Search Results (158)

Ureterolithiasis is a common cause of ureteral obstruction in dogs, often leading to kidney injury. Medical expulsive therapy (MET) using α-adrenergic antagonists has been proposed as a nonsurgical treatment option in selected cases and is thought to facilitate ureteral stone passage by reducing ureteral smooth muscle tone. A 9-year-old castrated male Chihuahua weighing 1.78 kg was presented with anorexia. Physical examination revealed 7% dehydration and pale mucous membranes. Serum biochemistry demonstrated severe azotemia, with markedly elevated symmetric dimethylarginine (>100 μg/dL; reference interval [RI], 0–14 μg/dL), blood urea nitrogen (157.9 mg/dL; RI, 7–25 mg/dL), and creatinine (2.2 mg/dL; RI, 0.5–1.5 mg/dL). On day 4 of hospitalization, ultrasonography revealed dilation of the renal pelvis (16.1 mm), ureteral distention (3.74 mm), and multiple ureteroliths (maximum diameter, 3.31 mm) at the ureterovesical junction. Antegrade pyelography confirmed a right ureteral obstruction. As the owner declined surgical intervention, MET including tamsulosin, was initiated with close clinical monitoring. After 3 days, improvement in azotemia and resolution of ureteral obstruction were observed. Although concurrent medical treatments were administered, this case provides clinical insight into the potential role of tamsulosin as part of medical management of obstructive ureterolithiasis in a dog with small distal ureteral stones. Full article

Dystocia represents a multifactorial and clinically significant reproductive disorder affecting a broad spectrum of reptilian species. Commonly resulting from prolonged vitellogenesis, endocrine disruption, or hepatic lipidosis, dystocia is often exacerbated by suboptimal husbandry or concurrent disease. This review critically evaluates the etiology, diagnostic criteria, and therapeutic interventions associated with this condition. Emphasis is placed on the interplay between metabolic exhaustion and hepatic compromise, which may lower the threshold for surgical intervention. The efficacy and limitations of oxytocin-based protocols are discussed in the context of hormonal receptor variability and response attenuation. Advanced diagnostic modalities, including ultrasonography, radiography/CT, and biochemical profiling, are reviewed for their utility in case stratification. Finally, surgical management options are considered for cases refractory to medical treatment, with attention paid to timing, anesthetic risk, and post-operative care. Collectively, this synthesis aims to inform evidence-based clinical decision-making and promote improved standards of care in reptile reproductive medicine. Full article

Background: Pelvic inflammatory disease (PID) is a common and potentially severe infection of the upper genital tract. Complications such as tubo-ovarian abscess (TOA), sepsis, and diffuse peritonitis contribute significantly to reproductive morbidity, particularly when diagnosis or treatment is delayed. Aim: The aim of this review is to present an updated, clinically relevant synthesis of the current evidence on the epidemiology, microbiology, diagnostic approach, imaging modalities, and management of PID, with a focus on severe forms including TOA, sepsis, and peritonitis. Content: PID is most frequently initiated by sexually transmitted pathogens—primarily Chlamydia trachomatis and Neisseria gonorrhoeae—which rapidly progresses to a polymicrobial infection involving anaerobic and enteric organisms. Diagnosis is predominantly clinical, supported by nucleic acid amplification tests, inflammatory markers, and imaging. Transvaginal ultrasonography remains the first-line diagnostic approach for suspected TOA, while CT or MRI is reserved for unclear cases or to assess rupture. Mild to moderate disease is managed with broad-spectrum combination antibiotics, whereas severe PID or TOA requires hospitalization, parenteral therapy, and timely source control through image-guided drainage or surgery. Ruptured abscesses and PID-associated sepsis demand urgent surgical intervention and multidisciplinary supportive care. Tailored approaches are necessary in pregnancy, adolescence, and immunosuppressed and postmenopausal patients. Conclusions: Prompt recognition, a low threshold for empiric antimicrobial therapy, the appropriate use of imaging, and decisive escalation to drainage or surgery are essential to limit morbidity and preserve reproductive health. Integrating guideline-based practice with structured clinical pathways may improve outcomes and reduce long-term sequelae of PID. Full article

