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Influence of Tubal Patency on Endometriosis Recurrence: a Retrospective Matched Case-control Study. 输卵管通畅对子宫内膜异位症复发的影响:一项回顾性匹配病例对照研究。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-03 DOI: 10.1016/j.jmig.2025.12.041
Sofie Neutens, Arne Vanhie, Barbara Van Elst, Annouschka Laenen, Christel Meuleman, Carla Tomassetti

Study objective: To study if bilateral non-patency of fallopian tubes is correlated with a lower recurrence rate of endometriosis.

Design: Retrospective 2:1 matched case control study.

Setting: University hospital with tertiary referral center for fertility and endometriosis surgery in Leuven, Belgium.

Patients: All patients undergoing complete laparoscopic excision of any rASRM-stage endometriosis between 2010 and 2014 (n=896).

Intervention: Comparison between patients with bilateral non-patent or absent fallopian tubes versus matched controls with at least one patent fallopian tube.

Measurements and main results: Primary outcome was the recurrence rate which was analyzed on 4 levels: overall recurrence, symptom recurrence, recurrence on imaging and need for reintervention. Out of 896 patients, 49 had bilateral non-patent or absent fallopian tubes. These cases were compared with 98 matched controls with at least one patent fallopian tube. Symptoms recurred in 12.2% of the cases (n=6) and 25.5% of the controls (n =25) (P=0.09). Recurrence was confirmed by imaging in 8% of the cases (n=4) and in 10.2% of the controls (n=10) (P=0.77). In 3 patients of the case group and in 12 patients of the control group, there was a need for reintervention (P=0.39). Within this subgroup, recurrence of endometriosis was histologically confirmed in none of the patients of the case group and in 5 patients of the control group (P=0.51).

Conclusion: This study did not observe a statistically significant reduction in endometriosis recurrence in patients with bilateral occlusion/absence of the fallopian tubes after endometriosis surgery. A type II error may count for this result.

研究目的:探讨双侧输卵管不通畅与子宫内膜异位症复发率的相关性。设计:回顾性2:1匹配病例对照研究。地点:比利时鲁汶大学医院生育和子宫内膜异位症三级转诊中心。患者:所有在2010年至2014年间接受腹腔镜完全切除任何rasrm期子宫内膜异位症的患者(n=896)。干预:双侧输卵管未闭或缺失患者与至少有一条输卵管未闭的匹配对照组的比较。测量方法及主要结果:主要观察指标为复发率,从总体复发率、症状复发率、影像学复发率、再干预率4个水平进行分析。896例患者中,49例双侧输卵管未通畅或缺失。这些病例与98例至少有一条输卵管未闭的对照组进行比较。12.2%的病例(n=6)和25.5%的对照组(n= 25)出现症状复发(P=0.09)。8%的病例(n=4)和10.2%的对照组(n=10)经影像学证实复发(P=0.77)。病例组3例,对照组12例,需要再干预(P=0.39)。在该亚组中,病例组中没有一例患者组织学上证实子宫内膜异位症复发,对照组中有5例患者(P=0.51)。结论:本研究未观察到双侧输卵管闭塞/缺失患者在子宫内膜异位症手术后复发的统计学显著降低。type II错误可能会计算在此结果中。
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引用次数: 0
A case of intramural perforated levonorgestrel-intrauterine system with mesosalpinx entrapment. 左炔诺孕酮-宫内系统穿孔伴输卵管系膜夹持1例。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-03 DOI: 10.1016/j.jmig.2025.12.032
Yui Honjo, Junko Ishigaki, Kenichi Someya, Bao-Liang Lin
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引用次数: 0
Author's Reply. 作者的回答。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-03 DOI: 10.1016/j.jmig.2025.12.039
Bahi Fayek, Yang Doris Liu, Mohamed A Bedaiwy
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引用次数: 0
Female Sexual Desire, Arousal, and Orgasmic Dysfunctions: A Systematic Review and Meta-Analysis of Treatment Options 题目:女性性欲、性唤起和性高潮功能障碍:治疗方案的系统回顾和荟萃分析。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.jmig.2025.06.004
Rafaela Germano Toledo MD , William D. Winkelman MD , Daniela Reyes-Gonzalez MD , Sophie Bergeron PhD , Anne Fladger MLS , Michele R. Hacker ScD , Mallika Anand MD, MS

Objective

To conduct a systematic review and meta-analysis of treatments for female sexual desire, arousal, and orgasmic dysfunction in patients without sexual pain conditions.

