Obstetrics and Gynecology Trainee Insights Regarding the Effect of the Supreme Court Decision.

The impact of the (Dobbs) Supreme Court decision on training of United States Obstetrics and Gynecology (OBGYN) residents and fellows needs qualitative exploration. We aimed to describe how OBGYN residents and fellows feel their training may be affected. We disseminated a REDCap survey from September 19, 2022, to December 1, 2022, among OBGYN residents and fellows with open-ended questions querying trainees' opinions around how the Dobbs decision may affect their training and the field of OBGYN.

Patient Experience and Healthcare Access Among Women With Recurrent Urinary Tract Infections.

Introduction: Up to 60% of women in the United States will experience a urinary tract infection (UTI) in their lifetime, making it one of the most common infections amongst women. This study aims to explore themes related to patient experiences and barriers to care when accessing and receiving care for recurrent UTIs (rUTIs).

Methods: This was a qualitative cohort study with a cross-sectional survey.

The Role of Uterine Preservation at the Time of Pelvic Organ Prolapse Surgery.

Objective: The aim of the study was to synthesize the current literature and provide surgeons with data to inform counseling of eligible patients for uterine-preserving prolapse surgery (UPPS).

Methods: We compared UPPS to similar techniques incorporating hysterectomy, including native-tissue repairs by vaginal, laparoscopic, or open approach; mesh-reinforced repairs by vaginal, laparoscopic, or open approach; obliterative repairs; and the Manchester procedure. Reviewed outcomes include surgical and patient-reported outcomes, complications, uterine pathology, and sexual function.

Associations between hysterectomy and pelvic floor disorders: a systematic review and meta-analysis.

Objective: Hysterectomy is the second most common surgery performed among women in the United States. The associations between hysterectomy and the risk of pelvic floor disorders remain unclear. The objective of this study is to systematically review the associations between hysterectomy and the likelihood of pelvic floor disorders.

Surgical retreatment after native-tissue apical prolapse surgery with hysterectomy vs hysteropexy.

Background: Interest in uterine-sparing procedures has increased due to the potential for lower blood loss and shorter operative time. Surgical efficacy of hysteropexy relative to traditional hysterectomy-based prolapse procedure remains uncertain over the long-term.

Objective: The objective of our study was to determine if there is a difference in the rate of surgical retreatment for prolapse after native-tissue apical prolapse surgery with hysterectomy vs uterine preservation.

Postoperative Activity Restrictions After Reconstructive Pelvic Surgery.

Importance: Restrictive physical activity after pelvic reconstructive surgery is recommended, although the optimal duration and intensity are not standardized.

Objective: This systematic review and meta-analysis aimed to evaluate the existing literature comparing clinical outcomes for liberal postoperative physical activity versus standard of care, defined as restricted postoperative physical activity, after pelvic reconstructive surgery.

Study Design: PubMed, CENTRAL, Scopus, Web of Science, and CINAHL databases were searched for observational and randomized studies comparing liberal postoperative physical activity and standard of care in women undergoing pelvic reconstructive surgery, reporting anatomic and functional outcomes.

Dynamic Changes of the Genital Hiatus at the Time of Prolapse Surgery: 1-Year Follow-Up Study.

Importance: The genital hiatus (GH) has been identified as a predictor of pelvic organ prolapse. An enlarged preoperative GH is a risk factor for recurrent prolapse after surgery.

Objective: The objective of this study was to determine the changes in preoperative and postoperative GH size compared with the intraoperative resting GH at 6 weeks and 12 months after native-tissue pelvic organ prolapse surgery.

Trainee Perspectives Regarding the Effect of the Supreme Court Decision on Obstetrics and Gynecology Training.

We aimed to describe obstetrics and gynecology (OBGYN) trainees' anticipation of how the U.S. Supreme Court decision may affect their training.

Surgical correction of the genital hiatus at the time of sacrocolpopexy - a 7-year Markov analysis: a cost-effectiveness analysis.

Introduction And Hypothesis: To perform a cost-effectiveness analysis of concurrent posterior repair performed at the time of laparoscopic hysterectomy with sacrocolpopexy over a 7-year time period. We hypothesize it is not cost-effective to perform a posterior colporrhaphy.

Methods: We used TreeAge Pro® to construct a decision model with Markov modeling to compare sacrocolpopexy with and without concurrent posterior repair (SCP and SCP+PR) over a time horizon of 7 years.

Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas: A Systematic Review.

Objective: To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms.

Data Sources: PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans.

Changes in sexual function over 12 months after native-tissue vaginal pelvic organ prolapse surgery with and without hysterectomy.

Background: There is a need to determine how preoperative sexual activity, uterine preservation, and hysterectomy affect sexual function after pelvic organ prolapse surgery.

