European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Impact of placenta accreta spectrum on sexual and psychological health: a comparative analysis using FSFI and SF-36","authors":"Dini Hidayat ,&nbsp;Sri Dewi Rahmawati Syarief ,&nbsp;Vyanda Sri Weningtyas ,&nbsp;Faradiba Janiyustika","doi":"10.1016/j.ejogrb.2026.114942","DOIUrl":"10.1016/j.ejogrb.2026.114942","url":null,"abstract":"<div><h3>Background</h3><div>Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition characterized by abnormal placental adherence to the myometrium. While hysterectomy remains the standard definitive management, conservative strategies such as wedge resection or delayed hysterectomy have been increasingly adopted to preserve fertility. The comparative impact of these approaches on women’s quality of life (QoL), particularly social and sexual functioning, has not been well investigated.</div></div><div><h3>Method</h3><div>A cross-sectional study included 185 women who underwent caesarean section (CS) for histopathologically confirmed PAS at Dr. Hasan Sadikin General Hospital, Bandung, West Java, from 2022 to 2024. A total of 161 met the inclusion criteria and were analyzed, while 24 were excluded. Sexual function and QoL were assessed using the Female Sexual Function Index (FSFI) and the 36-Item Short Form Health Survey (SF-36), respectively. Non-parametric analysis using the Mann–Whitney <em>U</em> test was applied for scale scores and categorical comparisons were analyzed using Chi-square or Fisher’s exact test, with p &lt; 0.05 considered significant.</div></div><div><h3>Result</h3><div>Median FSFI scores for desire (3.0 [2.5–3.5] vs. 3.0 [2.0–4.0], p = 0.015), arousal (2.5 [2.0–3.5] vs. 3.0 [2.0–4.0], p = 0.048), and pain (2.4 [2.0–2.7] vs. 3.0 [2.0–4.0], p = 0.021) differed significantly between the hysterectomy and conservative groups, although median values for desire were similar. Other FSFI domains and total scores were not significantly different (p &gt; 0.05). In the SF-36, a statistically significant difference was observed only in the social functioning domain, despite comparable median scores between groups.</div></div><div><h3>Conclusion</h3><div>Conservative management in PAS was associated with better preservation of specific aspects of sexual function, particularly pain and arousal.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114942"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application and validation of AI-driven methods to explore patient experiences of pre-cervical cancer","authors":"Michael Y. Luo ,&nbsp;Christopher Y.K. Williams","doi":"10.1016/j.ejogrb.2026.114953","DOIUrl":"10.1016/j.ejogrb.2026.114953","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to apply novel natural language processing (NLP) tools to explore patient experiences of pre-cervical cancer on social media and validate the performance of these tools.</div></div><div><h3>Methods</h3><div>All posts and comments were extracted from the forum r/PreCervicalCancer on social media platform <em>Reddit</em>. Using BERTopic, posts were clustered into topics according to their semantic similarity, which were manually reviewed. Topic headings were derived using a large language model (LLM) and compared to manually curated headings. Clustering outliers were reassigned by BERTopic, an LLM and by manual methods in parallel and compared. Post and comment sentiment were quantitatively analysed using VADER. Post upvote scores and comments counts were analysed to measure community engagement.</div></div><div><h3>Results</h3><div>4592 posts were extracted from r/PreCervicalCancer. Posts clustered into 10 different topics using BERTopic with 88.0% accuracy. 80.0% of topic headings generated by GPT-4o mini were deemed appropriate. Reassignment of clustering outliers by BERTopic and GPT-4o mini was limited, 52.8% and 41.1% accuracy, respectively. Key clinical findings reflect several common concerns among patients, particularly regarding specific lasting physical and psychological impact of procedures like LEEP, result anxiety, and challenges in healthcare navigation. Comments had less negative sentiment than posts (Cohen’s d = 0.46), suggesting support.