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Urge Incontinence: Updates in Non-pharmacologic Treatments
AbstractPurpose of reviewThe aim of this manuscript is to provide an overview of the recent literature on non-pharmacologic therapies for urgency urinary incontinence (UUI), specifically focusing on treatments for adult women who suffer from UUI in the setting of idiopathic overactive bladder syndrome (OAB).Recent findingsThis review describes recent studies examining the efficacy of biofeedback-assisted pelvic muscle therapy, the effect of bariatric surgery on urinary incontinence, alternative approaches for tibial and transcutaneous nerve stimulation, sacral neuromodulation as compared to botulinum toxin type A, and 5-ye...
Source: Current Obstetrics and Gynecology Reports - August 26, 2017 Category: OBGYN Source Type: research

Contemporary Treatment Strategies for Rare Epithelial Ovarian Cancers
We present a review of the rare epithelial ovarian cancer subtypes, including current best clinical practices for the management of each tumor type. (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - August 22, 2017 Category: OBGYN Source Type: research

Update on Surgical Treatments for Pelvic Organ Prolapse
AbstractPurpose of ReviewThe purpose of this review is to update readers on recent controversies and current evidence regarding surgical procedures for the treatment of female pelvic organ prolapse.Recent FindingsTopics discussed include the role of patient selection and individualized care that involves the patient in surgical decision-making. Perioperative decisions reflect rapidly advancing technology, innovations in surgical technique, surgical training, and surgeon ’s own unique preferences, all of which provide an opportunity for improved outcomes and also require deliberate attention to unanticipated patient safet...
Source: Current Obstetrics and Gynecology Reports - August 18, 2017 Category: OBGYN Source Type: research

Defecatory Dysfunction and the Pelvic Floor
AbstractPurpose of ReviewDefecatory dysfunction is infrequently considered a gynaecological problem. However, obstructed defecation (OD) more commonly affects women than men and is associated with pelvic floor dysfunction. Therefore, we set out to write a review from a urogynaecologists ’ prospective focusing on OD as it relates to the pelvic floor.Recent FindingsLiterature on this topic remains sparse and the studies tend to have a low sample size. It is clear that OD is associated with pelvic floor dysfunction including urinary incontinence and structural dysfunction; however, it is less clear which is the primary path...
Source: Current Obstetrics and Gynecology Reports - August 14, 2017 Category: OBGYN Source Type: research

Improvements in Contraception for Adolescents
AbstractPurpose of ReviewImproved contraceptive use has been cited as the main contributor to the dramatic decrease in adolescent pregnancy and birth in the USA. This review will explore empirical literature that underlies the recent trends in contraceptive use for adolescents.Recent FindingsThree major categories of findings were identified in our review. First, formal contraceptive practice recommendations from the Centers for Disease Control and Prevention remove some barriers to contraceptive care that may be particularly relevant for adolescents. The most important of these (1) indicates that the use of any contracept...
Source: Current Obstetrics and Gynecology Reports - August 7, 2017 Category: OBGYN Source Type: research

HPV Vaccination: Are We Meeting Our Targets in Cervical Cancer Prevention?
This article reviews a decade of data on vaccine safety, efficacy, disparities, and interventions to improve vaccination rates, focusing on the most recent year of published data. (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - August 3, 2017 Category: OBGYN Source Type: research

Conventional Laparoscopy vs. Robotic-Assisted Laparoscopy for Sacrocolpopexy and Sacrocervicopexy: a Review
AbstractPurpose of ReviewAn abdominal approach to apical pelvic organ prolapse surgery yields superior outcomes in terms of decreased recurrence rates. Furthermore, there is evidence to support that a minimally invasive approach yields better patient outcomes over an abdominal approach. However, there remains debate in the field over which minimally invasive approach is better. In this review, we compare conventional straight stick laparoscopy and robotic-assisted laparoscopy techniques for sacrocolpopexy and sacrocervicopexy (LSC and RASC).Recent FindingsWe reviewed data from recent retrospective and prospective studies t...
Source: Current Obstetrics and Gynecology Reports - August 2, 2017 Category: OBGYN Source Type: research

Bleeding Associated with Hormonal Contraceptives: Understanding and Managing a Common Problem
AbstractPurpose of ReviewChanges in menstrual bleeding are common with hormonal contraceptives, and unfavorable bleeding profiles are leading reasons for method dissatisfaction and discontinuation. Studies suggest that acceptance of menstrual disturbance is highly dependent on appropriate counseling. This review presents an overview of the pathophysiology of uterine bleeding related to hormonal contraceptive use, the expected bleeding profiles of the various hormonal contraceptives, and evidence supporting various management strategies for treatment of unscheduled bleeding.Recent FindingsPublished trials on treatments for ...
Source: Current Obstetrics and Gynecology Reports - July 22, 2017 Category: OBGYN Source Type: research

