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Older Patient Receptivity to the Integration of Patient Portals and Telehealth in Urogynecology: Promoters and Deterrents Urogynecology (IF 1.6) Pub Date : 2023-04-24 Dani Zoorob, Yasmin Hasbini
Importance Limited studies focus on the integration of online portals, including telehealth services, in urogynecology while identifying promoters and deterrents of utilization, especially for the older population. Objective This study aimed to identify facilitators, concerns, technical or personal issues encountered, and the desired features of the online patient portals among older urogynecology
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Factors Associated With Stress Urinary Incontinence and Diastasis of Rectus Abdominis in Women at 6–8 Weeks Postpartum Urogynecology (IF 1.6) Pub Date : 2023-04-17 Xiaohong Liu, Qin Wang, Yanling Chen, Jiamao Luo, Yifeng Wan
Importance In recent years, pelvic-abdominal dynamics has become a research topic in the field of pelvic floor dysfunction (PFD), and the relationship between diastasis of the rectus abdominis (DRA) and stress urinary incontinence (SUI) has been controversial. The study is helpful to further strengthen perinatal education, accurately identify the risk factors of SUI and DRA, and improve the quality
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Gender Equity in Academic Female Pelvic Medicine and Reconstructive Surgery Departments: A Cross-Sectional Observational Study Urogynecology (IF 1.6) Pub Date : 2023-04-17 Lei Alexander Qin, Kimia Menhaji, Yara Sifri, Anne Hardart, Charles J. Ascher-Walsh
Importance Gender equity in obstetrics and gynecology remains a barrier to career mobility and workplace satisfaction. Objective This study aimed to evaluate gender equity for academic positions in female pelvic medicine and reconstructive surgery (FPMRS) divisions with an Accreditation Council for Graduate Medical Education–accredited fellowship in the United States. Study Design This was a cross-sectional
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Healthcare Resource Utilization After Apical Prolapse Surgery in Women Who Received In-Office Versus Telephone-Only Preoperative Teaching Urogynecology (IF 1.6) Pub Date : 2023-04-17 Lannah L. Lua-Mailland, Gustavo Roversi, Meng Yao, Cecile A. Ferrando
Importance Despite increasing use of telehealth, no studies have evaluated telehealth use for preoperative teaching and its impact on healthcare resource utilization (HRU) after gynecologic surgery. Objectives This study aimed to compare HRU after apical prolapse surgery in women receiving in-office versus telephone-only preoperative teaching and identify factors associated with postoperative HRU
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Objective Changes in Pelvic Floor Muscle Strength and Length in Women With High-Tone Pelvic Floor Dysfunction After Pelvic Floor Physical Therapy (RELAX Trial) Urogynecology (IF 1.6) Pub Date : 2023-04-17 Lena J. Volpe, Morgan Zugelder, Rhonda Kotarinos, Elizabeth Kotarinos, Kimberly Kenton, Julia Geynisman-Tan
Importance Although pelvic floor physical therapy (PFPT) is effective in treating high-tone pelvic floor dysfunction (HTPFD), data on the mechanism of improvement are limited. Objectives This study aimed to compare squeeze intravaginal closure force after 6 weeks of PFPT in women affected by HTPFD and, secondarily, to describe changes in levator dimensions and short-term effects of PFPT on bladder
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Association Between Genital Hiatus Size 8 Weeks Postpartum and Pelvic Organ Prolapse 1 Year After the First Vaginal Delivery Urogynecology (IF 1.6) Pub Date : 2023-04-11 Heather A. Rosett, Amanda A. Allshouse, Ingrid E. Nygaard, A. Jolyn Hill, Carolyn W. Swenson
Importance Evidence suggests that genital hiatus (GH) enlargement precedes pelvic organ prolapse development remote from delivery. However, the association of postpartum GH enlargement and prolapse is unknown. Objective The aim of this study was to determine the association between enlarged GH at 8 weeks postpartum and prolapse 1 year after first vaginal delivery. Study Design This is a secondary
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Sexual Function in Women at 6 and 12 Months After Obstetric Anal Sphincter Injury: Is Pelvic Floor Physical Therapy Associated With Improved Outcomes? Urogynecology (IF 1.6) Pub Date : 2023-04-11 Lannah L. Lua-Mailland, Shannon L. Wallace, Meng Yao, Katie Propst
Importance Women with obstetric anal sphincter injury (OASI) are at increased risk of postpartum sexual dysfunction. Risk persists beyond 3 years after perineal trauma in up to half of patients with OASI. Objectives The aims of this study were to determine if postpartum pelvic floor physical therapy (PFPT) is associated with improved sexual function after vaginal delivery with OASI and to describe
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Pudendal Nerve Block Analgesia at the Time of Vaginal Surgery: A Randomized, Double-Blinded, Sham-Controlled Trial Urogynecology (IF 1.6) Pub Date : 2023-04-04 Emily A. Slopnick, Sarah B. Sears, Graham C. Chapman, David D. Sheyn, Megan K. Abrams, Kasey M. Roberts, Robert Pollard, Jeffrey Mangel
