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Objective: To investigate patient perspectives on climate change and climate change mitigation strategies in healthcare., Methods: A cross-sectional survey among gynaecological patients from two Dutch outpatient clinics. Main outcomes included patients' climate-related knowledge and worry, climate friendly healthcare perspectives and willingness to opt for climate friendly treatment alternatives. Multivariable linear regression analyses were performed to explore patient characteristics associated with climate friendly healthcare perspectives., Results: 274 surveys were included. Most patients (79 %) were worried about climate change. Although almost all (91 %) found it important to contribute to climate protection, patients showed hesitance regarding healthcare measures that would impinge on individual choices. 62 % was willing to opt for climate friendly treatments, but this proportion varied by medical condition. Climate-related knowledge and worry were both positively associated with climate friendly healthcare perspectives., Conclusion: Gynaecological patients are concerned about climate change and possess substantial self-reported climate-related knowledge. Patients vary in their support of climate action that involves individual patient care, but the majority is open to choose climate friendly treatment alternatives for certain medical conditions., Practice Implications: This exploratory study holds implications for the feasibility of integrating climate impact into clinical decision-making and provides a foundation for normative evidence for decarbonizing healthcare., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

As an example of a low- and middle-income country (LMIC), India ranks pre-eclampsia among the top three causes of maternal mortality, following haemorrhage and infections. It is one of the primary concerns for maternal and perinatal health in LMICs. Many LMICs lack clear consensus and guidelines for the prevention, diagnosis, and management of hypertensive disorders in pregnancy, including pre-eclampsia. The International Society for the Study of Hypertension in Pregnancy 2021 guidelines address LMIC applications, offering customisable solutions. Atypical presentations of pre-eclampsia contribute to diagnostic delays, resulting in additional adverse maternal and perinatal outcomes. Implementing management strategies faces challenges in both urban and rural settings. Adapting global research involving local populations is imperative, with the potential for cost-effective adoption of international guidelines. Prevention, early diagnosis, and education dissemination are essential, involving healthcare providers and advocacy initiatives. Encouraging government investment in pre-eclampsia management as a public health initiative is important. This article explores socio-economic, cultural, and legislative factors influencing the management of pre-eclampsia in LMICs, addressing emerging challenges and potential partnerships for healthcare provision., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Bladder endometriosis accounts for 70-85% of urinary tract endometriosis cases. Urinary tract endometriosis occurs in approximately 1% of those living with endometriosis. Underlying aetiology and pathogenesis are not fully understood, but there are several plausible theories. As well as the typical pain symptoms, those with bladder endometriosis can experience several urinary tract symptoms. The manifestation of these symptoms can have complex pathways and processes. Imaging is accurate in the diagnosis of bladder endometriosis and clinicians should be mindful of the risk of silent kidney loss. Management should be guided by symptoms; both medical and surgical options are feasible. Surgical management offers potentially definitive treatment. Excisional surgery via bladder shave or partial cystectomy offers good improvement in symptoms with relatively low rates of serious complications and recurrence., Competing Interests: Declaration of competing interest SK is a proctor for Intuitive and has received honorarium from Medtronic. All other authors have no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Abstract Background Improvement in the prediction and prevention of severe maternal morbidity (SMM) - a range of life-threatening conditions during pregnancy, at delivery or within 42 days postpartum - is a public health priority. Reduction of SMM at a population level would be facilitated by early identification and prediction. We sought to develop and internally validate a model to predict maternal end-organ injury or death using variables routinely collected during pre-pregnancy and the early pregnancy period. Methods We performed a population-based cohort study using linked administrative health data in Ontario, Canada, from April 1, 2006 to March 31, 2014. We included women aged 18–60 years with a livebirth or stillbirth, of which one birth was randomly selected per woman. We constructed a clinical prediction model for the primary composite outcome of any maternal end-organ injury or death, arising between 20 weeks’ gestation and 42 days after the birth hospital discharge date. Our model included variables collected from 12 months before estimated conception until 19 weeks’ gestation. We developed a separate model for parous women to allow for the inclusion of factors from previous pregnancy(ies). Results Of 634,290 women, 1969 experienced the primary composite outcome (3.1 per 1000). Predictive factors in the main model included maternal world region of origin, chronic medical conditions, parity, and obstetrical/perinatal issues – with moderate model discrimination (C-statistic 0.68, 95% CI 0.66–0.69). Among 333,435 parous women, the C-statistic was 0.71 (0.69–0.73) in the model using variables from the current (index) pregnancy as well as pre-pregnancy predictors and variables from any previous pregnancy. Conclusions A combination of factors ascertained early in pregnancy through a basic medical history help to identify women at risk for severe morbidity, who may benefit from targeted preventive and surveillance strategies including appropriate specialty-based antenatal care pathways. Further refinement and external validation of this model are warranted and can support evidence-based improvements in clinical practice.

Background: Adolescents in India contribute to 22% of the country’s population and are susceptible to various preventable and treatable health issues. Objectives: To estimate the burden and to describe the pattern of gynaecological disorders among adolescent girls attending the outpatient and inpatient departments of a private medical college hospital in South India. Materials and methods: This was a hospital based cross sectional analytical study done among 500 adolescent girls of 10-19 years age group in a private medical college hospital in South India during December 2020 to December 2021 using a pretested questionnaire. Data was analysed using IBM SPSS version 23. Chi-square test or Fischer exact test was done to find the association between categorical variables. Mann Whitney U test was used to compare the difference between means. P value less than 0.05 was considered to be significant for all comparisons. Results: Mean age of study population was 15.94 ± 2.52 years. Menstrual abnormalities reported in 303 (60.6%) girls followed by 240 (48%) girls had leucorrhoea, 68 (13.6%) had urinary tract infection and 54(10.8%) had PCOS. Conclusion: There is a high burden of gynaecological disorders and lack of awareness on various components of adolescent reproductive and sexual health among adolescents.

