Introduction and hypothesis: The pathophysiology of pelvic organ prolapse (POP) has not been fully elucidated, although accumulating evidence suggests that oxidative stress is involved. The present systematic review comprehensively discusses this topic. Methods: The PubMed/Medline, Scopus, and Web of Science databases were searched for relevant studies published up to May 2021. This systematic review was registered in the PROSPERO database (registration number CRD42021242240). Two independent researchers screened and selected articles that fulfilled predefined inclusion criteria, performed a quality assessment, and extracted the relevant data. Of 901 original articles retrieved, 8 fulfilled the selection criteria and were included in the review. Results: Elevated levels of markers of oxidative stress, such as advanced glycation end products, hydroxynonenal and hydroxydeoxyguanosine, were found in various parts of the pelvic floor of patients with POP. Accordingly, the levels of glutathione peroxidase and superoxide dismutase, known as major antioxidant enzymes, were reduced, compared to those in healthy controls. Levels of two other markers (mitofusin 2 and nuclear factor erythroid derived 2) also support hypotheses suggesting the involvement of oxidative stress in POP. Conclusions: In the literature available, an association between oxidative stress and pelvic organ prolapse was confirmed.

To analyze the safety, adequacy and accuracy of ultrasound-guided tru-cut biopsy in the diagnosis of ovarian cancer. A systematic search of PubMed, Web of Science, and Scopus was conducted through June 2024. Studies meeting predefined criteria were included in the review. The quality of diagnostic accuracy studies was assessed using QUADAS-2. A meta-analysis was performed on studies reporting complete 2 × 2 diagnostic data. A total of 2,250 articles were initially screened, and after the removal of duplicates, 54 articles were deemed eligible for full-text assessment. Ultimately, 18 studies, comprising 1,867 patients who underwent ultrasound-guided tru-cut biopsy, were included in the systematic review. A total of 16 complications were reported across 1,898 biopsies performed in the included studies, resulting in a mean complication rate of 0.58% (95% CI: 0.187- 0.964%). Adequacy for histological and immunohistochemical examination after one attempt was reported in 16 studies, with a mean adequacy rate of 95.1% (95% CI: 92.69- 97.50%) and a median rate of 95.97%. Diagnostic accuracy was assessed in 13 studies, revealing a mean diagnostic accuracy of 95.54% (95% CI: 93.19- 97.89%) and a median of 97.48%.In the meta-analysis of 10 studies, pooled sensitivity was 98.6%, specificity 41.9%, positive predictive value (PPV) 99.0%, and negative predictive value (NPV) 47.2%, with high heterogeneity observed in specificity and NPV estimates. Ultrasound guided tru-cut biopsy is a safe and effective diagnostic method, demonstrating a high adequacy rate for histological and immunohistochemical analysis. It shows excellent performance in confirming malignancy and supports preoperative decision making. To further define its role in the diagnostic pathway for ovarian cancer, additional prospective multicenter studies are needed-both to validate its reliability in negative cases and to ensure tissue adequacy for advanced molecular testing in the context of personalized medicine.

Pelvic organ prolapse (POP) is increasingly relevant in aging populations. Oxidative stress (OS) may weaken pelvic support structures, but previous studies relied on invasive tissue sampling, limiting longitudinal use. This study evaluated whether OS markers can be detected non-invasively in vaginal fluid and whether they correlate with POP severity. We prospectively enrolled 160 women with POP between February 2021 and June 2023. Vaginal fluid samples were collected, and three OS markers: 8-hydroxy-2′-deoxyguanosine (8-OHdG), 4-hydroxynonenal (HNE), and advanced glycation end products (AGE) were quantified using commercial ELISA kits. POP severity was assessed by POP-Q and ultrasound parameters. 8-OHdG was consistently detectable and significantly elevated in advanced POP compared to early stages (p = 0.001), showing a modest positive correlation with prolapse severity (ρ = 0.24, p < 0.001). Regression analysis confirmed 8-OHdG as an independent predictor of prolapse severity (R² = 0.964). AGE levels did not differ significantly between groups, and HNE values were below detection thresholds in most samples. No associations were found between OS markers and age, BMI, or menopause duration. Non-invasive assessment of oxidative stress in vaginal fluid is feasible. Elevated 8-OHdG correlates with POP severity, supporting its potential as a biomarker for disease monitoring and future translational research.

