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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.
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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.
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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
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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.
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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.
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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
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RESOURCES
ScribeMD.ai
https://www.scribemd.ai/ -
Saknas det avsnitt?
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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.
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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.
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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
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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.
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CHECK OUT OUR SPONSOR
Cerene Cryotherapy
https://cerene.com/healthcare-professionals/
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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.
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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
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RESOURCES
ACOG Resources on Coding and Billing:
https://www.acog.org/practice-management/coding -
In this episode of the BackTable OBGYN podcast, Drs. Kimberly (Kim) Kenton and Margaret (Maggie) Mueller discuss advancements in patient recovery guidelines, particularly after gynecologic surgeries.
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SYNPOSIS
The discussion first covers the evolution of post-operative care protocols, emphasizing the lack of evidence behind traditional post-op restrictions and highlighting recent studies that suggest liberal post-operative activities might lead to better recovery outcomes without compromising surgical results. Additionally, the episode touches on the impact of minimally invasive surgical techniques, such as single port surgeries, on patient recovery times and hospital system efficiencies. Finally, the conversation delves into the shift towards team-based care, where nurses and nurse practitioners actively participate in pre-op counseling, educating patients, and enhancing the overall healthcare team’s efficiency. The overarching theme is the crucial role of evidence-based practice in improving patient care and recovery in obstetrics and gynecology.
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TIMESTAMPS
00:00 - Introduction
02:57 - Exploring Postoperative Restrictions in Gynecologic Surgery
20:56 - Adapting Postoperative Visits
26:02 - Recovery Times, Hospital Stays, and the Impact on Patients and Healthcare
35:58 - Team-Based Care and Communication Strategies
44:38 - Surgical Techniques and Recovery Insights
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RESOURCES
Mueller MG, Kenton K. Activity Restrictions After Gynecologic Surgery. Obstet Gynecol. 2024 Mar 01; 143(3):378-382. PMID: 38207325; PMCID: PMC10863662. -
In this crossover episode of BackTable Urology and OBGYN, Dr. Suzette Sutherland interviews three urological/gynecologic innovators, Dr. Ali Haessler, Dr. Jay Shakuri-Rad, and Dr. Tova Weiss, who are all at different career stages and product development phases.
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SYNPOSIS
Dr. Tova Weiss, a urology resident at the University of Washington, discusses her development of a safer urinary catheter so that if a patient were to pull out their catheter, the distal part would disconnect from the catheter inside the urethra, preventing urethral trauma. Dr. Jay Shakuri-Rad, a practicing urologist specializing in robotics and neuromodulation, shares his creation of the Foramen Finder to enhance sacral neuromodulation procedures. Dr. Allie Haessler, a practicing urogynecologist, talks about her invention of a novel vaginal ring aimed at providing neuromodulation therapy for pelvic floor issues. They each discuss the inspiration behind their inventions, challenges faced, and the importance of failure in the path to innovation. The episode emphasizes the role of physicians in identifying healthcare gaps, collaborating across disciplines, and pushing the boundaries of medical technology to improve patient care.
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TIMESTAMPS
00:00 - Introduction
01:54 - Dr. Tova Weiss and the Urinary Catheter Accessory
08:49 - Dr. Jay Shakuri-Rad and the Foramen Finder
22:04 - Dr. Allie Haessler and the Neuromodulation Vaginal Ring
27:29 - Navigating the Patent Process and Protecting Innovation
29:52 - The Path to FDA Approval
37:11 - Advice for Aspiring Innovators in Medicine
40:52 - Embracing Failure and the Inventor’s Mindset -
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.
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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
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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.
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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
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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
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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.
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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
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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. -
In this episode of the BackTable OBGYN Podcast, hosts Dr. Mark Hoffman and Dr. Amy Park discuss how cultivating an effective team culture in surgery can mitigate complications.
The physicians emphasize that how surgical teams treat each other can significantly affect patient outcomes. They suggest under-promising and over-delivering to patients, their family, and members of the surgical team. The doctors recommend having a care culture, allowing everyone to voice their concerns without fear of reprisals. They also discuss the importance of self-management, leadership, and taking responsibility inside and outside the OR for complications and places where the surgery could have gone smoother. They agree that those who nurture a positive OR culture have higher success rates, noting that complications demand more than technical skills to handle - it takes emotional intelligence, humility, and a good support network.
