To clarify the current status of human T-cell leukemia virus type 1 (HTLV-1) among pregnant women in Japan, with a focus on its prevalence by age and region and the contribution of horizontal transmission.
Methods
The Japan Association of Obstetricians and Gynecologists conducted a nationwide questionnaire survey in 2025, collecting 2024 data from 1935 delivery facilities. Facilities reported total deliveries, HTLV-1 carrier cases, and testing details. Information was obtained on birth year, parity, residence, and prior HTLV-1 test results for carriers. Carrier prevalence by region and age group was analyzed, and prior negative results in multiparous carriers were used to estimate horizontal transmission.
Results
Responses were received from 1297 facilities (response rate: 67.0%), covering 461 271 deliveries (67.2% of national births). Among these, 331 HTLV-1 carriers were identified (0.07%), with the highest prevalence in Kyushu and Okinawa (0.25%). Carrier prevalence declined in younger cohorts (0.04% in women born ≥ 1990 vs. 0.09% before 1990; OR 0.435, p < 0.001). Among multiparous carriers, 16.3% had previously tested negative, suggesting horizontal transmission, particularly in urban regions (Kanto, Tokai, Kinki).
Conclusions
The prevalence of HTLV-1 among pregnant women in Japan has declined, largely due to effective mother-to-child transmission prevention implemented mainly in HTLV-1 high-prevalence areas. However, horizontal transmission accounts for a notable percentage of cases, highlighting the need to reinforce preventive education and strategies targeting sexual transmission and unsafe medical or cosmetic practices alongside continued perinatal screening and counseling.
目的：了解日本孕妇HTLV-1型人t细胞白血病病毒（human T-cell leukemia virus type 1, HTLV-1）感染现状，重点分析其年龄、地区流行情况及水平传播的贡献。方法：日本妇产科医师协会于2025年在全国范围内进行问卷调查，收集1935家分娩机构的2024年数据。设施报告了总交付量、HTLV-1携带者病例和测试细节。获得携带者的出生年份、胎次、居住地和先前HTLV-1检测结果等信息。分析了各地区和年龄组的带菌者流行率，并使用先前多产带菌者的阴性结果来估计水平传播。结果：从1297个设施收到答复（回复率：67.0%），涵盖461 271例分娩（占全国分娩的67.2%）。其中，HTLV-1携带者331例（0.07%），其中九州和冲绳地区患病率最高（0.25%）。在年轻人群中，携带者患病率下降（1990年以上出生的女性为0.04%，1990年之前为0.09%;OR 0.435, p）。结论：日本孕妇中HTLV-1的患病率下降，主要是由于在HTLV-1高流行地区实施了有效的母婴传播预防。然而，横向传播占病例的很大比例，突出表明需要加强预防教育和针对性传播和不安全医疗或美容做法的战略，同时继续进行围产期筛查和咨询。
{"title":"Decline in Human T-Cell Leukemia Virus Type 1 Pregnant Carriers and Emerging Concerns About Horizontal Transmission: A Nationwide Survey in Japan","authors":"Manabu Ogoyama, Akihiko Sekizawa, Shunji Suzuki, Shin-ichi Hoshi, Keiko Koide, Kiyonori Miura, Yoko Sagara, Isamu Ishiwata","doi":"10.1111/jog.70145","DOIUrl":"10.1111/jog.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To clarify the current status of human T-cell leukemia virus type 1 (HTLV-1) among pregnant women in Japan, with a focus on its prevalence by age and region and the contribution of horizontal transmission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Japan Association of Obstetricians and Gynecologists conducted a nationwide questionnaire survey in 2025, collecting 2024 data from 1935 delivery facilities. Facilities reported total deliveries, HTLV-1 carrier cases, and testing details. Information was obtained on birth year, parity, residence, and prior HTLV-1 test results for carriers. Carrier prevalence by region and age group was analyzed, and prior negative results in multiparous carriers were used to estimate horizontal transmission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses were received from 1297 facilities (response rate: 67.0%), covering 461 271 deliveries (67.2% of national births). Among these, 331 HTLV-1 carriers were identified (0.07%), with the highest prevalence in Kyushu and Okinawa (0.25%). Carrier prevalence declined in younger cohorts (0.04% in women born ≥ 1990 vs. 0.09% before 1990; OR 0.435, <i>p</i> < 0.001). Among multiparous carriers, 16.3% had previously tested negative, suggesting horizontal transmission, particularly in urban regions (Kanto, Tokai, Kinki).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of HTLV-1 among pregnant women in Japan has declined, largely due to effective mother-to-child transmission prevention implemented mainly in HTLV-1 high-prevalence areas. However, horizontal transmission accounts for a notable percentage of cases, highlighting the need to reinforce preventive education and strategies targeting sexual transmission and unsafe medical or cosmetic practices alongside continued perinatal screening and counseling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564446","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}
Nausea and vomiting of pregnancy (NVP) has been suggested as a potential risk factor for postpartum depression. However, existing evidence remains inconclusive because of variations in NVP definitions, limited sample sizes, and limited consideration of parity, despite potential differences in the caregiving burden between these two groups. We examined the association between postpartum depressive symptoms and the severity of NVP, assessed using multiple clinical criteria, stratified by parity.
