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The relative impact of age, pregnancy and vaginal delivery on urinary incontinence is still an unresolved issue that involves the controversial question about the protective effect of cesarean section.
Data on the experience that women undergoing urogynecologic surgery have with postoperative catheterization are severely limited. As the importance of our patients' perioperative experience becomes more valued, assessing the burden of postoperative catheterization, which has not yet been performed, is increasingly needed.
The Latzko transvaginal vesicovaginal fistula repair is a highly effective treatment for even complex fistulae. Our video demonstrates the Latzko technique and its application in a variety of circumstances including fistula management concurrent with treatment of uterovaginal prolapse, following complex urologic surgery, and in the postpartum setting after urologic injury. The technique of the procedure varies only slightly in these diverse conditions. The basic steps begin with hydro-dissecting the epithel...
Randomized controlled trials (RCT)s of surgery are fundamentally different from RCTs of medications because it is difficult to blind or mask a surgical procedure or perform "sham' operations. An additional challenge is the variation in skills and surgical proficiency of participating centers and surgeons. Addressing heterogeneity in surgical proficiency remains of paramount importance, especially when RCTs involve a new or complex procedure such as minimally invasive radical surgery. In the presence of such...
Although uterine leiomyomas and leiomyosarcomas are considered biologically-unrelated tumors, they share morphological and histological characteristics that complicate their differential diagnosis. The long-term therapeutic option for leiomyoma is laparoscopic myomectomy with morcellation, particularly for patients who wish to preserve their fertility. However, due to the potential dissemination of undiagnosed or hidden leiomyosarcoma from morcellation, there is a need to develop a preoperative assessment o...
Severe morbidity and mortality due to Rh disease have only been reduced by ∼50% globally during the last 50 years, despite the advent of anti-Rh(D) immunoglobin prophylaxis, resulting in more than 160.000 perinatal deaths and 100.000 disabilities annually. This apparent failure to take appropriate preventive measures is of great concern. Thus, there is a great need to do much better. We wish to draw attention to the unnecessary, continuing burden of Rh disease, to discuss some of the reasons for this fail...
Postpartum recovery from pelvic floor trauma associated with vaginal delivery may be impaired by the transient hypoestrogenic state associated with breastfeeding.
To determine the rates and predictors of fertility preservation services among reproductive-aged women with common cancers in the United States.
The use of polypropylene prolapse mesh to treat pelvic organ prolapse has been limited by mesh-related complications. Gynemesh PS mesh, implanted via sacrocolpopexy in rhesus macaques, negatively impacted vagina with thinning of vaginal muscularis and decreased vaginal smooth muscle contractility. The negative effect was attenuated when a bioscaffold derived from urinary bladder extracellular matrix (ECM) was used as a composite with Gynemesh PS.
Smartphones have recently been applied in the medical setting. However, the literature evaluating the utility of smartphones in gynecologic oncology is limited.
Minimally invasive hysterectomy is the standard of care in the majority of women diagnosed with endometrial cancer via robotic-assisted (RL), multi-port (MPL) and single-port laparoscopy (SPL) technology. While safe and efficacious, it is unclear how oncologic outcomes are impacted by surgical platform.
Cervical ripening is commonly needed for labor induction. Finding an optimal route of misoprostol dosing for efficacy, safety, and patient satisfaction is important and not well studied for the buccal route.
Fat mass has been shown to increase in ageing women, however, the extent to which menopausal status mediates these changes remains unclear.
This article, from the "To the Point" series prepared by the Association of Professors of Gynecology and Obstetrics (APGO) Undergraduate Medical Education Committee (UMEC), is an overview of issues to consider regarding learner mistreatment and its effects on the undergraduate medical education learning environment in the United States. National data from the American Association of Medical Colleges (AAMC) Graduate Questionnaire and local data regarding learner mistreatment provides evidence that the learni...
Hypertensive disorders of pregnancy (HDP, including preeclampsia or gestational hypertension) are associated with fetal growth restriction (FGR) in singleton pregnancies, an association that may be attributed to abnormal placentation as the shared etiology between these conditions. Given that the pathogenesis of these conditions in twin pregnancies may involve mechanisms other than abnormal placentation, it is unclear whether a similar association between HDP and FGR is present in twins. Data on the relatio...