BMC Women's Health最新文献

{"title":"From mechanics to mobilization: a biomechanically-informed rehabilitation framework for cesarean-related scars.","authors":"Ying Zhou, Jun Yao Huang, Wei Shi","doi":"10.1186/s12905-026-04702-w","DOIUrl":"10.1186/s12905-026-04702-w","url":null,"abstract":"<p><strong>Background: </strong>Cesarean delivery often results in both abdominal wall scars and uterine scars. However, current rehabilitation strategies for cesarean-related scars lack standardization and a biomechanically informed framework that integrates superficial (abdominal wall) and deep (uterine niche) scar management.</p><p><strong>Objective: </strong>To synthesize the pathomechanical basis of cesarean-related scarring and to propose a stage-specific, biomechanically informed rehabilitation framework, while explicitly acknowledging the evidence gap between superficial and deep scar management.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Web of Science, and Scopus from inception to August 2025, supplemented by hand-searching of reference lists. A total of 2,138 records were identified; after duplicate removal and screening, 345 full-text reports were assessed, of which 101 studies met the inclusion criteria. Studies on cesarean scar healing, adhesion biomechanics, mechanotransduction, assessment tools, and physiotherapeutic interventions were synthesized. Evidence was classified by level (I-IV) based on study design, adapted from the Oxford Centre for Evidence-Based Medicine hierarchy. A clear distinction was maintained between interventions applicable to superficial (abdominal wall) scars and those hypothetically extended to deep (uterine niche) defects.</p><p><strong>Results: </strong>Aberrant mechanical tension is identified as a biologically plausible contributor to pathological scar and adhesion formation following cesarean delivery. Subjective (e.g., POSAS, VSS) and objective (e.g., ultrasound elastography, transvaginal ultrasound) assessment tools are evaluated. Effective mechanotherapy interventions are unified into a proposed three-tier biomechanical framework: (1) reducing mechanical load transfer, (2) passive mechanical stabilization, and (3) mitigating external mechanical forces. However, a substantial evidence gap exists-most mechanotherapy studies focus on dermal scars, and direct validation for uterine niche rehabilitation is absent. Interventions such as silicone therapy, taping, and manual therapy are strongly applicable to superficial and adhesion-related components but remain hypothetical for myometrial defects.</p><p><strong>Conclusion: </strong>A biomechanical perspective is clinically relevant for post-cesarean scar care, particularly for abdominal wall scars and adhesion-related symptoms. The proposed three-tier framework offers a structured, phenotype-based approach to clinical reasoning. However, direct mechanotherapy for uterine niches remains unproven. This framework should be viewed as hypothesis-generating and a guide for superficial and adhesion-related management, not as a validated protocol for uterine isthmocele rehabilitation. Future prospective trials with ultrasound-based outcomes are urgently needed.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535229","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":"Combining transvaginal ultrasound radiomics with clinical-ultrasound semantic features for the identification of high-risk endometrial lesions.","authors":"Xiaohong Yao, Xuandan Ye, Lixia Chen, Yubing He, Jiahui Wu, Siliang Kang, Fan Liu, Lirong Zhu, Jian Zheng","doi":"10.1186/s12905-026-04709-3","DOIUrl":"10.1186/s12905-026-04709-3","url":null,"abstract":"<p><strong>Objective: </strong>Preoperative risk stratification of high-risk endometrial lesions remains a clinical challenge. This study aimed to preliminarily explore an integrated machine learning approach combining transvaginal ultrasound (TVUS) radiomics, clinical indicators, and ultrasound semantic attributes to assist in clinical triage.