Halder S, Singh S, Sood R
… +4 more, Mathur S, Manchanda S, Malhotra N, Singhal S
J Obstet Gynaecol Res
· 2026 Mar · PMID 41834193
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Synchronous human papillomavirus-independent gastric-type adenocarcinoma in situ affecting both cervical and vaginal epithelium constitutes an ultrarare preinvasive disease. The diagnostic complexity arises from asymptom...Synchronous human papillomavirus-independent gastric-type adenocarcinoma in situ affecting both cervical and vaginal epithelium constitutes an ultrarare preinvasive disease. The diagnostic complexity arises from asymptomatic presentation and skip lesions that obscure the true extent of the disease. We report the case of a 26-year-old woman diagnosed with atypical glandular cells during routine cervical cancer screening. Sequential conizations consistently demonstrated gastric-type adenocarcinoma in situ with persistently positive surgical margins. Post-conization colposcopic assessment and histopathology revealed extensive multifocal disease involving residual cervix and vaginum. Considering the substantial disease burden and potential for occult invasion, surgical intervention was undertaken, including type B1 radical hysterectomy, bilateral salpingectomy, bilateral ovarian tissue cryopreservation, total vaginectomy, and vaginal reconstruction. At 20 months of follow-up, the patient remains completely disease-free with no evidence of recurrence.
Kasuga Y, Sugiyama T, Sasaki S
… +1 more, Asakura K
J Obstet Gynaecol Res
· 2026 Mar · PMID 41819807
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AIM: Guided by the Developmental Origins of Health and Disease framework, maternal nutrition influences perinatal outcomes and lifelong offspring health. This commentary summarizes the pregnant and lactating women's sect...AIM: Guided by the Developmental Origins of Health and Disease framework, maternal nutrition influences perinatal outcomes and lifelong offspring health. This commentary summarizes the pregnant and lactating women's section of Dietary Reference Intakes for Japanese (2025), contextualizes them within current Japanese evidence, and identifies priorities for future research and revisions. METHODS: We conducted a narrative synthesis of the Dietary Reference Intakes and recent Japanese studies on maternal diet, fetal growth, anemia, folate, vitamin D, calcium, gestational weight gain, lactation, and preconception health, with attention to guideline-practice gaps. RESULTS: The Dietary Reference Intakes provide trimester-based additional energy and nutrient targets. However, Japanese cohort data show suboptimal intakes of energy, macro- and micronutrients, with persistently low folate awareness and intake. Anemia (Hb < 11 g/dL) is associated with adverse outcomes, and low vitamin D/calcium status impacts maternal bone health. While medical nutrition therapy is standard for gestational diabetes, nutrient targets have not been set yet. Guidance for hypertensive disorder of pregnancy recommends sodium restriction but lacks comprehensive nutrient specifications. Evidence gaps include body mass index-specific energy needs for appropriate gestational weight gain, robust diet-fetal growth relationships, and actionable guidance for lactation and the preconception period. CONCLUSIONS: The Dietary Reference Intakes for Japanese (2025) provide a necessary framework, yet significant implementation and evidence gaps remain. Research defining body mass index-stratified energy needs, nutrient-outcome dose responses, and preconception/lactation guidance, paired with education and surveillance, is critical for improving intergenerational health.
