Urogynecology (Hagerstown, Md.)最新文献

{"title":"YouTube and UTIs: What Is Online Video Content Teaching Our Patients?","authors":"Benjamin Worrall, Anthony-Joe Nassour, Kevin Zhuo, Maria Pilar Alvarado, Amanda Chung","doi":"10.1097/SPV.0000000000001672","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001672","url":null,"abstract":"<p><strong>Importance: </strong>YouTube is an important source of information about urinary tract infections (UTIs), which are the most common outpatient infections.</p><p><strong>Objective: </strong>This study aimed to assess the quality of YouTube videos about UTI prevention.</p><p><strong>Study design: </strong>Three doctors independently reviewed the first 50 YouTube search results for \"how to prevent UTIs,\" using the DISCERN and Patient Education Materials Assessment Tool (PEMAT); SPSSv28 was used for analysis with P < 0.05 considered significant.</p><p><strong>Results: </strong>Three non-English videos were excluded. Sixteen of 47 (34%) were produced by medical sources. Forty-three of 47 (91%) were targeted at patients, rather than clinicians. The median views per video was 24,110 (88-5,552,204). Nonmedical sources ranked higher in search results (rs = 0.41, P < 0.05). Nonmedical sources had more subscribers and views. Nonmedical sources were \"liked\" significantly more than nonmedical sources (U = 146, P < 0.05). The overall quality of evidence-based material was moderate (mean DISCERN, 3.1). Medical sources were significantly more accurate than nonmedical sources (DISCERN, 3.6 cf. 2.9; P = 0.03). The overall mean PEMAT understandability was 62.8%, and actionability was 65.7%, with no significant difference between medical and nonmedical sources. The video view count was not associated with significantly higher PEMAT or DISCERN scores.</p><p><strong>Conclusions: </strong>Videos by medical sources were more factually reliable, but there was no difference in delivery quality between medical and nonmedical sources. Patients may present with inaccurate preconceptions about UTI treatment from YouTube, which practitioners should be prepared to address. There is a role for medical institutions and all doctors who treat patients for UTIs to create YouTube content that is both factually accurate and accessible to patients.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activity Restrictions After Midurethral Sling: A Randomized Controlled Trial.","authors":"Pedro Alvarez, Cem Demirkiran, Leslie Rickey, Lisbet Lundsberg, Oz Harmanli","doi":"10.1097/SPV.0000000000001679","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001679","url":null,"abstract":"<p><strong>Importance: </strong>Postoperative activity restrictions can affect patient satisfaction after midurethral sling (MUS) surgery.</p><p><strong>Objective: </strong>The aim of the study was to assess the effect of a duration of postoperative activity restrictions on patient satisfaction and surgical outcomes after MUS surgery for stress urinary incontinence.</p><p><strong>Study design: </strong>Women undergoing MUS surgery alone for stress urinary incontinence were enrolled in this provider-blinded, randomized clinical trial. Randomization to either 3- or 6-weeks' duration of activity restrictions was assigned. Restrictions included abstaining from lifting greater than 20 pounds, high-impact activity, or strenuous exercise. Primary outcome was patient satisfaction with surgery, using a 5-point Likert patient satisfaction scale. Satisfaction scores were analyzed in a \"complete satisfaction\" (\"completely\" satisfied only) and a \"higher satisfaction\" approach (both \"completely\" and \"mostly\" satisfied). Secondary outcomes included objective and subjective assessment of incontinence symptoms and activity assessment.</p><p><strong>Results: </strong>Ninety-eight women underwent MUS surgery between July 2021 and September 2022, and 88 were randomized. Of them, 41 and 43 women with 3- and 6-week restrictions had patient satisfaction data, respectively. Baseline characteristics did not differ between groups. At the 6-month postoperative visit, overall patient satisfaction (\"completely\" and \"mostly\" satisfied) was very high at 92%. Complete satisfaction was significantly higher in the 3-week (73.2%) versus the 6-week restriction group (51.2%) (P = 0.04). \"Higher satisfaction\" did not reach a statically significant difference between groups (P = 0.11). Subjective urinary incontinence indices did not differ between groups.</p><p><strong>Conclusions: </strong>Return to normal activities 3 weeks after MUS surgery resulted in significantly higher satisfaction scores at 6 months compared to a 6-week restriction without compromising subjective and objective surgical success.