Pain accompanying medical procedures can be considered in the “mind-body” problem of accounting for and describing the relationship between mental and physical processes (psyche and soma). Background/Objectives: The purpose of this study is to evaluate the severity of pain among patients undergoing a minihysteroscopy procedure under local anesthesia using the “GUBBINI SYSTEM” (GUBBINI Mini Hystero-Resectoscope; Tontarra Medizintechnik, Tuttlingen, Germany) and to assess the association of various covariates with pain during the procedure, including patient emotional state. Methods: This study included 171 patients admitted to the Center for Hysteroscopy under Local Anesthesia at the Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital of the Karol Marcinkowski Medical University in Poznań, Poland, for hysteroscopic treatment under local anesthesia (paracervical, using lignocaine). The Center for Hysteroscopy is the first certified “CENTER OF EXCELLENCE” of The International Society for Gynecologic Endoscopy (ISGE) in Poland. Results: A positive relationship was observed between alexithymia and its trait of difficulty identifying emotions and pain, as well as between perceived pain and one of the deficits of emotional processing—signs of unprocessed emotion. Conclusions: In conclusion, before the hysteroscopy, adequate information and counseling related to the procedure can effectively reduce the pain and anxiety levels of the women, and nurses can navigate this stressful process. Providing education and counseling to all women undergoing hysteroscopy, and explaining the procedure in detail, should be the preferred approach.

Modern, small-diameter endoscopic instruments, such as resectoscopes (e.g., the GUBBINI System) and mini-hysteroscopes, are widely used in clinical practice. These tools allow endoscopic procedures to be conducted without cervical dilation, often in an outpatient setting, and under local anesthesia alone. Background/Objectives: The present retrospective study aimed to analyze the perioperative and delayed complications of hysteroscopy performed under local anesthesia. This study also assessed the pain experienced during hysteroscopy under local anesthesia, depending on the type of procedure performed. Methods: A retrospective analysis was conducted in 1945 patients who underwent hysteroscopy under local anesthesia at the Center for Hysteroscopy, Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital, Karol Marcinkowski Medical University, Poznań, Poland, between January 2021 and December 2023. Hysteroscopic procedures were performed with the GUBBINI Mini Hystero-Resectoscope through a paracervical block using lignocaine. Results: The procedure was discontinued in 46 patients, accounting for 2.36% of all hysteroscopies. The most common reasons for procedure discontinuation were severe pain and uterine perforation, accounting for 52.8% and 13% of discontinued procedures, respectively. The complication rates were low: uterine perforation occurred in 0.3% of cases (n = 6), and late complications requiring readmission occurred in 0.2% (n = 3). The average pain intensity score for all the patients was 2 points (2.8 ± 2.14). Conclusions: Our study confirmed that hysteroscopy performed under local anesthesia is a safe and effective diagnostic and therapeutic method for selected uterine pathologies, noting increased risks in cases such as extensive intrauterine adhesions. The low complication rates in both the perioperative and postoperative stages indicate the high safety profile of this procedure, particularly when performed by experienced personnel using standardized, validated protocols.

(1) Background: Transvaginal RFA is a minimally invasive treatment for myomas in women opting for uterus preservation. The present study aimed to evaluate the efficacy and safety of transvaginal RFA to treat myomas, reduce symptoms, decrease myoma volume, and identify prognostic factors for predicting treatment response. (2) Methods: The study group included 45 women treated for uterine fibroids at the Gynecological and Obstetrics Clinical Hospital in Poznań. From 1 July 2024 to 31 March 2025, a total of 45 transvaginal radiofrequency ablation (TV-RFA) procedures were performed. (3) Results: Ultrasound findings revealed that fibroid dimensions and volume significantly decreased at 1-month follow-up compared to those at pre-procedure (88.7 ± 116.3 vs. 64.6 ± 82.6 cm³; p = 0.003). Ultrasound findings demonstrated that fibroid depth (4.8 ± 2.1 vs. 4.1 ± 2.2; p = 0.01) and fibroid volume (88.7 ± 116.3 vs. 82.4 ± 93.9 cm³; p = 0.02) were significantly decreased at 3-month follow-up compared to their pre-procedure values. Menstrual bleeding duration showed significant differences between the pre-procedure state and 1-month follow-up (N = 23; T = 2; Z = 4.14; p < 0.001) and 3-month follow-up (N = 8; T = 1; Z = 2.38; p = 0.017), with a significant reduction after the RFA procedure. Significant differences were observed in bleeding severity at pre-procedure and at 1-month follow-up (N = 22; T = 11.5; Z = 3.73; p < 0.001); however, no significant differences in bleeding severity were noted at the 3-month follow-up (N = 7; T = 4; Z = 1.69; p = 0.09). These results should be interpreted cautiously due to the small number of patients with complete 3-month follow-up. (4) Conclusions: Transvaginal radiofrequency ablation is an effective, precise, and safe minimally invasive approach for treating uterine fibroids. These preliminary findings are promising but require confirmation in larger cohorts with longer follow-up.

