The Association of Preoperative Medication Administration and Preoperative and Intraoperative Factors With Postoperative Urinary Retention After Urogynecologic Surgery.

Objectives: The aim of this study was to determine if preoperative medication administration is associated with postoperative urinary retention (PUR) after urogynecologic procedures and identify preoperative and intraoperative factors that are predictive of PUR.

Methods: A retrospective review of patients who underwent prolapse and/or incontinence surgery was performed. The primary outcome was PUR, defined as postoperative retrograde void trial with postvoid residuals of greater than 100 mL.

Stigma Associated With Pelvic Floor Disorders.

Objectives: Although the impact of stigma is known for women with urinary incontinence, it has not been well studied among the full spectrum of pelvic floor disorders. This study quantifies the level of stigma among women presenting for urogynecologic care and tests the hypothesis that stigma related to pelvic floor disorders results in a delay in care seeking for these problems.

Methods: Women presenting for new patient visits (N = 523) in university medical center-based urogynecology clinics completed 2 anonymous questionnaires (Stigma Scale for Chronic Illnesses 8-item version and Pelvic Floor Bother Questionnaire) before their visit.

Use of X-ray to Assess Fecal Loading in Patients with Gastrointestinal Symptoms.

Background/aims: There is currently no gold standard for evaluating stool burden in the colon for patients with gastrointestinal symptoms. We aim to examine the relationship between fecal loading on single view abdominal X-ray imaging and gastrointestinal symptoms such as constipation, diarrhea, bloating, and accidental bowel leakage in adult outpatients.

Methods: This retrospective, cross-sectional study examined patients seen at University of Michigan from 2005 to 2017.

Genomic Profiling of Vulvar Lichen Sclerosus Patients Shows Possible Pathogenetic Disease Mechanisms.

Objective: Vulvar lichen sclerosus (LS) is known to occur in families, suggesting a genetic link. Genomic profiling of patients with vulvar LS was investigated to find underlying pathogenetic mechanisms, with the hope that targeted therapies and future clinical research will arise.

Methods: Two unrelated families with vulvar LS were investigated using whole-exome sequencing.

Biomarkers Implicated in Lower Urinary Tract Symptoms: Systematic Review and Pathway Analyses.

Purpose: Lower urinary tract symptoms are prevalent and burdensome, yet methods to enhance diagnosis and appropriately guide therapies are lacking. We systematically reviewed the literature for human studies of biomarkers associated with lower urinary tract symptoms.

Materials And Methods: PubMed®, EMBASE® and Web of Science® were searched from inception to February 13, 2018.

Comparison of Serum Vitamin D Levels in Relation to Bowel and Bladder Symptoms in Women with Vulvar Diseases.

We sought to investigate associations between vitamin D levels and bowel and bladder disorders in women with vulvar diseases. This is a planned sub-analysis of a cross-sectional study comparing the prevalence of bowel and bladder symptoms in women with biopsy-proven vulvar lichen sclerosus (LS) to a control group of women with non-lichenoid vulvar diseases. All subjects were recruited from a tertiary referral vulvar care clinic in a university-based practice.

Lower Urinary Tract Symptoms in a Chronic Pelvic Pain Population.

Objectives: This study aimed to characterize the prevalence of lower urinary tract symptoms in a chronic pain population.

Methods: In this observational cohort study, patients referred to a female pelvic pain clinic completed several validated questionnaires assessing bladder symptoms, central sensitization, pain symptoms, depression, anxiety, and neuropathic pain. Patients diagnosed as having interstitial cystitis were excluded.

Gender and Frequent Mental Distress: Comparing Transgender and Non-Transgender Individuals' Self-Rated Mental Health.

Background: Transgender individuals are more likely to experience social and economic barriers to health and health care, and have worse mental health outcomes than cisgender individuals. Our study explores variations in mental health among minority genders after controlling for sociodemographic factors.

Materials And Methods: Multistate data were obtained from the 2014 to 2016 Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System.

Gynecologic radiation oncology patients report unmet needs regarding sexual health communication with providers.

Purpose: Following radiation therapy (RT), women with gynecologic malignancies report high rates of sexual dysfunction, but little is known regarding sexual health communication between these patients and health-care providers. This study assessed these patients' beliefs/attitudes toward providers' sexual history taking.

Methods: Surveys were administered to women who presented for follow-up care for gynecologic cancers in an academic radiation oncology department.

Transcutaneous Electrical Nerve Stimulation to Improve Female Sexual Dysfunction Symptoms: A Pilot Study.

Objectives: To perform a pilot study using transcutaneous electrical nerve stimulation (TENS) on the dorsal genital nerve and the posterior tibial nerve for improving symptoms of female sexual dysfunction (FSD) in women without bladder problems. We hypothesize that this therapy will be effective at improving genital arousal deficits.