Background and Clinical Significance: To report a case of bilateral sterile intraocular inflammation following intravitreal aflibercept 8 mg (Eylea HD) injections. Case Presentation: An 89-year-old woman with bilateral neovascular age-related macular degeneration (nAMD) developed blurred vision and mild ocular pain in both eyes four days after receiving aflibercept 8 mg injections in both of her eyes. Examination revealed a marked anterior chamber reaction with Descemet’s folds, 2+ vitreous cells, and 3+ vitreous haze bilaterally. Intraocular pressures were normal, and B-scan ultrasonography confirmed attached retinas with bilateral vitreous opacities. The clinical presentation initially raised concern for infectious endophthalmitis; however, the bilateral presentation, quiet conjunctivae, and prior history of sterile inflammation after aflibercept 2 mg supported a diagnosis of sterile intraocular inflammation. The patient was hospitalized and treated with intensive topical corticosteroids, antibiotics, and cycloplegics, resulting in rapid improvement and complete resolution of symptoms within four days with recovery of baseline vision. Conclusions: Intravitreal aflibercept 8 mg can be associated with bilateral sterile intraocular inflammation, even in patients who previously tolerated standard-dose aflibercept. Awareness of this potential adverse event is essential to avoid unnecessary interventions and to guide appropriate management. Full article

Background: The radial artery (RA) is one of the terminal branches of the brachial artery, extending along the lateral forearm, crossing the anatomical snuffbox, and contributing to the palmar arches. Anatomical variations in the RA are of great clinical relevance due to their implications in procedures such as transradial catheterization, arterial cannulation, and bypass grafting. These variants may alter the course, branching pattern, or origin of the vessel, potentially increasing procedural complexity and the risk of iatrogenic injury. In critically ill patients and in surgical or interventional settings, accurate identification of RA anatomy is essential. The objective of this study was to systematically identify and describe RA variants reported in the scientific literature and to analyze their clinical relevance. Methods: A systematic search was conducted across six electronic databases: Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Latin American and Caribbean Literature in Health Sciences (LILACS), covering publications up to July 2025. Eligible studies included anatomical, radiological, and surgical investigations reporting RA variants. Study quality was evaluated using the Assessment of Quality in Anatomical Studies (AQUA) tool. Quantitative synthesis was performed using a random-effects model to estimate the pooled prevalence of RA variants and subgroup differences. Twenty-three studies met the inclusion criteria, and eleven were included in the meta-analysis, encompassing a total of 6320 participants. Results: Radial artery variants were categorized into three main types: variations in origin, course, and branching pattern. The pooled global prevalence of RA variants was 12% (95% CI: 6–18%), with substantial heterogeneity (I² = 97.7%). Higher prevalence was found in imaging-based studies (14%) compared with donor-based studies (12%). Sex-based subgroup analysis revealed a higher prevalence in females (18%; CI: 9–28%) compared with males (3%; CI: 3–4%), with moderate heterogeneity (I² = 61.3%). Regionally, European populations demonstrated a higher prevalence (20%) than Asian populations (11%), both showing high heterogeneity (I² > 98%). Notably, only one study from the Americas and none from Africa or Oceania were identified, representing a major geographical limitation in the available data. The findings of this study highlight the considerable variability in RA anatomy across populations. Such variations hold significant clinical importance, particularly in the context of transradial interventions, arterial cannulation, and reconstructive procedures where vascular integrity is critical. The high degree of heterogeneity observed may reflect differences in population genetics, sample size, and imaging or dissection methodologies. The limited representation of certain regions underscores the need for further anatomical and radiological studies to obtain a more comprehensive understanding of global RA variability. Preoperative or pre-procedural imaging using Doppler ultrasonography or computed tomography angiography is recommended to identify anomalous patterns and minimize iatrogenic complications. Conclusions: Radial artery variants are frequent and diverse. Their recognition is fundamental for the safety and success of invasive and surgical procedures in the upper limb. A standardized approach to vascular evaluation, particularly through preoperative imaging, is essential to improve procedural outcomes and reduce the risk of arterial injury in clinical practice. Full article