</div></div><div><h3>Conclusions</h3><div>In this cross-sectional study, we validated NLP tools to analyse content, sentiment and reactions to 4592 posts on pre-cervical cancer. Our findings suggest that, with minimal human oversight, automated methods can accurately conduct large-scale analyses of similar clinical content, unlocking new insights of patient experiences using non-traditional data sources.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114953"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency contraception pills among female students: Use, knowledge, perceptions, and expectations","authors":"Alison Catilaz ,&nbsp;Anne-Laure Clairet ,&nbsp;Marilia Girault ,&nbsp;Stéphanie Paris ,&nbsp;Virginie Nerich","doi":"10.1016/j.ejogrb.2026.114946","DOIUrl":"10.1016/j.ejogrb.2026.114946","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the rate of emergency contraception pills (ECP) use among female students, and to examine their characteristics, knowledge, perceptions and expectations regarding ECPs, with particular attention to the experiences and feedback of those who had previously used it.</div></div><div><h3>Study design</h3><div>A cross-sectional, voluntary online survey was conducted among female women students at the Marie and Louis Pasteur University during the 2022–2023 academic year. The questionnaire mainly assessed demographics, contraceptive use, knowledge and perceptions of ECP, and experiences with ECP use. Descriptive and comparative analyses were performed.</div></div><div><h3>Results</h3><div>Among 2,157 female students who completed the survey, i.e., response rate of 15.1 %, 39.1 % reported having previously used ECP at least once, with use increasing significantly with age groups (&lt; 20, 20–29, &gt;29 years). Female students who had used ECP showed higher knowledge and more positive perceptions about ECP, were more likely to use condoms, and primarily consulted pharmacists and the Internet for information. Most ECPs were obtained from community pharmacies, with nearly three-quarters of pharmacists providing information, but only 4 % of dispensations occurred in a confidential space. The main reasons for ECP use were condom breakage, forgetting regular contraception, or not using any regular contraceptive method. Practical and theoretical knowledge about ECP was higher among users.</div></div><div><h3>Conclusion</h3><div>Most female students were aware of emergency contraception and its indications, with a moderate rate of use. These results highlight the need to improve access to reliable information and to explore the role of healthcare professionals and educational strategies in promoting appropriate ECP use.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114946"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Stiffness Index as predictor of preterm birth in women with threatened preterm labor","authors":"Dario Colacurci ,&nbsp;Gabriele Saccone ,&nbsp;Alessandra Ammendola ,&nbsp;Giorgia Buonomo ,&nbsp;Chiara Murolo ,&nbsp;Mariavittoria Locci","doi":"10.1016/j.ejogrb.2025.114910","DOIUrl":"10.1016/j.ejogrb.2025.114910","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the uterine cervix stiffness in patients presenting with threatened preterm labor (PTL) measured with an aspiration-based device (expressed as Cervical Stiffness Index − CSI) and to correlate CSI with pregnancy outcomes.</div></div><div><h3>Study design</h3><div>Single-center, prospective, observational pilot study of patients with singleton pregnancies presenting with threatened PTL between 24^0/7 and 33^6/7 weeks. Patients underwent a physical examination, ultrasound examination, transvaginal ultrasound cervical length (CL) measurement and cervical stiffness assessment using the Pregnolia System, an aspiration-based device measuring the vacuum required to displace the tissue into the device tip by a fixed distance, a proxy for stiffness (CSI, mbar). Higher CSI indicates stiffer tissue.