Urogynecology (Hagerstown, Md.)最新文献

{"title":"Goal Achievement in Women With Urinary Incontinence After Midurethral Sling.","authors":"Julia K Shinnick, Vivian W Sung, Emily S Lukacz, Christopher Chermansky, Heidi S Harvie, David Ellington, Marie Fidela Paraiso, Stephanie Yu, Donna Mazloomdoost, Benjamin Carper, Rebecca G Rogers","doi":"10.1097/SPV.0000000000001893","DOIUrl":"10.1097/SPV.0000000000001893","url":null,"abstract":"<p><strong>Importance: </strong>Treatment goals are understudied among women undergoing midurethral sling (MUS) surgery for mixed urinary incontinence (MUI).</p><p><strong>Objectives: </strong>The objectives of this study were to describe treatment goals in participants with MUI undergoing MUS with or without perioperative behavioral and physical therapy (BPT). Secondary objectives included describing goal achievement and identifying predictors of achievement.</p><p><strong>Study design: </strong>Participants in a multicenter, randomized trial of MUS surgery with or without BPT completed patient-reported outcome (PRO) measures and the Self-Assessment Goal Achievement questionnaire (rating the importance of 9 preset goals on a 6-point scale, self-identifying 5 additional goals). At baseline, 6 months and 12 months, goal achievement was rated on a 5-point scale with 5 indicating \"greatly exceeded goal\" and scores ≥4 considered \"achieved.\" Self-identified goal themes were identified, and factors associated with goal achievement were examined.</p><p><strong>Results: </strong>Mean age of the 366 participants was 54.6 (10.4) years, 348 (95.0%) rated stress urinary incontinence-related goals 5/5 in importance, and 319 (87.2%) rated ≥1 of the urgency-related goals 5/5 in importance. Goal themes included coping, hygiene, effect on activities, sexual function, social function, and self-esteem. Achievement of at least 1 goal occurred in 346 of 366 (94.5%) with no differences between groups for most goals by 12 months. Compared with the MUS alone group, the MUS with or without BPT group had higher odds of achieving ≥1 urgency-related preset goal at 6 months (adjusted odds ratio, 2.90; 95% CI, 1.59-5.30, P<0.001). Goal achievement was associated with greater improvements in PROs.</p><p><strong>Conclusions: </strong>Among women with MUI undergoing MUS surgery with or without BPT, the majority reported high importance of both stress and urgency-related goals. Most stress- and urgency-related goals were achieved by 12 months.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284236","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":"Expectations Versus Experience in Urogynecologic Surgery: A Qualitative Study.","authors":"Antonella M D'Ascanio, Helen Y Zhang, Dominique Malacarne Pape, Cara L Grimes, Sarah E Andiman","doi":"10.1097/SPV.0000000000001887","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001887","url":null,"abstract":"<p><strong>Importance: </strong>Studies suggest that patients often do not feel fully prepared for surgery and may experience feelings of apprehension, fear, and distress. More information is needed about exactly how patients' preoperative expectations diverge from surgical experience and postoperative course.</p><p><strong>Objectives: </strong>The objectives of this study were to explore patient perspectives of the surgical experience, characterize areas of dissonance between expectations and reality, and to identify opportunities to improve perioperative care in urogynecology.</p><p><strong>Study design: </strong>We conducted a qualitative study of patients 6 weeks to 12 months after a hysterectomy with apical suspension. Patients were recruited from a 4-surgeon academic urogynecology practice between December 2022 and May 2024. Participants completed a 1:1 semistructured interview. Thematic analysis was performed using the grounded theory method, and Dedoose Software was used to produce descriptive reports.</p><p><strong>Results: </strong>Twenty-one interviews were completed. Five key themes emerged: (1) preoperative preparations, (2) interpersonal interactions, (3) perioperative stressors, (4) postoperative expectations, and (5) validation of surgical decision. Preoperative concerns included fear of anesthesia, anxiety surrounding voiding trials, and unease about the recovery process. Positive experiences were linked to supportive interactions with surgeons, nursing staff, and loved ones. Unexpected stressors included difficulties with medication access, understaffing, and unanticipated pain (eg, dysuria, shoulder pain, throat pain). Perceptions of recovery varied, but all participants agreed that they would recommend surgery to others, citing improvements in quality of life as a key factor in their satisfaction.