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SHOW NOTES
00:00 - Introduction
02:07 - Dealing with Surgical Complications
04:24 - The Emotional Impact of Complications on Surgeons
07:24 - The Importance of Patient Communication and Care Post-Complication
08:35 - The Role of Consent and Preoperative Counseling in Managing Complications
11:18 - The Importance of a Supportive and Open Culture in Medicine
15:32 - The Importance of Learning from Mistakes in Medicine
24:28 - The Role of Leadership and Teamwork in the Operating Room
29:56 - The Value of Familiarity in a Medical Team
30:38 - The Importance of Recognizing and Appreciating All Roles in a Medical Team
34:31 - The Role of Care and Empathy in Medical Practice
37:28 - The Role of Preparation in Avoiding Complications
40:53 - The Importance of Scheduling and Time Management in Medical Practice
50:31 - The Impact of Culture on Reporting and Addressing Adverse Events
51:19 - The Importance of Feedback and Self-Reflection in Medical Practice -
In this episode of BackTable OBGYN, host Dr. Mark Hoffman engages in a comprehensive discussion with Dr. Jorge Carrillo, a MIGS specialist at the Orlando VA Healthcare System and Site Director for the UCF/HCA Healthcare OB/GYN Residency Program, about the complexities of chronic pelvic pain from the perspective of a biopsychosocial model.
The conversation dwells mostly on the intricate relationship between pain, trauma, and the patient’s psychological state as it relates to chronic pelvic pain. Dr. Carrillo emphasizes the importance of adopting a trauma-informed care approach that creates a safe environment for patients. The discussion also covers the use of surveys for patient information, the importance of organizing thoughts during patient evaluation, and an outline of the four major categories of pelvic pain: gynecologic, urologic, gastrointestinal, and musculoskeletal. Dr. Carrillo shares valuable insights into managing complex conditions such as pelvic pain, providing an education-first approach for patients with emphasis on shared decision-making, and outlines how he and his team operate within a multidisciplinary framework for patient treatment.
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SHOW NOTES
00:00 - Introduction
04:32 - Dr. Carrillo’s Journey in the Medical Field
08:51 - The Importance of Trauma-Informed Care in Chronic Pelvic Pain
14:54 - Understanding the Biopsychosocial Model in Chronic Pelvic Pain
19:49 - The Initial Approach to Evaluating Patients with Chronic Pelvic Pain
25:25 - Understanding Nociplastic Pain and Sensitization
28:00 - Treatment Approaches for Sensitization
29:26 - The Importance of Organized Thinking in Pain Management
30:20 - The Role of Questionnaires in Patient Assessment
35:10 - The Importance of Multimodal Approach in Pain Management
43:00 - The Role of the Provider in Organizing Patient Care
45:37 - The Importance of Education in Pelvic Pain Management
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RESOURCES
International Pelvic Pain Society Handouts for Different Disorders of Chronic Pelvic Pain:
https://www.pelvicpain.org/public/resources/educational-resources/informational-handouts -
On this episode of the BackTable OBGYN Podcast, host Dr. Mark Hoffman is joined by Dr. Arpit Davé, an assistant professor at Penn State Health Milton S. Hershey Medical Center in the Department of Obstetrics and Gynecology. Together, they discuss the importance of surgical education and best practices for teaching new generations of surgeons.
Both Dr. Davé and Mark emphasize TATA, or tools, access, tissue handling, and anatomy, when practicing and teaching how to master surgery. They discuss the benefits of fostering a “sandbox-learning” environment, or a zone of safety where learners can practice techniques on patients. They also delve into systematic approaches for surgical training and the challenges in measuring the progress of trainees. Most importantly, Dr. Davé and Mark explore how to teach trainees not just surgery, but how to learn about surgery so that they feel competent doing new surgeries as their career in medicine progresses.
