Facts, views & vision in ObGyn

Pelvic neuropathy is an under-recognised contributor to chronic pelvic pain in women, yet a structured overview of its identifiable causes has been lacking. In this narrative review we searched PubMed, Embase and Web of Science from incepti…

We propose the junctional zone- magnetic resonance imaging (JZ-MRI) ReproClass, a four-tiered MRI-based classification for describing JZ morphology, developed from more than a decade of clinical experience in women with recurrent implantati…

BACKGROUND: Adenomyosis may alter the functional architecture of the inner myometrium and has been associated with impaired reproductive outcomes. Focal cystic adenomyotic lesions can persist despite hormonal suppression and may be challeng…

"Buddy operating" is a subtype of dual operating described in the Clark model, where two surgeons of comparable proficiency collaborate during complex procedures. Potential benefits include improved surgical efficacy and safety, shared intr…

BACKGROUND: In patients with colorectal endometriosis the optimal surgical approach for excising disease remains unknown. OBJECTIVES: To compare the safety and efficacy of classic colorectal resection with mini-laparotomy and extracorporea…

BACKGROUND: Obturator nerve compression is an uncommon cause of groin and medial thigh pain. Ganglion cysts extending into the obturator foramen are rare and usually managed via open or orthopaedic approaches. Robotic neuropelveology offers…

Ureteric injury is a serious complication of gynaecological surgery, particularly in cases involving deep endometriosis. This prospective cohort study assessed the feasibility and safety of intra-ureteric indocyanine green (ICG) for real-ti…

Arteriovenous shunts (AV-shunts) whilst rare, can complicate intrauterine surgical procedures leading to severe vaginal bleeding. We present the case of a 29-year-old woman who experienced sudden, torrential vaginal bleeding 10 days followi…

BACKGROUND: Robotic-assisted hysterectomy is increasingly performed using modular platforms such as the Hugo™ roboticassisted surgery (RAS) system, but optimal or personalised docking strategies remain undefined. OBJECTIVES: To establish e…

BACKGROUND: Rectal endometriosis is a severe form of deep endometriosis affecting up to 12% of patients, causing significant pain and bowel dysfunction. The optimal surgical approach can be individually tailored based on lesion size and loc…

BACKGROUND: Accurate and standardised characterisation of endometriosis extent is essential for patient counselling regarding pain and fertility outcomes, surgical planning, multidisciplinary communication, and clinical research. The Enzian…

BACKGROUND: Urinary tract endometriosis affects fewer than 6% of patients with endometriosis, with ureteral involvement representing the second most common site of disease (9-23%). The condition is often asymptomatic, which may result in si…

BACKGROUND: Laparoscopic cornuotomy is a relatively novel surgical approach to manage interstitial ectopic pregnancy (IEP) and there is little information regarding its safety and efficacy. OBJECTIVES: To describe the success, complication…

BACKGROUND: There is no standardisation of the degree of parametrial dissection and excision with hysterectomy in the presence of deep endometriosis (DE). OBJECTIVES: To apply an anatomical classification of dorso-lateral parametrectomy to…

This retrospective, single-centre cohort study evaluated the Four-Clamp Technique for primary laparoscopic access in 45 morbidly obese women (body mass index ≥40 kg/m2) undergoing gynaecological procedures at a tertiary centre between Janua…

BACKGROUND: Abnormal uterine bleeding (AUB) and postmenopausal bleeding (PMB) require systematic evaluation to exclude clinically significant intrauterine pathology, including premalignant and malignant endometrial disease. OBJECTIVES: To …

BACKGROUND: Deep endometriosis (DE) with intestinal involvement occurs in up to 16% of patients with endometriosis, representing one of the most challenging manifestations of the disease. OBJECTIVES: To describe a laparoscopic technique fo…

BACKGROUND: Uterine malformations are congenital anomalies arising from abnormal Müllerian duct development during embryogenesis. These can be linked to vaginal cysts, resulting in complex malformations. One rare form is the unicornuate ute…

Hysteroscopic metroplasty improves reproductive outcomes in women with a dysmorphic uterus, but the impact of adenomyosis in these patients is uncertain. We retrospectively analysed 69 women who underwent metroplasty for a dysmorphic uterus…

Advanced pelvic surgeries, such as radical hysterectomy, deep endometriosis surgery and sacrocolpopexy, pose risks to autonomic pelvic nerves leading to voiding dysfunction and reduced quality of life. This review article evaluates neuropel…