Data Source

MEDLINE, Embase, Web of Science, Cochrane Library, PsycINFO, and ClinicalTrials.gov.

Methods of Study Selection

Following the initial search in December 2024, a total of 8994 abstracts were screened, 278 full-text articles were reviewed, and 36 studies met criteria for data abstraction including a patient population with female sexual dysfunction (FSD) of desire, arousal, and/or orgasm (DAO) and outcome measures including the Female Sexual Function Index (FSFI), its DAO subscales, and the Female Sexual Distress Scale (FSDS). Studies including patients with sexual pain conditions were excluded. Two reviewers independently conducted each phase.

Tabulation, Integration, and Results

Of the 36 studies, 26 were RCTs and 10 were single-arm trials. Ten studies evaluated cognitive behavioral therapy (CBT), 24 investigated medication therapy, and 2 investigated devices. Meta-analyses were conducted for mindfulness-based CBT, flibanserin, and bremelanotide. Mindfulness-based CBT significantly improved total FSFI and subscales of desire, arousal, and orgasm. Conversely, flibanserin improved total FSFI and desire while bremelanotide improved total FSFI and its desire and arousal subscales. No studies directly compared CBT to pharmacotherapy.

Conclusion

In this systematic review of treatments of females with sexual DAO dysfunctions without pain, we found that CBT improves DAO; flibanserin improves desire; and bremelanotide improves both desire and arousal; and all 3 treatments reduce distress. Our findings align with previous literature and expand upon it to include multiple treatment modalities. This broader perspective offers a starting point for clinicians, including gynecologists, who frequently serve as the first point of care for FSD. Conclusions regarding most other treatments could not be drawn due to limited numbers of studies of FSD excluding pain, heterogeneous terminology for DAO disorders, and varying outcome measures across studies.
目的:对无性疼痛患者的女性性欲、性唤起和性高潮功能障碍的治疗方法进行系统回顾和荟萃分析。数据来源:MEDLINE, Embase, Web of Science, Cochrane Library, PsycINFO, clinicaltrials .gov。在2024年12月的首次检索之后,共有8,994篇摘要被筛选,278篇全文文章被审查,36项研究符合数据提取标准,包括女性性欲、觉醒和/或性高潮(DAO)的性功能障碍(FSD)患者群体,以及包括女性性功能指数(FSFI)、其DAO子量表和女性性困扰量表(FSDS)在内的结果测量。包括性疼痛患者的研究被排除在外。每个阶段由两名评审人员独立进行。制表、整合和结果:36项研究中,26项为随机对照试验,10项为单臂试验。10项研究评估认知行为疗法(CBT), 24项研究调查药物治疗,2项研究调查设备。对以正念为基础的CBT、氟立班色林和布雷美诺肽进行meta分析。以正念为基础的CBT显著改善了FSFI总分和欲望、觉醒和性高潮的分量表。相反,氟班色林改善了总FSFI和欲望,而布雷美诺肽改善了总FSFI及其欲望和觉醒亚量表。没有研究直接比较CBT和药物治疗。结论:本研究对无疼痛性DAO功能障碍女性的治疗进行了系统回顾,我们发现CBT改善了DAO;氟立班色林改善性欲;布雷梅酸酯能提高欲望和觉醒;这三种治疗方法都能减轻痛苦。我们的研究结果与以前的文献一致,并将其扩展到包括多种治疗方式。这种更广阔的视角为临床医生提供了一个起点,包括妇科医生,他们经常作为女性性功能障碍的第一护理点。由于FSD的研究数量有限,不包括疼痛,DAO障碍的术语不同,研究结果不同,因此无法得出关于大多数其他治疗方法的结论。
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引用次数: 0
Sexual Devices and Erotica 性装置和情色作品
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.jmig.2025.09.001
Sophie Tucker BA , Eliza Burr MD , Sara Perelmuter MPhil , Quynh Tran BS , Alexis Thompson MPH , Julia Rubin BS , Melissa Davide BA , Ibukunoluwa Omole BA , Yash Adroja BA , Jessica Yih MD , Rachel Rubin MD , Christine Vaccaro DO