Methods
A retrospective cohort study was conducted of 2124 women who received perinatal care from early pregnancy to delivery at a tertiary hospital in Japan between 2018 and 2024. Postpartum depressive symptoms were defined as an Edinburgh Postnatal Depression Scale score ≥ 9 at 1 month postpartum. NVP was clinically diagnosed and classified based on clinical interventions: no treatment, oral antiemetic use, intravenous therapy, and hospitalization. A multivariable logistic regression model was used to estimate adjusted odds ratios (aOR) stratified by parity.
Results
A total of 128 participants (6.0%) met the criteria for postpartum depressive symptoms. There was a significant interaction between NVP severity and parity (P for interaction = 0.007). Among primiparous women, NVP was not associated with the risk of postpartum depressive symptoms at any severity level. By contrast, among multiparous women, the risk increased progressively with the severity of NVP (P for trend = 0.009), with those requiring hospitalization exhibiting a significantly elevated risk (aOR 5.47, 95% confidence interval: 2.14–12.89).
Conclusions
Multiparous women who experienced severe NVP requiring hospitalization had an increased risk of postpartum depressive symptoms.
{"title":"Association Between the Severity of Nausea and Vomiting of Pregnancy and Postpartum Depression: A Retrospective Cohort Study","authors":"Takuma Yamada, Shuhei Terada, Takeshi Murakoshi","doi":"10.1111/jog.70146","DOIUrl":"10.1111/jog.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Nausea and vomiting of pregnancy (NVP) has been suggested as a potential risk factor for postpartum depression. However, existing evidence remains inconclusive because of variations in NVP definitions, limited sample sizes, and limited consideration of parity, despite potential differences in the caregiving burden between these two groups. We examined the association between postpartum depressive symptoms and the severity of NVP, assessed using multiple clinical criteria, stratified by parity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted of 2124 women who received perinatal care from early pregnancy to delivery at a tertiary hospital in Japan between 2018 and 2024. Postpartum depressive symptoms were defined as an Edinburgh Postnatal Depression Scale score ≥ 9 at 1 month postpartum. NVP was clinically diagnosed and classified based on clinical interventions: no treatment, oral antiemetic use, intravenous therapy, and hospitalization. A multivariable logistic regression model was used to estimate adjusted odds ratios (aOR) stratified by parity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 128 participants (6.0%) met the criteria for postpartum depressive symptoms. There was a significant interaction between NVP severity and parity (<i>P</i> for interaction = 0.007). Among primiparous women, NVP was not associated with the risk of postpartum depressive symptoms at any severity level. By contrast, among multiparous women, the risk increased progressively with the severity of NVP (<i>P</i> for trend = 0.009), with those requiring hospitalization exhibiting a significantly elevated risk (aOR 5.47, 95% confidence interval: 2.14–12.89).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multiparous women who experienced severe NVP requiring hospitalization had an increased risk of postpartum depressive symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564408","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":"Prioritizing Fetal Safety in the First Trimester: Paracetamol Over NSAIDs","authors":"Erkan Mavigök","doi":"10.1111/jog.70143","DOIUrl":"10.1111/jog.70143","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563156","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}
This review aims to explore Female Genital Tuberculosis (FGTB) as a significant, yet underdiagnosed cause of subfertility, with a focus on its clinical presentation, diagnostic complexities, and implications for reproductive outcomes. It highlights the importance of early recognition and the role of endoscopic findings in guiding timely treatment.
