051","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":"Risk factors for recurrent ectopic pregnancy - a retrospective case-control study.","authors":"Coşkun Ümit, Melike Doğanay","doi":"10.48095/cccg2026299","DOIUrl":"https://doi.org/10.48095/cccg2026299","url":null,"abstract":"<p><strong>Background: </strong>To investigate risk factors and clinical characteristics of recurrent ectopic pregnancies. The study specifically aims to compare demographic data, laboratory findings, and reproductive histories between patients with single and recurrent episodes to identify predictors for secondary prevention.</p><p><strong>Methods: </strong>From December 2007 to December 2011, 199 women with single ectopic pregnancy and 51 women with recurrent ectopic pregnancy were identified from our hospital records. The information collected for each woman included age, smoking status, recurrent time, signs and symptoms, laboratory findings, and treatment parameters.</p><p><strong>Results: </strong>The recurrence rate was 20.4%. Mean age was comparable between groups (30.2 ± 4.9 vs. 30.5 ± 5.7 years, P = 0.800). Gravidity was significantly higher in the recurrent group (3.4 ± 1.8 vs. 2.8 ± 1.5, P = 0.028), and gravida ≥ 4 was more frequent among recurrent cases (43.1 vs. 28.1%, P = 0.030). A history of abortion was significantly more common in the recurrent group (45.1 vs. 18.1%, P = 0.001), corresponding to an approximately fourfold increased risk (OR 3.9, 95% CI 1.7-7.9). Serum b-hCG levels were significantly higher in recurrent cases (5,135.8 ± 5,230 vs. 3,153.0 ± 5,643 mIU/mL, P = 0.040). b-hCG > 4,000 mIU/mL was more frequent in the recurrent group (33.3 vs. 18.1%, P = 0.017), whereas b-hCG levels between 2,001-4,000 mIU/mL were less frequent (7.8 vs. 23.1%, P = 0.015). Smoking status, intrauterine device use, prior cesarean section, ultrasonographic localization, rupture rates, treatment modalities, and complication rates did not significantly differ between groups (P > 0.05). In a multivariate analysis, only a history of abortion remained an independent predictor of recurrent ectopic pregnancy (OR 3.01, 95% CI 1.499-6.043, P = 0.002).</p><p><strong>Conclusion: </strong>When ectopic pregnancy is diagnosed early and appropriate treatment modality is selected, morbidity, mortality, radical intervention rate, and treatment costs are significantly reduced. Therefore, women of reproductive age should be informed about ectopic pregnancy symptoms by clinicians to increase community awareness. Moreover, for successful secondary prevention, identification of modifiable risk factors for recurrent ectopic pregnancy is important.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"299-305"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907616","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":"Dührssen-Schuchardt colpoperineotomy for vaginal hysterectomy in an extremely overweight patient.","authors":"Dubravko Habek","doi":"10.48095/cccg2026347","DOIUrl":"https://doi.org/10.48095/cccg2026347","url":null,"abstract":"<p><strong>Objective: </strong>Dührssen-Schuchardt incision is an extended vaginoperineal, deep lateral incision of the vagina, paracolpium, levator ani, and perineum represented by the expansion of the operating field during vaginal hysterectomy.</p><p><strong>Materials and methods: </strong>In 21 extremely overweight patients with premalignant (11) and malignant endometrial disease FIGO IA (10) and policomorbidities, total vaginal hysterectomy with a unilateral Dührssen-Schuchardt incision was performed. It was impossible to perform a laparotomic or laparoscopic procedure in any of the patients due to the mentioned comorbidities and polycomorbidities.</p><p><strong>Results: </strong>There were no postoperative complications related to the surgical procedure and the surgical wound; all wounds healed per primam, and no late postoperative complications related to the surgical technique were recorded.</p><p><strong>Conclusion: </strong>Therefore, this approach to total vaginal hysterectomy with the help of a Dührssen-Schuchardt incision is certainly a \"minimally invasive procedure.\"</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"347-349"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907652","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":"Comparison of the incidence of pelvic girdle pain and back pain in women after vaginal delivery and cesarean section in the Slovak female population.","authors":"Michaela Hroncová, Magdaléna Hagovská, Katarína Oravcová, Viliam Knap, Ján Švihra","doi":"10.48095/cccg202621","DOIUrl":"10.48095/cccg202621","url":null,"abstract":"<p><strong>Background: </strong>A common problem in women after childbirth is the frequent occurrence of pelvic girdle pain (PGP) and back pain (LBP). To date, no study has been conducted to determine the prevalence of these types of pain. The aim of our study was to compare the incidence of PGP and LBP in women after vaginal delivery and cesarean section in the Slovak Republic over the course of one year in 2024.</p><p><strong>Methods: </strong>Cross-sectional study, the research sample consisted of 791 women 12 weeks to one year after delivery. The average age was 31.43 years. Standardized questionnaires were used for the Slovak version Pelvic Gridle questionnaire and Oswestry Disability Index.</p><p><strong>Conclusion: </strong>Based on the type of delivery, the sample was divided into a group with spontaneous delivery comprising 633 women and a group with cesarean section comprising 158 women. Significant differences were observed in the incidence of pain and disability in the spine and in its intensity, with stronger pain in the cesarean section group. The type of delivery did not affect the incidence of pelvic girdle pain after delivery. Cesarean section was associated with greater pain intensity and disability in the spine. Disruption of the integrity of the abdominal wall, increased sensitivity in the area of the cesarean section scar, and a restricted movement regime may explain the higher incidence of pain in the spine in women after cesarean section.