Background: The vaginal microbiota plays a crucial role in maintaining urogenital health, and its disruption may contribute to adverse surgical outcomes. Transobturator tape (TOT) procedures are widely used in the treatment of stress urinary incontinence (SUI), yet factors influencing postoperative complications remain incompletely understood. This study aimed to evaluate the association between preoperative vaginal microbiota and postoperative complications following TOT surgery. Methods: This pilot observational study included 24 women diagnosed with SUI who underwent TOT surgery between February and December 2023. Prior to surgery, all patients received standardized preoperative preparation, including local estrogen therapy and antimicrobial treatment. Vaginal swabs were collected and analyzed using quantitative culture methods to assess microbial composition. Clinical, microbiological, and surgical data were analyzed. Associations between microbiota profiles and postoperative complications were evaluated using univariate and multivariable statistical analyses. Results: Postoperative complications occurred in 5 patients (20.8%). Patients with complications had significantly higher body mass index (BMI) (33.8 ± 5.0 vs. 27.9 ± 5.1 kg/m²; p = 0.028) and a higher prevalence of previous surgeries (80% vs. 42%; p = 0.048). Microbiological analysis revealed that Lactobacillus spp. deficiency was more frequent in patients with complications (60% vs. 21%; p = 0.048), as was the presence of mixed microbial flora indicative of dysbiosis (100% vs. 47%; p = 0.041). Multivariable logistic regression identified BMI (OR = 1.16; p = 0.031), previous surgeries (OR = 3.9; p = 0.049), Lactobacillus spp. deficiency (OR = 4.8; p = 0.038), and mixed flora (OR = 6.2; p = 0.027) as independent factors associated with postoperative complications. Conclusions: Preoperative vaginal microbiota may significantly influence outcomes following TOT surgery. Vaginal dysbiosis, particularly Lactobacillus spp. deficiency and mixed microbial flora, appears to be associated with an increased risk of postoperative complications. These findings suggest that microbiota assessment could be considered in preoperative evaluation. Further large-scale studies using advanced microbiome analysis are warranted to confirm these results.

Dysbiosis, or an altered microbiota composition, has been implicated in chronic endometrial inflammation and recurrent implantation failure. Despite growing research on the relationship between the genital microbiome and reproductive health, few studies have examined its role in ectopic pregnancy. Therefore, our study focuses on the microbiota of the cervical canal in women diagnosed with an ectopic pregnancy. Material and methods: The study group consisted of nine women of a reproductive age who were hospitalized at the Department of Maternal and Child Health, Gynecology and Obstetrics, Clinical Hospital of the University of Poznań, between February and September 2023. In nine patients, an ectopic pregnancy was diagnosed based on a transvaginal ultrasound examination. The swabs were collected for quantitative microbiological culture (using Amies transport medium). The microbiological analyses involved quantitative culture on selected selective and differential media, following the Standard Operating Procedure developed by the Institute of Microecology. Results: A reduced Lactobacillus spp. count (≤5 × 10⁷ CFU/mL) was observed in 78% of the patients participating in the study, including those that produce H₂O₂, i.e., with strong protective properties for the environment of the female reproductive tract. The molecular analyses revealed Ureaplasma spp. (U. parvum and U. urealyticum) in 33% of the samples (three patients). However, Chlamydia trachomatis and Mycoplasma genitalium were not detected in any of the analyzed samples. Conclusions: The ease of obtaining material and the minimally invasive nature of lower reproductive tract examinations may allow for the evaluation of microbiota imbalances, helping to identify individuals at an increased risk of reproductive complications.