The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
Sun
200 papers
The Kızıldemir VISTA Technique (Vertical Isthmocele Surgical Transvaginal Approach): Prospective Analysis of Anatomic and Reproductive Outcomes of a Novel Vertical Suture Technique.
Kizildemir YZ, Deniz E, Incebiyik M … +6 more , Kalir H, Karsli SE, Okuyan II, Kahveci B, Sak S, Sak ME
J Obstet Gynaecol Res · 2026 Apr · PMID 41991244 · Publisher ↗
OBJECTIVE: To evaluate the anatomic, clinical, and reproductive outcomes of the Kızıldemir VISTA (Vertical Isthmocele Surgical Transvaginal Approach), a novel continuous vertical suture technique for transvaginal isthmoc...
OBJECTIVE: To evaluate the anatomic, clinical, and reproductive outcomes of the Kızıldemir VISTA (Vertical Isthmocele Surgical Transvaginal Approach), a novel continuous vertical suture technique for transvaginal isthmocele repair, also referred to as cesarean scar defect-related disorder (CSDi). METHODS: This prospective single-arm pilot study, conducted at a university hospital, enrolled 21 women with symptomatic isthmocele (residual myometrial thickness [RMT] ≤ 3 mm) and secondary infertility or recurrent pregnancy loss. All patients underwent transvaginal repair using a novel continuous vertical (craniocaudal) suture technique. The primary outcome was the change in RMT at 3 months postoperatively. Secondary outcomes included symptom resolution (postmenstrual spotting, pelvic pain) and pregnancy rates at 12-month follow-up. RESULTS: The mean RMT significantly increased from 1.5 ± 0.5 mm preoperatively to 6.9 ± 1.8 mm postoperatively (p < 0.001). A corresponding significant reduction in niche depth was observed (7.1 ± 1.2 mm to 2.1 ± 1.0 mm; p < 0.001). Symptom resolution was high: postmenstrual spotting resolved in 14/16 patients (87.5%; p = 0.011) and chronic pelvic pain resolved in 6/7 patients (85.7%; p = 0.026). Among 20 patients desiring pregnancy, 14 (70%) conceived (57.1% spontaneous, 42.9% via ART), resulting in 11 live births and 3 ongoing pregnancies. Postoperative RMT was significantly higher in patients who conceived (7.3 ± 1.6 mm) compared to those who did not (5.8 ± 1.2 mm; p = 0.045). No major complications or 12-month recurrences were observed. CONCLUSION: The novel continuous vertical suture technique for transvaginal isthmocele repair appears to be a promising and feasible approach. Within this pilot cohort, it significantly restored myometrial integrity, effectively resolved associated symptoms, and was associated with favorable pregnancy rates, particularly in patients who achieved greater postoperative myometrial thickness.
Impact of Maternal Obesity on Delivery Outcomes Following Labor Induction: A Single-Center Retrospective Cohort Study.
Sakaguchi S, Nakamura E, Matsunaga S … +2 more , Kikuchi A, Takai Y
J Obstet Gynaecol Res · 2026 Apr · PMID 41986057 · Full text
AIM: This study evaluated the association between body mass index (BMI) at the onset of labor induction and delivery outcomes, including instrumental delivery, emergency cesarean section, labor duration, and cumulative o...
AIM: This study evaluated the association between body mass index (BMI) at the onset of labor induction and delivery outcomes, including instrumental delivery, emergency cesarean section, labor duration, and cumulative oxytocin dose among singleton term pregnancies. METHODS: We conducted a retrospective cohort study of singleton term pregnancies undergoing labor induction at a tertiary perinatal center. We analyzed BMI at induction onset as a continuous variable and applied multivariable regression models to evaluate instrumental delivery, emergency cesarean section, labor duration, and cumulative oxytocin dose. We also performed sensitivity analyses using pre-pregnancy BMI, models additionally adjusting for gestational weight gain and pregnancy complications, and restricted-indication analyses. RESULTS: Delivery BMI was not significantly associated with instrumental delivery (adjusted OR 0.96 per 1 kg/m increase; 95% CI 0.92-1.00), emergency cesarean section (adjusted OR 1.03; 95% CI 0.99-1.07), or labor duration. In contrast, cumulative oxytocin dose increased with higher delivery BMI (β = 0.04 per 1 kg/m increase; 95% CI 0.01-0.07), corresponding to approximately 20% greater oxytocin requirement per 5 kg/m increment in this cohort. This pattern persisted across sensitivity analyses. CONCLUSIONS: Higher maternal BMI at induction onset was associated with greater oxytocin requirements, while no clear associations were observed with mode of delivery or labor duration.