</div></div><div><h3>Results</h3><div>Between April 2022 and August 2024, 100 patients with signs and symptoms of PTL were recruited. Thirty-five had a PTB, of which 7 delivered &lt; 34 weeks, 5 within 14 days and 11 within 28 days from measurement. CSI and CL were significantly different between patients delivering at term and patients with a PTB. The Area under the Curve of CSI and CL for prediction of delivery ≤ 14 days from measurement were 0.979 (95 % CI, 0.952–1.000) and 0.744 (0.369–1.000), respectively; for delivery ≤ 28 days from measurement, 0.802 (0.612–0.993), and 0.764 (0.579–0.948), respectively; for PTB &lt; 34 weeks, 0.873 (0.729–1.000) and 0.836 (0.563–1.000), respectively; and for PTB &lt; 37 weeks 0.845 (0.763–0.926) and 0.779 (0.680–0.877), respectively.</div></div><div><h3>Conclusions</h3><div>In patients presenting with threatened PTL, a softer cervix as measured by CSI was associated with an increased risk of preterm birth. These findings suggest that CSI has potential as a predictor of PTB in symptomatic patients, but require confirmation in larger, independent cohorts.</div></div><div><h3>Clinical trial registration</h3><div>NCT05355649.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114910"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does BMI affect treatment outcomes following intradetrusor onabotulinumtoxinA (Botox) injection in patients with Overactive Bladder (OAB)?","authors":"Miriam O’Kane ,&nbsp;Adith Thomas ,&nbsp;Erin Fitzsimons-West ,&nbsp;Lily Bracken ,&nbsp;Ana DaSilva ,&nbsp;Hayser Medina Lucena ,&nbsp;Ivilina Pandeva ,&nbsp;Smita Rajshekhar ,&nbsp;Ashish Pradhan","doi":"10.1016/j.ejogrb.2025.114907","DOIUrl":"10.1016/j.ejogrb.2025.114907","url":null,"abstract":"<div><div>Overactive bladder (OAB) is a common condition among women, often impairing quality of life and frequently associated with obesity. Intradetrusor onabotulinumtoxinA (BoNT/A) is an established treatment for refractory OAB; however, the influence of body mass index (BMI) on treatment outcomes remains unclear. This retrospective cohort study examined whether obesity impacts subjective and objective treatment responses in women undergoing BoNT/A injections for refractory OAB. Data were collected from the British Society of Urogynaecology (BSUG) database for patients treated between 2013 and 2023 at a tertiary Urogynaecology Centre in the United Kingdom. Of 522 initial cases, 285 women met inclusion criteria. Patient-reported satisfaction at 6 months post-injection and changes in International Consultation on Incontinence Questionnaire – Overactive Bladder (ICIQ-OAB) scores were evaluated. Women were stratified into BMI &lt;30 and BMI ≥30 groups. Satisfaction rates were high and nearly identical between groups (76.8 % vs. 77.0 %, p = 0.973). Likewise, mean change in ICIQ-OAB scores showed minimal and statistically insignificant differences between BMI categories (p = 0.71). Logistic and linear regression analyses, adjusting for age and BoNT/A dose, confirmed that BMI was not a significant predictor of either patient satisfaction or symptom score improvement. Neither age nor BoNT/A dose significantly influenced outcomes. These findings suggest that BMI does not affect the efficacy of BoNT/A treatment for OAB, supporting its use irrespective of weight status. Clinically, BoNT/A remains a valuable therapeutic option for women with refractory OAB, while weight loss should continue to be encouraged for its broader health benefits, including improvements in urinary continence.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114907"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic surgical resolution of symptomatic biliary pathology during pregnancy: An early therapeutic approach at any gestational age","authors":"Nicolás Fernandez-Barra ,&nbsp;Camila A Fernández ,&nbsp;Enzo A Muñoz ,&nbsp;Bernardo I Cepeda ,&nbsp;Pedro Gutierrez-Contreras ,&nbsp;Pablo A Silva-Labarca ,&nbsp;Jose Galaz ,&nbsp;Paula A Vargas ,&nbsp;Carolina P Martinovic ,&nbsp;Juan F Prieto ,&nbsp;Daniela P Luna ,&nbsp;Erwin Buckel ,&nbsp;Constanza A Godoy ,&nbsp;Tamara A Álvarez ,&nbsp;Rolando Rebolledo ,&nbsp;Alejandro I Brañes ,&nbsp;José E Ruiz ,&nbsp;Julio E Benítez ,&nbsp;María B García ,&nbsp;Rose M Mege ,&nbsp;Juan P Kusanovic","doi":"10.1016/j.ejogrb.2025.114909","DOIUrl":"10.1016/j.ejogrb.2025.114909","url":null,"abstract":"<div><h3>Background</h3><div>Physiologic changes occurring during pregnancy lead to a higher risk for developing biliary diseases. It is estimated that for every 10,000 pregnant individuals, between 1 and 6 will require a cholecystectomy prior to delivery, most of them being done by a laparoscopic approach. Chile has one of the highest prevalence of gallbladder disease worldwide; however, the characterization of laparoscopic cholecystectomy during pregnancy in Hispanic populations has been poorly investigated.