Archives of Gynecology and Obstetrics最新文献

{"title":"Hormonal therapy or chemotherapy for advanced endometrial cancer? A mixed-methods study assessing physicians’ attitudes","authors":"Willem Jan van Weelden,&nbsp;Julia Mesu,&nbsp;Petronella B. Ottevanger,&nbsp;Johanna M.A. Pijnenborg,&nbsp;Johanna W.M. Aarts","doi":"10.1007/s00404-026-08486-0","DOIUrl":"10.1007/s00404-026-08486-0","url":null,"abstract":"<div><h3>Purpose</h3><p>Hormonal therapy and chemotherapy are common systemic therapy options in advanced and recurrent endometrial cancer. There is limited consensus on factors that affect therapy selection. This study aims to gain insight into those factors at the level of clinical decision-making and at the level of patient- and tumor-specific factors.</p><h3>Methods</h3><p>We performed an international cross-sectional study among medical oncologists and gynecologists. The survey consisted of (1) statements about barriers and facilitators that affect the process of decision-making and (2) hypothetical vignette cases investigating three patients and tumor factors that were tested with three levels each. Results were analyzed with descriptive statistics and linear mixed-effects models.</p><h3>Results</h3><p>167 physicians responded to the survey. The most important facilitating factors were: understanding the patient’s personal context and the role of multidisciplinary tumor board discussions. The most important barrier was the lack of evidence for prediction of response to hormonal therapy and chemotherapy. The three patient and tumor factors included in the vignette cases were severity of symptoms, performance status, and progesterone-receptor (PR) expression in the tumor. PR expression and performance status were most discriminative, with high PR expression and poor performance status favoring hormonal therapy.</p><h3>Conclusion</h3><p>The provision of personalized care in palliative treatment of endometrial cancer can be improved by multidisciplinary tumor board discussions with the personal context and preference of the patient in mind. The patient factors, severity of symptoms and WHO performance status, and the tumor factor, PR tumor expression, were most relevant for selecting hormonal therapy or chemotherapy.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08486-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the 7th October war on preterm birth rates and neonatal outcomes: a retrospective comparative study from northern Israel","authors":"Raghda Zidan Sweid,&nbsp;Adi Sharabi Nov,&nbsp;Hana Helfgot,&nbsp;Steven L. Warsof,&nbsp;Inbar Ben-Shachar","doi":"10.1007/s00404-026-08483-3","DOIUrl":"10.1007/s00404-026-08483-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Maternal psychological stress is associated with adverse obstetric and neonatal outcomes, including preterm birth and low birthweight. Warfare represents a significant source of acute and chronic stress, yet its impact on pregnancy outcomes remains unclear. This study aimed to evaluate the association between a 6-month period of continuous wartime exposure following October 7, 2023, during the “Iron Swords” conflict and preterm birth, neonatal outcomes, and obstetric management.</p><h3>Methods</h3><p>This retrospective cohort study included all deliveries at ZIV Medical Center during the 6-month conflict period, compared with a pre-war cohort from 2021 until October 6, 2023. The primary outcome was preterm birth (&lt; 37 weeks). Secondary outcomes included early preterm birth (&lt; 34 weeks), labor induction, mode of delivery, maternal complications, and neonatal outcomes. Multivariate logistic regression was used to identify independent predictors of preterm birth.</p><h3>Results</h3><p>A total of 699 conflict-period deliveries were compared with 7821 pre-war deliveries. Preterm birth rates were similar (&lt; 37 weeks: 6.6% vs. 5.5%; &lt; 34 weeks: 2.1% vs. 1.5%). Labor induction was markedly lower during the conflict (oxytocin 23.7% vs. 38.7%; cervical ripening balloon 3.3% vs. 7.7%; prostaglandins 4.1% vs. 6.5%), accompanied by reduced postpartum hemorrhage (7.9% vs. 12%). Neonatal outcomes, including birthweight distribution, NICU admissions, and survival, were comparable or slightly improved.</p><h3>Conclusion</h3><p>Prolonged wartime exposure was not associated with increased rates of preterm birth or adverse neonatal outcomes. Lower rates of obstetric intervention were observed during the conflict period and coincided with lower rates of maternal complications, although causality cannot be established.