Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Comparative diagnostic accuracy of office hysteroscopy and three-dimensional transvaginal ultrasonography versus histopathology in women with abnormal uterine bleeding.","authors":"Mohamed Fouad, Mohamed El Mahy, Sherif K Hamada, Magdy Ibrahim, Yomna Ali Bayoumi, Abdullah Sayed, Heba M. Hawas, Ahmed Nagy Shaker, Nada H Eisa, Ramy Mohamed Elnaggar, Ahmed Ali Zein El-Nizamy","doi":"10.48095/cccg2026273","DOIUrl":"10.48095/cccg2026273","url":null,"abstract":"<p><strong>Background and aim: </strong>Abnormal uterine bleeding (AUB) is a common gynecological complaint with significant clinical and quality--of-life implications. Accurate diagnosis of the underlying pathology is critical to guide management. While three-dimensional transvaginal ultrasonography (3D TVUS) offers non-invasive evaluation of the uterine cavity and myometrium, hysteroscopy remains the gold standard for direct visualization. This study evaluated the diagnostic performance of 3D TVUS and hysteroscopy in women presenting with abnormal uterine bleeding, using histopathology as the reference standard.</p><p><strong>Methods: </strong>This prospective observational cross-sectional study included 80 women presenting with AUB at Cairo University Hospital between June 2021 and April 2023. All participants underwent 3D TVUS, office hysteroscopy, and histopathological evaluation where applicable. Formal comparative analysis with hysteroscopy was restricted to intracavitary lesions, while myometrial lesions were evaluated primarily by TVUS. Diagnostic performance metrics (sensitivity, specificity, PPV - positive predictive value, NPV - negative predictive value, and accuracy) were calculated for individual lesions, overall pathology versus normal, and endometrial cavity lesions.</p><p><strong>Results: </strong>The mean age of participants was 38.6 ± 9.8 years; menorrhagia (30%) was the most common presentation. Endometrial polyps (20%), adenomyosis (17.5%), and intramural fibroids (15%) were the leading pathologies. TVUS showed superior performance for myometrial lesions, with the highest accuracy for intramural fibroids (92.5%). Hysteroscopy was more accurate for intracavitary lesions, particularly hyperplasia (97.5%) and intrauterine adhesions (98.8%). For overall pathology versus normal, TVUS demonstrated higher sensitivity (97.1%) and accuracy (93.8%), while hysteroscopy offered greater specificity (80.0%) but lower NPV (40.0%).</p><p><strong>Conclusion: </strong>3D TVUS and office hysteroscopy are complementary diagnostic modalities in AUB. TVUS is superior for myometrial lesions, while hysteroscopy remains more accurate for intracavitary pathology. A combined approach offers the most comprehensive diagnostic strategy, optimizing accuracy and minimizing unnecessary invasive procedures.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"273-284"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907529","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":"Lichen sclerosus - insights from a dermatologist and therapeutic approaches.","authors":"Táňa Rajcigelová, Anna Gajdošová, Zlatica Žingorová, Tereza Neplechová, Juraj Péč, Karolína Vorčáková","doi":"10.48095/cccg2026206","DOIUrl":"10.48095/cccg2026206","url":null,"abstract":"<p><p>Lichen sclerosus is a cutaneous disorder affecting the external genitalia, with diagnosis and treatment generally managed by a dermatovenerologist. However, in clinical practice, gynecologists are frequently the first physicians to encounter affected patients. Lichen sclerosus is characterized as chronic, lymphocyte-mediated inflammatory dermatosis that requires a multidisciplinary approach. The incomplete understanding of its etiopathogenesis is reflected in limited therapeutic options, which are primarily directed toward stabilization of clinical manifestations, symptom control, reduction of complications associated with chronic inflammation, and prevention of malignant transformation. This article reviews current conventional therapeutic strategies, discusses alternative approaches in the management of lichen sclerosus and additional recommendations applicable in gynecological practice.