Background: Preoperative evaluation in bariatric surgery aims to minimize perioperative risks and identify comorbid abdominal pathologies that may influence surgical planning. The role of routine abdominal ultrasonography (USG) remains debatable. Methods: This retrospective study included 1119 consecutive candidates for bariatric surgery who underwent routine preoperative ultrasonography (USG) between January 2022 and October 2024. Patients were stratified by BMI and categorized according to USG findings as normal, incidental, requiring follow-up/concomitant procedures, or necessitating cancellation. Baseline characteristics, USG findings, surgical outcomes, and predictors of cancellation were analyzed using univariate, multivariate, and Firth’s penalized logistic regression analyses. Ultrasonographic findings were further stratified as clinically significant (requiring intervention) or non-clinically significant (not requiring intervention) to standardize interpretation. Results: Abnormal USG findings were present in 77.5% of patients, with hepatic steatosis (60.8% [n = 680]), hepatomegaly (21.5%), and gallstones (13.9%) being the most frequent. Higher BMI was significantly associated with hepatomegaly, steatosis, and gallstones (all p < 0.05), but not with surgical cancellation. Bariatric surgery was cancelled in 11 patients (1.0%) due to critical findings exclusively identified on USG, including large ovarian/uterine masses, choledochal cysts, and suspected malignancies. In multivariate and Firth-adjusted regression, large ovarian/uterine masses (adjusted OR 12.9, 95% CI 3.0–55.2, p = 0.001; Firth OR 11.4, 95% CI 2.5–51.4, p = 0.002) and choledochal cysts (Firth OR 29.7, 95% CI 1.8–489.5, p = 0.048) emerged as independent predictors of cancellation. Conclusions: Although the overall cancellation rate was low, the detection of critical USG findings in 1.0% of patients had major clinical implications, preventing inappropriate or unsafe surgery and enabling timely referral for specialist management. Routine preoperative ultrasonography thus offers a clinically meaningful safeguard in bariatric surgery, supporting its inclusion in preoperative assessment algorithms. Full article

Background and Clinical Significance: Psoriasis, a chronic immune-mediated inflammatory disease, can affect musculoskeletal structures, including the Achilles tendon. Achilles pain in psoriasis patients may arise from tendinitis or neuropathic pain due to peripheral nerve dysfunction, such as sural nerve (SN) involvement, a condition frequently misdiagnosed due to limitations in conventional diagnostics. Fascial tissues are critical in nerve compression syndromes. This case explores the application of a novel quantitative Sonoguide Digital Palpation (SDP) protocol and ultrasound (US)-guided hydrodissection (HD) for SN dysfunction mimicking Achilles tendinopathy in a psoriasis patient. Case Presentation: A 41-year-old male with psoriasis presented with acute onset of right heel stiffness and paresthesia. Physical examination, radiographs, and ultrasound were performed. SDP, employing a validated four-criterion diagnostic framework (including fascial mobility quantification and concordant pain provocation), identified crural fascia restriction affecting SN and reproduced patient’s concordant Achilles pain. High-resolution ultrasonography provided key morphological evidence, revealing a 2.6-fold enlargement of the sural nerve’s cross-sectional area (CSA) on the affected side (13 mm²) compared to the asymptomatic side (5 mm²). Notably, a positive Tinel’s sign was elicited over the psoriatic plaque. US-guided HD was performed using 50 cc of 5% dextrose in water (D5W) without local anesthetic below the psoriatic lesion. Post-HD, the patient reported immediate and significant pain relief (Numeric Pain Rating Scale (NPRS) score reduction from 8 to 2), confirming the prompt correction of a clinically important fascial restriction, associated with improved SN mobility, objectively verified by a post-procedure SDP assessment. At 24-month follow-up, sustained symptom relief and complete functional recovery were reported. Conclusions: This case highlights SDP’s ability to objectively visualize and confirm fascial restriction as a cause of nerve dysfunction by quantitatively reproducing concordant pain. The objective finding of nerve swelling provides sonographic substantiation for the functional diagnosis of nerve dysfunction. This integrated diagnostic approach, combining dynamic functional assessment with morphological confirmation, offers a novel paradigm for evaluating peripheral nerve disorders. US-guided HD of the SN with D5W without local anesthetic shows promise as both a diagnostic confirmatory tool and therapeutic intervention for neuropathic Achilles pain in psoriasis patients with SN involvement, aligning with its efficacy in other peripheral neuropathies. The significant nerve swelling (13 mm²) provides robust morphological corroboration of the functional impairment diagnosed by SDP, offering a more comprehensive diagnostic paradigm. Full article

