Ginekologia polska最新文献

Objectives: The effects of posterior vaginal wall prolapse on pelvic floor function have not been adequately investigated, particularly for lower urinary tract symptoms (LUTS). We aimed to investigate the effects of isolated posterior compartment prolapse on LUTS.

Material and methods: The study was conducted as a PROSPECTIVE: cross-sectional study with female patients with isolated posterior prolapse who presented with any LUTS. All patients were evaluated according to the POP-Q system. A total of 41 patients with stage 2-3 isolated pelvic organ prolapse were included in the study group. The control group consisted of a total of 41 patients without significant pelvic organ prolapse. Study and control groups were compared in terms of demographic data and UDI-6, IIQ-7, ICIQ-FLUTS, LUTS QoL, FLUT Sex scales.

Results: The incidence of SUI, UI, frequency, nocturia, abnormal evacuation, difficulty in passage and vaginal farting in the study group was found to be statistically significantly higher than the control group. In the study group, the total scores on the UDI-6, IIQ-7, and LUTS QoL measures were significantly higher. While the total scores of the ICIQ-FLUTS Scale "Filling" and "Incontinence" subgroups were significantly higher in the study group, no significant difference was found in the "voiding" subgroup. There was no statistically significant difference between the two groups in terms of their total FLUT Sex scores.

Conclusions: It has been shown that isolated posterior prolapse may be associated with an increase in lower urinary tract system symptoms and a decrease in quality of life.

Background: Adenomyosis is a uterine disorder commonly associated with painful menstrual cycles, abnormal uterine bleeding, and dyspareunia, which can significantly impact fertility, pregnancy outcomes and overall quality of life. Recent literature reports suggest that adenomyosis is increasingly being identified in adolescents, particularly in those presenting with severe dysmenorrhea and heavy menstrual bleeding. In this review we evaluate the frequency of adenomyosis diagnosis on imaging studies in relation to the occurrence of dysmenorrhea, pelvic pain and heavy menstrual bleeding (HMB).

Methods: A thorough literature search was performed using PubMed, EMBASE and SCOPUS databases. It was confined to articles published from 1 January 2019, to 1 August 2024 and included only those available in English. Due to the very limited number of publications on this topic, an age range of 12-25 years was selected as the inclusion criteria. For articles that met the inclusion criteria, information regarding diagnosis on imaging and relation to the occurrence of symptoms was extracted.

Results: Five full-text articles were reviewed. Studies including adolescents and young women from 12-25 years of age who presented with HMB, pelvic pain, dysmenorrhea and an imaging-based diagnosis of adenomyosis. The prevalence of adenomyosis in this population ranged from 25 to 45%. It is crucial to consider adenomyosis in the differential diagnosis of adolescent girls presenting with dysmenorrhea, heavy menstrual bleeding, and pelvic pain. Dysmenorrhea was the most frequently reported symptom (from 81 to 100%) associated with imaging features of adenomyosis.

Objectives: This meta-analysis aims to explore the association between MMP-9-C1562T polymorphism and susceptibility to preeclampsia (PE).

Material and methods: Four English databases were searched to collect relevant records up to April 2024. The pooled odds ratio (OR) was calculated using Stata 15.0.

Results: A total of 10 studies were enrolled in our systematic review. The results showed that genotype CT at MMP-9-C1562T locus increased the risk of PE versus genotype TT (Genotype CT vs TT: OR = 2.32, 95% CI: 1.27-4.24, P = 0.006), but no significant differences were found in other gene models (C vs T: OR = 0.88, 95% CI: 0.71-1.08, P = 0.225; Genotype CC vs TT: OR = 1.51, 95% CI: 0.87-2.61, P = 0.139; Genotype CC + CT vs TT: OR = 1.63, 95% CI: 0.95-2.81, P = 0.079; Genotype CC vs CT + TT: OR = 0.80, 95% CI: 0.63-1.03, P = 0.086). Subgroup analysis by ethnicity showed a statistically significant difference in the heterozygous model in China (Genotype CT vs TT: OR = 2.38, 95% CI: 1.15 -4.91, P = 0.019).

Conclusions: Association of MMP-9-C1562T polymorphism with susceptibility to PE exists. Specifically, genotype CT increases the risk of PE versus genotype TT, particularly in Caucasian populations.

Objectives: This study aimed to investigate the relationship between controlling nutritional status index (CONUT) and prognostic nutrition index (PNI) scores that are used to evaluate nutritional status and GDM. Also, lipid abnormalities and albumin levels in pregnant women with normal glucose tolerance and GDM were researched.

Material and methods: This study was conducted as a retrospective study at Ankara Etlik City Hospital, Turkey. The study included 67 pregnant women with singleton pregnancies (32 pregnant diagnosed with GDM and 35 pregnant known to be normoglycemic).

