Women physicians receive lower Press Ganey patient satisfaction scores in a multicenter study of outpatient gynecology care.

Background: Emerging data suggest that patient satisfaction data are subject to inherent biases that negatively affect women physicians.

Objective: This study aimed to describe the association between the Press Ganey patient satisfaction survey and physician gender in a multi-institutional study of outpatient gynecologic care.

Study Design: This was a multisite, observational, population-based survey study using the results of Press Ganey patient satisfaction surveys from 5 unrelated community-based and academic medical institutions with outpatient gynecology visits between January 2020 and April 2022.

Low-fat dietary pattern reduces urinary incontinence in postmenopausal women: post hoc analysis of the Women's Health Initiative Diet Modification Trial.

Background: Urinary incontinence affects >40% of women in the United States, with an annual societal cost of >$12 billion and demonstrated associations with depressive symptoms, social isolation, and loss of work productivity. Weight has been established as an exposure that increases urinary incontinence risk and certain dietary components have been associated with urinary incontinence symptoms. We hypothesized that diet plays a key role in the association between weight and urinary incontinence in US women.

Racial Disparities in Outcomes of Women Undergoing Myomectomy.

Objective: To assess the association of racial and socioeconomic factors with outcomes of abdominal myomectomies.

Methods: All women undergoing abdominal myomectomy in California from 2005 to 2012 were identified from the OSHPD (Office of Statewide Health Planning and Development) using appropriate International Classification of Diseases and Current Procedural Terminology codes. Demographics, comorbidities, surgical approaches, and complications occurring within 30 days of the procedure were identified.

Supracervical Hysterectomy Is Protective against Mesh Complications after Minimally Invasive Abdominal Sacrocolpopexy: A Population-Based Cohort Study of 12,189 Patients.

Purpose: Although minimally invasive (robotic or laparoscopic) abdominal sacrocolpopexy (MISC) has become the new gold standard for durable pelvic organ prolapse repair after the vaginal mesh controversy, current literature is limited. Our objective was to study reoperation for mesh complications after MISC.

Materials And Methods: All women undergoing MISC in California from January 2012 to December 2018 were identified from Office of Statewide Health Planning and Development data sets using appropriate ICD-9/10 (International Classification of Diseases 9th/10th Revision) and CPT® (Current Procedural Terminology) codes.

Physical Activity, Diet, and Incident Urinary Incontinence in Postmenopausal Women: Women's Health Initiative Observational Study.

Background: Physical activity and macronutrient intake, important contributors to energy balance, may be independently associated with female urinary incontinence (UI).

Methods: We evaluated the association of baseline self-reported physical activity and macronutrient intake, via food frequency questionnaire, with incident UI subtypes after 3 years among 19 741 postmenopausal women in the Women's Health Initiative Observational Study. Odds ratios (ORs) for incident urgency, stress, and mixed UI were calculated using multivariable logistic regression.

Postoperative complications and recurrence rates after rectal prolapse surgery versus combined rectal prolapse and pelvic organ prolapse surgery.

Introduction And Hypothesis: Our primary objectives were to compare < 30-day postoperative complications and RP recurrence rates after RP-only surgery and combined surgery. Our secondary objectives were to determine preoperative predictors of < 30-day complications and RP recurrence.

Methods: A prospective IRB-approved cohort study was performed at a single tertiary care center from 2017 to 2020.

Incidence of Pelvic Floor Disorders in US Army Female Soldiers.

Objective: To determine the incidence of pelvic floor disorders (PFD) among active-duty US Army female soldiers.

Materials And Methods: We studied 102,015 women for incident PFD using the Stanford Military Data Repository, which comprises medical, demographic and service-related information on all soldiers on active duty in the US Army during 2011-2014. Cox proportional hazards estimated adjusted associations with PFD diagnoses.

Predictors of Colpocleisis Outcomes in an Older Population Based Cohort.

Purpose: Colpocleisis is an obliterative surgical option for women with pelvic organ prolapse that is often performed in a frail population. However, because outcomes remain largely unknown we aimed to assess the durability and perioperative safety of colpocleisis in a large population based cohort.

Materials And Methods: All women undergoing colpocleisis and other pelvic organ prolapse repairs in California (2005-2011) were identified using the Office of Statewide Health Planning and Development data sets.

