Archives of Gynecology and Obstetrics最新文献

{"title":"Lateral suspension vs. sacral colpopexy for treating pelvic organ prolapse: a systematic review and meta-analysis.","authors":"Andrea Lombisani, Veronica Tius, Chiara Ferraro, Martina Arcieri, Lorenzo Vacca, Daniela Caramazza, Stefano Restaino, Tommaso Simoncini, Giampiero Capobianco, Alfredo Ercoli, Giovanni Scambia, Giuseppe Vizzielli, Giuseppe Campagna","doi":"10.1007/s00404-025-08210-4","DOIUrl":"https://doi.org/10.1007/s00404-025-08210-4","url":null,"abstract":"<p><strong>Purpose: </strong>Although sacral colpopexy is considered the gold standard for correcting apical prolapse, it is associated with extended operative times and surgical complications. An alternative surgical approach is currently being investigated. This meta-analysis aims to summarize and compare the available data on laparoscopic sacral colpopexy (LSCP) and laparoscopic lateral suspension (LLS) as per the Dubuisson technique.</p><p><strong>Methods: </strong>A systematic search of PubMed (MEDLINE) and Google Scholar was conducted from the inception of each database until December 2024. Studies comparing LSCP and LLS on at least one efficacy outcome selected. Objective or subjective success rate, surgery-related data and follow-up data were extracted. Results were pooled using a random-effect meta-analysis.</p><p><strong>Results: </strong>A total of 6 studies were included. The meta-analysis did not report statistical differences between LSCP and LLS in terms of apical prolapse [OR = 1.24; CI 95% (0.61, 2.52); I² = 0%; P = 0.55] and anterior prolapse [OR = 0.78; CI 95% (0.45, 1.37); I² = 0%; P = 0.39] correction. Subjective success rate was similar (P = 0.72). LLS required shorter operative time [43.1 min, CI 95% (16.75, 69.45); I² = 97%; P = 0.001]. No major differences were found regarding intraoperative and early post-operative complications, re-operation and recurrence rates. Follow-up data regarding quality of life showed no significant differences about de novo stress urinary incontinence, intestinal impairment, sexual function, and pain after surgery.</p><p><strong>Conclusions: </strong>LLS provides similar outcomes to LSCP for apical and anterior prolapse in selected cases. However, limited long-term data and few studies on advanced prolapse prevent LLS from being declared an equally effective alternative at this time.</p><p><strong>Prospero registration number: </strong>CRD42024537270.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At-home self-collection device offers an effective and preferred method to engage high BMI women in cervical cancer screening: method comparison study.","authors":"Clair Kaplan, LaShonda Crane, Ann Collins, R Lamar Parker, Ronald Orso, Colleen McNicholas, Elizabeth Sutton, Lisa Memmel, Christine Conageski, Youri Hwang, Lindsay Kuroki, Jenell Coleman, Sangini S Sheth, Kimberly Harshberger, Ashley Jennings, Emeline Aviki, Diane Harper, Meghna Mukherjee, Karl Hibler, Megan Burke Fitzpatrick","doi":"10.1007/s00404-025-08189-y","DOIUrl":"https://doi.org/10.1007/s00404-025-08189-y","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer (CxCa) screening rates are lower among women with high BMI in the US, leading to increased prevalence and worse outcomes from cervical dysplasia and cancer in this group. The main barriers to participation in screening relate to the in-clinic speculum exam, which could be overcome with an at-home self-collect (SC) screening device optimized for differing body types.</p><p><strong>Methods: </strong>This prospective method comparison study recruited 609 screening-eligible participants aged 25 to 65 years, enrolled from November 20, 2023, to April 5, 2024. SC was performed by the participant in a simulated home environment, using a novel device optimized for differing body sizes. Eligible participants collected a vaginal sample with the SC device, followed immediately by a clinician-collection (CC) sample using a speculum and broom. The sample pairs were shipped to the lab, where the SC sample was eluted into PreservCyt and tested on an FDA-approved high-risk human papillomavirus (hrHPV) test approved for primary screening. Participants completed usability and preference surveys. Endpoints included the detection of hrHPV between SC and CC samples, as well as other study measures, such as clinical sensitivity for high-grade cervical dysplasia, usability, and preferences by BMI category. Five hundred ninety (590/599) participants had data available for this sub-analysis, based on body mass index (height and weight were recorded via self-report). Results and preferences of participants with a higher BMI (≥ 35) are highlighted herein.