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Advances in Gynecological Diseases (Second Edition)

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Dear Colleagues,

This Special Issue will focus on the latest diagnostic and therapeutic techniques that enable adequate treatment of gynecological pathologies. Technological innovations and new diagnostic techniques allow increasingly precise and faster diagnoses to be performed. Technological and pharmacological developments, combined with the use of minimally invasive surgery (hysteroscopy, laparoscopy and robotic surgery), have also enabled increasingly precise and tailored therapy to be introduced.

This is a new Special Issue that proceeds from the eleven papers we published in the first edition. For more details, you can access it here: https://www.mdpi.com/journal/jcm/special_issues/97O3T751ZC

You may choose our Joint Special Issue in IJERPH.

Dr. Guglielmo Stabile
Guest Editor

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Research

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19 pages, 1396 KB

Open AccessArticle

Long-Term Reproductive Outcomes After Palmer-Type Neosalpingostomy in Hydrosalpinx: A Seven-Year Real-World Cohort Study

by Laurențiu Augustus Barbu, Nicolae-Dragoș Mărgăritescu, Liliana Cercelaru, Tiberiu Stefăniță Țenea Cojan, Mădălina Costinela Stănică, Irina Enăchescu, Ana-Maria Țenea Cojan, Valentina Căluianu, Gabriel Florin Răzvan Mogoș and Liviu Vasile

J. Clin. Med. 2025, 14(22), 8043; https://doi.org/10.3390/jcm14228043 - 13 Nov 2025

Cited by 1 | Viewed by 790

Abstract

Background: Hydrosalpinx is a major cause of female infertility, but the long-term outcomes of Palmer-type neosalpingostomy remain insufficiently documented. Methods: We retrospectively analyzed 160 women with primary or secondary infertility and laparoscopically confirmed hydrosalpinx who underwent Palmer-type neosalpingostomy at a single specialized center in Romania (2018–2024). Patients were enrolled consecutively, and disease severity was classified intraoperatively using standardized criteria. The primary outcome was clinical pregnancy; secondary outcomes included live birth, miscarriage, ectopic pregnancy, recurrence, and time to conception. Results: The clinical pregnancy rate was 33.8%, intrauterine/live birth rate 25.6%, miscarriage rate 3.8%, and ectopic pregnancy rate 4.4%. Recurrence occurred in 21.2% of cases. Outcomes were strongly influenced by hydrosalpinx severity and pelvic adhesions: women with mild disease achieved the highest pregnancy rates, whereas those with severe adhesions had poor prognosis. Neither age, AMH, nor laterality were independent predictors. Median time to pregnancy was 9 months. Conclusions: Palmer-type neosalpingostomy can achieve satisfactory reproductive outcomes in selected women, particularly those with mild hydrosalpinx and no adhesions. This study provides long-term real-world evidence from Eastern Europe, complementing international literature and emphasizing the importance of individualized patient selection. Full article

(This article belongs to the Special Issue Advances in Gynecological Diseases (Second Edition))

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16 pages, 593 KB

Open AccessReview

Perception and Acceptance of HPV Vaccination Among Women Treated for Cervical Intraepithelial Neoplasia: An Evidence-Based Narrative Review

by Vasilios Lygizos, Rafaela Panagopoulou, Vasilios Pergialiotis, Eleni Sivylla Bikouvaraki, Sofoklis Stavros, Periklis Panagopoulos and Chrysi Christodoulaki

J. Clin. Med. 2025, 14(24), 8859; https://doi.org/10.3390/jcm14248859 - 15 Dec 2025

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Abstract

High-risk human papillomavirus (HPV), including types 16–18, is the established cause of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix. While preventive vaccination is highly effective in preventing infection from becoming reconstituted following treatment of existing disease, its use among cervical intraepithelial neoplasia (CIN)-positive females has remained sporadic. The following review provides an update on the current state of evidence about the acceptance, awareness, or perception of HPV vaccination by women following a diagnosis or treatment of CIN. Methods: A narrative synthesis of literature from the publication period of 2010 to 2025 was performed on PubMed, Scopus, and Google Scholar. Surveys that quantified literature on post-CIN vaccination attitudes, risk perceptions, or behavioral factors were considered. Results: Acceptance levels varied from 20–95% across all continents. The highest acceptance levels (≥80%) among the populations belong to the European and Oceanian groups, followed by moderate acceptance among the North Americans (60–80%), which was influenced by financial costs, misconceptions, and sociocultural stigmas. Several systemic-level features in Europe and Oceania have been shown to be consistently associated across these regions with high acceptance rates. These features include public funding of HPV vaccine delivery universally in these regions and reminder and recall systems established in their electronic health records. In these two regions, provider recommendation demonstrates particular significance because there is follow-up care after treatment of CIN. In these regions, mass awareness about HPV conducted in conjunction with their cervical screening programs increases baseline knowledge and favorability towards HPV vaccination. The lowest levels (20–70%) of awareness of HPV diseases and vaccination programs among Asians and Africans can be attributed to obstacles that include misconceptions about fertility concerns. In the case of Asia, there are various socially ingrained stigma factors that contribute to the poor awareness and acceptance levels. These factors include the possibility of being perceived as promiscuous, embarrassment linked to STI conditions, as well as the possibility of rejection from partners and in-laws. In particular regions, there might be stigmas attached to HPV vaccination that cause tension within married women who perceive the vaccine as an indicator of being unfaithful. Also, distrust from the general community has been driven by past incidents, including the halting of proactive HPV vaccine recommendations in Japan in 2013. Moreover, there are numerous myths concerning infertility and menstruation linked to poor vaccine acceptance. The key determinant of acceptance levels was physician endorsement, lack of knowledge of the association of HPV-CIN, or the belief that there is no need for vaccination after treatment. Conclusion: The acceptance of HPV vaccination among women following CIN is influenced by educational level, the structure of the healthcare system, and sociocultural factors. Incorporating evidence-based cervical vaccination counseling into follow-up care after biopsy could help increase its acceptance and prevent recurrent high-grade lesions. Full article

(This article belongs to the Special Issue Advances in Gynecological Diseases (Second Edition))

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