Methods
A comprehensive literature review was conducted using PubMed-indexed journals published since 1980, emphasizing studies on FGTB in the context of infertility. Key areas included epidemiology, pathogenesis, clinical features, diagnostic approaches, and treatment strategies. Particular attention was given to the role of hysteroscopy and laparoscopy in identifying characteristic tuberculous lesions and aiding early diagnosis.
Results
Traditional diagnostics like AFB staining and culture often yield false negatives, necessitating a composite reference standard incorporating imaging, biopsy, and endoscopy. Molecular tools such as GeneXpert and PCR have improved detection rates. Hystero-laparoscopy offers direct visualization of intrauterine adhesions, caseous nodules, and tubal beading—findings critical for early initiation of anti-tubercular therapy (ATT). Early ATT can restore fertility in many patients, but advanced cases may still require assisted reproductive techniques, often with limited success.
Conclusions
FGTB is a preventable cause of infertility that demands high clinical suspicion and multidisciplinary management. Early diagnosis and treatment significantly reduce reproductive morbidity. Enhanced clinician awareness, integration of endoscopic techniques, and access to advanced diagnostics are essential for improving outcomes in high-risk populations.
{"title":"Breaking the Silence on Female Genital Tuberculosis: A Modifiable Burden in Fertility Care","authors":"Rana Mondal, Mouli Nandi, Ifra Iqbal, Priya Bhave Chittawar","doi":"10.1111/jog.70131","DOIUrl":"10.1111/jog.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This review aims to explore Female Genital Tuberculosis (FGTB) as a significant, yet underdiagnosed cause of subfertility, with a focus on its clinical presentation, diagnostic complexities, and implications for reproductive outcomes. It highlights the importance of early recognition and the role of endoscopic findings in guiding timely treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review was conducted using PubMed-indexed journals published since 1980, emphasizing studies on FGTB in the context of infertility. Key areas included epidemiology, pathogenesis, clinical features, diagnostic approaches, and treatment strategies. Particular attention was given to the role of hysteroscopy and laparoscopy in identifying characteristic tuberculous lesions and aiding early diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Traditional diagnostics like AFB staining and culture often yield false negatives, necessitating a composite reference standard incorporating imaging, biopsy, and endoscopy. Molecular tools such as GeneXpert and PCR have improved detection rates. Hystero-laparoscopy offers direct visualization of intrauterine adhesions, caseous nodules, and tubal beading—findings critical for early initiation of anti-tubercular therapy (ATT). Early ATT can restore fertility in many patients, but advanced cases may still require assisted reproductive techniques, often with limited success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FGTB is a preventable cause of infertility that demands high clinical suspicion and multidisciplinary management. Early diagnosis and treatment significantly reduce reproductive morbidity. Enhanced clinician awareness, integration of endoscopic techniques, and access to advanced diagnostics are essential for improving outcomes in high-risk populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549703","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}
Patients with endometriosis are at a high risk of developing pelvic inflammatory disease. This case series presents three cases of colo-ovarian fistulas associated with endometriosis, highlighting the potential for conservative management in selected cases. Case 1 involved a 36-year-old woman in whom suspected communication between the colon and an endometriotic cyst was noted on computed tomography and magnetic resonance imaging (MRI). Case 2 involved a 42-year-old woman who presented with a colo-ovarian fistula on MRI. Case 3 involved another 42-year-old woman with a sigmoid colon perforation who was retrospectively diagnosed with a colo-ovarian fistula. All cases were associated with endometriosis. In Cases 1 and 2, symptoms were successfully managed conservatively. In Case 3, the colo-ovarian fistula only became apparent following hysterectomy and was treated by surgery. Although surgical intervention is commonly performed for colo-ovarian fistulas, our findings suggest that conservative treatment may be an option in select cases with endometriosis-associated fistulas.