Importance Effective opioid-sparing postoperative analgesia requires a multimodal approach. Regional nerve blocks augment pain control in many surgical fields and may be applied to pelvic floor reconstruction. Objective This study aimed to evaluate the impact of pudendal nerve block on postoperative pain control and opioid consumption after vaginal surgery. Study Design In this randomized, double-blind
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Postoperative Urinary Retention Urogynecology (IF 1.6) Pub Date : 2023-04-01 Colleen D. McDermott, Elena Tunitsky-Bitton, Omar F. Dueñas-Garcia, Marcella G. Willis-Gray, Lauren A. Cadish, Autumn Edenfield, Rui Wang, Kate Meriwether, Elizabeth R. Mueller
This clinical consensus statement on the management of postoperative (<6 weeks) urinary retention (POUR) reflects statements drafted by content experts from the American Urogynecologic Society’s POUR writing group. The writing group used a modified Delphi process to evaluate statements developed from a structured literature search and assessed for consensus. After the definition of POUR was established
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Prevalence and Bother of Postvoid Dribbling and Urine Spraying or Splitting: Survey of a General Gynecology Population Urogynecology (IF 1.6) Pub Date : 2023-04-01 Christina Hicks, Adam M. Hare, Jessica E. Pruszynski, David D. Rahn
Importance Postvoid dribbling is described well for men in urologic literature but is poorly defined for women, especially in those not presenting for urogynecologic care. Objective The objective was to assess prevalence and bother of postvoid dribbling, urine spraying (ie, deviation of the urine stream), and other bothersome voiding/storage symptoms in a general gynecology population. Study Design
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Anatomic Variation of Sacral Mesh Attachment During Minimally Invasive Sacrocolpopexy Urogynecology (IF 1.6) Pub Date : 2023-04-01 Stephanie Glass Clark, Rachel Dang, Sarah Bonnet, Halina M. Zyczynski, Lauren Giugale
Importance Although anatomic level of mesh attachment to the sacrum varied during minimally invasive sacrocolpopexy with a large proportion above S1, this was not associated with pelvic organ prolapse recurrence. Objective This study aimed to describe the anatomic level of sacral mesh attachment and its association with prolapse recurrence after minimally invasive sacrocolpopexy. Study Design This
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Centering Group Treatment for Women With Interstitial Cystitis/Bladder Pain Syndrome: A Prospective, Parallel-Group Cohort Study Urogynecology (IF 1.6) Pub Date : 2023-04-01 Kate V. Meriwether, Niharika Ravichandran, Cassandra J. Darley, Virginia Panter, Yuko M. Komesu
Importance Women with interstitial cystitis/bladder pain syndrome (ICBPS) face isolation and treatment challenges. Group medical visits using Centering models have successfully treated other conditions but have not been explored in ICBPS. Objective This study aimed to describe ICBPS pain and symptom control comparing standard treatment alone versus standard treatment augmented with Centering visits
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The Impact of Facial Personal Protective Equipment on Speech Intensity Urogynecology (IF 1.6) Pub Date : 2023-04-01 Tara Krishnan, Paul Rudy, Navin Viswanathan, Margaret Brommelsiek, Austin Bachar, Gary Sutkin
Importance Facial personal protective equipment (FPPE) filters small particles in the operating room (OR) but also affects speech production, diminishing the effective transfer of information among OR team members. Objective The aim of the study is to assess the attenuating effects of different combinations of layered FPPE on speech intensity, including potential differences in the effect of talkers
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Supraphysiologic Vaginal Estrogen Therapy in Aged Mice Mitigates Age-Associated Bladder Inflammatory Response to Urinary Tract Infections Urogynecology (IF 1.6) Pub Date : 2023-04-01 Bisiayo E. Fashemi, Caihong Wang, Rayvanth R. Chappidi, Haidy Morsy, Indira U. Mysorekar
Importance Bladder diseases characterized by chronic inflammation are highly prevalent in older women, as are recurrent urinary tract infections (rUTIs). Recurrent urinary tract infections lead to chronic inflammation of the bladder mucosa and cause lower urinary tract symptoms that persist even after the infection is cleared. Vaginal estrogen therapy (VET) has long been used for the treatment of
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The Impact of Language Discordance on Patients’ Perception of a Clinical Encounter and Trust in Provider Urogynecology (IF 1.6) Pub Date : 2023-04-01 Lauren Caldwell, Gabriela E. Halder, Amanda B. White, Rachel A. High, Michelle L. Wright, Rebecca G. Rogers
Importance The impact of language discordance on care for Spanish-speaking patients with pelvic floor disorders is unknown. Objective The aim of this study was to compare the impact of language concordance with the impact of language discordance on the patient experience and trust in their provider. Methods This cross-sectional cohort study enrolled English- and Spanish-speaking patients during