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"206-210"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413288","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":"Current overview of breast cancer risk assessment models - practical application in outpatient gynecological practice.","authors":"Adam Buryanek","doi":"10.48095/cccg2026254","DOIUrl":"10.48095/cccg2026254","url":null,"abstract":"<p><p>The rising incidence of breast cancer represents a serious medical problem. Women diagnosed with breast cancer before the age of 45 - that is, those who were not included in mammography screening programs - constitute a specific patient group. Identification of risk factors for the pathogenesis of breast cancer has led to the development of triage models based on both medical history data and genetic testing, as well as imaging methods; their updated versions are based on a combination of these modalities. The oldest empirical Gail model relies solely on basic medical history. The IBIS model, on the other hand, incorporates an expanded family history, as well as mammographic breast tissue density. The BOADICEA model enables the calculation of lifetime risk and risk of being a carrier of BRCA1/2 and other major mutations (BRCA1/2, TP53, PTEN, CHEK2, ATM). The Pecný model represents a Czech contribution. With new possibilities in genetic testing, the latest versions of these models now include the polygenic risk score (PRS), which increases their predictive value. With the growing integration of artificial intelligence (AI) and deep learning into clinical medicine, we can expect the emergence of new, AI-dependent triage models. A major limitation of the aforementioned models is their restriction to the Caucasian population. Calibration based on statistical data for other populations often does not work. This article will present current statistical data for the GAIL model, IBIS and its variants, and the BOADICEA model. The aim of this article is to present predictive models to the professional community and to highlight their potential applications in routine gynecological outpatient practice.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"254-260"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413290","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":"Age-specific incidence and mortality of cervical cancer in the Czech Republic - analysis of nationwide data and data from a gynecologic oncology center.","authors":"Karolína Robová, Tomáš Pichlík, Lukáš Rob, Helena Robová, Nikola Janovská, Ruth Tachezy, Michael Jiří Halaška","doi":"10.48095/cccg202661","DOIUrl":"10.48095/cccg202661","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the incidence and mortality of cervical cancer in individual age cohorts in the Czech Republic using nationwide data and data from the largest national gynecological oncology center.</p><p><strong>Materials and methods: </strong>Analysis of a single-institution cohort of newly treated cervical cancer cases from 2022-2024, and analysis of incidence and mortality trends in individual age groups using data from the Czech National Cancer Registry (ÚZIS - Institute of Health Information and Statistics) from 2000-2023.</p><p><strong>Results: </strong>The incidence and mortality of cervical cancer in the Czech Republic have declined significantly over the last 20 years. The decline correlates well with measures that have led to better organization and implementation of changes within the screening program. Analysis in individual age cohorts shows that the largest decline in incidence and mortality occurred in the cohort up to 34 years of age, yet in more than 50% of women with carcinomas in this cohort, cytological screening and subsequent management failed. The upward trend in incidence in the 35-44 and 45-54 age cohorts raises questions about the causes. The high percentage of invasive carcinomas in women examined by a gynecologist in the last three years requires an analysis of the quality of cytology laboratories and management by registering gynecologists. The introduction of high-risk human papillomavirus (HR HPV) testing and referral to expert colposcopy for discrepant findings is one way to improve the situation. Furthermore, audits of diagnosed carcinomas in women who have undergone screening should be introduced. The biggest challenge will be to activate the resistant population of women who underestimate the importance of regular screening examinations.</p><p><strong>Conclusion: </strong>Even though we can see an overall decline in incidence and mortality, when individual age cohorts are analyzed, it shows us ways for improvement in each specific age group of women individually.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 1","pages":"61-68"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500117","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":"Amniotic band syndrome - a case report of prenatally detected fetal upper limb amputation.","authors":"Klára Košťálová, Roman Chmel, Nikoleta Chubanovová, Michal Kozerovský","doi":"10.48095/cccg2026202","DOIUrl":"10.48095/cccg2026202","url":null,"abstract":"<p><p>Amniotic band syndrome (ABS) includes a rare group of fetal congenital anomalies with various phenotypic manifestations. Early prenatal diagnosis is essential in pregnancy management, including termination of pregnancy for severe forms of disability. Systematic postnatal multidisciplinary care of the newborn with disability induced by the amniotic band should maximize its quality of life. This report describes the case of a 28-years-old primigravida with intrauterine amputation of the fetal upper limb detected in week 31 of an otherwise uneventful pregnancy.