Background and Aims Adenomyosis is frequently found in hysterectomy specimens of women with endometrial cancer (EC), but its relationship with tumor characteristics remains debated. This study aimed to compare the histopathological, immunohistochemical (IHC) and molecular features of EC, and the allocation of adjuvant therapy, between patients with and without coexisting adenomyosis. Methods Single‐center retrospective cohort study of consecutive women who underwent hysterectomy for EC at ARNAS Garibaldi Nesima, Catania, Italy, between January 2023 and September 2024, with complete IHC and molecular profiling. Adenomyosis was defined histopathologically. FIGO 2023 stage, histotype and grade, myometrial invasion, lymphovascular space invasion (LVSI), nodal status, p53 and p16 expression, POLE, mismatch repair (MMR), KRAS and PIK3CA status, and adjuvant therapy were compared using Fisher’s exact and chi‐square tests, with odds ratio (OR) and 95% confidence interval (CI). Results Of 87 patients, 27 (31.0%) had coexisting adenomyosis. Adenomyosis was associated with FIGO stage I (81.5% vs. 46.7%; OR 5.03, 95% CI 1.68–15.04; p = 0.003), myometrial invasion < 50% (66.7% vs. 35.0%; OR 3.71, 95% CI 1.42–9.70; p = 0.010), absent/focal LVSI (77.8% vs. 50.0%; OR 3.50, 95% CI 1.24–9.89; p = 0.019) and a lower proportion of grade 3 endometrioid tumors (3.7% vs. 26.7%; p = 0.017). No differences were observed in nodal status or in p53, p16, POLE, MMR, KRAS, or PIK3CA status. Fewer patients with adenomyosis received adjuvant therapy (29.6% vs. 58.3%; OR 0.30, 95% CI 0.11–0.80; p = 0.020). Multivariable adjustment was not feasible given the sample size. Conclusion In this cohort, coexisting adenomyosis was associated with earlier‐stage, less invasive EC and, consistently, with less frequent allocation to adjuvant therapy. These are univariate associations from a small, single‐center retrospective series without survival data; they do not establish an independent or causal effect of adenomyosis and require confirmation in larger prospective multicenter studies.
Background Ectopic pregnancy (EP) is a serious maternal complication with a worldwide prevalence of about 2%. It is defined as the implantation of the product of conception outside the uterine cavity. Patients with EP may present with a wide range of clinical symptoms, including abdominal/pelvic pain, vaginal bleeding, missed menstrual cycle, and an empty uterine cavity on ultrasound. After diagnosing EPs, medical and/or surgical treatment options are available based on the patient’s hemodynamic status, ectopic location, fetal cardiac activity, size of the gestational sac, level of β‐HCG, and patient profile. Objective This narrative literature review aims to summarize published primary studies on the epidemiology and reported associated factors of EP in Saudi Arabia between 2000 and 2024. Results A total of 1342 EP cases were reported across the included studies. Reported prevalence estimates ranged from 0.23% to 1.20%. The reviewed studies were from different regions of the Kingdom, including Abha, Khamis Mushait, Yanbu, Makkah, Madina, Jeddah, Khobar, and Majmaah. The prevalence of EPs fluctuated between 2000 and 2019 and had three peaks: 1.13% (2012), 1.14% (2013), and 1.2% (2019). Multiple associated factors linked to EP were reported in this review, including a history of pelvic surgery, C‐sections, previous EP, abortions, intrauterine contraceptive device (IUCD) use, and pelvic inflammatory diseases (PIDs). Conclusions EP is a serious complication that causes significant maternal morbidity and mortality and has a substantial burden on the healthcare system. In this review, eleven studies were reviewed regarding the epidemiology of EPs in the Kingdom. No clear pattern or trend in prevalence was identified, although the majority of studies reported lower EP rates than the worldwide prevalence. Several associated factors were reported across the included studies; however, these findings should be interpreted cautiously because most studies were retrospective and descriptive in nature.
Background Hydrosalpinx, a fluid‐filled blocked fallopian tube, is a major cause of infertility and is mainly linked to pelvic inflammatory disease. However, its connection to endometriosis, especially hidden tubal endometriosis without visible signs, is not well studied. This research aimed to find the prevalence of confirmed endometriosis in salpingectomy samples removed due to hydrosalpinx and to evaluate the subsequent reproductive outcomes. Methods A cross‐sectional study involved 70 infertile women undergoing laparoscopic salpingectomy at a specialized center. We gathered demographic, surgical, and pathological information from medical records. The main outcome was the occurrence of endometriosis based on histopathology. The secondary outcome was the rate of clinical pregnancies (either spontaneous or through ART) after salpingectomy. We used SPSS v23.0 for statistical analysis, considering p < 0.05 as significant. Results The average age of participants was 37.38 ± 6.13 years. Clear histological evidence of endometriosis was found in 14.3% (10/70) of samples. Notably, 8% (4/50) of patients without a history of endometriosis had hidden tubal disease. The visual detection of endometriosis during laparoscopy was marginally significantly associated with a positive pathology (37.5% vs. 7.4%, p = 0.050). After salpingectomy, the total clinical pregnancy rate was 25.5% (12/47). However, none of the patients (0%) with a diagnosis of tubal endometriosis achieved pregnancy, while those with other pathologies had a 30% success rate. Conclusion Examining salpingectomy samples is essential for detecting endometriosis. Women with histologically confirmed tubal endometriosis may represent a subgroup with potentially poorer reproductive outcomes. However, this observation is exploratory and requires validation in larger studies with adequate adjustment for age, ovarian reserve, and ART‐related factors.
Background Urinary incontinence (UI) is a prevalent yet underreported condition significantly impacting women’s quality of life. In Saudi Arabia, cultural stigma often prevents help‐seeking, and comprehensive data on its impact are limited. This study aimed to estimate the prevalence and severity of UI among women in Saudi Arabia, identify associated medical and obstetric risk factors, and evaluate its impact on quality of life in order to inform a policy and service framework for integrated, stigma‐sensitive care. Methods A cross‐sectional study was conducted among 629 adult women across Saudi Arabia using an online, self‐administered questionnaire. The instrument included sociodemographic sections, the validated International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐UI SF), and assessments of risk factors and quality‐of‐life impact. Data were analyzed using descriptive statistics, chi‐square tests, and multiple logistic regression. Results Regarding the amount leaked among the 291 women who reported incontinence, most reported small‐volume leakage: 238 (81.8%), while moderate 51 (17.5%) and large amounts 2 (0.7%) were relatively rare. Key risk factors identified included higher age, overweight/obesity (with 60.7% of frequent UI cases being overweight), and multiparity (46.3% of all women had ≥ 3 deliveries). The impact on quality of life was substantial: 25.4% reported an impact on their social life, and 21.0% reported feelings of anxiety or nervousness. Multivariable analysis revealed that severe social impact was independently associated with high leakage frequency (AOR = 4.25, p < 0.001), higher perceived interference (AOR = 1.28, p < 0.001), and experiencing anxiety (AOR = 3.02, p = 0.005). Conclusion UI is highly prevalent among women in Saudi Arabia, with significant physical and psychosocial consequences. Symptom severity and psychological distress are the primary drivers of social impairment. There is an urgent need for targeted public health initiatives to destigmatize UI, raise awareness, and improve access to treatment. These findings support a national framework that embeds routine UI screening in primary care, strengthens access to pelvic‐floor and weight‐management services, and integrates mental‐health support and culturally sensitive awareness campaigns to reduce stigma and improve quality of life.
