ObjectiveTo explore the association between CA125 and dysmenorrhea in adenomyosis, and the factors affecting CA125 in adenomyosis.MethodsPatients were grouped a the presence of dysmenorrhea. The receiver operating characteristic (ROC) curve was applied to assess the utility of CA125 for dysmenorrhea. Binary logistic regression was employed to identify the factors associating dysmenorrhea and CA125 level.ResultsPatients in the dysmenorrhea group had higher CA125 levels than those in the non‐dysmenorrhea group. For those with dysmenorrhea, CA125 levels of diffuse subtype group were higher than those of the focal subtype group. The CA125 level of 35 U/mL was validated as the optimal cut‐point for dysmenorrhea in ROC curves. Compared with patients whose CA125 was 35 U/mL or less, those with CA125 levels greater than 35 U/mL were more likely to have dysmenorrhea. Thereafter, the multiple regression analysis showed that adenomyotic lesion volume was positively correlated with CA125 level in the total cohort and subtype groups, while age was negatively correlated with CA125 level in the total cohort and diffuse subtype.ConclusionsThe pathogenesis of adenomyosis is not clear. CA125 was associated with dysmenorrhea in adenomyosis, and, furthermore, CA125 level is positively correlated with the severity of the disease.

ObjectiveTo compare the return to work (RTW) time between single-port laparoscopic surgery (SPLS) and multiport laparoscopic surgery (MPLS) for benign ovarian tumors.MethodsA cross-sectional cohort study was conducted, which consisted of 335 women of reproductive age with benign ovarian tumors and who were keen on returning to work as early as possible. Surgical outcomes, postoperative pain score, postoperative satisfaction with the cosmesis score (CS), and the RTW time of the SPLS group were compared with those of the MPLS group. Besides, the RTW time and CS were calculated from the questionnaire survey by a single specialized gynecologist.ResultsWomen who met the inclusion criteria were included in the SPLS (n = 106) and MPLS groups (n = 229). The RTW time in the SPLS group (22.13 ± 27. 06 days) was significantly shorter than that in the MPLS group (46.08 ± 57.86 days) (P < 0.001). The multivariate Cox analysis results showed that age (HR = 0.984, 95% CI, 0.971−0.997, P = 0.020), SPLS (HR = 3.491, 95% CI, 2.422−5. 032, P < 0.001), and return to normal activity time (HR = 0.980, 95% CI, 0.961−0.998, P = 0.029) were independent factors of the RTW time.ConclusionsSPLS may be advantageous in terms of shortening the RTW time for women with benign ovarian tumors.

Objective: To identify an optimal magnetic resonance imaging-based classification for evaluating the efficacy of focused ultrasound ablation surgery (FUAS). Design：A retrospective cohort study. Setting: The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. Population: A total of 643 adenomyosis patients who received FUAS from June 2017 to December 2021. Methods: One-way ANOVA test and chi square test were used to identify an optimal classification for evaluating FUAS efficacy. Magnitude of the optimal classification relating to timing of recurrence in FUAS group was measured by cox regression with hazard ratio (HR) and 95% CI. K-M curve was applied to estimate the medium recurrence time of adenomyosis in the optimal classification. Main outcome measures: The identification of different classifications for FUAS efficacy and the factors contributing to recurrence after FUAS. Results: The rates of dysmenorrhea relief (χ2=10.079, P=0.018) and recurrence could be identified by classification 2 in FUAS group (χ2=10.582, P=0.014), but not in FUAS+ group (P＞0.05). Besides, the recurrence rate in FUAS group (22.2.0%) was higher than that in FUAS+ group (12.1%). Extrinsic subtype in classification 2 (HR=2.315, 95% CI 1.219～4.560, P=0.011) correlated to recurrence of adenomyosis in FUAS group. K-M curve showed that the medium recurrence time of extrinsic subtype (45.2 months) was shorter than that of other subtypes (52.0 months). Conclusions: Classification 2 was the optimal one to identify the rates of dysmenorrhea relief and recurrence. Extrinsic subtype was related to the earlier onset of recurrence after FUAS.