Pain experience with outpatient hysteroscopy: A prospective cohort study.

Background: Abnormal uterine bleeding (AUB) affects women of all ages and is one of the most common reasons for referral to a gynaecological clinic. Operative hysteroscopic procedures allow for a see-and-treat approach to AUB, and these techniques have been shown to be feasible and acceptable in the outpatient setting.

Objective: To assess if there is an increase in pain scores for women who are undergoing an operative hysteroscopic procedure with Myosure LITE® (Hologic; mechanical hysteroscopic tissue removal system) compared to outpatient diagnostic hysteroscopy alone.

Peripheral, Central, and Cross Sensitization in Endometriosis-Associated Pain and Comorbid Pain Syndromes.

Endometriosis-associated pain and the mechanisms responsible for its initiation and persistence are complex and difficult to treat. Endometriosis-associated pain is experienced as dysmenorrhea, cyclical pain related to organ function including dysuria, dyschezia and dyspareunia, and persistent pelvic pain. Pain symptomatology correlates poorly with the extent of macroscopic disease.

We live in a virtual world: Training the trainee using an integrated visual reality simulator curriculum.

Background: Gynaecology trainees struggle to obtain adequate procedural experience. Training programs integrating virtual reality simulators (VRS) have been suggested as a solution.

Aims: The study aimed to assess if a VRS training program (LapSim , Surgical Sciences, Göteborg, 2017) improved live operating performance at six months for novice and experienced trainees.

Telehealth for gynaecology outpatients during the COVID-19 pandemic: Patient and clinician experiences.

Background: The COVID-19 pandemic has necessitated alterations in provision of health care and how patients access it. Telehealth has replaced traditional face-to-face outpatient clinics in an unprecedented manner. This study aimed to assess overall patient and clinician satisfaction with telehealth consultations, to establish acceptability of telehealth during pandemic and non-pandemic times, and document feedback.

Preoperative Imaging in Patients with Deep Infiltrating Endometriosis: An Important Aid in Predicting Depth of Infiltration in Rectosigmoid Disease.

Study Objective: To determine the diagnostic accuracy of specialist-performed transvaginal ultrasound (TVUS) and pelvic magnetic resonance imaging (MRI) modalities in predicting depth of deep infiltrating endometriosis (DIE) of the rectosigmoid by comparison with histologic specimens obtained at surgery.

Design: A retrospective analysis, which met the Standards for Reporting of Diagnostic Accuracy Studies (2015) guidelines for a diagnostic accuracy study.

Setting: Tertiary teaching hospital.

Hysteroscopic management of retained products of conception: A systematic review.

Background: The management of retained products of conception (RPOC) is not well standardised due to a lack of evidence-based guidelines. Hysteroscopic resection has been proven to be safe and is hypothesised to have lower risk than dilation and curettage, but data comparing the two directly are limited.

Aim: The aim of this study is to evaluate the outcomes for hysteroscopic resection for the management of RPOC in comparison to current standard management techniques.

The myometrial-cervical ratio (MCR): Assessing the diagnostic accuracy of a novel ultrasound measurement in the diagnosis of adenomyosis.

Background: Adenomyosis is histologically defined by the presence of endometrial glands and stroma in the myometrium. To date, there are no standardised ultrasound findings that reliably predict histological adenomyosis.

Aims: This study aimed to determine the diagnostic accuracy of a novel sonographic measurement for adenomyosis, the myometrial-cervical ratio (MCR), when compared with histopathological diagnosis.

Botulinum toxin A (Botox) injection into muscles of pelvic floor as a treatment for persistent pelvic pain secondary to pelvic floor muscular spasm: A pilot study.

Background: Persistent pelvic pain (PPP) remains an important cause of morbidity. Pelvic floor muscle spasm is an important contributor to PPP.

Aims: The study's primary aim was to assess if botulinum toxin (BoNT) injection to pelvic floor muscles altered pain scores or quality of life (QoL) at six, 12 and 26 weeks.

Multimedia in improving informed consent for caesarean section: A randomised controlled trial.

Background: Multimedia modules have been used as an adjunct to improve patient knowledge and recall for various elective surgical procedures, but have been incompletely evaluated in patients undergoing caesarean section.

Aims: To compare the use of a supplementary multimedia module with written information in improving the informed consent process prior to elective caesarean section.

Materials And Methods: This was a prospective randomised controlled trial (ACTRN12616000430437).

The Role of the Mirena Intrauterine Device in the Management of Endometrial Polyps: A Pilot Study.

Study Objective: To study the hypothesis that the levonorgestrel intrauterine device (LNG-IUD) can have a role in the treatment of endometrial polyps confirmed at outpatient hysteroscopy in premenopausal women.

Design: Canadian Task Force classification level II1 (a controlled trial that is not randomised).

Setting: Outpatient hysteroscopy.

Multicentre retrospective study to assess diagnostic accuracy of ultrasound for superficial endometriosis-Are we any closer?