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Preoperative Activity Level and Postoperative Pain After Pelvic Reconstructive Surgery Urogynecology (IF 1.6) Pub Date : 2023-03-27 Nozomi Sakai, Jennifer M. Wu, Marcella Willis-Gray
Importance Higher preoperative activity level is associated with improved postoperative outcomes, but its impact on postoperative pain after urogynecologic surgery is unknown. Objective The aim of the study was to assess the relationship between preoperative activity level and postoperative pain. Study Design In this prospective cohort study, we evaluated women undergoing pelvic reconstructive surgery
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Voiding Trial Outcomes After Prolapse Surgery: Before Versus During the COVID-19 Pandemic Urogynecology (IF 1.6) Pub Date : 2023-03-27 Alexa Courtepatte, Jeannine M. Miranne, Tayler Murray, Maura Kelly, Vatche A. Minassian
Importance Coronavirus disease 2019 (COVID-19) has changed practice patterns resulting in same-day discharge after most urogynecologic surgical procedures. Objective We aimed to determine if COVID-19 practice patterns changed patients' voiding trial (VT) results after surgery. Study Design This is a retrospective cohort study of women undergoing urogynecologic surgery at an academic tertiary care
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Fecal Microbiota Transfer for Clostridium difficile Infection and Its Effects on Recurrent Urinary Tract Infection Urogynecology (IF 1.6) Pub Date : 2023-03-16 Nicole Wood, Katie Propst, Meng Yao, Cecile K. Ferrando
Importance Recurrent urinary tract infection (rUTI) poses a significant management challenge, and fecal microbiota transfer (FMT) has been shown in a limited manner to positively effect rUTI. Objectives The objective of this study was to compare UTI rates after FMT for Clostridium difficile infection (CDI) in patients with previously diagnosed rUTI and patients without a previous diagnosis of rUTI
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Effect of Squeeze, Cough, and Strain on Dynamic Urethral Function in Nulligravid Asymptomatic Women: A Cross-Sectional Cohort Study Urogynecology (IF 1.6) Pub Date : 2023-03-13 Liam C. Martin, Megan R. Routzong, Steven D. Abramowitch, Ghazaleh Rostaminia
Importance In the past, urethral shape, mobility, and urodynamics have been used to retrospectively demonstrate correlations with stress urinary incontinence. Our previous work has shown a relationship between urethral function and shape in symptomatic women. Objective This study aimed to characterize the effect of pelvic floor squeeze and strain maneuvers on urethral shapes and pressure in a cohort
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Patient-Specific Pessaries for Pelvic Organ Prolapse Using Three-Dimensional Printing: A Pilot Study Urogynecology (IF 1.6) Pub Date : 2023-03-09 Christopher X. Hong, Shufei Zhang, Ahmed Eltahawi, Ali Borazjani, Hamed Kalami, Aye Nyein San, Derek Sham, Golafsoun Ameri, Colleen D. McDermott
Importance Vaginal pessaries are an effective nonsurgical treatment for pelvic organ prolapse (POP) when properly fitted. However, pessary fitting and use are often unsuccessful or imperfect. Objective The objective of this study was to assess the feasibility of using patient-specific pessaries fabricated from three-dimensional (3D)-printed molds to improve POP symptoms and increase overall satisfaction
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Nonhome Discharge in Patients Undergoing Pelvic Reconstructive Surgery: A National Analysis Urogynecology (IF 1.6) Pub Date : 2023-03-09 James H. Ross, Nicole Wood, Adrienne Simmons, Lannah L. Lua-Mailland, Shannon L. Wallace, Graham C. Chapman
Importance Discharge to home after surgery has been recognized as a determinant of long-term survival and is a common concern in the elderly population. Objective The aim of the study was to determine the incidence and risk factors for nonhome discharge in patients undergoing major surgery for pelvic organ prolapse. Study Design We performed a retrospective cohort study using the American College
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Educating Women About Pelvic Floor Disorders During Pregnancy From the First to the “Fourth Trimester”: A Randomized Clinical Trial Urogynecology (IF 1.6) Pub Date : 2023-03-06 Emily Rutledge, Alaina Spiers, Jennifer Vardeman, Nickie Griffin, Tariq Nisar, Tristi Muir, Danielle D. Antosh
Importance Pregnancy and childbirth are risk factors for developing pelvic floor disorders (PFDs), and this continues postpartum (“fourth trimester”). Knowledge of PFDs among women of childbearing age is lacking and presents an opportunity for education. Objectives The aim of this study was to compare the increase in knowledge of PFDs in patients who received written handouts versus interactive workshops
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Cumulative Effects of Comorbid Burden and Overactive Bladder Symptoms on Fall Risk Among Older Women Seeking Treatment for Urogynecologic Conditions Urogynecology (IF 1.6) Pub Date : 2023-03-08 Steve R. Fisher, Gabriela E. Halder, Mi Jung Lee, Lindsay Allen, Gokhan S. Kilic
