New Insights into Gynecological Disease

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 15 November 2025 | Viewed by 818

Special Issue Editors


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Guest Editor Assistant
Department of Obstetrics and Gynaecology, AOOR Villa Sofia—Cervello, University of Palermo, 90146 Palermo, Italy
Interests: laparoscopic hysterectomy; vulvar squamous cell carcinoma; gynecological cancer

Special Issue Information

Dear Colleagues,

Associations between benign gynecologic pathologies and circulating inflammatory markers are unknown. Endometriosis is a common and painful condition affecting women of reproductive age. While the underlying pathophysiology is still largely unknown, much advancement has been made in understanding the progression of this disease. In recent years, a great deal of research has focused on non-invasive diagnostic tools, such as biomarkers, and on the identification of potential therapeutic targets. Benign (including endometrial pathology, uterine fibroids, endometriosis, and ovarian disorders) and malignant (including endometrial, cervical, and ovarian cancer) gynecological pathologies represent, respectively, the most common and most harmful diseases affecting women’s health. Gynecological cancer can occur in any female reproductive organ, with its increasing incidence and mortality rates making it essential to understand the molecular and cellular biology of this specific type of cancer cells. Despite the prevalence and public health impact of uterine leiomyomas, available treatments remain limited. Among the potential causes of leiomyomas, early hormonal exposure during periods of development may result in developmental reprogramming via epigenetic changes that persist in adulthood, leading to disease onset or progression. Recent developments in unbiased high-throughput sequencing technology enable powerful approaches to detect driver mutations, yielding new insights into the genomic instability of leiomyomas. Before undergoing any such treatment, patients should be counseled to discuss their fertility preservation options. Indeed, biological parenthood is possible in most cases as long as the subject is referred to a specialized fertility unit in good time. With the advantages of rapidly developing molecular biology technologies, it is critical to explore and study the intricacies of a gynecologic cancer cell. Moreover, in this era of low natality, physiological disease in ovulation disorders such as polycystic ovarian syndrome (PCOS) has found a really helpful contribution in nutraceutical supplementation, without side effects, sometimes aiding the recovery of ovarian stimulation by gonadotropins. This Special Issue aims to present recent research on the molecular and cellular advances in gynecologic disease research that can assist with diagnosis, prognosis, and targeted therapies, as well as actual knowledge and discovery of new fields for the future diagnosis and treatment of uterine and cervical pathologies, endometriosis, endometrial disease, and ovarian diseases, precision-based approaches to infertility and gynecological malignancies, and the medico-legal implications. In this scenario, artificial intelligence support may prove helpful. We welcome all articles contributing to increasing knowledge in this field.

Prof. Dr. Gaspare Cucinella
Guest Editor

Dr. Valentina Billone
Guest Editor Assistant

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Keywords

  • gynecological disease
  • endometriosis
  • gynecological cancer
  • nutraceutical supplementation
  • infertility
  • minimally invasive surgery
  • fertility preservation
  • psychological implications in gynecological malignancies
  • ethical and medico-legal implications
  • PCOS

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Published Papers (2 papers)