Balancing the possibility of needing a future incontinence procedure versus a future urethral sling revision surgery: a tradeoff analysis for continent women undergoing pelvic organ prolapse surgery.

Introduction And Hypothesis: Although urinary incontinence surgery has potential benefits such as preventing de novo stress urinary incontinence in women undergoing pelvic organ prolapse (POP) surgery, it comes with the potential cost of overtreatment and complications. We compared future surgery rates in a population cohort of women undergoing vaginal pelvic organ prolapse surgery.

Methods: All women undergoing POP repair in California from 2005 to 2011 were identified from the Office of Statewide Health Planning and Development databases.

Does Rectocele on Defecography Equate to Rectocele on Physical Examination in Patients With Defecatory Symptoms?

Objectives: Our primary objective was to determine the association between rectocele size on defecography and physical examination in symptomatic patients. Our secondary objective was to describe the associations between both defecography and physical examination findings with defecatory symptoms and progression to surgical repair of rectocele.

Methods: We performed a retrospective review of all patients referred to a female pelvic medicine and reconstructive surgery clinic with a diagnosis of rectocele based on defecography and/or physical examination at a single institution from 2003 to 2017.

Reoperation rates for pelvic organ prolapse repairs with biologic and synthetic grafts in a large population-based cohort.

Introduction And Hypothesis: As the long-term complications of synthetic mesh become increasingly apparent, re-evaluation of alternative graft options for pelvic organ prolapse (POP) repairs is critical. We sought to compare the long-term reoperation rates of biologic and synthetic grafts in POP repair.

Methods: Using the California Office of Statewide Health Planning and Development database, we identified all women who underwent index inpatient POP repair with either a synthetic or biologic graft between 2005 and 2011 in the state of California.

Urologic Injury and Fistula After Hysterectomy for Benign Indications.

Objective: To explore the rates and risk factors for sustaining a genitourinary injury during hysterectomy for benign indications.

Methods: In this population-based cohort study, all women who underwent hysterectomy for benign indications were identified from the Office of Statewide Health Planning and Development databases in California (2005-2011). Genitourinary injuries were further classified as identified at the time of hysterectomy, identified after the date of hysterectomy; or unidentified until a fistula developed.

Association Between Concomitant Hysterectomy and Repeat Surgery for Pelvic Organ Prolapse Repair in a Cohort of Nearly 100,000 Women.

Objective: To evaluate the association of hysterectomy at the time of pelvic organ prolapse (POP) repair with the risk of undergoing subsequent POP surgery in a large population-based cohort.

Methods: Data from the California Office of Statewide Health Planning and Development were used in this retrospective cohort study to identify all women who underwent an anterior, apical, posterior or multiple compartment POP repair at nonfederal hospitals between January 1, 2005, and December 31, 2011, using Current Procedural Terminology and International Classification of Diseases, 9th Revision procedure codes. Women with a diagnosis code indicating prior hysterectomy were excluded, and the first prolapse surgery during the study period was considered the index repair.

Rates and Risk Factors for Future Stress Urinary Incontinence Surgery after Pelvic Organ Prolapse Repair in a Large Population-based Cohort in California.

Objectives: To determine the rate and risk factors for future stress urinary incontinence (SUI) surgery in a large population-based cohort of previously continent women following pelvic organ prolapse (POP) repair without concomitant SUI treatment.

Methods: Data from the Office of Statewide Health Planning and Development were used to identify all women who underwent anterior, apical, or combined anteroapical POP repair without concomitant SUI procedures in the state of California between 2005 and 2011 with at least 1-year follow-up. Patient and surgical characteristics were explored for associations with subsequent SUI procedures.

Care Seeking Patterns for Women Requiring a Repeat Pelvic Organ Prolapse Surgery Due to Native Tissue Repair Failure Compared to a Mesh Complication.

Objective: To explore patient migration patterns in patients requiring repeat surgery after Pelvic Organ Prolapse (POP) repair as there is a limited understanding of care seeking patterns for repeat surgery after POP repair. We hypothesized that undergoing repeat surgery for a prolapse mesh complication would be associated with an increased incidence of migration to a new facility for care compared to those undergoing repeat surgery for recurrent POP.