The Predictive Value of Systemic Immune-Inflammation Index, Systemic Inflammatory Response Index, and Pan-Immune-Inflammation Value for Adnexal Torsion.
Basbuga HM, Yurken DS, Seyhan B … +1 more , Kinay T
J Obstet Gynaecol Res · 2026 Apr · PMID 41982170 · Publisher ↗
AIM: There is no diagnostic method available to make a definitive preoperative diagnosis of adnexal torsion currently. The aim of the study was to evaluate the predictive value of systemic immune-inflammation index (SII)...
AIM: There is no diagnostic method available to make a definitive preoperative diagnosis of adnexal torsion currently. The aim of the study was to evaluate the predictive value of systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV) for adnexal torsion diagnosis. METHODS: A total of 469 women who were operated on with the diagnosis of adnexal mass were included in the retrospective cohort study. According to intraoperative adnexal torsion diagnosis, the study population was divided into the torsion group (103 women) and the control group (366 women). Demographic, laboratory, ultrasonographic findings, and inflammatory indices of the two groups were compared. SII, SIRI, and PIV were calculated using preoperative complete blood count results. RESULTS: The mean SIRI (3537 ± 3781 vs. 1656 ± 236), SII (1669 ± 1408 vs. 805 ± 901), and PIV (106 421 ± 129 428 vs. 50 466 ± 74 302) values were higher in the torsion group than the control. According to the ROC curve analysis, the optimal cut-off values of SIRI (AUC 0.731), SII (AUC 0.755), and PIV (AUC 0.706) for predicting adnexal torsion were found as 1438, 944, and 62 557, respectively. CONCLUSION: The study results showed that the SII, SIRI, and PIV significantly increased in adnexal torsion cases. Evaluating these inflammatory indices together with ultrasonographic findings may facilitate the diagnosis of adnexal torsion.
The Carbon Footprint of a Cesarean Section: A Study on Real-Time, Prospectively Collected Data of Disposables, Energy, and Reusables.
Colenbrander E, Cohen E, de Haes F … +3 more , Weiland NS, Hehenkamp W, Salentijn D
J Obstet Gynaecol Res · 2026 Apr · PMID 41978313 · Full text
AIM: The healthcare sector, particularly operating rooms, is a major source of greenhouse gas emissions. To reduce this impact, it is important to assess the carbon footprint of medical procedures. The aim of this study...
AIM: The healthcare sector, particularly operating rooms, is a major source of greenhouse gas emissions. To reduce this impact, it is important to assess the carbon footprint of medical procedures. The aim of this study was to assess the carbon footprint of a cesarean section, focusing on CO-equivalent (COeq) emissions from disposable products, reusable products, and HVAC energy use. METHODS: A prospective observational study was conducted in a Dutch academic hospital (Feb-Jun 2025). For 50 C-sections, data on type, material, and weight of disposable and reusable products were collected. COeq emissions were estimated using predefined product groups linked to life cycle assessment (LCA) data. HVAC energy use was calculated from procedure time and corresponding LCA data. RESULTS: The mean COeq emission of a C-section was 33.5 [SD 2.2] kg COeq. Disposable products accounted for the largest share, with a mean contribution of 27.7 [SD 1.5] kg COeq. Among disposable the surgical drapes, sterile gauze pads, and surgical gowns were the highest emitting categories. Energy use during the procedure contributed an average of 3.4 [SD 0.9] kg COeq, while reusable products accounted for 2.4 [SD 0.1] kg COeq. The mean COeq emissions of planned and unplanned (urgency Levels S2 and S3) C-sections were comparable. CONCLUSION: The CO emissions of a C-section are substantial; disposable products were the highest contributors. Emission reduction could be achieved by minimizing unnecessary utilization of disposables, replacing disposables with reusable items, or by reducing the number of C-sections performed.
Beyond HER2-Negative: Clinical and Molecular Relevance of HER2-Ultralow Expression in Gynecologic Pathology.
