Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia最新文献

{"title":"Surgical treatment of apical prolapse Number 9 - 2026.","authors":"Marair Gracio Ferreira Sartori, Luiz Gustavo de Oliveira Brito, Lucas Schreiner, Aljerry Dias do Rego, Ana Selma Bertelli Picoloto, Andreisa Paiva Monteiro Bilhar, Carlos Del Roy, Daniela Siqueira Prado, Emerson de Oliveira, Jorge Milhem Haddad, Jussara Maria Valentim Cavalcante Nunes, Leticia Maria de Oliveira, Marilene Vale de Castro Monteiro, Rafael Mendes Moroni, Sergio Brazileiro Martins","doi":"10.61622/rbgo/2026FPS9","DOIUrl":"10.61622/rbgo/2026FPS9","url":null,"abstract":"<p><p>Apical genital prolapse represents a failure of DeLancey's level I support. Isolated vaginal hysterectomy does not correct apical prolapse. All surgery for uterine or vaginal vault prolapse should include apical suspension. Sacrocolpopexy is the most durable technique for correcting vaginal vault prolapse, with the exception of colpocleisis. Vaginal techniques remain valid options in selected patients. Uterine preservation, when based on shared decision-making, is possible and safe for carefully evaluated patients. Recognition of the apical component in advanced cystocele is essential to prevent recurrence. Correction of the genital hiatus reduces the risk of recurrence, regardless of the surgical approach. Intraoperative cystoscopy is mandatory in vaginal uterosacral suspensions. Concomitant correction of stress urinary incontinence should be considered when diagnosed clinically or functionally.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586220","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":"Surgical management of endometriosis: surgical techniques, adjuvant therapy, and long-term management Number 10 - 2026.","authors":"Agnaldo Lopes da Silva, Sérgio Podgaec, Ricardo de Almeida Quintarios, Júlio César Rosa E Silva","doi":"10.61622/rbgo/2026FPS10","DOIUrl":"10.61622/rbgo/2026FPS10","url":null,"abstract":"<p><p>• Surgical outcomes in endometriosis vary substantially according to disease phenotype, symptom profile, and reproductive priorities. • Excisional surgery for ovarian endometriomas is associated with lower recurrence rates but carries a consistent risk of postoperative ovarian reserve impairment. • Surgery for deep infiltrating endometriosis is associated with meaningful improvement in pain and quality of life when clinical indications are appropriate and execution is precise, but entails higher surgical complexity and morbidity. • Repeat surgical interventions are associated with diminishing symptomatic benefit and increasing cumulative risk, including adhesion-related morbidity and the loss of both organ function and ovarian reserve. • Postoperative hormonal therapy may reduce symptom recurrence and the likelihood of repeat surgery in women not seeking immediate pregnancy. • Endometriosis surgery should be integrated into a long-term, multidisciplinary care model focused on symptom control and quality of life rather than disease eradication.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586217","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":"Abnormal uterine bleeding during menopausal hormone therapy: Number 8 - 2026.","authors":"Ana Lúcia Ribeiro Valadares, Luiz Francisco Cintra Baccaro, Lúcia Helena Simões da Costa-Paiva, Elizabeth Jeha Nasser, Elvira Maria Mafaldo Soares, Marco Aurélio Albernaz, Mario Vicente Giordano, Eliana Aguiar Petri Nahas, Jaime Kulak, Luciano de Melo Pompei, Márcio Alexandre Hipólito Rodrigues, Maria Celeste Osório Wender, Maria Célia Mendes, Mona Lucia Dall'Agno, Rita de Cassia Dardes, Rodolfo Strufaldi","doi":"10.61622/rbgo/2026FPS8","DOIUrl":"10.61622/rbgo/2026FPS8","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586187","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":"Patient blood management in pregnancy, the peripartum, and the postpartum period.","authors":"Agnaldo Lopes da Silva, Álvaro Luiz Lage Alves, Gabriel Costa Osanan","doi":"10.61622/rbgo/2026FPS7","DOIUrl":"10.61622/rbgo/2026FPS7","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586081","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":"Transcutaneous tibial nerve electrostimulation in the treatment of neurogenic overactive bladder syndrome after ischemic stroke.","authors":"Marcia Maria Gimenez, Rodrigo Aquino Castro, Rebecca Sotelo Pinheiro da Silva, Maria Augusta Tezelli Bortolini, Fatima Fani Fitz, Marcia Maiumi Fukujima, Emerson Oliveira, Marair Gracio Ferreira Sartori","doi":"10.61622/rbgo/2026rbgo43","DOIUrl":"10.61622/rbgo/2026rbgo43","url":null,"abstract":"<p><strong>Objective: </strong>To prospectively evaluate the effects of transcutaneous tibial nerve electrical stimulation (TTNS) on urinary symptoms and quality of life in women with neurogenic overactive bladder (nOAB) secondary to ischemic stroke (IS).