Gynecology and pelvic medicine最新文献

{"title":"The effects of intrauterine devices on anti-Mullerian hormone levels-a mini-review.","authors":"Nora Khalil, Zachary W Walker","doi":"10.21037/gpm-2026-1-0006","DOIUrl":"https://doi.org/10.21037/gpm-2026-1-0006","url":null,"abstract":"<p><p>Intrauterine devices (IUDs) are contraceptive devices utilized by many women, especially those who struggle with the use of oral contraceptives. As the age of childbearing rises, it is crucial to have reliable assessments of ovarian reserve, such as anti-Müllerian hormone (AMH) levels. In efforts to provide clinicians with optimal knowledge in the evaluation of fertility, this review investigates the relationship between IUDs and AMH levels. A detailed search of PubMed articles was conducted with six relevant articles discovered. Hormonal IUDs have been shown to either decrease or have no significant impact on AMH levels, while copper IUDs consistently demonstrated no significant effect on AMH levels across all studies. When considering those with heavy menstrual bleeding (HMB), the implementation of hormonal IUDs was associated with a significant increase in AMH levels compared to the cohort's initial values, as well as the controls. The duration of IUD usage was also found to be positively correlated with AMH levels in some studies. Due to the sparsity of studies investigating this correlation, it is difficult to conclude any definitive findings. Future studies should consider differentiating types of hormonal IUDs when studying AMH levels, as well as diversifying the population under investigation to ensure the results are more generalizable. Subpopulations, such as patients with HMB, should continue to be examined as IUDs may impact AMH levels differently than what is typically seen in patients using IUDs exclusively for contraception.</p>","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"38"},"PeriodicalIF":0.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171023","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":"Cervical screening-using implementation science tools to maximise impact in a complex world.","authors":"Jordan Dixon, Lucy Boyd, Julia Brotherton","doi":"10.21037/gpm-2026-0008","DOIUrl":"https://doi.org/10.21037/gpm-2026-0008","url":null,"abstract":"","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"24"},"PeriodicalIF":0.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169387","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":"Mailing self-sampling kits to underscreened women: insights from the CapU4 trial.","authors":"Rakiya Saidu, Laura Cardoso, Louise Kuhn","doi":"10.21037/gpm-2026-0010","DOIUrl":"https://doi.org/10.21037/gpm-2026-0010","url":null,"abstract":"","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"23"},"PeriodicalIF":0.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robert's uterus unveiled: a comprehensive exploration of four cases and literature reviews.","authors":"Yingying Chen, Shanza Waseem, Heng Zhang, Shiqiao Tan, Li Luo","doi":"10.21037/gpm-2025-1-55","DOIUrl":"https://doi.org/10.21037/gpm-2025-1-55","url":null,"abstract":"<p><strong>Background: </strong>Robert's uterus is an exceptionally rare obstructive Müllerian anomaly characterized by an asymmetric septate uterus with a non-communicating hemi-cavity. It typically presents with dysmenorrhea and infertility, and its early diagnosis is crucial for optimizing reproductive outcomes. Here we present the case series to document the diverse external morphology (normal <i>vs.</i> saddle-shaped) and propose a structured diagnostic pathway for Robert's uterus.</p><p><strong>Case description: </strong>This retrospective case series (June 2020-June 2023) describes four patients with a postoperative diagnosis of Robert's uterus. The median age was 25 years. Three patients presented with severe dysmenorrhea, while all four presented with primary infertility. Preoperative imaging was suggestive but not always definitive; magnetic resonance imaging (MRI) confirmed the diagnosis in two cases. A notable finding was the variable external uterine contour observed during laparoscopy, ranging from normal to saddle-shaped. All patients underwent combined hysteroscopic-laparoscopic metroplasty. Postoperatively, dysmenorrhea resolved completely in all symptomatic patients. At the 6-12-month follow-up, no anatomical recurrence was observed, and one patient achieved a spontaneous pregnancy.</p><p><strong>Conclusions: </strong>Robert's uterus is a diagnostically challenging condition that requires a high index of suspicion. MRI is the preferred tool for definitive preoperative characterization. Combined hysteroscopic-laparoscopic metroplasty is an effective treatment that relieves symptoms and can restore reproductive potential. This series highlights the phenotypic variability of the condition and underscores the importance of a structured diagnostic pathway for patients with severe dysmenorrhea and infertility.</p>","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"30"},"PeriodicalIF":0.