Current Opinion in Obstetrics & Gynecology最新文献_第2页

Multicompartment pelvic floor prolapse: advances in diagnosis and surgical management. 多腔室盆底脱垂：诊断和手术治疗的进展。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-09-16 DOI: 10.1097/GCO.0000000000001069

Shannon L Wallace, Amy D Gee, Deepanjana Das

{"title":"Multicompartment pelvic floor prolapse: advances in diagnosis and surgical management.","authors":"Shannon L Wallace, Amy D Gee, Deepanjana Das","doi":"10.1097/GCO.0000000000001069","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001069","url":null,"abstract":"Purpose of review: Multicompartment pelvic organ prolapse, including concurrent rectal and vaginal prolapse, is increasingly recognized in aging populations. This review summarizes recent advances in diagnostic imaging, multidisciplinary evaluation, and surgical techniques for combined repair.Recent findings: Multicompartment prolapse is increasingly prevalent and often underrecognized without coordinated evaluation. Dynamic defecography, particularly upright or MRI-based, improves detection of multicompartment descent. Minimally invasive combined sacrocolpopexy (SCP) and ventral mesh rectopexy (VMR) is increasingly used with favorable outcomes. Surgical series report low complication rates and suggest a potential reduction in prolapse recurrence with combined repair. Robotic platforms, including newer systems, enhance precision, and visualization. Emerging techniques include laparoscopic resection rectopexy with SCP and selective use of biologic mesh. Multidisciplinary care improves coordination and recurrence prevention.Summary: Contemporary management of multicompartment prolapse requires a collaborative, patient-centered approach. Advances in imaging and minimally invasive surgery, particularly robotic SCP and VMR, have improved outcomes. Future research should focus on standardizing techniques, optimizing mesh configurations, and long-term functional results.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

#Birth control: contraception conversations on social media. #生育控制：社交媒体上的避孕对话。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-09-12 DOI: 10.1097/GCO.0000000000001070

Jayne Caron, Erica P Cahill

{"title":"#Birth control: contraception conversations on social media.","authors":"Jayne Caron, Erica P Cahill","doi":"10.1097/GCO.0000000000001070","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001070","url":null,"abstract":"Purpose of review: Social networks, now including social media platforms, are increasingly important sources of health information for many patients, particularly patients of reproductive age. Observing and understanding conversations about contraception happening on social media can help clinicians address patient concerns and misinformation.Recent findings: Studies evaluating social media posts on contraception have found the most popular methods discussed across platforms are intrauterine devices and oral contraceptive pills. Side effects are the most frequently discussed topic on all social media formats, with negative effects discussed much more frequently than benefits. People viewing social media are often more drawn to posts around the logistics of contraception. Most videos are created by nonhealthcare professionals and are more likely to contain misinformation than videos created by healthcare professionals.Summary: Social media is an important tool that patients are using to access information about contraception. Physicians and clinicians should understand the themes patients are discussing so that they can address them in counseling. Physicians, clinicians, and healthcare organizations should consider contributing high-quality information to social media to improve accuracy and counter misinformation.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Yoga, Pilates, and the pelvic floor: an updated review of current literature. 瑜伽、普拉提和骨盆底：最新文献综述。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-09-12 DOI: 10.1097/GCO.0000000000001068

