Ginekologia polska最新文献

{"title":"Efficacy of postsurgical medical therapy for infertile patients with deep endometriosis.","authors":"David Skhirtladze, Jenara Kristesashvili, Ramaz Charekishvili","doi":"10.5603/gpl.99414","DOIUrl":"https://doi.org/10.5603/gpl.99414","url":null,"abstract":"<p><strong>Objectives: </strong>Though laparoscopic surgery is effective for the treatment of deep endometriosis (DE), postoperative management remains controversial. Dienogest therapy after surgery may improve spontaneous pregnancy rates and decrease the severity of dysmenorrhea in infertile patients with DE. To determine the efficacy of postsurgical therapy with dienogest for improving fertility and reducing the intensity of dysmenorrhea in infertile patients with DE.</p><p><strong>Material and methods: </strong>This open label, randomized controlled trial was conducted involving 88 women aged 21-38 years with infertility who underwent surgery for DE. Three patients were lost to follow-up. After surgery, eligible patients were randomly divided into two groups. Forty-four patients who received dienogest for three months following surgery were enrolled in group 1. The remaining 41 patients comprised group 2 and did not receive any postsurgical treatment over the same period. The primary outcome measure was the pregnancy rate calculated nine months after surgery, while the mean intensity of dysmenorrhea was measured before and nine months after surgery.</p><p><strong>Results: </strong>The pregnancy rate in group 1 was significantly higher than in group 2 (47.7% vs 22%, p = 0.013) nine months following surgical intervention. Patients in group 1 exhibited a more statistically significant reduction in the mean score of dysmenorrhea intensity compared to group 2, from 8.7 to 2.8 vs 8.76 to 5.63, respectively (p < 0.001).</p><p><strong>Conclusions: </strong>The use of dienogest as an add-on therapy for treating DE may show significantly higher effectiveness compared to surgical intervention alone for improving fertility and reducing the severity of dysmenorrhea.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977484","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":"Initial paraneoplastic presentation of advanced choriocarcinoma.","authors":"Julia Rudnicka, Aleksandra Urban, Julia Gorny, Anna Danska-Bidzinska, Ewa Romejko-Wolniewicz","doi":"10.5603/gpl.100439","DOIUrl":"https://doi.org/10.5603/gpl.100439","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977485","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 artery embolization for arteriovenous malformation of the cervix.","authors":"Shangao Huang, Yueling Wu, Ying Zhang","doi":"10.5603/gpl.99083","DOIUrl":"https://doi.org/10.5603/gpl.99083","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977490","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":"Prenatal diagnosis of scimitar syndrome.","authors":"Aleksandra Sliwka, Marcelina Sztyler-Krakowska, Karol Bielasik, Przemyslaw Kosinski","doi":"10.5603/gpl.99477","DOIUrl":"https://doi.org/10.5603/gpl.99477","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977487","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":"Levels of a novel metabolic marker, spexin in patients with hirsutism: metabolic syndrome risk in idiopathic and polycystic ovarian syndrome (PCOS) hirsutism.","authors":"Nil Atakul, Berna Sermin Kılıc, Sahabettin Selek, Yildiz Atamer","doi":"10.5603/gpl.96191","DOIUrl":"https://doi.org/10.5603/gpl.96191","url":null,"abstract":"<p><strong>Objectives: </strong>Polycystic ovarian syndrome (PCOS) disease the most common endocrinopathy among reproductive age women , and its association with metabolic syndrome is investigated in many reports. The most common cause of hirsutism worldwide is considered to be idiopathic hirsutism (IH) defined as clinical hirsutism without underlying hormonal imbalance. Spexin is a novel peptide and is mainly involved in energy homeostasis and, has not yet made its way into clinical practice. We aim to investigate spexin in an understudied population of hirsute patients.</p><p><strong>Material and methods: </strong>This prospective case-control study analysis involved 48 patients with hirsutism.and, was further divided into two groups: 26 had PCOS syndrome and 22 had IH. 40 healthy, age and BMI-matched non-hirsute women enrolled as the control group. The spexin level was determined using a human spexin ELISA kit.</p><p><strong>Results: </strong>There was no statistically significant difference in spexin levels found between hirsutism and control patients 1514 vs 1425 ng/L, (p = 0.849). Spexin levels were found to be significantly higher in the PCOS hirsutism group than in the IH group (1668.5 ng/L vs 1021 ng/L), (p = 0.022). Correlations of spexin levels with total testosterone, low-density lipoprotein, and total cholesterol were found in hirsutism patients.