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Objective: Uterine-sparing surgery for pelvic organ prolapse (POP) repair has shown good results, but the potential negative implications of leaving the uterus in place are yet to be fully defined. We aimed to assess the risk of unanticipated abnormal gynecological pathology at the time of reconstructive pelvic surgery. Methods: A retrospective consecutive case series including women who underwent vaginal hysterectomy for POP repair at a tertiary medical center in 2006–2020. All patients were offered a free Pap smear test at the age of 65 years as part of a national screening program. Transvaginal ultrasound was routinely performed preoperatively. Standard 3 pedicle hysterectomy was performed with/without bilateral salpingo-oophorectomy (BSO). Results: The study comprised 462 women of mean age 63 ± 9.3 years without previous known malignant or premalignant pathology. Benign pathology was observed in 286 patients (61.9%). Endometrial malignancy was found in three patients (0.7%) and significant premalignant pathology in 15 patients (3.2%), including cervical intraepithelial neoplasia stage 2–3 in seven patients (1.5%) and complex hyperplasia with atypia in eight patients (1.7%). All these pathologies were found in postmenopausal women. None had preoperative clinical symptoms or endometrial thickness of ≥5 mm on preoperative ultrasound. In the 35 patients after BSO, adnexal findings were normal (77.2%) or benign (22.8%). Conclusions: Premenopausal women with uterovaginal prolapse and normal preoperative evaluation have a minimal risk of significant abnormal uterine pathology. In postmenopausal women, the risk of unanticipated malignant uterine pathology is 0.7% and 3.2% for significant premalignancy. [ABSTRACT FROM AUTHOR]

The study's aims were to examine whether the COVID-19 pandemic was associated with increases in depression levels of 21 months postpartum women who were initially sampled before the pandemic and whether COVID-19-related worries mediated the association between women's attachment orientations and this hypothesized increase. Participants comprised 185 postpartum women sampled in the maternity ward of a tertiary healthcare center in Israel followed from childbirth to 21 months postpartum in four-time points.. We analyzed demographic and obstetric information and the Experiences in Close Relationships (ECR) scale at T1; changes in the Edinburgh Postnatal Depression Scale (EPDS) levels at all timepoints (T1-4); and COVID-19-related worries at T4. Results showed a significant increase in depression levels at T4 compared to T2 and T3, and an increase in the prevalence of women at the lower clinical EPDS threshold. COVID-19-related worries mediated the association between anxious attachment and depression (indirect effect: B =.21, p <.05, 95% CI = (.015,.47), R2=0.12). The evident effect of COVID-19 on postpartum depression is associated with variability between people. Thus, early assessment of women's attachment orientations might provide a strategy for identifying and treating women at risk. [ABSTRACT FROM AUTHOR]

This document explores the relationship between politics and religion in Israel. It discusses how Zionism, while attempting to distance itself from traditional Jewish religious life, could not completely separate itself from Judaism. The document highlights the privileged status of Judaism and religiously Orthodox political parties within the Zionist movement and the State of Israel. It also examines the theological dilemma faced by Orthodox Jews with the emergence of Zionism as a secular political movement. The document concludes by discussing the different responses of Orthodox groups and rabbinic authorities to this dilemma, ranging from pragmatic accommodationism to principled rejectionism. Additionally, it discusses the role of religion in Israel's public life, including the status quo letter that established religious arrangements in the country. The document explores the intersection of religion and politics, such as the differences between pragmatic and principled Haredi rejections of Zionism and the role of religiosity in Mizrahi politics. It also examines the challenges faced by Muslim women in Israel and their struggle for improved status. The document acknowledges the close interweaving of politics and religion in Israel and its impact on the Israeli-Palestinian conflict. [Extracted from the article]