</div></div><div><h3>Objective</h3><div>To describe maternal and perinatal outcomes among pregnant individuals undergoing laparoscopic cholecystectomy for symptomatic gallbladder disease at a tertiary care center in Chile, across different gestational ages.</div></div><div><h3>Study Design</h3><div>A retrospective cohort study was conducted including all pregnant patients who underwent laparoscopic cholecystectomy between January 2002 and August 2023 in the High-Risk Pregnancy unit at the Sótero del Río hospital in Santiago, Chile. Information related to surgery, early postoperative evolution and perinatal outcomes were analyzed.</div></div><div><h3>Results</h3><div>A total of 158 pregnant patients who underwent laparoscopic surgery were included. The median gestational age at the time of surgery was 20 + 6 weeks (range 5–37 weeks). Most surgeries (61 %) were performed during the midtrimester, while 18 % were at the third trimester. The median admission-to-surgery interval was three days (range: 0–13), and the median hospitalization time was five days (range: 1–22). The mean gestational age at delivery was 38 weeks, and the rate of preterm birth &lt; 37 weeks was 13.5 %. There were three cases of surgical complications (1.9 %) and five pregnancy losses (3.6 %). There were no cases that required admission to an intermediate/intensive care unit after surgery.</div></div><div><h3>Conclusion</h3><div>In this single-center case series, laparoscopic cholecystectomy for symptomatic gallbladder disease during pregnancy was associated with acceptable maternal and perinatal outcomes across a wide range of gestational ages. Laparoscopic cholecystectomy appears feasible at different trimesters of pregnancy. Further studies are needed to determine if this alternative is better than conservative management.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114909"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive factors, exogenous hormone use and risk of migraine among women: Results from UK Biobank","authors":"Nana Wang ,&nbsp;Yongli Yang ,&nbsp;Xiaocan Jia ,&nbsp;Yuping Wang ,&nbsp;Chaojun Yang ,&nbsp;Jingwen Fan ,&nbsp;Chenyu Zhao ,&nbsp;Yacong Bo ,&nbsp;Xuezhong Shi","doi":"10.1016/j.ejogrb.2025.114892","DOIUrl":"10.1016/j.ejogrb.2025.114892","url":null,"abstract":"<div><h3>Aims</h3><div>The association between female reproductive factors and migraine risk remains inconclusive. This study aimed to investigate the association between reproductive factors and migraine.</div></div><div><h3>Methods</h3><div>This study included 268,440 female participants enrolled in the UK Biobank from 2006 to 2010. Cox proportional hazard models and restricted cubic spline were used for association analyses.</div></div><div><h3>Results</h3><div>With a median of 13.67 years follow-up, a total of 4,394 cases of migraine were documented. The adjusted HR (95 % CI) for menarche &gt; 14 years was 1.16(1.04,1.28) compared with 12 to 14 years; 1.48(1.32,1.66) for menopause &lt; 45 years compared with 45 to 55 years; 1.32 (1.18,1.48) for reproductive life expectancy &lt; 33 years compared with 33 to 40 years; 1.60(1.43,1.79) for hysterectomy; 1.52(1.37,1.69) for oophorectomy; 1.31(1.19,1.45) for pregnant; 1.66(1.47,1.86) for first live birth &lt; 22 years compared with &gt; 27 years; 1.31(1.17,1.47) for last live birth &lt; 27 years compared with &gt; 33 years; 1.16(1.03,1.30), 1.16(1.06,1.27), and 1.17(1.05,1.29) for 1, 2, and 3 or more children compared with no children; 1.18(1.10,1.28) for miscarriages; 1.13(1.04,1.24) for abortions; 1.62(1.51,1.74) for using HRT. Age at menarche, age at first or last live birth, age started oral contraceptive pills, age started HRT, and HRT duration were nonlinearly associated with migraine risk (<em>P</em> &lt; 0.001).</div></div><div><h3>Discussion</h3><div>Female reproductive factors, including gynecologic surgery, early first birth, and using HRT, were associated with incident migraine. The findings emphasize the need to incorporate reproductive history into clinical profiles and provide an evidence base for personalized prevention strategies in women.