J Obstet Gynaecol Res
· 2026 Mar · PMID 41819806
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AIM: The antenatal corticosteroid (ACS) administration rate in Japan is low. To achieve both high coverage and low overtreatment of ACS, understanding of facility-level factors is important. This study aimed to identify...AIM: The antenatal corticosteroid (ACS) administration rate in Japan is low. To achieve both high coverage and low overtreatment of ACS, understanding of facility-level factors is important. This study aimed to identify facility-level factors associated with ACS coverage and overtreatment and simulate the potential consequences of increased ACS use. METHODS: This observational study used data from the 2020 to 2022 Perinatal Registry Database maintained by the Japan Society of Obstetrics and Gynecology. Primary outcomes were: (1) ACS administration rate among preterm births before 34 weeks (ACS/34w rate) and (2) proportion of term births among ACS recipients (term/ACS proportion). Multivariable regression analyses examined associations with facility-level factors including perinatal care level, location, delivery volume, and prevalence of maternal conditions. A simulation estimated the impact of increasing ACS/34w rate to 80% in facilities with lower baseline rates. RESULTS: In the facility-level analysis of 244 facilities (376 717 records), the mean ACS/34w rate was 63.4%, and term/ACS proportion was 12.0%. The proportion of threatened preterm labor (coefficient: 4.4 [95% confidence interval: 2.1-6.7]), deliveries < 34 weeks (3.0 [0.1-5.8]), and cesarean section rate (-2.4 [-4.5 to -0.2]) were significantly associated with ACS/34w rate. ACS/34w rate (2.0 [0.8-3.3]), annual delivery volume (2.1 [0.6-3.5]), and cesarean section rate (1.5 [0.2-2.7]) were positively associated with term/ACS proportion, while perinatal care level was inversely associated (-3.5 [-6.3 to -0.6]). Simulation estimated 2311 additional ACS recipients and 465 term births per year. CONCLUSIONS: Facility-level factors influence ACS coverage and overtreatment. These findings may inform strategies for optimizing ACS use.
Levytska K, Chen SF, Cerda VR
… +3 more, Huang DS, Kim KH, Liang MI
J Obstet Gynaecol Res
· 2026 Mar · PMID 41819805
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AIMS: The United States is the only developed nation without a mandated paid parental leave. As of 2022, the Accreditation Council for General Medical Education has mandated a minimum 6-week parental leave during medical...AIMS: The United States is the only developed nation without a mandated paid parental leave. As of 2022, the Accreditation Council for General Medical Education has mandated a minimum 6-week parental leave during medical training in US training programs. Our objective was to evaluate current parental leave policies and attitudes toward leave across OBGYN subspecialties, identify barriers to fellows taking leave, and evaluate the level of support for lactation. METHODS: We distributed an anonymous electronic questionnaire to fellows and program directors (PDs) across OBGYN fellowships in five subspecialties (complex family planning, female pelvic medicine and reconstructive surgery, gynecologic oncology, maternal-fetal medicine, and reproductive endocrinology and infertility) in the United States at the end of the 2023-2024 academic year. RESULTS: A total of 148 fellows and 76 PDs participated in the survey. Typical program parental leave reported by all participants was 6 weeks. Most (69.9%) fellows felt this typical leave to be too short, compared to half (45.7%) of PDs (p = 0.001). Only 4 (3.0%) fellows believed there are no barriers to trainees taking leave in fellowship, compared to 14 (20.0%) PDs (p < 0.001). Most commonly cited barriers to taking leave were culture in medicine, limited number of co-fellows, and need to extend training. Across the entire cohort, 74.3% fellows reported that being in training influenced their decision of when to have children, compared to 42.5% PDs (p < 0.0001). Fewer fellows compared to PDs were satisfied with their program's parental leave policy (46.6% vs. 68.5%, p = 0.03), and 51.2% fellows were neutral toward or dissatisfied with institutional support for lactation. CONCLUSIONS: OBGYN fellows face barriers to being able to take leave in fellowship, are dissatisfied with parental leave length, and do not have enough lactation support.
