Effects of Social Determinants of Health and Social Support on Surgical Outcomes Among Patients Undergoing Hysterectomy.

Objective: To describe composite 30-day postoperative complication rates among patients undergoing hysterectomy during the coronavirus disease 2019 (COVID-19) pandemic and to determine baseline and postoperative mental health symptoms, levels of social support, and socioeconomic status and their association with hysterectomy outcomes.

Methods: This multicenter prospective cohort study at eight centers across the United States enrolled patients who underwent minimally invasive hysterectomy for benign indications during the COVID-19 pandemic. Patients completed preoperative and postoperative surveys assessing mental health (PHQ-9 [Patient Health Questionnaire]), social support (MOS-SS [Medical Outcomes Study Social Support Survey]), and socioeconomic status (Hollingshead Index [Hollingshead Four Factor Index of Socioeconomic Status]).

Reliability of Uroflowmetry Pattern Interpretation in Adult Women.

Introduction: Uroflowmetry is often used to assess lower urinary tract symptoms (LUTS). Criteria for characterization of flow patterns are not well established, and subjective interpretation is the most common approach for flow curve classification. We assessed the reliability of uroflowmetry curve interpretation in adult women.

Single-Port Robotic Sacrocolpopexy: Description of an Advanced Minimally Invasive Approach and Review of the Relevant Literature.

Introduction And Hypothesis: Sacrocolpopexy is the gold standard for the surgical management of apical prolapse. Over the years, surgical advancements have transformed the procedure from a laparotomy with a hospital stay of several days to a minimally invasive approach with a much shorter hospital stay. One recent innovation has the potential to transform minimally invasive sacrocolpopexy.

Surgical Decision-Making: Who Should Be Offered Sacrocolpopexy?

Introduction And Hypothesis: Women undergoing surgery for apical pelvic organ prolapse have several medically sound options for specific surgical approaches.

Methods: We review the principles of shared decision-making as they pertain to surgery for prolapse. We review the literature supporting the superior sacrocolpopexy as a durable treatment for prolapse and the factors that may differentiate it from other repairs in risk and benefit.

Feasibility of Home Collection for Urogenital Microbiome Samples.

Importance: Feasibility of home urogenital microbiome specimen collection is unknown.

Objectives: This study aimed to evaluate successful sample collection rates from home and clinical research centers.

Study Design: Adult women participants enrolled in a multicentered cohort study were recruited to an in-person research center evaluation, including self-collected urogenital samples.

Suture-Needle Management Device and Novel Port Configuration for Robotic Sacrocolpopexy.

Importance: Robot-assisted sacrocolpopexy (SCP) is a commonly performed procedure for the repair of apical pelvic organ prolapse; therefore, novel devices and techniques to improve safety and efficacy of this procedure should be explored.

Objective: The objective of this study was to assess safety and efficacy of 8-mm trocar site for use of a disposable suture/needle management device (StitchKit; Origami Surgical, Madison, NJ) for robot-assisted SCP with a 4-arm configuration and no assistant port.

Study Design: This is a retrospective case series of patients undergoing robot-assisted SCP at a tertiary center from 2018 to 2021.

Activity Restrictions After Gynecologic Surgery.

Gynecologic surgeons have traditionally restricted the physical activity of postoperative patients. Minimally invasive surgery and enhanced recovery after surgery programs have contributed to decreased hospital stays and more expeditious recovery. In this narrative review, we review the current state of postoperative activity restrictions in gynecology and other specialties, the purported risks and potential benefits of postoperative activity, the available evidence to refute or support activity in the postoperative activity, and, finally, the potential benefit of added activity in the postoperative period.

Successful Use of Acellular Small Intestinal Submucosa Graft in Vaginal Reconstruction.

Purpose: Various techniques for neovaginal construction have been employed in the pediatric and adult populations, including the use of intestinal segments, buccal mucosal grafts, and skin grafts. Small intestinal submucosa (SIS) extracellular matrix grafts have been described as a viable alternative, though prior experience is limited. Our purpose was to assess operative characteristics and patient outcomes with neovaginal construction using SIS grafts.

Use of a Computerized Decisional Analysis Tool in Patients With Urgency Urinary Incontinence.

Importance: Decision analysis tools (DAT) are shared decision making instruments that include patient input on treatment goals and values that have been shown to decrease decisional regret in women's health care.

Objective: We describe a novel, computerized DAT for patients with urinary incontinence (UI), and our primary aim was to assess the concordance between treatment fit as determined by the DAT and treatment selected after physician counseling in patients with urgency urinary incontinence and urgency predominant mixed urinary incontinence.

Study Design: We partnered with a health care startup to develop a computerized DAT incorporating evidence about UI and patient input about treatment goals and personal values.

Gender Differences in Letters of Recommendation for Gynecology Surgical Fellowship Applicants: Analysis of One Program's Recruitment Cycle.

Study Objective: To examine whether there are gender differences in letters of recommendation (LORs) written for residents applying to gynecology surgical fellowships.

Design: Retrospective study.

Setting: Single, academic institution.

Patient Satisfaction With Telehealth Visits for New Patient Appointments for Pelvic Floor Disorders: A Randomized Trial of Telehealth Versus Standard In-Person Office Visits.

Importance: The acceptability and safety of telehealth have been reported in urogynecology for preoperative and postoperative care but not new patient consultation.

Objectives: This study aimed to determine if new patient telehealth encounters are noninferior to in-person encounters for women presenting to a urogynecology clinic using a satisfaction questionnaire. Secondary objectives were to describe patient experiences and follow-up.