</p><p><strong>Conclusions: </strong>This study identified discrepancies between preoperative expectations and patients' perioperative experiences. Addressing these gaps through enhanced education and communication may reduce preoperative anxiety and improve patient satisfaction.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260806","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":"Perioperative Gabapentin and Opioid Requirements: A Randomized Controlled Trial.","authors":"Anna Guanzon, Douglass Hale, David Morse, Surya Sruthi Bhamidipalli, David Guise, Jennifer Hamner, Michael Heit","doi":"10.1097/SPV.0000000000001891","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001891","url":null,"abstract":"<p><strong>Importance: </strong>Utilizing nonopioid analgesics is critical for postoperative pain control. The exact regimen has not been determined.</p><p><strong>Objective: </strong>This study aimed to determine if preoperative gabapentin is noninferior to preoperative and postoperative gabapentin following prolapse surgery.</p><p><strong>Study design: </strong>This was a randomized, double-blinded, placebo-controlled noninferiority trial of patients undergoing prolapse repair. The primary outcome was the percentage of patients requiring an opioid prescription at discharge. Secondary outcomes included pain scores, total morphine milligram equivalents used, postoperative nausea, sedation scores using the Stanford Sleepiness Scale, and frequency of opioid refill requests. The control group received preoperative and postoperative gabapentin. The experimental group received preoperative gabapentin and postoperative placebo. Both groups received acetaminophen and ibuprofen preoperatively and postoperatively, with oxycodone available as needed. Patients who used ≥5 oxycodone doses received a prescription for opioids on discharge. Assuming 23.1% of patients who receive preoperative and postoperative acetaminophen, ibuprofen, and gabapentin require an opioid prescription at discharge and a 20% noninferiority margin, 55 patients per arm were required to achieve a power of 80% with a significance level of 0.05.</p><p><strong>Results: </strong>A total of 114 patients completed participation: 55 in the control group and 59 in the placebo group. The control group did not differ from the experimental group in terms of receiving an opioid prescription at discharge (27.0% vs 32.0%, P=0.57, absolute risk difference: 5.0%; 95% CI, -12%, 21%) or requesting a refill or new prescription for opioids within 6 weeks postoperatively (10.9% vs 15.3%, P=0.49).</p><p><strong>Conclusions: </strong>We cannot conclude that placebo is noninferior to postoperative gabapentin as a strategy to reduce opioid prescriptions at discharge because the upper margin of the 95% confidence interval exceeded our a priori established 20% margin.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254822","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":"Gender-Affirming Testosterone Treatment and Lower Urinary Tract Symptoms.","authors":"Fabiana M Kreines, Caroline Cox, Sunni L Mumford, Heidi S Harvie, Lily A Arya, Uduak U Andy","doi":"10.1097/SPV.0000000000001890","DOIUrl":"10.1097/SPV.0000000000001890","url":null,"abstract":"<p><strong>Importance: </strong>In the United States alone, 1.6 million people identify as transgender and gender diverse. Although transgender individuals commonly report lower urinary tract symptoms (LUTS), the factors underlying these symptoms are poorly understood.</p><p><strong>Objectives: </strong>Our primary aim was to compare the severity and effect of LUTS in transgender men/transmasculine individuals taking testosterone therapy with those not taking testosterone. We hypothesize that patients who are using gender-affirming testosterone have less severe LUTS compared with those who are not receiving such treatment.</p><p><strong>Study design: </strong>We conducted a cross-sectional study of transgender individuals assigned female at birth aged 18 years and older receiving care with Obstetrics and Gynecology and Family Medicine within a single tertiary care hospital system. Our primary outcome was LUTS as measured by the Patient Perception of Bladder Condition, a validated single-item questionnaire that queries if participants have bladder symptoms that cause problems.</p><p><strong>Results: </strong>One hundred thirty-one respondents were included in the analysis: 106 currently taking testosterone and 25 not taking testosterone. Mean age (±SD) for all participants was 30.4 ± 7.2 years. Overall, 108 (82.4%) of participants identified as White and 12 (9.2%) identified as Black. Sixty-nine participants (52.7%) identified as men, and 56 (42.8%) identified as nonbinary. Individuals taking testosterone were 5 times less likely to report moderate-to-severe bladder problems compared with those not taking testosterone: (6.6% [7/106] vs 36% [9/25], P <0.001).