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08483-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Indication-dependent heterogeneity in the effect of double-suture cerclage: concerns over indication classification and a call for stratified analysis","authors":"Edis Kahraman,&nbsp;Nadiye Köroğlu,&nbsp;Turgut Aydın,&nbsp;Mehmet Aytaç Yüksel","doi":"10.1007/s00404-026-08485-1","DOIUrl":"10.1007/s00404-026-08485-1","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08485-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the role of follicular output rate in clinical and embryological outcomes in IVF: a prospective study","authors":"Arshiya Firdaus,&nbsp;Anjali S. Mundkur,&nbsp;Vidyashree G. Poojari,&nbsp;Pratap Kumar,&nbsp;Srisailesh Vitthala,&nbsp;Prashanth K. Adiga","doi":"10.1007/s00404-026-08487-z","DOIUrl":"10.1007/s00404-026-08487-z","url":null,"abstract":"<div><h3>Purpose</h3><p>To examine the association between follicular output rate (FORT) and embryological and clinical outcomes, including live birth rate, in patients undergoing in vitro fertilization (IVF).</p><h3>Methods</h3><p>This prospective cohort study enrolled 166 patients undergoing IVF between October 2023 and January 2025. FORT was calculated as the ratio of pre-ovulatory follicles (16–24 mm) on trigger day to baseline antral follicle count (AFC; 3–9 mm), multiplied by 100. Patients were stratified into low, medium, and high FORT tertiles, and FORT was also evaluated as a continuous variable in multivariable logistic regression. An exploratory receiver operating characteristic (ROC) analysis was performed to assess discriminatory performance and to identify a data-derived reference threshold. All analyses were conducted separately for non-PCOS and PCOS cohorts.</p><h3>Results</h3><p>In non-PCOS patients (n = 136), the number of oocytes retrieved, mature oocytes, and good-quality embryos differed significantly across FORT tertiles (all p &lt; 0.05). Clinical pregnancy rates were 14.9%, 27.8%, and 37.2% in the low, medium, and high FORT groups respectively (p = 0.045), with corresponding differences in live birth rates (p = 0.049). On multivariable analysis, FORT (OR 1.04; 95% CI 1.002–1.079; p = 0.039) and the number of available embryos (OR 1.35; 95% CI 1.082–1.676; p = 0.008) remained independently associated with clinical pregnancy. Exploratory ROC analysis yielded an AUC of 0.607 (95% CI 0.52–0.69). A data-derived reference threshold of FORT at 64.2% was associated with higher clinical pregnancy rates compared with lower FORT values (40.9% vs. 23.3%; p = 0.030; OR 2.27, 95% CI 1.14–4.55). No significant associations were observed in the PCOS subgroup, though this analysis was limited by small sample size (n = 30).</p><h3>Conclusions</h3><p>FORT is significantly associated with embryological and clinical pregnancy outcomes, including live birth, in non-PCOS IVF patients. As a cycle-specific functional measure of follicular responsiveness, FORT may complement static ovarian reserve markers for counselling and outcome stratification. FORT values in the higher range (approximately ≥ 65%) were associated with improved clinical pregnancy rates, but the limited discriminatory performance of the ROC analysis underscores the need for external prospective validation of this cutoff before any clinical implementation.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08487-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtype matters: ovarian endometriosis impairs ovarian reserve and embryo quality—should these patients consider fertility preservation?","authors":"C. Meyer,&nbsp;C. Staib,&nbsp;S. Löb,&nbsp;A. Altides,&nbsp;M. Schwab,&nbsp;J. Büchel,&nbsp;A. Scherer-Quenzer,&nbsp;M. Kiesel,&nbsp;A. Wöckel,&nbsp;S. L. Herbert","doi":"10.1007/s00404-026-08446-8","DOIUrl":"10.1007/s00404-026-08446-8","url":null,"abstract":"<div><h3>Research question</h3><p>Which patients with endometriosis suffer from diminished ovarian reserve as well as impaired embryo quality and therefore could benefit from medical freezing as part of fertility preservation strategies?</p><h3>Design</h3><p>This retrospective study analyzed 205 patients who underwent follicle puncture at our center in preparation for IVF/ICSI treatment. All patients with laparoscopically confirmed endometriosis were classified according to rASRM and #ENZIAN. In total, 183 follicle punctures and 168 embryos were evaluated. Anti-Müllerian hormone (AMH) levels, the antral follicle count (AFC), the number of retrieved oocytes as well as the rate of mature oocytes and the fertilization rate were compared among the different subtypes of endometriosis. Embryo quality was assessed by the KIDScore™ on days 3 and 5.