</p><p><strong>Methods: </strong>This was a prospective case series with a six-month follow-up. Women with clinically and radiologically confirmed IS who developed nOAB symptoms persisting for more than six months after the cerebrovascular screened for eligibility. TTNS was administered twice weekly for six weeks, with 30 minute-minute sessions. Electrical stimulation was delivered at the sensory threshold using a fixed frequency of 10Hz and a pulse width of 250 µs. Outcomes were evaluated at baseline, immediately after treatment, and at six months using a one-week bladder diary and the King's Health Questionnaire (KHQ). Statistical analysis was performed using the Friedman test for repeated measures, with a significance threshold of p < 0.05.</p><p><strong>Results: </strong>Among 236 screened women with IS, 34 (21%) reported persistent nOAB symptoms; 31 completed the study protocol and were included in the final analysis. Mean age was 59.3 ± 13.6 years, and 67.7% were postmenopausal. Detrusor overactivity was identified in 51.6% of urodynamic studies. TTNS produced significant reductions in daytime frequency (11.95 to 6.99 voids/day post-treatment; 7.21 at follow-up), urgency episodes (13.32 to 0.97; 1.35 at follow-up), urge incontinence (9.19 to 0.26; 0.58 at follow-up), and nocturia (2.99 to 0.40; 0.64 at follow-up) (all p < 0.001). Significant improvements were observed across all KHQ domains, including general health perception (58.06 ± 24.48 to 30.65 ± 22.09), incontinence impact (60.22 ± 24.97 to 11.83 ± 22.02), physical and social limitations, emotional well-being, sleep and energy, and severity measures (all p < 0.001). Improvements were sustained at six months, with partial symptom recurrence in 19.6% and complete recurrence in 6.7% of participants.</p><p><strong>Conclusion: </strong>TTNS was associated with significant and sustained improvements in urinary symptoms and quality of life in women with post-stroke nOAB.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586154","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":"Insights about use of p57 in differentiation between complete and partial hydatidiform mole: a scoping review.","authors":"Isabelle Sasso Teixeira, Sheldon Rodrigo Botogoski, Renato Nisihara","doi":"10.61622/rbgo/2026rbgo16","DOIUrl":"10.61622/rbgo/2026rbgo16","url":null,"abstract":"<p><strong>Objective: </strong>To assess the utility of p57 in differentiating histological subtypes of hydatidiform mole and its applicability in clinical practice.</p><p><strong>Methods: </strong>A scoping review was conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. The article search was conducted in the PubMed, EMBASE, BVS, Cochrane, Web of Science, and Scopus databases. Studies published between 2015 and 2025 that evaluated the use of p57 in suspected cases of hydatidiform mole were included.</p><p><strong>Results: </strong>Nine studies met the inclusion criteria. Most demonstrated high specificity of p57 for CHM diagnosis and a significant reduction in diagnostic discordance compared to morphology alone. However, p57 does not distinguish PHM from non-molar abortions. In addition, rare cases of divergent p57 expression were reported, associated with genetic alterations that may require complementary evaluation using molecular techniques.</p><p><strong>Conclusion: </strong>IHC for p57 is a widely accessible, low-cost, and effective tool in clinical practice, particularly useful in resource-limited settings. Its routine use, in association with morphology and molecular methods when available, contributes to more accurate diagnoses and safer clinical management of GTDs.