Rathod G, Parmar P
J Obstet Gynaecol Res · 2026 Apr · PMID 41975577 · Publisher ↗
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Unveiling the Role of Irisin as a Biomarker in Adolescent and Young Adult PCOS: A Metabolic and Hormonal Comparison of Hyperandrogenic and Normoandrogenic Phenotypes.
Majeed S, Moin H, Fatima S … +3 more , Hashmi F, Akhtar T, Shafi R
J Obstet Gynaecol Res · 2026 Apr · PMID 41968844 · Publisher ↗
AIM: Polycystic ovary syndrome (PCOS) in adolescents and young adults is difficult to diagnose due to overlap with normal puberty. This study assessed irisin as a biomarker, comparing metabolic and hormonal profiles of h...
AIM: Polycystic ovary syndrome (PCOS) in adolescents and young adults is difficult to diagnose due to overlap with normal puberty. This study assessed irisin as a biomarker, comparing metabolic and hormonal profiles of hyperandrogenic (HA) and normoandrogenic (NA) phenotypes, determining an optimal cut-off, examining correlations with clinical markers, and identifying predictors of irisin levels. METHODS: A cross-sectional study was conducted involving 120 females aged 13-21 years, comprising 60 PCOS patients (38 HA-PCOS, 22 NA-PCOS) and 60 healthy controls. Metabolic and hormonal profiles, including serum irisin, insulin resistance indices, lipid profile, and reproductive hormones were assessed. Data were analyzed using SPSS version 22. RESULTS: Irisin levels were significantly elevated in HA-PCOS compared to NA-PCOS (p = 0.004) and controls (p < 0.001). Irisin showed positive correlation with BMI, glucose, insulin, HOMA-IR, TAGs, low-density lipoprotein, and luteinizing hormone, and negative correlation with high-density lipoprotein and QUICKI. An irisin threshold of 18.24 ng/mL demonstrated potential in identifying HA-PCOS (area under curve = 0.802). Multivariate regression identified glucose, TAGs, LH, and HOMA-IR as significant predictors of irisin levels (adjusted R = 0.908). CONCLUSION: HA-PCOS is marked by more severe metabolic disruption. Irisin may serve as a promising early biomarker for this phenotype and help predict long-term complications linked to metabolic disruption in PCOS.
Association Between Impaired Dendritic Cell Maturation and Uterine Adenomyosis Pain.
Xu Z, Guo W, Shen Y
J Obstet Gynaecol Res · 2026 Apr · PMID 41968803 · Publisher ↗
PURPOSE: To investigate the association between dendritic cell maturation deficits and pain in patients with adenomyosis and explore potential neuro-immune mechanisms. METHODS: Uterine tissues from 24 patients with adeno...
PURPOSE: To investigate the association between dendritic cell maturation deficits and pain in patients with adenomyosis and explore potential neuro-immune mechanisms. METHODS: Uterine tissues from 24 patients with adenomyosis (AM) and 15 controls were analyzed. Samples from the endometrial-myometrial interface (EMI) and middle myometrium (MM) were tested. To study the expression of nerve fiber marker (PGP9.5), nerve growth factor (NGF), mature DC (CD83+), and immature DC (CD1a+), the team used immunohistochemistry (IHC) and real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The correlation between these findings and pain scores was also analyzed. RESULTS: PGP9.5 and NGF expression in both EMI and MM regions were significantly higher in the AM group (p < 0.05), whereas the CD83+/CD1a+ ratio was reduced (p < 0.01). A significant negative correlation was observed between PGP9.5 and the CD83+/CD1a+ ratio (MM: r = -0.650, p = 0.011; EMI: r = -0.812, p < 0.001). VAS scores (VAS) were negatively correlated with the CD83+/CD1a+ ratio (MM: r = -0.851, p < 0.001; EMI: r = -0.814, p = 0.001), but there was no direct association with NGF. Two-way analysis of variance (ANOVA) revealed that the disease state (AM) was the main factor affecting the proportion of NGF and DC maturation (p < 0.05), whereas anatomical location had no significant impact. CONCLUSIONS: Based on our cross-sectional observational study, DC maturation deficits are associated with AM pain, potentially through neuro-immune interactions. However, NGF functions independently of DC. Exploring neuro-immune interactions is a new approach for treating AM-related pain.
Successful Multidisciplinary Management of Uterine Carcinoma Treated With Chemotherapy Under Mechanical Ventilation.
