BackTable OBGYN

Equity is not just a box to check; it is the framework for lasting change. In this week's BackTable podcast, guest host Dr. Veronica Lerner speaks with Dr. Ebony Carter, a high-risk obstetrician and Division Director for Maternal-Fetal Medicine at the University of North Carolina at Chapel Hill. Dr. Carter shares insights into her career journey, which was influenced by her mother's activism in health equity, her work on reproductive health disparities, and community engagement projects. ---SYNPOSISThe conversation underscores the importance of patient participation and agency in clinical decision-making. Dr. Carter and Dr. Lerner also discuss the development of an equity rubric for peer-reviewed journals, highlighting the need for inclusive and intentional research practices. They explore practical applications of the rubric, including the proper acknowledgment of contributors to foundational concepts. The episode further delves into Dr. Carter's mentorship initiatives at the Green Journal and her guiding philosophy of pursuing impactful, community-driven work rooted in passion and purpose.---TIMESTAMPS00:00 - Introduction02:06 - Dr. Carter's Journey and Inspiration05:19 - Community Engagement and Health Equity06:19 - Patient Advocacy and Shared Decision Making08:54 - Collaborative Research and Community Partnerships16:58 - Addressing Bias in Medical Practice22:12 - Equity in Academic Publishing28:26 - Diversifying the Peer Review Pool30:33 - Creating and Implementing the Equity Rubric31:17 - The Impact and Application of the Equity Rubric33:31 - Personal Reflections on Equity and Research35:25 - Citing Foundational Work38:48 - Mentorship and Training Future Leaders47:05 - Career Transitions and Future Goals52:36 - Final Thoughts and Advice for Aspiring Professionals---RESOURCESFull Equity Rubric:https://journals.lww.com/greenjournal/Documents/OnG_Equity_Rubric_1.pdf ​Equity Rubric Introduction Video:https://youtu.be/Jh5_L-pYkuE?si=JREjSSCr98jqjVVB Equity Rubric Introduction Video Slide Deck:https://journals.lww.com/greenjournal/Documents/Green%20Journal%20Equity%20Rubric%20YouTube_final_2022_01_16%20(Slides).pdf

Curious how cross-specialty teamwork is reshaping endometriosis care? In this episode of BackTable OBGYN, host Dr. Mark Hoffman speaks with Dr. Peter Movilla, Associate Medical Director at Newton Wellesley Hospital, and Dr. Anuradha Shenoy-Bhangle, Assistant Professor of Radiology at Harvard Medical School, about their collaborative efforts in advancing endometriosis care. --- SYNPOSIS The discussion covers the development and benefits of monthly multidisciplinary conferences that include gynecologists, radiologists, colorectal, urologic, and thoracic surgeons. The conferences aim to improve preoperative planning, intraoperative accuracy, and postoperative care through detailed imaging techniques, primarily MRI. They also highlight the importance of educating fellows and colleagues, the role of ultrasound screening, and future directions like AI and PET imaging. The episode emphasizes the challenges and rewards of treating endometriosis and fostering better patient outcomes through teamwork and innovation. --- TIMESTAMPS 00:00 - Introduction 01:55 - The Journey to Specialization 07:02 - Building a Multidisciplinary Team 15:07 - The Value of Postoperative Reviews 22:49 - Patient Counseling and Personalized Care 29:36 - Challenges in Endometriosis Treatment 31:00 - Educating Beyond the Clinic 33:05 - Innovations in Imaging 46:22 - Future Directions in Endometriosis Research 53:15 - Conference Highlights and Final Thoughts --- RESOURCES Recommendations for MRI technique in the evaluation of pelvic endometriosis: consensus statement from the Society of Abdominal Radiology endometriosis disease‑focused panel: https://drive.google.com/file/d/1VRBpw5V3AH-rWGEG43K1CMCx2flCXl2M/view?usp=sharing

When should you consider surgical management of chronic pelvic pain conditions? In this episode of the BackTable OBGYN podcast, Dr. Mark Dassel, a MIGS surgeon at Intermountain Health in Salt Lake City, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss medical and surgical management strategies for chronic pelvic pain, particularly endometriosis. --- SYNPOSIS Dr. Dassel emphasizes the importance of stopping the hormonal triggers associated with pain and explores various medical treatments, including hormonal therapies and the role of contraceptives. He also highlights his approach to surgical interventions such as endometriosis excision, endometrioma removal, and hysterectomy, and the importance of holistic treatment plans involving pelvic floor physical therapy and central pain modulators. The episode also covers the complexities of diagnosing and treating pelvic pain, the role of early intervention, and the value of multidisciplinary care. --- TIMESTAMPS 00:00 - Introduction 07:55 - Differentiating Causes of Chronic Pelvic Pain 10:13 - Multidisciplinary Care and Costs 14:26 - Acute vs Chronic Pain 17:00 - Centralized Pain 18:46 - When to Offer Surgery 23:42 - Fertility and Endometriosis 33:25 - Hormonal Suppression Post-Surgery 37:24 - Pelvic Floor Botox and Physical Therapy 44:42 - Hysterectomy for Pelvic Pain 51:53 - Nerve Ablation and Pain Management 57:10 - Final Thoughts

Endometrial ablation has become a cornerstone procedure in the treatment of abnormal uterine bleeding, but is it the right solution for every patient that meets the indication? In this episode of the BackTable OBGYN Podcast, Dr. Ted Anderson from Vanderbilt University joins host Dr. Mark Hoffman to discuss the evolution of endometrial ablation and its contemporary utilization, including patient selection, technical considerations, and alternative treatments for abnormal uterine bleeding. --- SYNPOSIS Dr. Anderson begins by detailing the history of abnormal uterine bleeding alongside the evolution of the endometrial ablation techniques that have been used to treat it. Shifting focus to current day practice, he then shares his approach to endometrial ablation, covering patient selection and the technical aspects of his approach. Throughout the conversation, Dr. Anderson emphasizes the importance of how we define success in endometrial ablation, explaining that eumenorrhea (normal bleeding that no longer interferes with life events) is the goal, as opposed to the more traditional view that amenorrhea is the target outcome. The episode closes with a discussion on the role of alternative treatments, such as the Mirena IUD and hysterectomy for abnormal uterine bleeding. --- TIMESTAMPS 00:00 - Introduction 09:29 - History of Abnormal Uterine Bleeding and Endometrial Ablation 23:31 - Evolution of Endometrial Ablation Devices/Techniques 31:11 - Selecting the Right Patient for Ablation Success 34:38 - Post-Tubal Sterilization Ablation Syndrome 38:27 - The Role of IUDs in Managing AUB 44:07 - Reevaluating Endometrial Ablation Success Metrics 49:55 - Innovative Ablation Techniques: Cryoablation and Steam 51:48 - Adenomyosis and Fertility-Sparing Treatments 57:28 - Final Thoughts