Closed-globe blunt ocular trauma may lead to severe ophthalmic complications, including intraocular hemorrhages, traumatic cataract, and retinopathy, the management of which remains a significant clinical challenge. We report the case of a 55-year-old male who, 15 years after right-eye trauma and unsuccessful conservative therapy, underwent surgical treatment using multistage vitreoretinal procedures. Despite an initially poor functional prognosis, a marked improvement in visual acuity was achieved, from 2.0 logMAR at baseline to 0.52 logMAR after completion of treatment. Imaging (OCT, B-scan ultrasonography) confirmed complete retinal attachment and the absence of active intra- or subretinal bleeding. This case demonstrates that, even after a long interval following trauma, vitreoretinal surgical interventions may lead to partial restoration of visual function and stabilization of ocular anatomy, underscoring the importance of individualized assessment of surgical indications in chronic post-traumatic retinal disorders. Full article

Early diagnosis of pancreatic cancer, particularly in intraductal papillary mucinous neoplasm (IPMN), remains challenging despite advances in imaging and biomarkers. Pancreatic adenocarcinoma (PDAC) has a high mortality rate; therefore, its early detection and adequate interventions are necessary to improve the disease outcome. Most IPMNs are asymptomatic and discovered incidentally. Magnetic resonance imaging (MRI) is a preferred tool for diagnosing malignant IPMNs, with a sensitivity of 90.7–94.1% and a specificity of 84.7–87.2% in detecting mural nodules > 5 mm, a strong predictor of high-risk lesions. Radiomics further enhances diagnostic accuracy (sensitivity 91–96%, specificity 78–81%), especially when combined with CA 19-9, which has lower sensitivity (73–90%) but higher specificity (79–95%). Computed tomography (CT), though less effective for small mural nodules, remains widely used; its accuracy improves with radiomics and clinical variables (sensitivity 90.4%, specificity 74%). Conventional endoscopic ultrasonography (EUS) shows lower performance (sensitivity 60%, specificity 80%), but its advanced variations have improved outcomes. Contrast-enhanced EUS (CE-EUS) visualizes mural nodules with more than 90% sensitivity and involvement of the main pancreatic duct, with a sensitivity of 83.5% and a specificity of 87%. EUS–fine-needle aspiration (EUS-FNA) allows cyst fluid analysis; however, CEA, glucose, and KRAS/GNAS mutations show poor value for malignancy risk. Cytology has low sensitivity (28.7–64.8%) but high specificity (84–94%) in diagnostic malignant changes and strongly affects further management. EUS–through-the-needle biopsy (EUS-TTNB) yields high diagnostic accuracy (sensitivity 90%, specificity 95%) but carries a range of 2–23% adverse events, which limits its wide use. EUS–confocal laser endomicroscopy (EUS-nCLE) provides real-time microscopic evaluation, detecting malignant IPMN with a sensitivity of 90% and a specificity of 73%, though its availability is limited. New emerging biomarkers available in cyst fluid or blood include mucins, miRNA panels (sensitivity 66.7–89%, specificity 89.7–100%), lipidomics, and cancer metabolite profiling, with diagnostic accuracy approaching 89–91%. Pancreatoscopy (POP) enables direct main pancreatic duct (MPD) visualization and biopsy with a sensitivity of 64–100% and a specificity of 75–100%, though adverse events occur in around 12% cases. Combining advanced imaging, EUS-based tissue acquisition, and novel biomarkers holds promise for earlier and more accurate detection of malignant IPMN, potentially improving PDAC outcomes. Full article

