Editorial

I was interested to read in the recent BMJ news piece (BMJ 386:169-210) of the 140 women with vaginal mesh complications who had finally reached an undisclosed settlement with the manufacturers and I must also applaud Professor Sohier Elneil's initiative of setting up regional mesh centres for such complications. For the generalist readers of TOG, let me signpost you to two useful and practical articles: Adishesh and team discuss and highlight factors and surgical tips to reduce the risk of incisional hernias following laparotomy (ref), while Harvey et al. help us understand and recognise urethral caruncles, often referred as an unnecessary 2-week wait. I would also like to particularly highlight the excellent infographic accompanying the Tips and Techniques article on abdominal wall incisional hernias. All TOG infographics are compiled here: https://obgyn.onlinelibrary.wiley.com/hub/journal/17444667/infographics and serve as an excellent free-to-access teaching resource for all. Endometriosis is a common problem encountered by clinicians and affects 10% of women of reproductive age. Two articles in this edition of TOG pertain to this pathology. The review by Campbell et al. raises our awareness of the association between endometriosis and epithelial ovarian cancers and examines the proposed malignant transformation mechanism as well as discussing risk reduction strategies. Our own Alex Grammatis and co-authors summarise the surgical treatment modalities for ovarian endometriosis which range from conventional cystectomy to alcohol sclerotherapy and also highlight the importance of informed decision-making by patients. Whether we like it or not, artificial intelligence (AI) has been incorporated into many aspects of health care and the wise clinician needs to be involved and engaged in its application. Athavale's commentary focuses on the uses and abuses of AI in health care and research, citing CTG interpretation and endometriosis diagnosis as two potential clinical areas where automation can provide a more consistent and reliable diagnosis by reducing observer variation. Our Spotlight on… Paediatric and Adolescent Gynaecology (PAG) condenses eight recent TOG articles (ref) which relate to PAG and reminds us of the role of specialised clinics, where consultations can involve up to three generations of a family. Professor Jha divides the Spotlight article into menstrual problems (commonest), fertility issues, vulval disorders and others. I really enjoyed reading our Editor-in-Chief's “What I've learnt…” session with Dame Donna Ockenden, the rock star of maternity safety, where our guest reflected on how important it is to speak up and not just to conform. We learn how seeing her first birth as a student motivated her to become a midwife, about her rise to become Head of Midwifery and Clinical Director and her eventual appointment to chair the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust. The Ockenden Report may have ruffled many feathers but I am reminded of the Japanese art of Kintsugi, where broken pieces of ceramic are repaired using gold lacquer to form and create a stronger and more beautiful work of art, fully acknowledging the previous cracks and fragments.