{"title":"Colo-Ovarian Fistula With a Background of Endometriosis: A Report of Three Cases","authors":"Sayuri Fukaya, Gentaro Izumi, Kaori Koga, Yuko Sanada, Yasushi Hirota, Yutaka Osuga","doi":"10.1111/jog.70140","DOIUrl":"10.1111/jog.70140","url":null,"abstract":"<p>Patients with endometriosis are at a high risk of developing pelvic inflammatory disease. This case series presents three cases of colo-ovarian fistulas associated with endometriosis, highlighting the potential for conservative management in selected cases. Case 1 involved a 36-year-old woman in whom suspected communication between the colon and an endometriotic cyst was noted on computed tomography and magnetic resonance imaging (MRI). Case 2 involved a 42-year-old woman who presented with a colo-ovarian fistula on MRI. Case 3 involved another 42-year-old woman with a sigmoid colon perforation who was retrospectively diagnosed with a colo-ovarian fistula. All cases were associated with endometriosis. In Cases 1 and 2, symptoms were successfully managed conservatively. In Case 3, the colo-ovarian fistula only became apparent following hysterectomy and was treated by surgery. Although surgical intervention is commonly performed for colo-ovarian fistulas, our findings suggest that conservative treatment may be an option in select cases with endometriosis-associated fistulas.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masafumi Toyoshima, Satoru Kyo, Akihito Horie, Eiji Kobayashi, Yoshito Terai, Tsuyoshi Yamashita, Takuma Fujii, Hironori Asada, Yasuhisa Terao, Kentaro Sekiyama, Kenbun Sone, Masaki Mandai, the Committee for Gynecologic Oncology Surgery, Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE)
Objective
This study investigated the reasons behind the decreasing trend of lymph node dissection for endometrial cancer (EC) in Japan, focusing on the impact of minimally invasive surgery (MIS) adoption, evolving clinical guidelines, and physician work-style reform.
Methods
A cross-sectional survey of the Japan Society of Gynecologic Oncology and Endoscopy (JSGOE) members was conducted to investigate facility demographics, MIS adoption, lymphadenectomy practices, factors influencing omission, impact of work-style reform, and perspectives on future EC management, such as molecular classification and sentinel lymph node biopsy (SLNB).
Results
In total, 424 responses were received, representing a response rate of 67.8%. MIS adoption for EC is widespread in Japan, with laparoscopy preferred over robotic surgery. Lymphadenectomy is commonly performed; however, the criteria for omission varied among institutions, with clinical guidelines published by the Japanese Society of Gynecologic Oncology having the greatest impact. Physician work-style reform significantly affected surgical practices such as surgical scheduling, adherence to time limits, and the number of surgeons participating in surgeries, while it had little impact on the criteria for lymphadenectomy omission. The adoption of molecular classifications is increasing with approximately half of the institutions planning to implement or having partially implemented them, while SLNBs remained relatively low.
Conclusion
This study highlights the significant impact of evolving clinical guidelines on lymphadenectomy practices for MIS for EC in Japan, and the limited impact of physician work-style reform.
