Urogynecology (Hagerstown, Md.)最新文献

{"title":"Letter to the Editor re: Using Chatbot to Better Understand What Matters Most to Urogynecologic Patients.","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1097/SPV.0000000000001898","DOIUrl":"10.1097/SPV.0000000000001898","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1142-1143"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284800","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":"Return to Baseline Activity Following Vaginal Pelvic Organ Prolapse Repair.","authors":"Erin E Mowers, Pamela Moalli, Lauren E Giugale","doi":"10.1097/SPV.0000000000001774","DOIUrl":"10.1097/SPV.0000000000001774","url":null,"abstract":"<p><strong>Importance: </strong>A lack of data on the time course of recovery following pelvic organ prolapse surgery limits evidence-based counseling.</p><p><strong>Objectives: </strong>The objective of this study was to define the time course of recovery following vaginal native tissue prolapse repair and identify factors affecting recovery. We hypothesized that half of the patients would return to baseline activity by 6 weeks.</p><p><strong>Study design: </strong>This was a secondary analysis of a previously published randomized controlled trial of perioperative pain control for women ≥18 years undergoing vaginal native tissue prolapse repair under general anesthesia and an enhanced recovery after surgery protocol. The Activities Assessment Scale was used to quantify perioperative functional status. Our primary outcome was the proportion of participants returning to baseline activity at 1,2, 6, and 12 weeks postoperatively. Secondary outcomes included factors associated with recovery.</p><p><strong>Results: </strong>Sixty-five participants (aged: 69.1±10.2 years) undergoing vaginal apical prolapse procedures were included. More than half (52.3%) returned to their baseline activity by 1 week postoperatively, with 69.2%, 84.1%, and 93.6% returning to baseline activity by 2, 6, and 12 weeks, respectively. On final multivariable analysis, chronic obstructive pulmonary disease [OR: 0.02 (95% CI, 0.001-0.43), P <0.05], total intraoperative morphine equivalents [OR: 0.89 (95% CI, 0.80-0.98), P <0.05], and total postanesthesia care unit phase 2 morphine equivalents [OR: 0.72 (95% CI, 0.52-0.99), P <0.05] were negatively associated with 6-week recovery.</p><p><strong>Conclusions: </strong>In women undergoing apical vaginal prolapse repair, >50% recovered baseline functional activity by 1 week, and >80% recovered by 6 weeks.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1034-1043"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566681","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":"Patient Decision Aids for Women With Urinary Incontinence: A Systematic Review.","authors":"Tsung Mou, Emily Bulczynski, Hailey Greenstone, Sofia Walters, Grace Doyle, Judy Rabinowitz, John B Wong, Michael K Paasche-Orlow","doi":"10.1097/SPV.0000000000001880","DOIUrl":"10.1097/SPV.0000000000001880","url":null,"abstract":"<p><strong>Importance: </strong>Across the urinary incontinence (UI) care continuum, women face multiple decision points from seeking an evaluation to selecting and pursuing treatment. Patient decision aids (PDAs) may facilitate decision making for UI care.</p><p><strong>Objective: </strong>The objective was to evaluate the availability, effectiveness, and quality of PDAs for women with UI.</p><p><strong>Study design: </strong>A systematic review and meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Embase, CINAHL, Web of Science, and Cochrane Central were searched from 2005, when the International Patient Decision Aid Standards (IPDAS) framework was introduced and the International Continence Society released updated UI definitions, through February 2026. Eligible studies evaluated PDAs for stress, urgency, or mixed UI. Primary outcomes followed the IPDAS framework and included attributes of the decision-making process, attributes of the choice, and health service outcomes.</p><p><strong>Results: </strong>Of 3,737 records screened, 9 studies met criteria, included 956 women (mean age 48-69 years). All PDAs focused on treatment selection in specialty care; none addressed care-seeking decisions or care occurred in primary care. Although these PDAs were associated with reduced decisional conflict, evidence for improved knowledge, patient-clinician communication, or satisfaction was lacking. Despite 8 of 9 studies meeting more than half of the IPDAS criteria, the overall risk of bias was high due to nonrandomized designs.