Ginekologia polska最新文献

Objectives: Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy associated with a wide range of psychological disorders. Recent literature suggests a correlation between PCOS and cognitive linguistics disorders. This study aimed to analyze the relationship between sex hormones, metabolic markers, and cognitive linguistic performance in patients with PCOS.

Material and methods: 48 women with PCOS and 56 healthy control women were included in the study. Standardized questionnaires were used to assess depressive symptoms [the Beck Depression Inventory (BDI-II)] and linguistic capability [the Wechsler Vocabulary Subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) test and "Łatysz" non-word reading test]. Baseline cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Laboratory tests included measurements of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), glucose, insulin, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and total cholesterol (TC). Oral glucose tolerance test (OGTT) results were also obtained.

Results: We observed significant differences in testosterone, DHEA-S, SHBG, insulin, insulin measured in 120-minute post-OGTT, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) values between women with and without PCOS. A negative correlation was found between the Wechsler Vocabulary Subtest of the WAIS-R test and testosterone, LDL, insulin, and HOMA-IR. Our study revealed a negative correlation between "Łatysz" non-word reading test and testosterone and a positive correlation between "Łatysz" non-word reading test and 120-minute post-OGTT blood glucose concentrations.

Conclusions: Our results suggest that there is a relationship between hormonal, metabolic markers, and cognitive functions in patients suffering from PCOS.

Objectives: Ovarian cancer is a highly lethal gynecological malignancy with poor prognosis. Early diagnosis of ovarian cancer is crucial for improving patient survival rates. Ultrasound is currently the most used imaging modality for the detection of ovarian cancer. However, its diagnostic accuracy is limited, particularly in the early stages of the disease. Circulating tumor DNA (ctDNA) has emerged as a promising noninvasive biomarker for cancer diagnosis. In this study, we aimed to investigate the clinical value of ultrasound combined with ctDNA (mutations in: TP53, KRAS, and PIK3CA) in the early diagnosis of ovarian cancer.

Material and methods: A total of 686 participants were enrolled, comprising 186 advanced symptomatic ovarian cancer patients, 16 histologically confirmed asymptomatic ovarian cancer patients, and 484 patients with benign ovarian lesions. Of the 202 ovarian cancer cases, 57.4% were high-grade serous carcinomas, followed by endometrioid (15.8%), clear cell (9.9%), mucinous (7.9%), and low-grade serous carcinomas (6.9%). All participants underwent standardized ultrasound examination and ctDNA analysis. Ultrasound characteristics were evaluated for morphological features including mass composition, border definition, and presence of ascites. Circulating tumor DNA was analyzed for mutations in TP53, KRAS, and PIK3CA genes. Diagnostic performance was assessed through sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculations for individual and combined detection methods.

Results: In asymptomatic ovarian cancer patients, ultrasonography revealed complex solid-cystic masses in 50.0% of cases and ascites in 43.75%, with 87.50% sensitivity and 94.33% specificity. Molecular analysis detected ctDNA mutations in 81.25% of asymptomatic cases, predominantly in TP53 (31.25%), KRAS (25.00%), and PIK3CA (25.00%). This analysis, which focused exclusively on these three genes, demonstrated 81.25% sensitivity and 97.46% specificity. The combined diagnostic approach significantly improved detection parameters (p < 0.001), with sensitivity increasing to 93.75%, specificity to 99.25%, PPV to 75.00%, and NPV to 99.85%. False-positive results decreased from 38 (ultrasound alone) and 17 (ctDNA alone) to 5 cases with the combined approach. Distinct mutation profiles were observed between cancer and benign groups, with only 15.91% of benign cases showing detectable ctDNA mutations.

Conclusions: Our results suggest that ctDNA is a promising biomarker for the early detection of ovarian cancer, with higher sensitivity and specificity than ultrasound. The combination of ultrasound and ctDNA may provide a more accurate diagnostic strategy for the early detection of ovarian cancer. These findings may contribute to the development of novel noninvasive biomarkers for the early diagnosis of ovarian cancer.

Objectives: Endometriosis is a widespread gynecological condition characterized by the presence of endometrial like tissue outside the uterine cavity. According to the literature, the frequency of endometriosis in adolescents remains unclear; however, studies suggest that histologically confirmed disease may be present in up to 47% of girls with chronic pelvic pain (CPP) and in nearly 70% of girls with primary dysmenorrhoea unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal therapy. The aim of this study was to review and compare current diagnostic and therapeutic recommendations and expert consensus for adolescent endometriosis.