Asano F, Momomura M, Shimazaki T … +5 more , Shibuya H, Matsumoto H, Kotani M, Morisada T, Kobayashi Y
J Obstet Gynaecol Res · 2026 Apr · PMID 41968800 · Publisher ↗
We report a rare case of stage IVB endometrial carcinoma complicated by respiratory failure requiring mechanical ventilation. A 61-year-old woman with severe obesity developed bilateral pleural effusions and was admitted...
We report a rare case of stage IVB endometrial carcinoma complicated by respiratory failure requiring mechanical ventilation. A 61-year-old woman with severe obesity developed bilateral pleural effusions and was admitted to the intensive care unit (ICU) for respiratory management. Because the organ failure was considered primarily tumor-related and hepatic and renal functions were preserved, weekly paclitaxel-carboplatin chemotherapy was initiated under mechanical ventilation through close multidisciplinary collaboration. The treatment was effective, leading to improvement in the pleural effusions and oxygenation, and the patient was successfully extubated and discharged after 4 months of hospitalization. Although the disease eventually progressed, the chemotherapy administered in the ICU achieved temporary tumor control and functional recovery. This case suggests that ICU-based chemotherapy for gynecologic malignancies, while nonstandard, may be feasible and beneficial in carefully selected patients with preserved organ function and potentially reversible, tumor-related organ failure.
Relationship Between Menopausal Symptoms, Stress Coping Styles, and Quality of Life in Turkish Women: A Cross-Sectional Study.
Karakoç S, Aşci Ö
J Obstet Gynaecol Res · 2026 Apr · PMID 41968786 · Publisher ↗
AIM: This study aimed to examine the relationship between menopausal symptoms, stress coping styles, and quality of life in Turkish women. METHODS: This cross-sectional study was conducted online with 699 women aged 45-5...
AIM: This study aimed to examine the relationship between menopausal symptoms, stress coping styles, and quality of life in Turkish women. METHODS: This cross-sectional study was conducted online with 699 women aged 45-59 years. Data were collected using a Personal Information Form, the Menopause Rating Scale (MRS), the Coping Style Scale (CSS), and the Menopause Specific Quality of Life Questionnaire (MENQOL). Descriptive statistics, correlation analyses, and linear regression analyses were performed. RESULTS: The mean age of participants was 50.31 ± 4.22 years, and the mean age at menopause was 48.15 ± 2.76 years. Of the participants, 61.2% were menopausal. The mean MRS score was 15.50 ± 8.10. The most frequently reported symptoms were nervousness (87.1%), physical and mental fatigue (86.6%), and joint and muscle disorders (85.0%). Weak to moderate positive correlations were found between total and subscale MRS scores and MENQOL subscales (r = 0.379-0.680). Increased severity of menopausal symptoms was significantly associated with decreased menopause-related quality of life (B = 0.113, p < 0.001). Self-confident and optimistic coping styles were negatively associated with psychological symptoms, whereas helpless/self-blaming and submissive coping styles showed weak positive associations with all menopausal symptoms. CONCLUSION: Menopausal symptoms negatively affect women's quality of life. Stress coping styles are associated with the severity and perception of these symptoms. Helpless/self-blaming and submissive coping styles may exacerbate menopausal symptoms, while self-confident and optimistic coping styles may reduce psychological complaints. Interventions aimed at improving stress coping skills may contribute to better quality of life among menopausal women.
Letter to "Management of Pregnancies With a History of Venous Thromboembolism: Low-Dose Low-Molecular-Weight Heparin and Low-Dose Acetylsalicylic Acid Prophylaxis".
Xu J, Yang D
J Obstet Gynaecol Res · 2026 Apr · PMID 41967914 · Publisher ↗
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Magnetic Resonance Imaging as a Non-Surgical Predictor of Endometriosis Fertility Index Surgical Factors.
Komatsu H, Uchida M, Hasegawa Y … +5 more , Tsukui Y, Kobayashi M, Hiraishi H, Kitahara Y, Iwase A
J Obstet Gynaecol Res · 2026 Apr · PMID 41956902 · Publisher ↗
AIM: Endometriosis affects 6%-10% of women of reproductive age and is associated with chronic pelvic pain, infertility, and impaired quality of life. The endometriosis fertility index (EFI) predicts spontaneous pregnancy...
