Female Pelvic Medicine and Reconstructive Surgery—What Does Certification Mean?

Weissbart, Steven; Wein, Alan J.; Smith, Ariana L.

doi:10.1007/s11934-018-0785-0

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Due to the relatively loose structure of the vagina, the operating physician can also improve the image resolution. In cases where the patient has excessive intestinal gas or is obese, vaginal ultrasound detection can avoid the interference of intestinal gas or the signaling attenuation of the abdominal wall fat layer, and then clearly show the tumor size, shape, and physical properties of the tumor (9,10). The borders of benign pelvic tumors are often clear and have a complete capsule, while malignant tumors usually have an irregular shape and lack a complete capsule.…”

Section: Discussionmentioning

confidence: 99%

Reliability of the application of transvaginal color Doppler ultrasound in the identification of pelvic tumors in women of childbearing age

Zhi

Wang

et al. 2020

Ann Transl Med

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Background: Recently, transvaginal color Doppler ultrasound (TVCDU) has been widely used in the diagnosis of pelvic tumors. This study aimed to assess the reliability of the application of TVCDU in the identification of pelvic tumors in women of childbearing age. Methods:The clinical data of 209 patients with pelvic tumors at childbearing age admitted to our hospital from January 2016 to December 2019 were retrospectively analyzed. The ultrasound signs, color Doppler ultrasound score (CDUS), and resistance index (RI) of benign and malignant pelvic tumors diagnosed by TVCDU were analyzed. The value of transabdominal color Doppler ultrasound (TACDU) and TVCDU in the diagnosis of benign and malignant pelvic tumors was calculated.Results: There were 150 cases with benign pelvic tumors and 59 cases with malignant tumors. Most benign tumors had an intact capsule and regular shape, were mainly cystic, and were rarely accompanied by ascites; meanwhile, malignant tumors were mostly non-capsular and irregular in shape, mainly solid or cystic, and were often accompanied by ascites. There were significant differences in the above-mentioned ultrasound signs between benign and malignant tumors (P<0.05). The CDUS score of benign pelvic tumors was significantly lower than that of malignant tumors, and the RI value was significantly higher than that of the malignant tumors (P<0.05). The sensitivity, specificity, and accuracy of TACDU in the diagnosis of benign pelvic and malignant tumors were 83.33%, 84.75%, and 83.73%, respectively; and the sensitivity, specificity, and the accuracy of TVCDU in the diagnosis of benign pelvic and malignant tumors were 95.33%, 88.14%, and 93.30%, respectively; thus TVCDU had a superior performance compared to TACDU, especially in sensitivity and accuracy (P<0.05). Conclusions:The sensitivity and accuracy of TVCDU in the differential diagnosis of benign pelvic and malignant tumors in women at childbearing age were significantly higher than those of TACDU. The combined application of CDUS and RI can further improve the accuracy in the diagnosis of pelvic tumors.

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Section: Discussionmentioning

confidence: 99%

Reliability of the application of transvaginal color Doppler ultrasound in the identification of pelvic tumors in women of childbearing age

Zhi

Wang

et al. 2020

Ann Transl Med

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Barriers to Referral to Fellowship-trained Minimally Invasive Gynecologic Surgery Subspecialists

Delara¹,

Misal²,

Yi³

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: To determine patterns and barriers for referral to fellowship-trained minimally invasive gynecologic surgeons. Design: Questionnaire. Setting: United States and its territories and Canada. Participants: Actively practicing general obstetrician/gynecologists (OB/GYNs). Interventions: Internet-based survey. Measurements and Main Results: Of 157 respondents, 144 (91.7%) general OB/GYNs were included. Subspecialty fellowship training resulted in the exclusion of 13 ( 8.3%) respondents. A total of 86 respondents (59.7%) considered referral to fellowship-trained minimally invasive gynecologic surgery (MIGS) subspecialists. The top 3 cited reasons for nonreferral were adequate residency training (n = 84, 58.3%), preference for continuity of care (n = 48, 33.3%), and preference for referral to other subspecialists (n = 46, 31.9%). The top 3 cited reasons for referral to MIGS subspecialists were complex pathology (n = 92, 63.9%), complex medical and/or surgical history (n = 76, 52.8%), and out of scope of practice (n = 53, 36.8%). If providers required intraoperative assistance, respondents consulted an OB/GYN colleague with comparable training (n = 50, 34.7%), gynecologic oncologist (n = 48, 33.3%), or non-OB/GYN surgical subspecialist (n = 33, 22.9%). Factors that were not associated with the decision to refer to MIGS subspecialists included years in practice (p = .13), additional training experiences beyond residency (p = .45), and number of hysterectomies performed by laparotomy (p = .69). Selfreported high-volume surgeons (p <.01) were less likely to refer. In contrast, providers who self-reported as low-volume surgeons (p = .02) and were aware of MIGS subspecialists in the community (p <.01) were more likely to consider referral. Respondents reported using a laparoscopic approach to hysterectomy most frequently (n = 79, 54.9%). In contrast, 36.8% preferred the laparoscopic route for themselves or their partner, whereas 48.6% preferred the vaginal approach. Conclusion: Most of the general OB/GYNs would consider referral to fellowship-trained MIGS subspecialists. Providers who reported adequate residency training and those who preferred continuity of care or referral to other surgical subspecialists were less likely to refer to MIGS subspecialists.

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Female Pelvic Medicine and Reconstructive Surgery—What Does Certification Mean?

Cited by 2 publications

References 40 publications

Reliability of the application of transvaginal color Doppler ultrasound in the identification of pelvic tumors in women of childbearing age

Reliability of the application of transvaginal color Doppler ultrasound in the identification of pelvic tumors in women of childbearing age

Barriers to Referral to Fellowship-trained Minimally Invasive Gynecologic Surgery Subspecialists

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