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114892"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between ultrasonographic findings and histopathological and molecular characteristics in endometrial cancer: A multicenter study","authors":"Irene Colombi ,&nbsp;Giuseppe Vizzielli ,&nbsp;Eugenia Costantini ,&nbsp;Silvia Pisaneschi ,&nbsp;Federica Perelli ,&nbsp;Anna Biasoli ,&nbsp;Stefano Restaino ,&nbsp;Francesca Ciccarone ,&nbsp;Gabriele Centini ,&nbsp;Francesco Giuseppe Martire ,&nbsp;Martina Pacifici ,&nbsp;Alberto Mattei ,&nbsp;Errico Zupi ,&nbsp;Lucia Lazzeri","doi":"10.1016/j.ejogrb.2025.114900","DOIUrl":"10.1016/j.ejogrb.2025.114900","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative assessment of endometrial cancer is crucial for tailoring surgical and therapeutic management. Identifying correlations between ultrasonographic features and tumor histopathological and molecular profiles may help improve the accuracy of presurgical staging.</div></div><div><h3>Objectives</h3><div>This multicenter retrospective study aimed to evaluate the association between ultrasonographic features, histopathological characteristics and molecular profiles in endometrial cancer to improve preoperative assessment and risk stratification.</div></div><div><h3>Study design</h3><div>A total of 156 women from three Italian centers underwent standardized transvaginal or transrectal ultrasound following IETA criteria prior to hysterectomy. Ultrasonographic parameters, including endometrial thickness, echogenicity, junctional zone integrity, and vascularity assessed by Doppler, were analyzed. Postoperative histopathology and molecular classification (p53, MMR, POLE, NSMP) were performed. Statistical analyses evaluated correlations among ultrasound features, pathology, and molecular data.</div></div><div><h3>Results</h3><div>Endometrioid histotype was detected in 88.46 % of cases, mostly low-grade and early-stage. Cases in the early stage (i.e. lesions confined to the uterine corpus) accounted for 77.27 % of all cases. Ultrasound staging was consistent with the final staging in 65.5 % of cases, with errors primarily involving the overestimation of p53-abnormal tumors and the underestimation of MMRd tumors. Increased endometrial thickness was associated with a higher stage and grade (median 20 mm for stage III, p = 0.007). An irregular junctional zone was associated with high-grade tumors (p = 0.016). Complex and multifocal vascular patterns were significantly linked to advanced stages, high grade, and molecular aggressiveness, such as p53 mutations and MMR deficiency. Tumors with scattered vessels showed a higher risk of extensive lymphovascular space invasion.</div></div><div><h3>Conclusions</h3><div>Ultrasound features, particularly vascularity, junctional zone irregularity, and endometrial thickness, are significantly associated with tumor stage, grade, and molecular profiles. Incorporating detailed ultrasonographic assessment into preoperative evaluation can help identify high-risk endometrial cancers and guide personalized management strategies.</div><div>Larger prospective studies are needed to validate these findings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114900"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of total laparoscopic excision of deep endometriosis (DE) on bladder and bowel dysfunction: a prospective longitudinal study","authors":"James S. Morris ,&nbsp;Smita Rajshekhar ,&nbsp;Giulia Gremmo ,&nbsp;Katie Keane ,&nbsp;Saikat Banerjee","doi":"10.1016/j.ejogrb.2025.114924","DOIUrl":"10.1016/j.ejogrb.2025.114924","url":null,"abstract":"<div><div>Deep endometriosis (DE) is established to cause chronic pelvic pain (CPP), lower urinary tract symptoms (LUTS) and altered bowel function. Although the aim of surgical excision is often to relieve CPP, evidence suggests it could also affect LUTS and bowel symptoms, especially where DE affects the bowel or urinary tract. We assessed the prevalence and improvements in CPP, LUTS and bowel symptoms in 130 patients preoperatively and 6 months following total excision of