Impact of Age on Perioperative Complications After Obliterative Vaginal Surgery.

Importance: Obliterative vaginal surgery is often reserved for older patients with prolapse, but the effect of age as an independent risk factor for perioperative complications in this cohort is poorly understood.

Objective: The aim of this study was to assess the association between age and perioperative complications in women undergoing obliterative vaginal surgery.

Study Design: This was a retrospective cohort study that included 371 patients undergoing colpocleisis between 2010 and 2013 at a single academic medical center.

Correlation of Digital Rectal Examination and Anorectal Manometry with Patient-Reported Outcomes Among Women with Fecal Incontinence.

Introduction And Hypothesis: Standardized digital rectal examination (DRE) correlates with anorectal manometry (ARM) measures. However, less is known about the relationship between DRE/ARM measures and patient-reported outcomes (PROs), especially among women with fecal incontinence (FI). Our aims were to evaluate associations between DRE and ARM measures and compare PROs with diagnostic evaluation measures for women with FI.

Disparities Research for Pelvic Floor Disorders: A Systematic Review and Critique of Literature.

Importance: Understanding the status of pelvic floor disorder (PFD) disparities research will allow the opportunity to advance future pelvic floor equity efforts.

Objectives: The aims of the study were to (1) characterize the landscape of PFD disparities literature using the 3 phases of disparities research framework, (2) describe the characteristics of PFD disparities studies, and (3) identify critical knowledge gaps.

Study Design: We performed a systematic review of peer-reviewed publications addressing disparities in PFDs among U.

Pelvic Floor Disorders in Black Women: Prevalence, Clinical Care, and a Strategic Agenda to Prioritize Care.

Pelvic floor disorders are a group of common conditions affecting women of all racial and ethnic groups. These disorders are undertreated in all women, but this is especially magnified in Black people who have been historically marginalized in the United States. This article seeks to highlight the prevalence of pelvic floor disorders in Black women, evaluate the clinical care they receive, examine barriers they face to equitable care, and present a strategic agenda to prioritize the care of Black women with pelvic floor disorders.

Correlation Between Mobile-Application Electronic Bowel Diary and Validated Questionnaires in Women with Fecal Incontinence.

Introduction And Hypothesis: Despite growing interest in a mobile-app bowel diary to assess fecal incontinence (FI) symptoms, data are limited regarding the correlation between mobile-app diary and questionnaire-based outcomes. The primary aim is to determine whether percentage reduction in FI episodes (FIEs)/week recorded on a mobile-app diary correlates with changes in scores of validated FI-symptom measures from baseline to 12 weeks in women with FI undergoing percutaneous tibial nerve stimulation (PTNS) versus sham.

Methods: This is a planned secondary analysis of a multicenter randomized trial in which women with FI underwent PTNS or sham.

Differences in Sexual and Physical Abuse History by Presenting Chief Complaint in an Outpatient Urogynecology Population.

Importance: One in 3 women experience sexual or physical violence in their lifetimes. Health consequences for survivors are numerous, including urogynecologic symptoms.

Objectives: We aimed to determine prevalence and factors that predict a history of sexual or physical abuse (SA/PA) in outpatient urogynecology, specifically whether the chief complaint (CC) predicts a history of SA/PA.

Frailty and Acute Postoperative Urinary Retention in Older Women Undergoing Pelvic Organ Prolapse Surgery.

Importance: Acute postoperative urinary retention (POUR) is common after pelvic reconstructive surgery, occurring in 15-45% of women. There is a paucity of data on the relationship between frailty and POUR after prolapse surgery.

Objective: This study aimed to examine the association between frailty and POUR in older women who underwent pelvic organ prolapse surgery.

Barriers to Urogynecologic Care for Racial and Ethnic Minority Women: A Qualitative Systematic Review.

Importance: Studies have sought to evaluate factors that have perpetuated disparities in health care, including urogynecologic care. However, there remains a lack of understanding of barriers to care specific to racial/ethnic minority populations.

Objectives: We aimed to report identified barriers to urogynecologic care (eg, care for symptoms/diagnoses of urinary incontinence [UI], accidental bowel leakage [ABL], and pelvic organ prolapse [POP]) for underrepresented racial and ethnic minority (URM) women in the United States.

Evidence-Informed, Interdisciplinary, Multidimensional Action Plan to Advance Overactive Bladder Research and Treatment Initiatives: Directives From State-of-the-Science Conference on Overactive Bladder and Cognitive Impairment.

This article outlines an evidence-informed, interdisciplinary, multidimensional, comprehensive action plan for the American Urogynecologic Society to improve care of women with overactive bladder (OAB) while minimizing treatment-related adverse events, including cognitive impairment. It is a "call to action" to advance basic, translational, and clinical research and summarizes initiatives developed at the State-of-the-Science Conference on OAB and Cognitive Impairment to (1) develop framework for a new OAB treatment approach in women, (2) define research gaps and future research priorities, (3) champion health equity and diversity considerations in OAB treatment, (4) foster community and promote education to remove stigma surrounding OAB and urinary incontinence, and (5) elevate visibility and impact of OAB, by creating partnerships through education and engagement with health care professionals, industry, private and public payers, funding agencies, and policymakers.

Overactive Bladder and Cognitive Impairment: The American Urogynecologic Society and Pelvic Floor Disorders Research Foundation State-of-the-Science Conference Summary Report.