Introduction

Sexual wellness is directly associated with overall physical and mental health. Sex span, which is the period spent enjoying a satisfying, vibrant, and joyful sexual life, is directly correlated to quality of life. Gynecologic surgeons are well-positioned to discuss sexual function with their patients as it pertains to a variety of pathologic pelvic conditions, including pelvic pain disorders, urinary/bowel incontinence, pelvic organ prolapse, as well as urogenital and non-urogenital cancers and other related conditions.

Objective

Describe sexual devices, tools, and erotica commonly used by female patients, and provide resources for clinicians. Vibrators, dildos, depth-limiting devices/collision aids, dilators, wands, and erotica are discussed in the context of evidence-based practices when available.

Conclusion

Sexual devices, tools, and erotica are means for both enhancing sexual pleasure and augmenting treatment of female sexual dysfunction. Despite a lack of standardized medical educational resources devoted to female sexuality, clinician familiarity with sexual devices, tools, practices, and erotica is necessary to build a comprehensive treatment plan supporting sexual health-related quality of life.
性健康与整体身心健康直接相关。性生活的持续时间是指享受满意、充满活力和快乐的性生活的时间,它与生活质量直接相关。妇科外科医生可以很好地与患者讨论性功能,因为性功能涉及到各种盆腔病理性疾病,包括盆腔疼痛疾病、尿/肠失禁、盆腔器官脱垂、泌尿生殖器和非泌尿生殖器癌症以及其他相关疾病。目的了解女性患者常用的性器具、性工具和性用品,为临床医生提供参考。振动器,假阳具,深度限制装置/碰撞辅助,扩张器,棒,和情色的背景下讨论的证据实践时,可用。结论性器具、性工具和性用品是增强性快感和增强女性性功能障碍治疗的手段。尽管缺乏专门针对女性性行为的标准化医学教育资源,但临床医生对性设备、工具、实践和色情的熟悉对于建立支持与性健康相关的生活质量的综合治疗计划是必要的。
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引用次数: 0
Female Sexual Function, Dysfunction, and Treatment: A Biopsychosocial Multidisciplinary Approach 女性性功能、功能障碍和治疗:生物心理社会多学科方法。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.jmig.2025.07.019
Anna Myers APRN-CNP , Jean Marino APRN-CNP , Karen Connor PT DPT , Erika L. Kelley PhD , Sheryl A. Kingsberg PhD , Rachel Pope MD, MPH

Objective

Female sexual function is a multidimensional, complex, often understated aspect of health that encompasses desire, arousal, and orgasm. Physiological, psychological, and emotional factors impact sexual satisfaction. This article presents an expert-guided summary of the physiology and pathology of female sexual dysfunction and management of female sexual dysfunction from a multidisciplinary team lens.

Data sources

Key peer-reviewed articles, summary articles and books, and consensus guidelines on identification and management of female sexual dysfunction identified via a multimodal search.

Methods of Study Selection

The multidisciplinary team iteratively selected key peer-reviewed articles, summary articles and books, and consensus guidelines on identification and management of female sexual dysfunction, with a particular focus on implications for minimally invasive gynecology.

Tabulation, Integration, and Results

In recent years, advancements in minimally invasive gynecology have provided practitioners with innovative techniques to address physical issues often affecting female sexual function.