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 1","pages":"21-25"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500094","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":"Cytological versus histological results in ASCUS cervical dysplasia - a retrospective study.","authors":"Tomas Rokos, Erik Kudela, Terezia Pribulova, Veronika Holubekova, Erik Kozubik, Michal Kalman, Kamil Biringer","doi":"10.48095/cccg202611","DOIUrl":"10.48095/cccg202611","url":null,"abstract":"<p><p>The cytological category of atypical squamous cells of undetermined significance describes cellular abnormalities that are more severe than inflammatory changes, but are quantitatively or qualitatively insufficient to be included in the squamous intraepithelial lesion category. This study aims to determine the risk level for the presence of high-grade dysplasia in patients with this cytological abnormality.</p><p><strong>Methods: </strong>We retrospectively searched our database for women with cytologically proven atypical squamous cells of undetermined significance lesions between January 2020 and June 2024. A total of 104 patients who had undergone colposcopy-directed biopsies were included in the study.</p><p><strong>Results: </strong>Among the 104 women with confirmed atypical squamous cells of undetermined significance cytological lesions who had undergone biopsies, 56 cases (53.8%) were negative, while 48 cases (46.2%) demonstrated cervical intraepithelial neoplasia. Cervical intraepithelial neoplasia 2+ was present in 23.1% (N = 24) of the cases. Furthermore, among 77 human papillomavirus positive women, the precancerous condition was not histologically confirmed in almost half of the cases (N = 36), while in 16 of the 23 human papillomavirus negative biopsies, the precancerous condition was not confirmed. Human papillomavirus status was unknown in 4 cases.</p><p><strong>Conclusion: </strong>We identified a 23.1% presence of cervical intraepithelial neoplasia 2+ lesions in patients with atypical squamous cells of undetermined significance cytological findings. Our study also suggests a lower specificity, but a better negative predictive value of the human papillomavirus test in detecting cervical intraepithelial neoplasia in these patients.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 1","pages":"11-15"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500128","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":"Molar ectopic pregnancy in a cesarean scar treated with methotrexate - a case report and review of the literature.","authors":"Ecem Yücel, İbrahim Kale, Osman Şanlı, Ayşe Nur İhvan","doi":"10.48095/cccg202656","DOIUrl":"10.48095/cccg202656","url":null,"abstract":"<p><p>Objective: To present a rare case of partial molar pregnancy implanted in a previous cesarean section scar and summarize the literature. Case report: A 33-year-old woman (gravida 5, two prior cesarean deliveries, two spontaneous abortions) presented with vaginal spotting and lower abdominal pain at 6 weeks of gestation. Transvaginal ultrasonography revealed a 28 × 19 mm gestational sac at the cesarean scar site, containing a 4mm fetus with positive cardiac activity. Vacuum curettage was performed under ultrasonographic guidance. Ten days postprocedure, rising serum beta-hCG levels and a persistent cystic mass on ultrasound raised suspicion for molar pregnancy. A single systemic dose of methotrexate was administered. Histopathology confirmed a partial molar pregnancy. The patient’s serum beta-hCG levels normalized within 8 weeks. Conclusion: Partial molar pregnancy in a cesarean section scar is an extremely rare condition that may present with vaginal bleeding and pelvic pain. Early recognition through ultrasonography and laboratory evaluation, combined with timely intervention including curettage and methotrexate therapy, can lead to complete resolution. Clinicians should consider this diagnosis in patients with previous cesarean sections to ensure optimal outcomes.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 1","pages":"56-60"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500187","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":"History and current possibilities of vNOTES in gynecology.","authors":"Jan Dvořák, Jaromír Mašata, Tomáš Fučík, Kamil Švabík","doi":"10.48095/cccg2026250","DOIUrl":"10.48095/cccg2026250","url":null,"abstract":"<p><p>Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) represents a minimally invasive surgical approach that combines the principles of vaginal surgery and endoscopy, utilizing natural transvaginal access to the peritoneal cavity. This review aims to summarize the historical development of the vNOTES technique, its current indications, contraindications, safety, and clinical outcomes in benign gynecological surgery. Based on a systematic review of the available literature, current evidence suggests that vNOTES is comparable to laparoscopic approaches in terms of safety and perioperative complications in patients with benign gynecological conditions. Several studies have reported potential advantages of vNOTES, including reduced postoperative pain, shorter length of hospital stay, and faster recovery. However, the technique has certain limitations, particularly with regard to patient selection, technical complexity, and a relatively long learning curve. vNOTES appears to be a promising evolution of the vaginal surgical approach in benign gynecology, and its wider implementation requires appropriate surgical expertise and further high-quality clinical research.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"250-253"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413265","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}