Ginekologia polska最新文献

{"title":"A new technique for sacrospinous ligament fixation: endoscopic sacrospinous ligament fixation (Peker technique).","authors":"Nurullah Peker, Selda Bayat Balkan, Serhat Ege, Senem Yaman Tunç, Elif Ağaçayak, Mehmet Sıddık Evsen","doi":"10.5603/gpl.106176","DOIUrl":"https://doi.org/10.5603/gpl.106176","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to introduce a new technique, endoscopic sacrospinous ligament fixation (e-SSLF), and to present its success rate and advantages.</p><p><strong>Material and methods: </strong>The hospital records of women who underwent e-SSLF and simultaneous vaginal hysterectomy due to stage 4 pelvic organ prolapse (POP) were evaluated. Unlike the classical SSLF technique, in e-SSLF the sacrospinous ligament (SSL) was exposed with two retractors, then visualized with a 5 mm diagnostic hysteroscope. The SSLF was performed endoscopically with Deschamps ligature needles. In the 24th postoperative hour, a contrast-enhanced pelvic computerized tomography (CT) was performed, and images were taken to confirm that the suture was passed to the correct location (2 cm medial to the sacrospinous process). Patient demographic and clinical data, surgery duration,total operation time, pre- and postoperative Pelvic Organ Prolapse Quantification (POP-Q) levels, and complications were evaluated.</p><p><strong>Results: </strong>Based on the evaluated medical records, 26 patients underwent e-SSLF. Postoperative CT images showed that the suture had passed to the correct place in all cases. There were no intraoperative complications, and only 2 patients experienced transient leg pain in the postoperative period. The median surgery duration was 101 seconds (25th percentile 96 seconds, 75th percentile 110 seconds). The median total operation time was 62 minutes (25th percentile 52 minute, 75th percentile 78 minute). Upon POP-Q staging at the 6-month postoperative follow-up, 24 patients (92.3%) were found to be in stage 0 and 2 (7.7%) were found to be in stage 1 POP.</p><p><strong>Conclusions: </strong>e-SSLF is a new surgical technique that is reliable and highly effective, showing fewer complications and good postoperative results due to the imaging, it provides. Imaging in SSLF will make significant contributions to gynaecology assistant training and reduce the learning curve of SSLF.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine fibroids - why you should choose tailored therapies based on the joint decision of the physician and the patient.","authors":"Michal Ciebiera, Tomasz Lozinski, Ayman Al-Hendy","doi":"10.5603/gpl.107627","DOIUrl":"https://doi.org/10.5603/gpl.107627","url":null,"abstract":"<p><p>Uterine fibroids (UFs) are the most common benign tumors of the myometrium, affecting up to 70% women by age 50. Although many cases remain asymptomatic, symptomatic UFs can significantly reduce quality of life through excessive bleeding, anemia, pelvic pain, infertility, and obstetric complications. Despite the availability of various conservative treatments - including pharmacotherapy, uterine artery embolization, and ultrasound thermoablation - surgical interventions, particularly hysterectomy, remain the dominant approach in many countries. This discrepancy between evidence-based recommendations and routine practice highlights the persistence of a paternalistic model of care, where patients are often excluded from treatment decisions and not informed about alternatives. Emerging concepts such as shared decision making (SDM) and personalized therapy emphasize the need to adapt treatment plans to each woman's clinical profile, reproductive goals, and preferences. SDM fosters trust, better adherence to therapy, and improved acceptance of complications by actively involving patients in choosing their care. The development of modern pharmacological options, like GnRH analogs, further expands possibilities for effective, reversible, fertility-preserving treatments. A paradigm shift toward patient-centered, individualized management is essential to address ethical challenges, reduce unnecessary hysterectomies, and improve outcomes. Implementing SDM and expanding access to conservative therapies require systemic changes in reimbursement, training, and patient education to ensure that care focuses not only on the disease but on the woman as a whole.