</p><p><strong>Conclusions: </strong>Genderaffirming testosterone therapy was associated with less bothersome LUTS in our population of transgender men/transmasculine individuals. Further research will be necessary to elucidate the nature of and underlying reason for this relationship.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221036","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: A Single-Site Survey Study.","authors":"Amine Sahmoud, Emily Hoffberg, Ryan Armstrong, Susan Wherley, Sangeeta Mahajan, David Sheyn","doi":"10.1097/SPV.0000000000001892","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001892","url":null,"abstract":"<p><strong>Importance: </strong>Disparities in urogynecologic care are well documented, but patient-reported barriers remain poorly characterized.</p><p><strong>Objective: </strong>The objective of this study was to evaluate how structural and informational barriers to urogynecologic care vary by race and neighborhood socioeconomic disadvantage, measured using the Area Deprivation Index (ADI).</p><p><strong>Study design: </strong>This cross-sectional study surveyed new urogynecology patients at a midwest academic medical center between January 2024 and May 2024 (IRB STUDY20231132). Participants completed a 23-item questionnaire adapted from the National Institutes of Health All of Us survey assessing access, symptom recognition, referral pathways, and perceived barriers. Demographic and clinical data were obtained by chart review. Zip code-linked ADI percentiles were analyzed using nonparametric tests and multivariable logistic regression, with ADI reported per 10-point increase.</p><p><strong>Results: </strong>Among 219 participants, Black patients resided in more disadvantaged neighborhoods than White patients (mean ADI 80.0 vs 53.4; P<0.001). Higher ADI was independently associated with ≥1-hour round-trip travel (odds ratio [OR], 1.42; 95% CI, 1.15-1.79; P<0.001) and seeing ≥2 health care providers before referral (OR, 1.17; 95% CI, 1.03-1.35; P=0.020). The Black race was independently associated with reporting multiple barriers (OR, 4.79; 95% CI, 1.76-13.19; P=0.002) and time off work as a barrier (OR, 4.42; 95% CI, 1.24-15.3; P=0.023). Higher ADI was also associated with a lack of awareness of urogynecology (OR, 1.27; 95% CI, 1.04-1.59; P=0.020). Appointment wait time ≥1 month was not associated with ADI or race.</p><p><strong>Conclusions: </strong>Race and neighborhood disadvantage were independently associated with distinct barriers to urogynecologic care, supporting targeted, equity-focused interventions. The authors encourage institutions to assess barriers faced by their community patient populations.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213755","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":"Sexual Function After Prolapse Repair and Retropubic Versus Single-incision Sling.","authors":"Jennie E Choi, Robert E Gutman, Cheryl B Iglesia, Greg Russell, Charles Rardin, Kimberly Kenton, Catherine A Matthews","doi":"10.1097/SPV.0000000000001888","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001888","url":null,"abstract":"<p><strong>Importance: </strong>Studies have shown that sexual function improves after surgical correction for stress urinary incontinence and pelvic organ prolapse. Current data suggest no significant difference in sexual function between transobturator and retropubic slings. However, there have been conflicting data regarding the newer, single-incision slings.</p><p><strong>Objective: </strong>The objective was to evaluate sexual function after placement of single-incision versus retropubic slings for management of stress incontinence among patients undergoing concomitant native tissue vaginal repair.</p><p><strong>Study design: </strong>We performed a secondary analysis of data collected through a multicenter, prospective randomized trial of patients with ≥ stage 2 prolapse and objectively confirmed stress urinary incontinence. Participants were randomized to concomitant single-incision sling with suprapubic sham incisions, or retropubic sling at the time of native tissue vaginal repair. All participants completed baseline and 12-month Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). The primary outcome was sexual function, as measured by change in summary PISQ-IR score.</p><p><strong>Results: </strong>Of 227 randomized participants who completed both baseline and 12-month questionnaires, 72 reported continued sexual activity. Of these, 36 (50%) were randomized to a single-incision and 36 (50%) to a retropubic sling. Sexual function was improved from baseline to follow-up (3.3-3.7 for single-incision, P<0.01; 3.2-3.8 for retropubic, P<0.01), and there was no difference between groups (P=0.21).