What surgical techniques and safety measures are important to consider when operating in a pregnant patient? In this episode of the BackTable OBGYN podcast, Dr. Craig Sobolewski, a minimally invasive GYN surgeon at Duke, speaks with host Dr. Mark Hoffman about the intricacies of laparoscopic surgery in pregnant patients. --- SYNPOSIS The surgeons delve into the critical importance of understanding anatomy and ensuring proper exposure during surgeries, particularly the challenges and techniques for operating during pregnancy. Key discussions include the use of liver retractors, the management of symptomatic ovarian cysts, and the methods for performing and evaluating abdominal cerclages. They also explore the physiological changes in pregnant patients and the adjustments needed for anesthesia, laparoscopic entry, pressures during surgery, and pre/post-operative care. --- TIMESTAMPS 00:00 - Introduction 07:20 - Laparoscopy in Pregnant Patients 11:23 - Common Surgeries During Pregnancy 15:56 - Laparoscopic Surgery Techniques 24:04 - Physiologic Changes in Pregnancy 27:33 - Access Methods and Pressure Considerations 28:53 - Managing Torsion and Cysts in Pregnancy 30:21 - Energy Use and Safety in Pregnant Patients 31:38 - Preoperative and Postoperative Care 34:15 - Cerclage Procedures and Counseling 47:46 - Professional Reflections and Conclusions

How does gynecology care in the United States compare to Canada? In this episode of the BackTable OBGYN podcast, Dr. Jonathon Solnik, head of gynecology and minimally invasive surgery at Mount Sinai in Toronto, speaks with hosts Dr. Mark Hoffman and Dr. Amy Park about the significant differences between the healthcare systems in the US and Canada. --- SYNPOSIS The doctors cover financial incentives and constraints faced by hospitals in the US vs. Canada, the role of insurance companies, and how resource limitations impact clinical practice. Dr. Solnik shares insights from his career journey, emphasizing the challenges and opportunities he has encountered in Canada, including longer wait times for elective surgeries and the intricacies of the Canadian global budget system. The conversation also covers the impact of robotics in surgery, standardization of care, and the differences in the handling of high-acuity medical cases. The episode provides an insightful discussion on how different healthcare models affect patient care, physician practices, and hospital administration. --- TIMESTAMPS 00:00 - Introduction 01:39 - Dr. Solnik's Career Journey 03:30 - Healthcare System Differences: US vs Canada 09:57 - Balancing Quality and Volume in Healthcare 12:18 - Private Practice in Canada 25:03 - Wait Times and Capacity Issues 34:44 - Oncology and Semi-Salaried Positions 39:03 - Negotiating CPT Codes and RVUs 42:14 - Access to Care in Remote Areas 44:42 - Robotics in Surgery 55:09 - Incentives and Productivity in Healthcare Systems 01:01:33 - Concluding Thoughts

How can we streamline the proper diagnosis and treatment of female urinary incontinence? The solution often lies in bridging comprehensive patient workup to pelvic floor physical therapy. Learn more in this BackTable OBGYN brief with Dr. Sarah Boyles and host Dr. Suzette Sutherland!  Key topics include what to look for during a pelvic exam, the importance of external skin inspection, prolapse evaluation, urethra assessment, and pelvic floor muscle strength testing. The doctors also address effective treatment options, the necessity (or lack thereof) of specific diagnostic tests, the significant role of bladder diaries, and the benefits of pelvic floor physical therapy. Practical advice for behavioral management, therapy for stress and urgency incontinence, and the reasons for structured evaluation methodologies are also highlighted. TIMESTAMPS 00:00 - Introduction 00:30 - Conducting a Thorough Pelvic Exam 02:45 - Evaluating Pelvic Floor Muscle Strength 04:28 - Initial Diagnostic Workup 06:07 - The Role of Bladder Diaries 09:49 - Treatment Algorithms for Urinary Incontinence 15:03 - Conclusion CHECK OUT THE FULL EPISODE OBGYN Ep. 61: Evaluating Female Urinary Incontinence: Essential Steps for the Generalist https://www.backtable.com/shows/obgyn/podcasts/61/evaluating-female-urinary-incontinence-essential-steps-for-the-generalist

What skills and disciplines can a surgeon take from their training to succeed in a new leadership / hospital administration role? In this episode of BackTable OBGYN, Dr. Mark Hoffman discusses his transition from a minimally invasive gynecologic surgeon to the Chief Medical Officer at his hospital with co-host Dr. Amy Park. --- SYNPOSIS The doctors cover the importance of high-functioning teams, the unexpected challenges of hospital administration, and the impact of clinical experience on decision-making. Additionally, they explore the broader responsibilities and skill sets required for effective leadership in a hospital setting, and offer advice for others considering a similar career shift. Dr. Hoffman emphasizes the value of servant leadership, the benefits of focusing on strengths, and the necessity of building strong, resilient teams. --- TIMESTAMPS 00:00 - Introduction 05:16 - Transitioning to Hospital Administration 07:17 - Balancing Workload 10:33 - Teamwork and Leaning into Strengths 13:30 - Decision Making in Administration 26:20 - Unique Challenges for OBGYNs in Hospital Administration 31:48 - Engagement in Leadership 35:03 - Focusing on People to Improve Patient Care 44:18 - Building Effective Leadership Teams 45:25 - Transitioning to Hospital Administration 52:07 - Finding Joy in Leadership and Mentorship

There are many challenges when it comes to operating on a post-hysterectomy patient, especially when they have endometriosis. In this episode of BackTable OBGYN, Dr. Emad Mikhail, an associate professor of OBGYN at the University of South Florida, discusses the intricacies of treating endometriosis after a hysterectomy. --- SYNPOSIS Dr. Mikhail shares his journey from medical school in Egypt to his current expertise in deep endometriosis surgery in Tampa, Florida. The conversation covers preoperative evaluation, the importance of understanding patient history, and surgical approaches for complex cases. He emphasizes the need for multidisciplinary collaboration, advanced imaging, and specialized surgical techniques to ensure optimal patient outcomes. --- TIMESTAMPS 00:00 - Introduction 05:52 - The Role of Hysterectomy in Endometriosis 08:58 - The Role of Ovaries in Endometriosis 11:12 - Surgical Techniques and Considerations 18:11 - Evaluating Deep Endometriosis 24:32 - Post-Hysterectomy Pain and Symptoms 31:26 - Surgical Approaches Post-Hysterectomy 39:49 - The Importance of Continuous Learning 43:09 - Scar Tissue vs. Lesion 51:47 - Comprehensive Preoperative Assessment 53:59 - Conclusion and Final Thoughts

There are tangible ways to advocate for health equity and address demographic disparities in patient care and the healthcare workforce. In this episode of the BackTable OBGYN Podcast, Dr. Teni Brown, an assistant professor of OBGYN at Northwestern University's Feinberg School of Medicine, speaks with hosts Dr. Amy Park and Dr. Mark Hoffman about DEI efforts and ways she has made real change. --- SYNPOSIS Dr. Brown shares her journey from Nigeria to the United States, detailing her path from middle school teacher to a leading advocate in diversity, equity, and inclusion (DEI) within the medical field. The conversation touches on systemic barriers in healthcare, the impact of historical practices like redlining, and practical steps institutions can take to foster a culture of equity. Dr. Brown emphasizes the importance of sustained engagement, multi-level interventions, and action-oriented solutions to create a more diverse and inclusive medical workforce. --- TIMESTAMPS 00:00 - Introduction 05:44 - Equity in OBGYN: Workforce and Patient Care 08:41 - Advocacy for Medication Access 15:25 - Systemic Barriers and Social Determinants of Health 20:22 - Understanding Redlining and Its Impact 25:10 - Efforts to Address Inequities 34:14 - Equity and Diversity in Healthcare 36:39 - The Role of Leadership in Promoting Equity 44:08 - AI and Technology in Addressing Gaps 50:00 - Vision for a More Equitable Future 58:26 - Final Thoughts and Encouragement

