Racial Disparities in Medical Management of Uterine Fibroids Prior to Myomectomy or Hysterectomy.

The symptomatic burden of uterine fibroids has been demonstrated to disproportionately affect Black and Hispanic women. The primary aim of this study was to evaluate if racial disparities seen in disease severity in regards to bleeding symptoms and surgical management also applied to presurgical medical management. A retrospective chart review evaluated women aged 18-50 with the diagnosis of fibroids who underwent a myomectomy or hysterectomy between 2012 and 2021.

The Relationship and Expression of , and in Early Peritoneal Endometriotic Lesions and Their Modulation In Vitro.

Background: can function as a tumor suppresser and has been shown to be elevated in both endometriotic lesion tissue and serum from women with endometriosis. To further explore the role of miR-451a in the pathophysiology of endometriosis, specifically, further evaluating its association with the tumor suppressor, phosphatase and tensin homolog (PTEN), we examined their expression in individual endometriotic lesion tissue to gain insight into their relationship and further explore if regulates PTEN expression.

Methods: A total of 55 red, peritoneal endometriotic lesions and matched eutopic endometrial specimens were obtained from 46 patients with endometriosis.

Chronic Pelvic Pain Educational Experience Among Minimally Invasive Gynecologic Surgery Fellows and Recent Graduates: A Needs Assessment.

Study Objective: Learning to evaluate and treat chronic pelvic pain (CPP) is an established curriculum objective within the Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). Our aim was to investigate current educational experiences related to the evaluation and management of CPP and the impacts of those experiences on FMIGS fellows and recent fellowship graduates, including satisfaction, confidence in management, and clinical interest in CPP.

Design: The AAGL-Elevating Gynecologic Surgery Special Interest Group for pelvic pain developed a 33-item survey tool to investigate the following topics: (1) current educational experiences with the assessment and management of patients with CPP, (2) satisfaction with fellowship training in CPP, (3) perceived preparedness to treat patients with CPP, (4) plans to incorporate management of CPP into clinical practice, and (5) perceived desires to expand CPP exposure.

Selecting the Appropriate Patient for Opioid Therapy: Risk Assessment and Treatment Strategies for Gynecologic Pain.

Chronic pelvic pain is a commonly encountered clinical entity, and many women with this chronic pain condition will be treated at some point in time with opioids for management of their pain. Clinicians in women's health are frequently asked and expected to participate in the care of women with chronic pelvic pain, as well as other gynecologic pain conditions, and should be familiar with the role of opioid therapy for these conditions. The goal of this article is to help determine which patients may be appropriate candidates for the initiation or continuation of opioid therapy for gynecologic pain.

Cesarean Scar Ectopic Pregnancy: Current Management Strategies.

Importance: Cesarean scar ectopic pregnancy (CSEP) has a high rate of morbidity with nonspecific signs and symptoms making identification difficult. The criterion-standard treatment of CSEP has been subject to debate.

Objective: This review defines CSEP, discusses pathogenesis and diagnosis, and compares treatment options and outcomes.

Hysteroscopic morcellator to overcome cervical stenosis.

Objective: To report a step-by-step technique to using a hysteroscopic morcellator to safely gain access into the intrauterine cavity in two patients with severe cervical stenosis and concomitant intrauterine pathology.

Design: Video article introducing the hysteroscopic morcellator for overcoming severe cervical stenosis.

Setting: Academic-based practice.

Prevention and management of urologic injury during gynecologic laparoscopy.

Purpose Of Review: This article provides an update on the best practices for the prevention, recognition, and management of urinary tract injuries that may occur during gynecologic laparoscopic surgery.

Recent Findings: Higher surgical volume is directly associated with improved surgical outcomes, denoted by consistently lower rates of complications for commonplace procedures such as hysterectomy. As a result, expert opinion on prevention of iatrogenic urologic injury suggests a real need for improved education and training of gynecologic surgeons.

Post-hysterectomy dyspareunia.

When appropriately performed, hysterectomy most often contributes substantially to quality of life. Postoperative morbidity is minimal, in particular after minimally invasive surgery. In a minority of women, pain during intercourse is one of the more long-lasting sequelae of the procedure.

Mechanical bowel preparation before laparoscopic hysterectomy: a randomized controlled trial.

Objective: To examine the influence of mechanical bowel preparation on surgical field visualization during laparoscopic hysterectomy.

Methods: The study's primary outcome was the percentage of operations rated "good" or "excellent" in terms of surgical field visualization at the outset of the case by the primary surgeon. Additional measures included assessment of visualization during the case and patient perioperative comfort.

Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial.

Objective: To examine the short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve when ovarian preservation is planned in view of determining the feasibility of conducting the study on a larger scale.

Design: Pilot randomized controlled trial.

Setting: Tertiary care, academic medical center.

Cornual placenta accreta managed by postpartum total laparoscopic hysterectomy.

The patient presented here delivered at 32 weeks' gestation after expectant management of spontaneous preterm membrane rupture. She had an unusually located placenta accreta at the left cornu that required a hysterectomy for treatment. The type of abnormal placentation and the laparoscopic approach to her surgery were unique features of her care.

Effect of extreme obesity on outcomes in laparoscopic hysterectomy.

Study Objective: To estimate the effect of body mass index (BMI) on several outcomes in laparoscopic hysterectomy, in particular in the extremes of obesity.

Design: Retrospective cohort study (Canadian Task Force classification II-3).

Setting: Tertiary-care university-based teaching hospital.