Obstetric Anal Sphincter Injury: Interpregnancy Interval and Route of Subsequent Delivery.

Importance: Knowledge on the interpregnancy interval (IPI) among women with an obstetric anal sphincter injury (OASI) is both limited and not well understood.

Objectives: The objectives of this study were to describe the IPI among women with OASI and to compare women with OASI based on the route of subsequent obstetric delivery and OASI recurrence.

Study Design: This was a retrospective single-cohort study of women who had an OASI between 2013 and 2015 at a tertiary academic medical center.

Association of Neighborhood-Level Socioeconomic Status With Prolapse Management Decision.

Importance: This study identifies how neighborhood-level socioeconomic status (SES) may affect patients' treatment decisions for pelvic organ prolapse (POP).

Objective: This study aimed to evaluate the association of neighborhood-level SES with the decision of surgical versus conservative POP management.

Study Design: This was a retrospective cohort study of patients newly diagnosed with POP at a tertiary medical center between 2015 and 2021.

Characterization of Pain Associated With Pelvic Organ Prolapse: Is Surgery the Answer?

Importance: Data on the incidence of pelvic organ prolapse (POP)-related pain, risk factors for its development, and treatment effects of surgery remain sparse.

Objectives: The aims of the study were to evaluate the incidence and characteristics of POP-related pain in patients presenting with POP and assess the outcome of pain after surgery.

Study Design: This was a retrospective study of patients presenting for initial evaluation of POP from May 2019 to May 2020.

Perineal lacerations and social media: can patients find reliable information on Instagram and TikTok?

Introduction And Hypothesis: Social media content related to patient experiences and education continues to grow. Information on how obstetric perineal lacerations are represented on social media is limited. Our goal is to characterize available social media content on obstetric perineal lacerations.

Current opinion: postpartum urinary disorders.

Purpose Of Review: The aim of this study was to describe the common postpartum urinary sequelae including urinary retention and incontinence, and to summarize the management of these conditions.

Recent Findings: Despite the high frequency of urinary disorders in obstetrics, screening and management protocols are rarely utilized by providers. Large variation exists in the literature regarding assessment of postpartum urinary retention, values of postvoid residuals and management of indwelling catheters in the immediate postpartum population.

Impact of Obstetric Anal Sphincter Injuries on Postpartum Sexual Function: A Prospective Cohort Study.

Importance: Sexual dysfunction, which is common in the postpartum period, often does not resolve by 6 months and is likely more severe in women with severe obstetric lacerations.

Objectives: The aims are to describe sexual function at 6 months postpartum in women who experienced obstetric anal sphincter injury (OASI) and to compare sexual function between women with mild and severe OASI.

Study Design: This is a prospective cohort study of women with OASI.

Impact of peripartum antibiotics on wound complications in women with obstetric anal sphincter injury.

Objective: To evaluate the role of antibiotics on preventing wound complications following obstetric anal sphincter injuries (OASI).

Methods: This is a cohort study with retrospective and prospective components of women who sustained an OASI at vaginal delivery. The primary objective of this study was to assess the impact of prophylactic antibiotics at the time of delivery on perineal wound complications.

AUGS-IUGA Joint Clinical Consensus Statement on Enhanced Recovery After Urogynecologic Surgery: Developed by the Joint Writing Group of the International Urogynecological Association and the American Urogynecologic Society. Individual writing group members are noted in the Acknowledgements section.

Introduction And Hypothesis: Enhanced recovery after surgery (ERAS) evidence-based protocols for perioperative care can lead to improvements in clinical outcomes and cost savings. This article aims to present consensus recommendations for the optimal perioperative management of patients undergoing urogynecological surgery.

Methods: A review of meta-analyses, randomized clinical trials, large nonrandomized studies, and review articles was conducted via PubMed and other databases for ERAS and urogynecological surgery.

Protracted Postpartum Urinary Retention: Incidence, Risk Factors, and Natural History of a Rare Postpartum Urinary Retention Subtype.

Importance: Postpartum urinary retention (PUR) is a multifactorial condition that requires a high degree of clinical suspicion for timely diagnosis and proper intervention.