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SHOW NOTES
00:00 - Introduction
04:34 - The Role of Teaching in Medicine and Lifelong Learning in Surgery
07:15 - The Challenges of Surgical Training Volume
09:22 - The Journey of Learning and Teaching Surgery
17:59 - Understanding TATA: Surgical Tools, Access, Tissue Handling, and Anatomy
27:01 - The Importance of Practice in Surgical Training
30:04 - The Role of Tissue Handling in Surgical Training
31:20 - Creating Zones of Safety in Surgical Practice
33:31 - The Concept of “Sandboxing” in Surgical Training
34:27 - The Importance of Incremental Learning in Surgery
35:22 - The Importance of Breaking Down Surgical Procedures into Steps
42:32 - The Meaning of “Access” in Surgery
47:26 - How to Teach Trainees to Handle Tough Surgeries and the Unknown
50:05 - The Future of Surgical Training and Education -
This episode of BackTable OBGYN features Dr. Matt Reeves, a seasoned OBGYN and CEO/Founder of the DuPont Clinic, and host Dr. Amy Park as they discuss the use of Rh immune globulin (RhoGAM) in pregnancy.RhoGAM is traditionally administered to Rh- women at 28 weeks gestation, within 72 hours of birth, and frequently after an abortion in order to prevent Rhesus alloimmunization in future pregnancies. However, with recent data showing negligible Rh- blood cell exposure in early pregnancy terminations, the need for RhoGAM in such cases is being questioned. Additionally, considering the scarcity of RhoGAM and the reality of smaller family sizes globally, the importance of RhoGAM in Rh alloimmunization prevention might not be as significant as previously thought. However, limited evidence and ingrained medical practices may cause the transition to be slow.---SHOW NOTES00:00 - Introduction03:09 - Understanding RhoGAM: Origin and Development06:06 - The Science Behind RhoGAM and Its Role in Pregnancy08:13 - The Controversy and Debate Around RhoGAM Usage11:52 - The Impact of RhoGAM on Public Health and Medical Practice15:25 - The Future of RhoGAM: Perspectives and Predictions29:24 - Closing Thoughts and Further Resources---RESOURCESHorvath, S., Goyal, V., Traxler, S., & Prager, S. (2022). Society of Family Planning committee consensus on Rh testing in early pregnancy. Contraception, 114, 1–5.https://doi.org/10.1016/j.contraception.2022.07.002Horvath S, Huang Z, Koelper NC, et al. Induced Abortion and the Risk of Rh Sensitization. JAMA. 2023;330(12):1167–1174. doi:10.1001/jama.2023.16953
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In this episode, host Dr. Suzette Sutherland is joined by Dr. Kelly Casperson, a urologist who specializes in women’s sexual health, to discuss the importance of education, therapy, and hormone replacement in female sexual health.
They explore topics such as the role of estrogen and testosterone in women’s sexual desire, FDA-approved medications for hypoactive sexual desire disorder, and the importance of sex education and communication within relationships. They also highlight the topic of gender inequality in sexual health care delivery and the lack of clinical resources specifically tailored to women’s needs. In sum, they aim to provide a deeper understanding of female sexual health and offer strategies for practitioners to provide more effective care.
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SHOW NOTES
00:00 - Introduction
05:53 - The Role of Urologists in Women’s Sexual Health
07:18 - The Importance of Communication in Addressing Sexual Dysfunction
10:23 - The Role of the Clitoris in Female Orgasm
19:52 - Understanding the Hormones Behind Female Sexual Desire
25:32 - The Misconceptions and Gender Bias Surrounding Hormones
26:04 - The Role of Testosterone in Menopause and Sexual Desire
30:02 - The Challenges of Commercially Available Testosterone Products
32:52 - Non-Hormonal Treatments for Low Libido
42:41 - The Importance of Referring to Sex Therapists and Other Resources
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RESOURCES
Dr. Kelly Casperson’s Website
https://kellycaspersonmd.com/
You Are Not Broken Podcast
https://kellycaspersonmd.com/you-are-not-broken-podcast/
“You Are Not Broken” by Kelly Casperson
https://kellycaspersonmd.com/you-are-not-broken-book/
“Magnificent Sex” by Peggy Kleinplatz
https://www.amazon.com/Magnificent-Sex-Lessons-Extraordinary-Lovers/dp/0367181371
American Association of Sexuality Educators, Counselors, and Therapists
https://www.aasect.org/ -
In this episode, Dr. Suzette Sutherland and Dr. Alana Desai from the University of Washington discuss the management of urinary tract stones in pregnant patients, considerations for ureteroscopy, and consequences of radiation exposure in the fetus.
First, the doctors underscore the importance of ultrasound as the first line imaging modality to minimize fetal exposure to radiation. Dr. Sutherland and Dr. Desai also delve into nausea and pain management options, recommended diets for prevention of stone formation during pregnancy, and the necessity of involving a multidisciplinary team in such cases. The episode concludes with a remarkable case study from Dr. Desai’s experience.