</p><p><strong>Methods: </strong>TVUS images (n = 956) from 239 patients were retrospectively analyzed across two centers. Clinical and ultrasound semantic features were evaluated blindly. Within a patient-level 5-fold cross-validation scheme repeated across five independent random seeds, 1,125 radiomics features were extracted and selected via nested LASSO regression to compute a Rad-score. Frameworks using nine machine learning algorithms were evaluated via Area Under the Curve (AUC), DeLong tests, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>The optimal validation AUCs for the Radiomics, Clinical-Semantic, and Combined models were 0.7589, 0.8965, and 0.9077 (CatBoost), respectively. The Combined framework yielded a statistically significant increase in AUC values compared with the Radiomics model (P < 0.001) and showed significant differences over the Clinical-Semantic model across seven algorithms (all P < 0.05). Endometrial-myometrial junction appearance was identified as the primary predictor. DCA indicated that the combined model's soft-voting configuration optimized initial triage at a 0.20 threshold, while its CatBoost configuration sustained higher net benefit across medium-to-high risk thresholds (0.30-0.60).</p><p><strong>Conclusion: </strong>Integrating clinical-ultrasound semantic features with radiomics offers an objective, non-invasive approach to potentially assist in individualized risk stratification. This combined framework may provide a potential stratified decision-support pathway for further clinical evaluation.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519852","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":"Association of vaginal dysbiosis with cervical lesions among women with non-16/18 high-risk HPV infections: a cross-sectional study of 2,264 women in Eastern China.","authors":"Shuying Yuan, Dan Wu, Kexin Hu, Yongxinag Li","doi":"10.1186/s12905-026-04714-6","DOIUrl":"10.1186/s12905-026-04714-6","url":null,"abstract":"<p><strong>Background: </strong>To investigate whether vaginal dysbiosis is associated with an increased risk of cervical lesions infected with non-16/18 high-risk human papillomavirus (HR-HPV) genotypes and to inform risk-stratified cervical cancer screening strategies.</p><p><strong>Methods: </strong>This cross‑sectional study included 2,264 women attending Jiaxing Maternal and Child Health Hospital between June 2023 and October 2024. HPV genotyping, vaginal microecological assessment, and Thinprep cytologic test (TCT) were performed. HR- HR-HPV infections were classified as HPV16/18-positive or non-16/18 HR-HPV infections. Logistic regression models were used to evaluate associations, adjusting for age. Multiplicative interaction was assessed using Wald tests for product terms. Benjamini‑Hochberg FDR correction was applied for multiple comparisons.</p><p><strong>Results: </strong>The overall HPV prevalence was 49.87%, with HR-HPV detected in 36.13%. HR‑HPV infection was significantly associated with cervical lesions in both normal (OR = 11.45) and dysbiotic (OR = 4.40) vaginal microbiota (both P < 0.001). Stratified analyses showed higher point estimates for HPV58 and HPV59 in the dysbiosis group (OR = 10.98 and 9.51, respectively) than in the normal group (OR = 7.50 and 6.44, respectively). However, formal multiplicative interaction tests did not reach statistical significance (Wald P = 0.526 and 0.559, respectively; FDR‑adjusted q = 0.559 for both). No HPV subtype remained significantly associated with ASC‑US after FDR correction.</p><p><strong>Conclusions: </strong>In this cross‑sectional study, vaginal dysbiosis is specifically associated with cervical lesions among women with non‑16/18 HR‑HPV infections, particularly HPV58 and HPV59, which showed elevated point estimates in the presence of dysbiosis. However, formal multiplicative interaction tests did not reach statistical significance. These findings are exploratory and hypothesis‑generating; causality cannot be inferred due to the cross‑sectional design. Prospective studies are needed to validate the observed associations before any clinical application can be considered. Our results should be interpreted with caution and do not support changes to current screening practice.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535256","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":"Comparison of vaginal natural orifice transluminal endoscopic surgery and multiport conventional laparoscopy for complete pelvic lymphadenectomy: Insights from a single-surgeon experience.","authors":"Kemal Gungorduk, Serkan Ustuntas, Emre Biton, Berican Sahin Uyar, Berke Nur Ergu, Furkan Karaoz, Varol Gulseren, Munteha Akbulut, Berfin Akan Isler","doi":"10.1186/s12905-026-04698-3","DOIUrl":"10.1186/s12905-026-04698-3","url":null,"abstract":"<p><strong>Background and objectives: </strong>We compared the outcomes of complete pelvic lymph node dissection performed via multiport conventional laparoscopy (MCL) versus vaginal natural orifice transluminal endoscopic surgery (vNOTES) in patients with endometrial cancer in whom sentinel lymph node (SLN) mapping was unsuccessful.