</p><p><strong>Conclusions: </strong>Existing PDAs for women with UI focus on reducing uncertainty about treatment selection in specialty care, yet do not show a causal effect of PDA reducing decision conflict or address the foundational decision of whether to seek care. Future PDA development should span the full care continuum and ensure rigorous evaluation.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1023-1033"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984615","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":"Barriers to Accessing Urogynecologic Care in a Federally Qualified Health Center.","authors":"Xiomara Brioso, Rebecca Borneman, Liz Yanes, Ayomipo Madein, Abigail Davenport, Nancy Ringel","doi":"10.1097/SPV.0000000000001782","DOIUrl":"10.1097/SPV.0000000000001782","url":null,"abstract":"<p><strong>Importance: </strong>Social and structural barriers affect access to urogynecologic care for underserved patients, but few studies explore patient experiences at federally qualified health centers (FQHCs).</p><p><strong>Objective: </strong>The objective of this study was to identify barriers to accessing urogynecologic care from the patient perspective at an FQHC affiliated with an academic medical center.</p><p><strong>Study design: </strong>Female-identifying patients ages 18-100 years who were referred for and subsequently missed their new urogynecology appointment from October 1, 2022, through February 28, 2023, were recruited for participation in qualitative interviews. A semi-structured interview guide was used for telephone interviews. Transcripts were coded thematically using grounded theory until theoretical saturation was reached.</p><p><strong>Results: </strong>Thematic saturation occurred with 17 participants. Participants were predominantly Hispanic, the mean age was 55 years, and most were insured by Medicaid or self-pay. The most common referral diagnosis was urinary incontinence (n=13). Major themes regarding barriers included scheduling issues, transportation, language barriers, and perceived costs. All participants identified at least 1 barrier to accessing urogynecologic care, with scheduling challenges related to poor communication from clinic staff as the most common reason. Transportation was the second most cited barrier.</p><p><strong>Conclusions: </strong>Barriers to accessing urogynecology care are prevalent, even at FQHCs with dedicated subspecialists on site. Poor communication and transportation were the most cited barriers. These findings can inform quality improvement projects to increase access to urogynecologic care in these settings. It is imperative that women's health providers advocate for expanded access and implement changes to address these inequalities in urogynecologic care.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1066-1072"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812348","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":"Content Validity of a Patient-Reported Measure of Postoperative Recovery.","authors":"Margaret G Mueller, Marie G Ganz, Nazema Y Siddiqui, Vivian Sung, Uduak Andy, Shawn Menefee, Victoria Dounoucos, James W Griffith, Joseph Schaffer, Donna Mazloomdoost, Kimberly Kenton","doi":"10.1097/SPV.0000000000001825","DOIUrl":"10.1097/SPV.0000000000001825","url":null,"abstract":"<p><strong>Importance: </strong>Despite increasing focus on the benefits of expedited recovery after minimally invasive surgery (MIS), urogynecology lacks a validated, simple question to assess recovery.</p><p><strong>Objectives: </strong>The objectives of this study were to explore how patients evaluate postoperative recovery following MIS for apical pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI), and to confirm understanding of a recovery patient-reported outcome (PRO).</p><p><strong>Study design: </strong>This study enrolled women who underwent MIS for apical POP or an isolated procedure for SUI (midurethral sling placement or urethral bulking) in the past 4 weeks. English and Spanish cognitive interviews were conducted with the goal of identifying components of a participant's perception of recovery and their understanding of the PRO.