Rachel Kopkin, Megan Corn, Lauren Tostrud

{"title":"Yoga, Pilates, and the pelvic floor: an updated review of current literature.","authors":"Rachel Kopkin, Megan Corn, Lauren Tostrud","doi":"10.1097/GCO.0000000000001068","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001068","url":null,"abstract":"Purpose of review: This review article examines recent research on the advantages and limitations of functional exercise, such as yoga and Pilates, in relation to pelvic floor health and urge urinary incontinence (UUI) and overactive bladder (OAB). There is ample evidence of functional exercises and mindfulness improving stress urinary incontinence, but limited data thus far for OAB or UUI.Recent findings: There continues to be a paucity of rigorous data on the use of functional exercise in the management of OAB, with most recent literature limited to small prospective pilot studies. The few recent randomized controlled trials support the safety of these exercise regimens; however, results were not consistently superior to generalized muscle strengthening. Recent data does continue to support the physiologic benefit of mindfulness and yogic breathing to the autonomic nervous system and its potential impact on reducing bothersome lower urinary tract symptoms. Promising work has been published on the feasibility of app- or video-based programs, offering a more accessible option to motivated individuals.Summary: While data remains uncertain as to the impact of yoga or Pilates on OAB symptom improvement, these low-impact exercises can have a role as complementary treatment strategies that are more accessible and provide a holistic approach to care.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review of chatbots in urogynecology. 泌尿妇科聊天机器人研究综述。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-09-10 DOI: 10.1097/GCO.0000000000001067

Joseph T Kowalski, Leanne Brechtel

{"title":"Review of chatbots in urogynecology.","authors":"Joseph T Kowalski, Leanne Brechtel","doi":"10.1097/GCO.0000000000001067","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001067","url":null,"abstract":"Purpose of review: Chatbots based on large language models have been rapidly incorporated into many aspects of medicine in a short time despite an incomplete understanding of their capabilities. This review focuses on ways these chatbots have been utilized in urogynecology.Recent findings: Publications regarding chatbots in urogynecology have centered on patient education, scientific literature review, clinical decision-making, documentation, and research. Several authors have evaluated the ability of chatbots to generate accurate and complete information about prolapse and urinary incontinence. While chatbots can generate accurate information about pelvic floor disorders most of the time, the studies we review indicate that incomplete, misleading, or incorrect information is generated up to 33% of the time. Newer chatbots that are trained for medical applications may help to limit some of these problems. Using chatbots to assist with scientific literature review and research is currently hampered by unpredictable 'hallucinations', where the chatbot may generate information or references that sound plausible but are factually incorrect.Summary: While chatbots are being rapidly integrated into many aspects of medicine, the research evaluating these tools in urogynecology is limited. Publicly available chatbots should only be used for patient education, clinical decision-making, and research with caution.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

First-trimester medication abortion: anemia and blood loss. 妊娠早期药物流产：贫血和失血。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-08-20 DOI: 10.1097/GCO.0000000000001063

Lucy Rose, Sarah Putnam, Eve Espey

{"title":"First-trimester medication abortion: anemia and blood loss.","authors":"Lucy Rose, Sarah Putnam, Eve Espey","doi":"10.1097/GCO.0000000000001063","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001063","url":null,"abstract":"Purpose of review: Although ample evidence demonstrates the safety and effectiveness of medication abortion, its safety in individuals with anemia is not well understood; modern literature describing quantitative blood loss from medication abortion is limited. As medication abortion is increasingly utilized, reviewing current guidelines and literature related to anemia and blood loss from medication abortion may help inform practice and future research.Recent findings: Guidelines have not established a safe minimum level of starting hemoglobin for medication abortion or a single standard for the provision of medication abortion in the setting of anemia. Studies assessing blood loss from early medication abortion report a low mean decrease in hemoglobin (0.1-0.7 g/dl); however, these studies used a variety of medication regimens, and most exclude individuals with significant anemia (hemoglobin < 9.5-10 g/dl) and gestational duration greater than 63 days.Summary: Communities most severely impacted by abortion restrictions and bans also experience significantly higher rates of anemia. Guidelines that restrict medication abortion to patients who meet arbitrary hemoglobin cutoffs can lead to delays and barriers to care. Studies using current medication regimens and including patients with moderate-to-severe anemia and gestational duration greater than 63 days are needed to inform eligibility and safety, and support provider buy-in and equity.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contemporary genitourinary fistula management: treatment, trends, and innovations. 当代泌尿生殖系统瘘管管理：治疗，趋势和创新。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-08-20 DOI: 10.1097/GCO.0000000000001065