Iwama N, Tagami K, Tomita H
… +9 more, Hamada H, Ishikuro M, Obara T, Metoki H, Ota C, Kuriyama S, Arima T, Yaegashi N, Saito M
J Obstet Gynaecol Res
· 2026 Mar · PMID 41819540
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This review aims to synthesize current evidence on maternal birth weight (MBW) as a determinant of reproductive health and pregnancy outcomes, examining biological mechanisms and potential intergenerational effects withi...This review aims to synthesize current evidence on maternal birth weight (MBW) as a determinant of reproductive health and pregnancy outcomes, examining biological mechanisms and potential intergenerational effects within the Developmental Origins of Health and Disease (DOHaD) framework. Evidence from large-scale cohort studies, systematic reviews, and experimental research examining the association between MBW and pregnancy-related outcomes, including hypertensive disorders of pregnancy, gestational diabetes mellitus, preterm birth, offspring birth weight, and selected congenital malformations, is summarized. Findings are interpreted within a DOHaD framework, with attention to methodological heterogeneity, population differences, and potential confounding by shared familial socioeconomic and lifestyle factors. Recent large-scale cohort studies, including those conducted in Japan, further indicate that MBW is associated with pregnancy complications, offspring birth weight, and specific congenital malformations, suggesting potential intergenerational pathways involving genetic, epigenetic, and placental processes. Despite accumulating evidence, substantial heterogeneity persists across populations, and the underlying causal pathways remain incompletely understood. Interpretation is further complicated by family-level factors, such as socioeconomic disadvantage, nutritional patterns, and shared lifestyle behaviors, which may partially influence both MBW and subsequent pregnancy outcomes. Nevertheless, MBW is a simple and widely available metric that may enhance preconception risk assessment, improve risk stratification for pregnancy complications, and contribute to individualized perinatal care. Overall, current epidemiological evidence is consistent with biological mechanisms linking MBW to pregnancy and offspring outcomes. Research priorities are outlined to clarify causal pathways and inform DOHaD-based interventions.
Yoshida A, Kaji T, Sugimoto T
… +3 more, Mineda A, Fujii S, Iwasa T
J Obstet Gynaecol Res
· 2026 Mar · PMID 41813081
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We report a pregnant woman with diffuse large B-cell lymphoma (DLBCL) presenting as a massive mediastinal tumor causing dyspnea. A 34-year-old multiparous woman was diagnosed with the tumor at 16 weeks of gestation. Duri...We report a pregnant woman with diffuse large B-cell lymphoma (DLBCL) presenting as a massive mediastinal tumor causing dyspnea. A 34-year-old multiparous woman was diagnosed with the tumor at 16 weeks of gestation. During attempts at airway management using ECMO cannulation and intubation, she developed cardiopulmonary arrest due to airway compromise but was resuscitated. R-CHOP chemotherapy was initiated empirically, and subsequent biopsy confirmed DLBCL, leading to continuation of therapy using DA-EPOCH-R. Despite repeated discussions, including the option of pregnancy termination, the patient strongly wished to continue the pregnancy. Partial tumor shrinkage was achieved; however, at 24 weeks, she developed sudden massive hemoptysis and cardiopulmonary arrest, which proved fatal despite resuscitation. Postmortem imaging demonstrated tumoral hemorrhage with bronchial communication. Although tumoral hemorrhage is a rare complication of lymphoma, it should be recognized as a possible cause of sudden death in malignant disease. This case highlightsthe potential for catastrophic tumoral hemorrhage during chemotherapy and the complex ethical dilemmas surrounding pregnancy continuation.