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586279","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":"Integrative decision-making in gynecology and obstetrics.","authors":"Ana Katherine Gonçalves","doi":"10.61622/rbgo/2026rbgo44","DOIUrl":"10.61622/rbgo/2026rbgo44","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586333","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":"Association between exposure to endocrine-disrupting chemicals and polycystic ovary syndrome: a systematic review.","authors":"Diemer Muñoz-Verbel, Eutimio Cueto-Almeida, Albeiro Marrugo-Padilla, Johana Márquez-Lázaro","doi":"10.61622/rbgo/2026rbgo19","DOIUrl":"10.61622/rbgo/2026rbgo19","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the available evidence on the association between endocrine disruptors and polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>A search was conducted in the MEDLINE (via PubMed); Science direct, Scopus and LILIACS databases for relevant studies published between 2013 and 2025. The inclusion criteria covered cohort, cross-sectional, and case-control studies published in English or Spanish. Data extraction and quality assessment were performed using the Joanna Briggs Institute (JBI) checklists, and the results were synthesized descriptively. The articles retrieved were reviewed by two evaluators; 49 were chosen for full-text review, 30 were included in the qualitative analysis.</p><p><strong>Results: </strong>This systematic review found that bisphenol A (BPA) is the most frequently associated endocrine disruptor with PCOS. This compound interferes with steroidogenesis by mimicking estrogen, which may contribute to insulin resistance and androgen dysfunction. Additionally, phthalates were found to be related to elevated androgen levels and ovarian dysfunction, while triclosan and cadmium were associated with hormonal imbalances affecting ovarian reserve and testosterone levels. Furthermore, perfluoroalkyl and polyfluoroalkyl substances (PFAS) were linked to reduced ovarian reserve and a higher prevalence of PCOS.</p><p><strong>Conclusions: </strong>The results of this review highlight the role of endocrine disruptors in the pathophysiology of polycystic ovary syndrome, emphasizing the need for further research to identify emerging disruptors and their potential mechanisms in the development of this disease. Therefore, it is crucial to adopt public health measures aimed at minimizing exposure to these compounds, particularly in women who are more susceptible to developing PCOS.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586240","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":"Assessment of the impact of nonavalent human papillomavirus vaccine on disease clearance time in women with active infection.","authors":"Nina Grillo, Rita Almendra, Cátia Correia","doi":"10.61622/rbgo/2026rbgo17","DOIUrl":"10.61622/rbgo/2026rbgo17","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) is a leading cause of cervical cancer (CC) worldwide. There is growing interest in the potential role of HPV vaccination as adjuvant measure in patients with active infection. This study aimed to assess whether the nonavalent HPV vaccine (9vHPV) promotes faster disease clearance in women with low-grade (LGD) and high-grade disease (HGD).</p><p><strong>Methods: </strong>Retrospective study including women aged 25-60 years who began follow-up in 2018 at a central Portuguese hospital after referral through organized CC screening. A total of 126 patients with HGD (69 vaccinated, 57 unvaccinated) and 277 with LGD (131 vaccinated, 146 unvaccinated) at baseline were followed with HPV cotesting (HPV test + cervical cytology) at 12, 18, 24, 36, and 48 months. Disease clearance was defined as the first negative cotest result. Kaplan-Meier curves and the Log Rank test were used to compare time to clearance between groups.</p><p><strong>Results: </strong>Among HGD patients, the vaccinated group showed a shorter mean time to disease clearance (17.4 months; 95% CI: 14.88-19.93) compared to the unvaccinated group (20.2 months; 95% CI: 17.07-23.34), although the difference was not statistically significant (p=0.228). In the LGD group, both vaccinated and unvaccinated patients had similar mean clearance times (25.9 months; 95% CI: 23.44-28.43 vs. 26.9 months; 95% CI: 24.41-29.37), also lacking statistical significance (p=0.637).</p><p><strong>Conclusion: </strong>Main findings suggest a negligible effect of 9vHPV in significantly reducing time to clearance in patients with active infection. Further research is needed to clarify its role in secondary prevention strategies.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586161","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":"Iron deficiency anemia in pregnancy: prevention, diagnosis and treatment: Number 5 - 2026.","authors":"Carlos Alberto Maganha, Antonio Alceu Dos Santos, Carolina Carvalho Mocarzel, Rone Peterson Cerqueira Oliveira, Isabel Cristina Céspedes, Rosiane Mattar","doi":"10.61622/rbgo/2026FPS5","DOIUrl":"10.61622/rbgo/2026FPS5","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586321","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}