Conclusion

The identification and management of female sexual dysfunction often requires a multidisciplinary approach, as physiological contributing factors rarely are the sole direct cause of dysfunction. The authors, who are part of a multidisciplinary sexual health division at a metropolitan teaching hospital, discuss normal female sexual function, dysfunction, implications of age and surgical changes, and treatment options through the biopsychosocial model.
目的:女性性功能是一个多维的、复杂的、通常被低估的健康方面,包括欲望、性唤起和性高潮。生理、心理和情感因素影响性满意度。这篇文章从多学科团队的角度介绍了女性性功能障碍的生理和病理以及女性性功能障碍的管理。数据来源:主要的同行评审文章、摘要文章和书籍,以及通过多模式搜索识别和管理女性性功能障碍的共识指南。研究选择方法:多学科团队反复选择关键的同行评议文章、摘要文章和书籍,以及关于女性性功能障碍识别和管理的共识指南,特别关注微创妇科的影响。制表、整合和结果:近年来,微创妇科的进步为从业者提供了创新的技术来解决经常影响女性性功能的身体问题。结论:女性性功能障碍的识别和处理往往需要多学科的方法,因为生理因素很少是功能障碍的唯一直接原因。作者是一家大都市教学医院多学科性健康部门的成员,他们通过生物心理社会模型讨论了正常女性性功能、功能障碍、年龄和手术改变的影响以及治疗选择。
{"title":"Female Sexual Function, Dysfunction, and Treatment: A Biopsychosocial Multidisciplinary Approach","authors":"Anna Myers APRN-CNP ,&nbsp;Jean Marino APRN-CNP ,&nbsp;Karen Connor PT DPT ,&nbsp;Erika L. Kelley PhD ,&nbsp;Sheryl A. Kingsberg PhD ,&nbsp;Rachel Pope MD, MPH","doi":"10.1016/j.jmig.2025.07.019","DOIUrl":"10.1016/j.jmig.2025.07.019","url":null,"abstract":"<div><h3>Objective</h3><div>Female sexual function is a multidimensional, complex, often understated aspect of health that encompasses desire, arousal, and orgasm. Physiological, psychological, and emotional factors impact sexual satisfaction. This article presents an expert-guided summary of the physiology and pathology of female sexual dysfunction and management of female sexual dysfunction from a multidisciplinary team lens.</div></div><div><h3>Data sources</h3><div>Key peer-reviewed articles, summary articles and books, and consensus guidelines on identification and management of female sexual dysfunction identified via a multimodal search.</div></div><div><h3>Methods of Study Selection</h3><div>The multidisciplinary team iteratively selected key peer-reviewed articles, summary articles and books, and consensus guidelines on identification and management of female sexual dysfunction, with a particular focus on implications for minimally invasive gynecology.</div></div><div><h3>Tabulation, Integration, and Results</h3><div>In recent years, advancements in minimally invasive gynecology have provided practitioners with innovative techniques to address physical issues often affecting female sexual function.</div></div><div><h3>Conclusion</h3><div>The identification and management of female sexual dysfunction often requires a multidisciplinary approach, as physiological contributing factors rarely are the sole direct cause of dysfunction. The authors, who are part of a multidisciplinary sexual health division at a metropolitan teaching hospital, discuss normal female sexual function, dysfunction, implications of age and surgical changes, and treatment options through the biopsychosocial model.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 10-15"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Female Dyspareunia and the Relationship to Neurophysiologic Mechanisms: A Scoping Review 女性性交困难及其与神经生理机制的关系:综述。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.jmig.2025.07.018
Elizabeth Cook MD , Amanda Yunker DO, MSCR , Rachel Lane Walden MLIS , Ella Barrett-Chan MD , Hargun Dhillon , Avonae Gentles MSc , Mahfuza Sreya BMLSc , William Zhu BSc , Sawsan As-Sanie MD, MPH , Paul J. Yong MD, PhD

Objective

This scoping review aims to evaluate recent studies that examine the relationship between dyspareunia and neurophysiologic factors, and to synthesize their results as it pertains to the development and treatment of introital/vulvar dyspareunia and deep dyspareunia

Data sources

A comprehensive search was conducted in PubMed (NLM), Embase (Elsevier), CINAHL (EBSCOhost), Web of Science (Clarivate), Psycinfo (ProQuest), and Cochrane Library (Wiley) to find peer reviewed studies written in English published in 2000 or later that discussed how neurophysiology is related to dyspareunia. Search terms: dyspareunia; painful intercourse; genito-pelvic pain; penetration disorder; neuropsychology; central nervous system sensitization; neur; central sensitization.

