Best Practices: Ultrasound Versus MRI in the Assessment of Pelvic Endometriosis.

Endometriosis is a common yet morbid disease. Imaging plays an important role in diagnosis and treatment planning. Both ultrasound (US) and MRI are used to detect disease.

Surgical Management of Endometriosis Involving the Bladder and Ureter.

Background: Endometriosis is a chronic, debilitating condition affecting up to 10% of reproductive-age women. Urinary tract endometriosis is found in 1%-6% of women diagnosed with pelvic endometriosis, with the most common sites being the bladder (70%-85%), ureter (9%-23%), and kidney (4%). Patients typically present with symptoms such as lower abdominal pain, dysuria, and urgency.

Association Between Laparoscopic Appearance of Superficial Endometriosis, Positive Histology, and Systemic Hormone Use.

Study Objective: To assess the association between laparoscopic appearance of superficial endometriosis lesions, histopathology, and systemic hormone use.

Design: Retrospective study.

Setting: Tertiary care academic medical center.

Interactive video module and simulated model for uterine manipulation during laparoscopic hysterectomy.

Background: Hysterectomy is one of the most common gynecologic surgeries, with an increasing proportion of hysterectomies performed by a laparoscopic approach. Uterine manipulation is critical for patient safety and surgical efficiency; however, the most junior member of the surgical team assumes the responsibility of uterine manipulation, commonly without preparation. The objective of our study was to determine whether kinesthetic learning using a low-cost simulated pelvic model while learning the uterine manipulation maneuvers of a laparoscopic hysterectomy improves learning efficacy and application efficiency compared to an interactive video module alone.

Endometriosis biomarkers of the disease: an update.

Purpose Of Review: Endometriosis is a complex benign gynaecologic condition with heterogenous presentations and a large impact on the global healthcare system and on the quality of life for millions of women. Currently, the gold standard for diagnosis involves direct visualization of lesions during surgery confirmed by histopathological diagnosis, resulting in an average delay in its initial diagnosis of 8-10 years. Therefore, the search for noninvasive diagnostic testing options has been subject to a large body of research.

Excision of Deep Endometriosis of the Rectosigmoid: Individualizing Care to the Presenting Pathology.

Study Objective: To highlight different surgical approaches for managing deep infiltrating endometriosis involving the rectosigmoid colon.

Design: Demonstration of specific surgical techniques with educational narrated video footage.

Setting: Bowel endometriosis is reported in 3.

Surgical Science-Simbionix Robotic Hysterectomy Simulator: Validating a New Tool.

Study Objective: To gather validity evidence for and determine acceptability of Surgical Science-Simbionix Hysterectomy Modules for the DaVinci Xi console simulation system (software; 3D Systems by Simbionix [now Surgical Science-Simbionix], Littleton, CO, and hardware; Intuitive Surgical, Inc., Sunnyvale, CA) and evaluate performance benchmarks between novice and experienced or expert surgeons.

Design: Prospective education study (Messick validity framework).

Current and Future Medical Therapies for Adenomyosis.

There is no approved medical therapy for adenomyosis and limited evidence to guide treatments in part due to the complexity of nonhistologic diagnosis and the prevalence of concomitant gynecologic conditions. Most available evidence focuses on the treatment of heavy menstrual bleeding, painful menses, and pelvic pain. Data evaluating fertility outcomes, sexual function, and quality of life following treatment are lacking.

Safety of Minimally Invasive Tissue Extraction in Myoma Management: A Systematic Review.

Objective: This review seeks to establish the incidence of adverse outcomes associated with minimally invasive tissue extraction at the time of surgical procedures for myomas.

Data Sources: Articles published in the following databases without date restrictions: PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews and Trials. Search was conducted on March 25, 2020.

Non-extirpative Treatments for Uterine Myomas: Measuring Success.

Objective: To analyze outcomes of nonextirpative treatments for uterine myomas compared with myomectomy.

