Skeletal muscle relaxants for the treatment of myofascial pelvic pain and high tone pelvic floor disorders.

Purpose Of Review: Chronic pelvic main is a complex process that includes many causes. In gynecology, the treatment of myofascial pelvic pain and high tone pelvic floor disorders can be managed with skeletal muscle relaxants for select clinical indications. A review of skeletal muscle relaxants will be included for gynecologic indications.

Role of video self-assessment in laparoscopic simulation training: a randomized pilot trial.

Background: Residency programs have implemented simulation training to compensate for reduced operating room exposure. Video recording is an educational tool that can be utilized for coaching, telepresence, and self-assessment during simulation training. Data is limited on the utility of video recording and self-assessment for laparoscopic training in Ob/Gyn residency programs.

Gender Equity in Academic Female Pelvic Medicine and Reconstructive Surgery Departments: A Cross-Sectional Observational Study.

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 observational study of all FPMRS divisions with an Accreditation Council for Graduate Medical Education-accredited fellowship program in the United States in July 2020 using publicly available demographic and academic data collected from online search engines.

Association of Myomectomy With Anti-Müllerian Hormone Levels and Ovarian Reserve.

Objective: To assess whether open and minimally invasive myomectomy are associated with changes in postoperative ovarian reserve as measured by serum anti-müllerian hormone (AMH) level.

Methods: This prospective cohort study included patients who were undergoing open abdominal myomectomy that used a tourniquet or minimally invasive (robot-assisted or laparoscopic) myomectomy that used vasopressin. Serum AMH levels were collected before the procedure and at 2 weeks, 3 months, and 6 months after surgery.

Surgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database.

Objectives: Despite increasing use of robotic technology for minimally invasive hysterectomy with sacrocolpopexy, evidence supporting the benefits of these costly procedures remains inconclusive. This study aimed to compare differences in perioperative complications, 30-day readmissions, and costs between robot-assisted and conventional laparoscopic hysterectomy with concurrent sacrocolpopexy using a large national database.

Methods: Using the 2009-2015 Nationwide Readmissions Database and procedure codes, we identified patients who underwent a robot-assisted or conventional laparoscopic hysterectomy with sacrocolpopexy.

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.

Correlation of surgical case volume and fellowship training with performance on simulated procedural tasks.

Background: High-volume and fellowship-trained surgeons have superior outcomes. However, in gynecology, a large proportion of cases are performed by low-volume surgeons. Simulation has been shown to be useful in assessing surgical skill and may be a useful tool in hospital credentialing and maintenance of privileges.

Quality metrics in minimally invasive gynecologic surgery.

Purpose Of Review: Quality improvement and patient safety are relevant to the advancement of clinical care, particularly in the field of minimally invasive gynecologic surgery (MIGS). Although safety and feasibility of MIGS have been established, identification of quality metrics in this field is also necessary.

Recent Findings: Surgical quality improvement has focused on national overarching measures to reduce mortality, surgical site infections (SSIs), and complications.

Virtual Interviews During COVID-19: Perspectives of Female Pelvic Medicine and Reconstructive Surgery Program Directors.

Objective: The aim of the study was to evaluate female pelvic medicine and reconstructive surgery (FPMRS) fellowship program directors' opinions regarding the effectiveness of virtual interviews for selecting fellows and their future interview mode preferences.

Methods: This was a cross-sectional online survey of all FPMRS program directors in the United States conducted from April 29, 2020, to May 30, 2020. At the time of this study, there were 73 program directors and 69 obstetrics and gynecology and urology-accredited FPMRS programs nationwide.

Olanzapine for the Prevention of Postdischarge Nausea and Vomiting after Ambulatory Surgery: A Randomized Controlled Trial.

Background: Postdischarge nausea and vomiting after ambulatory surgery is a common problem that is not adequately addressed in current practice. This prospective, randomized, double-blind, parallel-group, placebo-controlled study was designed to test the hypothesis that oral olanzapine is superior to placebo at preventing postdischarge nausea and vomiting.

Methods: In a single-center, double-blind, randomized, placebo-controlled trial, the authors compared a single preoperative dose of olanzapine 10 mg to placebo, in adult female patients 50 years old or less, undergoing ambulatory gynecologic or plastic surgery with general anesthesia.

Optimal Interval of Time from Operative Hysteroscopy to Embryo Transfer in an In Vitro Fertilization Cycle.

Study Objective: Data are limited regarding optimal timing between operative hysteroscopy and embryo transfer (ET). This study aimed to assess whether the time interval from operative hysteroscopy to ET affects implantation and clinical pregnancy rates.

Design: Retrospective cohort study (Canadian Task Force classification II-2).

Use of Paracervical Block Before Laparoscopic Supracervical Hysterectomy.

