Female Pelvic Medicine & Reconstructive Surgery

UNLABELLED: Patient-reported outcomes (PRO) are important for measuring quality of care, particularly for interventions aimed at improving symptom bother such as procedures for pelvic organ prolapse. We aimed to create a concise yet comprehensive PRO measurement tool to assess pelvic organ prolapse care in high-volume clinical environments. METHODS: The relevant concepts to measure prolapse treatment quality were first established through literature review, qualitative interviews, and a patient and provider-driven consensus-building process...

IMPORTANCE: There is conflicting evidence regarding predictive factors for bladder perforation during retropubic midurethral sling (R-MUS) placement and lack of evidence to support adoption of techniques to minimize such injury. OBJECTIVES: The aims of the study were to describe the incidence of and factors associated with bladder perforation during R-MUS placement and to explore whether retropubic hydrodissection decreases the likelihood of perforation. STUDY DESIGN: This is a case-control study of women undergoing R-MUS placement from 2007 to 2017...

No abstract text is available yet for this article.

IMPORTANCE: There have been no studies comparing 2% and 4% chlorhexidine gluconate (CHX) for vaginal surgical site preparation despite both commonly being used. OBJECTIVES: The primary objective was to assess the noninferiority of 2% CHX versus 4% CHX to reduce bacterial contamination rates at 60 minutes after surgical preparation of the vagina. Secondary objectives were to assess differences in colony-forming units and the sensation of postoperative vaginal burning and pain...

IMPORTANCE: There is increasing overlap in the urogynecologic and gynecologic oncologic patient populations. To improve patient advocacy and access to care, a collaborative surgical approach may benefit this cohort. OBJECTIVE: The aim of the study was to evaluate surgeon attitudes toward performing concurrent urogynecologic and gynecologic oncology procedures. We hypothesized that most surgeons are amenable to collaboration. STUDY DESIGN: We conducted a cross-sectional questionnaire of members of the Society of Gynecologic Oncology and the American Urogynecologic Society from August to November 2020...

IMPORTANCE: The U.S. Food and Drug Administration uses the Manufacturer and User Facility Device Experience database to evaluate the safety of urogynecologic meshes; however, reports on individual meshes have not been characterized. OBJECTIVE: The aim of the study was to compare complications among available urogynecologic meshes reported to the Manufacturer and User Facility Device Experience database. STUDY DESIGN: This study is a cross-sectional analysis of medical device reports (MDRs) of urogynecologic mesh from January 2004 to March 2019, using the Reed Tech Navigator (LexisNexis), which codes MDRs...

IMPORTANCE: Clinical data on the use of overactive bladder (OAB) medications are limited by the physician interpretation of adverse effects rather than those that are patient reported. OBJECTIVE: The aim of the study was to evaluate the association between OAB medications and adverse drug events (ADEs) through the self-reporting U.S. Food and Drug Administration Adverse Event Report System database. STUDY DESIGN: The U.S. Food and Drug Administration Adverse Event Report System (FAERS) database was queried from 2004 to 2019...

IMPORTANCE: Pelvic reconstructive surgery is often associated with transient postoperative voiding dysfunction. OBJECTIVE: This study aimed to compare postoperative active voiding trial (AVT) outcomes before and after implementation of an enhanced recovery program (ERP) for women undergoing pelvic reconstructive surgery. In addition, risk factors for postoperative urinary retention were identified. STUDY DESIGN: We retrospectively identified patients undergoing inpatient vaginal or robotic pelvic reconstructive surgery before and after implementation of an ERP at our institution...

OBJECTIVE: The aim of this study was to investigate trends and outcomes of ambulatory minimally invasive sacrocolpopexy (MISC) using data from a contemporary multicenter nationwide cohort. METHODS: We used the American College of Surgeons National Surgical Quality Improvement Program database to identify women who underwent nonemergent MISC (laparoscopic and robotic) from 2012 to 2018. Exclusion criteria were age <18 or ≥90 years, rectal prolapse, postoperative discharge day ≥3, and concomitant hysterectomy, transvaginal mesh repair, colpocleisis, and/or colorectal surgery...

IMPORTANCE: This study identifies barriers, including language and insurance status, Latina patients may face in accessing urogynecology care. OBJECTIVE: The aim of the study was to determine differences in objective prolapse severity at the time of presentation between Latina and non-Latina patients and the effect socioeconomic disparities may have on these differences. STUDY DESIGN: This is a retrospective cohort study of patients visiting urogynecology clinics at 2 academic institutions (1 private, 1 public)...