Data Sources: A systematic search of the following databases from inception to January 2020 was performed: Ovid Medline, Embase, PubMed, and Cochrane Controlled Register of Trials.

Methods Of Study Selection: Two authors reviewed titles and abstracts for relevance, and full articles were obtained and evaluated for inclusion.

Abdominal Ice after Laparoscopic Hysterectomy: A Randomized Controlled Trial.

Study Objective: To assess the impact of abdominal ice packs on opioid use and pain control after laparoscopic hysterectomy DESIGN: Randomized controlled trial.

Setting: Academic tertiary care medical center.

Patients: Total of 142 adult women undergoing laparoscopic (either conventional or robotic) hysterectomy were randomized to control (n = 69) or intervention (n = 73).

External beam radiotherapy versus vaginal brachytherapy in patients with stage II endometrial cancer: a systematic review and meta-analysis.

Objective: The choice of adjuvant treatment for women with stage II endometrial cancer is challenging, given the known increase in morbidity with external beam radiation compared with vaginal brachytherapy, and the lack of consensus on its benefits. We summarized the evidence on survival and recurrence for stage II endometrial cancer, defined as cervical stromal invasion, after adjuvant postoperative external beam radiotherapy and vaginal brachytherapy.

Methods: We searched the MEDLINE, EMBASE, CENTRAL, and Scopus databases from inception to January 2019 to identify studies that compared adjuvant postoperative external beam radiotherapy with or without vaginal brachytherapy and vaginal brachytherapy alone in stage II endometrial cancer.

MRI impacts endometriosis management in the setting of image-based multidisciplinary conference: a retrospective analysis.

Purpose: The aim of the study was to quantify the value of pre-operative magnetic resonance imaging (MRI) in guiding surgical management of women with endometriosis.

Methods: Pre-operative discussion of patient management and review of imaging occurred for 136 patients with endometriosis in an MRI-based multidisciplinary conference co-directed by an abdominal radiologist and gynecologic surgeon. A tri-compartmental report template guided the systematic imaging review.

Endometriosis in the postmenopausal female: clinical presentation, imaging features, and management.

Postmenopausal endometriosis is an important clinical entity which is likely under-recognized and in which the Radiologist can play a valuable role. In this review, we describe the clinical presentation and management of postmenopausal endometriosis, appraising the literature and providing case examples. Persons with postmenopausal endometriosis may present with symptoms including pelvic pain or dyschezia, but endometriosis may also be an asymptomatic, incidental finding.

Postpartum Contraception Usage Among Somali Women in Olmsted County, Minnesota.

Objective: To compare postpartum contraception use between Somali and non-Somali women.

Methods: A retrospective cohort study was performed using the Rochester Epidemiology Project. All Somali women aged 18 and older with live singleton births in Olmsted County, Minnesota, in 2009-2015 (n=317) were included, and a group of age-matched non-Somali women (n=317) were identified.

Implementation of the "Pregnancy Reasonably Excluded Guide" for Pregnancy Assessment: A Quality Initiative in Outpatient Gynecologic Surgery.

Objective: Preoperative evaluation for pregnancy at our institution lacked standardization among individual health care providers and surgical services. This pilot project aimed to improve assessment for pregnancy before scheduled outpatient gynecologic surgical procedures. The Pregnancy Reasonably Excluded Guide incorporates historic, evidence-based criteria to facilitate identification of patients with a higher chance of pregnancy.

Clinical Manifestations and Outcomes in Surgically Managed Gartner Duct Cysts.

Study Objective: Gartner duct cysts (GDCs) are rare embryological remnants of the mesonephric duct with the majority of cases discovered incidentally in asymptomatic patients. The largest prior published series evaluating the surgical management of GDCs included 4 patients. The present study aimed to determine the manifestations and outcomes of surgically managed patients with GDCs with important implications for surveillance, monitoring, and management.