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Affective temperament and emotional processing difficulties in women with PCOS and their potential impact on PCOS clinical presentation.","authors":"Witold Urban, Krzysztof Rutkowski, Katarzyna Klasa, Robert Jach, Olga Kacalska-Janssen, Michal Mielimaka","doi":"10.5603/gpl.103884","DOIUrl":"https://doi.org/10.5603/gpl.103884","url":null,"abstract":"<p><strong>Objectives: </strong>To assess alexithymia and affective temperament in patients with polycystic ovary syndrome (PCOS) and compare these patients to a group of patients undergoing endocrinological evaluation without a diagnosis of PCOS (non-PCOS). Additionally, the study explored the relationship between affective temperament, alexithymia, body mass index (BMI), and the severity of hirsutism in the PCOS group.</p><p><strong>Material and methods: </strong>A total of 46 patients with PCOS and 28 non-PCOS patients were recruited for the study. All participants underwent endocrinological and gynecological diagnostics. Alexithymia was assessed using the TAS-20 questionnaire, while affective temperament was evaluated with the TEMPS-A questionnaire.</p><p><strong>Results: </strong>Both PCOS and non-PCOS patients were found to fall within the \"intermediate alexithymic\" range. Patients with PCOS exhibited more pronounced cyclothymic temperament (p=0,019), and the difference in irritable temperament was close to statistical significance (p=0,072). In a stepwise linear regression analysis, total alexithymia emerged as a statistically significant positive predictor of BMI in PCOS group (β=0.368, p=0.012).</p><p><strong>Conclusions: </strong>Patients with PCOS exhibit higher cyclothymic temperament compared to the non-PCOS group. Both groups show \"intermediate alexithymia\", which could impact treatment adherence and mental health, highlighting the importance of psychological interventions for improving outcomes and quality of life.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary management of an isolated pelvic hydatid cyst: a rare case of laparoscopic cystectomy with colpotomy and endobag extraction.","authors":"Enes Serhat Coşkun, Davut Can Güner, Ali Selçuk Yeniocak, Havva Betül Bacak, Süleyman Salman","doi":"10.5603/gpl.104697","DOIUrl":"https://doi.org/10.5603/gpl.104697","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of ethanol sclerotherapy on pain and quality of life in patients with endometrial cysts.","authors":"Izabela Dymanowska, Karolina Frankowska, Monika Abramiuk, Malgorzata Charytanowicz, Barbara Terpilowska, Grzegorz Polak","doi":"10.5603/gpl.100816","DOIUrl":"https://doi.org/10.5603/gpl.100816","url":null,"abstract":"<p><strong>Objectives: </strong>Endometriosis is a prevalent chronic gynecological condition resulting in infertility, and severe pain that strongly deteriorates patients' quality of life. In addition to surgery and pharmacotherapy, there are also other methods of endometriosis management, such as sclerotherapy, which is used in patients with endometrial cysts. So far, there is a shortage of knowledge regarding sclerotherapy's influence on pain symptoms and quality of life. Therefore, the main objective of our study was to assess the effects of sclerotherapy on pain relief and quality of life.</p><p><strong>Material and methods: </strong>Study participants consisted of patients with ovarian endometriomas who have undergone ultrasound-guided transvaginal sclerotherapy with the use of high-percentage ethanol. Patients had no history of chronic diseases, besides endometriosis. They completed self-constructed both pre-procedural and post-procedural questionnaires between 3 and 6 months after sclerotherapy.</p><p><strong>Results: </strong>Our study included 59 patients. Sclerotherapy resulted in a significant alleviation of pain regardless of primary cyst volume, history of endometriosis surgery, post-procedural hormonal treatment, and elapsed time between two questionnaires collection. There was a significant decreasing in Visual Analog Scale (VAS) scores measured for pain during menstruation, sexual intercourse, and chronic pelvic pain after sclerotherapy. Moreover, this procedure resulted in significant improvement in life quality. Most patients reported that they would recommend this treatment method to other patients.</p><p><strong>Conclusions: </strong>Sclerotherapy is characterized by a great ability to alleviate pain and improve quality of life.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and clinical significance of miR-10a-5p in patients with hypertension during pregnancy.","authors":"Zhu Hu, Long Zhong, Zhenmei Lai","doi":"10.5603/gpl.104092","DOIUrl":"https://doi.org/10.5603/gpl.104092","url":null,"abstract":"<p><strong>Objectives: </strong>Dysregulated miR-10a-5p is associated with a variety of cardiovascular diseases and fetal growth in the second trimester. This study aimed to investigate the expression and clinical significance of serum miR-10a-5p in patients with hypertension during pregnancy (HDP).