Materials And Methods: Nine women with general FSD completed the study.

Completion of a validated pelvic floor symptom and bother instrument in real-life practice.

Introduction And Hypothesis: Validated questionnaires are commonly used in research, but successful completion rates in clinical settings are largely unknown. The primary goal of this study was to assess the frequency of appropriate completion of a validated research survey. We secondarily examined relationships between demographics and successful questionnaire completion.

Tibial Nerve Stimulation to Drive Genital Sexual Arousal in an Anesthetized Female Rat.

Background: There is clinical evidence that percutaneous tibial nerve stimulation can positively benefit women with female sexual interest/arousal disorder, yet no studies have explored the potential mechanisms further.

Aim: To investigate the effect of tibial nerve stimulation on vaginal blood perfusion (VBP) in an anesthetized rat model.

Methods: 16 ketamine-anesthetized rats were surgically implanted with a nerve cuff electrode on 1 tibial nerve.

Home opioid use following cesarean delivery: How many opioid tablets should obstetricians prescribe?

Aim: To quantify home opioid use after cesarean delivery and identify factors associated with increased opioid use.

Methods: A convenience sample of women discharged by postoperative day 2 following a term cesarean delivery of a singleton fetus from May 2015 to May 2016 were contacted 2 weeks post-partum and questioned regarding opioid use, pain control and pain expectations.

Results: Among 141 women included in the analysis, the median number of opioid tablets used was 36 (interquartile range 16-45) and the median number prescribed was 60 (interquartile range 42-65).

Postpartum depression screening and pelvic floor symptoms among women referred to a specialty postpartum perineal clinic.

Background: Postpartum depression and pelvic floor disorders are both common conditions that affect women; however, the association between the 2 has yet to be determined.

Objective: The aims of our study are to: (1) determine the prevalence of a positive postpartum depression screen in a specialty postpartum perineal clinic, and (2) identify risk factors for postpartum depression in this population.

Study Design: A retrospective chart review was performed of 294 women referred to a specialty postpartum perineal clinic at the University of Michigan from March 30, 2012, through May 3, 2016.

Time-Frequency Analysis of Increases in Vaginal Blood Perfusion Elicited by Long-Duration Pudendal Neuromodulation in Anesthetized Rats.

Objectives: Female sexual dysfunction (FSD) affects a significant portion of the population. Although treatment options for FSD are limited, neuromodulation for bladder dysfunction has improved sexual function in some women. A few studies have investigated peripheral neuromodulation for eliciting changes in vaginal blood flow, as a proxy for modulating genital sexual arousal, however results are generally transient.

Obesity and stress urinary incontinence in women: compromised continence mechanism or excess bladder pressure during cough?

Introduction And Hypothesis: We compared two hypotheses as to why obesity is associated with stress urinary incontinence (SUI): (1) obesity increases demand on the continence system (e.g. higher cough pressure) and (2) obesity compromises urethral function and urethrovaginal support.

Transgender Demographics: A Household Probability Sample of US Adults, 2014.

Objectives: To estimate the proportion of US adults who identify as transgender and to compare the demographics of the transgender and nontransgender populations.

Methods: We conducted a secondary analysis of data from states and territories in the 2014 Behavioral Risk Factor Surveillance System that asked about transgender status. The proportion of adults identified as transgender was calculated from affirmative and negative responses (n = 151 456).

Plexiform schwannoma: an unusual clitoral mass.

Acquired clitoral enlargement is a rare condition resulting from a variety of etiologies, including tumors and excess androgens. Few cases of nonmalignant schwannoma, a benign tumor of the peripheral nerve sheath, have been reported in the literature as causes of clitoral enlargement in patients without known neurofibromatosis. These painless, slow-growing tumors rarely recur once excised.

Patient Satisfaction With Nurse-Led Telephone Follow-up in an Ambulatory Setting.

Objectives: We studied our practice of using nurse telephone follow-up under physician direction to assess symptom improvement and patient satisfaction.

Methods: Women were recruited when their clinical care merited nurse telephone follow-up in the opinion of the attending physician. Women specified a preferred telephone number and completed a symptom questionnaire at the time of enrollment.

Structural Failure Sites in Anterior Vaginal Wall Prolapse: Identification of a Collinear Triad.

Objective: To test the null hypothesis that six factors representing potential fascial and muscular failure sites contribute equally to the presence and size of a cystocele: two vaginal attachment factors (apical support and paravaginal defects), two vaginal wall factors (vaginal length and width), and two levator ani factors (hiatus size and levator ani defects).

Methods: Thirty women with anterior-predominant prolapse (women in a case group) and 30 women in a control group underwent three-dimensional stress magnetic resonance imaging. The location of the anterior vaginal wall at maximal Valsalva was identified with the modified Pelvic Inclination Coordinate System and the six factors measured.