Background: Cornual pregnancy (CP) is a rare but life-threatening form of ectopic pregnancy. Severe complications include uterine rupture and massive hemorrhage, often requiring complex surgical management despite prompt intervention. We report a case of a ruptured left CP at 12 weeks, occurring three months after ipsilateral salpingectomy for a tubal pregnancy. Case Presentation: A 27-year-old woman, gravida 2, with a history of left salpingectomy, presented at 12 weeks of amenorrhea with severe pelvic pain and irregular uterine bleeding. Clinical examination, serum β-hCG testing, and transvaginal ultrasound confirmed hemoperitoneum due to rupture of a cornual pregnancy. Emergency laparoscopy was performed, with drainage of massive hemoperitoneum, excision of the ectopic gestation, and uterine wall repair. Uterine integrity was preserved, and the patient was discharged without complications. Discussion: Cornual ectopic pregnancy remains diagnostically and surgically challenging, with high risk of catastrophic hemorrhage. Transvaginal ultrasonography, supported by 3D ultrasound or MRI in equivocal cases, facilitates early diagnosis. Laparoscopy is increasingly recognized as the gold standard, offering reduced morbidity, faster recovery, and preservation of fertility compared with laparotomy, though it requires advanced surgical expertise. Long-term follow-up is essential due to the risk of uterine rupture in subsequent pregnancies, and elective cesarean delivery is often advised. Conclusion: This case demonstrates that minimally invasive laparoscopic management of ruptured CP with massive hemoperitoneum is feasible and safe when performed by experienced surgeons, but further studies are needed to optimize standardized protocols and assess reproductive outcomes. Full article

Background/Objectives: Adnexal masses are commonly encountered in the routine practice of gynecologists, and transvaginal ultrasonography is the preferred imaging modality for assessing the masses in size and complexity. There has been a notable lack of focus on comparative studies concerning benign adnexal tumors. This study aimed to define and compare the specific morphological and vascular characteristics of ovarian mature cystic teratomas (MCTs) and endometriomas using transvaginal ultrasound and Doppler analysis. Methods: This retrospective analysis included 93 patients who underwent surgical intervention for benign adnexal masses at the Obstetrics and Gynecology Clinic Narodni Front from 1 January 2020 to 1 January 2022. Morphological parameters included the appearance of tumors, the largest diameter, volume, capsule thickness, and the presence of fluid in the pouch of Douglas. Hemodynamic parameters included the localization and quantity of blood vessels within the mass, Resistance Index (RI), peak systolic velocity (Vmax), and end-diastolic velocity (Vmin) within detectable tumor vessels. Flow was also assessed in the uterine arteries, calculating the AURI (uterine artery RI) on both the tumor and contralateral sides. Results: There were 46 patients with ovarian mature cystic teratomas, as well as 46 patients with endometriomas; 1 patient presented with both tumors. There were significant differences in ultrasonographic morphological appearance between the two groups. MCTs most frequently presented as multilocular solid cysts (51.0%) or unilocular solid cysts with hyperechoic content (20.4%). Conversely, the majority of endometriomas were classified as unilocular cysts with ground-glass echogenicity (45.5%). A significant difference was identified in the RI of intracystic vessels and the RI of the ipsilateral uterine artery (AURI). Endometriomas presented elevated RI values (0.57 vs. 0.54, p = 0.04) and reduced AURI (0.81 vs. 0.83, p = 0.02) compared to teratomas. Conclusions: These findings confirm that specific morphological and Doppler parameters, particularly the RI and AURI, can assist in distinguishing between endometriomas and mature cystic teratomas. This suggests a potential role for Doppler analysis in improving diagnostic precision for common benign adnexal tumors in clinical practice. Full article