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Research

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10 pages, 1046 KiB  
Article
Are Urethral Pressure Profile Measurements Effective in Diagnosing Urodynamic Stress Incontinence in Women Presenting with Stress or Mixed Urinary Incontinence? Results from a Cross-Sectional Study
by Konstantinos Pantazis, Themistoklis Mikos, Sofia Tsiapakidou, Iakovos Theodoulidis, Stamatios Petousis, Konstantinos Dinas, Antonio Schiattarella, Antonio Simone Laganà and Apostolos P. Athanasiadis
Medicina 2025, 61(7), 1206; https://doi.org/10.3390/medicina61071206 - 1 Jul 2025
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Abstract
Background and Objectives: This study aims to evaluate the relevance of urethral pressure profile (UPP) measurements in the diagnosis of urodynamic stress incontinence (USI) in women with stress and mixed urinary incontinence (SUI and MUI). Materials and Methods: A cross-sectional chart [...] Read more.
Background and Objectives: This study aims to evaluate the relevance of urethral pressure profile (UPP) measurements in the diagnosis of urodynamic stress incontinence (USI) in women with stress and mixed urinary incontinence (SUI and MUI). Materials and Methods: A cross-sectional chart review was used. All patients who had urodynamic studies (UDSs) in the urogynecology unit of an academic hospital over the last 6 months and complained of SUI or MUI were analyzed. Clinical examination included prolapse grading with the POP-Q system. The presenting symptoms, initial diagnosis before UDS, and results from flow studies—cystometrography (CMG), which included a 1-3-5 cough test at 300–350 mL bladder filling, and urethral pressure profilometry (UPP)—were recorded. p < 0.05 was considered significant in all statistical comparison tests; receiver operator characteristic (ROC) curves were also used to determine the best predictor of SUI diagnosis. Results: In total, 57 women were included in this study, with a mean age of 60.7 (±9.3). Upon UDS, 28 women (49.1%) demonstrated USI (Group 1), while 29 women (50.9%) did not demonstrate USI (Group 2). No differences between the two groups were noted during free uroflowmetry and the filling phase of CMG. However, the women in Group 2 had a significantly lower MUCP, FUL, and post-void residual after pressure flow compared to the women in Group 1 (p = 0.038, 0.003, and 0.04, respectively, upon Student’s t test for independent parameters). The ROC analysis indicated that when using MUCP and FUL for the diagnosis of USI, the AUCs are 0.663 (0.525–0.782) and 0.756 (0.623–0.861), respectively. Conclusions: By exhibiting correlations between low MUCP/FUL and USI, UPP appears to be a valid test for USI. The value of UPP in diagnosing USI in those with SUI and MUI appears to be clinically important. Further studies are needed in non-SUI patients, in addition to SUI subgroups and various incontinence treatment groups. Full article
(This article belongs to the Special Issue New Insights into Gynecological Disease)
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Review

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17 pages, 373 KiB  
Review
Innovations in Stress Urinary Incontinence: A Narrative Review
by Tamas Szabo, Melinda-Ildiko Mitranovici, Liviu Moraru, Dan Costachescu, Laura Georgiana Caravia, Elena Bernad, Viviana Ivan, Adrian Apostol, Mihai Munteanu and Lucian Puscasiu
Medicina 2025, 61(7), 1272; https://doi.org/10.3390/medicina61071272 - 14 Jul 2025
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Abstract
Urinary incontinence is characterized by the involuntary leakage of urine. The primary cause of stress urinary incontinence in women is the weakening of the pelvic floor muscles. Stress urinary incontinence (SUI) is a significant global health problem that impacts mainly middle-aged women, with [...] Read more.
Urinary incontinence is characterized by the involuntary leakage of urine. The primary cause of stress urinary incontinence in women is the weakening of the pelvic floor muscles. Stress urinary incontinence (SUI) is a significant global health problem that impacts mainly middle-aged women, with a severe impact on their quality of life. Traditional diagnostic methods and treatments often fail, although technological innovations have improved diagnostic accuracy, such as specific questionnaires or transperineal ultrasound. While medical therapies and surgical procedures are continuously being developed, controversies about the correct choices regarding diagnostic and treatment methods continue to exist. The aim of our review was to identify the innovative diagnostic tools and effective treatment procedures for SUI. A narrative review was conducted due to the heterogeneity of the studies. New methods for diagnosis and treatment have gained ground, and we have covered them in our review; however, the field continues to expand. A personalized approach to diagnosis is also a requirement because of the limitations of conventional urodynamic studies, and we emphasize the importance of such personalization in enhancing clinical decision making. Future medical strategies that combine both preventive and therapeutic care are desirable. Newer technologies were brought to light in this review, including stem cell therapy and laser therapy. Full article
(This article belongs to the Special Issue New Insights into Gynecological Disease)
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