Importance Overactive bladder (OAB) syndrome and urinary incontinence, age, and comorbid burden are strong risk factors for falls in women. Less is known about their cumulative effects on fall risk in a urogynecologic population. Objective The purpose of this study was to investigate the effects of coexisting OAB, older age, and comorbidities on risk of falling among treatment seeking women with
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Knowledge of Pelvic Floor Dysfunction in African American and Afro-Caribbean Women Seeking Medical Care in a Primary Care Ambulatory Setting Urogynecology (IF 1.6) Pub Date : 2023-02-22 Sarin A. Soyemi, Joanne Sheu, Emily Hahm, Dominique Noriega, Eva Kristoferson, Jiamin Li, Luanna Chan, Dong Zhen, Rose Calixte, Patricia Gil
Importance Approximately one fourth of U.S. community-dwelling women will develop a pelvic floor dysfunction (PFD) within their lifetimes. Prior research has revealed that knowledge of PFD was low to moderate in the general population and lower among Black patients. Objective This study aimed to assess the proficiency of urinary incontinence and pelvic organ prolapse (POP) in self-identified African
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Information and Guidance on the Adoption of Surgical Innovation and Technology in Urogynecology Urogynecology (IF 1.6) Pub Date : 2023-03-01
The development of new technology and techniques (NTT) is an integral component of contemporary medicine. In surgery, rapidly advancing technology offers opportunities to innovate and study new approaches to help improve the quality and effectiveness of therapies. The American Urogynecologic Society is committed to the responsible implementation and use of NTT prior to the broad application of clinical
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Differences in Sexual and Physical Abuse History by Presenting Chief Complaint in an Outpatient Urogynecology Population Urogynecology (IF 1.6) Pub Date : 2023-03-01 Molly Hansbarger, Mary Ackenbom, Jonathan P. Shepherd
Importance One in 3 women experience sexual or physical violence in their lifetimes. Health consequences for survivors are numerous, including urogynecologic symptoms. Objectives We aimed to determine prevalence and factors that predict a history of sexual or physical abuse (SA/PA) in outpatient urogynecology, specifically whether the chief complaint (CC) predicts a history of SA/PA. Study Design
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Universal Urogynecologic Consultation and Screening for Fecal Incontinence in Pregnant Women With a History of Obstetric Anal Sphincter Injury: A Cost-Effectiveness Analysis Urogynecology (IF 1.6) Pub Date : 2023-03-01 Christina H. Swallow, Christina N. Harvey, Oz Harmanli, Jonathan P. Shepherd
Importance Obstetric anal sphincter injuries (OASIS) predispose for the development of fecal incontinence (FI), but management of subsequent pregnancy after OASIS is controversial. Objective We aimed to determine if universal urogynecologic consultation (UUC) for pregnant women with prior OASIS is cost-effective. Study Design We performed a cost-effectiveness analysis of pregnant women with a history
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Perioperative Outcomes of Colpocleisis at a Single Institution: A Retrospective Cohort Study Urogynecology (IF 1.6) Pub Date : 2023-03-01 Lauren Simms, Deepali Maheshwari, Oz Harmanli, Vida Rastegar, Naomi Diaz, Keisha Jones
Importance There is limited literature reporting perioperative outcomes among colpocleisis types. Objectives This study aimed to describe perioperative outcomes after colpocleisis at a single institution. Study Design Patients who underwent colpocleisis at our academic medical center between August 2009 and January 2019 were included. A retrospective chart review was performed. Descriptive and comparative
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d-Mannose for Recurrent Urinary Tract Infection Prevention in Postmenopausal Women Using Vaginal Estrogen: A Randomized Controlled Trial Urogynecology (IF 1.6) Pub Date : 2023-03-01 Stacy M. Lenger, Christine M. Chu, Chiara Ghetti, Michael J. Durkin, Zoe Jennings, Fei Wan, Siobhan Sutcliffe, Jerry L. Lowder
Importance Further research is needed to determine whether d-mannose plus vaginal estrogen therapy (VET) is beneficial over VET alone for recurrent urinary tract infection (rUTI) prevention. Objective The aim of this study was to evaluate d-mannose efficacy for rUTI prevention in postmenopausal women using VET. Study Design We conducted a randomized controlled trial comparing d-mannose (2 g/d) with
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Accuracy of Bladder Scanner in Measuring Bladder Volumes in Postpartum Women Urogynecology (IF 1.6) Pub Date : 2023-02-22 Veronica Jierong Zheng, Julia Geynisman-Tan, Justin Knoll, Kimberly Kenton, Oluwateniola Brown
Importance Ultrasound bladder scanners may provide a less invasive method to measure postpartum urinary volume, but their accuracy must be validated. Objective The objective of this study was to evaluate the accuracy of a bladder scanner in measuring bladder volumes in postpartum women. The secondary objective was to evaluate the effect of obesity on scanner accuracy. Study Design This prospective