Objectives: The aims of the study are to describe PUR incidence and to compare natural history, obstetric characteristics, and associated risk factors for protracted PUR (extending ≥3 days postpartum) versus PUR.

Study Design: This is a retrospective cross-sectional study of women who underwent an obstetric delivery over 24 months at an academic institution.

Postpartum urinary retention: an expert review.

Postpartum urinary retention is a relatively common condition that can have a marked impact on women in the immediate days following childbirth. If left untreated, postpartum urinary retention can lead to repetitive overdistention injury that may damage the detrusor muscle and the parasympathetic nerve fibers within the bladder wall. In rare circumstances, postpartum urinary retention may even lead to bladder rupture, which is a potentially life-threatening yet entirely preventable complication.

Starting a peripartum pelvic floor disorder clinic: what to expect in the first thirty-six months.

Introduction And Hypothesis: Subspecialty peripartum pelvic floor disorder (PFD) clinics provide care to a unique patient population. We aim to describe the experiences of such a clinic in the first 36 months after its establishment.

Methods: This is a descriptive case series of all women who presented to a subspecialty PFD clinic at an academic medical center over 36 months (January 2018-December 2020).

Intermediate term outcomes after transvaginal uterine-preserving surgery in women with uterovaginal prolapse.

Introduction And Hypothesis: There is growing interest in and performance of uterine-preserving prolapse repairs. We hypothesized that there would be no difference in pelvic organ prolapse (POP) recurrence 2 years following transvaginal uterosacral ligament hysteropexy (USLH) and sacrospinous ligament hysteropexy (SSLH).

Methods: This is a retrospective cohort study with a cross-sectional survey of women who underwent transvaginal uterine-preserving POP surgery from May 2016 to December 2017.

Recognition and Management of Pelvic Floor Disorders in Pregnancy and the Postpartum Period.

Often considered a condition of aging women, pelvic floor disorders may initially present in pregnancy and postpartum, having a negative impact on quality of life during this important time in a woman's life. This review outlines the clinical approach to implementing pelvic health into obstetric care through education and promotion of pelvic health in pregnancy, screening for pelvic floor disorders routinely, and providing support through resources, treatment, and referrals if pelvic floor disorders develop during pregnancy and postpartum.

Same-Day Discharge After Minimally Invasive Sacrocolpopexy Is Feasible, Safe, and Associated With High Patient Satisfaction.

Objectives: This study aimed to compare the incidence of adverse events and postoperative health care resource utilization, as well as to determine satisfaction in patients after a same-day discharge (SDD) protocol compared with routine care (discharge ≥postoperative day 1).

Methods: This is a prospective cohort study of SDD after minimally invasive sacrocolpopexy. Eligibility criteria included age younger than 80 years, American Society of Anesthesiologists grade I/II, caretaker for ≥24 hours postoperatively, and surgical start before 1 pm.

Peripartum pelvic floor disorder clinics inform obstetric provider practices.

Introduction And Hypothesis: The objective of this study is to evaluate obstetric providers' knowledge and practice patterns since the establishment of a peripartum pelvic floor disorder clinic.

Methods: This is a prospective, cross-sectional survey study of obstetric providers at an academic tertiary care health system. A 22-question survey was designed to collect provider demographic data, indications for and barriers to referrals, provider satisfaction, and impact of the clinic's existence on peripartum pelvic floor dysfunction diagnosis and management.

Subspecialty care for peripartum pelvic floor disorders.

Obstetrical perineal and anal sphincter lacerations can be associated with considerable sequelae. The diagnosis of short-term bowel, bladder, and healing problems can be delayed if patients are not seen until the traditional postpartum visit at 4 to 6 weeks. Specialized peripartum clinics create a unique opportunity to collaborate with obstetrical specialists to provide early, individualized care for patients experiencing a variety of pelvic floor issues during pregnancy and in the postpartum period.

Accurate diagnosis and repair of obstetric anal sphincter injuries: why and how.

