Qualitative assessment of provider approaches to dilation following vaginoplasty.

Study Objective: Most surgical vaginoplasties are followed post-operatively, when age appropriate, by patient-led dilation to maintain patency, but there is a lack of both standardized protocols and research comparing dilation practices within and across surgical routes. This study's objective is to determine surgeon attitudes about dilation and learn what protocols they use and endorse to take steps towards addressing the literature gap around dilation practices and outcomes.

Methods: We performed semi-structured interviews with ten providers (nine surgeons, one nurse) involved in vaginoplasty at a single tertiary care children's hospital about their dilation practices.

Pain Following Obstetric Anal Sphincter Injuries: A Prospective Cohort Study.

Importance: Studies characterizing pain and pain management following obstetric anal sphincter injury (OASI) are limited.

Objectives: Our primary objective was to analyze time to pain resolution following OASI. Secondary objectives included analyzing pain severity, location, triggers, and patterns of pain medication use.

Analytic performance of ScreenFire HPV RS assay Zebra BioDome format and its potential for large-scale population HPV screening.

Background: Easy-to-use, rapid, scalable, high-throughput, and cost-effective HPV tests are urgently needed for low-resource settings. Atila Biosystems' high-throughput, cost-effective, and clinically validated ScreenFire HPV Risk Stratification (RS) assay identifies 13 high risk HPV (hrHPV) in 4 groups based on their oncogenic risk (i.e.

The Hidden Burden: Unveiling the Cervical Cancer Burden Among Recent Afghan Women Immigrants in the United States.

Cervical cancer is a significant global health issue, ranking as the second most prevalent cancer among women of reproductive age. While prevention strategies like HPV vaccination and screening have made it highly preventable, these benefits are mostly seen in high-HDI nations. In contrast, LMICs lag behind, with Afghanistan facing a growing crisis due to war, poverty, and lack of awareness.

Green Cystoscopy: Does Minimizing the Use of Drapes Increase Infection Rates?

Importance: The U.S. health care system has an enormous carbon footprint made worse by the escalating use of single-use supplies.

Neonatal outcomes after intervention for suspected renal colic in pregnancy.

Objective: To compare neonatal outcomes following URS, stent, or PCN in pregnant women presenting with suspected renal colic.

Methods: Women undergoing a procedure for suspected renal colic during pregnancy at a large multi-center institution between 2008 and 2022 were retrospectively reviewed and categorized by initial intervention. Neonatal outcomes were recorded and linked to maternal and obstetric data.

Trends in severe maternal morbidity following an institutional team goal strategy for disparity reduction.

Background: Racial disparities in maternal pregnancy outcomes, specifically in morbidity and mortality, are persistent in the U.S., and a multifaceted approach to mitigating these disparate outcomes is critical.

Postpartum Readmission after Unscheduled Cesarean Delivery in Patients with Class 3 Obesity.

Objective:  This study aimed to identify risk factors for postpartum readmission (PPR) in class 3 obese patients undergoing unscheduled cesarean deliveries.

Study Design:  Retrospective cohort study of patients with a body mass index (BMI) of ≥40 kg/m undergoing unscheduled cesarean delivery from 2017 to 2020 comparing patients with and without PPR (unexpected admission, emergency room/overnight observation visit, unscheduled outpatient visit, or ambulatory surgery within 30 days). Medical history, operative data, and postpartum outcomes were compared between the cohorts.

Does type of anesthesia during procedural management of suspected renal colic during pregnancy have an impact on preterm birth?

Introduction: Anesthesia choice during the procedural management of suspected renal colic during pregnancy may vary based on available resources and patient or provider preferences, as there are no specific recommendations. Our objective was to evaluate whether preterm birth (<37 weeks) was associated with anesthesia type, anesthesia timing by trimester, or procedure type.

Methods: We retrospectively identified pregnant patients who required procedural management with ureteral stent, percutaneous nephrostomy (PCN), or ureteroscopy (URS) for suspected renal colic based on laboratory and imaging findings from 2009-2021 at our center.

A Multicenter Prospective Sham-controlled Trial Evaluating a Physiologic Closed-loop Wearable Tibial Neuromodulation System for Overactive Bladder.

Objective: To evaluate the effectiveness and safety of a home-based, physiologic closed-loop wearable tibial neuromodulation system in comparison to a sham control for the treatment of overactive bladder (OAB).