Objective: To evaluate the safety, adequacy, and accuracy of tru-cut biopsy of gynaecologic tumours in a population of Czech women. Methods: A four-year retrospective study of ultrasound-guided tru-cut biopsy of gynaecologic tumours was conducted in the Department of Obstetrics and Gynaecology, Charles University, Hradec Kralove, Czech Republic. Results: One hundred and four women with gynaecologic tumours underwent transvaginal tru-cut biopsy within the study period. The most common indication for tru-cut biopsy in more than one-half of the women was a suspicion of malignancy/inability to exclude malignancy (59, 56.7%). Most of the tumours were malignant on histopathological examination (71, 68.3%), with advanced ovarian cancer being the most common type of malignancy (43/71, 60.6%). The overall adequacy and accuracy rates of tru-cut biopsy were 93.3% and 93.3%, respectively. Most of the inadequate samples were obtained from overweight and obese women (5/7, 71.4%), with only one biopsy sample taken in the majority of the inadequate biopsies (5/7, 71.4%). Accuracy was higher for malignant than benign tumours (97.7% vs. 82.4%). For malignant tumours, accuracy was highest for advanced ovarian cancers (33/40, 82.5%). Only one case was complicated by bleeding, giving an overall complication rate of 1%. The complicated biopsy was taken by a gynae-oncology trainee. Conclusions: Tru-cut biopsy is a cost-effective and safe preoperative diagnostic modality for patients with gynaecologic tumours, offering high adequacy and accuracy. It is particularly useful in patients with advanced ovarian cancer, most of whom present late with inoperable tumours that contraindicate primary surgery.

Objective: Obstetric anal sphincter injuries (OASIS) represent a serious complication of vaginal delivery that can result in chronic anal incontinence and reduced quality of life. Accurate diagnosis is essential for optimal repair and prevention of long-term morbidity. This review summarizes current evidence on the advantages of elastography as a diagnostic adjunct for the detection of OASIS. Mechanism: Elastography is an advanced ultrasound (US)-based imaging technique that quantifies tissue stiffness, enabling functional assessment of the anal sphincter complex beyond anatomical visualization. By distinguishing the mechanical properties of healthy muscle, acute tears, and fibrotic tissue, elastography may improve the detection of subtle or occult sphincter defects that conventional endoanal US may miss. Findings in Brief: Shear-wave elastography (SWE) has demonstrated moderate to good intraobserver and interobserver reliability, with reported intraclass correlation coefficients (ICC) that vary by measurement conditions. Preliminary studies indicate that greater sphincter stiffness may be protective against perineal tears, suggesting potential for risk stratification. Elastography is non-invasive, free of ionizing radiation, and suitable for repeated evaluation during recovery. However, its diagnostic superiority over standard US for high-grade OASIS remains unconfirmed, and correlations with functional outcomes, such as incontinence severity, are inconsistent. Key limitations include operator dependency, a steep learning curve, and a lack of standardized acquisition protocols. Integration with artificial intelligence (AI) could improve consistency and diagnostic accuracy. Conclusions: Elastography represents a promising adjunct to traditional imaging for the evaluation and management of OASIS. By providing quantitative, biomechanical insights into sphincter integrity, it holds potential to improve early diagnosis, guide rehabilitation, and support recovery monitoring. However, robust evidence demonstrating superiority over established imaging modalities for the diagnosis of OASIS remains limited. Larger, longitudinal studies are needed to validate the clinical utility of elastography and to standardize the use of this technique in obstetric practice.

Objective: Historical and current view on the therapy of overactive bladder. Methods: This review summarizes the historical approach and current therapy of overactive bladder. The articles were gathered from Pubmed and Scopus databases. Studies published before December 2020 were used for the review. Results and Conclusion: Overactive bladder is a condition that quite a lot reduces the quality of life of our patients. Our therapeutic approach starts with non-pharmacological treatment, such as pelvic floor exercises. The next step is a pharmacological approach. The entry level drug is trospium. If the effect is not sufficient, propiverine, solifenacin, fesoterodine, darifenacin or mirabegron are used. Electrostimulation or botulinum toxin A application is an option only in cases that didn't respond to pharmacological treatment. It is safe to say, that in the end, there is a way of reducing the severity of overactive bladder symptoms for every patient.