Surgical advancements are focusing currently on minimally invasive techniques, the latest of which is natural orifice transluminal endoscopic surgery. Though this approach is feasible through different natural orifices, the vaginal approach is the one which gained attention the most, given the vaginal flexibility and the ability to access pelvic and abdominal organs. Compared to gynecologists, general surgeons were precedents for using the vaginal orifice as a port of surgical entry. However, this vaginal approach is being more frequently implemented during gynecological surgeries nowadays. Advantages of natural orifice transluminal endoscopic surgery include scarless surgery, better exposure, reduced pain scores, less peri-operative complications, shorter hospital stay and improved patient satisfaction. This article provides an idea on the application of vaginal natural orifice transluminal endoscopic surgery in gynecology along with future potentials.

No abstract

Objective To determine the effect of coronavirus disease 2019 (COVID‐19) vaccination and its association with sociodemographic factors on the menstrual cycle in premenopausal women and on postmenopausal bleeding. Methods This is a retrospective cross‐sectional study conducted between September 22, 2022, and November 30, 2022, via a questionnaire distributed to 359 health care workers (HCWs) at Lebanese American University Medical Center–Rizk Hospital and St John's Hospital. Inclusion criteria included female Lebanese HCWs who were vaccinated and aged 18 to 65 years. Results Change in cycle length was significantly associated with age (P = 0.025 after the first dose and P = 0.017 after the second dose), level of education (P = 0.013 after the first dose and P = 0.012 after the second dose), and fibroids (P = 0.006 after the second dose and P = 0.003 after the third dose). The change in cycle flow was significantly associated with age (P = 0.028), fibroids (P = 0.002 after the second dose and P = 0.002 after the third dose), bleeding disorders (P = 0.000), and chronic medications (P = 0.007). The change in symptoms was associated with polycystic ovary syndrome (P = 0.021), chronic medications (P = 0.019 after the second dose and P = 0.045 after the third dose), and fibroids (P = 0.000). Conclusion COVID‐19 vaccination can influence the menstrual cycle. Age, body mass index, level of education, underlying comorbidities, and use of chronic medications are significantly associated with changes in menstrual length, flow, and symptoms following vaccination.