Background/Objectives: Heterotopic cesarean scar pregnancy (HCSP) is an exceptionally rare and potentially life-threatening form of ectopic pregnancy, characterized by the coexistence of a viable intrauterine pregnancy and an ectopic implantation within a previous cesarean section scar. Its incidence has risen in recent years, primarily due to the increased rate of cesarean deliveries and the widespread use of assisted reproductive technologies (ART). This systematic review aims to provide a comprehensive synthesis of published evidence on HCSP, with a focus on epidemiology, diagnostic challenges, therapeutic strategies, complications, and maternal-fetal outcomes. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science up to May 2025, in accordance with PRISMA guidelines. Included studies comprised case reports, case series and retrospective reviews documenting confirmed HCSP cases. Data were extracted on clinical presentation, imaging, treatment approaches, outcomes, and complications. Results: Thirty studies reporting 40 confirmed HCSP cases were included. Transvaginal ultrasonography was the primary diagnostic tool, although diagnosis was often delayed by the presence of a viable intrauterine pregnancy. Management strategies included surgical intervention, local medical therapy and conservative approaches or expectant management. Maternal complications included hemorrhage and uterine rupture, while fetal outcomes were variable. In selected cases, intrauterine pregnancy continued to term. Conclusions: HCSP is a rare but high-risk obstetric entity requiring early recognition and multidisciplinary management. Prompt ultrasound-based diagnosis and individualized treatment can significantly reduce maternal morbidity and improve fetal outcomes. Further multicenter studies are warranted to establish standardized diagnostic and management protocols. Full article

Background: Undescended testis (UDT) is the most frequent pediatric anomaly of the male genitals, with a high incidence in premature male neonates. Due to the risk of long-term complications such as infertility, testicular malignancy, and psychological distress, special attention on the accuracy of management is needed. Despite the existence of well-established guidelines recommending early surgical intervention, significant delays in diagnosis, referral, and treatment are still observed in practice. Objectives: This study aims to evaluate the clinical management practices of undescended testis at a tertiary pediatric referral center over a ten-year period, with a particular focus on identifying risk factors associated with the development of postoperative testicular atrophy. Material and Methods: The following variables were extracted from patient records: the UDT location, age at surgery (we also recorded the mean age per year during the 10 years period), laterality (unilateral or bilateral), associated malformations and comorbidities, family history of UDT in first-degree relatives, type of surgical intervention (open vs. laparoscopic orchidopexy), and imaging diagnosis (ultrasonography, computer tomography). We considered testicular atrophy (TA) as negative outcome after orchidopexy. To identify the variables that independently contribute to the risk of postoperative testicular atrophy, we conducted a multivariate logistic regression analysis. Results: A total of 1082 pediatric patients UDT underwent orchidopexy between 2014 and 2023. The median age at surgery was 5.07 years, significantly exceeding current guideline recommendations. TA was observed in 24.8% of cases. Non-palpable testes, higher testicular position (particularly intra-abdominal), associated comorbidities, positive family history, and delayed surgical intervention were identified as independent risk factors for negative outcomes. The multivariate logistic regression model identified the most significant predictors of postoperative testicular atrophy as the presence of comorbidities (associated with more than an eightfold increase in risk), non-palpable testes (3.35 times higher risk compared to palpable ones), a positive family history of undescended testis (approximately 2.7 times higher risk), and older age at surgery, with each additional year of delay increasing the risk by 28.6%. Conclusions: Despite the availability of well-established guidelines, significant delays in the diagnosis and treatment of UDT persist in clinical practice. Testicular atrophy remains a relevant postoperative complication, particularly in patients with non-palpable testes, high testicular position, comorbidities, and late surgical intervention. Full article

