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Diagnostics
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Diagnosis and Management of Gynecological Diseases in 2025
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Diagnosis and Management of Gynecological Diseases in 2025

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1036

Special Issue Editor

Dr. Yasushi Kotani

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
Interests: uterine lesions; hysteroscopy; laparoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue highlights the latest advancements in the diagnosis and management of gynecological diseases, with a particular emphasis on innovative diagnostic techniques. Articles explore the use of cutting-edge imaging technologies, such as MRI and ultrasound, in detecting gynecological abnormalities with greater accuracy. Additionally, the role of molecular diagnostics, including genetic testing and biomarker analysis, is underscored for its potential to personalize treatment plans and improve patient outcomes. Overall, this Special Issue provides a comprehensive overview of the evolving diagnostic landscape in gynecological disease management.

Dr. Yasushi Kotani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gynecological diseases
  • diagnosis
  • management strategies
  • obstetrics and gynecology
  • women’s health
  • clinical practice guidelines
  • reproductive health disorders
  • personalized treatment approaches

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Published Papers (2 papers)

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Research

26 pages, 2115 KiB  
Article
Proinflammatory Cytokines in Women with PCOS in Atypical Pathogen Infections
by Izabela Chudzicka-Strugała, Iwona Gołębiewska, Grzegorz Brudecki, Wael Elamin, Beata Banaszewska, Marta Chudzicka-Adamczak, Dominik Strugała and Barbara Zwoździak
Diagnostics 2025, 15(13), 1669; https://doi.org/10.3390/diagnostics15131669 - 30 Jun 2025
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Abstract
Background/Objectives: Polycystic ovary syndrome (PCOS) is one of the most frequently diagnosed endocrine and metabolic disorders in women of reproductive age before menopause. It is associated with excess androgens and ovarian dysfunction, reduced fertility, the presence of obstetric disorders, but also metabolic disorders, [...] Read more.
Background/Objectives: Polycystic ovary syndrome (PCOS) is one of the most frequently diagnosed endocrine and metabolic disorders in women of reproductive age before menopause. It is associated with excess androgens and ovarian dysfunction, reduced fertility, the presence of obstetric disorders, but also metabolic disorders, and, among others, insulin resistance, obesity and type II diabetes. Its close relationship with changes in the diversity of the vaginal microbiome, vaginal inflammation and changes in the vaginal microenvironment, which can pave the way for pathogenic microorganisms, is emphasized. Methods: The research in the presented paper focuses on a group of women with PCOS (n = 490) of reproductive age (26–43 years), in whom the frequency of infections of the reproductive system caused by atypical pathogens, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma spp., were analyzed, and then the immune system response was assessed in terms of the level of serum proinflammatory cytokines, IL-1β, IL-6 and TNF-α. Results: Our results showed a 40% infection rate in the studied group of patients with PCOS, with C. trachomatis being the most common pathogen (17.7%), followed by Ureaplasma spp. (10%) and M. hominis (4.9%). In some cases, co-infections such as Mycoplasma and Ureaplasma were also observed in 3.1% or all three atypical bacteria, M. hominis, Ureaplasma spp. and C. trachomatis, in 4.3% of patients with PCOS. In our study, in women with PCOS and confirmed infection with any atypical pathogen (n = 196), we analyzed the levels of proinflammatory cytokines, IL-1 β a, IL-6 and TNF-α. The results were compared with a control group (control group A) consisting of patients with the same underlying disease, i.e., PCOS (n = 39), who did not experience infection with atypical pathogens or symptoms of gynecological infection. Additionally, a control group B (n = 28) consisting of healthy women (without PCOS and without infection) was introduced. The results regarding the levels of cytokines studied in this work (IL-1β, IL-6, TNF-α) may suggest that the presence of intracellular C. trachomatis in the infection will play a dominant role in the immune system response. In the infections with atypical pathogens analyzed in this study in patients with PCOS, no characteristic clinical features were observed, apart from indications in the form of an increase in the number of leukocytes in the assessment of the vaginal biocenosis, suggesting cervicitis and reported reproductive failure or lower abdominal pain. An additional problem is the inability to detect the presence of atypical pathogens in routine microbiological tests; therefore, confirmation of such etiology requires referral of the patient for targeted tests. Conclusions: Invasion of host cells by atypical pathogens such as C. trachomatis and infections with “genital mycoplasmas” can disrupt the function of these cells and lead to many complications, including infertility. The immune response with the production of proinflammatory cytokines such as TNF-α, IL-1β, and IL-6, observed in response to infection with C. trachomatis, M. hominis, and Ureaplasma spp., induces or amplifies inflammation by activating immune cells or controlling infection, but may lead to the facilitation of the survival of pathogenic microorganisms and irreversible damage to fallopian tube tissues. Especially in the case of the proinflammatory cytosine TNF-α, there seems to be a close correlation with infections with atypical pathogens and a marked immune response, as well as with increased IL-1β and IL-6 values compared with the absence of infection (both in the presence and absence of PCOS). The presented study may suggest the importance of extended diagnostics to include atypical pathogens in the case of PCOS and the importance of research in this area also from the point of view of the immune response. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gynecological Diseases in 2025)
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11 pages, 3928 KiB  
Article
Quantitative Classification of Uterine Myoma Perfusion on DCE-MRI: Retrospective Analysis of Data and Clinical Implications
by Alan Bruszewski, Agnieszka Lach, Maciej Wilczak and Karolina Chmaj-Wierzchowska
Diagnostics 2025, 15(12), 1464; https://doi.org/10.3390/diagnostics15121464 - 9 Jun 2025
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Abstract
Background/Objectives: The degree of vascularization of myomas plays an important role in both diagnosis and the selection of appropriate treatment. This is particularly relevant for minimally invasive therapies such as uterine artery embolization (UAE), high-intensity focused ultrasound (HIFU), or radiofrequency ablation (RFA) [...] Read more.
Background/Objectives: The degree of vascularization of myomas plays an important role in both diagnosis and the selection of appropriate treatment. This is particularly relevant for minimally invasive therapies such as uterine artery embolization (UAE), high-intensity focused ultrasound (HIFU), or radiofrequency ablation (RFA) in uterine myomas, as their effectiveness is highest in well-vascularized lesions. This study aimed to analyze the perfusion of uterine myomas using dynamic contrast-enhanced magnetic resonance imaging and to develop a new quantitative classification of lesion vascularization, referencing the Funaki classification. Methods: The study included 56 female patients. Three parameters were determined for each lesion: the maximum signal enhancement (Ratio), time to peak, and mean signal intensity (Mean). A KMeans cluster analysis (k = 3) was performed, dividing the data into three groups corresponding to Funaki types I–III. Results: Significant differences were observed between the groups. Type III myomas were found only in older patients, which may be relevant when qualifying patients for vascularization-targeted therapies such as HIFU or radiofrequency ablation. Conclusions: The proposed classification may serve as a basis for automating the assessment of myomas and supporting clinical decision-making. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gynecological Diseases in 2025)
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