</p><h3>Results</h3><p>The analyses revealed significant differences in the AFC among patients with peritoneal (mean AFC: 16.43), deep-infiltrating (11.84) and ovarian endometriosis (10.85) (<i>p</i> = 0.006). The largest difference was observed between superficial and ovarian endometriosis (<i>p</i> = 0.004). The number of retrieved oocytes also differed significantly among the subgroups (<i>p</i> = 0.012), with the strongest contrast between deep-infiltrating (11.18) and ovarian endometriosis (8.14). Although the AFC, AMH and number of retrieved oocytes were strongly correlated, AMH alone did not differ significantly between the subgroups. The rate of mature oocytes was the lowest in patients with deep-infiltrating endometriosis but did not reach statistical significance. Patients with endometriomas presented the lowest fertilization rates and KIDScore™ values; however, only the difference in KIDScore™ D5 reached statistical significance (FR: <i>p</i> = 0.077, D3: <i>p</i> = 0.659, D5: <i>p</i> = 0.005).</p><h3>Conclusions</h3><p>Endometriosis subtypes differ in their impact on the ovarian reserve. Patients with ovarian endometriosis exhibit a diminished ovarian reserve, reflected by a lower AFC, a lower number of retrieved oocytes and lower number of mature oocytes. Additionally, a lower embryo quality was also observed. These findings could not be replicated in patients with superficial or deep-infiltrating endometriosis. Our study highlights the importance of identifying the specific form of endometriosis. Given that diminished ovarian reserve and recued embryo quality were observed at the time of reproductive therapy, we propose that early elective oocyte cryopreservation may help prevent these adverse outcomes, particularly in patients with ovarian endometriosis. However, additional factors and fertility preservation strategies should be taken into account when considering its indication and fertility preservation strategy in patients with deep-infiltrating or superficial endometriosis.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08446-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of chromosomal abnormalities in miscarriages using single-nucleotide polymorphism arrays","authors":"Wantong Zhao,&nbsp;Haiwei Wang,&nbsp;Bin Liang,&nbsp;Hailong Huang,&nbsp;Na Lin,&nbsp;Liangpu Xu","doi":"10.1007/s00404-026-08337-y","DOIUrl":"10.1007/s00404-026-08337-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Chromosome abnormalities are a known cause of miscarriage. A detailed chromosomal study in miscarriages is delineated using high-throughput technologies.</p><h3>Methods</h3><p>564 miscarriages were collected, and the chromosomal abnormalities, including triploidy, trisomy, monosomy, uniparental disomy, and chromosomal deletions/duplications in miscarriages, were detected by high-throughput single-nucleotide polymorphism (SNP) array.</p><h3>Results</h3><p>There were 336 (59.6%) miscarriages with chromosomal abnormalities, including 325 (57.6%) miscarriages with pathogenic variants and 11 (2%) miscarriages with variations of unknown significance (VOUS). The remaining 228 (40.4%) miscarriages had no clinically relevant chromosomal variants. Among the 325 miscarriages with pathogenic variants, 23 miscarriages had triploidy and two miscarriages showed genome-wide uniparental disomy. Trisomy was found in 225 miscarriages and involved nearly every chromosome. Monosomy X was found in 39 miscarriages. Also, 32 miscarriages were with partial chromosomal deletions/duplications, particularly in 8p23 and Xp22 regions.</p><h3>Conclusions</h3><p>Our results confirmed that trisomy and monosomy X are potentially the most common causes of miscarriage. We also showed that chromosomal pathogenic deletions/duplications are involved with miscarriage. However, still nearly 40% of miscarriages had no chromosomal variants detected by SNP array. This may be attributed to a single gene mutation that requires high-throughput sequencing.