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Digital Therapeutic Device on Pelvic Floor Symptoms.","authors":"Milena M Weinstein, Gena C Dunivan, Noelani M Guaderrama, Holly E Richter","doi":"10.1097/SPV.0000000000001674","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001674","url":null,"abstract":"<p><strong>Importance: </strong>Women undergoing treatment for urinary incontinence (UI) often have additional pelvic floor disorders (PFDs). It is important to understand the effect of UI-focused pelvic floor muscle training (PFMT) on other PFDs.</p><p><strong>Objective: </strong>The objective of this analysis was to evaluate the prevalence of symptoms of pelvic organ prolapse (POP) and fecal incontinence (FI) in women treated for UI, and symptom changes following pelvic floor muscle training (PFMT) with and without a motion-based biofeedback device (MBBD).</p><p><strong>Study design: </strong>This was a post-hoc analysis of a randomized controlled trial comparing PFMT with and without an MBBD in women with UI. Symptomatic PFDs were defined using Pelvic Floor Distress Inventory-20 (PFDI-20) subscales, the Urogenital Distress Inventory Short Form (UDI-6), Colorectal Anal Distress Inventory-8 (CRADI-8), and the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6). Outcomes included the prevalence of multiple PFDs and change in UDI-6, CRADI-8, and POPDI-6 scores among participants with and without concomitant PFDs.</p><p><strong>Results: </strong>A total of 299 women were analyzed. Of 299 women, 161 (57%) reported symptoms of more than 1 PFD. Age and body mass index did not differ. Baseline UDI-6 scores were higher in those with additional PFD symptoms versus UI alone (45.7 ± 15.8 vs 60.7 ± 19.4, P < 0.001). For participants with UI plus at least 1 additional PFD symptom, improvement in UDI-6 scores at 6 and 12 months was significantly greater in the intervention group. For participants with FI, the CRADI-8 was significantly improved from baseline to 8 weeks, 12 months, and 24 months. For participants with POP symptoms, the POPDI score was significantly improved at all time points.</p><p><strong>Conclusions: </strong>Pelvic floor muscle training is effective in treating UI in the context of additional PFDs, as well as in treating symptoms of FI and POP.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trials and Tribulations of a Urinary Incontinence Screening Tool.","authors":"Falisha F Kanji, Tara Cohen, Claire S Burton, Catherine Bresee, Joshua Pevnick, Teryl Nuckols, Neil Wenger, Jennifer T Anger","doi":"10.1097/SPV.0000000000001678","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001678","url":null,"abstract":"<p><strong>Importance: </strong>Women experiencing symptoms of urinary incontinence (UI) may be reluctant to discuss their symptoms with their primary care physicians (providers) due to embarrassment and stigma surrounding the condition.</p><p><strong>Objectives: </strong>As part of a primary care quality improvement pilot intervention for UI, this study aimed to assess the success of an online screening tool in identifying bothersome urinary UI in a primary care setting. A secondary analysis sought to determine the percentage of women who discussed the condition with their providers.</p><p><strong>Study design: </strong>Providers from a regional medical group in Southern California and their female patients 18 years of age and older were invited to participate between July 2019 and February 2020. Female patients were recruited via a screening survey. Providers were alerted by email and the patient's electronic health record when a patient screened positive.</p><p><strong>Results: </strong>Twenty-four providers participated in the study. A total of 6,360 screening surveys were sent to female patients. Seven hundred nine (11.15%) responses were received. Three hundred two patients reported experiencing symptoms of UI, but only 166 patients chose to participate. Of the 166 participating patients, 35 (21.08%) spoke with their providers about their symptoms after they were screened.</p><p><strong>Conclusions: </strong>Online screening for UI is feasible. The observation that only 21% of patients had conversations with their providers about their symptoms during the appointment, even after the provider was notified of the positive screen, suggests the need for better tools, such as alerts in the medical record, to enhance provider awareness of their patients' UI.