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170903","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":"Shift work and hormonal-circadian disruption raise urinary incontinence: a narrative review.","authors":"Danielle Cristina Honorio França, Emanuelle Carolina Honorio França, Adenilda Cristina Honorio-França, Eduardo Luzía França","doi":"10.21037/gpm-2025-1-66","DOIUrl":"https://doi.org/10.21037/gpm-2025-1-66","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Pelvic floor dysfunction (PFD) is a multifactorial condition that affects a large proportion of women, compromising urogenital support and producing symptoms such as urinary incontinence (UI). The structural and functional integrity of the pelvic floor depends on coordinated interactions among muscular, hormonal, and neuroendocrine systems. Evidence indicates that circadian misalignment, particularly in women exposed to night-shift work, sleep deprivation, and endocrine disruption, can influence pelvic floor physiology through melatonin suppression, cortisol dysregulation, and inflammatory activation. This review intends to synthesize current evidence on the links between circadian rhythm disruption, hormonal imbalance, and PFD, with specific emphasis on occupational shift work as a model of chronic chronobiological stress, highlighting their integrated pathophysiological mechanisms and preventive approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a narrative literature review using PubMed, Scopus, and Web of Science covering the period from January 2020 to October 2025. Studies investigating the relationship between circadian regulation, hormonal modulation, and pelvic floor function were included. Particular attention was given to research addressing melatonin and cortisol pathways, estrogen modulation, and occupational factors such as night-shift work, sleep deprivation, and physical overload. Eligible study designs included randomized controlled trials, observational studies (cross-sectional and cohort studies), translational and experimental research, and high-quality mechanistic reviews, defined by methodological rigor, comprehensive literature synthesis, and critical appraisal of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key content and findings: &lt;/strong&gt;Circadian rhythm disruption-characterized by decreased melatonin secretion, altered cortisol levels, and increased oxidative stress-has been associated with inflammation, impaired muscle contractility, and delayed pelvic floor tissue repair. Beyond anatomical alterations, UI is increasingly recognized as a neuroimmunoendocrine disorder in which hormonal dysregulation contributes to tissue instability and loss of urethral support. Women exposed to night-shift work, sleep deprivation, or occupational overload show higher rates of involuntary urine loss, partly mediated by endocrine desynchronization and maladaptive voiding behaviors during chronically misaligned biological rhythms. Preventive measures include supervised pelvic floor physiotherapy, optimization of sleep hygiene, correction of work schedules, and local estrogen therapy when indicated. Chronobiological and immunomodulatory interventions have recently emerged as promising adjunctive strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Management of UI should move beyond a purely mechanical perspective toward an integrated model encompassing hormonal, metabolic, and behavioral modulation. Understandi","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"34"},"PeriodicalIF":0.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167875","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":"Factors influencing cervical cancer symptom help-seeking behavior: a qualitative study from a social ecological perspective.","authors":"Sudan Wang, Miao Guo, Ling Lu, Na Wu, Xulian Tu, Zhiying Liu","doi":"10.21037/gpm-2026-0016","DOIUrl":"https://doi.org/10.21037/gpm-2026-0016","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is one of the major public health problems that seriously jeopardizes women's health ranking as the fourth most frequently diagnosed cancer. China is the second country with the heaviest burden of cervical cancer in the world. In recent years, help-seeking behavior related to cancer symptoms has gradually attracted increasing attention. However, in China, no studies have explored cervical cancer patients' help-seeking behavior. This study aimed to examine the influencing factors of symptom seeking behaviors in patients with cervical cancer to provide an effective basis for achieving early diagnosis and treatment and improving the treatment outcomes of patients with cervical cancer.</p><p><strong>Methods: </strong>This qualitative study utilized a descriptive research design, and cervical cancer patients hospitalized in a tertiary first-class hospital in Beijing from March to May 2025 were selected as the research objects. Using a social ecological model as the theoretical framework, semistructured in-depth interviews were used to collect data, and data were analyzed using thematic analysis following Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.</p><p><strong>Results: </strong>Three main themes and ten subthemes were identified, covering individual, interpersonal, and environmental-policy levels, including disease knowledge, health beliefs, symptom appraisal, family and social support, economic constraints, stigma, and healthcare system factors.</p><p><strong>Conclusions: </strong>Cervical cancer symptom help-seeking behavior is influenced by multilevel factors across individual, interpersonal, and systemic domains. Targeted interventions addressing knowledge gaps, social support, and healthcare accessibility may promote earlier help-seeking and improve outcomes.</p>","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"26"},"PeriodicalIF":0.