Multimodal Radiographic Diagnosis of a Complex Müllerian Anomaly: A Case Report.

As evidenced by the 2021 American Society for Reproductive Medicine Müllerian Anomaly Classification (ASRM MAC), there are numerous possible configurations of the female genitourinary system. Some anomalies place patients at higher risk of infertility, miscarriage, fetal malpresentation, and preterm labor. Correct characterization of Müllerian anomalies is critical for proper infertility treatment and pregnancy counseling.

Testosterone therapy in females is not associated with increased cardiovascular or breast cancer risk: a claims database analysis.

Background: Testosterone therapy (TTh) has been shown to improve libido in women with sexual dysfunction, but its utilization has been limited due to concern for cardiovascular events and past studies reporting highly variable results.

Aim: To assess the association of TTh in women with major adverse cardiac events (MACEs), including heart attack, stroke, or death, using a large database.

Methods: The TriNetX Diamond Network was queried from 2009 to 2022.

Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder-a claims database analysis.

Background: Testosterone therapy (TTh) is recommended for postmenopausal women with hypoactive sexual desire disorder (HSDD); however, there remain insufficient data to support use of TTh in premenopausal women with sexual dysfunction.

Aim: In this study, we used a large national database to evaluate prescribing trends of TTh for women with HSDD.

Methods: We conducted a cohort analysis of information from electronic health records acquired from the data network TriNetX Diamond.

Involvement of vulva in lichen sclerosus increases the risk of antidepressant and benzodiazepine prescriptions for psychiatric disorder diagnoses.

While vulvar lichen sclerosus (VLS) causes intense pruritus, associated risks of mood disorders and prescription patterns and impact of concurrent sexual dysfunction are unknown. We queried TriNetX Diamond Network between 2009 and 2022, conducting three comparisons after propensity-score matching for demographics and relevant comorbidities: (1) women with lichen sclerosus (LS) sparing the vulva vs. women with VLS; (2) VLS patients who received treatment within 6 months of diagnosis vs.

Reduction in preterm birth among COVID-19-vaccinated pregnant individuals in the United States.

Background: Most studies investigating preterm birth and COVID-19 vaccination have suggested no difference in preterm birth rates between vaccinated and unvaccinated pregnant individuals; however, 1 recent study suggested a protective effect of COVID-19 vaccination on preterm birth rates in Australia.

Objective: This study aimed to determine whether a similar association and protective effect of COVID-19 vaccination on preterm birth would be found in our multistate, US cohort.

Study Design: A cohort study was conducted using the Vizient Clinical Database, which included data from 192 hospitals in 38 states.

Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer.

Objective: To assess the risk of recurrence of breast cancer associated with vaginal estrogen therapy in women diagnosed with genitourinary syndrome of menopause with a history of breast cancer using a large U.S. claims database.

Laparoscopic administration of bupivacaine at the uterosacral ligaments during benign laparoscopic and robotic hysterectomy: a randomized controlled trial.

Background: Postoperative pain continues to be an undermanaged part of the surgical experience. Multimodal analgesia has been adopted in response to the opioid epidemic, but opioid prescribing practices remain high after minimally invasive hysterectomy. Novel adjuvant opioid-sparing analgesia to optimize acute postoperative pain control is crucial in preventing chronic pain and minimizing opioid usage.

The relationship between COVID-19 vaccination status in pregnancy and birthweight.

Background: Despite findings that maternal COVID-19 infection in pregnancy is associated with low birthweight (weight of ≤2500 g), previous studies demonstrate no difference in low birthweight risk between COVID-19 vaccinated and unvaccinated pregnant persons. Few studies, however, have examined the association between unvaccinated, incomplete vaccination, and complete vaccination on low birthweight, and they have been limited by small sample sizes and lack of adjustment for covariates.

Objective: We sought to address key limitations of prior work and evaluate this association between unvaccinated, incomplete, and complete COVID-19 vaccination status in pregnancy and low birthweight.

Perioperative Pain Management With Opioid Analgesics in Colpopexy Increases Risk of New Persistent Opioid Usage.

Importance: Although the use of perioperative pain medications is highly investigated, limited studies have examined the usage of pain medication for post hysterectomy prolapse repair and the few that have have been restricted to smaller sample sizes.

Objective: Our objective was to assess the association of perioperative opioid usage after posthysterectomy prolapse repairs with development of new persistent opioid usage.

Study Design: The TriNetX Diamond Research Network was queried to create our cohorts of opioid-naive adult women with vaginal repair or laparoscopic sacrocolpopexy.

