Estimated National Cost of Pelvic Organ Prolapse Surgery in the United States.

Objective: To estimate the national cost of pelvic organ prolapse (POP) surgery in the United States.

Methods: In this cross-sectional, population-based study, we used the 2016-2018 Healthcare Cost and Utilization Project National Inpatient Samples and National Ambulatory Surgery Samples to identify patients undergoing POP surgery using International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes, ICD-10 procedural codes, and Current Procedural Terminology codes. Cost-to-charge ratios and weighted estimates were used to calculate nationwide costs.

Health Care Disparities in Patients Undergoing Hysterectomy for Benign Indications: A Systematic Review.

Objective: To explore how markers of health care disparity are associated with access to care and outcomes among patients seeking and undergoing hysterectomy for benign indications.

Data Sources: PubMed, EMBASE, and ClinicalTrials.gov were searched through January 23, 2022.

The effect of 12-month postoperative weight change on outcomes following midurethral sling for stress urinary incontinence: a secondary analysis of the ESTEEM and TOMUS randomized trials.

Introduction And Hypothesis: Prior studies demonstrate mixed results on the impact of obesity on the success of midurethral slings (MUS), with little known about how postoperative weight change affects outcomes. We aimed to examine the effect of postoperative weight change on outcomes 12 months after MUS for stress urinary incontinence (SUI).

Methods: This secondary analysis utilized data from two multicenter randomized trials of women undergoing MUS placement.

Association of Artificially Sweetened Beverage Consumption and Urinary Tract Cancers in the Women's Health Initiative Observational Study.

Background: Insufficient data exist to conclude whether consumption of artificially sweetened beverages is associated with a higher risk of urinary tract cancers.

Objective: We sought to investigate whether urinary tract cancer incidence differed among women who consumed various amounts of artificially sweetened beverages.

Design Setting And Participants: This was a secondary analysis of data from the Women's Health Initiative Observational Study, a multicenter longitudinal prospective study of the health of 93 676 postmenopausal women with a mean follow-up time of 13.

Artificially sweetened beverages and urinary incontinence-a secondary analysis of the Women's Health Initiative Observational Study.

Objective: The aim of this study was to determine if higher artificially sweetened beverage intake is associated with higher prevalence of urinary incontinence symptoms.

Methods: We conducted a secondary analysis of data from the Women's Health Initiative Observational Study. Our analytic cohort included 80,388 women.

Postprocedural Pain Associated With 5 Versus 20 Intradetrusor Injections of onabotulinumtoxinA for Treatment of Overactive Bladder: A Multicenter Randomized Clinical Trial.

Importance: Intradetrusor injection of onabotulinumtoxinA is performed via varying injection paradigms but no studies have studied the various effects of these paradigms on patient experience with the procedure.

Objectives: This randomized clinical trial aims to compare pain and procedure time between patients receiving a 100-unit dose of onabotulinumtoxinA in 5 injections compared to 20 injections for the treatment of idiopathic overactive bladder or urgency urinary incontinence.

Study Design: Patients presenting with refractory overactive bladder or urgency urinary incontinence at 2 clinical sites were identified and randomized to undergo onabotulinumtoxinA treatment with 5 injections versus 20 injections.

Postoperative Urinary Incontinence in Diabetic Patients Undergoing Pelvic Reconstructive Surgery.

Importance: Diabetes is an independent risk factor for urinary incontinence, and its impact on rates of postoperative incontinence after pelvic reconstructive surgery remains unexplored.

Objective: The aim of the study was to compare the incidence of postoperative stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence in patients with diabetes mellitus undergoing surgery for pelvic organ prolapse (POP) with or without SUI surgery.

Study Design: This is a secondary analysis of a multicenter retrospective cohort study involving 10 diverse medical centers that identified a cohort of women with diabetes who had prolapse and/or anti-incontinence surgery.

Disparities in Complications After Prolapse Repair and Sling Procedures: Trends From 2010-2018.

Objective: To compare 30-day complication rates after prolapse repair and sling procedures across racial/ethnic groups, and evaluate trends over time.

Methods: We identified female patients in a national outcomes-based database who underwent prolapse repair and/or sling procedures between January 1, 2010 and December 31, 2018, stratified by race and ethnicity, and compared 30-day postoperative complication rates. Multivariable logistic regression adjusted for confounders.

Surgical Outcomes in Urogynecology-Assessment of Perioperative and Postoperative Complications Relative to Preoperative Hemoglobin A1c-A Fellows Pelvic Research Network Study.