Background And Objective: Some patients who undergo laparoscopic hysterectomy request overnight admission for pain management, thus increasing costs for a surgery that is safe for same-day discharge. We wanted to evaluate whether a paracervical block of bupivacaine with epinephrine before laparoscopic supracervical hysterectomy would decrease overnight admission rates, postoperative pain, and pain medication requirement.

Methods: This was a randomized, double-blind, placebo-controlled, parallel-group trial (Canadian Task Force classification I) at an academic medical center.

Detection of endometrial precancer by a targeted gynecologic cancer liquid biopsy.

Endometrial cancer is the most common gynecologic malignancy in industrialized countries, and both its incidence and its associated mortality are increasing. The "liquid biopsy" is becoming an important transformative precision oncology tool, but barriers intrinsic to blood sampling have limited its use in early cancer detection. We hypothesized that using a more targeted sample for analysis-namely, a uterine lavage-should provide a more sensitive and specific diagnostic test for endometrial cancer.

Resident simulation training improves operative time of the retropubic midurethral sling procedure for stress incontinence.

Introduction And Hypothesis: Our aim was to assess whether immediate preoperative resident simulation training decreases operative time and improves resident proficiency when performing a retropubic midurethral sling (MUS) procedure.

Methods: This prospective cohort study took place over 8 months at the Icahn School of Medicine, New York, USA. During the first 4 months, all retropubic MUS procedures were performed by residents who underwent immediate preoperative simulation training.

Beta-3 adrenoceptor expression in the uterosacral ligament in the postmenopausal women with pelvic organ prolapse.

Aims: β3-adrenoceptor (β3-AR) agonist is known to relax the detrusor muscles. Considering that both pelvic organ prolapse (POP) and overactive-bladder (OAB) are frequently seen in the elderly population, the effect of β3-AR agonist on the pelvic floor tissues should be investigated. As a first step, this pilot, experimental, and descriptive study was designed to investigate the presence of β3-AR expression in the uterosacral-ligaments (USLs) in postmenopausal (PMP) women with POP.

Transdermal light neuromodulation: Optogenetics in the murine urinary tract.

Background: Optogenetics is a biologic technique that uses light to control living neurons, which have been genetically modified to express light-sensitive ion-channels.

Objectives: Using an adenovirus to modify the sciatic nerves of mice, we aim to demonstrate peripheral neuromodulation of bladder pain using transdermal light.

Study Design: This pilot study is divided into: A) Confirmation and Application and B) Behavioral Step.

Neurologic injury and patient displacement in gynecologic laparoscopic surgery using a beanbag and shoulder supports.

Objective: To quantify the incidence of peripheral neuropathy in gynecologic laparoscopic surgery using a combination of beanbag, eggcrate foam, and shoulder supports; and to assess patient displacement during surgery in a steep Trendelenburg position and determine variables correlated with displacement.

Methods: A retrospective study included all gynecologic laparoscopic surgeries performed by one high-volume surgeon at a US center between September 15, 2007, and September 15, 2012. Data included neurologic deficits or extremity pain, any other complications, and-for the final study year-surgical time as well as patient and beanbag displacement.

Comparison of the Memory Foam Pad Versus the Bean Bag with Shoulder Braces in Preventing Patient Displacement during Gynecologic Laparoscopic Surgery.

Study Objective: To compare the amount of patient displacement when a memory foam pad is used versus a bean bag with shoulder braces. The secondary aim was to evaluate for postoperative extremity symptoms including pain, numbness, and weakness.

Design: A prospective randomized pilot study (Canadian Task Force classification I).

Predictors of laparoscopic simulation performance among practicing obstetrician gynecologists.

Background: While simulation training has been established as an effective method for improving laparoscopic surgical performance in surgical residents, few studies have focused on its use for attending surgeons, particularly in obstetrics and gynecology. Surgical simulation may have a role in improving and maintaining proficiency in the operating room for practicing obstetrician gynecologists.

Objective: We sought to determine if parameters of performance for validated laparoscopic virtual simulation tasks correlate with surgical volume and characteristics of practicing obstetricians and gynecologists.

A pilot study of cardiac electrophysiology catheters to map and pace bladder electrical activity.

Aims: This is a pilot study to evaluate the feasibility of using diagnostic cardiac electrophysiology catheters for recording intrinsic urinary bladder electrical activity and for electrical pacing capture of bladder tissue.

Methods: During cystoscopy, a curved quadripolar catheter was introduced and contact was made with the right and left halves of the dome and trigone in adult female patients undergoing cystoscopy. Electrical activity was recorded, using a commercially available cardiac electrophysiologic recording system, before and during pacing at 0.

Patient Preferences for Abdominal Incisions Used for Pelvic Organ Prolapse Surgery.

Objectives: Approaches for performing sacrocolpopexy (laparotomy, laparoscopy, and robotically assisted) differ with regard to length of surgery, postoperative pain, and cosmetic appearance of skin incisions. The aim of our study is to better understand what factors influence patient preferences for surgical approach.

Methods: A cross-sectional study was performed using a survey.