Explore the vast range of titles available.

Adenomyosis is a common gynecological disease characterized by the presence of ectopic endometrial tissue (endometrial stroma and glands) within the myometrium. It is classified into two main types: diffuse and focal. The aim of this study was to present the outcomes of patients with focal adenomyosis following treatment with transcervical radiofrequency ablation. This was a retrospective analysis of patients treated with the Sonata System. A total of 574 cases were analyzed, all performed at two centers in Germany: Academic Hospital Cologne Weyertal and Hospital Böblingen. Thirty patients with focal adenomyosis were treated with transcervical radiofrequency ablation. All surgeries were performed without any complications. The mean surgery's time was 30.7 minutes, while the mean ablation time was 8.5 minutes. At the time of this report, 27 patients had returned for follow-up. 89% of patients reported improvement in their symptoms. No patient reported a worsening of their symptoms. The procedure reduced the average focal lesion size from 4.4 cm to 2.8 cm. No postoperative complications were observed. All patients reported satisfaction with the procedure. Transcervical radiofrequency ablation appears to be an effective approach for treating adenomyosis. The Sonata System, in particular, offers notable advantages, making it a potentially valuable alternative to conventional procedures like hysterectomy and tissue excision. This minimally invasive approach preserves the uterus, providing a less invasive and more patient-centered treatment option for adenomyosis.

Objectives Adenomyosis is a common and refractory disease in gynecology. Preserving the uterus during treatment for adenomyosis remains a problem. High-intensity focused ultrasound (HIFU) is widely used in treatment of solid tumors. This study aimed to analyze patients with adenomyosis who were treated by HIFU and to preliminarily examine the characteristics of patients who are more suitable for HIFU to treat adenomyosis with reliable efficacy. Methods Over 2 years, 67 women who were diagnosed with adenomyosis and treated with HIFU at our gynecology department were included in this study. We investigated outcomes of their symptoms (dysmenorrhea and hypermenorrhea) and the volume of their uterine lesions. We also compared the patients’ clinical profiles. Results The women had a mean follow-up duration of 11.6 ± 0.46 months. In the numerical rating scale, used to assess the degree of dysmenorrhea, the score was significantly lower (mean difference: −1.94, 95% confidence interval: −2.704 to −1.176) 3 months after HIFU treatment compared with before treatment, then it remained stable for 3 to 12 months. Hypermenorrhea was reduced to a certain degree, with a mean difference of −0.54 (−1.01–0.02). Conclusions HIFU is a new noninvasive treatment method for adenomyosis that may help relieve dysmenorrhea.

Background: Adolescence is the period of life between the ages of 10 and 19. This period is essentially dominated by puberty. The first menstruation, called menarche, occurs, on average, at the age of 12–13. The period after menarche, especially the first 2 years, is characterized by anovulatory cycles, which can be accompanied by menstrual irregularities. This review aims to describe the current status of the diagnostic and therapeutic challenges of the physiological and pathological causes of menstrual irregularities in adolescence and evaluates the benefits from interdisciplinary collaboration to ensure optimal care. Methods: A systematic literature search was conducted in the PubMed database in April 2024 using the following term: “menstrual disorder adolescence”. A total of 1724 abstracts were screened, and relevant articles from the last 10 years were included. In addition, a supplementary topic-relevant literature search of the guidelines of the European Society of Human Reproduction and Embryology (ESHRE) and the guidelines of the Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaft (awmf) was carried out. Results: In addition to cycle irregularities that occur physiologically as a result of anovulatory cycles in the context of the immaturity of the hypothalamic–pituitary–gonadal axis, there are other cycle abnormalities that can be classified as pathological and need to be recognized and treated. Conclusions: Increasing awareness of the various specialist disciplines of physiological and pathological cycle abnormalities in adolescence and interdisciplinary cooperation between them can have a positive influence on the quality of life of adolescent women with cycle abnormalities.

Microwave endometrial ablation (MEA) is a minimally invasive treatment for uterine myoma with hypermenorrhea, which can replace conventional hysterectomy. However, cases requiring additional treatment because of postoperative recurrence are often encountered. MEA cauterizes the endometrium and is not recommended for patients who wish to preserve fertility. We present the cases of a patient with myoma-related hypermenorrhea who underwent microwave ablation of the inflowing blood vessels to the uterine myoma under transvaginal ultrasound guidance. A 43-year-old woman was diagnosed with chronic myeloid leukemia and treated with dasatinib 2 years ago. Worsening hypermenorrhea was observed after treatment initiation. Ultrasound and pelvic magnetic resonance imaging revealed a uterine myoma. Therefore, she underwent MEA under transvaginal ultrasound guidance. Visual analog scale evaluation demonstrated considerable improvement in hypermenorrhea and dysmenorrhea; the myoma size showed reduction. The postoperative course was uneventful, and the patient was discharged on the day after surgery. No postoperative complications were observed. This patient is currently undergoing infertility treatment. The microwave ablation of myoma under transvaginal ultrasound guidance can effectively and safely reduce the myoma size. These findings suggest that this method is a novel treatment option for patients with myoma-related hypermenorrhea who wish to preserve their fertility and have children.