Objectives: Poor control of diabetes mellitus is a known predictor of perioperative and postoperative complications. No literature to date has established a hemoglobin A1c (HbA1c) cutoff for risk stratification in the urogynecology population. We sought to identify an HbA1c threshold predictive of increased risk for perioperative and postoperative complications after pelvic reconstructive surgery.

Anticholinergic prescribing pattern changes of urogynecology providers in response to evidence of potential dementia risk.

Introduction And Hypothesis: Recent publications show an association between exposure to anticholinergic medications and the risk of developing dementia. We hypothesized that urogynecology providers have changed their overactive bladder syndrome treatment as a result of this literature.

Methods: This was an anonymous, cross-sectional, web-based survey of American Urogynecologic Society members.

Hysterectomy Complications Relative to HbA Levels: Identifying a Threshold for Surgical Planning.

Study Objective: To evaluate whether diabetes diagnosis and level of diabetes control as reflected by higher preoperative glycosylated hemoglobin (HbA) levels are associated with increased complication rates after hysterectomy and to identify a threshold of preoperative HbA level past which we should consider delaying surgery owing to increased risk of complications.

Design: Retrospective cohort study.

Setting: Hospitals in the Michigan Surgical Quality Collaborative between June 4, 2012, and October 17, 2017.

Preoperative MRI and LDH in women undergoing intra-abdominal surgery for fibroids: Effect on surgical route.

Introduction: Our institution implemented a preoperative protocol to identify high-risk cases for which power morcellation should be avoided.

Material And Methods: In this retrospective cohort study, an institutional protocol requiring preoperative Magnetic Resonance Imaging with diffusion-weighted imaging and serum Lactate Dehydrogenase levels was implemented. Chart review was performed including all women who underwent intra-abdominal surgery for symptomatic fibroids from 4/23/2013 to 4/23/2015.

Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options.

Idiopathic overactive bladder (OAB) is a chronic condition that negatively affects quality of life, and oral medications are an important component of the OAB treatment algorithm. Recent literature has shown that anticholinergics, the most commonly prescribed oral medication for the treatment of OAB, are associated with cognitive side effects including dementia. β3-adrenoceptor agonists, the only alternative oral treatment for OAB, are similar in efficacy to anticholinergics with a more favorable side effect profile without the same cognitive effects.

Common Benign Chronic Vulvar Disorders.

Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to atrophy of normal vulvar and vaginal tissues. It is typically treated with lubricants, moisturizers, and intravaginal estrogen.

Temporal trends of postpartum haemorrhage in Switzerland: a 22-year retrospective population-based cohort study.

Aim: Postpartum haemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality. Studies have reported an increase in incidence of postpartum haemorrhage in recent years. Our goal was to investigate changes in the incidence of postpartum haemorrhage (PPH) and its risk factors in Switzerland from 1993 to 2014.

[Competence-based catalogue of learning objectives for conducting medical consultations].

Issue: In 2012 the German medical licensure regulations (Approbationsordnung) made teaching and assessing the conduction of medical consultations a mandatory part of medical education. A catalogue of learning objectives (LO) based on existing references was developed to assist medical schools in meeting this requirement.

Methods: A body of relevant material was compiled using literature research and surveying experts.

Improving patient-centered communication: Results of a randomized controlled trial.

Objective: Patient-centered communication is a key element for improving the quality of care in terms of therapeutic relationship, patient participation, and treatment process. Postgraduate trainings provide an essential way of promoting patient centeredness on the job where learning opportunities are often limited by time, patient volume, and economic pressure. In the present study, changes in patient centeredness during clinical routines of postgraduate physicians (internal medicine) after a three-day communication training were assessed.

[Integrated Peer Teaching of Communication and Clinical Skills: How to Train Student Tutors?].

Aim: This paper describes the theory-based development of a standardized training model for peer tutors. The aim is to qualify tutors to teach communication skills integrated with practical clinical skills, to medical students in the pre-clinical curriculum. As a result, students are encouraged to form a basic understanding of the biopsychosocial model of diseases early in their studies.

Training physicians in shared decision-making-who can be reached and what is achieved?

Objective: To report on experiences with a general shared decision-making (SDM) physician training program offered to physicians throughout Germany.

Methods: This study enrolled 150 physicians in an 8-h SDM training program. Physicians were assessed with standardized instruments before and after training.

Multiple target deep brain stimulation for multiple sclerosis related and poststroke Holmes' tremor.

Background: The results from thalamic deep brain stimulation (DBS) for atypical tremor syndromes including tremor from multiple sclerosis (MS) and stroke are often disappointing. Three recent case reports have suggested that simultaneous stimulation of multiple thalamic targets can result in sustained improvement in such cases.

Methods: We analyzed the effectiveness of multiple target DBS in one patient with MS-related tremor and another with poststroke Holmes' tremor.