OBGYN Briefs - Bridging the Orgasm Gap Female sexual wellness is a topic that deserves more research, education, and attention, both for our patients and for providers. In this BackTable OBGYN Brief, Dr. Kelly Casperson speaks with host Dr. Suzette Sutherland about a range of issues related to women's sexual health. The conversation highlights the disparities between men's and women's sexual health resources and focuses on the gaps in sex education, communication, and healthcare training. Dr. Casperson emphasizes the biological, psychological, and social aspects of female sexual dysfunction and draws attention to the lack of adequate research and resources for women. The episode explores the importance of understanding the clitoris, the biases in sexual pleasure, and the role of informed consent in surgical procedures affecting sexual function. These insights aim to destigmatize female sexual health issues and promote better awareness and education. TIMESTAMPS 00:00 - Introduction 00:24 - Challenges in Women's Sexual Health 01:01 - Sex Education, Communication Gaps, and Bias 02:29 - Prevalence and Misconceptions 03:23 - Education about Clitoral Stimulation 03:59 - Impact of Medications and Relationships 07:16 - Orgasm Gap and Pleasure Inequality 09:23 - Understanding the G-Spot and Clitoral Anatomy 10:35 - Sling Surgery and Sexual Function CHECK OUT THE FULL EPISODE OBGYN Ep. 44: https://www.backtable.com/shows/obgyn/podcasts/44/urologys-role-in-advancing-female-sexual-health

Proper pain management after surgery is essential to promote healing and improve patient satisfaction. In this BackTable OBGYN Brief, Dr. Steven McCarus and Dr. Paula Bilica with host Dr. Amy Park discuss how to advocate for non-opioid analgesia following OBGYN surgery.  The discussion focuses on the importance of reducing opioid use in women's health through various strategies such as utilizing Exparel and ERAS protocols. They share compelling arguments and data for covering costs, enhancing patient satisfaction, and hospital administration's role. The guests emphasize the need for a team approach and the presence of a dedicated champion to advocate for better pain management practices in women's health.

Curious about how to leave your mark as a mentor and leader in the field of OBGYN? In this episode of the BackTable OBGYN Podcast, Dr. Starr Hampton, a professor of OBGYN and Senior Associate Dean for Medical Education at Warren Alpert Medical School at Brown University, discusses her journey from a newly appointed faculty member to a leader in medical education. --- SYNPOSIS Dr. Hampton emphasizes the importance of kindness, mentorship, and taking opportunities when offered new roles. The conversation covers topics such as transitioning from medical school to residency to practice, fostering a supportive educational environment, and international health work. Dr. Hampton shares valuable insights on creating a culture of psychological safety and the significance of giving corrective yet supportive feedback to trainees. --- TIMESTAMPS 00:00 - Introduction 02:43 - Early Career and First Leadership Roles 12:09 - Navigating National Organizations 24:15 - Mentorship and Sponsorship 28:34 - The Value of Kindness and Psychological Safety 32:14 - Changing Culture 33:48 - Balancing Wellness and Professional Life 39:57 - Advice for Seeking out Mentorship and Positive Experiences 45:21 - Naming Your Work 50:09 - Transitioning to New Jobs/Roles 56:06 - Global Health Initiatives and Personal Growth 01:01:17 Conclusion and Future Topics

Operating on the pregnant patient can be intimidating, but there are many ways to do so safely. In this episode of the BackTable OBGYN podcast Dr. Jamal Mourad, a MIG surgeon at Mayo Clinic, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss the nuances of robotic surgery, particularly in the pregnant patient. --- SYNPOSIS Dr. Mourad shares his extensive experience with robotic platforms and his techniques for addressing complex cases such as transabdominal cerclage in pregnant patients and the management of endometriosis and uterine niche. The conversation covers best practices, the importance of continuous learning through observations and video analysis, and practical tips for improving surgical outcomes. The episode also emphasizes the importance of interdisciplinary collaboration and mentorship in advancing surgical skills and patient care. --- TIMESTAMPS 00:00 - Introduction 04:05 - Single Port vs. Multi-Port Approach 06:08 - Robotic Surgery on Pregnant Patients 08:20 - Anesthesia During Pregnancy 10:39 - Transabdominal Cerclage Techniques 19:27 - Techniques for C-section Scar Ectopic Pregnancy 23:45 - Surgical Considerations in the Pregnant Patient 28:37 - Diagnosing and Treating Ovarian Torsion 32:20 - Managing Placenta Accreta Spectrum 35:29 - Innovations in Robotic Surgery 39:26 - Mentorship and Continuous Learning 54:50 - Concluding Thoughts and Advice for Early Learners

Postoperative pain control is an essential aspect of patient recovery and satisfaction. While pain management is important in all surgical settings, C-sections, hysterectomies, and myomectomies are particularly frequent, accentuating the need for reliable non-opioid alternatives in OBGYN. Dr. Steven McCarus and Dr. Paula Bilica discuss the efficacy of multimodal pain control options in gynecologic and obstetric surgeries, including Exparel, a non-opioid liposomal bupivacaine. The doctors highlight the opioid epidemic and the need for alternative pain relief methods. They share insights on how the introduction of Exparel has transformed their practices by reducing the reliance on opioids, enhancing patient recovery post-surgery, and improving overall patient outcomes. Specific techniques and procedures for using Exparel in various types of surgeries such as C-sections, hysterectomies, and myomectomies are detailed, along with the benefits observed in clinical practices. TIMESTAMPS 00:00 - Introduction 00:42 - The Opioid Epidemic and Pain Management 02:46 - The Role of Exparel in Pain Management 04:53 - Multimodal Pain Control 06:12 - Techniques for Using Exparel 10:08 - Patient Outcomes and Benefits CHECK OUT THE FULL EPISODE OBGYN Ep. 67: https://www.backtable.com/shows/obgyn/podcasts/67/non-opiod-pain-management-in-gyn-surgery

Peer review can be a daunting process as a physician, but there are ways to focus the process on constructive feedback and quality improvement rather than criticism and punishment. In this episode of the BackTable OBGYN Podcast, host Dr. Amy Park welcomes urogynecologist Dr. Maggie Mueller to discuss how we can improve the peer review process in the field of obstetrics and gynecology. --- SYNPOSIS Dr. Mueller delves into her personal involvement in peer review, the challenges faced by providers, and the importance of these processes. Key topics include shifting from a punitive to a quality improvement focus, best practices for peer review committees, the integration of human and system factors, the role of multidisciplinary teams, and transparency. The conversation also highlights the ethical considerations and the impact of peer review on provider well-being, emphasizing the need for structured support systems. Dr. Mueller shares insights into the future trends in peer review, advocating for higher physician involvement and leadership in creating more effective and transparent processes. --- TIMESTAMPS 00:00 - Introduction 02:21 - Diving into Peer Review 04:14 - The Peer Review Process Explained 07:07 - Challenges and Improvements in Peer Review 13:14 - Changing the Culture Around Peer Review 21:14 - Moving Away from a Punitive Mindset 25:12 - Education to Become a Reviewer 31:39 - Legal Considerations 32:42 - Ethical Considerations 38:31 - Future Trends in Peer Review 41:20 - Closing Remarks