Sugihara M, Ota K, Maeda E
… +4 more, Morimoto Y, Matsumoto R, Ota Y, Shimoya K
J Obstet Gynaecol Res
· 2026 Mar · PMID 41813076
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AIM: To assess fertility knowledge among Japanese medical students using the Japanese version of the Cardiff Fertility Knowledge Scale and to identify associated factors. METHODS: We conducted a cross-sectional survey of...AIM: To assess fertility knowledge among Japanese medical students using the Japanese version of the Cardiff Fertility Knowledge Scale and to identify associated factors. METHODS: We conducted a cross-sectional survey of first- through sixth-year students at Kawasaki Medical School. Fertility knowledge was assessed using the 13-item Cardiff Fertility Knowledge Scale-Japanese version (CFKS-J), scored as the percentage of correct responses. Scores across academic years were compared using one-way analysis of variance. Factors associated with the continuous knowledge score and with high fertility knowledge (≥ 80%) were examined using multivariable linear and logistic regression models, adjusting for academic year and key covariates. RESULTS: A total of 613 students were included. The mean fertility knowledge score was 72.7%. Scores increased from the first to third year and then plateaued (from 55.0% in first-year to 83.5% in sixth-year students; p < 0.001). Item-level analysis showed particularly low correct responses for the obesity-related item and lower accuracy for items on mumps in males, amenorrhea and the possibility of conception, and sexually transmitted infections. In multivariable models, higher academic year was independently associated with higher knowledge, whereas not remembering whether sex education had been sufficient and not remembering having thought about age at childbearing were associated with lower scores. High fertility knowledge was less likely among students who had never learned about fertility or preconception care. CONCLUSIONS: Fertility knowledge among Japanese medical students improved in earlier years but plateaued thereafter. Recall- and awareness-related factors and item-specific gaps highlight targets for curriculum-based fertility and preconception education.
Mochizuki T, Sawada N, Sugimura K
… +3 more, Shimura H, Kira S, Mitsui T
J Obstet Gynaecol Res
· 2026 Mar · PMID 41803009
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Urethral prolapse (UP) is an uncommon condition that typically affects prepubertal girls and postmenopausal women, with adolescent cases rarely reported. We describe an 18-year-old girl with autism spectrum disorder and...Urethral prolapse (UP) is an uncommon condition that typically affects prepubertal girls and postmenopausal women, with adolescent cases rarely reported. We describe an 18-year-old girl with autism spectrum disorder and chronic diarrhea who presented with genital bleeding and a circumferential mass arising from the external urethral meatus. Marked leukocytosis (22 030/μL), neutrophilia, and elevated C-reactive protein levels indicated a systemic inflammatory response, although urine culture yielded only normal flora. Cystoscopy confirmed UP without intravesical lesions. The patient was treated with bladder drainage and intravenous piperacillin-tazobactam, leading to normalization of inflammatory markers; however, the prolapse persisted and required surgical excision. Postoperatively, she experienced complete symptom resolution, including disappearance of prolonged toilet use. This case illustrates the importance of considering UP in adolescents presenting with vulvar masses and highlights how hygiene-related factors and voiding patterns may contribute to complications such as suspected secondary infection or severe local inflammation. Surgical excision was safe and effective.
Chen X, Lin J, Gao H
… +5 more, Wang J, Lin T, Yang J, Chen F, Xu J
J Obstet Gynaecol Res
· 2026 Mar · PMID 41802718
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BACKGROUND: Observational studies have reported associations between various sleep traits and polycystic ovary syndrome (PCOS); however, it remains unclear whether these relationships are causal or driven by confounding...BACKGROUND: Observational studies have reported associations between various sleep traits and polycystic ovary syndrome (PCOS); however, it remains unclear whether these relationships are causal or driven by confounding factors. This study aimed to clarify the direction and magnitude of potential causal effects between eight self-reported sleep characteristics and PCOS risk using a bidirectional and multivariable Mendelian randomization (MR) framework. METHODS: Genome-wide association study (GWAS) summary statistics for eight sleep traits (sleeplessness/insomnia, sleep duration, snoring, daytime dozing, chronotype, getting up in the morning, daytime napping, and sleep apnea syndrome) and PCOS were analyzed. Univariable MR analyses were conducted using inverse-variance weighted (IVW) meta-analysis as the primary method, supplemented by weighted median and MR-Egger regression. Sensitivity analyses included Cochran's Q test, the MR-Egger intercept, MR-PRESSO, and leave-one-out analyses. Multivariable MR analyses were further performed with adjustment for adiposity and insulin resistance. RESULTS: Genetically predicted sleeplessness/insomnia was associated with an increased risk of PCOS (IVW OR = 1.67, 95% CI = 1.24-2.27, p = 8.6 × 10). Sleep apnea syndrome was also associated with PCOS in univariable analyses (IVW OR = 1.07, 95% CI = 1.03-1.11, p = 1.3 × 10); however, this association was attenuated after multivariable adjustment (p = 0.20). No evidence of reverse causation from PCOS to sleep traits was observed. The results were consistent across sensitivity analyses, with no evidence of horizontal pleiotropy. CONCLUSION: Our MR analyses support a potential causal role of sleeplessness/insomnia in increasing the risk of PCOS, whereas the association with sleep apnea syndrome may be mediated by adiposity or other confounding factors. These findings highlight the importance of sleep management in strategies for the prevention of PCOS.
