Ultrasound-guided erector spinae nerve block for relief of endometriosis pain in the emergency department
We report the case of a 23-year-old female with a past medical history of endometriosis who presented to a freestanding emergency department with a chief complaint of 10/10 pelvic pain on a numeric rating scale. She had tried non-steroidal inflammatory medications and heat with no success. The patient had medication intolerances to opioid analgesics and was given ketorolac intramuscularly with no relief of her pain. The emergency physician discussed and offered to perform an erector spinae plane nerve block (ESPB) for pain relief. Ultrasonography was utilized for visualization of landmarks with a curvilinear transducer; a ...
Source: Pain Physician - March 21, 2024 Category: Anesthesiology Authors: Robert Stenberg Kristen Septaric Erin L Simon Source Type: research
Bowel endometriosis excision – approaches and outcomes
Hand sewing discoid excisions does not require the use of a circular stapler and can be performed by a skilled laparoscopic surgeon. There is limited prior data on outcomes following hand sewn closure of discoid resection for bowel endometriosis. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: L Chatroux, P Maghsoudlou, M Ajao, L King, J Einarsson Source Type: research
Assessment of education and management of endometriosis among colorectal surgery residents
Nearly 20% of women with endometriosis are diagnosed with deep infiltrating disease and among those, 5-12% have bowel or rectovaginal involvement. Gynecologic and colorectal surgeons highly trained in endometriosis resection are important to maximize adequate resection and minimize complications. Prior data suggests that endometriosis-focused surgical training for colorectal surgeons can be optimized. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: G Rivera Ortiz, AL Gubbels, G Poles, N Mahnert Source Type: research
The impact of surgeons ’ specialty on surgical outcomes following colorectal resection for endometriosis
It is estimated that 5-25% of women with endometriosis have colorectal involvement. Surgical management options include shaving, discoid excision, and resection. In cases of large bowel infiltration, colorectal resection may be the most suitable technique. However, colorectal resection is also associated with the highest rate of postoperative complications. Currently, data focusing on surgeons ’ specialty and surgical outcomes are scant. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: K Hamilton, R Meyer, R Schneyer, G Levin, M Truong, K Wright, M Siedhoff, M Barnajian, Y Nasseri Source Type: research
Feasibility and impact of a postoperative pelvic floor physical therapy telehealth appointment: a pilot study
Laparoscopic surgery is a common intervention for chronic pelvic pain (CPP) as it is currently the only way to definitively diagnosis endometriosis. Pelvic floor physical therapy (PFPT) has recently been introduced as an option for the management of CPP with the aim of relaxing pelvic muscles in order to reduce spasm and associated pain. With an increased focus on multimodal care for CPP, more patients are being referred to PFPT preoperatively. While patients may experience improvement in their pain syndrome prior to surgery, patients may suffer a setback in PFPT progression postoperatively from limitations in movement and...
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: UOPS Medicine, N Donnellan, N Goodman Source Type: research
Prevalence of endometriosis and pelvic pain in patients with hereditary connective tissue disorders
Chronic pelvic pain is one of the most common reasons for referral to a gynecologic provider, accounting for up to 20% of outpatient visits in the specialty. The true prevalence of chronic pelvic pain is difficult to assess, with rates of 4-25% reported in the literature. Endometriosis is similar, but has an accepted prevalence of around 10% for reproductive women. Chronic pain is a hallmark of many hereditary connective tissue disorders (HCTDS) with over 92% of female patients with EDS reporting pain. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: N Jesse, A Yunker Source Type: research
Diaphragmatic endometriosis excisions and associated pathology in VATS procedures
It is estimated that in approximately 12% of endometriosis cases, lesions are found outside of the pelvis. The most common site of extra-pelvic disease is the diaphragm. (Andres et al. 2020). Despite the estimated low incidence of concomitant diaphragmatic and pleural cavity disease, patients with diaphragmatic disease opt to undergo a Video-Assisted Thoracic Surgery (VATS) procedure to further evaluate for thoracic endometriosis. Data are limited showing the proportion of diaphragmatic endometriosis patients who also have pleural cavity involvement. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: T Gallant, M Luna-Russo, C King Source Type: research
Urinary tract injuries during hysterectomy for endometriosis: a NSQIP study
Urinary tract injuries following hysterectomy are rare, though endometriosis is a known risk factor. Rates of injury in this setting following wide adoption of laparoscopy are of interest. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: B Hickey, K Stewart, A Cope, K Tessier, C Fok, S Hutto Source Type: research
Battle of the bots: a comparative analysis of generative ai responses from leading chatbots to patient questions about endometriosis
The use of generative artificial intelligence (AI) has begun to permeate through most industries including medicine, and it is inevitable that patients will begin using these large language model chat bots as a modality for education. Different chatbots can provide different answers to the same question due to variability in training data, the statistical nature of response production and use-specific interactions. As healthcare information technology continues to evolve, it is imperative to evaluate chatbots and the accuracy of the information they provide to patients, and to determine if there is variability between them...