</p><p><strong>Material and methods: </strong>103 healthy pregnant women (control group) and 120 pregnant women with HDP (HDP group) were enrolled in this study. The relative miR-10a-5p was analyzed by qRT-PCR and its association with clinical indicators was performed by Pearson's correlation analysis. The diagnostic and prognostic value were by receiver operator characteristic (ROC) curve and Kaplan-Meier curve analysis, respectively. The risk factor evaluation of HDP was performed by multivariate logistic regression analysis. Adverse pregnancy outcomes were recorded during follow-up.</p><p><strong>Results: </strong>The miR-10a-5p level was significantly declined in HDP patients compared to control (p < 0.001). The reduced miR-10a-5p was negatively related to SBP (r = -0.6777, p < 0.0001), DBP (r = -0.6026, p < 0.0001), TNF-α (r = -0.7020, p < 0.0001) and IL-6 (r = -0.7149, p < 0.0001). MiR-10-5p was a risk factor of HDP (OR = 0.433, 95% CI: 0.247-0.759, p = 0.003). HDP pregnant women with low miR-10a-5p expression levels (13/68) faced more probability of adverse pregnancy outcomes than those of high miR-10a-5p expression levels (8/52).</p><p><strong>Conclusions: </strong>Declined miR-10a-5p contributed to the diagnosis and prognosis of HDP and was also a risk factor of HDP.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of apparent diffusion coefficient in the diagnosis of endometrial carcinoma and its pathohistological features.","authors":"Milica Zorić, Milica Šarošković, Jelena Vuković, Igor Nosek, Nataša Prvulović Bunović, Miloš Vuković","doi":"10.5603/gpl.103995","DOIUrl":"https://doi.org/10.5603/gpl.103995","url":null,"abstract":"<p><strong>Objectives: </strong>MR differentiation between endometrial cancer, hyperplasia, and the normal endometrium using ADC values and their correlation with the pathohistological characteristics of endometrial cancer.</p><p><strong>Material and methods: </strong>The retrospective study included 131 patients, 55 with endometrial cancer, 21 with hyperplasia, and 55 patients with normal endometrium. Mean ADC values were obtained by measuring the region of interest (ROI) in the corresponding part of the endometrium.</p><p><strong>Results: </strong>The mean ADC values of endometrial cancer (0.646 ± 0.112 × 10⁻³ mm²/s) were significantly lower than those of endometrial hyperplasia (1.660 ± 0.394 × 10⁻³ mm²/s) and normal endometrium (1.503 ± 0.312 × 10⁻³ mm²/s) (p<0.001), while the ADC values of endometrial hyperplasia did not differ from normal endometrium. No difference was found between ADC values in different grades of endometrial cancer (p=0.219; p>0.05), depending on the depth of myometrial invasion (p=0.506; p>0.05), the presence of metastases in lymph nodes (p=0.202; p>0.05), and lymphovascular invasion (p=0.366; p>0.05). Regarding the FIGO stage, the only significant difference in ADC values was obtained for stage 4b (p=0.023; p<0.05). ADC values below 1.120 × 10⁻³ mm²/s with 100% sensitivity and 94.5% specificity indicate the presence of cancer, with a positive predictive value of 94.8% and a negative predictive value of 100%.</p><p><strong>Conclusions: </strong>The ADC is a useful diagnostic tool in the differentiation between endometrial cancer and hyperplasia with high sensitivity and specificity, but its use in differentiating pathohistological characteristics of endometrial cancer is not possible.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Diagnostic Parameters of Cytodiagnostics as a screening tool conducted in 2005-2020 as part of the National Population-Based Cervical Cancer Screening Program in Poland.","authors":"Klaudyna Madziar, Maria Buda, Witold Kedzia","doi":"10.5603/gpl.98522","DOIUrl":"https://doi.org/10.5603/gpl.98522","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the diagnostic parameters of cytodiagnosis as a screening method used in the National Population-Based Cervical Cancer Screening Program compared to out-program screening.</p><p><strong>Material and methods: </strong>A retrospective analysis of 800 results obtained during routine screening for the National Population-Based Cervical Cancer Screening Program and out-program samples. Abnormal cytologic interpretations, which were an indication for colposcopy as well as HPV DNA HR test and the final histopathology test, both from in- and out-program patients, were statistically analyzed.