Introduction: Surgical Site Infection (SSI) is one of the most common complications of postcaesarean section, which is mainly associated with increase morbidity and mortality. This is also an important cause of prolonged hospital stay, patient dissatisfaction and higher treatment cost. There is very limited data available on the incidence, outcome and clinical spectrum of postcaesarean SSI from Southern Rajasthan. Aim: The aim was to find out the frequency of SSI and variables contributing to it in women who had a caesarean section in a tertiary care centre in Rajasthan, India. Materials and Methods: This was a prospective observational study conducted over a duration of six months from June 2019 to November 2019 at SHKBM, Jhalawar Hospital and Medical College, Jhalawar, Rajasthan, India. All the women who developed postcaesarean SSI during hospital stay or within 30 days following surgery were included in the study. Demographic data and all the potential risk factors were noted. Pus samples from the infected wound were sent for culture and sensitivity. Data was presented as frequencies and percentages. Statistical Package for Social Sciences software (SPSS) version 26.0 and Epi Info Software were used for the statistical analysis. Results: A total of 1157 cases underwent caesarean section during study period, among them 53 cases had postcaesarean SSI, which gave a incidence rate of 4.5%. In present study, majority of women belonged to 21-25 years of age group 33 (62.26%), 31 (58.49%) cases were unbooked, 47 (88.67%) of SSI was seen in emergency caesarean section, and 48 (90.56%) of SSI cases had pfannenstiel incision. Anaemia (81.13%), hypertensive disorder (13.2%) and urinary tract infection (3.77%) were associated medical risk factors for SSI. There were other obstetrics and intraoperative risk factors found to be associated with postcaesarean SSI, out of them previous caesarean section was most common (56.6%). Klebsiella was the most common organism isolated. Conclusion: Infrequent antenatal visits, emergency caesarean sections, anaemia and history of previous caesarean section were the most common risk factors for SSI.

Background: Blended teaching combines traditional in‐person components (simulation‐based training and clinical‐based placement) with online resources. Due to the COVID‐19 pandemic, we modified our Women's Health Interprofessional Learning through Simulation (WHIPLS) program – to develop core obstetric and gynaecological skills – into a blended teaching program. There is limited literature reporting the observations of blended teaching on learning. Aims: To qualitatively evaluate the blended teaching program and explore how it contributes to learning. Materials and Methods: This study was performed at Monash University in Melbourne, Australia. A total of 98 medical students and 39 midwifery students participated. Data were collected by written survey and analysed by authors using a thematic analysis framework. Results: Students reported that in‐person teaching remains a vital aspect of their curriculum, contributing an averaged 63.2% toward an individual's learning, compared with online. Five substantial themes demonstrate how students learnt and maximised education opportunities using a blended teaching program: 'low‐pressure simulation environments', 'peer‐assisted learning', 'haptic learning', 'scaffolded learning' and 'the impact of online discourse'. Discussion: In‐person teaching remains a cornerstone of obstetric and gynaecological clinical skills education, of which interprofessional simulation and clinical‐based placement are key components. Teaching via online discourse alone, is not sufficient to completely replace and provide comparable learning outcomes, but certainly plays an important role to prime students' learning and to maximise in‐person opportunities and resources. Our study reveals key pedagogies of a blended (online and in‐person) learning program, providing further evidence to support its ongoing utility as a feasible and warranted approach to learning. [ABSTRACT FROM AUTHOR]

Background: Gynaecology trainees struggle to obtain adequate procedural experience. Training programs integrating virtual reality simulators (VRS) have been suggested as a solution. Aims: The study aimed to assess if a VRS training program (LapSim®, Surgical Sciences, Göteborg, 2017) improved live operating performance at six months for novice and experienced trainees. Additional outcomes included the association between LapSim® logged time and live operating performance at six months, LapSim® scores and live operating performance at zero and sixmonths and the difference in benefit for novice and experienced gynaecology trainees. Methods: A prospective intervention study was conducted. Novice and experienced trainees were enrolled, and comparisons made at zero‐ and six‐month time points. The intervention groups were provided with a laparoscopic gynaecology curriculum incorporating VRS. Controls underwent routine training only. Assessment of live operating performance was conducted after six months training. Results: Thirty‐five trainees participated, and 25 had access to the VRS curriculum (17 novice and eight experienced trainees). Access to the VRS curriculum and time spent training on the LapSim® made no difference to live operating ability for either intervention group (P > 0.05). The median (interquartile range) hours of VRS usage were 7.9 (4.5–10.8) and 6.0 (4.0–6.8) for novice and experienced trainees respectively. The intervention group provided positive feedback on the utility of VRS in their laparoscopic skill development. Conclusion: Optimal utilisation of VRS in Australian training paradigms remains incompletely understood. Further research is required to establish the most effective integration of VRS into training models to ensure uptake and transferability to the operating theatre. [ABSTRACT FROM AUTHOR]