Methods of study selection

A total of 1101 studies were screened and 108 were included in the review.
Abstract and full text screening were performed by 4 authors. Articles were also excluded if they did not include an objective diagnostic tool or objective treatment outcome of dyspareunia. We included original peer-reviewed published research in the form of randomized control trials, cohort studies, case control studies, case series of greater than 20 participants, and systematic reviews.

Integration and Results

Multiple study types were noted: 22 randomized control trials, 9 prospective cohort studies, 3 retrospective cohort studies, 30 case control, 16 case series, 17 cross-sectional, and 11 systematic reviews. Of these articles, 72 focused on introital/superficial dyspareunia, 23 focused on deep dyspareunia, and 13 on both. Data was synthesized in text and table format, separated by type of dyspareunia (introital vs deep) and either etiology/diagnosis or treatment.

Conclusion

There are complex neurophysiologic mechanisms that influence both introital and deep dyspareunia, highlighting the roles of peripheral and central sensitization, nerve fiber density, and neuroplasticity in this condition. There are several promising treatments, including TENS, botulinum toxin A, physical therapy, and various multimodal approaches; but further research is needed to establish standardized therapeutic guidelines.
目的:本综述旨在评价近期有关性交困难与神经生理因素之间关系的研究,并综合其与内/外阴性交困难和深度性交困难的发展和治疗相关的研究结果。我们在PubMed (NLM)、Embase (Elsevier)、CINAHL (EBSCOhost)、Web of Science (Clarivate)、Psycinfo (ProQuest)和Cochrane Library (Wiley)进行了全面的检索,以找到2000年或以后发表的同行评议的英文研究,这些研究讨论了神经生理学如何与性交困难相关。搜索词:性交困难;性交疼痛;genito-pelvic疼痛;渗透障碍;神经心理学;中枢神经系统敏化;神经细胞;中央敏感。研究选择方法:筛选了1101项研究,其中108项纳入本综述。摘要和全文筛选由4位作者完成。没有客观诊断工具或客观治疗结果的文章也被排除。我们纳入了随机对照试验、队列研究、病例对照研究、超过20名参与者的病例系列和系统评价等形式的同行评议发表的原始研究。整合与结果:纳入了多种研究类型:22项随机对照试验、9项前瞻性队列研究、3项回顾性队列研究、30项病例对照、16项病例系列、17项横断面研究和11项系统评价。在这些文章中,72篇聚焦于室性/浅表性性交困难,23篇聚焦于深部性交困难,13篇聚焦于两者。数据以文本和表格形式合成,按性交困难的类型(室内性与深度性)、病因/诊断或治疗进行分类。结论:影响内性和深性性交困难的神经生理机制复杂,突出了外周和中枢敏化、神经纤维密度和神经可塑性在这种情况下的作用。有几种有希望的治疗方法,包括TENS、肉毒杆菌毒素A、物理治疗和各种多模式方法;但需要进一步的研究来建立标准化的治疗指南。
{"title":"Female Dyspareunia and the Relationship to Neurophysiologic Mechanisms: A Scoping Review","authors":"Elizabeth Cook MD ,&nbsp;Amanda Yunker DO, MSCR ,&nbsp;Rachel Lane Walden MLIS ,&nbsp;Ella Barrett-Chan MD ,&nbsp;Hargun Dhillon ,&nbsp;Avonae Gentles MSc ,&nbsp;Mahfuza Sreya BMLSc ,&nbsp;William Zhu BSc ,&nbsp;Sawsan As-Sanie MD, MPH ,&nbsp;Paul J. Yong MD, PhD","doi":"10.1016/j.jmig.2025.07.018","DOIUrl":"10.1016/j.jmig.2025.07.018","url":null,"abstract":"<div><h3>Objective</h3><div>This scoping review aims to evaluate recent studies that examine the relationship between dyspareunia and neurophysiologic factors, and to synthesize their results as it pertains to the development and treatment of introital/vulvar dyspareunia and deep dyspareunia</div></div><div><h3>Data sources</h3><div>A comprehensive search was conducted in PubMed (NLM), Embase (Elsevier), CINAHL (EBSCOhost), Web of Science (Clarivate), Psycinfo (ProQuest), and Cochrane Library (Wiley) to find peer reviewed studies written in English published in 2000 or later that discussed how neurophysiology is related to dyspareunia. Search terms: dyspareunia; painful intercourse; genito-pelvic pain; penetration disorder; neuropsychology; central nervous system sensitization; neur; central sensitization.</div></div><div><h3>Methods of study selection</h3><div>A total of 1101 studies were screened and 108 were included in the review.</div><div>Abstract and full text screening were performed by 4 authors. Articles were also excluded if they did not include an objective diagnostic tool or objective treatment outcome of dyspareunia. We included original peer-reviewed published research in the form of randomized control trials, cohort studies, case control studies, case series of greater than 20 participants, and systematic reviews.</div></div><div><h3>Integration and Results</h3><div>Multiple study types were noted: 22 randomized control trials, 9 prospective cohort studies, 3 retrospective cohort studies, 30 case control, 16 case series, 17 cross-sectional, and 11 systematic reviews. Of these articles, 72 focused on introital/superficial dyspareunia, 23 focused on deep dyspareunia, and 13 on both. Data was synthesized in text and table format, separated by type of dyspareunia (introital vs deep) and either etiology/diagnosis or treatment.</div></div><div><h3>Conclusion</h3><div>There are complex neurophysiologic mechanisms that influence both introital and deep dyspareunia, highlighting the roles of peripheral and central sensitization, nerve fiber density, and neuroplasticity in this condition. There are several promising treatments, including TENS, botulinum toxin A, physical therapy, and various multimodal approaches; but further research is needed to establish standardized therapeutic guidelines.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 34-59"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Board Of Directors-Ed Calendar 董事会编辑日历
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/S1553-4650(25)00968-9
{"title":"Board Of Directors-Ed Calendar","authors":"","doi":"10.1016/S1553-4650(25)00968-9","DOIUrl":"10.1016/S1553-4650(25)00968-9","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Page A1"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Systematic Review and Meta-Analysis of Energy-based Devices For Postmenopausal Sexual Dysfunction 基于能量的装置治疗绝经后性功能障碍的系统综述和荟萃分析。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.jmig.2025.05.019
Fiona G. Li MD , Akshara Shyamsunder MD , Erin Nesbitt-Hawes PhD , Rebecca Deans PhD , Jason Abbott PhD

