Lower Urinary Tract Symptoms in Relation to Leiomyoma Volume, Location, and Position in Reproductive-aged Women in the USA.

Introduction And Hypothesis: Uterine leiomyomata are widely believed to contribute to lower urinary tract symptoms in women, but it is unclear whether leiomyoma size, position, and location have important implications for these symptoms. We assessed whether greater leiomyoma volume, anterior position, and subserosal location were associated with urinary incontinence and frequent urination in a racially diverse, nationwide sample of premenopausal women in the USA.

Methods: A cross-sectional analysis of 477 premenopausal women from 12 USA sites undergoing evaluation for laparoscopic radiofrequency ablation or myomectomy for leiomyomata was carried out.

A comparative analysis of generative artificial intelligence responses from leading chatbots to questions about endometriosis.

Introduction: The use of generative artificial intelligence (AI) has begun to permeate most industries, including medicine, and patients will inevitably start using these large language model (LLM) chatbots as a modality for education. As healthcare information technology evolves, it is imperative to evaluate chatbots and the accuracy of the information they provide to patients and to determine if there is variability between them.

Objective: This study aimed to evaluate the accuracy and comprehensiveness of three chatbots in addressing questions related to endometriosis and determine the level of variability between them.

Childcare as a social determinant of access to healthcare: a scoping review.

Introduction: As health systems strive to screen for and address social determinants of health (SDOH), the role of access to childcare and barriers to healthcare posed by childcare needs remains underexplored. A gap exists in synthesizing existing evidence on the role of access to childcare as a SDOH.

Methods: This scoping review aimed to examine and analyze existing literature on the role of childcare needs as a social determinant of access to healthcare.

Radiofrequency Ablation for the Treatment of Uterine Fibroids: A Systematic Review and Meta-Analysis by the AAGL Practice Committee.

Objective: To systematically review clinical and patient-reported outcomes after radiofrequency ablation (RFA) for the treatment of uterine fibroids.

Data Sources: We searched Medline, EMBASE, Cochrane Registry of Controlled Trials (CENTRAL) on September 8, 2023, and requested additional data from industry sources. We included published, peer-reviewed studies of patient-centered outcomes of RFA when used for symptomatic fibroids.

Video-Based Coaching for Laparoscopic Salpingectomy: A Randomized Controlled Trial.

Objective: To evaluate the effect of video-based coaching on the gynecology resident performance of laparoscopic salpingectomy.

Methods: PGY-1 and PGY-2 residents were randomized before their gynecology rotations to standard gynecology curriculum (control group) or standard curriculum plus two video-coaching sessions by a fellowship-trained minimally invasive gynecologic surgeon (VBC group). Residents were video recorded intraoperatively performing three unilateral laparoscopic salpingectomies.

Pregnancy Outcomes After Laparoscopic Radiofrequency Ablation of Uterine Leiomyomas Compared With Myomectomy.

Objective: To compare pregnancy outcomes after laparoscopic radiofrequency ablation and myomectomy.

Methods: The ULTRA (Uterine Leiomyoma Treatment With Radiofrequency Ablation) study is an ongoing multicenter prospective cohort study with longitudinal follow-up up to 5 years comparing outcomes of radiofrequency ablation with myomectomy in premenopausal women older than age 21 years with symptomatic uterine leiomyomas. Participants were queried every 6 months after surgery to assess the incidence of pregnancy and pregnancy outcomes.

Association between Endometriosis and Surgical Complications among Benign Hysterectomies.

Study Objective: To investigate the effect of endometriosis on perioperative outcomes in patients undergoing hysterectomy for benign disease.

Design: A retrospective cohort study.

Setting: The American College of Surgeons National Surgical Quality Improvement Program database.

Radiofrequency Ablation for Treatment of Leiomyomas: Review of the Manufacturer and User Facility Device Experience (MAUDE) Database.

Radiofrequency ablation (RFA) is a relatively novel, increasingly popular treatment option for leiomyomas. We studied medical device-related reports of leiomyoma RFA devices to determine whether there are emerging device-related issues. The Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database was queried from 2012 through November 2022.