Shirasath KR, Karwasra R, Ahmed NZ
… +4 more, Kumar P, Alam S, Goyal SN, Agrawal YO
J Obstet Gynaecol Res
· 2026 Mar · PMID 41802716
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AIM: The present study aimed to evaluate the therapeutic potential of the Unani formulation Ark-e-Kasni in alleviating the symptoms of polycystic ovary syndrome (PCOS). METHODS: In the present study, letrozole and a high...AIM: The present study aimed to evaluate the therapeutic potential of the Unani formulation Ark-e-Kasni in alleviating the symptoms of polycystic ovary syndrome (PCOS). METHODS: In the present study, letrozole and a high-fat diet (HFD) were used to induce PCOS-like symptoms in rats. After induction, different groups were treated with varying doses of Ark-e-Kasni (5, 10, and 20 mL/kg), metformin, and finasteride. At the end of treatment, blood and ovaries were collected for biochemical and histological analysis. RESULTS: A significant weight gain and prolonged diestrous phase were observed in PCOS rats, accompanied by a considerable elevation in LH (42.52 ± 0.90 mIU/mL) and testosterone (8370 ± 122.18 pg/mL), and a low level of FSH (11.86 ± 0.43 mIU/mL). Moreover, an increase in insulin (14.31 ± 0.35 mIU/mL), TNF-α (358.81 ± 9.81 pg/mL), IL-1β (143.74 ± 3.39 pg/mL), and IL-6 (154.04 ± 2.04 pg/mL), and a reduction in SOD, CAT, and GSH were noticed. While the Ark-e-Kasni restored the levels of LH (30.97 ± 1.04 mIU/mL), testosterone (5651.83 ± 182.69 pg/mL), FSH (15.66 ± 0.56 mIU/mL), insulin (5.48 ± 0.23 mIU/mL), TNF-α (212.16 ± 8.66 pg/mL), IL-1β (78.79 ± 1.46 pg/mL), and IL-6 (74.53 ± 1.60 pg/mL), and lipid markers. Histological and microscopic analysis showed reduced cystic follicles and enhanced corpus luteum formation, improving ovarian morphology. CONCLUSION: The findings suggest that Ark-e-Kasni ameliorates PCOS through diverse molecular mechanisms. Ark-e-Kasni may modulate steroidogenic enzyme activity to reduce hyperandrogenism, enhance insulin sensitivity through the PI3K/Akt pathway, and inhibit the downstream inflammatory pathway of NF-κB.
Mizusawa Y, Honda H, Arase T
… +3 more, Kishimoto S, Shibahara H, Shiotani M
J Obstet Gynaecol Res
· 2026 Mar · PMID 41795225
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Women with Swyer syndrome must be informed that pregnancy is possible through oocyte donation, although it carries medical risks and requires careful preparation, including hormone treatment and gonadectomy. We present t...Women with Swyer syndrome must be informed that pregnancy is possible through oocyte donation, although it carries medical risks and requires careful preparation, including hormone treatment and gonadectomy. We present two cases of Swyer syndrome in which live births were achieved through oocyte donation and reviewed prior reports identifying a high rate of preeclampsia and Caesarean section as significant outcomes. Oocyte donation carries medical risks, such as preeclampsia, raises social issues which are unsolved yet, especially in Japan, where oocyte donation is usually anonymous. Nevertheless, strengthened collaboration between reproductive medicine and perinatal care is necessary, as is the development of social support systems to enable women with Swyer syndrome to achieve pregnancy more safely.