Background: There is a finite volume of surgery performed annually by trainees and certified specialists alike. The detailed assessment of this surgical substrate is important, since it guides true exposure in gynaecological surgical training and practice after fellowship. Aims: This study quantifies the volume and profile of major gynaecological surgical procedures performed in Australia within a specified five‐year period and discusses the implications for training and practice. Materials and Methods: Australian Institute of Health and Welfare data were examined to quantify the total number of major gynaecological procedures performed between 2013 and 2018. Medicare data were analysed to quantify the number of billed procedures. These data were compared with published Australian RANZCOG trainees and operative gynaecologists, to estimate the potential annual average exposure for each procedure. Results: Major open, laparoscopic and vaginal surgeries constitute less than 27% of the 600 000 gynaecological procedures performed annually in Australia. Most major gynaecological surgeries are performed at rates lower than 12 cases per year for both trainees and specialists. Over the study period, laparotomies, vaginal hysterectomies and continence procedures decreased, and operative laparoscopies and laparoscopic hysterectomies increased. Conclusions: The volume of available major gynaecological procedures in Australia may not allow sufficient exposure for optimal training and practice for all trainees and specialists in operative gynaecology. This shortfall may compromise the ability to obtain and maintain proficiency in some core gynaecological operative procedures. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has necessitated alterations in provision of health care and how patients access it. Telehealth has replaced traditional face‐to‐face outpatient clinics in an unprecedented manner. This study aimed to assess overall patient and clinician satisfaction with telehealth consultations, to establish acceptability of telehealth during pandemic and non‐pandemic times, and document feedback. Materials and Methods: A prospective observational study involving women presenting to a general gynaecology outpatient department was performed. Women who attended for consultation between 13 July and 4 September 2020 were invited to participate in a questionnaire following their telehealth appointment. Clinicians consulting in the outpatient department were invited to complete a questionnaire at the end of the eight‐week study period. Satisfaction, utility and acceptability data were obtained using visual analogue scales (VAS). Results: Twenty‐six out of 56 (46.4%) clinicians and 124/870 (14.3%) patients completed the questionnaire. Patients who responded were older and more likely to have been born in Australia than women who did not (P = 0.0355 and P = 0.005, respectively). Overall patient satisfaction with telehealth was high (median VAS (interquartile range), 8.6 (5.6–9.8)). More women found telehealth to be acceptable during a pandemic than afterward (8.9 vs 6.6, P < 0.0001). Clinicians were less satisfied with telehealth than patients (7.1 vs 8.6, P = 0.02); however, most would be happy to continue using telehealth in non‐pandemic times (7.0 (6.2–9.8)). Conclusion: Telehealth consultations allow provision of gynaecological care at a time when reducing risk of infection to patients and staff is paramount. Telehealth gynaecology consultations are efficient and convenient without significant detriment to patient or clinician satisfaction. [ABSTRACT FROM AUTHOR]

This consensus statement has been developed by the Thai Interest Group for Endometriosis (TIGE) for use by Thai clinicians in the diagnosis and management of endometriosis. TIGE is a group of clinical and academic gynaecologists with a particular interest in endometriosis. Endometriosis is an oestrogen-dependent inflammatory disease which causes chronic symptoms such as dysmenorrhoea, chronic pelvic pain, dyspareunia and subfertility, and it is common in reproductive-age women. There is limited overall data on its prevalence in different clinical settings in Thailand, but it is clear that the disease causes significant problems for patients in terms of their working lives, fertility, and quality of life, as well as placing a great burden on national healthcare resources. Decisions about selecting the appropriate treatment for women with endometriosis depend on many factors including the age of the patient, the extent and severity of disease, concomitant conditions, economic status, patient preference, access to medication, and fertility need. Several hormonal treatments are available but no consensus has been reached about the best option for long-term prevention of recurrence. Bearing in mind differences in environment, genetics, and access to the healthcare system, this treatment guideline has been tailored to the particular circumstances of Thai women. [ABSTRACT FROM AUTHOR]