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of ChatGPT to Generate Informed Consent for Surgery in Urogynecology: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1097/SPV.0000000000001675","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001675","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Treatment Strategy for Overactive Bladder in the National Institute of Health All of Us Research Program.","authors":"Joris Ramstein, Seyedeh Neelufar Payrovnaziri, Heike Thiel de Bocanegra, Jenny Chang, Argyrios Ziogas, Dena Moskowitz","doi":"10.1097/SPV.0000000000001673","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001673","url":null,"abstract":"<p><strong>Importance: </strong>Overactive bladder (OAB) is a condition characterized by urinary urgency, frequency, and incontinence, affecting up to 43% of women. While treatment disparities are well-documented, this study sheds light on broader systemic barriers and the need for equitable approaches to improve diagnosis and management.</p><p><strong>Objective: </strong>This study aimed to examine the types of OAB treatments (no treatment, pharmacotherapy, advanced therapy) received by patients in the United States, stratified by race, ethnicity, and socioeconomic factors, using data from the All of Us Research Hub.</p><p><strong>Study design: </strong>Data were collected from 20,941 female patients diagnosed with OAB in the All of Us Research Hub. Patients were categorized into 3 treatment groups: (1) no treatment, (2) pharmacotherapy, or (3) advanced therapy. Demographic factors such as race, ethnicity, age, income, and health status were analyzed using univariate and multivariate logistic regression models to determine the influence on treatment type.</p><p><strong>Results: </strong>Of the participants, 71% received no treatment, 27% were treated with pharmacotherapy, and 2% underwent advanced therapy. On multivariate analysis, Asian and Hispanic patients were less likely to receive pharmacotherapy compared to White patients (odds ratio (95% CI), 0.47 (0.31-0.72) and 0.84 (0.74-0.95) respectively). Additionally, factors such as increasing age, unemployment, and lower income were associated with greater odds of receiving pharmacotherapy.</p><p><strong>Conclusions: </strong>Significant differences exist in the treatment of OAB, particularly among Asian and Hispanic patients. Socioeconomic factors and self-reported health status also affect access to treatment. Addressing these disparities is crucial to improving health care equity and access for patients with OAB.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed Opportunities: A Mixed-Methods Assessment of Disparities in Treatment for Fecal Incontinence.","authors":"Vienne Seitz, Jed Calata, Ling Mei, Emily R W Davidson","doi":"10.1097/SPV.0000000000001619","DOIUrl":"10.1097/SPV.0000000000001619","url":null,"abstract":"<p><strong>Importance: </strong>Previous work identified racial disparities in access to fecal incontinence (FI) treatments. However, less is known about patient perspectives of these barriers.</p><p><strong>Objectives: </strong>This study assessed differences in FI symptom severity and treatment utilization between Black and White patients.</p><p><strong>Study design: </strong>This mixed-methods assessment studied adult non-Hispanic Black and White women treated for FI who either did not respond to medical therapy nor received sacral neuromodulation or did not follow up after medical therapy. Structured interviews queried patients about treatments offered and symptom severity.</p><p><strong>Results: </strong>Of the 118 patients in the retrospective evaluation, 59 (50%, 24 Black and 35 White) were interviewed. Black patients were more likely than White patients to report occasional, weekly, or daily solid and stool incontinence (75.0% vs 48.6%, P = 0.042; 87.5% vs 51.4%, P = 0.004, respectively) and flatal incontinence (83.3% vs 62.9%, P = 0.088).Of those prescribed fiber supplements and antidiarrheal medications, Black patients were less likely to report symptom improvement (25.0% vs 70.0%, P = 0.013; 57.1% vs 87.5%, P = 0.092, respectively, for each medication type) and ongoing regimen adherence (25.0% vs 63.3%, P = 0.013; 28.6% vs 87.5%, P = 0.035, respectively).Black patients were more likely to report impairment in daily functioning secondary to FI (83.3% vs 57.1%, P = 0.034) and were more likely to seek a follow-up visit with a health care professional that performs sacral neuromodulation (79.2% vs 28.6%, P < 0.001).</p><p><strong>Conclusions: </strong>Black patients were more likely to have severe symptoms and poorer treatment outcomes and desire future follow-up, highlighting the importance of addressing racial differences in patient preferences in FI management strategies.