Hiratsuka D, Makabe T, Matsuo M
… +3 more, Iriyama T, Harada M, Hirota Y
J Obstet Gynaecol Res
· 2026 Mar · PMID 41795222
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A 33-year-old woman with secondary infertility after a term emergency cesarean delivery due to cesarean scar disorder (CSDi) underwent combined hysteroscopic and laparoscopic cesarean scar repair. Eight months later, at...A 33-year-old woman with secondary infertility after a term emergency cesarean delivery due to cesarean scar disorder (CSDi) underwent combined hysteroscopic and laparoscopic cesarean scar repair. Eight months later, at 34 years of age, she conceived spontaneously. Cervical length was 28.3 mm in early pregnancy (unchanged from preconception) but shortened to 20.5 mm at 13 + 5 weeks of gestation, and cervical insufficiency was suspected. A Shirodkar cerclage was performed at 15 + 4 weeks of gestation. Thereafter, cervical shortening did not progress and the pregnancy remained uncomplicated. Elective cesarean delivery at 37 + 1 weeks of gestation resulted in a healthy female infant, and both maternal and neonatal courses were uneventful. Cesarean scar repair may affect cervical competence; thus, pregnancies after CSDi repair should include close cervical length surveillance and consideration of cerclage when significant shortening is detected. Further evidence is needed to optimize postoperative pregnancy management.
Takahashi Y, Hamamoto K, Taguchi M
… +3 more, Taneichi A, Takei Y, Fujiwara H
J Obstet Gynaecol Res
· 2026 Mar · PMID 41793077
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We present a rare case of severe lymphatic leakage resembling hypovolemic shock following retroperitoneal lymphadenectomy for endometrial cancer. A 62-year-old female developed massive lymphorrhea and chylous ascites fol...We present a rare case of severe lymphatic leakage resembling hypovolemic shock following retroperitoneal lymphadenectomy for endometrial cancer. A 62-year-old female developed massive lymphorrhea and chylous ascites following total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy. Immediately postoperatively, massive lymphatic leakage caused hypotension and oliguria necessitating vasopressor support. Conservative management, including fasting and octreotide, was unsuccessful. Lymphangiography with Lipiodol and subsequent embolization using N-butyl cyanoacrylate were performed but did not achieve hemodynamic stabilization. Re-laparotomy was undertaken, and indocyanine green injection into the bilateral inguinal lymph nodes, along with oral milk ingestion, enabled precise intraoperative identification of leakage sites. These were successfully ligated with adjunctive fibrin glue and oxidized cellulose. Hemodynamics rapidly improved following repair. Although most lymphatic leakages resolve conservatively, severe cases can cause life-threatening circulatory failure. This case highlights the importance of a multidisciplinary approach, including interventional radiology and surgical repair, to achieve successful outcomes.
J Obstet Gynaecol Res
· 2026 Mar · PMID 41792951
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AIM: This study aimed to evaluate reproductive health (RH) protective attitudes among married women and to identify predictors of these attitudes using the Reproductive Health Protective Attitudes Scale (RHPAS). MATERIAL...AIM: This study aimed to evaluate reproductive health (RH) protective attitudes among married women and to identify predictors of these attitudes using the Reproductive Health Protective Attitudes Scale (RHPAS). MATERIALS AND METHODS: This analytical and cross-sectional study was conducted with 372 married women who visited the gynecology outpatient clinic of a training and research hospital in İzmir, western Türkiye, between May and December 2023. Data were collected using the Individual Identification Form and the RHPAS. Descriptive statistics were used to assess socio-demographic, obstetric, and RH characteristics. Group differences in RHPAS scores were analyzed with t-tests and ANOVA. Correlation and multiple linear regression analyses were conducted to identify relationships and predictors of RH protective attitudes. A significance level of p < 0.05 was accepted. RESULTS: The mean RHPAS score was 133.11 ± 17.45, indicating a generally positive attitude toward RH protection. Significant differences in RHPAS scores were found by living place, family type, income level, and contraceptive use (p < 0.05). Negative correlations were observed between RHPAS scores and both the number of pregnancies (r = -0.104, p = 0.045) and number of living children (r = -0.152, p = 0.003). Regression analysis showed that living in urban areas, nuclear family type, higher income, pregnancy experience, contraceptive use, fewer children, and having an RH diagnosis were significant predictors of higher RHPAS scores (p < 0.05, R = 0.173). CONCLUSION: Married women showed favorable RH protective attitudes. Education and counseling should be prioritized to improve awareness and access to RH services, especially by addressing influencing socio-demographic and obstetric factors.