The objective of this retrospective analysis was to determine the incidence and extent of vaginal mucositis (VM) in women with gynaecological cancer undergoing external (chemo)radiation therapy (CRT). A retrospective analysis was set up to collect data on the incidence and severity of VM in women treated with external pelvic RT for gynaecological cancer at the Jessa Hospital, Hasselt and ZOL, Genk, BE between January 2017 and June 2018. At the start and end of their external (C)RT, they rated the frequency and intensity of five common symptoms of VM. Thirty-three patients treated with RT for gynaecological cancer met the inclusion criteria. A non-negligible proportion of patients already experienced at least one VM symptom to any degree before the start of RT, a proportion that further increased towards the end of the RT (73%). At the end of RT, on average, about 25% of these patients reported moderate-to-severe symptoms (against about 7% before the (C)RT). These results suggest that VM is a rather frequent side effect in gynaecological cancer patients that aggravates during treatment up to a moderate severity level. Although the small sample size, these data highlight the need for attention to VM. What is already known about this topic? Radiotherapy plays an important role in the treatment of gynaecological malignancies. A debilitating complication in patients undergoing pelvic radiotherapy is vaginal mucositis, an inflammation of the vaginal mucosal lining. To date, the incidence of vaginal mucositis is still not well documented. What this paper adds? A non-negligible proportion of patients already experienced at least one symptom related to vaginal mucositis before the start of radiotherapy. Most patients presented mild to moderate vaginal mucositis symptoms at the end of external pelvic radiotherapy. Burning sensation, pruritus, and pain were the most frequently documented radiotherapy-induced complications. The implications of this paper: Vaginal mucositis is an underrated side effect of pelvic radiotherapy that needs to be tackled multidisciplinary by a team of nurses, radiotherapists, oncologists, and gynaecologists. The team should tackle the complication from the start of radiotherapy by using the most appropriate measures. Due to a possible link between acute vaginal mucositis and late vaginal toxicity, the team needs to follow-up patient's post-radiotherapy to support patients in late complications and advise/encourage patients in performing vaginal dilatation to prevent vaginal stenosis. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition that prehabilitation is important as a means of preparing patients physically and psychologically for cancer treatment. However, little is understood about the role and optimal nature of prehabilitation for gynaecological cancer patients, who usually face extensive and life-changing surgery in addition to other treatments that impact significantly on physiological and psychosexual wellbeing.Review Question: This scoping review was conducted to collate the research evidence on multimodal prehabilitation in gynaecological cancers and the related barriers and facilitators to engagement and delivery that should be considered when designing a prehabilitation intervention for this group of women.Methods: Seven medical databases and four grey literature repositories were searched from database inception to September 2021. All articles, reporting on multimodal prehabilitation in gynaecological cancers were included in the final review, whether qualitative, quantitative or mixed-methods. Qualitative studies on unimodal interventions were also included, as these were thought to be more likely to include information about barriers and facilitators which could also be relevant to multimodal interventions. A realist framework of context, mechanism and outcome was used to assist interpretation of findings.Results: In total, 24 studies were included in the final review. The studies included the following tumour groups: ovarian only (n = 12), endometrial only (n = 1), mixed ovarian, endometrial, vulvar (n = 5) and non-specific gynaecological tumours (n = 6). There was considerable variation across studies in terms of screening for prehabilitation, delivery of prehabilitation and outcome measures. Key mechanisms and contexts influencing engagement with prehabilitation can be summarised as: (1) The role of healthcare professionals and organisations (2) Patients' perceptions of acceptability (3) Factors influencing patient motivation (4) Prehabilitation as a priority (5) Access to prehabilitation.Implications For Practice: A standardised and well evidenced prehabilitation programme for women with gynaecological cancer does not yet exist. Healthcare organisations and researchers should take into account the enablers and barriers to effective engagement by healthcare professionals and by patients, when designing and evaluating prehabilitation for gynaecological cancer patients. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic (COVID-19) has had unprecedented effects on healthcare delivery. A 34-question online survey was sent to obstetrics and gynaecology trainees within the West Midlands to assess the impact of the pandemic on training, working practices and well-being. 101 responses were received from obstetrics and gynaecology trainees. Trainees reported a significant reduction in both elective and emergency surgeries as well as outpatient clinics. Over one third of respondents felt additional training time may be required following reduction of clinical opportunities. 44% of trainees felt their workload increased significantly. 55% of trainees felt the pandemic had a significant negative impact on their physical and mental well-being. Obstetrics and gynaecology trainees in the West Midlands have adapted to the challenges of the COVID-19 pandemic despite significant impact on their training, working practices and wellbeing. It is important to tailor training to improve trainees' education and combat lost training time during the pandemic. This should be considered for long-term shaping of the obstetrics and gynaecology training pathway. What is already known on this subject? Little research is available about the impact of the COVID-19 pandemic on obstetrics and gynaecology trainees. This is the first study of its kind to assess the effect of the pandemic on obstetrics ang gynaecology trainees in the United Kingdom. What do the results of this study add? The results of this study have shown that obstetrics and gynaecology training has been heavily affected during the COVID-19 pandemic. There have been significant impacts on their training, working patterns and physical and mental wellbeing. What are the implications of these findings for clinical practice and/or further research? These findings can be used to mould the obstetrics and gynaecology training pathway based on the feedback given by the trainees during the pandemic. The survey questions can also be utilised as a framework for similar research projects across the United Kingdom Deaneries, among other specialties and around the world. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery (ERAS) protocols were first reported for colorectal and gynaecologic procedures. The main benefits have been a shorter length of stay and reduced complications. A retrospective audit was conducted of all patients who underwent ambulatory pelvic organ prolapse surgery at the Townsville Day Surgery between January 2008 and June 2019. Following the publication of a former audit, a modified ERAS protocol was adopted at our practice. We omitted a carbohydrate-rich fluid intake prior to surgery in our local protocol. Data were analysed for the type of surgery, postoperative complications, and readmissions. All surgeries were performed by a single consultant urogynecologist. A total of 1381 women underwent 1937 surgeries. Transvaginal mesh (55.8%) was the commonest procedure, followed by a posterior repair (23.9%). Ninety-five patients (4.4%) had various complications, with a failed trial of the void as the commonest complication (87 patients). Only 8 patients (0.4%) required an unplanned admission after their procedures. Site-specific ERAS protocol is effective for providing standardised care in the surgical treatment of women with pelvic organ prolapse and urinary incontinence in an outpatient setting. Complication rates are low and reduce further with experience and familiarity with the protocol. What is already known on this subject? Enhanced recovery after surgery (ERAS) protocols are being increasingly used in surgical practices. The main objective of the protocol has been on reducing postoperative morbidity and stay. The commonly practiced protocol includes a high protein intake diet and a glucose drink prior to surgery. What do the results of this study add? Our study utilises a modified ERAS protocol of omitting the high protein diet and the glucose drink for the minimally invasive uro-gynaecology procedures. The modified protocol is safe and associated with lower complications and readmission rates. What are the implications of these findings for clinical practice and/or further research? The present study demonstrates the safety and effectiveness of our modified ERAS protocol that allows for patients to undergo surgical procedures and discharge on the same day, thus minimising the impact on the quality of life and vocations. A multi-center randomised controlled trial will conclusively demonstrate a cause-effect relationship between early discharge and patient preparation with our modification of the ERAS protocol. Further research should also consider patient satisfaction as an additional outcome measure. [ABSTRACT FROM AUTHOR]

The first foray into gynaecological minimal access surgery took place in 1936, when Swiss gynaecologist Boesch performed the first laparoscopic sterilisation. By 1988 advancements in surgical technology allowed Harry Reich to perform the first laparoscopic hysterectomy, and by 2022 the majority of gynaecological surgery can be carried out laparoscopically. Minimal access surgery reduces hospital stay and enhances post-operative recovery such that patients are often able to return to near normal function within one week. However, advancements in medical management of gynaecological conditions, the European Working Time Directive and the COVID-19 pandemic are just a few examples of how surgical volume has significantly decreased in recent times. The impact that this reduction in case load has had, and will continue to have, on the training of endoscopic surgeons in gynaecology must not be underestimated. It is well documented in the literature that improving training in laparoscopy results in better patient safety, thus it is imperative that we strive for structured minimal access training in gynaecology. [ABSTRACT FROM AUTHOR]

