Early Return to Competition After vNOTES Ovarian Cystectomy in a Professional Athlete: A Case Report

There are currently no studies that have evaluated return-to-sport or return-to-competition outcomes in professional athletes following gynecologic surgery. In addition, reports describing return to competition after vaginal natural orifice transluminal endoscopic surgery (vNOTES) in professional athletes are extremely limited. The present report focuses on early return to competition following vNOTES ovarian cystectomy in a professional athlete. We report the case of a 20-year-old nulliparous professional bowler who underwent vNOTES ovarian cystectomy for a 9-cm left serous cystadenoma. The operation time was 66 minutes with minimal blood loss, and the patient was discharged on postoperative day three. She resumed training on postoperative day four, became asymptomatic by day 10, and returned to a national competition on postoperative day 23, finishing fourth. This case demonstrates an exceptionally rapid postoperative recovery and represents one of the earliest documented returns to competition following gynecologic adnexal surgery, suggesting that vNOTES may offer distinct advantages for athletes who require preservation of abdominal wall integrity and rapid restoration of core function.