</p><p><strong>Results: </strong>BMI ranged from 16 to 66 for the entire study group, with 114/590 (19.3%) representing a BMI of 35 or greater, comprising the analysis group. The agreement for detection of hrHPV was equivalent across BMI categories. Over a third (36.8%) of participants in Class II (BMI: 35-40) and Class III (BMI > 40) categories had delayed or avoided their cervical cancer screening, and 91% reported that they would be more likely to stay up to date with routine screening if an at-home self-collect option were available. Preferences for self-collect among women in Class II + categories were higher for a self-collect option for screening, reporting that SC made them feel more in control of their experience.</p><p><strong>Discussion: </strong>In women with a BMI ≥ 35, cervical cancer screening by SC with this uniquely designed device demonstrated equivalent or superior HPV detection performance and was strongly preferred by participants. Offering this option could improve screening rates in women with BMI ≥ 35, a group that represents a significant portion of the US population who delay screening and help reduce disparities in cervical cancer incidence and outcomes.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Pilates on sleep quality, eating disorders and occupational balance in pregnant women.","authors":"Fatma Tayhan, Aysenur Karakus","doi":"10.1007/s00404-025-08202-4","DOIUrl":"https://doi.org/10.1007/s00404-025-08202-4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of Pilates exercise during pregnancy on sleep quality, eating disorder symptoms, and occupational balance.</p><p><strong>Methods: </strong>This cross-sectional observational comparative study included 120 pregnant women: a Pilates group (n = 60, age = 27.98 ± 3.99) and a non-Pilates group (n = 60, age = 28.90 ± 4.25). Sleep quality, disordered eating, and occupational balance were assessed using the Pittsburgh Sleep Quality Index (PSQI), Eating Disorder Examination Questionnaire (EDE-Q), and Occupational Balance Questionnaire (OBQ), respectively. Statistical analyses included t-tests, chi-square tests, and multiple linear regression models.</p><p><strong>Results: </strong>Demographic characteristics were similar between the groups. The Pilates group showed better sleep quality (PSQI: 3.90 ± 1.26 vs. 6.28 ± 2.67, p < 0.001), fewer eating disorder symptoms (EDE-Q: 0.23 ± 0.36 vs. 1.26 ± 0.99, p < 0.001), and higher occupational balance (OBQ: 21.16 ± 1.94 vs. 18.43 ± 3.61, p < 0.001). Regression analyses revealed that Pilates participation was a significant predictor of sleep quality (B = - 1.694, p < 0.001), eating disorder symptoms (B = - 0.965, p < 0.001), and occupational balance (B = 1.550, p = 0.007). Additionally, poor sleep quality and higher eating disorder scores were associated with lower occupational balance (both p < 0.05).</p><p><strong>Conclusion: </strong>Pilates during pregnancy may enhance maternal well-being by improving sleep, reducing disordered eating, and promoting occupational balance. These findings support the integration of structured, meaningful physical activity like Pilates into prenatal care routines.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the risk factors for relaparotomy following cesarean delivery.","authors":"Liri Lewi, Gil Gutvirtz, Tamar Wainstock, Gali Pariente, Eyal Sheiner","doi":"10.1007/s00404-025-08199-w","DOIUrl":"https://doi.org/10.1007/s00404-025-08199-w","url":null,"abstract":"<p><strong>Purpose: </strong>Cesarean delivery (CD) is the most common obstetrical surgery with increasing rates worldwide. Although considered relatively safe, intra- and post-operative complications have been reported. One rare, but significant, complication after CD is relaparotomy. The present study was conducted to define risk factors for relaparotomy following a CD.