AIM: Endometriosis affects 6%-10% of women of reproductive age and is associated with chronic pelvic pain, infertility, and impaired quality of life. The endometriosis fertility index (EFI) predicts spontaneous pregnancy postoperatively, but requires operative findings, limiting its use in non-surgical cases. This study evaluated whether magnetic resonance imaging (MRI) could serve as an alternative to EFI. METHODS: This retrospective study included 34 women aged 18-43 years who underwent laparoscopic ovarian cystectomy at Gunma University Hospital (2018-2022). Surgical videos were reviewed to calculate EFI. Preoperative MRI findings were assessed using ovarian cyst shape, ovarian position, and follicle location. MRI indicators were compared with EFI surgical factor scores using logistic regression. RESULTS: The mean EFI was 5.7 ± 1.8. Abnormal follicle location on MRI significantly correlated with lower EFI surgical factor scores (p < 0.05), whereas cyst shape and ovarian position showed no significant associations. Postoperatively, six women conceived spontaneously, and three conceived through assisted reproductive technology (ART). CONCLUSION: Abnormal follicle location may noninvasively predict surgical factors for EFI. Considering that MRI is routinely performed preoperatively in Japan, MRI-based EFI prediction can be used as a supporting finding to assist in determining whether to proceed with ART without surgical intervention.
Medical Education Research in Japanese Obstetrics and Gynecology, 2014-2024: A Bibliometric Analysis.
Kamijo K, Kondo Y, Sakaguchi K … +2 more , Isobe M, Watari T
J Obstet Gynaecol Res · 2026 Apr · PMID 41956896 · Publisher ↗
AIM: To describe the characteristics of medical education research in Japanese obstetrics and gynecology and identify gaps in themes, target populations, and patterns of international collaboration. METHODS: We conducted...
AIM: To describe the characteristics of medical education research in Japanese obstetrics and gynecology and identify gaps in themes, target populations, and patterns of international collaboration. METHODS: We conducted a bibliometric review of English-language articles indexed in PubMed from January 2014 to December 2024. We included peer-reviewed original articles, reviews, and letters whose first author was an obstetrics and gynecology professional affiliated with a Japanese institution and whose primary focus was education of medical students, junior/senior residents, or attending physicians. Two reviewers independently screened records and extracted publication characteristics including publication trends, research themes, target populations, and international co-authorship. Annual trends were assessed with the Mann-Kendall test and quantified using the Theil-Sen slope. RESULTS: Of 61 records screened, 28 articles met inclusion criteria: 21 original articles, one review, and six letters or commentaries. The number of publications increased over time; however, the annual trend was not statistically significant (0.38 articles per year; p = 0.065). Surgical skills training (32.1%) and simulation-based education (21.4%) were the most frequent themes. Senior residents were the most commonly studied population (82.1%), followed by attending physicians (46.4%), junior residents (21.4%), and medical students (17.9%). No article reported international co-authorship. CONCLUSIONS: Medical education research output in Japanese obstetrics and gynecology was modest and concentrated on surgical skills training and simulation-based education for senior residents, with minimal attention to earlier learner stages, nontechnical competencies, or international collaboration. These baseline data may inform strategic investment in broader educational themes, target populations, and partnerships.
Correction to "Determination of Awareness of Pregnant Women on Climate Change: A Cross-Sectional Study".
J Obstet Gynaecol Res · 2026 Apr · PMID 41956894 · Publisher ↗
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Cesarean Section in Women With a Neobladder: A Case Report Focusing on Anatomical Changes and Surgical Considerations.
Kwon JY, Ham S, Sung JH … +3 more , Song W, Han DH, Oh SY
J Obstet Gynaecol Res · 2026 Apr · PMID 41956892 · Publisher ↗
As an increasing number of women who underwent augmentation cystoplasty (AC) reach childbearing age, there is a growing need for detailed guidance on pregnancy and delivery management. The recommended mode of delivery ma...
As an increasing number of women who underwent augmentation cystoplasty (AC) reach childbearing age, there is a growing need for detailed guidance on pregnancy and delivery management. The recommended mode of delivery may vary depending on individual anatomy and clinical circumstances. Even when vaginal delivery is attempted, the possibility of emergency cesarean section must always be anticipated. Therefore, a thorough understanding of AC-associated alterations in pelvic anatomy, which directly influence surgical planning and execution, is important. However, detailed operative guidance in surgical context remains limited. Here, we report a pregnant woman who had AC at the age of nine and had relied on clean intermittent catheterization in her life and delivered her baby with an emergency cesarean section. Along with preoperative MRI findings, we provide comprehensive intraoperative documentation, including extensive surgical photographs, and describe technical challenges encountered during cesarean delivery. Our report aims to contribute practical insights into obstetric management in this complex population.