Human trafficking is a complex health issue, with many providers unsure how best to detect, counsel, and care for victims and survivors of human trafficking. In this episode of the BackTable OBGYN Podcast, hosts Dr. Amy Park and Dr. Mark Hoffman are joined by Dr. Julia Geynisman-Tan, a urogynecologist at Northwestern, to discuss signs of human trafficking and resources for caring for this patient population. --- SYNPOSIS Dr. Geynisman-Tan shares her extensive experience in caring for survivors of human trafficking and discusses the complexities surrounding this issue. She emphasizes the importance of trauma-informed care, recognizing signs of trafficking, and providing support to survivors. The conversation covers her journey into this field, the challenges faced by survivors, and practical steps that healthcare professionals can take to aid these vulnerable patients. The episode underscores the need for multidisciplinary approaches and the critical role of healthcare providers in identifying and assisting those affected by human trafficking. --- TIMESTAMPS 00:00 - Introduction 05:08 - Identifying Signs of Human Trafficking in Patients 09:14 - Referral and Support Systems for Trafficking Survivors 11:31 - Common Health Issues Among Trafficking Survivors 13:17 - Understanding the Complexities of ‘The Life' 18:13 - Immigration and Human Trafficking 20:48 - Providing Trauma-Informed Care 25:55 - Identifying Resources for Victims 29:23 - Healthcare Protocols 32:50 - Addressing Needs and Building Trust 36:58 - Psychosomatic Effects of Trauma 40:50 - Impact on Pregnancy 42:55 - Supporting Survivors and Long-Term Rehabilitation 48:30 - Conclusions --- RESOURCES Human Trafficking Hotline: https://humantraffickinghotline.org/en HEAL Trafficking: https://healtrafficking.org/

Surgical approaches to endometriosis continue to move towards greater levels of precision and efficacy as we learn more about the intricacies of this complex condition. Still, endometriosis continues to challenge gynecologic surgeons worldwide. How has endometriosis surgery evolved, and how can we apply what we've learned to continue to improve patient outcomes? In this episode of BackTable OBGYN, Dr. Tommaso Falcone, a renowned surgeon and expert in reproductive endocrinology and fertility, discusses the past, present, and future of endometriosis surgery. --- SYNPOSIS Dr. Falcone shares his journey from McGill University to his current roles at the Cleveland Clinic, offering insights into advancements in minimally invasive surgery, the role of teamwork in medical innovation, and the complexities of treating endometriosis. The episode covers the evolution of surgical techniques, postoperative care, and fertility strategies, emphasizing the importance of managing patient expectations and the future directions for research and treatment. --- TIMESTAMPS 00:00 - Introduction 02:09 - Dr. Falcone's Journey and Career 08:09 - Evolution of REI and MIGS 13:35 - Innovations in Endometriosis Treatment 20: 45 - Excision vs Ablation 25:30 - Challenges and Future Directions in Endometriosis Research 32:39 - Understanding the Placebo Effect in Chronic Pain 34:18 - Exploring Fibrosis in Endometriosis 35:31 - Challenges in Diagnosing and Treating Endometriosis 40:57 - Innovations in Surgical Techniques 53:56 - Managing Patient Expectations and Complications 56:06 - Concluding Thoughts

Endometriosis is a very difficult disease to diagnose and manage, but effective imaging can make all of the difference. In this episode of the BackTable OBGYN podcast, Mayo Clinic radiologist Dr. Wendaline VanBuren and gynecologist Dr. Tatnai Burnett discuss the complexities of diagnosing, imaging, and surgically treating endometriosis. --- SYNPOSIS The doctors delve into the importance of advanced imaging techniques such as MRI and dedicated protocols, the critical need for a multidisciplinary approach with radiologists and GYN surgeons, and the future potential of imaging in improving endometriosis diagnosis, treatment, and surgical planning. The discussion also covers the upcoming International Endometriosis Imaging Congress aimed at advancing standardized care and collaboration in the field. --- TIMESTAMPS 00:00 - Introduction 05:15 - Dr. VanBuren's Journey to Endometriosis Imaging 08:24 - Dr. Burnett's Surgical Training and Insights 11:57 - Challenges in Diagnosing and Understanding the Pathophysiology of Endometriosis 13:24 - The Role of Imaging in Surgical Planning 25:51 - Imaging Follow-Up, Monitoring for Malignant Transformation 32:03 - Protocol for MRI Imaging of Endometriosis 34:47 - The Role of Radiologists in Endometriosis 36:12 - The Complexity of Bowel Endometriosis 48:02 - The Future of Endometriosis Imaging --- RESOURCES International Endometriosis Imaging Congress-March 8-9, 2025 https://eice.ltd/international-endometriosis-imaging-congress/

Stay up to date on the latest advancements in gynecologic surgery. In this episode of the BackTable OBGYN Podcast, hosts Dr. Amy Park and Dr. Mark Hoffman invite Dr. Johnny Yi, a pioneer in the field of minimally invasive surgery and urogynecology, to discuss the latest advancements in, benefits of, and challenges with single port robotic gynecologic surgery. --- SYNPOSIS The discussion covers evolutionary strides in robotic-assisted surgeries such as sacral colpopexy and myomectomies, the transition from traditional laparoscopy, and the intricacies of handling large uteri procedures. The episode also navigates the global adoption of these technologies, particularly in South Korea and Japan, and the varying applications in different specialties. Key topics include surgical skill requirements, training needs, innovative techniques, FDA approvals, and the future potential of single port surgeries. Overall, this discussion provides a well-rounded perspective on the current state and forward-looking innovations in the field of gynecologic surgery. --- TIMESTAMPS 00:00 - Introduction 03:57 - Single Port Robotic Surgery 08:27 - Benefits of Robotics with Sacral Colpopexy 11:37 - Technical Aspects of Single Port Surgery 14:40 - Training for Single Port Surgery 19:43 - Global Adoption and Future Potential of Single Port Surgery 25:35 - Access into the Abdomen 29:39 - Challenges and Innovations in Single Port Surgery 31:34 - Evaluating Risks and Success Rates 33:16 - Cost Analysis 35:16 - Training and Simulation for Single Port Surgery 39:35 - Future of Single Port and vNOTES Surgery 45:05 - Patient Reactions and Satisfaction 46:34 - Closing Techniques 52:14 - Future Prospects and Final Thoughts --- RESOURCES Oh S, Yi J, Song AY, Jee J, Bae N, Shin JH. Intraoperative Complications and Perioperative and Surgical Outcomes of Single-Port Robotics-Assisted Sacrocolpopexy. Int Urogynecol J. 2024 Jul; 35 (7):1521-1526 Epub 2024 June 20.

How can we educate women about vaginal estrogen for genitourinary syndrome of menopause, especially given the black box warning? In this Brief, Dr. Rachel Rubin and host Dr. Suzette Sutherland discuss misconceptions around the use of estrogen creams and suppositories, particularly focusing on dosage and application for safe, effective treatment. They address common factors leading to inadequate results and the safety of low-dose vaginal estrogen. The doctors emphasize the importance of patience with treatment, correct understanding of hormone products, and education of patients to combat misinformation. Dr. Rubin and Dr. Sutherland also challenge misleading black box warnings associated with vaginal estrogen and stress the necessity for advocacy to update these labels and educate patients. TIMESTAMPS 00:00 - Introduction 00:20 - Debunking Myths About Estrogen Cream Usage 04:10 - Safety and Proper Usage/Dosage of Estrogen Products 05:48 - Patient Education and Compliance 08:23 - Addressing the Black Box Warning on Vaginal Estrogen 10:48 - Conclusion CHECK OUT THE FULL EPISODE OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic

Everyone knows about the dangers of opioids, but how can physicians provide quality postoperative pain control without opioids? This episode of the BackTable OBGYN podcast, hosted by Dr. Amy Park, features a discussion with experts Dr. Steven McCarus and Dr. Paula Bilica on non-opioid pain control in obstetric and gynecologic surgery. --- This podcast is supported by: Pacira https://www.pacira.com/ --- SYNPOSIS Highlighting the use of Exparel, a liposomal bupivacaine formulation, the discussion addresses how it has transformed post-operative pain management by reducing opioid exposure. The episode covers techniques for Exparel application in surgeries such as hysterectomies and C-sections, with positive patient outcomes noted. The conversation also emphasizes the importance of collaboration among healthcare professionals to advocate for better pain management protocols and patient satisfaction, spotlighting upcoming initiatives like the No Pain Act. --- TIMESTAMPS 00:00 - Introduction 04:47 - Introduction to Liposomal Bupivacaine (Exparel) 07:10 - Techniques and Applications of Exparel 20:13 - The No Pain Act 25:07 - Patient Success Stories with Exparel 26:30 - Administrative Hurdles and Solutions 30:24 - Safety and Efficacy of Exparel 32:42 - Educating Staff and Implementing Protocols 38:05 - Final Thoughts

OBGYN Briefs - Managing Genitourinary Syndrome of Menopause Frequent UTIs and vaginal atrophy/dryness are common signs of genitourinary syndrome of menopause (GSM). In this Brief, Dr. Rachel Rubin discusses the management of GSM and why estrogen is so vital to these tissues. They address the lack of information and awareness about GSM among urologists and gynecologists while emphasizing its impact on the urinary and genital symptoms experienced by menopausal women. Dr. Rubin details how GSM is not just a matter of vaginal atrophy but involves broader symptoms like urinary tract infections and bladder issues. The doctors also discuss a range of treatment options available, including local vaginal supplementation products like estradiol creams and DHEA suppositories, and their benefits for urinary health. TIMESTAMPS 00:00 - Introduction 00:20 - Understanding Genitourinary Syndrome of Menopause (GSM) 01:42 - Symptoms and Implications of GSM 03:00 - Vaginal Supplementation Products 05:09 - DHEA and SERM Therapy 08:44 - Estrogen and Vaginal Health CHECK OUT THE FULL EPISODE OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic 

Pregnancy and childbirth have a significant impact on the pelvic floor, often more than patients realize and even more still than most of our current postpartum care models are designed to address. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Lisa Hickman, a urogynecologist and pelvic reconstructive surgeon from The Ohio State University, to discuss peripartum pelvic floor disorders and her dedicated clinic for women with advanced obstetric lacerations. --- This podcast is supported by: PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS The conversation touches on key aspects of pelvic floor health, the impact of pregnancy and childbirth, and effective strategies for preventing and managing pelvic floor disorders. The episode emphasizes the importance of patient education, tailored postpartum care, and multidisciplinary collaboration with pelvic floor physical therapists and other healthcare personnel. Dr. Hickman shares insights on building a sustainable clinical model for peripartum pelvic floor disorders, securing stakeholder support, and implementing standardized processes to enhance patient outcomes. --- TIMESTAMPS 00:00 - Introduction 04:21 - Understanding the Pelvic Floor 05:36 - Impact of Pregnancy and Childbirth 07:48 - Preventing and Managing Tears 22:56 - Postpartum Care and Challenges 28:54 - Starting a Peripartum Clinic: A Roadmap 33:54 - Pelvic Floor PT and Patient Education 40:03 - Impact of Repair Techniques on Long-term Outcomes 50:56 - Sustaining and Expanding the Program --- RESOURCES Hickman LC, Propst K, Swenson CW, Lewicky-Gaupp C. Subspecialty care for peripartum pelvic floor disorders. Am J Obstet Gynecol. 2020 Nov;223(5):709-714. doi: 10.1016/j.ajog.2020.08.015. Epub 2020 Sep 2. PMID: 32888923; PMCID: PMC7720615.

Thoracic endometriosis occurs in about 12% of patients with advanced endometriosis. Due in part to its lower incidence and inherent diagnostic challenges, many providers are not well-versed in the workup and management of this advanced disease. In this episode of The BackTable OBGYN Podcast, host Dr. Mark Hoffman interviews Dr. Shanti Mohling, a gynecologic surgeon at Northwest Endometriosis and Pelvic Surgery, regarding her approach to thoracic endometriosis. --- CHECK OUT OUR SPONSOR PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS The physicians discuss the embryological and congenital theories of endometriosis etiology, the impacts of retrograde menstruation, and epigenetic factors. Dr. Mohling shares insights into her advanced surgical techniques for treating endometriosis, including diaphragmatic and thoracic disease, and the importance of a comprehensive history, exam, and diagnostic imaging. Her practice patterns, patient care strategies, and interdisciplinary collaborations for optimal outcomes are also highlighted. --- TIMESTAMPS 00:00 - Introduction 06:40 - Pelvic Pain Workup 08:09 - Thoracic Endometriosis 14:12 - Medical Management Post-Surgery 18:48 - In-Office Ultrasound Techniques 23:33 - Collaboration in Surgery 24:59 - Preparing for Thoracic Endometriosis Surgery 36:44 - Managing Postoperative Care 41:13 - Theories on Endometriosis Etiology 46:31 - Concluding Thoughts

Can cranberry juice prevent UTIs? In this BackTable OBGYN Brief, Dr. Suzette Sutherland and Dr. Anne Cameron discuss various strategies for preventing recurrent UTIs, including which supplements are effective. They cover the efficacy of cranberry supplements, emphasizing the importance of quality and proper compound concentration in products like Ellura. The discussion also addresses the limitations of cranberry juice and the resurgence of methenamine hippurate as a non-antibiotic preventive measure, supported by recent studies. Additionally, they outline comprehensive approaches, including lifestyle modifications, hydration, vaginal estrogen, and hygiene practices, while aiming to destigmatize the condition. TIMESTAMPS 00:00 - Introduction 00:28 - Cranberry Supplements for UTI Prevention 01:22 - Choosing the Right Cranberry Product 03:05 - Effectiveness and Dosage 05:27 - Cranberry Juice vs. Supplements 06:45 - Exploring Hiprex and Vitamin C 07:08 - Methenamine Hippurate: An Old Medication Revisited 08:59 - Overall Strategy for Managing Recurrent UTIs 11:09 - Vaginal Estrogen 11:48 - Final Thoughts CHECK OUT THE FULL EPISODE BackTable OBGYN Ep. 42 - Recurrent UTIs: Controlling Those Nasty Little Bladder Infections https://www.backtable.com/shows/obgyn/podcasts/42/recurrent-utis-controlling-those-nasty-little-bladder-infections

