Gynecology

When a patient’s pregnancy test is positive but ultrasound is inconclusive, a stepwise approach is essential to make an accurate-and timely-diagnosis.

A large multiyear cohort study by investigators at ColumbiaUniversity in New York City shows limited short-term benefit and significantly higher cost for robotic-assisted hysterectomy than for laparoscopic hysterectomy. The findings, say the researchers, point to the need for “rational strategies to implement new surgical technologies.”

The common disorder now called “polycystic ovary syndrome” (PCOS) is imprecisely labeled, according to an independent panel convened by the National Institutes of Health (NIH).The panel met in December 2012 in an evidence-based methodology workshop sponsored by the NIH Office of Disease Prevention and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The current genitourinary fistula classification systems have poor to fair prognostic value, as does an empirically derived scoring system that predicts fistula closure 3 months after surgery, according to the findings of a new prospective cohort study.

Continuous infusion of the NSAID ketorolac, a powerful nonopioid analgesic, is a safe therapeutic option for the management of postoperative pain, concludes a double-blind randomized controlled trial.

A randomized UK study of menorrhagia shows that the levonorgestrel intrauterine system (LNG-IUS) is more effective than standard medical treatment in reducing the adverse effect of the menstrual problem on women's quality of life.

First know the anatomy and the risk factors, but don't forget to screen for and recognize injury as well.

Women should wait 12 to 18 months after weight-loss surgery before trying to become pregnant, according to an evidence-based literature review.

Modifying the surface of pelvic mesh with phosphorylcholine (PC) may help reduce the incidence of mesh-related complications.

The use of fluids to increase blood flow before major surgery, with or without inotropes or vasoactive drugs, does not reduce mortality but may be associated with fewer complications and shorter hospital stays.

The use of size 1 multifilament sutures, when compared with 2/0 monofilament sutures, in pelvic organ prolapse surgery with vaginal closure was associated with a significantly higher number of short-term complications, according to a UK study.

Treatment of fibroids with hysteroscopic morcellation has pros and cons. For in-office treatment, the advantages and disadvantages are described here.

Prophylactic dexamethasone decreases the incidence of postoperative nausea and vomiting without causing observable adverse effects in patients after laparoscopic gynecological surgery, concludes a new meta-analytic review.

There is a prevalence of ileocecal involvement (IC) in women with deep, infiltrating endometriosis (DIE) according to the study presented at AAGL.

A study to determine the prevalence rate of endometriosis in Hispanic women found that endometriosis may be under diagnosed due to failure to biopsy suspected lesions at the time of surgery and failure to accurately dictate and thoroughly describe operative findings in OpNote.

As health care expenditures have risen and hospitals struggle to contain costs, there has been greater acceptance of reusing instruments that originally were designed and sold for single-use only. In a new Committee Opinion, ACOG discuss regulatory, safety, cost, and ethical issues surrounding reprocessed single-use devices.

Preoperative measurement of intra-abdominal visceral fat, and the ratio of intra-abdominal visceral fat to subcutaneous fat, may help predict women at greater risk for difficulties during robotic surgery.

The use of NovaSure for endometrial ablation results a variety of poor pregnancy outcomes, according to a study presented by Shannon Smith, MD, at the Global Congress of the American Association of Gynecologic Laparoscopists.

Although operative time is longer as compared with laparotomy, minimally invasive hysterectomy in obese patients is safe, with less blood loss and shorter hospital stays.

While the cervical stump may serve as a tissue barrier for a patient who has undergone a laparoscopic sacrocervicopexy for organ prolapse, mesh erosion and bacterial infection can still occur.

In obese patients, laparoscopic ports should be placed more than 10 centimeters from the midline to minimize the chance of injury to epigastric vessels, according to research presented at the 41st Global Congress of the American Association of Gynecologic Laparoscopists.

Radiofrequency volumetric thermal ablation is a safe and effective treatment for menorrhagia in women with symptomatic fibroids, providing both clinically and statistically significant reduction in blood loss, according to new research.

More than 64% of the adult women in the United States are overweight or obese, and these patients pose special challenges for surgeons. New research examining outcomes and complication rates, particularly in the emerging field of robotic surgery, will allow better management of these patients, and ObGyn.net will be paying special attention to this research at AAGL 2012 in Las Vegas.

ObGyn.net is headed to AAGL 2012 in Las Vegas, and we want to know: Which plenary sessions interest you most?

With AAGL 2012 right around the corner, we’re looking back at some of the most popular articles to come out previous AAGL meetings.