</p><p><strong>Conclusions: </strong>Our findings conclude that both IH and PCOS hirsutism patients have an increased risk of metabolic syndrome; hyperandrogenemia and dyslipidemia contribute to the progression of upcoming research on metabolic syndrome. Low spexin levels in IH in hirsute patients Could potentially elucidate the pathogenesis of the condition, consequently assisting in diminishing the risk of associated complications.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977486","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":"Thoracic endometriosis complicating pregnancy.","authors":"Hanna Rodak, Magdalena Kolak, Andrzej Jaworowski, Hubert Huras","doi":"10.5603/gpl.99110","DOIUrl":"https://doi.org/10.5603/gpl.99110","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977489","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":"Vulval squamous cell cancer - does precursor lesion margin status affect recurrence-free survival after optimal surgical resection for early-stage disease?","authors":"Andrew A Durden, Pete Sanderson, Nidal Ghaoui, Scott Fegan, Cameron Martin, Chee Thum, James May","doi":"10.5603/gpl.98720","DOIUrl":"https://doi.org/10.5603/gpl.98720","url":null,"abstract":"<p><strong>Objectives: </strong>Vulval cancer accounts for around 4% of all gynaecological malignancies and most tumours ( > 90%) are of a squamous cell histotype. Most lesions arise on a background of differentiated VIN (dVIN) or lichen sclerosus (LS). Surgical treatment has undergone a paradigm shift with less radical surgery being attempted to preserve vulval structure and function, without compromising oncological outcome.</p><p><strong>Material and methods: </strong>In this single site retrospective analysis, we consider the data from a tertiary oncology unit, to assess progression-free survival based on the presence of a precursor lesion at the margin of resection.123 patients with FIGO stage 1 vulvar SCC (n = 33 1A, n = 90 1B) were included.</p><p><strong>Results: </strong>One Hundred Five patients (85%) had an associated precursor lesion (dVIN and/or LS). Within the follow-up period, 33 patients (26.8%) had invasive recurrence, of which 24 (72.7%) had surgical resection margins which were positive for a precursor lesion. In patients with an acceptable microscopically clear invasive resection margin of > 2 mm the presence of a precursor lesion at the margin conveyed a higher risk of malignant recurrence when compared to those with completely clear margins (HR = 2.42; 95% CI 1.14-5.16).</p><p><strong>Conclusions: </strong>This study adds to the available literature emphasising the clinical significance of dVIN or LS at the surgical margin of optimally resected disease. In those who have marginal involvement of a precancerous lesion, increased surveillance should be considered. Future work should explore the need for additional adjuvant therapy in this cohort.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536188","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":"Influence of pregnancy and mode of delivery on pelvic floor function: a review of literature.","authors":"Justyna Zarzecka, Monika Pycek, Katarzyna Pietrzykowska-Szczubełek, Ewa Barcz, Andrzej Pomian","doi":"10.5603/gpl.98418","DOIUrl":"https://doi.org/10.5603/gpl.98418","url":null,"abstract":"<p><p>Pelvic floor disorders (PFDs), such as pelvic organ prolapse (POP) and urinary incontinence (UI), severely affect women's quality of life. Among these, stress urinary incontinence (SUI) is the most common, impacting a significant proportion of women. In the US, the lifetime risk of undergoing surgery for UI or POP stands at 20%. Pregnancy-related factors, notably delivery method and UI occurrence during pregnancy, have a potent correlation with PFD onset. The pathophysiology of PFDs during pregnancy is complex, with factors like increased intra-abdominal pressure, changes in bladder neck mobility, and shifts in pelvic floor muscle strength and collagen metabolism playing pivotal roles. PFD risk factors span across pregnancy, labor, and the postnatal phase and include UI or fecal incontinence (FI) during pregnancy, advanced maternal age, elevated BMI, multiple births, instrumental and spontaneous vaginal deliveries, and newborns weighing over 4000 grams. Conversely, Cesarean deliveries are linked with a reduced long-term risk of UI and POP compared to vaginal births. Current prognostic models can predict the likelihood of PFD development based on variables such as delivery method, number of births, and familial history. Preventive measures encompass lifestyle changes like caffeine reduction and weight management, alongside pelvic floor muscle training (PFMT) during pregnancy. Thus, expectant mothers are advised to participate in physical activities, prominently including PFMT.