Endometriosis is a complex disease that may affect a woman’s fertility and quality of life. Owing to substantial variations in symptom severity, lesion distribution, and reproductive impact, its management presents considerable clinical challenges. The most recent internationally recognized guidelines include those issued by the European Society of Human Reproduction and Embryology (ESHRE, 2022), the German Society of Gynecology and Obstetrics (DGGG/SGGG/OEGGG S2k, 2025), the World Endometriosis Society (WES), the National Institute for Health and Care Excellence (NICE, 2024), and the American College of Obstetricians and Gynecologists (ACOG, reaffirmed 2022). To provide a comprehensive overview of these recommendations, we critically compared these guidelines, with particular emphasis on the recently updated German S2k guideline. Searches were conducted through PubMed and institutional repositories using selected key terms, and the AGREE II tool (Appraisal of Guidelines for Research and Evaluation) was employed to assess methodological quality. Key clinical domains examined included indications for conservative and radical surgery, management of endometriomas and deep infiltrating endometriosis (DIE), the role of surgery before Assisted Reproductive Technology (ART), the impact of second-look procedures, and integration of psychosocial dimensions via Patient-Reported Outcome Measures (PROMs). The results show a general trend toward interdisciplinary treatment models, cautious use of radical resection techniques, and customized, symptom-based surgical interventions. Despite ongoing disagreements, there is general agreement on collaborative decision-making, preserving fertility, and adjusting surgery time and technique between the guidelines to meet the requirements of individual patients.

Background/Objectives: The most prevalent benign tumors in women are uterine fibroids. Most patients—more than half—do not exhibit any symptoms, but the most common clinical signs include irregular uterine bleeding, pelvic pain, gastrointestinal problems, increased frequency of urination, and, in some cases, infertility. Venous thromboembolism is a very rare consequence, especially when significant uterine fibroids are present. This syndrome usually develops because of pelvic vascular systems being compressed, which causes venous stasis. Pharmacological treatment, minimally invasive procedures, and surgical techniques are examples of therapy alternatives. The purpose of this study is to present, compare, and potentially elucidate the underlying mechanisms of VTE development in fibroids. Methods: we have synthesized findings from 24 documented instances of venous thromboembolism (VTE) linked to uterine fibroids. Results: the principal mechanism underlying thromboembolic events was identified as the mechanical compression of pelvic venous structures due to mass effect. Additionally, we recognized other pertinent risk factors, including oral contraceptive use, May-Thurner syndrome, myomatous erythrocytosis, and intravenous leiomyomatosis. None of the reviewed case reports provided evidence of confirmed inherited thrombophilia in the patients under investigation. The femoral and popliteal veins, primarily in the left leg, were most frequently impacted by thrombosis and the ensuing blockage. Imaging techniques confirmed that individuals suffered pulmonary embolisms in half of the cases. When the right treatment was given as soon as possible, most of VTEs had favorable outcome. In almost half of the cases examined, the patient had a hysterectomy. Since all symptoms were alleviated and the chance of additional thromboembolic consequences was reduced, this treatment strategy turned out to be the most successful. Conclusions: Clinicians should maintain a low threshold for venous imaging in women with large pelvic masses and unilateral limb symptoms. Despite being uncommon, VTE associated with UFs can cause serious morbidity. Mechanical venous compression is the main mechanism, which is often exacerbated by additional prothrombotic variables. Clinicians should maintain a low threshold for venous imaging in women with significant pelvic masses and unilateral limb symptoms, look for concurrent thrombophilia, and investigate early surgical consultation to address compressive etiologies when VTE is still unexplained. It would be simpler to ascertain the actual incidence and pinpoint risk variables that can be altered with standardized reporting of fibroid-associated VTE and prospective registries.

Adenomyosis and uterine fibroids are among the most common benign uterine disorders in women of reproductive age and represent major causes of abnormal uterine bleeding, pelvic pain, and infertility. Despite their distinct histopathological features, they frequently coexist and share several hormonal and molecular mechanisms, making diagnosis and treatment challenging. This narrative review examines the current evidence on their epidemiology, pathophysiology, clinical presentation, imaging characteristics, reproductive impact, and therapeutic management, with particular attention to the role of imaging in the differential diagnosis and management of coexisting disease. A non-systematic narrative review of the literature was conducted using PubMed/MEDLINE and Scopus. Relevant original studies, systematic reviews, meta-analyses, consensus statements, and clinical guidelines addressing adenomyosis, uterine fibroids, imaging, fertility, and treatment were considered. Additional references were identified through manual screening of the bibliographies of the retrieved articles. Although adenomyosis and uterine fibroids differ in their biological origin and morphological appearance, they commonly present with overlapping symptoms, including heavy menstrual bleeding, dysmenorrhea, chronic pelvic pain, and reproductive dysfunction. Transvaginal ultrasound remains the first-line imaging modality, whereas magnetic resonance imaging is particularly valuable in complex cases, lesion characterization, and preoperative assessment. Accurate imaging phenotyping may help distinguish isolated from coexisting disease and support individualized medical, surgical, or minimally invasive treatment planning. A structured imaging-based approach integrated with clinical findings and reproductive goals may improve disease characterization and support individualized management of adenomyosis and uterine fibroids. Further standardization of imaging criteria and validation of emerging diagnostic technologies may improve patient stratification and treatment selection.

Introduction/Objective: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and an important public health concern, with increasing prevalence driven by rising obesity and insulin resistance. This study aimed to review current evidence on preventive strategies for GDM, including lifestyle interventions, supplementation, and pharmacological approaches. Material and methods: A literature review was conducted using MEDLINE, Scopus, and PubMed databases for the period from 2000 to 2025. Peer-reviewed studies addressing GDM prevention were included, while studies focused exclusively on treatment of established GDM, animal studies, articles not available in full text, and those not published in English were excluded. Study selection was performed independently by two authors, and in cases of discrepancy, consensus was reached among all authors. Results: Elevated pre-pregnancy and gestational body mass index is the most important modifiable risk factor for GDM. Lifestyle interventions, including maintenance of normal body weight, a balanced diet, and regular physical activity, represent the most effective preventive strategy, with physical activity showing the greatest impact. Among supplements, myo-inositol shows potential to reduce GDM incidence and improve glycemic control, whereas evidence for vitamin D, probiotics, and omega-3 fatty acids remains inconsistent. Metformin may reduce GDM risk in high-risk populations, particularly in women with polycystic ovary syndrome, but findings are heterogeneous, and concerns remain regarding long-term offspring outcomes. Conclusion: Lifestyle modification and dietary regimen remain the cornerstone of GDM prevention. Pharmacological therapy and dietary supplements may have a potential role in high-risk groups; however, there is insufficient evidence to support their routine use. Further large-scale studies are needed to establish optimal prevention strategies.