Vulvovaginal disorders can be very complex to manage, and many OBGYNs struggle with diagnosis and treatment, especially if topical steroids don't improve symptoms. In this episode of the BackTable OBGYN Podcast, guest host Dr. Jessica Ritch welcomes Dr. Hope Haefner, a leading expert in women's health, to discuss diagnosis and management of several vulvovaginal diseases. --- CHECK OUT OUR SPONSOR PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS The discussion covers the importance of accurate diagnosis through physical exams and intake surveys, approaches to pain and symptom management, the significance of vestibulectomy, and the implementation of different treatments for conditions such as vulvodynia, lichen sclerosus, and hidradenitis suppurativa. Dr. Haefner emphasizes the importance of early treatment, the multidisciplinary approach in their clinic, the use of different types of steroids for lichen sclerosus, and innovative treatments and diagnostics. She discusses next-step treatments if common treatments aren't working, such as the “lichen sclerosus cocktail.” Finally, the episode highlights the need for ongoing professional education and provides resources for further learning. --- TIMESTAMPS 00:00 - Introduction 04:21 - Common Symptoms and Initial Diagnosis 07:19 - Examination and Workup 13:44 - Treatment Approaches for Vulvodynia 20:27 - Managing Lichen Sclerosus 32:27 - Products to Avoid 36:29 - Anoscopy for HPV 40:34 - Addressing Hidradenitis Suppurativa 44:39 - Final Thoughts and Resources --- RESOURCES Resources for Everything Vulvovaginal Disorder (by Dr. Haefner): https://www.dropbox.com/sh/r8nhr1j8c19tn9n/AACRLvxGGSgEtZCi6Zzh-yBQa?e=2&dl=0

OBGYN Brief - Definition and Diagnosis of a Clinical UTI Cultures are key when it comes to managing UTIs. In this brief, Dr. Anne Cameron discusses the definitions, symptoms, prevalence, and management of urinary tract infections (UTIs). They delve into the differences between bladder infections and kidney infections, the importance of symptomatology along with bacterial evidence for proper diagnosis, and the higher susceptibility of women to UTIs compared to men. The brief emphasizes the complexities of recurrent UTIs, including the challenges in treatment due to improper antibiotic use, persistence of infection, and anatomical or physiological risk factors. Dr. Cameron also explains the necessity of urine cultures in ensuring effective treatment and the various factors that contribute to recurrent UTIs. TIMESTAMPS 00:00 - Introduction 00:15 - Definitions and Symptoms of UTIs 01:49 - Prevalence of UTIs in Women and Men 02:44 - Recurrent UTIs: Definitions and Challenges 04:48 - Investigating and Treating Persistent UTIs CHECK OUT THE FULL EPISODE BackTable OBGYN Ep. 42 - Recurrent UTIs: Controlling Those Nasty Little Bladder Infections https://www.backtable.com/shows/obgyn/podcasts/42/recurrent-utis-controlling-those-nasty-little-bladder-infections

Women's health has a history of being underfunded in the United States, leading many women to receive suboptimal care. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park engage in a detailed discussion with Dr. Louise P. King, a minimally invasive gynecologic surgeon, and Christopher Robertson, a law professor at Boston University, regarding the inequitable reimbursement structures that persist within the field of OBGYN. --- SYNPOSIS The guests emphasize the systemic discrepancies between gynecologic and other surgical disciplines. The conversation delves into the origins of these disparities, the complexities of revising current codes and creating new codes, and potential legislative and legal remedies to address gender-based inequities. The guests also stress the importance of patient care outcomes and the role of proper reimbursement in enhancing healthcare delivery. --- TIMESTAMPS 00:00 - Introduction 06:28 - Background on RVUs and Disparities in OBGYN 12:39 - Gender Disparities in Medical Billing 18:00 - Efforts to Address Inequities 31:22 - RUC Structure and Surgical Specialties 32:42 - Billing and Reimbursement Inequities 35:15 - Diagnosis Related Groups 36:42 - Turnover Times and Gender Disparities 40:21 - Advocacy and Legislative Solutions 48:23 - Legal Approaches for Change 52:44 - Conclusion --- RESOURCES Watson KL, King LP. Double Discrimination, the Pay Gap in Gynecologic Surgery, and Its Association With Quality of Care. Obstet Gynecol. 2021 Apr 1;137(4):657-661. doi: 10.1097/AOG.0000000000004309. PMID: 33706362. Robertson, Christopher T. and Kupke, Annabel and King, Louise P., Structural Sex Discrimination: Why Gynecology Patients Suffer Avoidable Injuries and What the Law Can Do About It (May 9, 2024). Emory Law Journal, Forthcoming, Boston Univ. School of Law Research Paper Forthcoming, Available at SSRN: https://ssrn.com/abstract=4800783 or http://dx.doi.org/10.2139/ssrn.4800783

With contemporary treatment options, your female patients don't have to live with urinary incontinence! In this crossover episode of BackTable Urology and OBGYN, host Dr. Suzette Sutherland from University of Washington interviews Dr. Sarah Boyles, a urogynecologist at The Oregon Clinic, regarding female urinary incontinence, its diagnostic criteria, and various treatment options to help improve quality of life in the incontinence patient. --- CHECK OUT OUR SPONSOR PearsonRavitz https://pearsonravitz.com/backtable --- SYNPOSIS First, Dr. Boyles explains the importance of patient history and physical examination, along with the need for certain diagnostic tests for proper characterization of the type of urinary incontinence in a patient. She also explores behavioral treatments, pelvic floor physical therapy, vaginal pessaries, and advanced interventions such as urethral bulking and surgery for stress incontinence. The doctors further discuss innovative pharmaceutical and neuromodulation options for urge incontinence. Dr. Boyles concludes with a mention of patient education resources that are available on her platform, thewomensbladderdoctor.com. --- TIMESTAMPS 00:00 - Introduction 02:35 - The Women's Bladder Doctor Initiative 07:03 - Types of Urinary Incontinence 11:49 - Diagnostic Approaches to Urinary Incontinence 28:39 - Treatment Algorithms for Urinary Incontinence 31:12 - Bladder Retraining and Pelvic Floor Therapy 40:00 - Urethral Seals and Vaginal Pessaries 50:47 - Treatment for Urgency 57:51 - Future Directions --- RESOURCES Pearson Ravitz https://pearsonravitz.com/ The Women's Bladder Doctor https://thewomensbladderdoctor.com/

Often the first practical thing we're taught in medical school is the importance of taking a thorough patient history. In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Ted Lee bring us back to the basics and emphasize the importance of conducting a quality patient interview to elucidate symptoms of endometriosis. The physicians first explore the limitations and practicalities of patient surveys, and move on to discuss the importance of thorough history taking along with specific symptoms to look for. The conversation also delves into the diagnostic challenges and delay of diagnosis in endometriosis patients. They explain the role of surgical diagnosis in endometriosis, emphasizing the necessity of listening to and believing patients' experiences with chronic pelvic pain. TIMESTAMPS:  00:00 - Introduction 00:14 - Initial Patient Workup: Surveys and History 01:19 - Key Patient History Indicators 04:24 - Endometriosis Symptoms 07:49 - Treatment Approaches and Surgical Considerations 09:32 - Barriers to Diagnosis CHECK OUT THE FULL EPISODE BackTable OBGYN Ep. 30: Ambulatory Workup of Endometriosis Patients https://www.backtable.com/shows/obgyn/podcasts/30/ambulatory-workup-of-endometriosis-patients

In the modern era of rapid technological progress and AI, the medical community is abuzz with discussions on how medicine will change and how practice will adapt. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Arnold Advincula, a leading figure in minimally invasive and robotic surgery, to discuss the evolution and impact of robotic surgery in the field of gynecology. --- SYNPOSIS Dr. Advincula shares his journey from training to pioneering robotic-assisted procedures, emphasizing the benefits and challenges faced along the way. The conversation delves into the future of robotics, including the potential of AI in surgery and the integration of digital tools to enhance surgical outcomes. Listeners gain insights into the importance of ergonomic surgery, the advancements in robotic technology, the future of minimally invasive gynecologic surgery, and the collaborative efforts required to elevate patient care in gynecology. --- TIMESTAMPS 00:00 - Introduction 06:05 - Pioneering Robotic Surgery 12:50 - Challenges and Innovations 24:43 - Allure of Robotic Surgery 28:05 - Challenges in Rural Healthcare 35:00 - Future of Minimally Invasive Surgery 42:00 - Advancements in Surgical Training 43:35 - Ergonomics 49:28 - The Future of Gynecologic Surgery 53:06 - Closing Thoughts --- RESOURCES BackTable OBGYN Ep. 2: Surgeon Ergonomics https://www.backtable.com/shows/obgyn/podcasts/2/surgeon-ergonomics

