Editorial: Highlights in gynecology 2021/22

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This collection highlights diverse research in women's health, including multidisciplinary management of a rare form of endometriosis to optimize surgical outcomes.

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This editorial in Frontiers in Reproductive Health presents a collection of gynecology research and summarizes three included manuscripts, including a systematic review/meta-analysis of Middle Eastern epidemiology for conditions such as endometriosis and adenomyosis, a cross-sectional study characterizing Hispanic/Latinx endometriosis patient phenotypes via a translated EPHect Minimal Clinical Questionnaire, and a case report describing extrapelvic (medial thigh) musculoskeletal endometriosis. The systematic review reports pooled prevalences (e.g., endometriosis among women undergoing laparoscopy and adenomyosis among women undergoing hysterectomy) but notes limitations of low sample sizes and inconsistent methodology/representativeness across included studies. The Hispanic/Latinx cross-sectional study compiles self-reported data from 1,378 individuals across 23 countries and highlights higher reported pain measures and pain catastrophizing in this cohort, while the editorialed case report discusses a trauma- and progenitor-cell–based pathogenic theory and emphasizes multidisciplinary management considerations for surgical resection. This paper is centrally about endometriosis and adenomyosis only as part of an editorial overview of manuscripts summarizing prevalence and patient phenotype evidence, including explicit quantitative reporting for both conditions.

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Abstract

Gynecology 2021/2022, we present a collection of papers focusing on global themes central to 13women's health. This collection aims to highlight the broad diversity of research performed 14 across the Gynecology section and to spotlight the main areas of interest. the authors explore the various management options for this rare form of the disease and 59 suggest a multidisciplinary approach to ensure optimal margins and minimize morbidity 60 secondary to surgical resection and defect closure. 61 describes a rare form of endometriosis and highlights importance of approaching this complex 67 conditions' diagnosis and treatment in a multidisciplinary approach. 68 69 70
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Editorial on the Research TopicHighlights in gynecology 2021/22 In this Frontiers in Reproductive Health Research Topic entitled “Highlights in Gynecology 2021/2022”, we present a collection of papers focusing on global themes central to women's health. This collection aims to highlight the broad diversity of research performed across the Gynecology section and to spotlight the main areas of interest. In addition, this Editorial introduces three manuscripts published as a collection in response to the above-mentioned Research Topic. - Summary of “Prevalence of Common Gynecological Conditions in the Middle East: Systematic Review and Meta-Analysis” (Mousa et al.) This systematic review critically assesses the evidence from epidemiological research and performs a meta-analysis of studies estimating the prevalence of endometriosis, polycystic ovary syndrome (PCOS), uterine fibroids, and adenomyosis in Middle Eastern populations. Most studies from the region have low sample sizes and there are inconsistencies in terms of the methodology and representativeness of the study samples; therefore, a meta-analysis of the available evidence from these studies represents a valuable contribution to the literature. The authors conclude that the pooled prevalence of PCOS diagnosed according to NIH criteria is 8.9% (range, 4%–27.6%), with the highest prevalence (18.8%) observed in the Gulf Arab states (range, 12.1%–27.6%). The prevalence of endometriosis is limited to women undergoing laparoscopic surgery (12.9%; range, 4.2%–21%), and the prevalence of adenomyosis in women undergoing hysterectomy is 30.8% (range, 25.6%–37.7%). The prevalence of uterine fibroids is estimated to be 28.2% overall in the region (range, 18.5%–42.6%) and 57.1% among women with heavy menstrual bleeding. The authors highlight the potential health disparities in these populations and call for further research to understand the regional environmental and genetic risk factors for these conditions. - Summary of “Ibero-American Endometriosis Patient Phenome: Demographics, Obstetric-Gynecologic Traits, and Symptomatology” (Flores-Caldera et al.) In this cross-sectional study, the authors collect self-reported data on the demographics, lifestyle, and endometriosis symptoms of Hispanic/Latinx endometriosis patients from April 2019 to February 2020. In general, Hispanic/Latinx individuals with endometriosis are underrepresented in research databases and are thus unlikely to benefit from any advancements in pathophysiology, biomarkers, and novel treatments. To fill this knowledge gap, Flores-Caldera et al.for the first time in the literature, define the clinical profile of endometriosis patients from Latin America and the Caribbean using a Spanish translation of EPHect's Minimal Clinical Questionnaire (EPQ-M). A total of 1,378 individuals from 23 countries answered the questionnaire. Patients were recruited through collaborations with patient associations in South America, Central America, the Caribbean, and Spain. This study represents the first attempt to generate a clinical-demographic profile of Hispanic/Latinx endometriosis patients. The survey results suggest that, compared with other cohorts, Hispanic/Latinx endometriosis patients reported a higher prevalence and severity of dysmenorrhea and dyspareunia and high levels of pain catastrophizing. - Summary of “Case Report: Extrapelvic Endometriosis in the Medial Thigh” (Pascoal et al.) present the case of a 39-year-old nulliparous woman with a rare form of extrapelvic musculoskeletal endometriosis in the medial thigh. Extrapelvic musculoskeletal endometriosis is a rare entity with likely multifactorial pathogenesis. Interestingly, the patient had a history of pelvic fractures. The authors formulate a possible fascinating pathogenic theory for the insurgence of extrapelvic endometriosis based on the stem/progenitor cell theory and the role that musculoskeletal trauma may have in the development of this condition. In addition, the authors explore the various management options for this rare form of the disease and suggest a multidisciplinary approach to ensure optimal margins and minimize morbidity secondary to surgical resection and defect closure. Both Mousa et al. and Flores-Caldera et al. present epidemiological insights into common gynecological conditions in underrepresented populations in women's health. These valuable contributions are important for highlighting potential health disparities and the need to expand the basis of gynecological research to diverse populations to better understand the population-specific environmental and genetic risk factors. Lastly, Pascoal et al. describe a rare form of endometriosis and highlight the importance of approaching this complex condition's diagnosis and treatment in a multidisciplinary approach. Statements Author contributions All authors provided critical feedback, helped shape the Editorial, reviewed, revised, and confirmed the final submitted version, and contributed equally. All authors contributed to the article and approved the submitted version. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher’s note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Summary Keywords endometriosis, PCOS (polycystic ovarian syndrome), uterine fibroids, adenomyosis, gynecology Citation Buggio L and Rahmioglu N (2023) Editorial: Highlights in gynecology 2021/22. Front. Reprod. Health 4:1123881. doi: 10.3389/frph.2022.1123881 Received 14 December 2022 Accepted 21 December 2022 Published 11 January 2023 Volume 4 - 2022 Edited and reviewed by Jose M. Teixeira, Michigan State University, United States Updates Copyright © 2023 Buggio and Rahmioglu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. *Correspondence: Laura Buggio [email protected] Specialty Section: This article was submitted to Gynecology, a section of the journal Frontiers in Reproductive Health Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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