Characterization of the GU microbiome in women with self-perceived bladder health over the life course.

Background: A variety of factors influence bladder health, including environmental factors, life experiences, biologic foundations, and coexistent medical conditions. A biologically diverse microbial community exists in the urine that is likely influenced by the microbial inhabitants of the vagina. The relationship between the genitourinary (GU) microbiome and self-perceived bladder health is unknown.

Natural history of lower urinary tract symptoms in treatment-seeking women with pelvic organ prolapse; the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN).

Background: The association of pelvic organ prolapse with overactive bladder and other lower urinary tract symptoms, and the natural history of those symptoms are not well characterized. Previous cross-sectional studies demonstrated conflicting relationships between prolapse and lower urinary tract symptoms.

Objective: This study primarily aimed to determine the baseline association between lower urinary tract symptoms and prolapse and to assess longitudinal differences in symptoms over 12 months in women with and without prolapse.

Mesh complications after total vs supracervical laparoscopic hysterectomy at time of minimally invasive sacrocolpopexy.

Introduction And Hypothesis: Our objective was to compare mesh exposure rates (4 months and 1 year) after total (TLH) vs supracervical (SLH) laparoscopic hysterectomy at time of minimally invasive sacrocolpopexy (SCP). Secondary outcomes included 30-day complications and midurethral mesh exposure rates.

Methods: This a retrospective cohort study at a tertiary care referral center from 2011 to 2018.

Longitudinal urinary microbiome characteristics in women with urgency urinary incontinence undergoing sacral neuromodulation.

Introduction And Hypothesis: The objective was to evaluate the stability of the urinary microbiome communities in women undergoing sacral neuromodulation (SNM) for urgency urinary incontinence (UUI). We hypothesized that clinical response to SNM therapy would be associated with changes in the urinary microbiome.

Methods: Women completed the Overactive Bladder Questionnaire Short-Form, the International Consultation on Incontinence Questionnaire Short Form, and the Female Sexual Function Index at baseline and 3 months post-SNM implantation.

The Leadership Landscape: The Role of Gender in Current Leadership Positions in Obstetrics and Gynecology Departments.

Study Objective: To describe the proportion of female faculty in departmental administrative and educational leadership roles in Obstetrics and Gynecology departments.

Design: Cross-sectional observational study (II-3).

Setting: Accredited Obstetrics and Gynecology residency programs.

Sex Differences in Commercial Patient Reviews of Women and Men Urogynecologic Surgeons.

Objective: The objective of our study was to describe differences in commercial patient reviews of women and men urogynecologic surgeons.

Materials And Methods: Reviews of surgeons on Healthgrades.com in 4 metropolitan areas were included.

How Does the Urethra Respond to Bladder Filling in Continent and Incontinent Women?

Objective: The objective of this study was to describe mean urethral pressure (MUP) during filling cystometry in continent and incontinent women.

Methods: Incontinent women were recruited from a urogynecology clinic if they answered "sometimes" or "always" to 1 of the items on the Medical, Epidemiologic, and Social Aspects of Aging questionnaire. Participants were categorized by Medical, Epidemiologic, and Social Aspects of Aging scores into stress urinary incontinence (SUI) or urgency urinary incontinence (UUI) groups.

Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial.

Objective: The aim of this study was to compare 3-month postpartum anal incontinence symptoms in women who sustain obstetric anal sphincter injuries and begin immediate vaginal electrical stimulation versus sham therapy.

Methods: In this double-blind randomized controlled trial, women who sustained obstetric anal sphincter injuries were randomized to receive self-administered vaginal electrical stimulation using a commercial device or sham therapy with an identical device. Anal incontinence symptom severity was assessed at 1 week (baseline) and again at 13 weeks postpartum using the Fecal Incontinence Severity Index.

Do gender and racial differences exist in letters of recommendation for obstetrics and gynecology residency applicants?

Background: Studies in several fields demonstrate gender and racial differences in descriptions of applicants in letters of recommendation. However, gender and racial biases in obstetrics and gynecology residency letters of recommendation are understudied.

Objective: This study aimed to determine whether there are differences in the letters of recommendation written for medical students applying for obstetrics and gynecology residency based on applicant gender and underrepresented in medicine status.

Surgical Outcomes in Benign Gynecologic Surgery Patients during the COVID-19 Pandemic (SOCOVID study).

Study Objective: To determine the incidence of perioperative coronavirus disease (COVID-19) in women undergoing benign gynecologic surgery and to evaluate perioperative complication rates in patients with active, previous, or no previous severe acute respiratory syndrome coronavirus 2 infection.

Design: A multicenter prospective cohort study.

Setting: Ten institutions in the United States.

Baseline Characteristics, Evaluation, and Management of Women With Complaints of Recurrent Urinary Tract Infections.

Objective: The aims of this study were to determine the proportion of women presenting for recurrent urinary tract infections (UTIs) who met the diagnostic criteria (culture-proven UTI ≥3 in 1 year or ≥2 in 6 months) and to assess advanced testing utilization, preventive therapy use, and risk factors.

Methods: This is a retrospective chart review of women seen as new urogynecology consults for recurrent UTI (rUTI) between April 1, 2017, and April 1, 2018, followed through April 1, 2019. Exclusion criteria included catheter use, cancer treatment within 2 years, and prior organ transplant, urinary diversion, conduit, or bladder augmentation.