</p><p><strong>Conclusion: </strong>For sexually active patients undergoing native tissue vaginal repair and concurrent sling placement for stress incontinence, sexual function scores overall improved in patients randomized to both single-incision and retropubic slings and were not different between groups.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159332","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 Antibiotics in Sacral Neuromodulation.","authors":"Ashley J Murillo, Megan Bradley, Jonathan P Shepherd","doi":"10.1097/SPV.0000000000001873","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001873","url":null,"abstract":"<p><strong>Importance: </strong>Preoperative antibiotics are currently recommended before sacral neuromodulation (SNM), but no guidelines exist for postoperative prophylaxis.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the cost-effectiveness of 3 antibiotic strategies for preventing SNM infections requiring explantation.</p><p><strong>Study design: </strong>A decision analysis model (TreeAge Pro) compared (1) intravenous preoperative and oral postoperative antibiotics (PrePostAbx), (2) intravenous preoperative antibiotics without postoperative antibiotics (PreAbxOnly), and (3) no antibiotics either preoperatively or postoperatively (NoAbx). Model inputs included SNM success/continuation, risk of antibiotic side effects, infection and explanation rates, and reimplantation±repeat infection. Modeled costs (2022 USD) included antibiotics ±side effects, explantation due to infection, and reimplantation. Effectiveness was reported as quality-adjusted life years (QALYs) over a 1-year horizon. Monte Carlo simulation (n=10,000) addressed uncertainty, and net monetary benefit (NMB) was used for comparison due to similar, nonnormally distributed QALYs.</p><p><strong>Results: </strong>PrePostAbx had the highest median costs ($28,848), $25 more than PreAbxOnly ($28,823). NoAbx had the lowest costs ($28,784) and the highest QALY (0.95) when accounting for antibiotic side effects (PrePostAbx and PreAbxOnly QALY=0.91). In 70.2% of 10,000 iterations, NoAbx was dominant, with lower costs and higher QALYs. At a willingness-to-pay threshold of $100,000, NMBs were similar (PrePostAbx=$62,158; PreAbxOnly=$62,176; NoAbx=$66,216). Utilizing a baseline infection rate of 3.23%, NoAbx was preferred. However, if infection rates exceed 5%, NoAbx would no longer be cost-effective.</p><p><strong>Conclusions: </strong>For infection rates <5%, omitting antibiotics for SNM is preferred, offering the lowest costs and the highest quality of life. Although abandoning all antibiotics is potentially controversial, PreAbxOnly is cost-effective compared with PrePostAbx due to lower costs, reduced side effects, and reduced antimicrobial resistance.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159363","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":"Sexual Function in a Randomized Trial of Pelvic Yoga for Urinary Incontinence.","authors":"Nancy Yang, Leslee L Subak, Abigail Shatkin-Margolis, Michael Schembri, Harini Raghunathan, Margaret A Chesney, Sarah Pawlowsky, Alison J Huang","doi":"10.1097/SPV.0000000000001705","DOIUrl":"10.1097/SPV.0000000000001705","url":null,"abstract":"<p><strong>Importance: </strong>Urinary incontinence (UI) can negatively affect sexual function in women. Although many women with UI seek complementary strategies such as pelvic floor yoga techniques to improve sexual functioning, evidence of their efficacy is limited.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the effects of a pelvic floor yoga program versus a general physical conditioning program on multidimensional sexual function in women with UI.</p><p><strong>Study design: </strong>Ambulatory women aged 45 and older with daily UI were enrolled in a multicenter randomized trial in 2019-2022. Participants were randomized to a 12-week program of group instruction and self-practice of Hatha yoga techniques tailored to pelvic floor function (pelvic yoga) or a time-equivalent program of general skeletal muscle exercises (physical conditioning). Intervention effects on sexual function, a prespecified secondary trial outcome, were examined using linear mixed models of change in Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR) scores over 6 and 12 weeks of intervention instruction.</p><p><strong>Results: </strong>Among 240 participants (121 pelvic yoga, 119 physical conditioning; ages 45-90 years), UI frequency averaged 3.4±2.2 episodes/day, and 129 (54.7%) participants were sexually active at baseline. Compared with physical conditioning, pelvic yoga did not result in significantly greater improvements in any PISQ-IR domain over 6 and 12 weeks. Within-group analyses showed that sexually active participants in the yoga group had a 3.7 (95% CI: 1.4-6.1) point improvement in condition-specific impact on sexual activity.