Robert A de Leeuw

RATIONALE: Adenomyosis is a common uterine disorder, yet its aetiology remains debated. The tissue injury and repair (TIAR) hypothesis suggests that repeated microtrauma from menstrual contractions damages the endometrial-myometrial interfa…

Objective: To correlate the sonographic severity of adenomyosis, assessed with real-time ultrasound and a novel semi-quantified method (XI-VOCAL counting and categories) with adenomyosis-associated symptoms. Methods: This observational stud…

OBJECTIVE: To correlate the sonographic severity of adenomyosis, assessed with real-time ultrasound and a novel semi-quantified method (XI-VOCAL counting and categories) with adenomyosis-associated symptoms. METHODS: This observational stu…

OBJECTIVE: To achieve consensus on a standardized definition and diagnostic criteria of primary dysmenorrhea. METHODS: A modified Delphi procedure was conducted from January to October 2024. Consensus on a question was predefined as a rate…

OBJECTIVE: To assess the prevalence of surgically confirmed endometriosis among assigned-female-at-birth (AFAB) transgender and gender diverse (TGD) individuals undergoing laparoscopic pelvic surgery. DESIGN: Retrospective multicenter coho…

OBJECTIVE: To review magnetic resonance elastography (MRE) techniques and evaluate the feasibility of quantifying the extent of fibrosis in patients with benign uterine disorders. MATERIALS AND METHODS: A systematic search of the MEDLINE a…

PURPOSE: Transvaginal ultrasound (TVUS) is pivotal for diagnosing reproductive pathologies in individuals assigned female at birth, often serving as the primary imaging method for gynecologic evaluation. Despite recent advancements in AI-dr…

INTRODUCTION: Endometriosis is an inflammatory disorder characterized by ectopic endometrial-like tissue, affecting approximately 10% of women. It significantly impairs quality of life through symptoms such as dysmenorrhea, pelvic pain, and…

OBJECTIVES: The reported prevalence of adenomyosis ranges widely due to different study populations, diagnostic tests and criteria. Categorizing the severity of disease may prove important. This study aims to develop a semi-quantifiable son…

OBJECTIVE: To study the impact of laparoscopic niche repair on subendometrial peristalsis in women with a large niche. METHODS: A explorative prospective cohort study that included women with a large niche (residual myometrium ≤ 3 mm), actu…

ObjectiveAdhesions between the uterus, bladder and anterior abdominal wall are associated with clinical sequelae, including chronic pelvic pain and dyspareunia, and can also yield complications during surgery. The transvaginal sonographic (…

INTRODUCTION: A symptomatic uterine niche is a long-term complication after a cesarean section (CS). A group of international niche experts reached consensus on a standardized definition of a disorder caused by a symptomatic niche, named ce…

INTRODUCTION: Uterine artery embolization (UAE) is a less-invasive alternative for hysterectomy in therapy-resistant symptomatic adenomyosis. Comparative data are lacking. Our objective is to evaluate the non-inferiority of UAE compared wit…

OBJECTIVE: To examine the impact of the COVID-19 pandemic on the substitution of surgical procedures in benign gynaecology in the Netherlands. DESIGN: Quantitative longitudinal study evaluating the effects of the COVID-19 pandemic. SETTIN…

Background : Many women suffer from undiagnosed pelvic pain, potentially due to pelvic neuropathies, but are often treated symptomatically without addressing underlying causes. Pelvic neuropathies can cause severe symptoms, affecting qualit…

IMPORTANCE: Approximately 60% of women develop a uterine niche after a cesarean delivery (CD). A niche is associated with various gynecological symptoms including abnormal uterine bleeding, pain, and infertility, but there is little consens…

BackgroundHysteroscopic resection is the first-choice treatment for symptomatic type 0 and 1 fibroids. Traditionally, this was performed under general anesthesia. Over the last decade, surgical procedures are increasingly being performed in…

The uterine junctional zone is the subendometrial area in the myometrium that contributes to peristalsis and aids in spermatozoa and blastocyst transport. Alterations in the appearance of the junctional zone on transvaginal sonography (TVS)…

BACKGROUND: Uterine disorders have clear overlapping symptoms and ultrasound discrimination is not always easy. Accurately measuring vascularity is of diagnostic and prognostic value. Power Doppler is limited to imaging only the larger vess…

OBJECTIVES: To evaluate whether the Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis need to be better defined and, if deemed necessary, to reach consensus on the updated definitions. METHODS: A modified Delphi pr…

Measuring vascularization in uterine fibroids is important for their diagnosis, treatment and prognosis. Vascularization can be measured by power Doppler ultrasound. The power Doppler signal depends on fibroid characteristics and on a varie…

BACKGROUND: Intrauterine adhesions (IUAs) are one of the main reproductive system diseases in women worldwide. Fusion between the injured opposing walls leads to partial-to-complete obliteration of the cavity and/or cervical canal. The main…