</p><p><strong>Methods: </strong>A case-control study was conducted comparing all singleton CD that occurred in a tertiary medical center between the years 1991 and 2021. CDs complicated by relaparotomy (defined as the reopening of the fascia) were compared with CDs that were not complicated by relaparotomy. Generalized estimation equation (GEE) models were constructed to control for confounding variables.</p><p><strong>Results: </strong>During the study period, 49,922 CDs met our inclusion criteria, of them, 97 (0.2%) had undergone relaparotomy. The group of women complicated with relaparotomy tended to be multiparous and to have undergone a previous CD. Furthermore, these women had higher rates of placental complications (placenta previa, abruption and placenta accreta), preterm delivery, preeclampsia and chorioamnionitis. They also had higher rates of cervical tears and post-partum hemorrhage. Their neonates had lower birth weight and lower 5 min Apgar scores. In a GEE model, several independent risk factors for relaparotomy following CD were noted, with cervical tear being the most prominent (adjusted OR = 27.15, 95%CI 9.32 - 79.13, p < 0.001).</p><p><strong>Conclusion: </strong>Independent risk factors for relaparotomy following CD include cervical tear, placenta previa and accreta, placental abruption, preterm delivery, preeclampsia, and a previous CD. These risk factors should be taken into account when dealing with high-risk patients expected to undergo repeated CD.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"eHealth educational intervention: effects of an online video program in prevention of the pelvic women's health-a non-randomized experimental study.","authors":"Laura Fuentes-Aparicio, Fernando Domínguez-Navarro, Ana Maudos-Soriano, David Hernández-Guillén","doi":"10.1007/s00404-025-08200-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08200-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the effects of an online educational video program on pelvic floor health knowledge, sexual function, quality of life, and motivation for physical activity in women engaged in low- and high-intensity exercise.</p><p><strong>Methods: </strong>A two-arm clinical trial was conducted with 60 women aged 18-35, divided into low- and high-intensity activity groups. Participants completed a six-week online video course covering pelvic floor anatomy, function, and self-management. Pre- and post-intervention assessments included validated questionnaires: PIKQ (pelvic floor knowledge), FSFI-19 (sexual function), BREQ-2 (exercise motivation), and EQOL-6D (quality of life). Data were analyzed using repeated measures ANOVA.</p><p><strong>Results: </strong>Pelvic floor knowledge improved significantly in both groups (low-intensity: p < 0.001, d = 0.668; high-intensity: p < 0.001, d = 0.825), especially in POP-related knowledge (p < 0.001). Sexual function improved in desire (p = 0.046) and arousal (p = 0.027) for the low-intensity group, and in pain during intercourse for the high-intensity group (p = 0.049). No significant changes were found in exercise motivation (p > 0.05). Anxiety and depression scores improved only in the low-intensity group (p = 0.031).</p><p><strong>Conclusions: </strong>The online program effectively enhanced pelvic floor knowledge and aspects of sexual function, showing promise as a preventive educational tool for active women.</p><p><strong>Trial registration: </strong>Registered in ClinicalTrials.gov (NCT05667012). Last update: 2024-12-06.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Prevention of spontaneous preterm birth.","authors":"Georgios Daskalakis, Maria Goya, Vasilios Pergialiotis, Luis Cabero, Ioannis Kyvernitakis, Aris Antsaklis, Birgit Arabin","doi":"10.1007/s00404-025-08152-x","DOIUrl":"https://doi.org/10.1007/s00404-025-08152-x","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the clinical manifestations associated with isthmocele: a meta-analysis study.","authors":"Foruzan Sharifipour, Zahra Javanbakht, Parichehr Nouri, Shahla Faal Siahkal","doi":"10.1007/s00404-025-08188-z","DOIUrl":"https://doi.org/10.1007/s00404-025-08188-z","url":null,"abstract":"<p><strong>Purpose: </strong>Isthmocele is recognized as a potential complication following cesarean delivery. Women affected by isthmocele experience an increased risk of various complications throughout their lives. The objective of this study was to investigate the clinical manifestations associated with isthmocele.