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Complex Urethral Diverticulectomy: Is a Synchronous Prophylactic Autologous Fascial Sling Needed? Urogynecology (IF 1.6) Pub Date : 2023-02-04 Amanda L. Schaaf, Yeonsoo S. Lee, Amanda A. Myers, Jared Schommer, Giovanni Gonzalez, Anita Chen, Steven Petrou
Importance Urethral diverticulectomy is performed with or without concomitant pubovaginal sling (PVS). Patients with complex UD are more frequently offered concomitant PVS. However, there is paucity of literature comparing postoperative incontinence rates for patients with simple versus complex UD. Objective The objective of this study is to examine postoperative stress urinary incontinence (SUI)
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Surgeon Counseling Regarding Return to Sexual Activity After Pelvic Reconstructive Surgery Urogynecology (IF 1.6) Pub Date : 2023-02-04 Lauren Caldwell, Shunaha Kim-Fine, Danielle D. Antosh, Katherine Husk, Kate V. Meriwether, Jaime B. Long, Christine A. Heisler, Patricia L. Hudson, Svjetlana Lozo, Shilpa Iyer, Rebecca G. Rogers
Importance Patients highly value surgeon counseling regarding the first sexual encounters after pelvic reconstructive surgery. Objectives We performed a qualitative analysis of usual surgeon counseling regarding return to sexual activity after surgery for pelvic organ prolapse and/or urinary incontinence. Methods Participating surgeons provided a written description of their usual patient counseling
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Toileting Behaviors and Lower Urinary Tract Symptoms Among Female Physicians and Medical Students Urogynecology (IF 1.6) Pub Date : 2023-02-04 Aaron Perlow, Cara J. Joyce, Stacey Bennis, Elizabeth R. Mueller, Colleen M. Fitzgerald
Importance A greater understanding of the relationship between toileting behaviors and lower urinary tract symptoms (LUTS) has the potential to generate awareness and improvement of overall bladder health in specific populations. Objective The aim of the study was to investigate the prevalence and correlation between maladaptive toileting behaviors and LUTS among female medical trainees and attending
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Treatment for Urinary Incontinence in Women Older Than 65 Years Urogynecology (IF 1.6) Pub Date : 2023-02-03 Giulia I. Lane, Elisabeth Erekson, Andrea Austin, Donald Carmichael, Vatche A. Minassian, Francine Grodstein, Julie PW Bynum
Importance Urinary incontinence (UI) is common among women older than 65 years and negatively affects quality of life. However, the prevalence of UI treatment and determinants of treatment are largely unknown. Objectives The aim of this study was to identify rates of UI treatment and factors associated with treatment in older women with self-reported UI. Study Design This is a retrospective cohort
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Pelvic Pain and Pelvic Floor Muscle Dysfunction in Women Seeking Treatment for Prolapse Urogynecology (IF 1.6) Pub Date : 2023-02-01 Anuradha Gore, Kimberly A. Kenne, Joseph T. Kowalski, Catherine S. Bradley
Importance Pelvic floor muscle dysfunction (PFMD) can cause pelvic pain, but its associations with pelvic organ prolapse (POP) and POP treatment outcomes are poorly understood. Objectives The objectives of this study were to determine (1) if pelvic pain is associated with PFMD in women seeking POP treatment and (2) if baseline PFMD in women seeking management of POP is associated with improvement
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Fecal Incontinence and the Risk of Urinary Tract Infection in Patients Presenting for Urogynecological Consultation Urogynecology (IF 1.6) Pub Date : 2023-01-30 Sierra M. Jansen, Katherine Pellino, Qianqian Zhou, Heidi W. Brown, Christine A. Heisler
Importance Urinary tract infection (UTI) is common in urogynecology patients. Patients with fecal incontinence (FI) often attribute their UTIs to FI, but this association has not been evaluated. Objectives The objectives of this study were to compare the prevalence of UTI in urogynecology patients with and without FI and to characterize factors associated with UTI and recurrent UTI. Study Design
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Recurrence of Anterior Vaginal Prolapse After Robotic Sacrocolpopexy: Does Cervical Preservation Affect Outcome? Urogynecology (IF 1.6) Pub Date : 2023-02-01 Sarah E. Eckhardt, Janet S. Lee, John N. Nguyen
Importance Anterior vaginal prolapse (AVP) is the most common site of recurrence after sacrocolpopexy (SCP). Supracervical hysterectomy helps to prevent mesh exposure, but it is unclear if cervical preservation (CP) affects adequate reduction of AVP. Objective Our primary objective was to determine the difference in AVP recurrence rates in patients who have undergone SCP with or without CP. Secondary
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Symptom and Anatomical Phenotypes Provide Insights Into Interactions of Prolapse Symptoms and Anatomy Urogynecology (IF 1.6) Pub Date : 2023-02-01 Allan Fong, Aline Talhouk, Derek Chiu, Nicole Koenig, Geoffrey W. Cundiff