Results: There were no statistical differences between the groups in terms of maternal age, gravidity, parity, history of miscarriage and weight gain during pregnancy. Body mass index (BMI) was higher in the GDM group (p = 0.001). There was no difference in the CONUT score between the groups (p = 0.254). The PNI score was lower in the GDM group (p = 0.003). Of the laboratory data, only fasting blood glucose, triglycerides (TG) and total cholesterol (TC) were statistically significantly higher, and albumin was lower in the GDM group (p = 0.026, p = 0.007, p = 0.003 and p = 0.003, respectively).

Conclusions: PNI has the potential to be a useful predictor of GDM, whereas CONUT does not. Low albumin levels and increased TG, and TC in the first trimester seem to be significant in the development of GDM.

Objectives: Endometriosis is a common chronic disease in childbearing women and a major cause of infertility. Our study aimed to identify and validate a novel gene signature for diagnosing endometriosis based on histone-related genes (HRGs), and to investigate their biological functions in endometriosis.

Material and methods: RNA sequence data were downloaded from the Gene Expression Omnibus database, and HRGs were retrieved from the GeneCards database. We identified differentially expressed genes using the limma package, and constructed a diagnostic model using the rms package. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were performed for visualization, annotation, and integrated discovery. Subsequently, we validated the model using the recall and decision curve analysis (DCA). Additionally, we analyzed the immune microenvironment features using CIBERSORT.

Results: A total of 18 differentially expressed HRGs were identified in patients with endometriosis compared with controls. GO and KEGG enrichment was mainly in spindle organization, positive regulation of the cell cycle process, progesterone-mediated oocyte maturation, and cellular senescence and cell cycle. We obtained a signature of four HRGs (JUNB, FRY, LMNB1, and SPAG1). DCA revealed that the diagnostic model benefits patients with endometriosis, regardless of the incidence. CIBERSORT analysis showed that the number of plasma cells increased significantly in endometriosis samples from all four datasets.

Conclusions: Our findings provide novel insights into the function of HRGs in the development of endometriosis and identify a new signature of four HRGs that may serve as valuable diagnostic markers and therapeutic targets for this disease.

Objectives: to explore the opinions of pregnant and postpartum women on the services provided via remotely conducted consultation and to assess the sense of security of patients under the care conducted remotely my midwives and gynecologists.

Material and methods: An anonymous, self-administered survey questionnaire was completed by 86 women who had at least one telephone consultation with a gynecologist or midwife during pregnancy or after birth. The questionnaire was spread via social media between February 1 and August 1, 2022.

Results: More than half of the surveyed group (51.2%) had 1-3 consultations performed remotely during pregnancy and 53.5% after birth. Phone call only was the most popular form of remote consultations performed during pregnancy (69.8%) and after birth (43.0%). Simple app was used in 10.5% consultations during pregnancy and 4.7% after birth. The predominant reason of the remotely conducted consultation during pregnancy and after birth was the need of getting the prescription or consultation of blood/urine test results (61.6%). Although phone-made medical consultations were a convenience and time-saver for most women, the preferred form of visit is to meet the caregiver in person.

Conclusions: Special times, such pandemic was, requires a different, individual approach, and perhaps thanks to these experiences we will be able to behave wiser in future states of public health emergency. Teleconsultations were an acceptable form of medical consultation to discuss the results, effects of treatment or to write a referral or prescription.

Objectives: Human papillomavirus (HPV) is a prevalent sexually transmitted infection with significant implications for public health. In Poland, a nationwide vaccination program offers a choice between the 9-valent (9v) and 2-valent (2v) HPV vaccines. We aimed to assess the cost-effectiveness of the 9v vs 2v vaccine from the public payer perspective in Poland.

Material and methods: A cost-effectiveness analysis was conducted to compare the public health and economic benefits of using 9v vs 2v vaccine in Poland over 100-year horizon using a previously published deterministic dynamic transmission model. A target population of girls and boys aged 12-13 years was considered. The model was populated with local epidemiological inputs, utilities, and costs, including vaccine and administration costs, as well as costs related to medical procedures for HPV-related diseases.

Results: The 9v vaccine reduced the prevalence of HPV infections and HPV-related diseases substantially more than 2v vaccine when both are compared to no vaccination strategy. The total discounted cost savings of using the 9v vaccine instead of 2v, excluding the vaccine costs, amounted to EUR 66 million. The incremental cost-effectiveness ratio amounted to 8094 EUR per quality-adjusted life year, much below the official cost-effectiveness threshold in Poland set up at the three times the annual gross domestic product per capita. 9v cost-effectiveness ratio remained unchanged when shorter time-horizons of 20, 40, 60, or 80 years were considered.

Conclusions: Using 9v HPV vaccine in Poland is highly cost-effective compared to the 2v vaccine.