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"202-205"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413231","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":"Atypical eclampsia without severe hypertension - the role of ophthalmic artery Doppler and sFlt-1/PlGF ratio: a case report.","authors":"Vera Oom, Constança Fernandes, Edward Araujo Júnior, Gustavo Yano Callado, Sara Proença, Catarina Nascimento, Renato Augusto Moreira De Sá, Filomena Nunes","doi":"10.48095/cccg2026181","DOIUrl":"10.48095/cccg2026181","url":null,"abstract":"<p><p>Eclampsia remains one of the most severe obstetric emergencies associated with substantial maternal and perinatal morbidity and mortality. Although classically regarded as a hypertensive complication of pre-eclampsia, atypical presentations without sustained hypertension or severe clinical features may occur, complicating risk prediction and timely intervention. We report a case of atypical eclampsia in a 21-year-old woman hospitalized with a diagnosis of pre-eclampsia without severe features. Despite predominantly normal blood pressure values and initially stable laboratory findings, the sFlt-1/PlGF ratio and Doppler assessment of the uterine and ophthalmic arteries revealed significant abnormalities. The patient subsequently developed generalized tonic-clonic seizures, requiring urgent obstetric intervention. This case underscores the limitations of conventional diagnostic criteria in identifying patients at risk for sudden neurological deterioration and highlights the potential value of angiogenic biomarkers and targeted Doppler evaluation in refining risk stratification among women with pre-eclampsia.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 3","pages":"181-185"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413281","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":"Vulvodynia and persistent vulvar pain - diagnosis, treatment, and the role of laser vaporization.","authors":"Roman Chmel, Nikoleta Chubanovová, Zlatko Pastor","doi":"10.48095/cccg2026124","DOIUrl":"10.48095/cccg2026124","url":null,"abstract":"<p><p>This article reviews the issue of persistent vulvar pain and vulvodynia, which are common conditions in women of reproductive age. Vulvodynia is defined as chronic vulvar pain lasting at least 3 months with no identified cause. It is characterized by increased sensitivity of the vulvar and vestibular tissues, neuroproliferation, increased vascularization, and structural changes of the mucosa. In contrast, persistent vulvar pain is usually associated with a specific, identifiable underlying condition. Both types of pain may coexist and overlap. This article comments on the current classification of vulvar pain according to the consensus of international societies dealing with this condition. It also summarizes the principles of differential diagnosis and therapeutic options for the management of vulvar pain. Treatment should be based on a comprehensive multidisciplinary approach including local and systemic pharmacotherapy, physiotherapy, psychotherapy, and in selected cases, surgical interventions. This article focuses on novel and promising therapeutic modalities in the treatment of vulvodynia, particularly various types of laser therapy. The review is supplemented by a case report of a patient with chronic provoked vestibulodynia treated by laser vaporization.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 2","pages":"124-130"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875546","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":"Oxidative stress and antioxidant imbalance in endometrial carcinogenesis.","authors":"Jule Eriç Horasanlı, Pelin Bahçeci, Gamze Avcıoğlu, Arif Caner Erdoğan, Özcan Erel, Salim Neşelioğlu","doi":"10.48095/cccg2026306","DOIUrl":"https://doi.org/10.48095/cccg2026306","url":null,"abstract":"<p><strong>Objective: </strong>To assess dynamic thiol-disulfide homeostasis as a biomarker of oxidative stress in patients with endometrial cancer and to evaluate its association with tumor grade and stage.</p><p><strong>Methods: </strong>This prospective case-control study included 35 patients with histopathologically-confirmed endometrial cancer and 36 age-matched healthy controls. Venous blood samples were obtained after overnight fasting. Serum thiol-disulfide homeostasis parameters were measured using a fully-automated spectrophotometric method. Native thiol, total thiol, disulfide concentrations, and related ratios were analyzed. Tumor grade and International Federation of Gynecology and Obstetrics stage were recorded for all patients.