Gynecology and Minimally Invasive Therapy-GMIT最新文献

{"title":"Torsion in a Pregnant Noncommunicating Uterine Horn - Journey from Misdiagnosis to Laparoscopic Management: A Case Report.","authors":"Megha Dharamdasani, Rebecca Mallick, Shafia Siddiqui","doi":"10.4103/gmit.gmit_34_22","DOIUrl":"10.4103/gmit.gmit_34_22","url":null,"abstract":"<p><p>Pregnancy in a noncommunicating uterine horn (NCUH) is extremely rare and torsion of the pregnant horn is even rarer. Only a few cases have been reported so far. Diagnosis of such extraordinary pathologies can be challenging, and this often leads to misdiagnosis and delay in appropriate treatment. We present the case of a NCUH pregnancy which was initially misdiagnosed on ultrasound and treated with standard miscarriage management regimen. Ongoing symptoms and suspicion of sepsis prompted surgical treatment, and laparoscopy revealed a torted NCUH pregnancy, completely distinct from the unicornuate uterus. The rarity in our case was not only conception in a noncommunicating horn but also the complete torsion of the gravid horn and ipsilateral adnexa. This shows the complexities of dealing with rare uterine abnormalities and highlights the importance of a high degree of clinical suspicion and consideration of atypical presentations of an anomalous uterus, especially if medical treatment fails.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"355-358"},"PeriodicalIF":1.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vesicovaginal Adhesion as an Independent Factor of Postoperative Recurrence after Laparoscopic Sacrocolpopexy.","authors":"Kenji Kuroda, Koetsu Hamamoto, Kazuki Kawamura, Ayako Masunaga, Akio Horiguchi, Keiichi Ito","doi":"10.4103/gmit.GMIT-D-24-00029","DOIUrl":"10.4103/gmit.GMIT-D-24-00029","url":null,"abstract":"<p><strong>Objectives: </strong>Laparoscopic sacrocolpopexy (LSC), which is known for its low recurrence rate, is considered the gold standard for treating pelvic organ prolapse (POP). However, in some cases, prolapse recurrence occurs even after LSC, and its cause remains unclear. Thus, the current study aimed to investigate the factors correlated with POP that contribute to postoperative prolapse recurrence.</p><p><strong>Materials and methods: </strong>The study enrolled 95 patients who underwent LSC at our hospital between June 2016 and December 2023. The Pearson's Chi-square test, multiple logistic regression analysis, and Cox proportional hazards analysis were performed to determine the independent factors contributing to prolapse recurrence.</p><p><strong>Results: </strong>Based on the Pearson's Chi-square test, age (≥74 or <74 years), pelvic organ prolapse staging system (4 or ≤3), and the presence of vesicovaginal adhesion were significantly correlated with prolapse recurrence (all <i>P</i> < 0.05). Among the preoperative and intraoperative factors, only the presence of vesicovaginal adhesion was a significant factor in the univariate and multivariate logistic regression analyses (<i>P</i> = 0.0034). In addition, only the presence of vesicovaginal adhesion was an independent factor of shorter time to prolapse recurrence in the multivariate Cox proportional hazards model (hazard ratio: 17.46, 95% confidence interval: 1.69-180.15, <i>P</i> = 0.0163).</p><p><strong>Conclusion: </strong>Vesicovaginal adhesion can be an independent factor of postoperative recurrence after LSC. In patients with POP undergoing LSC, particularly those with vesicovaginal adhesion, the anterior mesh may need to be fixed firmly.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 2","pages":"164-169"},"PeriodicalIF":2.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barbed Suture Causing Ureterovaginal Fistula Postconservative Surgery for Deep Infiltrating Endometriosis.","authors":"Dipak Limbachiya, Ayush Heda, Mahan Gowda","doi":"10.4103/gmit.GMIT-D-25-00057","DOIUrl":"10.4103/gmit.GMIT-D-25-00057","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"369-370"},"PeriodicalIF":1.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline Ovarian Tumor Recurrence after Two Decades: The Importance of Long-term Surveillance.","authors":"Wen-Chun Shih, Pei-Chen Li, Dah-Ching Ding","doi":"10.4103/gmit.GMIT-D-25-00007","DOIUrl":"10.4103/gmit.GMIT-D-25-00007","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"367-368"},"PeriodicalIF":1.