endometriosis using the British Society for Gynaecological Endoscopy (BSGE) Pelvic Pain Questionnaire. Pain symptoms and LUTS are graded 0–10 whilst bowel function is scored 0–4, each using Likert scales. Patients with urinary tract DE reported median bladder pain and bladder voiding dysfunction of 7/10 (95 % CI: 3–8) and 7/10 (95 % CI: 0–9), respectively. Improvements at follow-up did not reach statistical significance at the Šidák-adjusted significance threshold, although 80.0 % and 60.0 % of patients reported clinically important improvements to these respective symptoms. There were also no cases of <em>de novo</em> LUTS following excision of urinary tract DE. Patients with bowel DE reported CPP and menstrual dyschezia of 7/10 (95 % CI: 6–8) and 8/10 (95 % CI: 4–8), respectively. Although a significant proportion of patients with bowel DE reported clinically important improvements in bowel symptoms, the difference in symptomatic severity failed to reach statistical significance. Whilst excision of DE can produce clinically important improvements in LUTS and bowel symptoms in a large proportion of patients, there is also a considerable risk of occasioning <em>de novo</em> bowel symptoms.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114924"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of mediolateral or lateral episiotomy in preventing obstetric anal sphincter injury (OASI) in nulliparous women undergoing vacuum-assisted delivery: A systematic review and meta-analysis","authors":"Giovanni Morganelli ,&nbsp;Gabriella Maria Celora ,&nbsp;Maria Chiara Bassi ,&nbsp;Andrea Dall’Asta ,&nbsp;Maurizio Di Serio ,&nbsp;Vito Andrea Capozzi ,&nbsp;Tullio Ghi ,&nbsp;Stefania Fieni","doi":"10.1016/j.ejogrb.2026.114939","DOIUrl":"10.1016/j.ejogrb.2026.114939","url":null,"abstract":"<div><h3>Background</h3><div>The potential preventive effect of mediolateral and lateral episiotomy on the risk of anal sphincter injury related to vacuum delivery in nullipara has been reported by different well-designed studies in the last years.</div></div><div><h3>Objectives</h3><div>The aim of this systematic review and <em>meta</em>-analysis is to summarize the available evidence on the protective effect of mediolateral or lateral episiotomy towards the occurrence of obstetric anal sphincter injury (OASI) in nulliparous women who were submitted to vacuum-assisted delivery.</div><div><em>Search strategy:</em> PubMed, Embase, CINAHL, Cochrane Library and Scopus databases were retrospectively searched without any temporal restriction up to March 1st 2025.</div><div><em>Selection criteria:</em> Randomized controlled trials, retrospective, prospective case-control or cohort studies investigating the incidence of perineal tears involving anal sphincter muscles and/or rectal mucosa after vacuum-assisted birth with and without mediolateral/lateral episiotomy in nulliparous women were included.</div><div><em>Data collection and analysis:</em> Risk of bias assessment was conducted for each included study by applying ROB2 score for RCTs and ROBINS-I score for non-randomized studies. Data were extracted and analyzed with Review Manager 5.4.1, results were reported by means of pooled Odd-ratios (ORs) and presented as Forest plots.</div><div><em>Main results:</em> 31 studies (3 RCTs and 28 non-randomized studies) were included. Cumulative sample size consisted in 608,359 nulliparous women who were submitted to vacuum-assisted delivery. Mediolateral/lateral episiotomy was found to halve the incidence of OASI (OR 0.56 [95 % CI 0.42–0.73]) with high between-study heterogeneity reported (I² = 99 %). At sensitivity analysis, a significant reduction in OASI incidence in case of mediolateral/lateral episiotomy was confirmed (OR 0.58 [95 %CI 0.44–0.78]); this analysis was conducted on low/moderate risk of bias studies (1RCT e 5 non-randomized studies, 15,799 patients) and associated with low heterogeneity (I² = 42 %).</div></div><div><h3>Conclusions</h3><div>This updated meta-analysis on the role of mediolateral/lateral episiotomy in nulliparous women submitted to vacuum assisted delivery confirms its protective role from OASI.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114939"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}