目的：探讨日本子宫内膜癌（EC）淋巴结清扫呈下降趋势的原因，重点探讨微创手术（MIS）的采用、临床指南的不断完善和医生工作方式的改革对淋巴结清扫的影响。方法：对日本妇科肿瘤与内窥镜学会（JSGOE）成员进行横断面调查，调查设施人口统计、MIS采用情况、淋巴结切除术实践、影响遗漏的因素、工作方式改革的影响，以及对未来EC管理的看法，如分子分类和前哨淋巴结活检（SLNB）。结果：共收到回复424份，回复率67.8%。MIS在日本广泛应用于EC，腹腔镜手术优于机器人手术。淋巴结切除术是常用的；然而，各机构的遗漏标准各不相同，日本妇科肿瘤学会发布的临床指南影响最大。医师工作作风改革对手术安排、手术时间遵守、参与手术人数等手术实践有显著影响，而对淋巴结切除遗漏标准影响不大。分子分类的采用正在增加，大约一半的机构计划实施或已经部分实施，而slnb仍然相对较低。结论：本研究强调了日本对MIS for EC的淋巴结切除术实践的不断发展的临床指南的重大影响，以及医生工作方式改革的有限影响。
{"title":"A Survey of Current Practice and Perspectives on Lymphadenectomy in Minimally Invasive Surgery for Endometrial Cancer in Japan","authors":"Masafumi Toyoshima, Satoru Kyo, Akihito Horie, Eiji Kobayashi, Yoshito Terai, Tsuyoshi Yamashita, Takuma Fujii, Hironori Asada, Yasuhisa Terao, Kentaro Sekiyama, Kenbun Sone, Masaki Mandai, the Committee for Gynecologic Oncology Surgery, Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE)","doi":"10.1111/jog.70138","DOIUrl":"10.1111/jog.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the reasons behind the decreasing trend of lymph node dissection for endometrial cancer (EC) in Japan, focusing on the impact of minimally invasive surgery (MIS) adoption, evolving clinical guidelines, and physician work-style reform.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey of the Japan Society of Gynecologic Oncology and Endoscopy (JSGOE) members was conducted to investigate facility demographics, MIS adoption, lymphadenectomy practices, factors influencing omission, impact of work-style reform, and perspectives on future EC management, such as molecular classification and sentinel lymph node biopsy (SLNB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 424 responses were received, representing a response rate of 67.8%. MIS adoption for EC is widespread in Japan, with laparoscopy preferred over robotic surgery. Lymphadenectomy is commonly performed; however, the criteria for omission varied among institutions, with clinical guidelines published by the Japanese Society of Gynecologic Oncology having the greatest impact. Physician work-style reform significantly affected surgical practices such as surgical scheduling, adherence to time limits, and the number of surgeons participating in surgeries, while it had little impact on the criteria for lymphadenectomy omission. The adoption of molecular classifications is increasing with approximately half of the institutions planning to implement or having partially implemented them, while SLNBs remained relatively low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the significant impact of evolving clinical guidelines on lymphadenectomy practices for MIS for EC in Japan, and the limited impact of physician work-style reform.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yukihiro Azuma, Rina Fujioka, Koji Yamamoto, Mei Matsumoto, Hiroki Nagata, Ikumi Wada, Maako Moriyama, Hiroaki Komatsu, Fuminori Taniguchi
Aim
To identify the predictors for periureteral adhesions preoperatively.
Methods
Preoperative predictors for periureteral adhesions were evaluated in 407 patients who underwent laparoscopic hysterectomy (LH) for benign uterine diseases in our hospital between 2013 and 2022.
Results
Periureteral adhesions were observed in 57 patients (14%). Multivariate analysis identified the following predictors for periureteral adhesions: endometriosis (odds ratio (OR), 8.54; 95% confidence interval (CI), 1.51–48.30; p < 0.05), obliteration of Douglas' pouch (OR, 89.50; 95% CI, 5.07–1580.03; p < 0.01), and ureteral flexion on drop infusion pyelography (DIP) (OR, 647.00; 95% CI, 63.00–6650.02; p < 0.001). Ureteral flexion on DIP diagnosed periureteral adhesion most accurately (sensitivity: 93.0%, specificity: 95.1%, accuracy: 94.8%). Operation time to complete LH was significantly longer in the adhesion group than in the non-adhesion group (162 min vs. 148 min; p < 0.01). Iatrogenic ureteral injury (IUI) was more common in the adhesion group than in the non-adhesion group (OR, 19.14; 95% CI, 1.51–1013.84; p < 0.01).
Conclusion
These results suggest that preoperative DIP is a useful predictor of periureteral adhesions. Preoperative preventive measures for IUI, such as ureteral stenting, are important in cases where severe adhesions are suspected.