Emerging Therapies in the Management of High-Grade Serous Ovarian Carcinoma: a Focus on PARP Inhibitors
AbstractPurpose of ReviewThe aims of this review are to describe key clinical trials that led to Federal Drug Administration (FDA) approval of poly(ADP-ribose) polymerase (PARP) inhibitors for ovarian cancer treatment, contextualize current indications, and to present future perspectives on the use of PARP inhibitors in this setting.Recent FindingsSince 2014, the FDA has approved three PARP inhibitors for the treatment of relapsed ovarian cancer, initially for patients with BRCA mutations and more recently, for a broader patient population.SummaryHigh-grade serous ovarian carcinomas (HGSOC) account for more than 70% of epi...
Source: Current Obstetrics and Gynecology Reports - July 22, 2017 Category: OBGYN Source Type: research

In Pursuit of Solving a Global Health Problem: Prototype Medical Device for Autotransfusing Life-Threatening Postpartum Hemorrhage in Resource-Limited Settings
AbstractPurpose of ReviewThe purpose of the review is to provide an overview of innovative technologies being developed to prevent and treat postpartum hemorrhage in resource-limited settings and to discuss a promising new device designed specifically to address the lack of safe blood supplies in many areas of the world.Recent FindingsThere are several new technologies being used or tested to address the significant global health problem of postpartum hemorrhage, the leading cause of maternal morbidity and mortality worldwide. None of these new technologies have addressed the persistent lack of safe blood supplies in low r...
Source: Current Obstetrics and Gynecology Reports - May 20, 2017 Category: OBGYN Source Type: research

Care of the Transgender Child and Adolescent
AbstractPurpose of ReviewTransgender and gender non-conforming individuals are becoming increasingly visible in our society. Because they turn to physicians for assistance in transitioning as well as for their routine health care, it is important that gynecologists be knowledgeable resources and advocates.Recent FindingsUpdates on emerging long-term outcomes following early treatment of transgender adolescents are reviewed. Current guidelines for puberty suppression and gender-affirming hormone therapy are outlined. We emphasize providing a welcoming clinical environment and continued awareness of the mental healthcare cha...
Source: Current Obstetrics and Gynecology Reports - May 20, 2017 Category: OBGYN Source Type: research

Reproductive and Obstetrical Care for Transgender Patients
AbstractPurpose of ReviewThe purpose of this article is to briefly summarize some of the available reports regarding fertility, reproduction, and obstetrical care for transgender patients, as well as address some of the ethical and legal considerations.Recent FindingsTransgender individuals desire reproductive options but reproductive desires among individuals vary significantly. Some options for cross-gender hormones can permanently affect one ’s ability to biologically reproduce. Current standard of care is to offer fertility preservation prior to transitioning, but emerging research suggests that there may not be a hi...
Source: Current Obstetrics and Gynecology Reports - May 9, 2017 Category: OBGYN Source Type: research

CystoSure ™: A Unique Catheter-Based Instrument for Cystoscopy and Bladder Diagnostics in the Operating Room and Office
AbstractPurpose of ReviewDespite professional society recommendations and data supporting use, cystoscopy continues to be an underutilized tool by a gynecologist in the operating room and in the office. Traditional cystoscopy may present challenges for use by the gynecologic surgeon. CystoSure ™ is a unique catheter-based access sheath which makes cystoscopy safe, simple, and standardized in the operating room, at the office, and by the bedside.Recent FindingsCystoscopy is a cornerstone of urogynecologic office evaluation while also playing a critical role in the intraoperative assessment of the lower urinary tract in gy...
Source: Current Obstetrics and Gynecology Reports - May 8, 2017 Category: OBGYN Source Type: research

A High-Strength, Absorbable, Antibacterial Knotless Tissue Control Device for Fascial Closure
This article serves as a technological assessment of the latest barbed suture offered by Ethicon —STRATAFIX™ SYMMETRIC PDS™ Plus Knotless Tissue Control Device. This device is indicated for soft tissue approximation and can be used to close high tension areas, such as fascia.SummaryBarbed sutures were successfully introduced to gynecologic surgery many years ago, and their safety and effectiveness have been demonstrated in a variety of gynecological surgical procedures. By eliminating the need to tie surgical knots, barbed suture provides a few key advantages over conventional suture, such as reducing operating room ...
Source: Current Obstetrics and Gynecology Reports - May 6, 2017 Category: OBGYN Source Type: research

Non-Contraceptive Benefits of Hormonal Contraception: Established Benefits and New Findings
AbstractPurpose of ReviewThe majority of women who use contraception acknowledge the non-contraceptive benefits and many women use contraception solely for these benefits. The purpose of this review is to discuss the established benefits and highlight recent advances in our understanding of non-contraceptive benefits.Recent FindingsCombined hormonal contraception (CHC), especially extended-cycle CHC, provides significant improvement for women suffering from heavy menstrual bleeding, pelvic pain, menstrual migraines, and mood disorders. The levonorgestrel intrauterine device (LNG IUD) provides improvement in pain and bleedi...
Source: Current Obstetrics and Gynecology Reports - May 3, 2017 Category: OBGYN Source Type: research