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hysteroscopy as an Alternative to Curettage in Persistent Pregnancy of Unknown Location.","authors":"Ishai Levin, Aviad Cohen, Yael Shulman, Yossi Tsur, Yaron Gil, Shikma Bar-On","doi":"10.4103/gmit.GMIT-D-25-00015","DOIUrl":"10.4103/gmit.GMIT-D-25-00015","url":null,"abstract":"<p><p>This study evaluates the effectiveness of hysteroscopy in managing persistent pregnancy of unknown location (PUL) as an alternative to traditional curettage. Six patients diagnosed with PUL underwent hysteroscopy, four of them by the vaginoscopic approach and without anesthesia, and two under general anesthesia. The objective of the procedure was to locate the pregnancy, treat it, or take a tissue sample in cases of PUL where imaging studies were nonconclusive. Results showed that in five patients, hysteroscopy successfully identified and removed a gestational mass, leading to complete resolution of beta-human chorionic gonadotropin (ß-hCG) levels within 24 days. One patient was diagnosed with extrauterine pregnancy due to the absence of intrauterine gestational mass in hysteroscopy and a plateauing level of ß-hCG a day after the procedure. The findings indicate that hysteroscopy may offer a safe and more precise alternative to traditional blind curettage.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"343-347"},"PeriodicalIF":1.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hysteroscopy: The Uterine Stethoscope Decoding Implantation Failures.","authors":"Nayanika Gaur, Kirti Gaur, Manish Jha","doi":"10.4103/gmit.GMIT-D-24-00068","DOIUrl":"10.4103/gmit.GMIT-D-24-00068","url":null,"abstract":"<p><strong>Objectives: </strong>To offer or not to offer hysteroscopy has remained an important question among clinicians treating infertility. With this question, we studied the impact of hysteroscopic diagnosis and treatment of pathologies in terms of improvement in implantation rates in patients requiring <i>in vitro</i> fertilization (IVF) treatment at our center.</p><p><strong>Materials and methods: </strong>We performed a retrospective analysis of 432 infertile patients who underwent hysteroscopy prior to embryo transfer (ET) between January 2016 and December 2023: Group 1: patients with previous IVF failure and Group 2: patients without previous IVF failure. Chi-square test of independence was used to check if the relationship found in the contingency table is significant or not as 5% level of significance.</p><p><strong>Results: </strong>A significant number of participants in Group 1 and Group 2, 70.5% (<i>n</i> = 98 of 139) and 79.9% (<i>n</i> = 234 of 293), respectively (<i>P</i> < 0.0031), were diagnosed and treated for some intrauterine pathology, suggesting their significant role in causing infertility. 51.1% (<i>n</i> = 71 of 139) and 63.1% (<i>n</i> = 185 of 293) patients in Group 1 and Group 2, respectively, were diagnosed with endometritis, showing that there is a significant role of performing hysteroscopy even without an obvious indication of intrauterine pathology diagnosed on ultrasound (<i>P</i> < 0.017).</p><p><strong>Conclusion: </strong>Although Cochrane review suggests a low level of evidence to support screening hysteroscopy prior to IVF, the results of our study direct us to offer hysteroscopy, preferably to all women planned for IVF-ET cycle irrespective of the ultrasound findings and especially to the patients who have experienced IVF Failure in previous cycles.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"326-330"},"PeriodicalIF":1.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Management with Mazindol for Obese Women Diagnosed with Endometrial Carcinoma Undergoing Robot-assisted Hysterectomy: A Pilot Case Series and Literature Review.","authors":"Kuniaki Ota, Toshifumi Takahashi, Yoshiaki Ota, Yumiko Morimoto, Hana Okamoto, Shogo Kawamura, Wataru Saito, Mitsuru Shiota, Koichiro Shimoya","doi":"10.4103/gmit.GMIT-D-25-00050","DOIUrl":"10.4103/gmit.GMIT-D-25-00050","url":null,"abstract":"<p><strong>Objectives: </strong>Obesity poses major perioperative challenges in gynecologic malignancies, particularly endometrial cancer, and increases surgical complexity and risk. Although robot-assisted hysterectomy (RAH) and bilateral salpingo-oophorectomy are preferred for early-stage cases, the obese patients make it limit their feasibility. Preoperative weight loss may improve outcomes; however, the pharmacological options remain understudied. This study explored the feasibility of a preoperative mazindol-based weight-loss program in severely obese patients.