Methods: This multicenter, prospective, randomized, double-blind, sham-controlled trial included 125 adult subjects with OAB who were randomized 1:1 to receive either active therapy with the Vivally System or sham therapy. Patients were allowed to continue concomitant OAB medications if therapy was stable and the remained on a consistent regimen throughout the study.

Utilization of a Postpartum Fasting Blood Glucose to Predict Impaired Glucose Tolerance in Patients with Gestational Diabetes Mellitus.

Objective:  The Endocrine Society recommends a postpartum fasting blood glucose (FBG) be performed for patients with gestational diabetes mellitus (GDM) prior to hospital discharge to screen for ongoing hyperglycemia. There are limited data, however, on whether an FBG can screen for glucose intolerance and if it correlates with the gold standard 4- to 12-week 2-hour oral glucose tolerance test (OGTT). Our objective was to evaluate if FBG correlates with the gold standard 2-hour OGTT.

Effects of Antihypertensive Therapy During Pregnancy on Postpartum Blood Pressure Control.

Objective: To compare differences in postpartum blood pressure (BP) control (BP below 140/90 mm Hg) for participants with hypertension randomized to receive antihypertensive treatment compared with no treatment during pregnancy.

Methods: This study was a planned secondary analysis of a multicenter, open-label, randomized controlled trial (The CHAP [Chronic Hypertension and Pregnancy] trial). Pregnant participants with mild chronic hypertension (BP below 160/105 mm Hg) were randomized into two groups: active (antihypertensive treatment) or control (no treatment unless severe hypertension, BP 160/105 mm Hg or higher).

From Diagnosis to Fertility: Optimizing Treatment of Adenomyosis for Reproductive Health.

Adenomyosis is a benign gynecologic disorder that had previously not been well studied or understood. However, it is now become a more common diagnosis with long-standing implications especially for fertility. In this literature review, the pathophysiology and diagnosis along with management options for uterine preservation and fertility along with more definitive options are reviewed.

Window of Opportunity: Rate of Referral to Infertility Providers among Reproductive-Age Women with Newly Diagnosed Gynecologic Cancers.

Fertility preservation is an important part of oncologic care for newly diagnosed gynecologic cancers for reproductive-age women, as many treatment options negatively impact fertility. The goal of this study is to examine factors that influence access to fertility specialists for women with newly diagnosed gynecologic cancer. This institutional review board approved a retrospective cohort study investigating the impacting factors on the referral rate from gynecologic oncologists (GO) to reproductive endocrinologists and infertility (REI) specialists at a single academic institution between 2010-2022 for patients age 18-41 at diagnosis.

Mitigating multiples, less is more: examining trends in multifetal gestation rates with assisted reproductive technology.

Purpose: Multifetal gestation (MFG) is much more common in pregnancies that utilize assisted reproductive technologies (ART). We assessed how these rates have changed over the previous decade and the impact on live birth rates (LBR).

Methods: This retrospective cohort study uses the National Summary Reports of the Society for Assisted Reproductive Technology (SART) from 2014 to 2020.

Prolonged treatment of neuroendocrine carcinoma of the cervix with a PARP inhibitor based on next generation sequencing.

•Next generation sequencing identified a BRCA 2 mutation in a patient with stage IVB neuroendocrine cancer of the cervix.•Treatment with rucaparib resulted in disease stabilization for 74 months.•The patient remains fully active working full time as a nurse and pursing a nurse practitioner degree.

Management of obesity in menopause.

The increasing prevalence of obesity imposes significant health challenges, particularly in women undergoing menopause. Effective obesity management is essential to mitigate associated comorbidities and improve quality of life. The pillars of obesity treatment encompass lifestyle modifications, pharmacotherapy and surgical interventions.

Dynamic Changes of the Genital Hiatus at the Time of Prolapse Surgery: 1-Year Follow-Up Study.

Importance: The genital hiatus (GH) has been identified as a predictor of pelvic organ prolapse. An enlarged preoperative GH is a risk factor for recurrent prolapse after surgery.

Objective: The objective of this study was to determine the changes in preoperative and postoperative GH size compared with the intraoperative resting GH at 6 weeks and 12 months after native-tissue pelvic organ prolapse surgery.