</p><p><strong>Results: </strong>Out of 800 abnormal cytologic results, we obtained 7 - suspicion of squamous cell carcinoma, 105 - HSIL, 152 - ASC-H, 269 - LSIL, 254 - ASCUS, and 13 - AGC. Cervical pathology was confirmed on histopathology in 422 patients: cervical cancer was detected in 21 patients, with the following findings in the remaining women: 103 - CIN 3, 126 - CIN 2, 173 - CIN 1, koilocytosis without CIN - 143, and lesion-free histopathology - 378. Out of 800 abnormal cytologic results, HPV DNA was detected in 539 women, including 387 - HPV DNA HR, 240 - HPV DNA 16, and only 22 - HPV DNA 18.</p><p><strong>Conclusions: </strong>The prevention program significantly improved the detection parameters of the in-program as compared to out-program cytodiagnostics. The goal of the screening programs should be to identify lesions consistent with ≥ CIN2. Molecular testing, which can identify at least 14 HPV HR genotypes, should be the first-line screening tool. A positive molecular test result should not be an indication for advanced diagnostics. Other than conventional or liquid-based cytology, an ultimate detection test is necessary.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of 40:1 myo-inositol/D-chiro-inositol treatment on serum asprosin levels in polycystic ovary syndrome: a prospective randomized pilot study.","authors":"Ozlen Emekci Ozay, Yusuf Ozay, Oguzhan Edebal, Marco Calcagno, Ali Cenk Ozay","doi":"10.5603/gpl.103763","DOIUrl":"https://doi.org/10.5603/gpl.103763","url":null,"abstract":"<p><strong>Objectives: </strong>Asprosin, a novel adipokine primarily secreted by white adipose tissue, has been implicated in the pathogenesis of insulin resistance and metabolic dysfunction. Its elevated levels characterize patients with polycystic ovary syndrome (PCOS) exhibiting metabolic alterations. Aim of this work was to evaluate the effects of insulin sensitizer administration, as inositols, on asprosin levels and then compare these results with the effects of metformin treatment.</p><p><strong>Material and methods: </strong>30 patients with PCOS were enrolled in this study and randomly divided into two groups: (i) group 1 assumed a dietary supplement based on 40:1 myo-inositol (MI)/D-chiro-inositol (DCI), (ii) group 2 assumed metformin (MET), for 12-16 weeks of treatment.</p><p><strong>Results: </strong>The reduction of serum asprosin levels in patients with PCOS after treatment with MET and MI/DCI is the most intriguing result. Its levels decreased more in the inositol group, although they did not reach statistical significance probably due to the lower number of patients.</p><p><strong>Conclusions: </strong>The observed dysregulation of asprosin levels in PCOS highlights a potential link between this novel adipokine and the pathophysiology of the disorder, suggesting a modulatory effect of the combined 40:1 MI/DCI on asprosin levels. Of course, further studies may contribute to disclosing molecular mechanisms underlying asprosin reduction and open toward new perspectives.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colposcopy in pregnancy.","authors":"Edyta Keczkowska, Natalia Zeber-Lubecka, Katarzyna Szlendak-Sauer, Monika Nekanda-Trepka, Maciej Brazert, Michal Ciebiera","doi":"10.5603/gpl.104421","DOIUrl":"https://doi.org/10.5603/gpl.104421","url":null,"abstract":"<p><p>Colposcopy is a method of enhanced diagnostics of cervical dysplasia, aimed at preventing cervical cancer. Its role is the same in and out of pregnancy. It is often performed after obtaining abnormal results of cervical cytology or a test for human papillomavirus (HPV16 and HPV18), or any other abnormal findings such as polyps, or unexplained bleeding from the cervix. However, in pregnancy, the first screening test is still a cytological examination of the cervical smear. Colposcopy allows for the identification of suspicious lesions, which allows for a biopsy to be collected for histopathological evaluation. Biopsy is not recommended during pregnancy except for the detection of lesions suspected of being invasive. Colposcopy is minimally invasive, generally well tolerated and crucial for the early detection of cervical intraepithelial neoplasia (CIN) and other gynecological lesions. In pregnancy, this role is reduced to observing the cervix for the progression of lesions. Pregnancy-related lesions in the cervix sometimes make it difficult to assess the cervix effectively and reliably. Therefore, the experience of the physician performing colposcopy during pregnancy is of great importance. In this review we want to summarize the current data about colposcopy during pregnancy.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}