IMPORTANCE: Data on the correlation between length of stay and postoperative complications following urogynecologic surgery are limited. OBJECTIVES: The objective of this study was to use a nationwide database to examine the correlation between length of stay and 30-day postoperative complications following minimally invasive apical prolapse repair. STUDY DESIGN: This retrospective cohort study included women in the American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2018 who underwent laparoscopic/robotic sacrocolpopexy or uterosacral/sacrospinous repair and were discharged on postoperative day 0 (POD0) or 1 (POD1)...

IMPORTANCE: Following the recent expansion of telemedicine during the COVID-19 pandemic, this remote model of care in female pelvic medicine and reconstructive surgery will likely remain and continue to evolve. OBJECTIVE: This study was conducted to assess patients' perceptions of and willingness to participate in a synchronous telemedicine visit beyond the COVID-19 pandemic for women with pelvic floor disorders. STUDY DESIGN: We conducted a cross-sectional study of women who completed a synchronous telemedicine visit from March 16 through May 22, 2020, at a urogynecology practice in an academic medical center...

IMPORTANCE: Posterior compartment surgery is considered a risk factor for postoperative urinary retention because of the impact of postoperative pain on the pelvic floor; however, few studies have examined the association between posterior compartment reconstructive surgery and urinary retention. OBJECTIVE: The aim of the study was to compare rates of urinary retention in patients undergoing vaginal reconstructive surgery, without hysterectomy, in the posterior compartment only versus any apical and/or anterior compartment (with or without posterior compartment)...

IMPORTANCE: Linguistic differences suggestive of gender bias have been detected in letters of recommendation (LOR) for female and male residency and fellowship program applicants within multiple medical specialties. OBJECTIVE: The aim of the study was to determine whether linguistic differences exist in LOR for female and male physicians applying to female pelvic medicine and reconstructive surgery (FPMRS) fellowship. STUDY DESIGN: A retrospective analysis of FPMRS fellowship applications submitted to a university-affiliated academic center from 2010 to 2020 was performed...

IMPORTANCE: There is a paucity of evidence-based, physician-authored content available on social media. Data are lacking on physicians use of social media, including intended audience and content. OBJECTIVE: The aim of this study was to explore the patterns of Twitter and Instagram use for popular urogynecology hashtags between physicians, patients, and allied health professionals (AHPs). STUDY DESIGN: Twelve hashtags derived from the Urogynecology Tag Ontology project were used as search terms to select Twitter and Instagram posts...

IMPORTANCE: Understanding postoperative opioid consumption is key to reducing opioid misuse. OBJECTIVE: The aim of the study was to quantify the amount of outpatient opioids consumed after urogynecologic surgery. STUDY DESIGN: This is a prospective multicenter cohort study sponsored by the American Urogynecologic Society Fellow's Pelvic Research Network. Women undergoing pelvic organ prolapse or urinary incontinence surgery between May 2019 and January 2021 were included...

No abstract text is available yet for this article.

INTRODUCTION AND HYPOTHESIS: The current terminology used to describe cosmetic gynecologic procedures includes many nondescriptive, trademarked, or informal names, which contributes to substantial ambiguity about their aims and specific techniques. The development of clear, uniform descriptive terminology for cosmetic gynecology is needed for patients, researchers, and practitioners across multiple specialties. METHODS: This document was developed from a collaboration of selected members from the International Urogynecological Association (IUGA) and the American Urogynecologic Society (AUGS)...

IMPORTANCE: Resources for learning and enhancing knowledge in medicine, such as mobile applications (apps), have dramatically increased in recent years; however, there is lack of a valid source for identifying the best and most reliable mobile apps. OBJECTIVES: The goal of this study was to identify the highest scoring available pelvic anatomy apps based on quality, content, and functionality for obstetrician-gynecologists using a validated tool. STUDY DESIGN: This was a systematic evaluation of anatomy apps in the Apple iTunes (iOS) and Google Play (Android) stores...

IMPORTANCE: Antibiotics are commonly used to treat and prevent urinary tract infection (UTI), but resistance is growing. Nonantibiotic prophylaxis such as methenamine hippurate (MH) shows clinical promise, but its impact on bladder factors influencing recurrent UTIs (rUTIs) is not well described. OBJECTIVE: The aim of the study was to examine the effect of MH on bladder inflammation and barrier function in aged mice and women with rUTI. STUDY DESIGN: This study included urine samples from an experimental study involving aged female mice with and without methenamine treatment as well as women with rUTI who received either no prophylaxis, MH alone, vaginal estrogen therapy and/or d-mannose alone, or MH in addition to vaginal estrogen therapy and/or d-mannose...