Importance Women pursue treatment to relieve symptoms, while surgeons repair anatomy, underlining the importance of the relationship between symptoms and anatomy. Objective We hypothesized different anatomical and symptom phenotypes associated with pelvic organ prolapse (POP). Our objective was to investigate prevalence of phenotypes to explore associations of symptoms with anatomical defects. Methods
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Dynamic, High-Fidelity, 3-Dimensional Pelvic Model Improves Education on Pelvic Organ Prolapse and the Pelvic Organ Prolapse Quantification System and Interest in Urogynecology Urogynecology (IF 1.6) Pub Date : 2023-02-01 Alexandra I. Goodwin, Sean C. Trahan, Allison E. Neuwirth, Todd Goldstein, Kristen Demertzis, Peter S. Finamore, Danielle L. O’Shaughnessy
Importance Pelvic organ prolapse (POP) affects millions of women globally. Still, medical students and obstetrics and gynecology residents gain minimal exposure to POP during training. Objectives Our goal was to increase exposure to POP by creating a high-fidelity, dynamic, 3-dimensional pelvic model of prolapse and using it to teach through didactic learning sessions. Study Design This was a prospective
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Pregnancy and Outcomes After Prolapse Surgery: A Case Series Urogynecology (IF 1.6) Pub Date : 2023-01-25 Brittni Boyd, Kristen Buono, Atieh Novin, Emily Whitcomb
Importance There are limited data on whether pelvic organ prolapse (POP) surgery is durable after subsequent delivery. Objectives The aims of this study were to evaluate the safety and durability of POP surgery after delivery and to describe the medical decision-making and clinical outcomes of patients who gave birth after POP surgery. Study Design This study is a retrospective case series of patients
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Rectocele: Correlation Between Defecography and Physical Examination Urogynecology (IF 1.6) Pub Date : 2023-01-23 Carly A. Crowder, Nichole Sayegh, Noelani M. Guaderrama, Sarah E.S. Jeney, Kristen Buono, Janis Yao, Emily L. Whitcomb
Importance There is a lack of consensus regarding the clinical applicability of fluoroscopic defecography in evaluation of pelvic organ prolapse. Objectives The aim was to evaluate the association between rectocele on defecography and posterior vaginal wall prolapse (PVWP) on physical examination. The secondary objective was to describe radiologic and clinical predictors of surgical intervention
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Barriers to Urogynecologic Care for Racial and Ethnic Minority Women: A Qualitative Systematic Review Urogynecology (IF 1.6) Pub Date : 2023-02-01 Mary F. Ackenbom, Charelle M. Carter-Brooks, Sarin A. Soyemi, Carrie K. Everstine, Meryl A. Butters, Esa M. Davis
Importance Studies have sought to evaluate factors that have perpetuated disparities in health care, including urogynecologic care. However, there remains a lack of understanding of barriers to care specific to racial/ethnic minority populations. Objectives We aimed to report identified barriers to urogynecologic care (eg, care for symptoms/diagnoses of urinary incontinence [UI], accidental bowel
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Cost-effectiveness Analysis: Autologous Rectus Fascial Sling Versus Retropubic Midurethral Sling for Female Stress Urinary Incontinence Urogynecology (IF 1.6) Pub Date : 2023-02-01 Xibei Jia, Rui Wang, Cynthia Hall, Michael K. Flynn
Importance There are limited data on the economic comparison between retropubic midurethral sling and autologous fascial sling. Objective This study aims to evaluate the cost-effectiveness of autologous rectus fascial sling compared with retropubic midurethral sling from both hospital and health care perspectives. Study Design A decision tree model was developed with 1 year of follow-up. We included
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Safety and Efficacy of Single Incision Sling Versus Midurethral Sling in the Treatment of Stress Urinary Incontinence: A Randomized Controlled Trial Urogynecology (IF 1.6) Pub Date : 2023-02-01 Martin Huser, Robert Hudecek, Ivan Belkov, Ivan Horvath, Jiri Jarkovsky, Samuel Tvarozek
Importance This study compares the long-term efficacy and safety of an innovative single-incision sling (SIS) with the inside-out transobturator tape (TOT) sling in the treatment of female stress urinary incontinence. Objectives Women with urodynamic stress urinary incontinence were randomized to either SIS or TOT groups and followed up for 4 years. The primary outcome was objective cure defined
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Stress Urinary Incontinence After Operations for Uterine Prolapse: A Nationwide Cohort Study Urogynecology (IF 1.6) Pub Date : 2023-02-01 Karen R. Husby, Kim O. Gradel, Niels Klarskov
Importance Concomitant surgery for stress urinary incontinence (SUI) during pelvic organ prolapse (POP) operations are debated. Objectives We aimed to assess the risk of an SUI operation after a uterine prolapse operation and compare the risk after the Manchester procedure versus vaginal hysterectomy. Study Design We performed a nationwide historical cohort study including women with no history