Objective: Vulvar necrotising fasciitis (VNF) is a severe soft tissue infection associated with substantial morbidity and high mortality. At Stony Brook Medicine, US, patients with known or suspected VNF are treated by a structured multidisciplinary team consisting of members of the Departments of Emergency Medicine and Medicine, the Divisions of Gynecologic Oncology, Burn and Surgical Intensive Care Units, Infectious Disease and Plastic Surgery, and the nursing, nutrition, physical/occupational therapy and social work services. Method: This is a retrospective review of patients presenting to Stony Brook University Hospital with VNF over an 18-month period. Results: A total of 10 patients were treated for VNF during the study period. All patients were treated by the structured multidisciplinary team, including extensive initial surgical debridement by the gynaecologic oncologists. All patients survived to discharge. Conclusion: The results of this review demonstrated that prompt diagnosis, rapid implementation of appropriate antibiotic coverage, surgical debridement of necrotic tissue, and comprehensive care delivered by a structured multidisciplinary team contributed to positive clinical outcomes and decreased the risk of death from VNF. [ABSTRACT FROM AUTHOR]

Background: Adolescents in India contribute to 22% of the country's population and are susceptible to various preventable and treatable health issues. Objectives: To estimate the burden and to describe the pattern of gynaecological disorders among adolescent girls attending the outpatient and inpatient departments of a private medical college hospital in South India. Materials and methods: This was a hospital based cross sectional analytical study done among 500 adolescent girls of 10-19 years age group in a private medical college hospital in South India during December 2020 to December 2021 using a pretested questionnaire. Data was analysed using IBM SPSS version 23. Chi-square test or Fischer exact test was done to find the association between categorical variables. Mann Whitney U test was used to compare the difference between means. P value less than 0.05 was considered to be significant for all comparisons. Results: Mean age of study population was 15.94 ± 2.52 years. Menstrual abnormalities reported in 303 (60.6%) girls followed by 240 (48%) girls had leucorrhoea, 68 (13.6%) had urinary tract infection and 54(10.8%) had PCOS. Conclusion: There is a high burden of gynaecological disorders and lack of awareness on various components of adolescent reproductive and sexual health among adolescents. [ABSTRACT FROM AUTHOR]

Fertility Sparing Surgery (FSS) appears to be a safe means of treating early-stage ovarian cancer based on relatively limited evidence. However, there is currently insufficient evidence to aid women in counselling about their potential fertility outcomes. The aim of this study was to assess the reproductive outcomes and prognosis of women who have undergone FSS for ovarian malignancy. Between 1 June 2008 and 1 June 2018, a retrospective review of a clinical database was conducted to identify all consecutive patients who underwent FSS in a central London gynaecological oncology centre. All patients with a histological diagnosis of ovarian malignancy (excluding borderline ovarian tumours) were eligible. All identified patients were then prospectively called into a follow up and asked to complete a questionnaire about their fertility outcomes. A total of 47 women underwent FSS; 36 were included in this study. The mean age was 30.3 years (95% Confidence Interval [CI]: 27.6 to 33.0 years). During the study period, 17/36 (47.2%) of the women had attempted to conceive following surgery, with a successful live birth rate of 52.9% (9/17). The mean time of recurrence was 125.3 months (95% CI: 106.5–144.1 months). The mean time to death was 139.5 months (95% CI: 124.3–154.8). The cancer grade, tumour stage and use of Assisted Reproductive Technology (ART) were the main factors significantly associated with the risk of recurrence and death. In conclusion, this study suggests that a large proportion of women will not attempt to conceive following FSS. For those who do attempt to conceive, the likelihood of achieving a live birth is high. However, careful counselling about the higher risk of recurrence and worse survival for women with high grade cancer, disease Stage > IA and potentially those who undergo ART is essential before contemplating FFS. [ABSTRACT FROM AUTHOR]

Three‐dimensional ultrasound (3DUS) is becoming a standard part of obstetric and gynaecological ultrasound examinations. With most high‐end ultrasound systems now incorporating three‐dimensional functionality, the technology can be used to enhance and/or confirm a diagnosis in many gynaecological pathologies. Part one of this two‐part series covered the technical aspects of performing three‐dimensional gynaecological ultrasound. This paper, part two, presents a pictorial essay of 3DUS in gynaecological imaging serving to educate sonographers and other ultrasound users on the typical appearance of some common, and not so common ultrasound findings. [ABSTRACT FROM AUTHOR]

A female domestic shorthair cat of unknown age, weighing 2.9 kg, was presented with a single horn of the uterus protruding through the vulva. The cat had a history of recent parturition, delivering four kittens, and was mildly dehydrated and generally stable. The exposed uterine tissue was congested and oedematous, with areas of devitalization and necrosis. Manual reduction of the prolapsed uterus was unsuccessful because of severe oedema. The protruding uterus was amputated, and a midline laparotomy was performed for staged ovariohysterectomy. Postoperatively, the cat appeared healthy with no vulval discharge and no recurrence of clinical signs. This case report demonstrates the different methods involved in the correction of a uterine prolapse. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to present selected oncological problems among girls and young women. Mechanism: Malignant ovarian cancers grow faster in girls. Due to the lack of an anatomic barrier, they spread rapidly from the pelvis to the organs in the entire peritoneal cavity. High-grade cancers may be associated with an insufficient immune response that controls the early tumour growth. Findings and brief: Paediatric cancers represent about 1% of all diseases; fortunately, in developmental age gynaecology this is not a frequent problem, yet its significance requires intense specialist actions. Although they most often occur in adult women, malignant lesions may also affect girls (e.g., cervical germ cell tumour). Therefore, the importance of early detection of neoplastic ovarian lesions at any age is emphasised. Cervical cancer is also an oncological issue in developmental age gynaecology (the immature metaplastic epithelium is particularly sensitive to the oncogenic effects of HPV (Human Papillomavirus)), hence any prophylaxis, especially vaccinations, are of great importance in this respect). Apart from typical genital cancers, there can also be cancers where the genitourinary system is just one of the possible locations. Conclusions: Fortunately, cancers are not frequent in developmental age gynaecology, yet the significance of this problem requires intense specialist actions.