Matoba Y, Oomori Y, Nishibuchi I
… +10 more, Uegami S, Nakamoto K, Uyama T, Tomono K, Nosaka S, Ohge H, Takahashi S, Murakami Y, Yamaguchi K, Banno K
J Obstet Gynaecol Res
· 2026 Mar · PMID 41791852
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Reirradiation for cervical cancer recurrence in previously irradiated fields is challenging due to dose limitations. To our knowledge, this is the first case report describing successful reirradiation using a bioabsorbab...Reirradiation for cervical cancer recurrence in previously irradiated fields is challenging due to dose limitations. To our knowledge, this is the first case report describing successful reirradiation using a bioabsorbable spacer for vaginal cuff recurrence after initial concurrent chemoradiotherapy (CCRT) and hysterectomy. A 70-year-old woman with cervical cancer Stage IIIC2r initially received CCRT and chemotherapy. Three years later, uterine recurrence led to hysterectomy. Eighteen months post-surgery, vaginal cuff recurrence was diagnosed by imaging and tumor biopsy. A bioabsorbable spacer was surgically placed around the vaginal cuff tumor via an open abdominal approach. Reirradiation (55 Gy in 22 fractions) was started 23 days postoperatively. Use of the spacer provided adequate dose reduction to the small bowel, sigmoid colon, and rectum, with the rectal D1cc reduced to 37.9 Gy. Mild paralytic ileus occurred, but resolved conservatively, and there were no severe complications. The patient remains disease-free at 6 months post-treatment. In this case, bioabsorbable spacer placement allowed safe reirradiation for cervical cancer vaginal cuff recurrence. This technique may represent a promising approach for selected patients with in-field recurrent cervical cancer, although further accumulation of cases and longer follow-up are required.
J Obstet Gynaecol Res
· 2026 Mar · PMID 41773447
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OBJECTIVE: This paper aims to evaluate the effectiveness of manual lymph drainage (MLD) and complex decongestive therapy (CDT) in managing lower limb lymphedema (LLL) following cervical cancer surgery and its impact on p...OBJECTIVE: This paper aims to evaluate the effectiveness of manual lymph drainage (MLD) and complex decongestive therapy (CDT) in managing lower limb lymphedema (LLL) following cervical cancer surgery and its impact on patient quality of life. METHODS: Patients with postoperative LLL following cervical cancer surgery were included. A total of 57 patients in the control group received pneumatic compression therapy, while 57 patients in the CDT group received additional CDT. Outcomes included symptom relief rates, maximum limb circumference, tissue water content, and Gynecologic Cancer Lymphedema Questionnaire (GCLQ), Visual Analog Scale (VAS), and EORTC QLQ-C30 score. RESULTS: Posttreatment, the CDT group had a higher total remission rate, smaller affected limb circumference, less extracellular and truncated water, lower GCLQ, VAS, and QLQ-C30 symptom scores, and higher 50 kHz bioelectrical impedance and QLQ-C30 health/function scores than the control group (p < 0.05). CONCLUSION: CDT combined with pneumatic compression therapy was effective in treating LLL after cervical cancer surgery, reducing edema and pain in the lower limbs, and improving patients' quality of life.