</p><p><strong>Materials and methods: </strong>A systematic search was conducted across Medline, Scopus, and Web of Science for studies potentially eligible for inclusion as of November 6, 2024. All observational studies that evaluated the clinical symptoms associated with isthmocele were considered for this systematic review. The outcomes of interest included abnormal bleeding (hypermenorrhea, polymenorrhagia, amenorrhea, and spotting), dyspareunia, dysmenorrhea, pelvic pain, vaginal discharge, and urinary incontinence. Data extraction and statistical analyses were performed using EndNote X9 and Review Manager software, respectively. The NIH Quality Assessment Tool for Observational Studies was utilized to assess the quality of the included studies.</p><p><strong>Results: </strong>Out of 5,530 studies reviewed, eight studies met the criteria for inclusion in this review. A total of 703 women with isthmocele were compared to 754 women without isthmocele regarding clinical symptoms. The findings indicated that isthmocele was positively correlated with the incidence of vaginal spotting (odds ratio (OR) = 2.39, 95% CI 1.79, 3.19; I² = 71%, P < 0.00001, N = 6), and amenorrhea (OR = 3.00, 95% CI 1.89, 4.76; I² = 0%, P < 0.00001, N = 2). No other significant relationships between isthmocele and additional clinical manifestations were identified.</p><p><strong>Conclusion: </strong>The results of this study demonstrate a positive correlation between isthmocele and the incidence of amenorrhea and vaginal spotting. A comprehensive understanding of the clinical manifestations associated with isthmocele could contribute to improved care for women affected by this condition.</p><p><strong>Prospero id: </strong>CRD42024619952.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep pelvic endometriosis: clinical features, diagnosis, and treatment - a comprehensive review.","authors":"Faruk Abike, Fatma Basak Tanoglu, Guliz Sidar","doi":"10.1007/s00404-025-08187-0","DOIUrl":"https://doi.org/10.1007/s00404-025-08187-0","url":null,"abstract":"<p><p>Deep infiltrative endometriosis (DIE) is characterized by the infiltration of endometrial tissue into the pelvic organs, such as the rectovaginal septum, utero-ovarian, and uterosacral ligaments. Bowel involvement occurs in approximately 3.8-37% of cases, whereas urinary tract involvement is less common (1-6%). The pathophysiology of DIE includes deep infiltration of endometrial tissue into the peritoneum, with the gastrointestinal system being a common site. The pathogenesis of endometriosis involves hormonal functional changes in estrogen and progesterone receptors and the influence of immune factors like peritoneal macrophages, natural killer cells, and lymphocytes. Diagnostic methods, including transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI), play crucial roles in identifying and assessing endometriosis. Medical treatment options include oral contraceptives, progesterone pills and devices, and gonadotropin-releasing hormone (GnRH) analogs or antagonists. Surgical treatment options are shave excision, disc excision, and colorectal resection. This review provides a comprehensive overview of DIE, its pathophysiology, diagnostic methods, treatment options, as well as implications for fertility and pregnancy outcomes.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline Z-scores in non-invasive prenatal screening: does its presence hold clinical significance?","authors":"Xiaoli Pan, Lixin Weng, Yun Pan, Shuqing Pan, Shanshan Wu, Changshui Chen, Haibo Li","doi":"10.1007/s00404-025-08193-2","DOIUrl":"https://doi.org/10.1007/s00404-025-08193-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the utility of repeated testing for the detection of fetal cell-free DNA (cfDNA) from maternal peripheral blood in cases with borderline Z-scores and to analyze the associated pregnancy outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 83,443 pregnant women who voluntarily underwent non-invasive prenatal testing (NIPT) at the Affiliated Women and Children's Hospital of Ningbo University between January 2020 and January 2024. Pregnant women whose initial NIPT results indicated borderline Z-scores were subsequently followed up.