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: N Cohen, K Kho, K Smith Source Type: research
Pain without prejudice? examining disparities in endometriosis and pelvic pain management stratified by race in an integrative healthcare system
An estimatedApproximately 10% of reproductive age women suffer from endometriosis; however, racial variations in prevalence and treatment are unknown. Black women are often undertreated for pain and medical conditions. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: E Zaritsky, A Childs, E Hen, L Tucker, M Weintraub-Ritterman, C Wicks Source Type: research
Approach to the obliterated anterior Cul-De-Sac during a total laparoscopic hysterectomy
An obliterated anterior cul-de-sac occurs when the vesico-uterine avascular space is absent leading to distortion of normal anatomy. Risk factors include cesarean deliveries, prior pelvic surgeries, infection, and endometriosis. Knowledge of anatomy and good surgical technique is critical to safe completion of a hysterectomy. The laparoscopic approach provides advantages of improved visualization posteriorly, global survey, assistance of the pneumo-peritoneum in plane dissection, and decreased blood loss. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: A Nutaitis, M Billow Source Type: research
Technique for excision of rectovaginal endometriotic nodules
Rectovaginal endometriosis is a severe form of endometriosis, often presenting with different symptoms including but not limited to pelvic pain, dysmenorrhea, dyspareunia, dyschezia. History, physical exam and imaging techniques are crucial for diagnosis and surgical counseling. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: G Namazi, S Nahas, J Cruz, M Stuparich Source Type: research
Multidisciplinary surgical management of deep endometriosis with single robot port set-up
DE endometriosis is a chronic condition that affects up to 10% of reproductive aged women. The presenting symptoms can vary depending on the location, lesion severity, fibrosis and anatomic distortion. Bowel and diaphragmatic endometriosis are estimated to affect 5-12% and 1-1.5%, respectively, of women with DE. Surgical management of these complex cases requires skilled minimally invasive, colorectal and cardiothoracic surgeons. Utilization of the optics and ergonomics provided with the robot can allow for more complete endometriosis excisions and thus improved patient outcomes. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: J Clay, A Spivak, D Raymond, T Gallant, M Luna Russo Source Type: research
Fertility sparing approach for hemorrhagic ascites associated with endometriosis
Endometriosis can present in a variety of ways. This is an example of an unusual presentation of endometriosis but an important presentation. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: K Schmidt, A Mohr-Sasson, S Shah, A Bhalwal Source Type: research
Key techniques for difficult bladder dissection during robotic assisted total laparoscopic hysterectomy
Bladder dissection can be challenging in patients with a history of cesarean section, endometriosis, or prior pelvic surgeries that result adhesive disease of the bladder to the lower uterine segment. It is important for gynecologic surgeons to master techniques to safely accomplish a difficult bladder dissection during minimally invasive hysterectomy to avoid injury or conversion to laparotomy. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - March 21, 2024 Category: OBGYN Authors: M Caplan, M Misal Source Type: research