</p><p><strong>Results: </strong>Sixty-three women recovering from POP procedures (41/63) and SUI procedures (22/63) underwent a cognitive interview at a median time since the index surgery of 3 weeks (range: 0-8). Common factors influencing a participant's report of recovery included activity and/or pain level, ability to participate in regular activities, and resolution of symptoms. Most participants defined recovery as getting back to \"normal,\" and viewed recovery as distinct from symptom resolution; however, some included symptom resolution in their definition. All participants understood the PRO, and the majority (48/63) felt either 75% or \"completely\" recovered at the time of their interview.</p><p><strong>Conclusions: </strong>Women undergoing surgical procedures for POP or SUI define recovery as getting back to normal or regular activities. \"To what extent do you feel physically recovered after surgery\" is understood by both English and Spanish-speaking participants recovering from POP or SUI surgery.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1120-1126"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195711","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":"Effect of Postoperative Weight Change on Outcomes After Midurethral Sling.","authors":"Marcela Toro Bejarano, Minita S Patel, Okezi Obrutu, Olga Ramm","doi":"10.1097/SPV.0000000000001919","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001919","url":null,"abstract":"<p><strong>Importance: </strong>Midurethral sling surgery is the gold standard surgical treatment for stress urinary incontinence, and many patients experience weight changes over time. The effect of these changes on long-term outcomes remains unclear.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the association between postoperative weight change of at least 10% and long-term retreatment and complication outcomes after midurethral sling surgery.</p><p><strong>Study design: </strong>This retrospective cohort study included adult women undergoing primary midurethral sling surgery for stress urinary incontinence between 2008 and 2019 within an integrated health care system. Eligible patients had at least 5 years of follow-up and longitudinal weight data. Postoperative weight change was categorized as stable (<10%) or at least 10% (loss, gain, or fluctuation). The primary outcome was retreatment for stress urinary incontinence identified using procedural codes. Secondary outcomes included sling-related complications. Multivariable logistic regression adjusted for age, body mass index, and comorbidities. Time to retreatment was assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Among 6,924 patients, 44.9% experienced at least 10% weight change. Overall, 5.2% underwent retreatment. Retreatment rates were lowest in the stable group (4.5%) and higher with weight gain (6.4%). Complications occurred in 16.5% and were lowest in the stable group (14.4%) and highest in the fluctuating group (26.4%). After adjustment, postoperative weight gain was independently associated with increased odds of stress urinary incontinence retreatment (adjusted odds ratio [aOR], 1.53; 95% CI, 1.17-1.99). Weight fluctuation had the strongest association with postoperative complications (aOR, 2.07; 95% CI, 1.49-2.84), followed by weight loss (aOR, 1.40; 95% CI, 1.18-1.65) and weight gain (aOR, 1.29; 95% CI, 1.09-1.52). Weight fluctuation was also independently associated with de novo urgency incontinence (aOR, 1.55; 95% CI, 1.12-2.12).</p><p><strong>Conclusions: </strong>Significant postoperative weight change may be associated with an increased risk of retreatment and complications. A better understanding of weight change patterns may improve long-term outcomes.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876991","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":"Early Onset of Intradetrusor OnabotulinumtoxinA for Urgency Urinary Incontinence.","authors":"Sarah Ashmore, Margaret G Mueller, Michelle Mucasey, Katherine Maher, Kimberly Kenton","doi":"10.1097/SPV.0000000000001807","DOIUrl":"10.1097/SPV.0000000000001807","url":null,"abstract":"<p><strong>Importance: </strong>The onset of symptom improvement following intravesical onabotulinum toxinA for urgency urinary incontinence is not well known.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the early efficacy of intradetrusor onabotulinumtoxinA for the treatment of urgency urinary incontinence.