Chemerin as a Novel Mediator of Fetal Endothelial Dysfunction in Gestational Diabetes Mellitus: Integration of Bioinformatics, Clinical, and In Vitro Evidence.
Zeng S, Wang H, Yang W … +3 more , Zeng Y, ShenTu W, Fang Y
J Obstet Gynaecol Res · 2026 Apr · PMID 41947503 · Publisher ↗
OBJECTIVE: This study aimed to elucidate chemerin's role in gestational diabetes mellitus (GDM)-related fetal endothelial dysfunction and its association with non-invasive hemodynamic parameters. METHODS: We integrated b...
OBJECTIVE: This study aimed to elucidate chemerin's role in gestational diabetes mellitus (GDM)-related fetal endothelial dysfunction and its association with non-invasive hemodynamic parameters. METHODS: We integrated bioinformatics (GSE87295 dataset, n = 5/group), a prospective clinical cohort (30 GDM, 31 controls), and functional in vitro experiments. Chemerin and von Willebrand factor (vWF) were quantified by ELISA. Fetal aortic pulse wave velocity (APV) was assessed by Doppler ultrasound. Human umbilical vein endothelial cells (HUVECs) were treated with recombinant chemerin (0-40 nM). RESULTS: Transcriptomic analysis revealed chemerin (RARRES2) co-expression with inflammatory and metabolic genes, with tissue-level mRNA downregulation but pathway activation in GDM. Clinically, GDM exhibited elevated umbilical cord serum chemerin (median [IQR]: 244980.49 [244890.56-245318.24] vs. 244463.32 [244429.48-244589.77] pg/mL, p < 0.0001) and vWF (17727.80 [8267.68-40286.38] vs. 11804.38 [2793.55-30280.01] ng/mL, p < 0.0001), alongside reduced fetal APV (28.4 ± 3.1 vs. 35.2 ± 2.8 cm/s, p < 0.0001). Serum chemerin correlated positively with vWF (r = 0.538, p < 0.0001) and negatively with APV (r = -0.493, p < 0.0001). In vitro, chemerin induced dose-dependent impairment of HUVEC migration (40% reduction at 40 nM, p < 0.0001) and proliferation (35% reduction, p < 0.0001), with concomitant vWF mRNA upregulation (2.1-fold, p < 0.05). CONCLUSION: Elevated circulating chemerin is associated with fetal endothelial dysfunction in GDM. Discordant mRNA/protein levels suggest post-transcriptional regulation. Cord blood chemerin may serve as a biomarker of fetal vascular injury, while fetal APV offers a non-invasive clinical tool. CMKLR1 antagonist studies are needed to establish therapeutic potential.
Combined Large Cell Neuroendocrine Carcinoma of the Endometrium Treated With Paclitaxel, Carboplatin, and Durvalumab, Followed by Maintenance Therapy With Durvalumab and Olaparib (DUO-E Regimen): A Case Report.
Suzuki T, Sonehara K, Nabeshima H … +3 more , Shioya Y, Yamanaka S, Kondo S
J Obstet Gynaecol Res · 2026 Apr · PMID 41947481 · Publisher ↗
Combined large cell neuroendocrine carcinoma (LCNEC) of the endometrium is rare and carries a poor prognosis. A 61-year-old woman with suspected endometrial serous carcinoma was referred to our hospital. Imaging studies...
Combined large cell neuroendocrine carcinoma (LCNEC) of the endometrium is rare and carries a poor prognosis. A 61-year-old woman with suspected endometrial serous carcinoma was referred to our hospital. Imaging studies staged the disease as stage IIIC1. We performed a total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and retroperitoneal lymph node dissection. Histopathological examination revealed a combination of LCNEC, endometrioid carcinoma, and multiple lymph node metastases. Postoperative computed tomography showed multiple pulmonary metastases not detected preoperatively. Given the advanced and recurrent nature of the disease, treatment with paclitaxel, carboplatin, and durvalumab was initiated. After the first cycle, the pulmonary metastases disappeared. Maintenance therapy with durvalumab and olaparib was continued because of proficient mismatch repair status. This case demonstrates that durvalumab may be a viable treatment option for endometrial LCNEC, as it is also approved for small cell lung cancer, which shares similarities with neuroendocrine carcinoma.