</p><p><strong>Conclusions: </strong>Among midlife and older women with daily UI, a 12-week pelvic yoga intervention did not result in meaningfully greater improvements in sexual function compared with nonspecific physical conditioning exercise.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"635-645"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662849","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":"Health Care Sustainability: Strategies for Operating Rooms and Urogynecologic Procedures.","authors":"Chi Chiung Grace Chen, Sarah Andiman, Jaime Long, Leise Knoepp, Krista Reagan, Bilal Chughtai, Angela DiCarlo-Meacham, Alexandra I Melnyk","doi":"10.1097/SPV.0000000000001835","DOIUrl":"10.1097/SPV.0000000000001835","url":null,"abstract":"<p><p>In 2023, the World Health Organization (WHO) concluded that climate change is the biggest threat to public health. Health care has a large carbon footprint with operating rooms contributing an inordinate amount to this issue. Surgeons have an opportunity to lead sustainability efforts by changing individual practices and collaborating with other stakeholders. Some of these changes that have been suggested include using reusable devices, including gowns, drapes, and specula; updating instrument trays and surgeon preference cards to minimize opening unused instruments; using clean energy sources where possible and adapting energy-saving options, including powering down operating room lights and heating, ventilation, and air conditioning (HVAC), turning off water faucets when not in use, and running decontamination equipment at capacity; educating staff on properly separating waste to reduce regulated medical waste and increase recyclables; and encouraging anesthesia colleagues to use regional anesthetic and intravenous propofol when appropriate. In addition to decreasing adverse environmental impact, many of these strategies result in significant cost savings. Ultimately, a culture change must occur where all health care professionals recognize and take responsibility for the significant and adverse effect that health care, most notably procedural and surgical care, has on the environment while balancing the potential effects to the health of our patients.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"32 6","pages":"569-577"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984602","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":"Evaluating Use of Chat-Generative Pretrained Transformer for Patient Education of Pelvic Floor Disorders.","authors":"Carly Crowder, Delaney Sztraicher, Taylor Brueseke, Skylar Mogab, Charles Ihara, Dena Moskowitz","doi":"10.1097/SPV.0000000000001722","DOIUrl":"10.1097/SPV.0000000000001722","url":null,"abstract":"<p><strong>Importance: </strong>Pelvic floor disorders (PFDs) affect a growing number of women, who often avoid seeking medical attention. The emergence of digital technologies, including artificial intelligence and natural language processing, such as Chat-Generative Pretrained Transformer (ChatGPT) presents an opportunity for patients to access medical information online. This study evaluated ChatGPT's potential as a tool for patient education regarding pelvic floor disorders.</p><p><strong>Objectives: </strong>The primary outcome was to assess readability of ChatGPT responses to common patient questions about PFDs. Secondary outcomes included assessment of quality, accuracy, and reproducibility of ChatGPT responses.</p><p><strong>Study design: </strong>ChatGPT 3.5 was queried for responses to common patient questions regarding PFDs. Queries were made using 2 separate accounts and on 2 separate dates. Each response was scored for readability by the Flesch Reading Ease score. Three independent reviewers evaluated ChatGPT outputs for quality and accuracy using a 5-point Likert Scale. Responses from separate accounts and dates were reviewed for reproducibility. Analysis was primarily descriptive.</p><p><strong>Results: </strong>The average readability for all PFDs was found to be 33.57/100, corresponding to a college reading level. The median quality ranged from 3 to 4, indicating responses were of \"fair\" to \"good\" quality. Expert reviewers found that content was on average 86.71% accurate with 25% variation across responses.</p><p><strong>Conclusions: </strong>ChatGPT produces content at a college reading level, which is relatively accurate, of fair to good quality, and reproducible as judged by urogynecologists. Large language models may be a helpful patient education tool; however, further work remains to make ChatGPT accessible to individuals with low health literacy.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"706-711"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977406","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}