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170074","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":"Bacterial vaginosis: a narrative review of concepts and best practices.","authors":"José Eleutério Junior, Renata Mírian Nunes Eleutério, Ana Katherine Gonçalves, Paulo César Giraldo","doi":"10.21037/gpm-2025-1-52","DOIUrl":"https://doi.org/10.21037/gpm-2025-1-52","url":null,"abstract":"<p><strong>Background and objective: </strong>Bacterial vaginosis (BV) is a multifaceted condition characterized by an imbalance of the vaginal microbiota. This disruption includes not only <i>Gardnerella vaginalis</i> but also a range of anaerobic bacteria, with clinical outcomes varying according to the specific bacterial composition. This review aims to provide an updated overview of the concepts, diagnosis, and management of BV.</p><p><strong>Methods: </strong>We conducted a search on MEDLINE (Medical Literature Analysis and Retrieval System Online), Google Scholar, and Scopus for publications in English, prior to September 2025, using the keywords [vaginal microbiota] OR [vaginal microbiome] OR [vaginosis] OR [bacterial vaginosis] OR [dysbiosis] AND [vagina] AND [diagnosis] AND [treatment]. We also reviewed the references of the articles obtained through our literature searches.</p><p><strong>Key content and findings: </strong>BV is characterized by a shift from aerobic to anaerobic microbiota. Anaerobic bacteria and their metabolites can significantly impact the local immune response, resulting in various complications in women's reproductive health. Although most affected individuals remain asymptomatic, dysbiosis may negatively influence pregnancy outcomes and elevate the risk of sexually transmitted infections. Diagnosis is traditionally based on the Amsel criteria and Nugent Score. More recently, nucleic acid amplification tests, particularly those utilizing multiplex platforms, have been implemented to identify bacterial species such as <i>Gardnerella</i>, <i>Fannyhessea</i>, and <i>Sneathia</i>. Bacterial composition and the presence of biofilm are critical factors influencing treatment outcomes. Alternatives to conventional antibiotic therapy, including biofilm-disrupting agents and probiotics, are essential for addressing persistent and recurrent BV.</p><p><strong>Conclusions: </strong>BV has long been recognized, and diagnosis has traditionally been based on Amsel's criteria and Nugent's score. While new diagnostic tools have offered valuable insights, they have also introduced new questions about this complex condition. Metronidazole remains the primary treatment, although adjuvant therapies, such as biofilm disruption and probiotics, are often required. Further large-scale, in-depth studies are needed to address ongoing uncertainties.</p>","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"37"},"PeriodicalIF":0.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169153","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":"Treatment of recurrent low grade serous ovarian cancer: MEK inhibition and the RAMP 201 trial.","authors":"Maryam Ali, Rebecca Brooks","doi":"10.21037/gpm-2025-1-71","DOIUrl":"10.21037/gpm-2025-1-71","url":null,"abstract":"","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"22"},"PeriodicalIF":0.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427261","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":"Efficacy at a cost: camrelizumab and famitinib within the expanding landscape of combination therapies.","authors":"Teresa Zumarraga-Lizundia, Arantzazu Barquin-Garcia, Ainhoa Madariaga","doi":"10.21037/gpm-2025-1-73","DOIUrl":"10.21037/gpm-2025-1-73","url":null,"abstract":"","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"20"},"PeriodicalIF":0.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427226","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":"Urinary manifestations of genitourinary syndrome of menopause: a review of the pathophysiology, clinical presentation, and management.","authors":"Jacqueline C Saad, Caroline A Brandon","doi":"10.21037/gpm-2025-1-79","DOIUrl":"10.21037/gpm-2025-1-79","url":null,"abstract":"<p><p>The term genitourinary syndrome of menopause (GSM), previously known as vulvovaginal atrophy or atrophic vaginitis, was introduced in 2014 by the North American Menopause Society (NAMS) and International Society for the Study of Women's Sexual Health (ISSWSH) to highlight a broader scope of urogenital symptoms associated with menopause. While the majority of studies focus on vulvovaginal symptoms and sexual dysfunction, a large proportion of women also present with one or more urinary complaints related to urogenital atrophy, such as urinary frequency, urgency, nocturia, dysuria, urinary incontinence, or recurrent urinary infections. Population-based studies show that despite its prevalence, the condition is underdiagnosed and undertreated. The cornerstone of GSM treatment is local estrogen therapy, while other therapeutic options for GSM also show promise in improving urinary symptoms, including intravaginal dehydroepiandrosterone (DHEA) and ospemifene. While vaginal energy-based devices remain experimental, limited data also suggest some benefit. Treating GSM has significant personal and societal cost implications. The purpose of this review is to synthesize the current literature on pathophysiology, diagnosis, and treatment modalities of this complex condition, with a focus on the urinary manifestations of GSM. A summary of various international guidelines on the management of GSM is also provided to help guide clinicians treating this condition.</p>","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":"9 ","pages":"15"},"PeriodicalIF":0.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427210","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}