Changes in Diagnostic Methods, Criteria, and Treatment for Chronic Endometritis After National Health Insurance Coverage of Assisted Reproductive Technology in Japan: A Nationwide Follow-up Survey (IZANAMI Project).
Jwa SC, Kuroda K, Shirasawa H … +3 more , Harada M, Osuga Y, Yamada M
J Obstet Gynaecol Res · 2026 Apr · PMID 41947471 · Publisher ↗
AIM: To evaluate how diagnostic methods, criteria, and treatment for chronic endometritis (CE) changed in Japan after introducing health insurance coverage of assisted reproductive technology (ART). METHODS: We conducted...
AIM: To evaluate how diagnostic methods, criteria, and treatment for chronic endometritis (CE) changed in Japan after introducing health insurance coverage of assisted reproductive technology (ART). METHODS: We conducted two nationwide, web-based facility surveys targeting all 616 registered ART facilities. The surveys were administered before ART insurance coverage (December 2021 to February 2022) and after coverage (December 2023 to January 2024). Facilities that responded to both surveys (283 facilities) were included. We evaluated whether facility-level CE diagnostic methods, CD138-positive plasma cell cutoff values, and first- and second-line treatment choices changed between surveys. RESULTS: CE testing was implemented by 238 facilities in the precoverage and 244 postcoverage periods. The adoption of diagnostic methods did not significantly change. Although the overall number of facilities that adopted CD138 immunohistochemical staining was stable (145 vs. 149 facilities), 23 facilities discontinued CD138 staining postcoverage while 27 newly introduced it; discontinuation occurred predominantly in clinics (91.3%), whereas 44% of new adopters were hospitals/university hospitals (p < 0.001). The cutoff value of CD138-positive cells (6-10 cells/20 high-power fields) increased between the surveys (p = 0.01). Doxycycline remained the first-line therapy. Regarding second-line therapy, ciprofloxacin plus metronidazole remained the most frequent, while probiotics significantly increased (p = 0.005). CONCLUSIONS: After ART insurance coverage in Japan, overall CE diagnostic methods and CD138 adoption remained largely unchanged. However, facilities tended to adopt higher CD138 cutoff values and treatment selections shifted. Establishing unified diagnostic criteria and treatment protocols is warranted to support standardized CE care for future health insurance coverage.
Nationwide Survey of Institutional Factors Related to the Use of Gonadotropin-Releasing Hormone Analogs for Ovarian Protection in Women Receiving Chemotherapy in Japan.
Sakaguchi S, Nakamura E, Huang H … +1 more , Takai Y
J Obstet Gynaecol Res · 2026 Apr · PMID 41943500 · Full text
AIM: This study aimed to investigate institutional factors associated with the clinical implementation of gonadotropin-releasing hormone (GnRH) analogs for ovarian protection in women receiving chemotherapy among fertili...
AIM: This study aimed to investigate institutional factors associated with the clinical implementation of gonadotropin-releasing hormone (GnRH) analogs for ovarian protection in women receiving chemotherapy among fertility preservation facilities in Japan. METHODS: We conducted a nationwide, cross-sectional, web-based survey between May 1 and May 31, 2025, targeting all 172 medical facilities accredited by the Japan Society of Obstetrics and Gynecology (JSOG) as fertility preservation service providers. The questionnaire assessed institutional characteristics, awareness of the recommendation of GnRH agonists for ovarian protection, and current clinical use of GnRH analogs. Logistic regression analyses were performed to identify institutional factors associated with the use of GnRH agonists. RESULTS: A total of 128 facilities responded (response rate, 74.4%). Although 83.6% of facilities were aware of the recommendation of GnRH agonists for ovarian protection, only 26.6% reported experience using them. University hospitals (adjusted odds ratio [aOR], 7.6; 95% confidence interval [CI], 3.0-20.6; p < 0.001) and facilities with a full-time "oncofertility navigator" (aOR, 3.9; 95% CI, 1.3-13.6; p = 0.02) were more likely to report GnRH agonist use. Only 3.9% of facilities reported experience prescribing GnRH antagonists for ovarian protection, mainly in specific clinical situations such as urgent chemotherapy initiation or contraindications to GnRH agonists. Notably, 67.2% of responding facilities indicated that they would be more likely to use GnRH analogs for ovarian protection under the hypothetical condition that public insurance coverage were available. CONCLUSION: Despite high awareness of recommendations for GnRH agonists, the clinical implementation of GnRH analogs for ovarian protection remains limited in Japan. Institutional characteristics and policy-related factors were associated with reported GnRH agonist use, although causal relationships cannot be inferred. These findings highlight a gap between current clinical practice and available evidence and underscore the need for careful evaluation of the role of GnRH analogs within existing fertility preservation frameworks.