</p><p><strong>Methods: </strong>This retrospective cohort study included 42 patients with grade I or II endometrioid endometrial cancer who underwent hysterectomy with bilateral salpingo-oophorectomy, followed by comprehensive retroperitoneal pelvic lymphadenectomy after failed bilateral SLN mapping. Patients underwent either vNOTES (n = 21) or MCL (n = 21). Demographic characteristics, operative times, perioperative and postoperative complications, pain scores, and quality of recovery-15 (QoR-15) scores were collected and compared between the two groups.</p><p><strong>Results: </strong>Demographic and clinical characteristics were comparable between the two groups, with no statistically significant differences. Operative times were significantly longer in the vNOTES group (53.8 ± 7.4 min) compared to the MCL group (46.9 ± 9.2 min; P = 0.01), whereas estimated blood loss (17.7 ± 5.6 mL vs. 18.8 ± 5.0 mL; P = 0.50) and lymph node yield (32.1 ± 6.6 vs. 35.0 ± 8.1; P = 0.21) did not differ significantly. Postoperative pain assessed by visual analogue scale (VAS) was lower in the vNOTES group at 6 h (4.3 ± 1.1 vs. 5.5 ± 1.0; P = 0.01), 12 h (3.5 ± 0.8 vs. 4.8 ± 1.1; P < 0.001), and 24 h (2.1 ± 0.6 vs. 3.1 ± 0.9; P < 0.001). These findings were corroborated by the faces pain scale-revised (FPS-R), which demonstrated significantly lower pain in the vNOTES group at all time points. QoR-15 scores at 48 h were higher in the vNOTES group (109.3 ± 4.7 vs. 104.9 ± 4.1; P = 0.002), indicating improved postoperative recovery. The observed mean difference of approximately 4.4 points remained below the reported minimal clinically important difference of 8.0 points for this instrument, indicating that the statistically significant benefit should be interpreted with caution regarding its clinical magnitude.</p><p><strong>Conclusion: </strong>vNOTES for complete pelvic lymphadenectomy offers reduced postoperative pain, scar-free surgery, and enhanced recovery while maintaining staging adequacy comparable to MCL. Future prospective, multicentre, randomised trials with long-term oncologic follow-up are required to validate these findings.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535310","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 evaluation of the tests that can predict de novo stress urinary incontinence after advanced pelvic organ prolapse surgery: a prospective study.","authors":"Reyhan Gündüz, Elif Ağaçayak","doi":"10.1186/s12905-026-04687-6","DOIUrl":"10.1186/s12905-026-04687-6","url":null,"abstract":"<p><strong>Background: </strong>De novo stress urinary incontinence (SUI) may reduce patient satisfaction following a pelvic organ prolapse (POP) surgery and may necessitate additional anti-incontinence surgery in the future. The aim of this study is to evaluate physical examination tests that can predict de novo SUI after POP surgery.</p><p><strong>Methods: </strong>A total of 30 patients diagnosed with stage 3-4 POP who underwent POP surgery were included in this study. The results of the Q-tip test, reduced stress test, and urodynamic stress urinary incontinence test, which were performed before the surgery, and stress test results for SUI at 3 and 6 months after the surgery were recorded. The physical examination tests were compared and occult SUI and de novo SUI rates were determined.</p><p><strong>Results: </strong>Occult SUI detection rates were found to be 46.7% for the Q-tip test, 20% for the reduced stress test, and 3.3% for the urodynamic test. The rates of de novo SUI were determined as 3.3% and 10%, respectively, at the 3rd and 6th months postoperatively. The presence of gravida, parity, and the number of living children increased the detection rate of occult SUI by the Q-tip test at statistically significant level. It was also determined that the high number of abortions statistically increased the risk of de novo SUI at 6 months postoperatively and occult SUI did not significantly affect the risk of de novo SUI.</p><p><strong>Conclusion: </strong>Our findings suggest that less invasive and cost-effective physical examination tests may be considered in the preoperative evaluation of patients undergoing POP surgery; however, these results should be interpreted cautiously.