Objective

To evaluate the efficacy of energy-based treatments in the management of sexual dysfunction in postmenopausal women and guide evidence-based practice, highlighting quality and evidence gaps.

Data Sources

We performed a systematic review of available data until December 2024 from PubMed, Embase, and Scopus.

Methods of Study Selection

Two independent reviewers screened 954 possible manuscripts for inclusion using title and abstract with full-text extraction as appropriate. All randomized controlled trials (RCTs) with sham or placebo control investigating an energy-based vaginal treatment in postmenopausal women that assessed the severity of sexual dysfunction or dyspareunia were included in this study. Meta-analyses were performed for any comparable measures of the primary outcome.

Tabulation, Integration, and Results

From 9 included sham or placebo RCTs, 610 participants were enrolled, with 5 of 9 trials (55%) (including 248 participants in total) using a double-blinded methodology; 6 studied carbon dioxide laser, 3 studied radiofrequency treatment, 1 studied erbium-doped yttrium-aluminum-garnet laser, and 1 studied hybrid frequency laser. Pooled data from 6 studies with high heterogeneity suggest significant improvement in sexual function as measured by the Female Sexual Function Index with a mean change of 4.18 out of 36 (95% confidence interval, 2.89–5.47) and improvement in dyspareunia assessed by visual analog scale out of 10 from 4 studies with a mean change of −5.15 (95% confidence interval, −5.97 to −4.43).