</p><p><strong>Study design: </strong>We performed a prospective observational study of women undergoing intradetrusor onabotulinumtoxinA for the treatment of urgency urinary incontinence. Adult women receiving an initial or subsequent injection of 100 units of intradetrusor onabotulinumtoxinA were included. Participants completed 3-day baseline voiding diaries, the Urinary Distress Inventory-6, and Incontinence Impact Questionnaire-7 before the procedure. Voiding diaries, Urinary Distress Inventory-6, and Incontinence Impact Questionnaire-7 were repeated daily for 14 days postprocedure. Statistical analysis of paired data (preprocedure and postprocedure) was performed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Thirty-one participants completed baseline and follow-up questionnaires. The median (range) baseline Urinary Distress Inventory-6 was 33 (8-71) and the Incontinence Impact Questionnaire-7 was 38 (0-100). The median baseline daily voids, urgency urinary incontinence episodes, urgency episodes, and nocturia episodes were 13 (8-20), 5 (2-15), 8 (3-17), and 4 (0-6), respectively. For all measures, day 1 outcomes were significantly improved from baseline. Day 1 median Urinary Distress Inventory-6 was 25 (0-67), Incontinence Impact Questionnaire-7 was 24 (0-81), daily voids were 10 (5-20), daily urgency urinary incontinence episodes were 2 (0-15), daily urgency episodes were 3 (0-20), and daily nocturia episodes were 2 (0-4). Significant improvement persisted over the 14-day follow-up.</p><p><strong>Conclusions: </strong>Women undergoing intradetrusor onabotulinumtoxinA for urgency urinary incontinence had significant subjective and objective improvement 1 day postprocedure.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1103-1110"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020926","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":"Enhanced Consent and Preparedness for Surgery: A Randomized Controlled Trial.","authors":"Carson F Woodbury, Hayley C Barnes, Menaka Yadav, Jasmin Nwachokor, Ana Burgos, Kayeromi Gomez, Thythy T Pham, Elizabeth R Mueller, Marian Acevedo-Alvarez","doi":"10.1097/SPV.0000000000001821","DOIUrl":"10.1097/SPV.0000000000001821","url":null,"abstract":"<p><strong>Importance: </strong>Prior studies of patient decision aids in urogynecology have not shown benefit, but these tools may have been written at a reading level above that of the average patient.</p><p><strong>Objectives: </strong>The primary aim was to determine if consent using an audiovisual decision aid (AVDA) written below eighth-grade reading level in English or Spanish affects patient preparedness for surgery. Secondary aims included correlating health literacy with preparedness and assessing patient satisfaction with the decision for surgery.</p><p><strong>Study design: </strong>We conducted a randomized controlled trial on patients undergoing surgery for pelvic organ prolapse or urinary incontinence. We compared standard informed consent (control) with watching the AVDA. The primary outcome was the overall response on the \"Preoperative Preparedness For Surgery\" questionnaire. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults. Postoperatively, satisfaction with the decision for surgery was assessed.</p><p><strong>Results: </strong>One hundred fifty-one participants completed the study. In each group, 98.7% of participants strongly agreed or agreed that they felt prepared for surgery (AVDA 74/75, control 75/76, P = 0.364). Most participants had adequate health literacy (AVDA 82.1%, control 81.8%). Among those with low health literacy, there was no significant difference in preparedness for surgery between AVDA and control ( P = 0.363). Most participants in both groups were satisfied with their decision for surgery (AVDA 98.6%, control 100%, P = 0.737).</p><p><strong>Conclusions: </strong>Use of an audiovisual decision aid written below eighth-grade reading level did not significantly affect preparedness for surgery, even among participants with low health literacy. Preparedness for surgery was high in both groups.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1111-1119"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195701","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":"Cost Effectiveness of Prophylactic Uterosacral Ligament Suspension During Hysterectomy.","authors":"Ashley J Murillo, Monica Saleeb, Jonathan P Shepherd, Stephanie Glass Clark","doi":"10.1097/SPV.0000000000001916","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001916","url":null,"abstract":"<p><strong>Importance: </strong>Standard hysterectomy care includes incorporating uterosacral ligaments into the vaginal cuff to reduce prolapse risk. A high uterosacral ligament suspension (USLS) results in a higher cuff attachment and is commonly used to treat prolapse but is rarely performed prophylactically. With limited data on its preventive value, computer modeling can assess whether prophylactic USLS should be routinely included to prevent prolapse.