Radiofrequency Ablation of Leiomyomas.

Radiofrequency ablation (RFA) of leiomyomas represents a significant advancement in the treatment of this common uterine condition. In the appropriately selected patient, both laparoscopic and transcervical options provide effective treatment for bleeding and bulk symptoms in a uterine-sparing manner. Compared with other minimally invasive leiomyoma treatment options, RFA procedures have comparable or favorable safety profiles, recovery timelines, and reintervention rates.

Ice-POP: Ice Packs for Postoperative Pain: A Randomized Controlled Trial.

Study Objective: To evaluate the benefit of ice packs as a supplement to standard pain management following laparoscopic hysterectomy (LH).

Design: This Institutional Review Board-approved randomized controlled trial involved patients undergoing LH for benign conditions. Subjects were randomized to receive standard enhanced recovery after surgery pain management or standard enhanced recovery after surgery plus ice packs.

Addressing childcare as a barrier to healthcare access through community partnerships in a large public health system.

Objective: In our public health system, a survey of reproductive-aged women identified lack of childcare as the most common reason for missing or delaying healthcare. Community-based organisations (CBOs) in our county identified a similar need, so we partnered to develop a hospital-based childcare centre for patients to use during appointments.

Methods: In a large academic public health system, a partnership with a non-profit childcare CBO was formed to address lack of childcare as a barrier to accessing healthcare.

A Randomized, Placebo-Controlled Trial Evaluating the Single and Combined Efficacy of Radiofrequency and Hybrid Fractional Laser for Nonsurgical Aesthetic Genital Procedures in Post-Menopausal Women.

Background: The efficacy of interventions that provide long-term relief of genitourinary symptoms of menopause has not been determined.

Objectives: The authors sought to evaluate radiofrequency and hybrid fractional laser (HFL) treatments for menopausal vulvovaginal symptoms.

Methods: Thirty-one postmenopausal women completed all treatments and at least 1 follow-up.

Enhanced Recovery After Surgery in Minimally Invasive Gynecologic Surgery.

Enhanced recovery after surgery (ERAS) is a multimodal, multidisciplinary approach to optimize patient outcomes by minimizing surgical stress with the goal of returning to normal physiologic function. Using minimally invasive surgery as the preferred route for gynecologic surgery is an integral component of ERAS and is strongly correlated with improved postoperative outcomes. Implementation of ERAS programs in minimally invasive gynecologic surgery results in substantial improvements in clinical outcomes with higher rates of same-day discharge, reduction in postoperative nausea and vomiting, improved patient satisfaction, and decreased opioid consumption without increase in complications, readmissions, or health care costs.

Preparing for the Fundamentals of Laparoscopic Surgery Exam: A Survey of Residents in Obstetrics & Gynecology.

Objective: To describe the actual work-load and experience for first-time resident test takers preparing to meet the new high stakes cognitive and technical skills testing requirement for board certification in Obstetrics and Gynecology.

Design: A retrospective observational study. Participating residents completed a 2 page questionnaire about their preparation for the exam.

Academic Medicine Faculty Perceptions of Work-Life Balance Before and Since the COVID-19 Pandemic.

Importance: How the COVID-19 pandemic has affected academic medicine faculty's work-life balance is unknown.

Objective: To assess the association of perceived work-life conflict with academic medicine faculty intention to leave, reducing employment to part time, or declining leadership opportunities before and since the COVID-19 pandemic.

Design, Settings, And Participants: An anonymous online survey of medical, graduate, and health professions school faculty was conducted at a single large, urban academic medical center between September 1 and September 25, 2020.

Current and Future Surgical and Interventional Management Options for Adenomyosis.

Historically, hysterectomy has been the recommended treatment for patients with adenomyosis. However, in the past two decades, various uterine-sparing treatment methods have emerged. These range from excisional techniques such as adenomyomectomy or wedge resection to uterine artery embolization, radiofrequency thermal ablation, hysteroscopic excision, endometrial ablation, and high-intensity focused ultrasound.