Conclusion

Data from both blinded and unblinded RCTs suggest that energy-based treatments may be beneficial for the treatment of sexual dysfunction and dyspareunia. High heterogeneity and variability in outcomes despite similar protocols suggest considerable uncertainty of the results and require caution when interpreting these data.
目的:评价能量疗法治疗绝经后妇女性功能障碍的疗效,指导循证实践,突出质量和证据差距。数据来源:我们对PubMed、Embase和Scopus截至2024年12月的可用数据进行了系统回顾。研究选择方法:两名独立审稿人筛选了954篇可能的论文,使用标题和摘要,并酌情提取全文。所有随机对照试验(RCT)均采用假对照或安慰剂对照,对绝经后妇女进行能量阴道治疗,评估性功能障碍或性交困难的严重程度。对主要结局的任何可比指标进行meta分析。制表、整合和结果:从9个纳入的假或安慰剂随机对照试验中,纳入610名受试者,其中5/9(55%)试验(共包括248名受试者)采用双盲方法。6人研究二氧化碳激光器,3人研究射频治疗,1人研究铒铝激光器,1人研究混合频率激光器。来自6项异质性较高的研究的合并数据显示,女性性功能指数(Female sexual function Index)测量的性功能显著改善,平均变化为4.25/36 [95% CI: 2.96, 5.53], 4项研究的视觉模拟量表(visual analogue scale)评估的性交困难改善,平均变化为-5.15 [95% CI-5.97, -4.43]。结论:盲法和非盲法随机对照试验的数据表明,能量治疗可能有利于治疗性功能障碍和性交困难。尽管方案相似,但结果的高度异质性和可变性表明结果存在相当大的不确定性,在解释这些数据时需要谨慎。
{"title":"A Systematic Review and Meta-Analysis of Energy-based Devices For Postmenopausal Sexual Dysfunction","authors":"Fiona G. Li MD ,&nbsp;Akshara Shyamsunder MD ,&nbsp;Erin Nesbitt-Hawes PhD ,&nbsp;Rebecca Deans PhD ,&nbsp;Jason Abbott PhD","doi":"10.1016/j.jmig.2025.05.019","DOIUrl":"10.1016/j.jmig.2025.05.019","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of energy-based treatments in the management of sexual dysfunction in postmenopausal women and guide evidence-based practice, highlighting quality and evidence gaps.</div></div><div><h3>Data Sources</h3><div>We performed a systematic review of available data until December 2024 from PubMed, Embase, and Scopus.</div></div><div><h3>Methods of Study Selection</h3><div>Two independent reviewers screened 954 possible manuscripts for inclusion using title and abstract with full-text extraction as appropriate. All randomized controlled trials (RCTs) with sham or placebo control investigating an energy-based vaginal treatment in postmenopausal women that assessed the severity of sexual dysfunction or dyspareunia were included in this study. Meta-analyses were performed for any comparable measures of the primary outcome.</div></div><div><h3>Tabulation, Integration, and Results</h3><div>From 9 included sham or placebo RCTs, 610 participants were enrolled, with 5 of 9 trials (55%) (including 248 participants in total) using a double-blinded methodology; 6 studied carbon dioxide laser, 3 studied radiofrequency treatment, 1 studied erbium-doped yttrium-aluminum-garnet laser, and 1 studied hybrid frequency laser. Pooled data from 6 studies with high heterogeneity suggest significant improvement in sexual function as measured by the Female Sexual Function Index with a mean change of 4.18 out of 36 (95% confidence interval, 2.89–5.47) and improvement in dyspareunia assessed by visual analog scale out of 10 from 4 studies with a mean change of −5.15 (95% confidence interval, −5.97 to −4.43).</div></div><div><h3>Conclusion</h3><div>Data from both blinded and unblinded RCTs suggest that energy-based treatments may be beneficial for the treatment of sexual dysfunction and dyspareunia. High heterogeneity and variability in outcomes despite similar protocols suggest considerable uncertainty of the results and require caution when interpreting these data.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 81-93"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emphasizing Sexual Health in Gynecologic Surgery 强调妇科外科的性健康。
IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.jmig.2025.10.001
Barbara Levy MD, FACOG, FACS , Cheryl B. Iglesia MD, FACOG, FACS
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引用次数: 0
期刊
Journal of minimally invasive gynecology
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