</p><p><strong>Materials and methods: </strong>A retrospective case series study was conducted on four women (body mass index [BMI] ≥35 kg/m²) who were suspected of having stage 1A endometrial cancer based on preoperative magnetic resonance imaging between January 2021 and July 2024. The patients received nutritional counseling and mazindol (1.0 mg/day) before undergoing surgery. The effect of mazindol was indexed by each patient's weight loss before surgery, and surgery-related parameters included the time of surgery, the amount of blood loss, and the presence of surgical complications.</p><p><strong>Results: </strong>Patients experienced a median weight reduction of 13.7 kg (range, 9.1-17.4 kg), with a corresponding decrease in BMI. Operative time was 247.5 min, with a console time of 214 min and blood loss of 75 g. The Trendelenburg angle was 18°-19°, which facilitated adequate surgical visualization. No adverse effects or postoperative complications were observed.</p><p><strong>Conclusion: </strong>Preoperative administration of mazindol resulted in significant weight loss, enabling safer RAH with reduced surgical complexity. This suggests that mazindol may be a viable option for weight reduction in obese patients absolutely requiring gynecologic surgery for malignant diseases.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"337-342"},"PeriodicalIF":1.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Intratumoral Ethanol Injection Followed by High-intensity Focused Ultrasound Ablation for Hyperintense Uterine Fibroids on T2-weighted Magnetic Resonance Images.","authors":"Kaiyin Qu, Zhi Wang, Min Zou, Wen Zhou, Jian Wang, Yu Xiong","doi":"10.4103/gmit.GMIT-D-24-00013","DOIUrl":"10.4103/gmit.GMIT-D-24-00013","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate the safety and efficacy of intratumoral ethanol injection followed by high-intensity focused ultrasound (HIFU) for hyperintense uterine fibroids on T2-weighted magnetic resonance images (T2WI).</p><p><strong>Materials and methods: </strong>Patients with hyperintense uterine fibroids who received intratumoral ethanol injection followed by HIFU in our hospital from January 2022 to February 2024 were retrospectively reviewed.</p><p><strong>Results: </strong>A total of 195 patients with 209 fibroids were pretreated with intratumoral ethanol injection before HIFU. The median volume of anhydrous ethanol injected in each patient was 10.0 (interquartile range: 5.0, 13.0) ml. During the procedure of intratumoral ethanol injection, 1 patient experienced facial flushing and 7 patients experienced coughing. The median sonication time of HIFU was 800.0 (interquartile range: 499.5, 1300) s. Significant grayscale change was observed in 133 (63.6%) fibroids, and homogeneous grayscale change was observed in 76 (36.4%) fibroids. The average nonperfused volume ratio (NPVR) of fibroids was 81.2% ±13.0%. No significant difference was observed in NPVR between fibroids using different volumes of ethanol (<i>P</i> > 0.05). The frequent adverse effects during HIFU were lower abdominal pain and sacrococcygeal region pain, with a median pain score of 3.0 (interquartile range: 2.0, 3.0) points. The frequent adverse effects after HIFU included vaginal discharge, lower abdominal pain, or sacrococcygeal pain. All adverse effects were minor. No severe adverse effects occurred.</p><p><strong>Conclusion: </strong>Intratumoral ethanol injection followed by HIFU treatment is safe and effective for hyperintense uterine fibroids. This strategy offers a new option for patients with hyperintense uterine fibroids who want to avoid surgery.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"36-43"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robert's Uterus: An Uncommon Presentation of Congenital Mullerian Duct Anomaly.","authors":"Pandit Palaskar, Samruddhi Pujalwar, Rinku Palaskar, Arun Sanap","doi":"10.4103/gmit.GMIT-D-24-00011","DOIUrl":"10.4103/gmit.GMIT-D-24-00011","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"93-95"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tips and Tricks for Laparoscopic Myomectomy: A Video Presentation.","authors":"Dalia Meky, Theofanis Manias, Nikolaos Tsampras","doi":"10.4103/gmit.GMIT-D-24-00047","DOIUrl":"10.4103/gmit.GMIT-D-24-00047","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"89-90"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}