</p><p><strong>Objectives: </strong>This study evaluates the costs and cost-effectiveness of adding prophylactic USLS to benign hysterectomies.</p><p><strong>Study design: </strong>A cost-effectiveness model (TreeAge Pro, 2024 $U.S.) incorporated Medicare Physician Fee Schedules and Diagnosis-Related Group costs. A utility of 0.864 was assigned for prolapse occurrence following hysterectomy ± uterosacral ligament suspension, with a mean onset of 7 years. Sensitivity analysis varied prolapse onset (0-20 years) with a 3% discount rate. The model estimated the minimum additional percentage of prolapse prevented for prophylactic USLS to be cost-effective at a $100K per quality-adjusted life year threshold.</p><p><strong>Results: </strong>USLS added $4,992.87 in costs. It was cost-effective when prolapse risk was relatively reduced by ≥7.1%. In 87.0% of modeled scenarios, USLS met cost-effectiveness criteria. The minimum preventive benefit required for cost-effectiveness ranged from 5.8% (immediate prolapse after hysterectomy) to 10.5% (20-year delay). Including prolapse treatment costs would further improve cost-effectiveness.</p><p><strong>Conclusions: </strong>Prophylactic USLS increases costs and procedural risks but is cost-effective with modest prolapse risk reduction. While prospective comparative studies may be impractical, and inclusion of prophylactic USLS with all hysterectomies may overly stress the current system, it would still be reasonable to consider prophylactic USLS during hysterectomies.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820491","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":"Talking About Vibrators: A Qualitative Study of Urogynecology Patients and Physicians.","authors":"Caitlin E Carlton, Meheret Mekonnen, Karissa A Leong, Brittany L Roberts, Bradley E Jacobs, Cara L Grimes, Rebecca G Rogers, Erin C Deverdis","doi":"10.1097/SPV.0000000000001914","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001914","url":null,"abstract":"<p><strong>Importance: </strong>Sexual dysfunction is common in urogynecology patients. Vibrator use can improve sexual function. While patients are open to learning about vibrators, the topic is rarely discussed in a clinical context.</p><p><strong>Objectives: </strong>The objective of this study was to explore urogynecology patients' and physicians' beliefs and opinions about discussing vibrators in the clinical setting for improving sexual function.</p><p><strong>Study design: </strong>A qualitative study was conducted between September 2024 and February 2025. Urogynecology patients and practicing urogynecologists completed screening questionnaires, followed by one-on-one phone interviews. Transcripts were analyzed using rigorous grounded theory methods to identify key themes in the 2 cohorts.</p><p><strong>Results: </strong>Twenty-six urogynecology patients and 25 urogynecology physicians participated; thematic saturation was achieved at 19 interviews in both groups. Patient interviews yielded 3 thematic categories: (1) conversation barriers, (2) conversation facilitators, and (3) specific suggestions. Conversation barriers included embarrassment, fear of judgment, believing they're too old, lack of background knowledge, time constraints, and physician discomfort. Conversation facilitators included societal normalization, physician-initiated conversations, screening questions, patient-physician rapport, handouts/brochures, and posters. Specific suggestions were to be matter-of-fact, cite data, and use a health context. Major themes from physician interviews were causes of physician avoidance-including feeling underprepared, personal discomfort, concern about brand influence, and topic complexity; causes of perceived patient avoidance-patient disinterest and patient discomfort; and resulting practice patterns.</p><p><strong>Conclusions: </strong>Urogynecology patients and physicians identified key barriers to discussing vibrator use. Participants also highlighted several strategies to facilitate these conversations. Addressing the identified knowledge and resource gaps may improve urogynecologists' competence and confidence in this area.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802723","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}