{"title":"Prediction of Periureteral Adhesions by Drop Infusion Pyelography Before Laparoscopic Hysterectomy: A Retrospective Study","authors":"Yukihiro Azuma, Rina Fujioka, Koji Yamamoto, Mei Matsumoto, Hiroki Nagata, Ikumi Wada, Maako Moriyama, Hiroaki Komatsu, Fuminori Taniguchi","doi":"10.1111/jog.70141","DOIUrl":"10.1111/jog.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify the predictors for periureteral adhesions preoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Preoperative predictors for periureteral adhesions were evaluated in 407 patients who underwent laparoscopic hysterectomy (LH) for benign uterine diseases in our hospital between 2013 and 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Periureteral adhesions were observed in 57 patients (14%). Multivariate analysis identified the following predictors for periureteral adhesions: endometriosis (odds ratio (OR), 8.54; 95% confidence interval (CI), 1.51–48.30; <i>p</i> < 0.05), obliteration of Douglas' pouch (OR, 89.50; 95% CI, 5.07–1580.03; <i>p</i> < 0.01), and ureteral flexion on drop infusion pyelography (DIP) (OR, 647.00; 95% CI, 63.00–6650.02; <i>p</i> < 0.001). Ureteral flexion on DIP diagnosed periureteral adhesion most accurately (sensitivity: 93.0%, specificity: 95.1%, accuracy: 94.8%). Operation time to complete LH was significantly longer in the adhesion group than in the non-adhesion group (162 min vs. 148 min; <i>p</i> < 0.01). Iatrogenic ureteral injury (IUI) was more common in the adhesion group than in the non-adhesion group (OR, 19.14; 95% CI, 1.51–1013.84; <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results suggest that preoperative DIP is a useful predictor of periureteral adhesions. Preoperative preventive measures for IUI, such as ureteral stenting, are important in cases where severe adhesions are suspected.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534714","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}
The effects of smoking status, which is a risk factor for many cancers, on ovarian cancer awareness in women has not yet been adequately investigated.
Aims
The aim of this study was to determine the relationship between smoking status and ovarian cancer awareness levels in women.
Methods
This descriptive study was conducted with the help of an online questionnaire form between 22.03.2023 and 22.05.2023 among volunteer women over the age of 18. No sample calculation was made. The questionnaire included 15 questions about sociodemographic and health-related data and the Ovarian Cancer Awareness Scale (Cronbach's alpha = 0.768).
Results
228 women participated in the study. The mean age of the participants was 36.71 ± 11.59 years, 85.5% were university graduates, 21.9% were health personnel and 26.8% were smokers. It was determined that 44.3% of the participants had a family history of cancer and 32.7% of them had gynecologic cancer. In our study, the mean score of the ovarian cancer awareness scale was 47.75 ± 14.62. The level of ovarian cancer awareness was found to be statistically significantly higher in university graduates, health personnel and non-smokers (p < 0.001, p < 0.001, p = 0.003, respectively). A weak negative correlation was observed with age and smoking duration and ovarian cancer awareness scores (p = 0.001, r = −0.212; p = 0.037, r = −0.274, respectively).
Conclusion
In conclusion, the findings suggest that smoking may have a negative impact on ovarian cancer awareness and suggest that efforts to increase women's awareness of ovarian cancer through smoking cessation campaigns and health education programs may be more effective, with a particular focus on smokers.