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C-Clamp Technique: A Retrospective Review of a Novel Technique to Prevent Bladder Injury in Retropubic Midurethral Slings Urogynecology (IF 1.6) Pub Date : 2023-02-01 Christopher J. Jayne, Madeline Bach, Adekorewale Odulate-Williams, Adriana Ocon, Gazala Siddiqui
Importance Synthetic mesh midurethral slings have become the criterion-standard treatment for stress urinary incontinence with urethral hypermobility in women. Iatrogenic bladder injury is a known risk of the procedure. Objective Our objective was to show that a novel “C-clamp technique” can significantly reduce the risk of bladder and urethral injury at the time of bottom-up retropubic synthetic
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Retreatment of Stress Urinary Incontinence After Midurethral Sling With Prior Urethral Bulking Urogynecology (IF 1.6) Pub Date : 2023-02-01 Afiba Arthur, Noelani M. Guaderrama, Jing Zhang, Joanie Chung, Emily L. Whitcomb
Importance There is limited current literature regarding the retreatment of stress urinary incontinence (SUI) after midurethral sling (MUS) placement with prior urethral bulking. Objective The objective was to evaluate the retreatment and perioperative complications of MUS placement with prior urethral bulking compared with MUS placement without prior urethral bulking. Study Design This was a retrospective
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Addition of Transversus Abdominis Plane Block to Conventional Pain Regimens in Robotic Sacrocolpopexy Procedures—A Pilot Randomized Controlled Trial (SACROTAP) Urogynecology (IF 1.6) Pub Date : 2023-02-01 Dani Zoorob, Ibrahim Tsolakian, Eric Shuffle, Paul Perring, Rose Maxwell
Importance There have been no randomized trials assessing the benefits of integration of transversus abdominis plane (TAP) blocks in sacrocolpopexy procedure postoperative pain management. Objective The aim of this study was to assess the variation in pain perception upon adding TAP blocks to conventional oral pain medications in patients undergoing sacrocolpopexy. The primary outcome was the reduction
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Long-Term Pain After Minimally Invasive Total Hysterectomy and Sacrocolpopexy Urogynecology (IF 1.6) Pub Date : 2023-02-01 C. Emi Bretschneider, Erinn Myers, Elizabeth G. Geller, Kimberly Kenton, Barbara Henley, Jennifer M. Wu, Catherine A. Matthews
Importance There are limited long-term data on patient-reported pain after surgical treatment of uterovaginal prolapse. Objective This study aimed to evaluate pain in women undergoing minimally invasive total hysterectomy and sacrocolpopexy with a lightweight polypropylene Y-mesh (Upsylon) >2 years after surgery. Study Design This is a planned secondary analysis of a 5-site randomized trial comparing
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General Versus Regional Anesthesia in Sacrospinous Ligament Fixation for Pelvic Organ Prolapse: Assessment of a National Database Urogynecology (IF 1.6) Pub Date : 2023-02-01 Anna Romanova, Bertille Gaigbe-Togbe, Daniel Lieberman, Catherine Seaman, Carson Woodbury, Ann Tran, Anne Hardart, Lisa Dabney
Importance Sacrospinous ligament fixation is a prolapse repair surgical procedure that can be performed under general or regional anesthesia. Little is known about the impact of anesthesia on postoperative outcomes. Objectives The primary objective of this study was to compare 30-day complication rates for patients undergoing sacrospinous ligament fixation by anesthesia type. Secondary objectives
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Frailty and Acute Postoperative Urinary Retention in Older Women Undergoing Pelvic Organ Prolapse Surgery Urogynecology (IF 1.6) Pub Date : 2023-02-01 Stephanie W. Zuo, Charelle M. Carter-Brooks, Halina M. Zyczynski, Mary F. Ackenbom
Importance Acute postoperative urinary retention (POUR) is common after pelvic reconstructive surgery, occurring in 15–45% of women. There is a paucity of data on the relationship between frailty and POUR after prolapse surgery. Objective This study aimed to examine the association between frailty and POUR in older women who underwent pelvic organ prolapse surgery. Study Design This secondary analysis
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Prevention of Postoperative Constipation in Urogynecology Patients: A Systematic Review Urogynecology (IF 1.6) Pub Date : 2023-02-01 Carson F. Woodbury, Arielle C. Coughlin, Bethany Dubois, Anna Romanova
Importance Constipation is common after pelvic surgery, and studies suggest that surgeons underestimate the negative impact of constipation on patients. Patients undergoing pelvic reconstructive surgery are a unique population requiring special consideration in the prevention and management of constipation. Objective This study aimed to systematically review the literature to identify evidence for
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Perioperative Pain Management With Opioid Analgesics in Colpopexy Increases Risk of New Persistent Opioid Usage Urogynecology (IF 1.6) Pub Date : 2023-02-01 Pranjal Agrawal, Una Choi, Brian Liao, Taylor P. Kohn, Jaden Kohn, Kathryn Dumas, Marisa Clifton
