Robert A. de Leeuw

Pelvic neuropathy is an under-recognised contributor to chronic pelvic pain in women, yet a structured overview of its identifiable causes has been lacking. In this narrative review we searched PubMed, Embase and Web of Science from incepti…

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 stu…

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 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…

Objectives: To evaluate the diagnostic accuracy, interobserver agreement, and independent predictive value of individual Morphological Uterus Sonographic Assessment (MUSA) features for adenomyosis.Methods: Patients who underwent transvagina…

OBJECTIVE: To evaluate whether the COVID-19 pandemic influenced treatment modality, care intensity, and care setting in benign gynecological care in the Netherlands. DESIGN: Retrospective longitudinal cohort study evaluating the effects of…

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…

OBJECTIVE: This study aimed to determine the accuracy of the sliding-bladder sign assessed using preoperative transvaginal ultrasound (TVS) for identifying the presence of bladder-to-uterine (BTU) adhesions in patients undergoing hysterecto…

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…

BACKGROUND: Heavy menstrual bleeding (HMB) is common in adolescents and may indicate a bleeding disorder. The pictorial blood loss assessment chart (PBAC) defines HMB as a score ≥150, while an elevated self-bleeding assessment tool (self-BA…

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), act…

OBJECTIVE: Adhesions 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…

INTRODUCTION: Imaging fibroid vascularity may predict fibroid growth and aid to determine most appropriate therapy. Microvascular (MV) flow imaging is relatively new and is able to detect slow flow in small vessels. Data on feasibility, rep…

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…