{"title":"Smoking and Ovarian Cancer Awareness: Assessing the Impact on Knowledge and Perception Among Adult Women","authors":"Duygu Ayhan Başer, Elif Buse Şahin, Nadide Yıldız, Büşra Yılmaz Demiralay, İzzet Fidancı, Hilal Aksoy","doi":"10.1111/jog.70137","DOIUrl":"10.1111/jog.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effects of smoking status, which is a risk factor for many cancers, on ovarian cancer awareness in women has not yet been adequately investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to determine the relationship between smoking status and ovarian cancer awareness levels in women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive study was conducted with the help of an online questionnaire form between 22.03.2023 and 22.05.2023 among volunteer women over the age of 18. No sample calculation was made. The questionnaire included 15 questions about sociodemographic and health-related data and the Ovarian Cancer Awareness Scale (Cronbach's alpha = 0.768).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>228 women participated in the study. The mean age of the participants was 36.71 ± 11.59 years, 85.5% were university graduates, 21.9% were health personnel and 26.8% were smokers. It was determined that 44.3% of the participants had a family history of cancer and 32.7% of them had gynecologic cancer. In our study, the mean score of the ovarian cancer awareness scale was 47.75 ± 14.62. The level of ovarian cancer awareness was found to be statistically significantly higher in university graduates, health personnel and non-smokers (<i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> = 0.003, respectively). A weak negative correlation was observed with age and smoking duration and ovarian cancer awareness scores (<i>p</i> = 0.001, <i>r</i> = −0.212; <i>p</i> = 0.037, <i>r</i> = −0.274, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, the findings suggest that smoking may have a negative impact on ovarian cancer awareness and suggest that efforts to increase women's awareness of ovarian cancer through smoking cessation campaigns and health education programs may be more effective, with a particular focus on smokers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488991","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}
Yoshihide Inayama, Koji Yamanoi, Masumi Sunada, Rin Mizuno, Taito Miyamoto, Mana Taki, Ryusuke Murakami, Michiyasu Miki, Masaki Mandai
Aim
To investigate recent trends in laparoscopic and robot-assisted surgery in gynecology in Japan.
Methods
This study analyzed National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data from April 2014 to March 2024. We investigated the number of hysterectomies performed for benign diseases, uterine prolapse surgeries, and surgeries for uterine cancer. Subgroup analyses were performed according to the patient age.
Results
Among hysterectomies for benign diseases, laparoscopic hysterectomies (LHs) increased markedly, from 16 016 (29.4%) in 2014 to 34 429 (53.4%) in 2023. The number of robot-assisted hysterectomies increased from 462 (0.8%) in 2018, when first insured, to 8088 (12.5%) in 2023. Conversely, conventional hysterectomies decreased from 38 398 in 2014 to 21 975 in 2023. Among the surgeries for uterine prolapse, the number of laparoscopic sacrocolpopexies (LSCs) increased from 1478 (15.2%) in 2016 to 4147 (35.4%) in 2019. After robot-assisted sacrocolpopexy was covered by insurance, its numbers increased to 2994 (23.0%) in 2023, while LSCs declined slightly (3765 cases [28.9%] in 2023). For uterine malignancies, the number of laparoscopic and robot-assisted surgeries for early-stage endometrial cancer increased from 1180 in 2014 to 6104 in 2023, whereas that for laparoscopic surgeries for cervical cancer remained generally stable.
Conclusions
The use of laparoscopic and robot-assisted surgeries has grown steadily for hysterectomy for benign diseases, uterine prolapse surgery, and endometrial cancer surgery. After the approval of robotic surgery, LH for benign diseases and laparoscopic surgery for endometrial cancer showed a slight increase, whereas LSCs began to decline slightly.
{"title":"Trends in Laparoscopic and Robot-Assisted Surgery in Gynecology: A 10-Year Nationwide Study in Japan","authors":"Yoshihide Inayama, Koji Yamanoi, Masumi Sunada, Rin Mizuno, Taito Miyamoto, Mana Taki, Ryusuke Murakami, Michiyasu Miki, Masaki Mandai","doi":"10.1111/jog.70133","DOIUrl":"10.1111/jog.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate recent trends in laparoscopic and robot-assisted surgery in gynecology in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analyzed National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data from April 2014 to March 2024. We investigated the number of hysterectomies performed for benign diseases, uterine prolapse surgeries, and surgeries for uterine cancer. Subgroup analyses were performed according to the patient age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among hysterectomies for benign diseases, laparoscopic hysterectomies (LHs) increased markedly, from 16 016 (29.4%) in 2014 to 34 429 (53.4%) in 2023. The number of robot-assisted hysterectomies increased from 462 (0.8%) in 2018, when first insured, to 8088 (12.5%) in 2023. Conversely, conventional hysterectomies decreased from 38 398 in 2014 to 21 975 in 2023. Among the surgeries for uterine prolapse, the number of laparoscopic sacrocolpopexies (LSCs) increased from 1478 (15.2%) in 2016 to 4147 (35.4%) in 2019. After robot-assisted sacrocolpopexy was covered by insurance, its numbers increased to 2994 (23.0%) in 2023, while LSCs declined slightly (3765 cases [28.9%] in 2023). For uterine malignancies, the number of laparoscopic and robot-assisted surgeries for early-stage endometrial cancer increased from 1180 in 2014 to 6104 in 2023, whereas that for laparoscopic surgeries for cervical cancer remained generally stable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of laparoscopic and robot-assisted surgeries has grown steadily for hysterectomy for benign diseases, uterine prolapse surgery, and endometrial cancer surgery. After the approval of robotic surgery, LH for benign diseases and laparoscopic surgery for endometrial cancer showed a slight increase, whereas LSCs began to decline slightly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495918","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}
Li Xiang, Yutaka Naito, Masafumi Toyoshima, Mika Terasaki, Akihito Yamamoto, Akira Shimizu, Shunji Suzuki, Kazufumi Honda
Objective
This study aimed to investigate the clinical significance of actinin-4 in endometrial carcinoma. Actinin-4, an actin-binding protein involved in cytoskeletal dynamics, has been implicated in the progression of various cancers; however, its precise role in endometrial carcinoma is not fully understood. This research sought to evaluate actinin-4 protein expression and gene amplification and correlate these findings with clinicopathological parameters and patient survival to determine its prognostic value.