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08337-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-delivery prediction of vaginal delivery in late-onset foetal growth restriction: development and internal validation of a model with decision curve analysis and bedside calculator","authors":"Manal Massalha,&nbsp;Misgav Rottenstreich,&nbsp;Bryon DeFrance,&nbsp;Kinga Malinowski,&nbsp;Jon F. Barrett,&nbsp;Eran Ashwal","doi":"10.1007/s00404-026-08462-8","DOIUrl":"10.1007/s00404-026-08462-8","url":null,"abstract":"<div><h3>Purpose</h3><p>Foetal growth restriction (FGR) complicates 5–10% of pregnancies and is a major contributor to perinatal morbidity and mortality. In late-onset FGR, induction of labour is recommended; however, intrapartum caesarean rates remain high (20–40%). Accurate counselling regarding the likelihood of vaginal delivery is essential, yet no validated prediction model exists for this population. We aim to develop and internally validate a pre-delivery prediction model for vaginal delivery in patients with late-onset FGR undergoing a trial of labour, and to assess its clinical utility.</p><h3>Methods</h3><p>This retrospective cohort study included singleton pregnancies with late-onset FGR managed at a tertiary centre (2017–2024). Eligible patients had no prior caesarean delivery, underwent attempted labour, and had complete Doppler assessment within 7 days of delivery. Logistic regression models were constructed using clinical and Doppler variables. Internal validation was performed using bootstrap resampling, and clinical utility was assessed with decision curve analysis.</p><h3>Results</h3><p>Among 477 patients, 378 (79.2%) achieved vaginal delivery. Nulliparity (OR 0.22, 95% CI 0.12–0.38; <i>p</i> &lt; 0.001), pre-pregnancy BMI (OR 0.93 per kg/m², 95% CI 0.90–0.96; <i>p </i>&lt; 0.001), abnormal cerebroplacental ratio (OR 0.47, 95% CI 0.28–0.78; <i>p</i> = 0.004), and pre-gestational diabetes (OR 0.28, 95% CI 0.10–0.78; <i>p</i> = 0.015) were independently associated with lower odds of vaginal delivery. The model demonstrated moderate discrimination (AUC 0.74, 95% CI 0.70–0.80) and good calibration, with net benefit above a 55% threshold.</p><h3>Conclusion</h3><p>This four-variable model provides individualised prediction of vaginal delivery in late-onset FGR. External validation is required before clinical implementation.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08462-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NIPT-based prenatal screening of maternal Xq28 copy number variations in a cohort of 80,371 pregnancies","authors":"Lulu Meng,&nbsp;Yiyun Xu,&nbsp;Yixuan Liang,&nbsp;Ran Zhou,&nbsp;Jingyu Zhao,&nbsp;Haiqin Huo,&nbsp;Qinxin Zhang,&nbsp;Jie Gao,&nbsp;Tingting Liu,&nbsp;Min Dai,&nbsp;Peina Du,&nbsp;Yan Wang,&nbsp;Ping Hu,&nbsp;Zhengfeng Xu","doi":"10.1007/s00404-026-08482-4","DOIUrl":"10.1007/s00404-026-08482-4","url":null,"abstract":"<div><h3>Purpose</h3><p>Copy number variation (CNVs) can result in various genomic diseases and variable clinical phenotypes. This study aimed to assess the feasibility and reliability of noninvasive prenatal testing (NIPT) for prenatal screening of maternal copy number variation (CNVs) involving the Xq28 recurrent region.</p><h3>Methods</h3><p>In this retrospective, single-center study, we analyzed the NIPT data of 80,371 pregnant women to detect the maternal CNVs from 2017 to 2022. Maternal CNVs involving the int22h1/int22h2-mediated chromosome Xq28 recurrent region detected by NIPT were focused on. Chromosomal microarray analysis (CMA) was then performed to validate NIPT results if the remaining maternal lymphocytes were available.</p><h3>Results</h3><p>A total of 48 (0.060%, 95% CI 0.045% ~ 0.079%) maternal CNVs involving int22h1/int22h2-mediated chromosome Xq28 recurrent region were identified by NIPT, including 29 (0.036%, 95% CI 0.025% ~ 0.052%) pathogenic deletions sizing from 128.1 kb to 93,244.3 kb, 17 (0.021%, 95% CI 0.013% ~ 0.034%) pathogenic duplications sizing from 442.5 kb to 2059.1 kb and two (0.002%, 95% CI 0.000% ~ 0.009%) variants of uncertain significance (VOUS) sizing from 215.2 kb to 326.1 kb. The detection rates of typical Xq28 recurrent microdeletions and microduplications were 0.005% (4/80,371, 95% CI 0.002% ~ 0.013%) and 0.006% (5/80,371, 95% CI 0.003% ~ 0.015%), respectively. Chromosomal microarray analysis (CMA) was performed to validate NIPT results in 22 cases for which remaining maternal lymphocytes were available. The positive predictive value (PPV) of NIPT for maternal CNV’s detection in the 22 cases was 100.0% (95% CI 85.1% ~ 100.0%).</p><h3>Conclusions</h3><p>This study illustrated the feasibility and potential of NIPT to detect maternal CNVs involving the Xq28 recurrent region.