Importance: Overactive bladder (OAB) is prevalent in older adults in whom management is complicated by comorbidities and greater vulnerability to the cognitive effects of antimuscarinic medications.

Objectives: The aim of this study is to provide a comprehensive evidence-based summary of the 2021 State-of-the-Science (SOS) conference and a multidisciplinary expert literature review on OAB and cognitive impairment.

Study Design: The American Urogynecologic Society and the Pelvic Floor Disorders Research Foundation convened a 3-day collaborative conference.

Racial Differences in Urinary Catheter Use Among Female Nursing Home Residents.

Objective: To assess racial differences in prevalence of indwelling urinary catheterization and intermittent catheterization among female NH residents in the United States (US).

Methods: We performed a cross-sectional analysis using the 2019 Minimum Data Set 3.0 and developed a multivariable logistic regression model to examine the association between catheter use and race.

Postoperative delirium in older patients after undergoing pelvic organ prolapse surgery.

Introduction And Hypothesis: To determine the 7-day incidence and risk factors of postoperative delirium (POD) occurring after prolapse surgery in women aged ≥60 years.

Methods: A prospective study of women ≥60 years undergoing prolapse surgery at a large academic center. The primary outcome is positive Confusion Assessment Method delirium screen administered in person or by telephone at the time of hospital discharge and postoperative days 1, 3, 5, and 7.

What Is Being Reported About Vaginal "Lasers"?: An Examination of Adverse Events Reported to the Food and Drug Administration on Energy-Based Devices.

Background: A description of energy-based genitourinary non-surgical devices (energy-based devices) safety data is outlined given their rapid adoption.

Objectives: The authors sought to describe adverse events for energy-based devices in the Manufacturer and User Facility Device Experience database and to compare with similar devices and other subspecialty applications. We hypothesized that products with genitourinary applications had similar adverse events to dermatologic or general surgery applications.

Patient Preparedness for Pelvic Organ Prolapse Surgery: A Randomized Equivalence Trial of Preoperative Counseling.

Objective: Preoperative counseling can affect postoperative outcomes and satisfaction. We hypothesized that patient preparedness would be equivalent after preoperative counseling phone calls versus preoperative counseling office visits before prolapse surgery.

Methods: This was an equivalence randomized controlled trial of women undergoing pelvic organ prolapse surgery.

Preoperative Counseling Method and Postoperative Opioid Usage: A Secondary Analysis of the PREOP Study.

Objective: The purpose of this analysis is to determine if postoperative opioid usage differs among women randomized to office or phone preoperative counseling for pelvic organ prolapse surgery.

Methods: This was a planned exploratory analysis of the Patient Preparedness for Pelvic Organ Prolapse Surgery study, which randomized women to standardized preoperative counseling by office visit or phone call before prolapse surgery. Inclusion criteria were the completion of the assigned counseling intervention and submission of a 7-day postoperative pain and medication diary.

Validation of Transvaginal Hysterectomy Surgical Model - Modification of the Flowerpot Model to Improve Vesicovaginal Plane Simulation.

Study Objective: To establish face and construct validity for a novel variation of American College of Obstetrics and Gynecology "Flowerpot Model" for transvaginal hysterectomy (TVH) surgical simulation with improved vesicovaginal dissection during surgical education simulation.

Design: Cross-sectional face and construct validation study using the "Flowerpot Model." The vesicovaginal dissection plane was modified to include additional felt and balloon materials to simulate the bladder.

Incidence of postoperative cognitive dysfunction in older women undergoing pelvic organ prolapse surgery.

Introduction And Hypothesis: Postoperative cognitive dysfunction (POCD), a transient impairment of memory, concentration, and information processing, has been reported after 7-26% of non-cardiac surgeries with associated increase in morbidity and death. Our primary aim was to determine the incidence of POCD 2 weeks after prolapse surgery in women ≥ 60 years old. Our secondary aim was to identify risk factors for POCD.

Sporadic compared to recurrent urinary tract infections: Considerations for urogynecologic patients.

Aims: To describe the uropathogens and antimicrobial resistance patterns in women with singular, sporadic urinary tract infection (UTI) vs those with recurrent UTI (rUTI) in a urogynecologic population.

Methods: This was a cross-sectional analysis of women treated for a UTI by a urogynecologic provider in a 1-year timeframe. Subjects were divided into two groups: (a) sporadic UTI-no history of rUTI and a single infection in the study timeframe and (b) rUTI-history of rUTI and ≥2 UTIs in the study timeframe.

Outcomes of native tissue transvaginal apical approaches in women with advanced pelvic organ prolapse and stress urinary incontinence.

Introduction And Hypothesis: Limited data exist comparing different surgical approaches in women with advanced vaginal prolapse. This study compared 2-year surgical outcomes of uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) in women with advanced prolapse (stage III-IV) and stress urinary incontinence.

Methods: This was a secondary analysis of a multicenter 2 × 2 factorial randomized trial comparing (1) ULS versus SSLF and (2) behavioral therapy with pelvic floor muscle training versus usual care.

Postoperative Opioid Utilization in Older Women Undergoing Pelvic Organ Prolapse Surgery.

Objectives: The objective of this study was to determine total postoperative opioid consumption by women 60 years and older during the first week after pelvic organ prolapse surgery. We secondarily aimed to describe opioid prescribing patterns in this cohort.

Methods: This is a secondary analysis of a prospective cohort study assessing changes in cognition in women 60 years and older undergoing prolapse surgery.