Importance Although the use of perioperative pain medications is highly investigated, limited studies have examined the usage of pain medication for post hysterectomy prolapse repair and the few that have have been restricted to smaller sample sizes. Objective Our objective was to assess the association of perioperative opioid usage after posthysterectomy prolapse repairs with development of new
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Differences in Surgical Practice Patterns of Vaginal Native Tissue Repair for Pelvic Organ Prolapse Between Urologists and Gynecologists Urogynecology (IF 1.6) Pub Date : 2023-02-01 Rahul Dutta, Dylan T. Wolff, Catherine A. Matthews
Importance Surgeon specialty training may influence the combination of transvaginal procedures for pelvic organ prolapse (POP) repair. Isolated transvaginal anterior compartment repair (AR) without concurrent apical suspension (ApS) is a known risk factor for POP recurrence. Objectives Our primary aim was to compare the prevalence of isolated AR between urologists versus gynecologists. Our secondary
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Factors Associated With Increased Estimated Blood Loss and Factors Associated With Utilization of Type and Screen in Benign Gynecology: A Retrospective Chart Review Urogynecology (IF 1.6) Pub Date : 2023-02-01 Sierra M. Jansen, Desna Ghatalia, Alyssa Mayo, Amanda Lokke, Timothy R. Petersen, Tasha Serna-Gallegos, Kate V. Meriwether
Importance There is minimal literature discussing factors associated with increased estimated blood loss (EBL) or transfusion in gynecologic surgery in tertiary academic centers. Objective The aim of the study was to determine factors associated with transfusion and increased blood loss during gynecologic surgery. Study Design This retrospective cohort investigated patients undergoing benign gynecologic
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Complications After Orchiectomy and Vaginoplasty for Gender Affirmation: An Analysis of Concurrent Versus Separate Procedures Using a National Database Urogynecology (IF 1.6) Pub Date : 2023-02-01 Colin B. Russell, Christopher X. Hong, Pamela Fairchild, C. Emi Bretschneider
Importance Gender-affirming orchiectomy may be performed in isolation, as a bridge to vaginoplasty, or concurrently with vaginoplasty for transgender and nonbinary persons, although there is a paucity of data on immediate postoperative outcomes on the various procedural approaches. Objective The aim of the study is to compare 30-day surgical outcomes after gender-affirming orchiectomy and vaginoplasty
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The Impact of Pelvic Floor Physical Therapy on Bladder and Bowel Function After Obstetric Anal Sphincter Injury Urogynecology (IF 1.6) Pub Date : 2023-02-01 Lannah L. Lua-Mailland, Meng Yao, Shannon L. Wallace, Katie Propst
Importance Women with obstetric anal sphincter injury (OASI) are at increased risk of pelvic floor disorders. No standard of care exists for management of pelvic floor dysfunction after OASI. Objectives The aims of this study were to evaluate the impact of pelvic floor physical therapy (PFPT) on bladder and bowel function after OASI and to describe adherence to PFPT. Study Design A retrospective
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Effect of Kegel Exercises on Lower Urinary Tract Symptoms in Young Gymnasts: A Prospective Cohort Study Urogynecology (IF 1.6) Pub Date : 2023-01-16 Celia Rodríguez-Longobardo, Amelia Guadalupe-Grau, Miguel Ángel Gómez-Ruano, Olga López-Torres
Importance Lower urinary tract symptoms (LUTS) have been shown to exist in young athletes. The use of pelvic floor muscle training as a preventive strategy at an early age may be useful to avoid possible pelvic floor dysfunction in the future. Objectives The aim of the study was to describe LUTS in underaged gymnasts. We also aimed to evaluate the effects of a 12-week Kegel exercise intervention
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Predictors of Recovery Expectancy in Preparation for Pelvic Reconstructive Surgery in Women With Pelvic Organ Prolapse: A Prospective Cohort Study Urogynecology (IF 1.6) Pub Date : 2023-01-12 Andrew Doering, Douglass Hale, Jennifer Hamner, Michael Heit
Importance Recovery expectancy is a modifiable predictor of actual recovery after surgery. Identifying predictors of recovery expectancy will allow clinicians to preoperatively modify recovery expectancy and optimize actual recovery. Objectives The primary objective was to identify patient characteristics that predict a patient's recovery expectancy. The secondary objective was to validate previous
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Foley Balloon Pull Test of Pelvic Floor Muscle Strength Urogynecology (IF 1.6) Pub Date : 2023-01-10 Sean Spector, Saifuddin Mama, Michele Andrews, Lioudmila Lipetskaia
Importance Methods for pelvic floor muscle (PFM) strength testing are limited by their subjective nature, prohibitive cost, training burden, or lack of validation. Objectives The objectives of this study are to validate a new, inexpensive, and accessible method for PFM strength testing using a 30-mL Foley balloon inserted into the vagina, the Foley Balloon Pull Test (FPT), and to demonstrate external