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08482-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative in vivo assessment of surgical smoke particle exposure from different energy modalities during gynecologic laparoscopy","authors":"Samer El-Safadi,&nbsp;Carolin Elena Bautista,&nbsp;Ivo Meinhold-Heerlein,&nbsp;Thilo Schwandner,&nbsp;Felix Zeppernick,&nbsp;Isabela Perales,&nbsp;Tatiana Pfiffer,&nbsp;Andrea Plaikner,&nbsp;Christhardt Köhler,&nbsp;Giovanni Favero","doi":"10.1007/s00404-026-08410-6","DOIUrl":"10.1007/s00404-026-08410-6","url":null,"abstract":"<div><h3>Background</h3><p>Minimally invasive surgery (MIS) is widely used in gynecology because of its perioperative advantages over open surgery. However, concerns regarding the oncologic safety of MIS in early-stage cervical cancer have renewed interest in potential mechanisms of tumor cell dissemination during laparoscopic procedures. Surgical smoke generated by electrosurgical instruments has emerged as one possible factor. Although composed mainly of water vapor, surgical plume contains particulate matter produced during thermal tissue destruction and has been associated with occupational exposure risks and impaired intraoperative visibility. Nevertheless, quantitative in vivo data on particle generation during laparoscopic surgery remain limited.</p><h3>Objective</h3><p>This prospective study is the first to quantify particle size and concentration in electrosurgical smoke during laparoscopic procedures, assessing their potential role in tumor recurrence.</p><h3>Methods</h3><p>Using advanced laser-based detection, particle emissions were measured during laparoscopic surgeries for benign diseases in 40 patients. Data were analyzed to assess correlations between particle load, surgical duration, and instrument type (monopolar vs. bipolar).</p><h3>Results</h3><p>Monopolar devices produced approximately 100 times more particles than bipolar instruments, highlighting a substantial disparity in emission. While bipolar tools generated significantly fewer and larger particles, monopolar energy produced mostly small ones (0.3–5 µm). The overwhelming particle load from monopolar electrosurgery was strongly correlated with longer operative times and more intensive instrument use.</p><h3>Conclusion</h3><p>Monopolar electrosurgical instruments generated substantially higher concentrations of surgical smoke particles than bipolar devices during laparoscopic surgery, particularly in the fine particle range. Although measured during benign gynecologic procedures and without biological plume analysis, these findings provide important in vivo data on particle generation. Improved understanding of surgical smoke dynamics may inform strategies to reduce aerosol exposure and guide future investigations in minimally invasive gynecologic oncologic surgery, particularly in the context of cervical cancer.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08410-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual functioning after total versus subtotal laparoscopic hysterectomy—long term follow up results after 7 years","authors":"Tobias Brodkorb,&nbsp;Ahmed Elnahrawy,&nbsp;Saskia Spaich,&nbsp;Marc Sütterlin,&nbsp;Sebastian Berlit,&nbsp;Benjamin Tuschy,&nbsp;Lukas Goerdt","doi":"10.1007/s00404-026-08479-z","DOIUrl":"10.1007/s00404-026-08479-z","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to evaluate sexual function in the long term after total laparoscopic hysterectomy (TLH) versus laparoscopic supracervical hysterectomy (LASH) in patients with benign indications.</p><h3>Methods</h3><p>As part of a longitudinal follow-up, 74 patients who had originally participated in a prospective study on sexual function after TLH or LASH were surveyed again (TLH: n = 45; LASH: n = 29). The median follow-up period was 92 months (TLH) and 98 months (LASH). Sexual function was assessed using the validated Female Sexual Function Index (FSFI). Statistical analyses were performed using a 2 sample t test, Chi² test and Fisher’s exact test.</p><h3>Results</h3><p>Over the long term, there was no significant difference in the FSFI total score between TLH and LASH (22.51 vs. 22.25, p-value: 0.261). Within the TLH group, sexual function remained stable compared to baseline data (p = 0.20). In contrast, the LASH group showed a significant deterioration in the total score (p = 0.028), particularly in the lubrication (p = 0.007) over time.</p><h3>Conclusion</h3><p>Both surgical methods ensure comparable sexual function. While TLH shows stable results over the years, LASH shows a significant decrease in some areas of sexual function, particularly with regard to lubrication. However, these differences do not result in a significantly worse overall outcome compared to TLH.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08479-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}