Obstetric anal sphincter injuries represent the minority of obstetric lacerations, but can have a significant long-term impact on urinary and fecal continence, as well as pelvic organ support. Accurate diagnosis of lacerations, appropriate repair, and close follow-up are essential to healthy healing and to improve outcomes for women. The infrequency of these injuries has resulted in a lack of familiarity with laceration repair and postpartum care of this population at all levels of practice.

Pelvic organ prolapse recurrence in young women undergoing vaginal and abdominal colpopexy.

Introduction And Hypothesis: While pelvic organ prolapse (POP) recurrence is believed to increase over time, outcomes of young women who undergo POP surgery are unclear. We hypothesized POP recurrence incidence among women <49 years would be higher after vaginal versus abdominal colpopexy.

Methods: This is a retrospective cohort study with a cross-sectional survey of women 18-49 years who underwent primary POP surgery from January 2003 to September 2013.

Fertility and fertility preservation: knowledge, awareness and attitudes of female graduate students.

Purpose: To evaluate the general knowledge of female graduate students on reproductive aging and fertility preservation options, as well as to investigate the perceptions, personal beliefs, and desires regarding fertility and preservation modalities.

Materials And Methods: A cross-sectional online survey study of female graduate students and medical trainees from academic institutions in Ohio was performed. Women were excluded if the online survey was incomplete or if they were >45 years.

Preservation of gonadal function in women undergoing chemotherapy: a systematic review and meta-analysis of the potential role for gonadotropin-releasing hormone agonists.

Purpose: To evaluate the available randomized controlled trials (RCTs) in the literature investigating the use of gonadotropin-releasing hormone agonist (GnRHa) co-treatment for ovarian preservation in women receiving chemotherapy.

Methods: A systematic review of the literature was performed from 1960 through 2017 to identify relevant RCTs. Included patients had lymphoma, ovarian cancer, or breast cancer.

Value of selective venous catheterization in the diagnosis of hyperandrogenism.

Objective: To discuss the clinical utility of ovarian vessel sampling in the context of the evaluation and treatment of ovarian hyperthecosis.

Design: Patient presentation in video format, ovarian vessel sampling demonstration, surgical technique explanation, surgical histology discussion and ovarian hyperthecosis review.

Setting: Academic medical center.

Surgical Anatomy of the Uterosacral Ligament Colpopexy.

Objective: The aim of this study was to describe the relationship of the uterosacral ligament (USL) to the ureter and rectum along a surgeon's target location for suture placement under conditions simulating live surgery.

Methods: Dissections were performed in 11 unembalmed female cadavers. Steps were taken to identify the USL simulating USL colpopexy.

The Incidence of Perioperative Adverse Events in the Very Elderly Undergoing Urogynecologic Surgery.

Objectives: To determine the incidence of perioperative adverse events in very elderly women (age ≥ 80 years) undergoing urogynecologic procedures and to examine the effect of preoperative functional status/capacity on these outcomes.

Methods: This is a retrospective analysis of all women aged 80 years or older who underwent a urogynecologic procedure at a tertiary care specialty practice between 2006 and 2014. Subjects were identified by their Current Procedural Terminology codes and the electronic medical record was queried for demographic and perioperative data.

Preservation of gonadal function in women undergoing chemotherapy: a review of the potential role for gonadotropin-releasing hormone agonists.

A cancer diagnosis in women of reproductive age has unique medical and psychosocial ramifications, especially with treatments that are known to cause gonadal toxicity. For patients who undergo chemotherapy, a multidisciplinary team approach is essential to ensure that the patients' reproductive wishes are addressed. Currently, embryo and oocyte cryopreservation are the standard of care for those who wish to preserve their fertility.

Hemostatic Techniques for Myomectomy: An Evidence-Based Approach.

Uterine leiomyomas are the most common benign gynecologic tumor. They are also a significant cause of morbidity, necessitating treatments ranging from hormonal suppression to surgical intervention. Myomectomy, the removal of these highly vascular tumors, offers significant quality of life and fertility-sparing benefit for patients affected by uterine leiomyomas but with a risk of substantial intraoperative blood loss.