Background: To establish whether the ultrasound findings of minimal endometriosis are confirmed at laparoscopy and that a correlation can be established as to the anatomical sites in this mild form of the disease.

Aims: Patients with pain and suspicion of endometriosis had an ultrasound scan by a sonologist with expertise in endometriosis as part of their pre-operative workup.

Measurements And Main Results: The clinical histories of 53 patients who had laparoscopy to investigate pelvic pain were reviewed.

Can Narrowband Imaging Improve the Laparoscopic Identification of Superficial Endometriosis? A Prospective Cohort Trial.

Study Objective: To assess the usefulness of narrowband imaging (NBI) to detect additional areas of endometriosis not identified by standard white light in patients undergoing laparoscopy for the investigation of pelvic pain.

Design: A prospective cohort trial (Canadian Task Force classification II). Evidence obtained from a well-designed cohort study.

Vinorelbine Potently Induces Placental Cell Death, Does Not Harm Fertility and is a Potential Treatment for Ectopic Pregnancy.

Ectopic pregnancies complicate 1-2 pregnancies and are a leading cause of maternal death. An effective oral drug therapy that replaces surgery might make its treatment safer, cheaper, simpler and therefore more widely accessible. The only current medical treatment offered to women is intramuscular methotrexate, but this only reliably resolves smaller ectopic pregnancies.

Is outpatient hysteroscopy the new gold standard? Results from an 11 year prospective observational study.

Background: In Australia, gynaecologists continue to investigate women with abnormal bleeding and suspected intrauterine pathology with inpatient hysteroscopy despite some evidence in the literature that that there is no difference in safety and outcome when compared to an outpatient procedure.

Aims: This prospective study assessed the safety, effectiveness and acceptability of outpatient hysteroscopy over 11 years at a tertiary hospital in Australia. Resource savings were then calculated.

Are endometrial nerve fibres unique to endometriosis? A prospective case-control study of endometrial biopsy as a diagnostic test for endometriosis in women with pelvic pain.

Study Question: Can the presence of endometrial nerve fibres be used as a diagnostic test for endometriosis in women with pelvic pain?

Summary Answer: Endometrial fine nerve fibres were seen in the endometrium of women both with and without endometriosis, making their detection a poor diagnostic tool for endometriosis.

What Is Known Already: Laparoscopy and biopsy are currently the gold standard for making a diagnosis of endometriosis. It has been reported that small density nerve fibres in the functional layer of the endometrium are unique to women with endometriosis and hence nerve fibre detection could function as a less invasive diagnostic test of endometriosis.

Endometriosis: Does the menstrual cycle affect magnetic resonance (MR) imaging evaluation?

Purpose: To determine if the menstrual cycle affects MR interpretation in patients with pelvic endometriosis.

Materials And Methods: Thirty-one patients with either laparoscopically proven endometriosis, or a high clinical suspicion of deep infiltrative endometriosis, were prospectively recruited from May 2008 to October 2009 and January to June 2012. Two pelvic MR scans were performed for pre-operative planning; during menses and the other mid-cycle.

The effect of patient body mass index on surgical difficulty in gynaecological laparoscopy.

Introduction: Over the past three decades, rates of overweight and obesity internationally have risen to epidemic proportions. There are currently no published prospective studies examining the effect of obesity on gynaecologic laparoscopy for benign indications within a population with obesity rates comparable to Australian women.

Aims: To assess and quantify whether increasing patient body mass index negatively impacted upon the ability to successfully complete planned laparoscopic surgery.

Use of a multimedia module to aid the informed consent process in patients undergoing gynecologic laparoscopy for pelvic pain: randomized controlled trial.

Study Objective: To determine whether providing additional information to the standard consent process, in the form of a multimedia module (MM), improves patient knowledge about operative laparoscopy without increasing anxiety.

Design: Randomized controlled trial (Canadian Task Force classification I).

Setting: Two outpatient gynecologic clinics, one in a private hospital and the other in a public teaching hospital.

Compromised verbal episodic memory with intact visual and procedural memory during pregnancy.

This study investigated episodic and procedural memory performance in early and late pregnancy. Twenty-six women in the third trimester of pregnancy, 20 women in the first trimester of pregnancy, and 24 nonpregnant controls were administered a battery of verbal and visual episodic memory tasks and two procedural memory tasks. Results indicated that compared to controls, both pregnant groups had reduced scores on immediate and delayed verbal episodic memory tasks, but were unimpaired on visual and procedural memory tasks.

Decreased sleep efficiency, increased wake after sleep onset and increased cortical arousals in late pregnancy.

Background: Anecdotal reports of sleep disturbance during pregnancy are abundant; however, objective measurement of sleep changes has so far produced conflicting results.

Aims: To objectively measure sleep architecture and investigate subjective sleep quality in the first and third trimester of pregnancy, when compared to the nonpregnant state.

Methods: Twenty-seven women in the third trimester of pregnancy, 21 women in the first trimester of pregnancy and 24 nonpregnant control women underwent overnight polysomnography and completed questionnaires regarding sleep quality and mood.