Success Rate of Transobturator Paravaginal Repair for Pelvic Organ Prolapse.
Leerasiri P, Charoonwatana T, Hengrasmee P … +1 more , Asumpinwong C
J Obstet Gynaecol Res · 2026 Apr · PMID 41936435 · Publisher ↗
AIM: To evaluate the short-term anatomical and functional outcomes of transobturator paravaginal repair in women with pelvic organ prolapse (POP). METHODS: A retrospective cohort study was conducted in 42 patients with s...
AIM: To evaluate the short-term anatomical and functional outcomes of transobturator paravaginal repair in women with pelvic organ prolapse (POP). METHODS: A retrospective cohort study was conducted in 42 patients with stage 3 or higher cystocele and paravaginal defects treated between 2023 and 2024. The procedure was performed using the Siriraj Urogynecology Mesh Kit trocar set without any mesh material. The primary outcome was anatomical success (POP-Q Ba ≤ 0) at 6 months postoperatively. Secondary outcomes included perioperative data, complications, and short-term morbidity, which were recorded and analyzed. RESULTS: Forty-two patients were enrolled. Mean age was 68.71 ± 9.20 years. The anatomical success rate at 6 months was 83.3% for the anterior compartment (95% CI: 68.6-93.0) and 92.0% for the apical compartment (95% CI: 83.8-99.4) at 6 months postoperatively. Mean ICIQ-VS scores improved from 23.2 ± 8.9 to 7.1 ± 8.3 (p < 0.001), and quality-of-life scores improved from 7.0 ± 2.8 to 1.1 ± 2.5 (p < 0.001). POP-Q points Ba and C showed significant improvement (p < 0.001). Higher BMI and advanced POP stage were significantly associated with recurrence. CONCLUSIONS: Transobturator paravaginal repair demonstrated favorable short-term anatomical outcomes for both anterior and apical compartments with minimal morbidity. Although these early results are promising, longer follow-up is necessary to confirm long-term durability and recurrence rates.
Effects of Kegel Exercises on Women With Urinary Incontinence: A Systematic Review and Meta-Analysis.
Alashram AR
J Obstet Gynaecol Res · 2026 Apr · PMID 41916745 · Publisher ↗
BACKGROUND: Urinary incontinence (UI) is a common health condition among women. Pelvic floor muscle training is used to increase pelvic floor muscle (PFM) strength. OBJECTIVES: This review aims to explore the effects of...
BACKGROUND: Urinary incontinence (UI) is a common health condition among women. Pelvic floor muscle training is used to increase pelvic floor muscle (PFM) strength. OBJECTIVES: This review aims to explore the effects of Kegel exercises on women with UI. METHODS: "PubMed, Scopus, MEDLINE, Web of Science, EMBASE, and CINAHL" were searched from inception to October 2025. Randomized controlled trials (RCTs) administering Kegel exercises to women with UI, compared with active or passive comparators, and consisting of at least one outcome measure assessing UI were selected. The "Cochrane Risk of Bias 2 (RoB 2) tool" was used to evaluate the quality of the selected studies. RESULTS: Eleven studies (819 women) met eligibility criteria. The findings revealed nonsignificant differences in the Incontinence Questionnaire-Short Form [standardized mean difference (SMD) = 0.106, 95% confidence interval (CI): -0.134 to 0.345, p = 0.387, I = 40%], the PAD test [SMD = -0.048, 95% CI: -0.466 to 0.370, p = 0.822, I = 75%], and the PFM strength [SMD = 0.035, 95% CI: -0.508 to 0.579, p = 0.898, I = 82%]. Other outcomes revealed significant improvements, especially when Kegel exercises were combined with other treatments. CONCLUSIONS: The evidence for the effects of Kegel exercises on UI is limited. Further studies are warranted to explore the effects of Kegel exercises on women with different health and medical characteristics.
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