Polypharmacy and Multimorbidity in the Urogynecology Population and Their Effect on Pelvic Floor Symptoms.

Importance: Polypharmacy and multimorbidity are common in older adults but has not been well studied in the urogynecologic patient population.

Objectives: The objective of this study was to determine the prevalence of polypharmacy and multimorbidity in a diverse outpatient urogynecologic population and to examine whether polypharmacy and/or multimorbidity were associated with lower urinary tract symptoms, pelvic organ prolapse, defecatory distress, and/or female sexual dysfunction.

Study Design: This is a secondary analysis of a dual-center cross-sectional study of new patients presenting for evaluation of pelvic floor disorders at 2 urban academic outpatient urogynecology clinics.

Perioperative opioid prescribing after male fertility procedures is associated with new persistent opioid use: retrospective analysis of a large claims database.

Objective: To assess the risk of new persistent opioid use in opioid-naïve men who underwent male fertility procedures.

Design: Retrospective cohort study using a claims database.

Setting: A database linking electronic medical record data and claims-assessing men who underwent fertility procedures between 2010 and 2021.

Cost drivers for benign hysterectomy within a health care system: Influence of patient, perioperative, and hospital factors.

Objective: To identify patient, perioperative, and hospital factors that drive total hospital charges for benign hysterectomy.

Methods: The authors conducted a retrospective cohort study between July 2014 and February 2019 at five academic and community hospitals within an integrated healthcare system in the state of Maryland with a Global Budget Revenue methodology for hospital charges. Predictor variables included patient, perioperative and hospital characteristics.

Risk Factors for Postoperative Narcotic Use in Benign, Minimally-Invasive Gynecologic Surgery.

Background And Objectives: To evaluate postoperative opioid use after benign minimally-invasive gynecologic surgery and assess the impact of a patient educational intervention regarding proper opioid use/disposal.

Methods: Educational pamphlets were provided preoperatively. Patients underwent hysterectomy, myomectomy, or other laparoscopic procedures.

The COVID-19 Residency Application Cycle Did Not Affect Geographic Dispersal Patterns Among Applicants Entering the Urology Match: A Quantitative Mapping Study.

Objective: To assess whether pandemic-related restrictions with video-based interviewing increased geographic clustering of urology applicants matching at a residency program near where they were raised or attended medical school.

Materials And Methods: We utilized publicly available data from the urology match to compare dispersal patterns between applicants matching during the COVID-19 application cycle (2021) and those matching in the 5 prior application cycles (2016-2020). Variables included home state, undergraduate institution, medical school, and residency.

Fertility-sparing Surgery for Patients with Cervical, Endometrial, and Ovarian Cancers.

Objective: Nearly 10% of the 1.3 million women living with a gynecologic cancer are aged <50 years. For these women, although their cancer treatment can be lifesaving, it's also life-altering because traditional surgical procedures can cause infertility and, in many cases, induce surgical menopause.

The Effect of Social Determinants of Health on Overactive Bladder Symptom Severity.

Purpose: Social determinants of health may significantly impact overall health and drive health disparities. We evaluated the association between social determinants of health and overactive bladder severity.

Materials And Methods: We conducted a multicenter, cross-sectional study of patients presenting to outpatient female pelvic medicine and reconstructive surgery clinics at Montefiore Medical Center (Bronx, New York) and Johns Hopkins Bayview Medical Center (Baltimore, Maryland) from November 2018 to November 2019.

Skin cancer risk and tanning in pageant contestants.

Since tanned skin may be perceived as a marker of beauty in American pageant culture, we evaluated pageant contestants regarding motivations for tanning, skin care behaviors, and possible tanning addiction. Responses were analyzed via summary statistics and compared across Fitzpatrick skin types. Statistically significant differences were found between skin types regarding tanning frequency, feelings of attractiveness after tanning, and perceptions of elevated mood after tanning.

Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function.

Objectives: Here we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers.

Methods: Men presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (PDE5) inhibitor use, and testosterone use.

Evaluation of Reported Fertility Preservation Counseling Before Chemotherapy Using the Quality Oncology Practice Initiative Survey.

Importance: The opportunity to discuss fertility preservation is essential for patients of reproductive age with newly diagnosed cancer before the initiation of treatment.

Objective: To identify factors associated with fertility preservation counseling among patients of reproductive age before initiating chemotherapy.

Design, Setting, And Participants: This cross-sectional study used data obtained from the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative, an oncologist-led quality assessment program that surveys approximately 400 oncology practices biannually, from January, 2015, to June, 2019.