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497285","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":"Physiotherapy and rehabilitation for survivors of female genital mutilation/cutting: a scoping review.","authors":"Juliet Lucy Ekowa, Adaeze Imelda Onyekwelu, Kadiree Ekundayo Fatai","doi":"10.1186/s12905-026-04708-4","DOIUrl":"10.1186/s12905-026-04708-4","url":null,"abstract":"<p><strong>Background: </strong>Female genital mutilation/cutting (FGM/C) affects more than 230 million girls and women worldwide and is associated with chronic pelvic pain, pelvic floor dysfunction, lower urinary tract symptoms, psychosexual dysfunction, and reduced quality of life. Although physiotherapy and rehabilitation may contribute to multidisciplinary care, the available evidence has not been comprehensively synthesised.</p><p><strong>Objective: </strong>To map the existing evidence on physiotherapy and rehabilitation for women living with FGM/C and identify evidence gaps relevant to clinical practice and future research.</p><p><strong>Methods: </strong>A scoping review was conducted following the Arksey and O'Malley framework, Levac et al.'s methodological enhancements, and PRISMA-ScR guidelines. Electronic databases and grey literature were searched from inception to January 2026. Eligible studies included adolescent (≥ 15 years) and adult women living with FGM/C, together with rehabilitation-relevant studies involving healthcare professionals. Data were charted and synthesised narratively.</p><p><strong>Results: </strong>Of 872 records identified, 21 studies met the inclusion criteria. Most evidence was observational or descriptive, with only one randomized controlled trial and one rehabilitation-focused case report directly evaluating rehabilitation interventions. Frequently reported rehabilitation-related impairments included psychosexual dysfunction, chronic pelvic pain, pelvic floor dysfunction, lower urinary tract symptoms, dyspareunia, and reduced quality of life. Reported rehabilitation approaches included pelvic floor rehabilitation, bladder retraining, biofeedback, psychosexual rehabilitation, and multidisciplinary care. Only one study included adolescents, and none specifically evaluated rehabilitation interventions for this population.</p><p><strong>Conclusion: </strong>Women living with FGM/C experience substantial rehabilitation needs affecting physical, psychosexual, urinary, and psychosocial health. Although physiotherapy and rehabilitation are increasingly recognised as important components of multidisciplinary care, direct evidence evaluating rehabilitation interventions remains limited. Future research should prioritise rehabilitation-focused intervention studies, implementation research, and standardised outcome measures to strengthen the evidence base and inform comprehensive, survivor-centred care.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497280","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":"Ethanol sclerotherapy versus cystectomy in the management of endometriomata: a systematic review and meta-analysis.","authors":"Sarah L M Bennet, Sangeetha Nagenthiran, Thomas Bainton, Jeffery Ahmed, Victoria Male, Mark Johnson","doi":"10.1186/s12905-026-04645-2","DOIUrl":"10.1186/s12905-026-04645-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The management of endometriomata remains a challenge, with current options associated with either high recurrence rates or significant reduction in ovarian reserve. Ethanol sclerotherapy has been suggested as a treatment that is effective while maintaining ovarian reserve.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PubMed, EMBASE, MEDLINE, SCOPUS and CENTRAL were searched with no restriction on date or language. Keywords and MESH terms for 'endometrioma' AND 'ethanol sclerotherapy' AND 'cystectomy' were used. Studies were included if they made a direct comparison between ethanol sclerotherapy and cystectomy in the management of endometriomata in women of reproductive age. Randomised controlled trials (RCTs), cohort or case control studies were included. Searches were performed 11th February 2025 and repeated 21st August 2025. Risk of bias was assessed using ROB2 for RCTs and ROBINS-I for observational studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Searches identified 172 studies with 16 of these fitting the inclusion criteria. Unfortunately, a formal analysis of between group change in Anti-Mullerian hormone (AMH) was not possible due to insufficient reporting of change score variance data, as such an exploratory between group pre- and post- analysis was performed instead. This found no significant difference in AMH at baseline (mean difference (MD) 0.02, 95% CI -0.20 to 0.25, p = 0.830) while post procedure AMH was significantly higher in the sclerotherapy arm (MD 0.75, 95% CI 0.43 to 1.06, p &lt; 0.001). Overall risk of bias was high; however, similar results were seen following a sensitivity analysis excluding studies at highest risk of bias (high for ROB2 and critical for ROBINS-I) (MD -0.25, 95% CI -0.57 to 0.08, p = 0.136 and MD 0.60, 95% CI 0.22 to 0.97, p = 0.002, respectively). Studies reporting on Antral Follicle Count (AFC) gave conflicting results and all were assessed as at high or critical risk of bias. No significant difference was seen in recurrence (LogOR 0.28, 95% CI -0.57 to 1.12, p = 0.523). Rates of serious complications were low at 0.24% for sclerotherapy and 0.76% for cystectomy. It was not possible to pool data on symptomatology. Number of oocytes retrieved was higher in the sclerotherapy arm (MD 3.23, 95% CI 1.34 to 5.12, p &lt; 0.001). Number of mature oocytes retrieved was also higher in the sclerotherapy arm (MD 2.79, 95% CI 1.08 to 4.51, p = 0.001), however this became non-significant when studies at the highest risk of bias were excluded (MD 0.79, 95% CI -0.61-2.19, p = 0.27). Data on pregnancy rate could not be pooled due to the wide variation in definition of clinical pregnancy. No significant difference was seen in live birth rate between interventions (logOR 0.59, 95% CI -0.30 to 1.48, p = 0.192).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our results show ethanol sclerotherapy maintains ovarian reserve when compared to ovarian cystectomy in the treatment of endometrioma, as evidenced by the higher post-procedu","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497211","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":"Adherence and continuance intention of biofeedback-assisted pelvic floor muscle training: a theory-driven study among women with pelvic floor disorders.","authors":"Ying-Hsuan Chao, Chia-Jung Chiang, Chung-Hung Tsai, Ya-Min Cheng, Li-Chieh Kuo, Fong-Chin Su","doi":"10.1186/s12905-026-04711-9","DOIUrl":"10.1186/s12905-026-04711-9","url":null,"abstract":"<p><strong>Background: </strong>Adherence to pelvic floor muscle training (PFMT) remains a major challenge in the conservative management of pelvic floor disorders in women. Although biofeedback-assisted PFMT facilitates motor learning, sustained engagement may be influenced by a range of behavioral and experiential factors. This study investigated clinical and behavioral determinants of engagement with PFMT technologies and examined changes in manometry-derived pelvic floor muscle performance during a supervised biofeedback-assisted PFMT.</p><p><strong>Methods: </strong>This prospective observational study examined outpatient care for women with pelvic floor disorder. Participants completed six PFMT sessions with manometer-based biofeedback. Based on baseline Pelvic Floor Distress Inventory-20 (PFDI-20) scores, participants were stratified into low- and high-symptom groups. Changes in muscle performance were evaluated using repeated-measures analysis of variance. Adherence determinants were examined using partial least squares structural equation modeling (PLS-SEM).</p><p><strong>Results: </strong>Participants with lower baseline symptoms showed higher program adherence. Significant improvements in contraction and peak pressure occurred over time (p < .01), with comparable benefits across symptom groups. Perceived usefulness emerged as the strongest predictor of sustained engagement, followed by self-efficacy, confirmation, and early engagement. Satisfaction and perceived ease of use did not directly predict continuance. Privacy and comfort concerns negatively influenced satisfaction, indirectly reducing continuance intention. Higher baseline quality of life impairment correlated with lower adherence.</p><p><strong>Conclusions: </strong>Biofeedback-assisted PFMT enhances pelvic floor muscle performance across varying symptom severities; however, sustained engagement is primarily driven by perceived functional benefit rather than satisfaction alone. These findings highlight the need to integrate behavioral, experiential, and functional considerations in PFMT interventions.</p><p><strong>Trial registration: </strong>The Institutional Review Board of National Cheng Kung University Hospital, Tainan, Taiwan, thoroughly reviewed and approved the procedures and consent form (Reference Number AER112385 Registration number NCT07243028 at ClinicalTrials.gov).