Aim: (1) To determine changes in sexual function in women, stratified by preoperative sexual activity status, after native-tissue pelvic organ prolapse surgery. (2) To examine the impact of hysterectomy and uterine preservation on sexual function.

Intention matters: Success rate of bilateral salpingo-oophorectomy at the time of vaginal hysterectomy for pelvic organ prolapse.

Objective: The objective of this study was to determine the incidence of successful bilateral salpingo-oophorectomy at the time of vaginal hysterectomy for pelvic organ prolapse and to evaluate associated factors and success rate over time.

Study Design: This was a retrospective chart review of all women who underwent vaginal hysterectomy for pelvic organ prolapse who were consented for bilateral salpingo-oophorectomy "if possible" and "including extraordinary measures" between 2014 and 2019 at a tertiary medical center. Baseline demographic data along with prolapse stage, operative findings, operative time, and complications were recorded.

Who Places High Value on the Uterus? A Cross-sectional Survey Study Evaluating Predictors for Uterine Preservation.

Study Objective: To determine predictors for placing high value on the uterus in patients who no longer desire fertility. The secondary objective was to identify reasons for placing high value on the uterus.

Design: Cross-sectional survey study.

Revision sacrocolpopexy: tips and tricks for optimal outcomes.

Introduction And Hypothesis: The aim of this video is to highlight important considerations and techniques for revision sacrocolpopexy in women with symptomatic recurrence of pelvic organ prolapse after sacrocolpopexy.

Methods: In this video, we show five patients who presented with recurrent symptomatic pelvic organ prolapse after prior sacrocolpopexy. We demonstrate techniques for robotic-assisted laparoscopic sacrocolpopexy revision including surgical dissection, revision of existing mesh, and/or addition of new mesh.

Determining the Ideal Intraoperative Resting Genital Hiatus Size-Balancing Surgical and Functional Outcomes.

Importance: The intraoperative resting genital hiatus (GH) size can be surgically modified but its relationship to prolapse recurrence is unclear.

Objectives: The objective of this study was to identify the optimal intraoperative resting GH size as it relates to prolapse recurrence and functional outcomes at 1 year.

Study Design: This prospective cohort study was conducted at 2 hospitals from 2019 to 2021.

Development and validation of the Value of Uterus instrument and visual analog scale to measure patients' valuation of their uterus.

Background: Currently, there are no clear frameworks or tools to objectively or subjectively evaluate patient attitudes toward uterine preservation and how they influence the decision to proceed with hysterectomy vs uterine preservation when undergoing prolapse surgery.

Objective: This study aimed to develop a reliable and valid instrument to measure patients' valuation of their uterus.

Study Design: The Value of Uterus instrument was developed on the basis of existing literature and created with structured patient-reported outcome measurement development methodology.

Surgical Correction of the Genital Hiatus at the Time of Sacrocolpopexy-Are Concurrent Posterior Repairs Cost-Effective?

Objective: The objective was to perform a cost-effectiveness analysis of posterior repair performed at the time of sacrocolpopexy (SCP).

Methods: We used TreeAge Pro to construct a decision model comparing laparoscopic hysterectomy with SCP with and without concurrent posterior repair (SCP and SCP + PR). Using a time horizon of 1 year, we modeled prolapse recurrence, prolapse retreatment, and complications, including rectal injury, rectovaginal hematoma requiring surgical take-back, and postoperative dyspareunia.

Perioperative outcomes in a nationwide sample of patients undergoing surgical treatment of ovarian endometriomas.

Objective: To evaluate the perioperative outcomes of premenopausal women undergoing cystectomy or oophorectomy for ovarian endometriomas (OMAs) and other benign neoplasms.

Design: Retrospective cohort study.

Setting: Clinical database containing information from 580 US hospitals.

Surgical Correction of Pelvic Organ Prolapse Has No Effect on Renal Function.

Objective: The aims of the study were to determine whether symptomatic pelvic organ prolapse (POP) is a cause of subclinical renal impairment by characterizing baseline renal function in women undergoing surgical correction for POP and to assess the effect of surgical POP repair on estimated glomerular filtration rate (eGFR) postoperatively.

Methods: A prospective cohort study was designed to evaluate women undergoing surgical repair for at least stage II anterior or apical POP at a single institution. Data collected included preoperative serum creatinine values, patient demographics, and clinical risk factors for renal impairment.

Surgical Outcomes in Benign Gynecologic Surgery Patients during the COVID-19 Pandemic (SOCOVID study).

Study Objective: To determine the incidence of perioperative coronavirus disease (COVID-19) in women undergoing benign gynecologic surgery and to evaluate perioperative complication rates in patients with active, previous, or no previous severe acute respiratory syndrome coronavirus 2 infection.

Design: A multicenter prospective cohort study.

Setting: Ten institutions in the United States.