Nancy Wei, Courtney Pfeuti, Brian J Linder

{"title":"Contemporary genitourinary fistula management: treatment, trends, and innovations.","authors":"Nancy Wei, Courtney Pfeuti, Brian J Linder","doi":"10.1097/GCO.0000000000001065","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001065","url":null,"abstract":"Purpose of review: To synthesize the current literature regarding the evaluation and management of genitourinary fistula in women.Recent findings: Genitourinary fistula are aberrant communications between the urinary tract and genital tract that present with urinary leakage per the vagina. Initial management often involves conservative measures, such as urethral catheter or ureteral stent placement, progressing to surgical repair when needed. Key surgical principles include a tension-free, watertight closure with well-vascularized tissue including tissue interposition as appropriate, and postoperative urinary drainage. When surgical management of vesicovaginal fistula is necessary, a transvaginal repair is the most common. Other minimally invasive approaches are increasing and result in similarly high success rates with lower patient morbidity compared to open abdominal surgeries. The initial management of ureterovaginal fistula commonly includes ureteral stent placement. When not feasible or in persistent fistula, laparoscopic and robotic surgical repair with ureteral reconstruction offers high success rates with lower morbidity than an open approach.Summary: Successful management of genitourinary fistula ranges from conservative urinary tract drainage to surgical interventions based on etiology, location, and complexity. Approaches to repair are shifting toward less invasive procedures. With optimal technique and surgical planning, high success rates can be achieved, particularly in primary repairs.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Probiotics: utility, benefits, and risks for gynecologic conditions. 益生菌：对妇科疾病的效用、益处和风险。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-08-20 DOI: 10.1097/GCO.0000000000001064

Madeline Carmain, Elisabeth C Sappenfield, Elena Tunitsky-Bitton

{"title":"Probiotics: utility, benefits, and risks for gynecologic conditions.","authors":"Madeline Carmain, Elisabeth C Sappenfield, Elena Tunitsky-Bitton","doi":"10.1097/GCO.0000000000001064","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001064","url":null,"abstract":"Purpose of review: The vaginal microbiome plays an important role in protecting the vagina and bladder from infection. There is significant interest in understanding whether probiotics can normalize the vaginal microbiome and lead to decreased incidence of vulvovaginal-associated infections. Probiotics are an appealing treatment option as they are well tolerated, have a low risk profile, and potentially can reduce antibiotic usage.Recent findings: Recent research suggests that probiotics may play a role in preventing recurrent bacterial vaginosis (BV) when administered with or after antibiotic treatment. Probiotics do not seem to be helpful for preventing recurrent vulvovaginal candidiasis. Probiotics prevent vaginal colonization with uropathogens from the gastrointestinal tract, and decrease recurrent urinary tract infections (UTIs) 76% when administered as part of a nonantibiotic recurrent UTI treatment bundle, which includes D-mannose, cranberry supplementation, and probiotics. Probiotics are a hopeful treatment for human papillomavirus (HPV), and evidence suggests that probiotic administration increases clearance of HPV and results in the resolution of abnormal papanicolaou test results.Summary: Evidence shows that probiotics are useful treatments for BV, recurrent UTIs, and HPV. More research is necessary to recommend specific bacterial strains or products for each indication.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The new age of periviability. 新的生存时代。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-08-15 DOI: 10.1097/GCO.0000000000001061

Amythis Soltani, Anne R Waldrop, Andrea Henkel

{"title":"The new age of periviability.","authors":"Amythis Soltani, Anne R Waldrop, Andrea Henkel","doi":"10.1097/GCO.0000000000001061","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001061","url":null,"abstract":"Purpose of review: This review focuses on the clinical and ethical complexities of managing pregnancies between 20 and 25 weeks and 6 days of gestation, known as periviability, where fetal survival is uncertain and viability cannot be uniformly defined.Recent findings: Recent literature highlights that outcomes during periviability depend on a constellation of factors, including gestational age, fetal weight, institutional resources, and access to neonatal intensive care. Advances in neonatal and obstetric care have pushed the threshold of viability earlier, but survival and morbidity remain highly variable. The diagnosis of life-limiting fetal anomalies or severe maternal complications during this time frequently necessitates urgent decision-making around abortion. Legal changes post-Dobbs have further complicated access to abortion care. Additionally, new recommendations surrounding feticidal injection are highlighted. Studies also emphasize that parental decisions are guided more by intuitive beliefs than by statistics alone, underscoring the importance of values-based counseling.Summary: Periviability challenges clinicians to balance medical, legal, and ethical considerations while supporting patients through highly individualized, time-sensitive decisions. A shared decision-making model grounded in ethical principles is essential. Ongoing dialogue and refined, patient-centered guidelines are needed to ensure compassionate, equitable, and evidence-based care at the threshold of viability.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of office-based ultrasound in family planning practice. 办公室超声在计划生育实践中的作用。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-08-15 DOI: 10.1097/GCO.0000000000001062