Material and methods: A descriptive qualitative review of the clinical guidelines and expert consensus statements by the American College of Obstetricians and Gynecologists (ACOG), the European Society of Human Reproduction and Embryology (ESHRE), the North American Society for Pediatric and Adolescent Gynecology (NASPAG), and the Polish Society of Gynecologists and Obstetricians (PTGiP) was conducted. NASPAG guaidance present a textbook-based expert consensus and was included due to the limited availability of high-quality evidence in adolescent populations.

Results: Adolescent endometriosis remains underrecognized and insufficiently studied. Current clinical guidelines and expert consensus statements emphasize the importance role of through symptom assessment and detailed medical history in the diagnostic process. The reviewed literature supports a clinical diagnosis based on symptoms presentations and response to hormonal therapy, without routine laparoscopic confirmation.

Conclusions: Endometriosis in adolescents requires an age-specific diagnostic and therapeutic process. Adherence to current clinical guidelines and expert consensus may help reduce diagnostic delays, limit unnecessary invasive procedures, and improve long-term quality of life.

Objectives: Low ovarian reserve is a major concern as older women seek pregnancy. Women 35 and older who want to conceive have fewer high-quality oocytes, which is linked to a drop in Anti-Müllerian Hormone (AMH). Women in this age bracket may need hysterectomy for abnormal uterine bleeding, leiomyomas, and pre-/malignant reasons. Those with preserved ovaries after hysterectomy nevertheless experience menopause. This circumstance impacts women's sexuality. Interventions to improve ovarian function in this age group may illuminate both concerns.

Material and methods: We did an observational case-control study of 35-50-year-old individuals who had hysterectomy for a benign disease. The trial group received perioperative PRP for their ovaries, while the control group received no treatment. Patients' preoperative AMH and Female Sexual Function Index (FSFI) scores were compared to those 3 months following surgery.

Results: Our study found a substantial drop in postoperative AMH levels in the control group (p < 0.001), whereas the PRP group showed a slight increase in AMH levels. The PRP group has a significant difference in preoperative and postoperative AMH levels (p = 0.0001). The PRP group had a much higher total FSFI score. Subgroup analysis shows this variation in lubrication, orgasm, contentment, and pain. The PRP group had substantial differences in orgasm, pleasure, and pain pre- and post-operation.

Conclusions: PRP supports ovarian regeneration but has limited benefits. This information should be used to build standardized PRP protocols and undertake more extensive investigations by applying PRP to numerous organs, including the ovaries.

Objectives: Congenital uterine anomalies are the result of abnormal development of the Müllerian ducts and occur in approximately 5% of the general female population. These malformations often remain asymptomatic and undiagnosed until complications arise, especially during reproductive years. Accurate diagnosis and classification are crucial for counseling, reproductive planning, and appropriate surgical management. Recent advances in three-dimensional (3D) imaging and printing technology have enhanced diagnostic and therapeutic strategies in complex gynecologic cases. This report aims to present a rare postpartum complication associated with a congenital uterine anomaly, characterize the histopathological and radiological features of the case, and assess the role of printed three-dimensional (3D) anatomical modeling in supporting accurate post hoc classification and surgical decision-making.

Material and methods: A 25-year-old primiparous woman with a congenital uterine malformation underwent cesarean section at 28 weeks of gestation due to premature rupture of membranes and regular uterine contractions. One month postpartum, the patient presented with vaginal discharge and reported a palpable resistance in the vagina. Pelvic examination revealed a lobulated, dark pink, nonbleeding, firm mass measuring approximately 15 × 10 cm protruding into the vagina, along with an intact vaginal septum located 2-3 cm from the introitus. Ultrasound demonstrated an irregular mass in the right uterine cavity with indistinct margins suggestive of a necrotic fibroid. The patient underwent surgery involving removal of the vaginal mass and resection of the vaginal septum. Histopathological examination revealed fascicularly arranged, shadowed spindle cells consistent with necrotic smooth muscle tissue of myometrial origin, indicative of degenerative tissue of the uterine septum. Subsequently, a patient-specific 3D printed uterine model was generated using imaging and surgical data to facilitate detailed postoperative anatomical assessment.

Results: Postoperative assessment using the 3D printed model enabled a precise classification of the malformation as a "double septate uterus with cervix and septate vagina" (ESHRE/ESGE classification U2bC2V1) with an intracavitary FIGO type 2 submucosal leiomyoma. The 3D model provided a tangible visualization of the uterine architecture, improving anatomical understanding, facilitating retrospective diagnosis, and supporting interdisciplinary evaluation.