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878217","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":"Rectus muscle re-approximation in cesarean section - a surgical dilemma: to close or not to close?","authors":"Orkun Cetin, Kübra Ak, Tuba Bozhüyük Sahin, İpek Dokurel Çetin","doi":"10.5603/gpl.98027","DOIUrl":"https://doi.org/10.5603/gpl.98027","url":null,"abstract":"<p><strong>Objectives: </strong>Cesarean section is one of the most common operations worldwide since decades. However, the optimum surgical cesarean section technique is still being discussed. Closure or non-closure of the rectus muscles is also unclear among obstetricians. We aimed to evaluate the effect of rectus muscle re-approximation (RMR) in cesarean section on postoperative pain among singleton primi gravida elective cesarean sections at term.</p><p><strong>Material and methods: </strong>The current study was planned as a prospective, blinded, randomized controlled trial. A total of 279 elective primi gravida singleton cesarean sections; 142 undergoing RMR and 137 not-undergoing RMR were included in the study. All participants were managed with our clinic's postoperative protocol and obstetric outcomes were also recorded. The patients' pain was assessed face to face 24 hours and 48 hours after operation by using visual analog scale (VAS) score.</p><p><strong>Results: </strong>The elective singleton primi gravida cesarean sections with and without RMR exhibited no significant difference with respect to maternal age, Body Mass Index, delivery week and other obstetric outcomes. The VAS scores at 24th and 48th hours (67 ± 24 versus 69 ± 25, p: 0.635; 47 ± 25 versus 52 ± 26, p: 0,126, respectively) were similar between the RMR and non-RMR group.</p><p><strong>Conclusions: </strong>RMR has not any negative effect on postoperative pain, operation time, analgesic use and hospital stay in singleton primi gravida elective CS at term. Additionally, RMR did not lead to any adverse postoperative risks such as increased blood loss and sub-rectus hematoma.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878220","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 Ureaplasma/Mycoplasma genital tract infection on preterm labor.","authors":"Marcin Przybylski, Ilona Wicher-Gozdur, Joanna Kippen, Sonja Millert-Kalinska, Agnieszka Zawiejska, Robert Jach, Dominik Pruski","doi":"10.5603/gpl.99827","DOIUrl":"https://doi.org/10.5603/gpl.99827","url":null,"abstract":"<p><strong>Objectives: </strong>Genitourinary tract infections in pregnant women are one of the causes of abnormal pregnancy development including miscarriages, premature labor or premature rupture of membranes (PPROM). Atypical bacteria responsible for reproductive tract infections include Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum. Identification of pathogens and appropriately selected therapy can improve obstetric outcomes in patients with symptoms of threatened miscarriage or threatened preterm labor. The purpose of our study is to analyze the impact of reproductive tract infections with ureaplasma and mycoplasma bacteria during pregnancy.</p><p><strong>Material and methods: </strong>In the presented study, we retrospectively analyzed the cases of 201 pregnant patients hospitalized in the Obstetrics and Gynecology Department of Poznan Regional Hospital in 2019-2022, who had a swab taken from external os area of the cervix for atypical bacteria - Ureaplasma and Mycoplasma. Only patients with symptoms of threatened miscarriage or threatened preterm labor were included in the study group. Microbiological tests were performed in the hospital laboratory with the Mycoplasma IST 3 test from Biomerieux.</p><p><strong>Results: </strong>We found a higher incidence of preterm labor in patients with symptoms of threatened preterm labor and a genital tract infection with Ureaplasma/Mycoplasma bacteria, compared to patients not infected with Mycoplasma/Ureaplasma - 31.1% vs 20% (p = 0.098). This observation in the case of Ureaplasma/Mycoplasma monoinfection group applied to 6 patients. - 75% of the group. Pregnant patients who had co-infection with other types of bacteria (48 patients in total) gave birth before 37 weeks of pregnancy in 27.1% of cases. We obtained a significant difference (p = 0.007) when comparing groups with positive and negative cultures for Ureaplasma/Mycoplasma by the presence of monoinfection/coinfection and the week of pregnancy in which delivery occurred. We also noted the effect of atypical bacterial infection for PPROM - this complication preceded preterm delivery in 40% of ureaplasma-positive patients, compared to 20% of PPROM without infection. We found a similar rate of preterm labor and pregnancy loss in Ureaplasma/Mycoplasma-positive patients who received antibiotic therapy (35.7%) compared to a group of pregnant women who did not receive treatment (31.6%).</p><p><strong>Conclusions: </strong>Infection of the genital tract with atypical bacteria Ureaplasma and Mycoplasma has a negative impact on the course of pregnancy. Identification of the type of microorganisms in cervical canal secretions of pregnant patients with symptoms of threatened miscarriage or preterm labor seems crucial. The impact of antibiotic therapy though, requires further analysis.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878215","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}