Methods: In this retrospective population based study, all females who underwent an index POP repair procedure (with or without mesh) at nonfederal facilities who subsequently underwent a repeat surgery (recurrent prolapse repair or mesh complication) were identified from the Office of Statewide Health Planning and Development for the state of California (2005-2011).

What Impacts the All Cause Risk of Reoperation after Pelvic Organ Prolapse Repair? A Comparison of Mesh and Native Tissue Approaches in 110,329 Women.

Purpose: Several factors are hypothesized to impact the risks of mesh augmented pelvic organ prolapse repair, including 1) the characteristics of the material, 2) surgical experience and 3) patient selection. We present a large, population based approach to explore the impact of these factors on outcomes and describe an ideal mesh use strategy.

Materials And Methods: Data from the Office of Statewide Health Planning and Development were accessed to identify all women who underwent pelvic organ prolapse repair in California from 2005 to 2011.

Where do Women go for Revision Surgeries? Geographic Migration Patterns after Urethral Sling Placement in California.

Introduction: Although long-term rates of sling revision after urethral sling placement have been well studied, details of these revisions have not been addressed. In this study we explore the timing, location and migration of patients from one facility to another for revision procedures.

Methods: Using data from the Office of Statewide Health Planning and Development (OSHPD) for the state of California (2005 to 2011), all females who underwent index outpatient urethral sling procedures at nonfederal facilities were identified (CPT 57288).

Physician Gender Is Associated with Press Ganey Patient Satisfaction Scores in Outpatient Gynecology.

Background: Patient satisfaction is gaining increasing attention as a quality measure in health care, but the methods used to assess it may negatively impact women physicians.

Objective: Our objective was to examine the relationship between physician gender and patient satisfaction with outpatient gynecology care as measured by the Press Ganey patient satisfaction survey.

Study Design: This cross-sectional study analyzed 909 Press Ganey patient satisfaction surveys linked to outpatient gynecology visits at a single academic institution (March 2013-August 2014), including self-reported demographics and satisfaction.

Racial and Socioeconomic Disparities in Short-term Urethral Sling Surgical Outcomes.

Objective: To evaluate the association of racial and socioeconomic factors with the risk of adverse events in the first 30 days following urethral sling placement.

Methods: We accessed nonpublic data from the Office of Statewide Health Planning and Development in California from 2005 to 2011. All female patients who underwent an ambulatory urethral sling procedure in the entire state of California over the study period were identified (Current Procedural Terminology 57288).

Impact of Distance to Treatment Center on Care Seeking for Pelvic Floor Disorders.

Objective: The aim of this study was to evaluate the impact of distance from residence to treatment center on access to care for female pelvic floor disorders at an academic institution.

Methods: A retrospective cross-sectional study was conducted of women seen for pelvic floor disorders at an academic institution from 2008 to 2014. Patient characteristics were extracted from charts.

Unplanned Hospital Visits in the First 30 Days After Urethral Sling Procedures.

Objective: To evaluate unplanned hospital visits within 30 days of urethral sling placement in the form of emergency department visits, inpatient admissions, or repeat surgery.

Methods: We accessed nonpublic data from the Office of Statewide Health Planning and Development in the state of California for the years 2005-2011. All female patients who underwent an ambulatory urethral sling procedure (Current Procedural Terminology 57288) without concomitant surgery (other than cystoscopy) were included.

When and how to excise vaginal mesh.

Purpose Of Review: Since 2011, there has been increasing attention paid to the use of synthetic grafts (mesh) in pelvic reconstructive surgery. Although synthetic grafts are considered permanent implants to improve outcomes, the use of this material has created inadvertent complications such as erosion, chronic pain, and dyspareunia. Patient evaluation is complex and surgical techniques carry risks not yet completely understood.

Assessing the use of the IUGA/ICS classification system for prosthesis/graft complications in publications from 2011 to 2015.

Introduction And Hypothesis: Complications of pelvic organ prolapse and urinary incontinence surgery have gained increasing attention from both lay media and medical societies. The International Urogynecological Association and International Continence Society proposed the category-time-site system to classify complications in 2011. Our objective is to assess the usage of the category-time-site system in the literature.