</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497238","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 interplay of risk and protective factors for psychosocial outcome in women after induced abortion - an interview study from Germany.","authors":"Jennifer Stünkel, Samuel Tomczyk","doi":"10.1186/s12905-026-04668-9","DOIUrl":"10.1186/s12905-026-04668-9","url":null,"abstract":"<p><strong>Background: </strong>Abortions are one of the most common gynecological treatments worldwide. Although many studies investigate risk factors (RF) for a negative abortion-related psychosocial outcome (APO), less is known about protective factors (PF) and the interplay of RFs and PFs.</p><p><strong>Methods: </strong>From May to August 2022, we conducted a semi-structured interview study in Germany and interviewed 23 women (21-43 years) who had undergone an elective abortion within the last 12 months, asking them about their experiences, perceived RF, PF and APO. The data was analyzed using qualitative content analysis.</p><p><strong>Results: </strong>We found three different patterns: The first group of women found the process, especially the legal requirements, stressful but reported a mostly positive outcome with sufficient social support as PF. Women who reported neuroticism-related personality factors as RF sought less social support and more frequently used emotion-focused coping strategies such as self-care and distraction and often showed a mixed outcome. A third group of women experienced intimate partner violence (IPV) and also reported distraction as PF. Regardless, all women who survived IPV reported a negative APO.</p><p><strong>Conclusions: </strong>The majority of women find the legal requirements (e.g., mandatory counseling, waiting periods) burdensome. At the same time, they offer no benefit to women who find themselves in critical situations such as coercion and domestic violence, which was a major RF. The protection of women who survived IPV should therefore be improved and the access to abortion improved. Further research is needed to include effects on more vulnerable groups such as migrants or queer individuals.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497225","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":"Pregnancy history is associated with lower odds of osteoporosis among Taiwanese women.","authors":"Yuen-En Chang, Song-Shan Huang, Chueh-Yi Huang, Chia-Lung Shih","doi":"10.1186/s12905-026-04691-w","DOIUrl":"10.1186/s12905-026-04691-w","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a major public health concern worldwide. Although female reproductive factors have been suggested to influence bone health, their associations with osteoporosis remain inconclusive.</p><p><strong>Objective: </strong>This study aimed to investigate the associations between reproductive characteristics and the odds of osteoporosis in Taiwanese women.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from women randomly selected from the Taiwan Biobank. Bone mineral density (BMD) status was classified into three categories according to the World Health Organization (WHO) criteria: normal BMD (T-score > - 1.0), osteopenia (- 2.5 < T-score ≤ - 1.0), and osteoporosis (T-score ≤ - 2.5). Univariable and multivariable logistic regression analyses were performed to assess the association between reproductive factors and the odds of BMD status.</p><p><strong>Results: </strong>Among the 4,854 participants, 3,107 (64.0%) were classified as having normal BMD, 1,374 (28.3%) as having osteopenia, and 373 (7.7%) as having osteoporosis. Univariate analysis showed that a history of pregnancy was associated with a higher odd of osteopenia (odds ratio [OR] = 1.946, 95% CI: 1.589-2.382, p < 0.001), osteoporosis (OR = 1.825, 95% CI: 1.288-2.586, p = 0.001), and low BMD level (T-score < -0.1) (OR = 1.919, 95% CI: 1.597-2.306, p < 0.001). After adjusting for known confounders, pregnancy history was associated with a lower odd of osteoporosis (adjusted OR = 0.644, 95% CI: 0.422-0.981, p = 0.041), but not significantly associated with the odds of osteopenia or low BMD level.</p><p><strong>Conclusions: </strong>Pregnancy history was independently associated with lower odds of osteoporosis among Taiwanese women after adjustment for known confounding factors. However, given the cross-sectional nature of this study, causal relationships cannot be established. Future longitudinal studies are warranted to validate this finding.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469109","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}