Abstract Background Standardised assessment is key to structured surgical training. Currently, there is no consensus on which surgical assessment tool to use in live gynaecologic surgery. The purpose of this review is to identify assessment tools measuring technical skills in gynaecologic surgery and evaluate the measurement characteristics of each tool. Method We utilized the scoping review methodology and searched PubMed, Medline, Embase and Cochrane. Inclusion criteria were studies that analysed assessment tools in live gynaecologic surgery. Kane’s validity argument was applied to evaluate the assessment tools in the included studies. Results Eight studies out of the 544 identified fulfilled the inclusion criteria. The assessment tools were categorised as global rating scales, global and procedure rating scales combined, procedure-specific rating scales or as a non-procedure-specific error assessment tool. Conclusion This scoping review presents the current different tools for observational assessment of technical skills in intraoperative, gynaecologic surgery. This scoping review can serve as a guide for surgical educators who want to apply a scale or a specific tool in surgical assessment.

Introduction: Primary vaginal malignant melanomas are rare tumours with a limited number of cases published in the literature. They primarily affect post-menopausal women with a median age of 57–68 years and have a dismal prognosis. The 5-year survival rate, regardless of treatment, is approximately 5–25%. Case description: We present the case of an 87-year-old female who presented with haematuria and urinary incontinence. She was diagnosed with AJCC stage IIIC vaginal melanoma. Considering her age and the extent of malignancy, surgery was not a viable option and immunotherapy with nivolumab and ipilimumab was initiated as treatment. Discussion: The diagnosis of vaginal melanomas includes pathological analysis and immunohistochemistry (IHC) of the mass, imaging to determine extent, and genetic testing. Surgery is the preferred treatment in suitable cases. For metastatic or unresectable cases, immunotherapy or targeted therapy is the preferred first-line treatment. Due to the lack of an adequate number of cases to conduct randomized clinical trials, prognostic factors and treatment protocols for vaginal melanomas are not clearly defined. At present, the management of these tumours is largely based on retrospective studies and anecdotal evidence accompanied by significant knowledge gaps. Our case will be a valuable addition to the existing literature on vaginal melanomas that are managed non-surgically.

Abstract Background Endometriosis (where endometrial-like tissue is found outside the uterus) affects ~ 176 million women worldwide and can lead to debilitating pelvic pain. There is an unmet need for new medical treatment options for endometriosis. Pelvic peritoneal mesothelial cells of women with endometriosis exhibit detrimental metabolic reprogramming that creates an environment favouring the formation and survival of endometriosis lesions. We have generated powerful preclinical proof-of-concept data to show that it is possible to correct this metabolic phenotype using dichloroacetate (DCA), a non-hormonal compound previously used to treat rare metabolic disorders in children. We plan a single-arm, open-label, single site exploratory clinical trial to inform the design of a future randomised controlled trial (RCT) to determine the efficacy of DCA for the treatment of endometriosis-associated pain. Methods We will recruit 30 women with endometriosis-associated pain over a 6-month period. All participants will receive approximately 6.25 mg/kg oral DCA capsules twice daily for 6 weeks, with a dose increase to approximately 12.5 mg/kg twice daily for a further 6 weeks if their pain has not been adequately controlled on this dose regime and side-effects are acceptable. If pain is adequately controlled with minimal side-effects, the lower dose will be continued for a further 6 weeks. The primary objective is to determine whether it is possible to achieve acceptable recruitment and retention rates within the defined exclusion and inclusion criteria. Secondary objectives are to determine the acceptability of the trial to participants, including the proposed methods of recruitment, treatment, follow-up frequency and number of questionnaires. The recruitment rate will be determined by the proportion of patients recruited from the pool of eligible women. The retention rate will be determined by the proportion of participants who attended the final trial visit. Discussion This is a feasibility study to explore effectiveness and acceptability of the proposed field methodology (recruitment, retention, study processes and compliance with treatment). The results will be used to inform the design of a future RCT. Trial registration ClinicalTrials.gov, NCT04046081 Registered 6 August 2019

Objective: Sexual and reproductive health is an integral part of the health and well-being of adolescents. In this paper, the authors summarized the outline of the problems of sexual violence against children, with special emphasis on that against girls. The commentary was written from the point of view of general gynaecologists, sexologists, obstetrics and gynaecology nurses, clinical psychologist, and dermatologist. Mechanism: For the convenience of the readers’ better understanding, we described things in the following order; first, we explained the concept of child sexual abuse, then we discussed symptoms of sexual violence against children, and special attention was given to the issue of Sexually Transmitted Diseases (STD). Lastly, we emphasized general principles of physical diagnostics in the case of suspicion of sexual harassment of children. Findings in Brief: This work reveals the importance of holistic care of sexual assault victims. Conclusions: The cooperation of gynaecologists with dermatologists, medical examiners, paediatricians, psychologists, and dieticians is essential to interdisciplinary collaboration for children. Acquaintance by doctors with symptoms that can be a sign of sexual abuse of a child is necessary. If they appear in the form of physical injuries or STDs, they will probably be possible to diagnose only by medical service.