Methods
A retrospective analysis was conducted on endometrial carcinoma patients who underwent surgical resection. Actinin-4 protein expression was assessed using immunohistochemical staining (IHC), and ACTN4 gene amplification was evaluated by fluorescence in situ hybridization (FISH). The intensity of actinin-4 staining was graded, and gene amplification of ACTN4 was defined using the ACTN4/CEP19 ratio. Statistical analysis, including Kaplan–Meier survival analysis and Cox proportional hazards modeling, was performed to correlate actinin-4 expression with clinicopathological features and survival outcomes.
Results
Overexpression of actinin-4 protein by IHC was significantly associated with advanced clinical stage and histological subtypes. While no significant difference was observed in overall survival (OS), patients with high actinin-4 IHC demonstrated significantly poorer progression-free survival (PFS). ACTN4 gene amplification by FISH was significantly associated with poorer prognosis for both OS and PFS compared to the group without amplification.
Conclusion
This study suggests that actinin-4 plays a role in the progression of endometrial carcinoma, particularly influencing tumor aggressiveness and progression-free survival.
{"title":"Prognostic Significance of Actinin-4 Protein Expression and Gene Amplification in Endometrial Carcinoma","authors":"Li Xiang, Yutaka Naito, Masafumi Toyoshima, Mika Terasaki, Akihito Yamamoto, Akira Shimizu, Shunji Suzuki, Kazufumi Honda","doi":"10.1111/jog.70132","DOIUrl":"10.1111/jog.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the clinical significance of actinin-4 in endometrial carcinoma. Actinin-4, an actin-binding protein involved in cytoskeletal dynamics, has been implicated in the progression of various cancers; however, its precise role in endometrial carcinoma is not fully understood. This research sought to evaluate actinin-4 protein expression and gene amplification and correlate these findings with clinicopathological parameters and patient survival to determine its prognostic value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on endometrial carcinoma patients who underwent surgical resection. Actinin-4 protein expression was assessed using immunohistochemical staining (IHC), and <i>ACTN4</i> gene amplification was evaluated by fluorescence in situ hybridization (FISH). The intensity of actinin-4 staining was graded, and gene amplification of <i>ACTN4</i> was defined using the <i>ACTN4</i>/<i>CEP19</i> ratio. Statistical analysis, including Kaplan–Meier survival analysis and Cox proportional hazards modeling, was performed to correlate actinin-4 expression with clinicopathological features and survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overexpression of actinin-4 protein by IHC was significantly associated with advanced clinical stage and histological subtypes. While no significant difference was observed in overall survival (OS), patients with high actinin-4 IHC demonstrated significantly poorer progression-free survival (PFS). <i>ACTN4</i> gene amplification by FISH was significantly associated with poorer prognosis for both OS and PFS compared to the group without amplification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that actinin-4 plays a role in the progression of endometrial carcinoma, particularly influencing tumor aggressiveness and progression-free survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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