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SHOW NOTES
00:00 - Introduction
02:06 - Incidence and Risk Factors of Kidney Stones in Pregnancy
03:29 - Physiological Changes and Stone Formation in Pregnancy
07:04 - Diagnosing Kidney Stones in Pregnancy
13:08 - Expectant Management vs. Intervention
14:41 - Managing Pain and Nausea in Pregnant Patients with Kidney Stones
17:13 - Decompression Methods for Kidney Stones in Pregnancy
23:13 - Ureteroscopy as a Preferred Intervention
26:05 - Case Description from Dr. Desai
30:04 - Considerations for Ureteroscopy in Pregnant Patients
31:14 - Preventing Kidney Stones in Pregnancy
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RESOURCES
Lyon, M., Sun, A., Shah, A., Llarena, N., Dempster, C., Sivalingam, S., Calle, J., Gadani, S., Zampini, A., & De, S. (2023). Comparison of Radiation Exposure for Pregnant Patients Requiring Intervention for Suspected Obstructing Nephrolithiasis. Urology, 182, 61–66. https://doi.org/10.1016/j.urology.2023.09.023
Thongprayoon, C., Vaughan, L. E., Chewcharat, A., Kattah, A. G., Enders, F. T., Kumar, R., Lieske, J. C., Pais, V. M., Garovic, V. D., & Rule, A. D. (2021). Risk of Symptomatic Kidney Stones During and After Pregnancy. American journal of kidney diseases : the official journal of the National Kidney Foundation, 78(3), 409–417. https://doi.org/10.1053/j.ajkd.2021.01.008 -
In this crossover episode of BackTable OBGYN with Urology, Dr. Suzette Sutherland, Director of Female Urology at the University of Washington, and Dr. Anne Cameron, Professor of Urology at the University of Michigan, share their insights on the prevention and management of urinary tract infections (UTIs).
First, they emphasize the importance of dispelling misconceptions about recurrent UTIs being a result of poor hygiene or incorrect behaviors, explaining that they can stem from genetic or hormonal risk factors. Dr. Cameron describes her algorithm for managing UTIs in specific patient populations. She further discusses the impact of factors such as fluid intake, bowel habits, and vaginal health on the incidence of UTIs. Dr. Cameron also highlights the potential for UTIs in diabetic patients on certain medications and the importance of a collaborative approach with diabetic healthcare teams. Additionally, the doctors explore various treatment strategies, such as cranberry supplements and gentamicin bladder installations, cautioning against antibiotic overuse due to the risk of resistance.
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EARN CME
Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/2P5fzK
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SHOW NOTES
00:00 - Introduction
02:13 - Understanding UTIs: Definitions, Symptoms, and Prevalence
04:39 - Recurrent UTIs: Definitions, Causes, and Treatment Challenges
12:00 - Understanding Asymptomatic Bacteriuria
15:00 - Cystitis vs. Pyelonephritis vs. Urosepsis
20:57 - Antimicrobial Resistance and Antibiotic Stewardship
24:36 - Treatment Guidelines for UTIs
31:13 - Self-start Antibiotic Therapy for UTIs
34:37 - Preventing UTIs: Hydration, Lifestyle Factors, and Bowel Health
38:33 - The Connection Between Vaginal Health and UTIs
42:40 - The Role of Supplements in UTI Prevention: D-Mannose and Cranberry, and Methenamine Hippurate
57:18 - Identification and Treatment of UTIs in Patients with Indwelling Catheters
01:00:04 - The Role of Gentamicin Bladder Installations in UTI Prevention
01:04:27 - The Impact of Diabetes Medications on UTIs
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RESOURCES
AUA Guidelines for UTI Treatment:
https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti -
In this episode of BackTable OBGYN, Dr. Mark Hoffman is joined by Dr. Sarah Rassier, a minimally invasive gynecologic surgeon and Director of the Fibroid Clinic at Mayo Clinic, to discuss the multiple treatment modalities of fibroids with a focus on laparoscopic myomectomy.
Drs. Hoffman and Rassier discuss the various factors they consider when deciding on the most suitable approach for a myomectomy. Specifically, they touch on pre-surgical patient optimization, the use of laparoscopic techniques in surgery, and the significance of efficient incision planning and closure. Dr. Rassier also highlights the practice of using preventative measures, such as iron infusions and Lupron, in certain patients to manage fibroids before surgical intervention. The conversation wraps up with a discussion about how future developments could potentially revolutionize fibroid management.
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SHOW NOTES
00:00 - Introduction and Overview of the Podcast
03:32 - Discussion on Fibroids and Their Different Treatment Options
06:40 - The Future of Fibroid Treatment
09:17 - Patient-Centered Decision Making in Fibroid Treatment
11:40 - Preparation and Approach for Myomectomy
13:18 - Discussion on the Use of MRI in Fibroid Treatment
15:55 - The Role of Laparoscopy in Myomectomy
29:00 - Umbilicus vs. Suprapubic Approach
32:04 - Cosmetic Considerations in Surgery
32:27 - - C-sections After Myomectomies?
34:51 Instruments and Techniques for Fibroid Removal
36:28 - Minimizing Blood Loss in Surgery
38:47 - The Importance of Efficient Closure in Surgery
44:46 - Tissue Extraction Techniques
49:02 - The Future of Myomectomy - Visa fler