In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Ted Lee discuss the clinical approach to diagnosing endometriosis through physical exam and imaging, and the collaborative surgical approach to treating it.  Dr. Lee explains the importance of detailed patient history and various examination techniques, including palpation and rectovaginal exams, to identify potential signs of endometriosis. He emphasizes the specificity of these exams in differentiating endometriosis pain from other causes. The discussion also covers the role of imaging, such as MRI, particularly in advanced cases, and the collaborative approach with colorectal surgeons for bowel-related complications. Dr. Lee shares insights on the use of physical therapy and managing musculoskeletal pain related to endometriosis, highlighting the importance of multi-disciplinary care for optimal patient outcomes. TIMESTAMPS 00:00 - Introduction 00:15 - Initial Patient Assessment for Endometriosis 01:00 - Detailed Physical Exam Techniques 07:00 - Imaging and Further Diagnostic Steps 10:55 - Collaborative Surgical Approach CHECK OUT THE FULL EPISODE BackTable OBGYN Ep. 30: Ambulatory Workup of Endometriosis Patients https://www.backtable.com/shows/obgyn/podcasts/30/ambulatory-workup-of-endometriosis-patients

In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman is joined by MIGS specialist Dr. Uchenna Acholonu to discuss the intricacies of complex gynecologic surgeries, focusing particularly on handling large uteruses during total laparoscopic hysterectomy (TLH). --- SYNPOSIS The discussion begins with talk of the doctors' practices and friendship. They then cover comprehensive patient evaluations and various surgical techniques, including skeletonizing the uterines, colpotomy tricks, uterine manipulators, and morcellation. Dr. Acholonu also shares his personal routines and preferences, including the use of a flexible scope to get around the big uterus. The duo exchange insights on surgical techniques, patient-centered care, and the continuous learning necessary in the medical field. They emphasize the significance of safety, adequate planning, and the benefits of engaging in community networks for better surgical outcomes. The conversation concludes with a light-hearted note on their shared experiences and camaraderie, offering both educational value and a glimpse into the dynamic relationship between two seasoned professionals. --- TIMESTAMPS 00:00 - Introduction 04:01 - Building a Subspecialty Practice 07:34 - Patient Referrals 12:41 - Surgical Approach 16:06- The Big Uterus 28:36 - Surgical Steps in TLH, Skeletonizing the Uterines 32:56 - Challenges and Solutions 36:49 - Energy Sources and Surgical Tools 42:34 - Colpotomy 44:43 - Tissue Extraction and Morcellation 50:27 - Closing and Post-Operative Care 52:05 - Use of Lupron 53:16 - Final Thoughts

Gynecologic oncology experts Dr. Matthew Powell from Washington University School of Medicine and Dr. Amanda Fader from Johns Hopkins Hospital discuss the increasing rates of endometrial cancer along with future directions of treatments and screenings. --- SYNPOSIS First, the physicians discuss trends in endometrial cancer rates and delve into the factors driving these trends, such as the obesity epidemic and aging population. They explore the differences between endometrioid and non-endometrioid cancers, along with the impact of racial and geographic disparities. The conversation also covers advances in diagnostics and treatments—including immunotherapy and targeted therapies—and the critical need for better awareness, screening practices, and research funding to combat this public health threat. --- TIMESTAMPS 00:00 - Introduction 03:11 - Types of Endometrial Cancer 04:44 - Rising Rates and Risk Factors 08:03 - Disparities in Endometrial Cancer Care 10:37 - Symptoms and Diagnosis 13:52 - Ultrasound vs. Biopsy 16:17 - Challenges in Biopsies 20:58 - Management/Treatment Approaches 23:03 - Geographic Disparities/Access to Care 26:07 - Vaginal Brachytherapy 32:11 - Innovations in Treatment and Research 40:34 - Future Directions: Endometrial Screening 43:54 - AI in Gynecologic Oncology --- RESOURCES Beavis, A. L., Blechter, B., Najjar, O., Fader, A. N., Katebi Kashi, P., & Rositch, A. F. (2023). Identifying women 45 years and younger at elevated risk for endometrial hyperplasia or cancer. Gynecologic Oncology, 174, 98–105. https://doi.org/10.1016/j.ygyno.2023.04.019 Mirza, M. R., Sharma, S., Roed, H., Landrum, L. M., Gilbert, L., Gold, M. A., Novák, Z., Edelson, M., Meirovitz, M., Diaz, J. P., Huygh, G., Buscema, J., Pothuri, B., Eshed, H. D., Coleman, R. L., Slomovitz, B. M., Kostadinov, R., Stevens, S., Ronzino, G., & Powell, M. A. (2024). Post hoc analysis of progression-free survival (PFS) and overall survival (OS) by mechanism of mismatch repair (MMR) protein loss in patients with endometrial cancer (EC) treated with Dostarlimab plus chemotherapy in the ruby trial. Journal of Clinical Oncology, 42(16_suppl), 5606–5606. https://doi.org/10.1200/jco.2024.42.16_suppl.5606 Society of Gynecologic Oncology (SGO): https://www.sgo.org/

Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation. --- SYNPOSIS Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology's adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis. --- TIMESTAMPS 00:00 - Introduction 06:00 - How ScribeMD AI Works 14:14 - Integration with EMR 20:31 - Legal Considerations with AI Technology 26:34 - Cost Implications of AI Scribes 38:46 - Future of AI in Medical Diagnosis 41:45 - Conclusion and Final Thoughts --- RESOURCES ScribeMD.ai https://www.scribemd.ai/

Hosts Dr. Mark Hoffman and Dr. Amy Park invite Dr. Vadim Morozov, a minimally invasive gynecologic surgeon at MedStar Washington Hospital Center, to discuss the applications and implications of artificial intelligence (AI) in gynecologic surgery both currently and in the future. --- SYNPOSIS Dr. Morozov shares his insights on the basics of AI as well as how it is currently being used in medicine and research. He shares his experiences working with AI to develop algorithms for robotic gynecologic procedures. Furthermore, he predicts the direction AI is going in medicine and highlights the complexities and ethical considerations of integrating AI into medical practice. The conversation delves into the advancements, potentials, and concerns surrounding AI, addressing its impact on surgery, privacy, and the future of medical practice. --- TIMESTAMPS 00:00 - Introduction 03:52 - AI in Gynecologic Surgery 06:10 - Understanding AI Basics 13:24 - AI in Medical Applications 17:09 - Future of AI in Medicine 33:24 - AI in Surgery 45:10 - Data and Privacy Concerns 57:35 - Call to Action: Get Involved --- RESOURCES BUMP Study: Goodday, S.M., Karlin, E., Brooks, A. et al. Better Understanding of the Metamorphosis of Pregnancy (BUMP): protocol for a digital feasibility study in women from preconception to postpartum. npj Digit. Med. 5, 40 (2022). https://doi.org/10.1038/s41746-022-00579-9