Background/Objectives: Vitamin D deficiency is linked to muscle loss and fat changes in older adults, but data regarding palliative patients are limited. Ultrasound offers a practical tool to assess these changes. This study explores the relationship between vitamin D levels and ultrasound-measured muscle, fat, and their ratio in older adult palliative patients. Methods: This prospective cross-sectional study was conducted in a tertiary palliative care unit (June–September 2024). A total of 187 patients were grouped by serum vitamin D levels (<50 vs. ≥50 nmol/L). Demographic and clinical variables included sex, BMI, Activities of Daily Living (ADLs), calf circumference (CC), and comorbidities. Ultrasonography assessed muscle thickness (MT), subcutaneous fat thickness (SFT), and cross-sectional area (CSA) of Rectus Femoris (RF) and Biceps Brachii (BB). MT/SFT ratio was calculated. Logistic regression identified independent predictors. Results: Mean age was 75.1 ± 14.4 years; 55.6% of participants were female. Vitamin D deficiency (67.9%) was significantly associated with female sex (p = 0.037), ADL dependency (p < 0.001), lower BMI (p = 0.020), and reduced CC (p = 0.006). RF-MT, RF-SFT, RF-CSA, BB-MT, and BB-CSA were lower in the deficient group. RF-MT/SFT ratio was higher (p = 0.049). ADL dependency (p = 0.002) and RF-MT/SFT (p = 0.015) were independent predictors. Conclusions: Vitamin D deficiency was linked to a higher muscle-to-fat ratio, mainly due to fat loss rather than muscle gain. This may misrepresent muscle preservation and should be interpreted cautiously. Although vitamin D levels appear to be associated with physical function, additional prospective cohort and interventional supplementation studies are warranted to determine whether routine screening and targeted vitamin D supplementation can effectively support physical function in this population. Full article

Background: The aim of this study was to evaluate the cervical regeneration process following monopolar electrosurgical conization (MESC), using a multimodal approach including ultrasonographic, cytologic, colposcopic, and histologic assessments, and to determine the relationship between the extent of excision and the capacity for cervical tissue regeneration. Methods: This prospective observational study included 28 patients who underwent MESC due to abnormal cervical cytology or biopsy-confirmed cervical intraepithelial neoplasia. Preoperative, postoperative one month and six month cervical measurements were obtained using two-dimensional transvaginal ultrasonography. Monthly colposcopic evaluations were conducted, cervical biopsies were taken at the third month, and a cytological assessment was performed at the sixth month. Cervical volume and length regeneration were calculated and analyzed in relation to the dimensions of the excised cone. Regeneration percentages and their correlations with excised tissue dimensions were evaluated using paired t-tests and Pearson correlation analysis. Results: Mean cervical volume and length regeneration rates at six months were 84.61% ± 5.64 and 86.36% ± 3.33, respectively. The transformation zone was histologically visible in 32.1% of patients at three months and cytologically in 75.9% at six months. An inverse correlation was observed between both cone volume and length and cervical regeneration (p < 0.005). Patients with larger preoperative cervical dimensions exhibited a higher regenerative capacity. Positive surgical margins were found in only one patient (3.4%), and no high-grade cytologic abnormalities were noted at follow-up. Conclusions: MESC may enable substantial cervical regeneration within six months. Larger excisions impair healing and delay transformation zone reformation, which may inform the optimal timing for initiating gynecological and colposcopic examinations, as well as for performing cervical interventions when indicated. Full article