Impact of COVID-19 on gynecologic and obstetrical services at two large health systems.

Background: The COVID-19 pandemic disrupted medical care in the US, leading to a significant drop in utilization of some types of health services. We sought to quantify how the pandemic influenced obstetrics and gynecology care at two large health care organizations.

Materials And Methods: Comparing 2020 to 2019, we quantified changes to obstetrics and gynecology care at two large health care organizations in the United States, Allegheny Health Network (in western Pennsylvania) and Johns Hopkins University (in Maryland).

Intravenous Acetaminophen Before Pelvic Organ Prolapse Repair: A Randomized Controlled Trial.

Objective: To compare the effect of preoperative intravenous (IV) acetaminophen compared with placebo on pain scores after pelvic organ prolapse surgery.

Methods: This double-blind placebo-controlled multicenter trial randomized women undergoing prolapse surgery to IV acetaminophen (1,000 mg) or preoperative saline stratified by surgical route (laparoscopic or vaginal). The primary outcome was the change from baseline in patient-reported visual analog scale pain scores at 24 hours after surgery.

Impact of Case Order on Laparoscopic Sacrocolpopexy: Do Surgeons Need a Warm-Up?

Objectives: Warm-up is defined as a preparatory activity or procedure. Using case order as a surrogate for surgeon warm-up, first cases were compared with second or later cases for intraoperative complications, operative time, and length of stay (LOS) among women undergoing laparoscopic sacrocolpopexy.

Methods: This is a retrospective study of laparoscopic sacrocolpopexies performed from 2009 through 2014 at a large academic center.

Comparison of complications and prolapse recurrence between laparoscopic and vaginal uterosacral ligament suspension for the treatment of vaginal prolapse.

Introduction And Hypothesis: Our objective was to compare complications and prolapse recurrence between laparoscopic (L-USLS) and vaginal (V-USLS) uterosacral ligament suspensions.

Methods: This is a retrospective study of USLS procedures performed at a large academic center from 2011 to 2014. Patient demographics, surgical data, complications, and prolapse recurrence of L-USLS and V-USLS were compared.

Predictors of postoperative acute urinary retention in women undergoing minimally invasive sacral colpopexy.

Objectives: Our aim was to determine predictors of acute urinary retention in women undergoing laparoscopic and robotic sacral colpopexy.

Methods: Records from all minimally invasive sacral colpopexies performed from 2009 to 2012 were reviewed. All women had a retrograde fill voiding trial (RGVT) on postoperative day 1, except in cases of intraoperative bladder injury or chronic urinary retention.

Apical support at the time of hysterectomy for uterovaginal prolapse.

Introduction And Hypothesis: The aim was to determine factors associated with performing concurrent apical support procedures in hysterectomies carried out for uterovaginal prolapse.

Methods: Hysterectomies performed for uterovaginal prolapse from 2000 to 2010 were identified by ICD-9 codes. Uterovaginal prolapse was a proxy for apical descent.

Utility of dipstick urinalysis in peri- and postmenopausal women with irritative bladder symptoms.

Introduction And Hypothesis: Previous studies of dipstick urinalysis (UA) in asymptomatic peri- and postmenopausal women demonstrate poor sensitivity to detect a urinary tract infection (UTI). We hypothesized that sensitivity of this test would be improved in symptomatic peri- and postmenopausal women.

Methods: This was a cross-sectional study of 76 women seeking urogynecology care for irritative bladder symptoms.

Changes in prolapse surgery trends relative to FDA notifications regarding vaginal mesh.

Introduction And Hypothesis: In 2008 and 2011, the US Food and Drug Administration (FDA) released notifications regarding vaginal mesh. In describing prolapse surgery trends over time, we predicted vaginal mesh use would decrease and native tissue repairs would increase.

Methods: Operative reports were reviewed for all prolapse repairs performed from 2008 to 2011 at our large regional hospital system.

Hysterectomy surgery trends: a more accurate depiction of the last decade?

Objective: The objective of the study was to describe trends in hysterectomy route at a large tertiary center.

Study Design: We reviewed all hysterectomies performed at Magee-Womens Hospital from 2000 to 2010. This database was chosen over larger national surveys because it has been tracking laparoscopic procedures since 2000, well before laparoscopic hysterectomy International Classification of Diseases, ninth revision (ICD-9) procedure codes were developed.