Jayne Caron, Jade M Shorter

{"title":"The role of office-based ultrasound in family planning practice.","authors":"Jayne Caron, Jade M Shorter","doi":"10.1097/GCO.0000000000001062","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001062","url":null,"abstract":"Purpose of review: This review highlights the evolving role of ultrasound in family planning clinics. Given the increasing complexity of contraceptive management, abortion care, and early pregnancy assessments, understanding the utility of both traditional and point-of-care ultrasound (POCUS) is timely and relevant for improving patient outcomes and enhancing clinical efficiency.Recent findings: The literature indicates that ultrasound significantly aids in intrauterine device (IUD) placement, localization, and removal, particularly with challenging anatomy. Studies suggest that ultrasound guidance can reduce procedure times, pain, and complications associated with IUD insertions. In addition, the review discusses the role of ultrasound in nonpalpable contraceptive implant removals and the use of ultrasound in abortion care, where it may enhance safety and efficacy. Early pregnancy assessments using ultrasound are also reviewed, with findings supporting its use in diagnosing ectopic pregnancies and early pregnancy loss.Summary: The findings highlight the importance of integrating ultrasound into routine clinical practice for family planning and early pregnancy care. By facilitating rapid diagnosis and management within a single visit, POCUS can potentially reduce emergency department utilization and improve patient satisfaction. Future research should focus on standardizing ultrasound protocols and exploring its broader applications in reproductive health to further enhance clinical outcomes.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interface between reproductive and metabolic dysfunction in polycystic ovary syndrome. 多囊卵巢综合征中生殖和代谢功能障碍的界面。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-08-01 Epub Date: 2025-04-29 DOI: 10.1097/GCO.0000000000001037

Melody A Rasouli, Jessica Katz, Daniel A Dumesic

{"title":"Interface between reproductive and metabolic dysfunction in polycystic ovary syndrome.","authors":"Melody A Rasouli, Jessica Katz, Daniel A Dumesic","doi":"10.1097/GCO.0000000000001037","DOIUrl":"10.1097/GCO.0000000000001037","url":null,"abstract":"Purpose of review: New concepts have emerged regarding how interrelationships of hyperandrogenism and hyperinsulinemia from systemic insulin resistance contribute to the origins of polycystic ovary syndrome (PCOS). Although these androgen-insulin interrelationships are associated with several reproductive and metabolic variables, their specific cause and effect relationships remain unclear. This review examines specific causal relationships between hyperandrogenism and hyperinsulinemia from systemic insulin resistance to understand how these complex interactions contribute to the phenotypic expression of PCOS.Recent findings: Clinical interventions for the treatments of hyperandrogenism and hyperinsulinemia from systemic insulin resistance as well as in-vitro studies of androgen and insulin actions on critical target tissues are examined to understand why androgen-insulin interrelationships are central to the origins of PCOS.Summary: Bidirectional interrelationships between hyperandrogenism and hyperinsulinemia from systemic insulin resistance in normal-weight PCOS women may have originally evolved as an ancient metabolic adaptation to simultaneously favor fat storage and energy utilization for survival and reproduction during famine. These androgen-insulin interactions in PCOS now predispose to metabolic diseases and pregnancy complications in today's obesogenic environment and, therefore, require improved preventive healthcare to optimize the long-term health of PCOS women and their children.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"167-174"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0