Turan V, Ahmad MFB, Di W
… +15 more, Gook D, Kaul N, Kim SH, Ko J, Le TMC, Lee JR, Li W, Mathew J, Novero V, Sirayapiwat P, Suzuki N, Tzeng CR, Wiweko B, Yasushi T, Oktem O
J Obstet Gynaecol Res
· 2026 Mar · PMID 41760553
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Fertility preservation (FP) is a rapidly expanding field in reproductive medicine with still limited data on outcomes. FP aims to protect the fertility of children, women, and men who face the potential risk of fertility...Fertility preservation (FP) is a rapidly expanding field in reproductive medicine with still limited data on outcomes. FP aims to protect the fertility of children, women, and men who face the potential risk of fertility loss for various medical conditions, including but not limited to cancer and its gonadotoxic treatment forms. Therefore, it is crucial to provide evidence-based recommendations to assist health professionals in discussing FP options. Our aim was to provide a guideline for multidisciplinary medical staff in considering the availability of FP options and to help them decide whether to provide FP. The objective of any FP intervention is to minimize or eliminate primary disease burden and to ensure the maintenance or preserving reproductive health. Therefore, people who are at risk of losing fertility should be evaluated for and counseled about future reproductive risks. Embryo, oocyte, and ovarian tissue cryopreservation are the established FP options in adult females, with ovarian tissue cryopreservation the only option for prepubertal girls. A wide range of variables affect the choice of the FP strategy. These include age and ovarian reserve of women, the time available before the initiation of cancer treatment, pubertal status, and cancer type and stage. In males, sperm cryopreservation is a highly effective method in adolescent and adult males, while testicular tissue cryopreservation, which is experimental, is the only available option for prepubertal males. This review addressed the important clinical questions and provided answers for FP in females, males, and children according to the indications and availability of FP.
Kuroda K, Hamamoto K, Kawamura K
… +3 more, Masunaga A, Kobayashi H, Ito K
J Obstet Gynaecol Res
· 2026 Mar · PMID 41757917
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AIM: The Prolapse Quality-of-Life Questionnaire (P-QOL) is a validated tool for assessing symptom severity and treatment outcomes in patients with pelvic organ prolapse (POP). This study investigates whether the total sc...AIM: The Prolapse Quality-of-Life Questionnaire (P-QOL) is a validated tool for assessing symptom severity and treatment outcomes in patients with pelvic organ prolapse (POP). This study investigates whether the total score of selected P-QOL component questions may serve as a surrogate marker for the Overactive Bladder Symptom Score (OABSS) and the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) in patients with POP undergoing transvaginal mesh surgery (TVM). METHODS: The study enrolled 148 patients who underwent TVM at our institution between September 2014 and March 2024. Correlations between the total score of selected P-QOL component questions and the OABSS or ICIQ-SF score were assessed using Spearman's rank correlation coefficient. The Kruskal-Wallis test compared P-QOL scores between OABSS ≥ 3 and ≤ 2 groups, and ICIQ-SF ≥ 6 and ≤ 5 groups at pre-operation and at 3, 6, and 12 months postoperatively. RESULTS: Significant correlations were observed between the total score of selected P-QOL component questions and the OABSS or ICIQ-SF score both preoperatively and postoperatively. Box plot analyses showed significant differences in P-QOL scores between the OABSS ≥ 3 and ≤ 2 groups and the ICIQ-SF ≥ 6 and ≤ 5 groups at all time points. Additionally, post-void residual urine volume, P-QOL scores, and OABSS and ICIQ-SF scores significantly decreased at 3, 6, and 12 months postoperatively compared with preoperative values. CONCLUSIONS: The P-QOL provides reliable information regarding urinary storage conditions both preoperatively and postoperatively, making it a potential utility in reflecting urinary storage symptoms instead of the OABSS and ICIQ-SF for evaluating urinary storage symptoms in patients with POP.