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"243-249"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric Anal Sphincter Injury and Female Sexual Dysfunction: A Systematic Review.","authors":"Dora Jericevic Schwartz, Isabella Cervantes, A U Amanda Nwaba, Mary Duarte Thibault, Moiuri Siddique","doi":"10.1097/SPV.0000000000001593","DOIUrl":"10.1097/SPV.0000000000001593","url":null,"abstract":"<p><strong>Importance: </strong>This is the first systematic review on female sexual dysfunction (FSD) in patients who sustained obstetric anal sphincter injury (OASI).</p><p><strong>Objective: </strong>The aim of the study was to characterize FSD following OASI.</p><p><strong>Study design: </strong>Between January and April 2024, we conducted a literature search of studies that explored outcomes of FSD following OASI, reporting on rates of dyspareunia and/or using questionnaires that measured female sexual function.</p><p><strong>Results: </strong>Fourteen studies with 1,907 OASI patients met inclusion criteria. Rates of dyspareunia in the first year after OASI ranged from 27% to 35% with only 40%-57% of women having resumed sexual activity at 3 months postpartum. The Female Sexual Function Index (FSFI) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were the most utilized questionnaires. Using the FSFI, the range of FSD was 47%-81% among patients with OASI. The FSFI subdomain scores (maximum 6) for desire and arousal had the least improvement with time, ranging from 1.3-2.1 at 2 months to 3-3.1 at 4 months. Pain, lubrication, and orgasm domains showed greater improvement with time, ranging from 1.4-1.6 at 2 months and up to 3.5-3.8 at 4 months. Five studies used the PISQ-12 with mean scores of 34.1-39 (range 0-48), 3 of which included a non-OASI control group and found similar PISQ-12 scores between groups. Physical therapy did not significantly impact FSD.</p><p><strong>Conclusions: </strong>One-third of patients with OASI experience dyspareunia in the first year postpartum, 1in 2 patients do not resume intercourse at 3 months postpartum, and FSD, measured by the FSFI, may be present in 80% of women with OASI at 3 months postpartum.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"292-300"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Racial, Ethnic, and Socioeconomic Disparities in Pelvic Organ Prolapse Surgery.","authors":"Samantha DeAndrade, Krystal DePorto, Kaitlin Crawford, Lucas Saporito, AnMarie Nguyen, Tajnoos Yazdany, Christopher Tenggardjaja","doi":"10.1097/SPV.0000000000001633","DOIUrl":"10.1097/SPV.0000000000001633","url":null,"abstract":"<p><strong>Importance: </strong>Racial/ethnic and socioeconomic disparities have been observed in the mode of pelvic organ prolapse surgery. Some of the disparities may be attributed to differences in access to care and advanced surgical technology across the United States, although this is difficult to study.</p><p><strong>Objective: </strong>We aimed to investigate whether racial/ethnic or socioeconomic disparities in a mode of prolapse surgery exist in a managed care setting, where differences in access are minimized.</p><p><strong>Study design: </strong>This was a retrospective cohort study of patients who underwent apical pelvic organ prolapse surgery within Kaiser Permanente Southern California facilities between 2014 and 2017. We conducted bivariate tests to examine the associations between patient characteristics and multivariate logistic regression to predict the odds of having obliterative and native tissue repair surgical procedures by race and income.</p><p><strong>Results: </strong>The analytic sample consisted of 2,798 patients who underwent prolapse surgery. Hispanic/Latina, Non-Hispanic White, Non-Hispanic Black, Asian, and \"other\" race represented 51.1%, 37.0%, 5.7%, 5.3%, and 0.8% of the sample, respectively. Median household income varied by racial groups. After adjusting for patient characteristics and regional factors, we did not find significant differences in apical prolapse surgery mode by race/ethnicity or income level.</p><p><strong>Conclusions: </strong>Within this managed care setting, no disparities in mode of apical prolapse surgery were observed by race/ethnicity or income level when regional and patient-level confounders were controlled for, such as prolapse stage and comorbidities. This may suggest that a significant driver of racial/ethnic disparities observed in prolapse surgery may be attributed to structural level factors.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"174-182"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AUGS 45th Presidential Address: My Story and AUGS.","authors":"Jennifer M Wu","doi":"10.1097/SPV.0000000000001654","DOIUrl":"10.1097/SPV.0000000000001654","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 3","pages":"171-173"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}