What are the main arguments of reproductive healthcare providers in favour or against their involvement in offering expanded carrier screening (ECS) for recessive disorders at fertility clinics in the Netherlands? Semi-structured interview study with 20 reproductive healthcare providers between May 2020 and January 2021. Participants included 11 gynaecologists, seven fertility doctors, one nurse practitioner and one clinical embryologist, recruited from academic medical centres (n = 13), peripheral facilities associated with academic centres (n = 4), and independent fertility treatment centres (n = 3) in the Netherlands. An interview guide was developed, and thematic content analysis was performed using ATLAS.ti software. Arguments of reproductive healthcare providers in favour of their potential involvement in offering ECS included: (i) opportunities offered by the setting; (ii) motivation to assist in reproduction and prevent suffering; and (iii) to counter unwanted commercialization offers. Arguments against involvement included: (i) lack of knowledge and familiarity with offering ECS; (ii) insufficient staff and resources, and potential high costs for clinics and/or couples; (iii) the emotional impact it may have on couples; (iv) perceived complexity of counselling and expected elongation of waiting lists; and (v) expected low impact on reducing the burden of diseases. Participants felt that more evidence and research on the costs–benefits, implications and demand are needed prior to their involvement. While agreeing that the field of medically assisted reproduction provides a unique opportunity to offer ECS, reproductive healthcare workers feel a lack of capability and limited motivation to offer ECS to all or a selection of couples at their fertility clinics. [ABSTRACT FROM AUTHOR]

Objective: Although these days the priority is to fight the Covid-19 pandemic, the importance of human papillomavirus (HPV) infection is not to be neglected. Mechanism: Cervical cancer is caused mainly by a chronic infection with one or more of the high-risk subtypes of HPV —most commonly a sexually transmitted disease acquired early in life. Most HPV infections go away on their own, but some can lead to a precancerous state that, if left untreated, can undergo complete neoplastic transformation. Findings in Brief: There is a hope that in the future the combination of screening tests with vaccinations against oncogenic strains of HPV will allow reductions in the percentage of those contracting cervical cancer. Conclusions: The importance of educational activities should be emphasized in developmental gynecology in the context of oncological prevention. The roles of both doctors and nurses are important here. During the Covid-19 Pandemic, these kinds of activities are not to be abandoned. In addition, efforts should be made to develop more practical and workable HPV and cervical screening strategies for use during a pandemic.

Background There has been increasing evidence that physicians in gynaecology are not routinely enquiring about work during consultations. Aims To explore the effect gynaecological conditions can have on work functioning, the importance of work outcomes among patients and whether work considerations are discussed during clinical consultations. Methods A cross-sectional survey was administered to employed patients attending a gynaecological clinic at Guy's Hospital. The survey assessed four areas: demographics, gynaecological condition (including self-assessed severity), work status and perceived impact of the condition on work functioning and job satisfaction. Simple descriptive analysis and statistical techniques were used to interpret the data. Results One hundred and six participants participated (mean age: 37.49 ± 9.09). About 95% found it important to be able to work whilst receiving treatment and 82% of patients had reported at least a slight impact on their working ability due to their condition. Of the 31 patients for whom it was their first appointment, 77% said it would be useful to discuss the possible impacts their gynaecological condition could have on their work. About 66% (19/29) of the participants attending a follow-up appointment reported that their doctor had not discussed their work with them. Conclusions The symptoms of gynaecological conditions can impact patients' ability to work. There is a lack of useful discussion from doctors about the perceived impact gynaecological conditions can have on a patient's ability to work, despite patients finding it important to be able to remain or return to work. [ABSTRACT FROM AUTHOR]

Copyright of Izmir Katip Celebi University Faculty of Health Sciences Journal / İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi is the property of Izmir Katip Celebi University, Faculty of Health Sciene Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Although hysterectomy is one of the most frequently performed gynaecological surgeries, there is a dearth of evidence on perioperative care. The aim of the current study was to identify sociodemographic, surgical-related and work-related predictors of recovery following different approaches of hysterectomy.Methods: Eligible patients for this retrospective cohort study were women who underwent vaginal, abdominal or laparoscopic hysterectomy for both benign and malignant gynaecological disease in 2014 in Máxima Medical Centre in the Netherlands. The main outcome measure was full return to work (RTW). Data were collected using a patient survey. Potential prognostic factors for time to RTW were examined in univariate Cox regression analyses. The strongest prognostic factors were combined in a multivariable model.Results: In total 83 women were included. Median time to full return to work was 8 weeks (interquartile range [IQR] 6-12). The multivariable analysis showed that higher age (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.012-1.095) and same day removal of indwelling catheter (HR 0.122, 95% CI 0.028-0.539) were predictors of shorter duration until full RTW after hysterectomy.Conclusions: This study provided insight in the predictors of recovery after hysterectomy. By identifying patient specific factors, pre-operative counselling can be individualized, changes can be made in perioperative care and effective interventions can be designed to target those factors. [ABSTRACT FROM AUTHOR]