The intravenous formulation for supplementing iron currently available in Japan requires frequent administration. In contrast, ferric carboxymaltose (FCM) can improve iron-deficiency anemia (IDA) with only a small number of administrations; however, its efficacy and safety have not been established in Japanese patients. In this randomized, open-label study, we verified the noninferiority of FCM to saccharated ferric oxide (SFO) in Japanese patients with IDA due to hypermenorrhea, with the mean change from baseline to the highest observed hemoglobin level as the primary endpoint. Two hundred and thirty-eight eligible subjects (119 in FCM group, 119 in SFO group) were administered the investigational medicinal product and included in the analysis. The adjusted mean change from baseline to the highest observed hemoglobin level (95% CI) was 3.90 g/dL (3.77, 4.04) in the FCM group and 4.05 g/dL (3.92, 4.19) in the SFO group, and the difference between the groups (95% CI) was − 0.15 g/dL (− 0.35, 0.04). The noninferiority of FCM was verified. Incidence of adverse events was < 60% in both groups, and no significant difference was observed between the treatment groups. These results indicate that FCM can be a new, well-tolerated, and rapid treatment option for Japanese patients with IDA.

The health of children and adolescents is a priority for the health care of any state. Since it is they who will ensure the health of the nation in the near future. According to the WHO, the prevalence of menstrual pain syndrome in the structure of adolescent gynecological pathology is extremely high, with about15% of them characterizing menstrual pain as excruciating. According to numerous studies, the reproductive potential of modern teenage girls is low due to the high overall morbidity. According to O.V. Bulganina, E.E. Grigorieva (2014), the results of determining the main risk factors for the development of menstrual dysfunctions in teenage girls made it possible to determine the significance of each factor separately and their total impact on the menstrual cycle.

HintergrundMyome des Uterus zählen zu den häufigsten benignen Erkrankungen der Frau. Die Inzidenz beträgt 25–30 %, und mehr als 60 % der Frauen im Alter bis 50 Jahre entwickeln im Laufe ihres Lebens uterine Myome. Minimal-invasive Therapieoptionen und Uteruserhalt gewinnen nach wie vor an Bedeutung. Die operativ-hysteroskopische Resektion uteriner Myome hat sich seit mehr als 20 Jahren etabliert, als moderne Option ergänzt die transzervikale Radiofrequenzablation (RF-Ablation) das Spektrum der operativen Myombehandlung.FragestellungDie operativ-hysteroskopische Resektion und die RF-Ablation von Myomen werden als Operationstechniken mit transzervikalem Zugang auf Grundlage eigener Ergebnisse und aktueller Studiendaten einander gegenübergestellt.Material und MethodenDie operativ-hysteroskopische Myomresektion ist als etablierte Operationstechnik submuköser Uterusmyome in unserer Abteilung mit ca. 70 Eingriffen jährlich eine Standardtherapie. Die seit 2011 von uns praktizierte transzervikale ultraschallgesteuerte RF-Ablation submuköser und intramuraler Myome findet im Rahmen unseres Kompetenzzentrums mit inzwischen 77 Eingriffen zunehmend Anwendung.ErgebnisseDie Operationsdauer kann bei der RF-Ablation im Vergleich mit der hysteroskopischen Resektion von Myomen vergleichbarer Größe deutlich gesenkt werden. Weiterhin lassen sich perioperative Risiken durch das kontinuierliche intrauterine Ultraschallmonitoring der RF-Ablation reduzieren.DiskussionDie klassische hysteroskopische Resektion von Myomen ist nach wie vor der Standard der minimal-invasiven transzervikalen operativen Behandlung submuköser Myome. Die RF-Ablation bietet jedoch Vorteile hinsichtlich einer Reduzierung von Operationsdauer und perioperativen Risiken sowie hinsichtlich des Spektrums therapierbarer Myome.

Introduction: If a woman suffers from congenital fibrinogen deficiency (CFD), she might undergo hypermenorrhea monthly and possibly to suffer from hemoperitoneum due to a ruptured follicle or corpus luteal cyst every month, which seriously threaten her health and quality of life. Here, we creatively used a combination of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the combined oral contraceptives (COC) for a girl with CFD.Case presentation: A 14-year-old girl presented with no obvious cause of persistent and severe lower abdominal pain that began 8 h prior. After examination, she was diagnosed as hemoperitoneum. CFD was diagnosed when she was 2 years old and she had two hospitalizations due to hemorrhagic anemia caused by menorrhagia. Therefore, after successful conservative treatment of hemoperitoneum, a combination of LNG-IUS and COC was used for the long-term conservative management of hypermenorrhea and hemoperitoneum. During the half-year of follow-up, she had hypomenorrhea without hemoperitoneum.Conclusions: To the best of our knowledge, this was the first patient treated with such a procedure in the literature, and we recommend every woman with CFD at puberty or reproductive age receives this two-pronged treatment.

We report the case of a patient with uterine myoma who developed uncontrollable massive hemorrhage from the uterus during anticoagulant therapy after cardiac valve replacement and required hysterectomy. There was a discrepancy between the laboratory findings regarding the blood coagulation system and the clinical manifestations, suggesting a combination of multiple factors, such as a hormonal imbalance. This was a case that demanded strict attention to the management of the uterine lesions during the conduct of anticoagulant treatment.