</p><p><strong>Results: </strong>Among 83,443 pregnant women undergoing NIPT, 700 cases (0.84%) initially showed borderline Z-scores. After retesting, this number decreased to 211 cases (0.25%) and further decreased to 26 cases (0.03%) after re-sampling. Among the initial 700 cases, 34 exhibited abnormal NIPT results, corresponding to a positive rate of 5.29%. Subsequent prenatal diagnosis confirmed a total of six fetal abnormalities, including one case of trisomy 13 mosaicism, one case of trisomy 21 mosaicism, one case of 47,XXY, two cases of copy number variations (CNVs), and one case with B-ultrasound findings indicating an abnormality (nuchal translucency [NT] of 3.5 mm and omphalocele). The overall rate of fetal abnormalities was 0.9%.</p><p><strong>Conclusion: </strong>Initial NIPT outcomes suggested elevated screening positive rates and a higher incidence of fetal abnormalities among cases with borderline Z-scores compared to the general population. Establishing a defined borderline Z-score threshold in NIPT protocols is crucial to mitigate the risk of missed screenings. Implementing re-construction and/or re-sampling procedures significantly reduces the failure rate attributed to borderline Z-scores, facilitating the accurate identification of most of pregnancies with normal fetal development and decreasing the need for unnecessary invasive prenatal diagnostic interventions. Pregnant women with detection failures due to borderline Z-scores should be actively counseled and encouraged to pursue prenatal diagnosis.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal Natural orifice transluminal endoscopic hysterectomy vs. abdominal laparoscopic approach in real-life practices: a retrospective cohort study.","authors":"Ala Aiob, Yara Nakhleh Francis, Haya Hebi, Saaed Awwad, Susana Mustafa Mikhail, Avishalom Sharon, Inshirah Sgayer, Lior Lowenstein","doi":"10.1007/s00404-025-08195-0","DOIUrl":"https://doi.org/10.1007/s00404-025-08195-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to retrospectively evaluate the surgical outcomes of total hysterectomy performed via Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) compared to laparoscopic hysterectomy (LAP) in treating benign gynecologic conditions in a real-world clinical setting.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at Galilee Medical Center, Israel, between March 2021 and 2023. A total of 133 women were included in the study. The vNOTES group comprised 58 women, while 75 women underwent LAP. All women eligible for laparoscopic hysterectomy for benign conditions were offered the vNOTES approach. Exclusion criteria included prior pelvic radiation, active genital infections, rectovaginal endometriosis, or the need for oncogynecologic surgery related to malignancy.</p><p><strong>Results: </strong>The vNOTES group demonstrated significantly shorter operative times (69.5 vs. 117.4 min, p < 0.001) and anesthesia durations (102 vs. 146.3 min, p < 0.001), as well as reduced blood loss (108.6 mL vs. 237.9 mL, p < 0.001) compared to the LAP group. Postoperative pain, assessed by VAS scores, was significantly lower in the vNOTES group than in the LAP group (2.33 vs. 3.11, p = 0.013), with fewer requests for intravenous analgesics. No significant differences were observed between the groups in complication rates, conversion to laparotomy, or postoperative hospital stays.</p><p><strong>Conclusion: </strong>The vNOTES hysterectomy demonstrated shorter operative and anesthesia times, reduced blood loss, lower postoperative pain, and intravenous analgesic requirements compared to laparoscopic hysterectomy, without increasing complication rates. These findings suggest that vNOTES offers a viable, minimally invasive alternative to conventional laparoscopic hysterectomy for the treatment of benign gynecologic conditions. Further prospective studies are needed to assess long-term outcomes and the impact on quality of life.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}