</p><p><strong>Results: </strong>Native thiol and total thiol levels were significantly lower in patients with endometrial cancer compared with healthy controls (both P < 0.001). Patients with grade 2 tumors exhibited significantly reduced native and total thiol levels compared with grade 1 patients and controls (P < 0.001). A significant inverse correlation was observed between tumor stage and thiol levels, with lower native and total thiol concentrations in stage IB compared with stage IA disease (R = -0.586, and R = -0.604, resp.; P < 0.001). Disulfide levels and thiol-disulfide ratios did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Dynamic thiol-disulfide homeostasis is markedly impaired in endometrial cancer and is associated with tumor grade and stage. Reduced thiol levels reflect increased oxidative stress and diminished antioxidant capacity, suggesting that thiol-based redox parameters may serve as complementary biomarkers for disease severity and progression in endometrial cancer.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"306-313"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907640","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":"Personalized approach to infertility treatment in a patient with polyendocrine metabolic ovarian syndrome and chronic pancreatitis.","authors":"Soňa Šimová, Lenka Mekiňová, Michal Ješeta, Eva Lousová, Robert Hudeček","doi":"10.48095/cccg2026322","DOIUrl":"10.48095/cccg2026322","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in fertile women, with an estimated prevalence of 10-15%. It is a heterogeneous disease characterized by a complex pathogenesis. Genetic predisposition, neuroendocrine regulation disorders, and environmental influences play a key role. Dysregulation of the hypothalamic-pituitary-ovarian axis occurs with subsequent chronic anovulation, hyperandrogenemia, and metabolic abnormalities. Phenotypic variability reflects different pathophysiological mechanisms - based on genomic association studies, three subtypes of PCOS can be distinguished: reproductive, metabolic, and indeterminate. PCOS is one of the main causes of female infertility and a risk factor for the development of cardiometabolic diseases. Objective: The aim of the article is to summarize current recommendations of the European Society of Human Reproduction and Embryology (ESHRE 2023) regarding the diagnosis and treatment of polyendocrine metabolic ovarian syndrome (PMOS) in patients with fertility disorders and to demonstrate their practical application through a selected clinical case.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"91 4","pages":"322-325"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907675","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":"Analysing risk factors for foetal growth outcomes - the influence of maternal conditions and congenital cytomegalovirus infection.","authors":"Miroslava Mandžáková, Jozef Záhumenský, Eva Vajdová, Zuzana Matušíková, Monika Rosoľanková, Peter Papcun","doi":"10.48095/cccg2025189","DOIUrl":"https://doi.org/10.48095/cccg2025189","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyse the risk factors differentiating small for gestational age (SGA) and appropriate for gestational age (AGA) neonates.</p><p><strong>Materials and methods: </strong>A retrospective-prospective cohort study was conducted from 2019 to 2024 at the 2nd Department of Obstetrics and Gynaecology, University Hospital Bratislava. The study involved 174 term neonates from singleton pregnancies, including 125 SGA and 49 AGA infants. Various maternal, foetal, and placental risk factors were analysed, with a particular focus on congenital cytomegalovirus infection (cCMV).</p><p><strong>Results: </strong>Neonates' birth weights ranged from 1,480 to 4,470 grams. Of the risk factors assessed, only maternal COVID-19 infection during pregnancy was significantly associated with AGA outcomes (P = 0.009). No significant associations were found between common risk factors (e. g. hypertension, diabetes mellitus) and foetal growth restriction. Congenital CMV infection was not significantly associated with SGA. Logistic regression analysis confirmed the association of COVID-19 infection with foetal weight, while no significant effect was observed for CMV.</p><p><strong>Conclusion: </strong>Maternal COVID-19 infection was associated with AGA outcomes, potentially due to enhanced medical surveillance and immune responses. However, the study's small sample size limits the interpretation of these findings, and further research is required to fully understand the impacts of COVID-19 on pregnancy. No significant association between congenital CMV infection and foetal growth restriction was found in this cohort, which was most likely due to the low prevalence of cCMV. Moreover, documented risk factors for foetal growth restriction, including hypertension and diabetes mellitus, were not statistically significant in our study population.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"189-193"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643778","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}