This episode of the BackTable OBGYN podcast features Dr. Barbara Levy, an OBGYN and seasoned expert in medical coding and reimbursement, discussing the nuances of medical billing, the process of creating medical codes, and how medical practices and expenses are valued differently. --- CHECK OUT OUR SPONSOR Cerene Cryotherapy https://cerene.com/healthcare-professionals/ --- SYNPOSIS Key topics from this episode include the impact of indirect practice expenses, the role of different organizations in surveying costs and implementing new codes, the importance of coding for procedure reimbursement, and a task force's findings on gender disparities in coding. The conversation transitions into the practical implications of where procedures are performed (office vs. surgical center vs. hospital) and how this impacts payment and patient costs. Dr. Levy emphasizes the efficiency and patient benefits of office-based procedures, exemplified by the Cerene cryotherapy ablation device. The complexities of the reimbursement system, including work Relative Value Units (RVUs), facility fees, and the push towards bundling services, are unpacked. The episode underscores the importance of understanding healthcare economics to advocate effectively for patient care improvements. --- TIMESTAMPS 00:00 - Introduction 02:24 - History of Medical Coding 11:32 - The Process of Medical Code Creation 21:15 - Understanding RVUs and Practice Expenses 26:35 - Challenges of Accurately Valuing Procedures 32:05 - Changing Codes/Reimbursement: Endometriosis Example 36:06 - The Art and Science of Medical Coding 39:26 - Site of Service and Facility Fees 51:15 - Benefits of Outpatient Procedures 55:46 - Example: Cerene Cryoablation 58:14 - Addressing Gender Disparities in Medical Reimbursement --- RESOURCES ACOG Resources on Coding and Billing: https://www.acog.org/practice-management/coding

This episode of BackTable OBGYN features an extensive discussion with Dr. Keith Isaacson, a specialist in Reproductive Endocrinology and Infertility, regarding the complexities of diagnosing and treating adenomyosis, emphasizing surgery, medical treatments, and research in the field. Dr. Isaacson describes the pivots in the field's understanding of adenomyosis and endometriosis, including the impact of these conditions on fertility and potential treatment pathways. Adenomyosis has been redefined in the past five years as a disease that affects women of all reproductive ages and causes dysmenorrhea, heavy menstrual bleeding, and infertility. Because the disease is found in the myometrium of the uterus, it has historically been difficult to diagnose unless through pathology following hysterectomy; however, imaging has since improved and there are now criteria seen on ultrasound that are consistent with adenomyosis. Dr. Isaacson then discusses the differences and misconceptions about adenomyosis compared to endometriosis. Additionally, the episode touches on the evolution of treatment strategies over the years, including medical therapy versus surgery. Furthermore, Dr. Isaacson highlights the crucial role of research in uncovering disease pathophysiology and new therapeutic approaches. --- SHOW NOTES 00:00 - Introduction 04:06 - Definitions, Symptoms, and Insights 11:33 - Exploring Treatment Options for Adenomyosis and Infertility 21:30 - The Intersection of Endometriosis and Adenomyosis 30:09 - Imaging, Surgery, and Pathology 36:31 - The Future of Research and Patient-Centric Care --- RESOURCES Moawad G, Fruscalzo A, Youssef Y, Kheil M, Tawil T, Nehme J, Pirtea P, Guani B, Afaneh H, Ayoubi JM, Feki A. Adenomyosis: An Updated Review on Diagnosis and Classification. J Clin Med. 2023 Jul 21;12(14):4828. doi: 10.3390/jcm12144828. PMID: 37510943; PMCID: PMC10381628.

This episode features host Dr. Mark Hoffman and guest Dr. Jessica Ritch as they discuss the lack of menopause education and research during medical training, and the necessity for practitioners to learn more about menopausal symptoms and management strategies. The episode begins with Dr. Ritch, a minimally invasive gynecologic surgeon, describing her path into menopause care, including the development of her podcast, EnRitched Menopause. She touches on the role of laboratory workup in menopause, but emphasizes the patient's symptoms are more important to address than numerical values on labs. She then delves into treatment options, including the complexities of hormone replacement therapy, and the multifactorial nature of sexual function issues. Most importantly, the physicians emphasize listening to patients, offering comprehensive care beyond hormone therapy, and utilizing resources like podcasts to educate both practitioners and patients. Finally, they explore new treatments and the potential future advancements in menopause care. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/I7Ougz --- SHOW NOTES 00:00 - Introduction 08:52 - The EnRitched Menopause Podcast: A Resource for Patients and Practitioners 15:22 - Common Patient Presentations of Menopause 20:43 - The Role of Laboratory Evaluation of Hormone Levels 24:20 - Testosterone in the Menopausal Patient 27:13 - Navigating Hormone Therapy: Estrogen, Progesterone, and Testosterone 31:03 - Physiologic Hormonal Changes in Menopause 35:00 - Shared Decision-Making 39:00 - Exploring Sexual Function and Libido in Menopause 45:38 - The Power of a Physician's Support and Trusted Advice 50:09 - Innovative Approaches and Future Directions in Menopause Care --- RESOURCES EnRitched Menopause Podcast: https://podtail.com/en/podcast/enritched-menopause/welcome-to-enritched-menopause/ Rosy App: https://play.google.com/store/apps/details?id=com.rosywellness&pli=1 (Google) https://apps.apple.com/us/app/rosy-womens-sexual-health/id1444780510 (Apple)

In this episode of BackTable OBGYN, renowned reproductive endocrinologist and minimally invasive gynecologic surgeon Dr. Charles (Chuck) Miller delves into the topic of isthmoceles, a common yet often overlooked complication of C-sections, and shares his best practices for repair. Dr. Miller shares his extensive experience in diagnosing and treating isthmoceles, discussing various surgical techniques including hysteroscopic, laparoscopic, and robotic-assisted resection. He emphasizes the importance of an aggressive surgical approach for achieving higher success rates in terms of future fertility and resolving symptoms such as abnormal bleeding. Moreover, Dr. Miller highlights the need for standardized treatment protocols and reflects on the mentorship, the ongoing journey of learning and adapting in medicine, and the noble profession of healthcare. The episode offers insightful perspectives on a lesser-known gynecologic issue, underscores the value of experience and mentorship in medicine, and advocates for concerted efforts toward establishing best practices in surgical procedures. --- SHOW NOTES 00:00 - Introduction 07:18 - Defining Isthmocele and the History of Isthmocele 10:00 - The Diagnosis of Isthmocele and Its Impact on Fertility 19:31 - Exploring Surgical Techniques for Isthmocele Repair 27:54 - Understanding Hysteroscopic Resection 30:12 - Addressing C-Section Ectopics and Isthmocele Repairs 36:46 - Adapting the Surgical Approach to Different Patient Scenarios 39:35 - Postoperative Complications and Safety Measures 40:55 - The Future of Isthmocele: Surgical Standardization 50:51 - Closing Thoughts and Acknowledgements --- RESOURCES Ban Y, Shen J, Wang X, Zhang T, Lu X, Qu W, Hao Y, Mao Z, Li S, Tao G, Wang F, Zhao Y, Zhang X, Zhang Y, Zhang G, Cui B. Cesarean Scar Ectopic Pregnancy Clinical Classification System With Recommended Surgical Strategy. Obstet Gynecol. 2023 May 1;141(5):927-936. doi: 10.1097/AOG.0000000000005113. Epub 2023 Apr 5. PMID: 37023450; PMCID: PMC10108840.