Conclusions: This case demonstrates the diagnostic and educational utility of 3D printing in the management of rare Müllerian anomalies. Integration of patient-specific 3D models into clinical practice may improve diagnostic precision and surgical planning, particularly in complex gynecological malformations.

Objectives: Quality of life (QoL) is a subjective assessment of various aspects of daily functioning - physical health, mental state, sexuality, level of independence and self-sufficiency, relationships, and the alignment of one's life with personal beliefs and values. Sexuality is an essential element of human existence, regardless of age or health condition.

Material and methods: The study was conducted among 84 women diagnosed with breast cancer and took place from September to October 2025. The diagnostic survey method was employed, along with the following research tools: Female Sexual Function Index (FSFI), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core-30 (EORTC-QLQ-C30), Breast Cancer 23 (QLQ-BR23), and self-administered questionnaire.

Results: Breast cancer and its surgical treatment can have a negative impact on women's quality of life, especially in areas such as fatigue, financial stress, and emotional well-being. More specific concerns related to breast cancer include arm-related symptoms and anxiety about the future. Although the overall QoL measured by the EORTC-QLQ-C30 - did not significantly differ depending on the type of surgery, certain symptoms did show variation. The QLQ-BR23 symptom scale revealed differences in areas: side-effects from treatment and breast-related discomfort. Differences were noted in sexual functioning and sexual satisfaction. Studies show that women who had breast-conserving surgery reported more sexual difficulties.

Conclusions: Among examined patients after breast-conserving surgery, 89.7% of people reported sexual dysfunction. Among all domains of FSFI, only the orgasm domain showed a statistically significant difference depending on the type of surgery performed. The QLQ-BR23 symptom scale revealed differences in areas: side-effects from treatment, breast-related discomfort, and sexual functioning and sexual enjoyment.

Objectives: Vaginal flatus is a common postpartum issue that can impact women's quality of life. This study investigates the effectiveness of Kegel exercises in reducing vaginal flatus among postpartum women.

Material and methods: In this study, forty postpartum women were enrolled between July 2022 and December 2022 at the Gynecology and Obstetrics Clinic of Istanbul Camlıca Medipol Hospital. The required sample size was calculated based on a power analysis assuming a medium effect size (Cohen's d = 0.5), a power of 80%, and a significance level of 5%, resulting in a minimum of 17 participants per group. To account for potential dropouts, 20 participants were included in each group. Women in this study were randomly assigned to either an experimental or a control group. The experimental group performed Kegel exercises, whereas the control group received no intervention. Participants in the experimental group completed Kegel exercises three times daily in three different positions for three weeks. Additionally, a six-week home exercise program was implemented, including fast and slow contractions targeting both type I and type II muscle fibers. The assessment included vaginal flatus frequency and bother scores measured through a validated questionnaire, as well as sexual quality of life evaluated using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PSQ-12).

Results: A significant reduction in vaginal flatus frequency and bother scores was observed in the experimental group following the intervention (p < 0.01). The mean vaginal flatus frequency score decreased from 2.95 to 2.0 in the experimental group. Comparisons of pre- and post-intervention vaginal flatus frequency/bother scores and PSQ-12 values revealed a statistically significant difference only in the experimental group (p < 0.05).

Conclusions: The findings indicate that Kegel exercises effectively reduce the frequency and bother associated with vaginal flatus in postpartum women. Incorporating pelvic floor exercise into postpartum care programs may improve overall well-being and sexual health outcomes.

Obstetric forceps have played a pivotal role in perinatal medicine for centuries, representing one of the most significant innovations in the history of obstetrics. As a life-saving instrument, forceps revolutionized the management of complicated labours by offering an alternative to destructive procedures and maternal mortality, thereby transforming the outlook for both mothers and newborns. Throughout their history, however, forceps have provoked both admiration and controversy - praised for their ability to facilitate safe delivery, yet criticized for their potential risks and the technical skill required for their proper use. This article provides a comprehensive overview of obstetric forceps, addressing not only their origins and the secretive circumstances of their invention by the Chamberlen family, but also the successive stages of their design evolution, from early concealed prototypes to the sophisticated instruments used in modern practice. We also examine the cultural, social, and medical impact of forceps across different eras, highlighting their central role in shaping the practice of operative vaginal delivery and the broader history of perinatal care. Finally, current debates surrounding the role of forceps in contemporary obstetrics are discussed, offering insight into the future of this instrument in the context of alternative techniques such as vacuum extraction and cesarean section.