Pelvic pain (PP) is common in pregnant women and can be caused by several diseases, including obstetrics, gynaecological, gastrointestinal, genitourinary, and vascular disorders. Timely and accurate diagnosis as well as prompt treatment are crucial for the well-being of the mother and foetus. However, these are very challenging. It should be considered that the physiological changes occurring during pregnancy may confuse the diagnosis. In this setting, ultrasound (US) represents the first-line imaging technique since it is readily and widely available and does not use ionizing radiations. In some cases, US may be conclusive for the diagnosis (e.g., if it detects no foetal cardiac activity in suspected spontaneous abortion; if it shows an extrauterine gestational sac in suspected ectopic pregnancy; or if it reveals a dilated, aperistaltic, and blind-ending tubular structure arising from the cecum in suspicious of acute appendicitis). Magnetic resonance imaging (MRI), overcoming some limits of US, represents the second-line imaging technique when an US is negative or inconclusive, to detect the cause of bowel obstruction, or to characterize adnexal masses. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Most high‐end ultrasound systems now incorporate three‐dimensional imaging as a standard feature. As such, the use of three‐dimensional ultrasound is becoming routine in many facets of medical ultrasound, especially obstetrics and gynaecology. Three‐dimensional ultrasound can enhance or even alter a diagnosis in many gynaecological pathologies. However, like any technique, the usefulness and accuracy of the application relies on the operator having adequate application knowledge and technical acquisition skills to be able to use it to its full potential. This is the first part of a two‐part series on this topic. This article serves to educate sonographers and other ultrasound users on how to incorporate a three‐dimensional ultrasound assessment into their routine gynaecological examinations, why this should be done and how to overcome some of the pitfalls encountered with this technique. [ABSTRACT FROM AUTHOR]

Sex refers to a set of somatic and mental characteristics. The former are determined according to three criteria: gender, external and internal genital organs, and tertiary sex characteristics (breast, specific hair, specific fat distribution, body proportions), the latter distinguish women from men. Every single person experiences problems related to sex - in childhood, adolescence, maturity, old age. In women, these issues are particularly complex at each stage of development. Additionally, during pregnancy, gynaecologists should discuss sexual health with their patients. The sexual health of women with disabilities is a special issue in this respect. Disabilities are a serious social and health problem in both urban and rural agglomerations. Sexual health problems, in the light of these aspects, should also be the task of rural medicine.

ABSTRACT INTRODUCTIONThere are important changes in the health care needs of women presenting to general practice in New Zealand, which prompted an evaluation of postgraduate training needs of general practitioners (GPs) who care for women in the community. AIMTo evaluate the perceived relevance of the curriculum of Otago University postgraduate programmes in women's health to GPs' work profile to identify any need for curricular change. This study was also performed to investigate the need for refresher courses or a Master's degree in obstetrics, gynaecology and women's health. METHODSIn total, 426 GPs and GP trainees who had completed the postgraduate Certificate and Diploma programmes in women's health were invited to complete an online survey. The survey consisted of multiple-choice questions with five-point Likert scale ratings to rate the relevance of papers to general practice, and options for free-text comments. RESULTSThere were 86 responses (20.2% response rate) and we analysed 73 (17.1%). Curriculum modules related to gynaecological care were rated as more relevant than obstetric and newborn care. GPs suggested more training in contraception and management of infertility, abnormal uterine bleeding and pelvic pain including procedural skills such as insertion of long-acting reversible contraceptives, implants and intrauterine devices. An interest in a refresher course was indicated by 76.6% of GPs. DISCUSSIONGPs recognised the need for enhanced training in women's gynaecological care. Revision of the postgraduate women's health curriculum and development of new refresher courses will enable GPs, trainees and prospective GPs to improve their care for women in the community.

Background and Aims: Respiratory depression is a rare but serious complication during opioid administration. Therefore, early detection of signs of deterioration is paramount. The current standard of care of using manual intermittent respiratory rate (RR) measurement is labour intensive and inefficient. We evaluated a wireless sensor monitor, Aingeal (Renew Health Ltd, Ireland), to continuously monitor RR, heart rate (HR) and temperature compared to standard clinical measurements. Methods: Patients who underwent major gynaecological operations and received postoperative opioid patient-controlled analgesia were recruited. Patients were connected to the sensor monitor via a central station software platform. The primary outcome was comparison of RR between sensor and nursing monitoring, with secondary outcomes being HR and temperature between two methods. Feedback from patients and healthcare providers was also collected. Bland-Altman analyses were used to compare the vital signs recorded in sensor against those in patient's electronic record. Results: A total of 1121 hours of vital signs data were analysed. Bias for RR was -0.90 (95% confidence interval (CI): -9.39, 7.60) breaths/min between nursing and averaged sensor readings. Bias for heart rate was -1.12 (95% CI: -26.27, 24.03) and bias for temperature was 1.45 (95% CI: -5.67, 2.76) between the two methods. Conclusion: There is satisfactory agreement of RR measurements, as well as HR and temperature measurements, by the wireless sensor monitor with standard clinical intermittent monitoring with overall good user experience.

A recent editorial in this Journal argued that increasing surgical complexity coupled with more limited training calls for separating obstetrics from gynaecology. The speciality suffers manpower challenges and high attrition rates. There is an apparent gulf in approach between researchers focussing on the views of UK graduates or trainees and workforce planners who address the problem through overseas recruitment. Whilst available literature provides scant, if any, indication as to how to address current challenges, it is important that advocates for women's health assess and mitigate potential drawbacks when exploring the way forward. [ABSTRACT FROM AUTHOR]

Background: Postoperative analgesia for major abdominal surgeries, especially with midline incisions, can be challenging particularly in morbid obese patients. This study aimed to compare surgical transversus abdominis plane (TAP) block and surgical rectus sheath (RS) block for postoperative analgesia in patients undergoing major gynaecological surgery regarding their efficacy and adverse effects. Sixty female patients aged 18–60 years were randomly allocated to two equal groups; (group TB, n = 30) patients received surgical TAP block, or (RB group, n = 30) patients received surgical RS block. Results: Postoperative total morphine consumption was significantly higher among patients in the TB group than patients in the RB group (Mean ± SD; 18.2 ± 4.4 mg versus 14.3 ± 3.5 mg respectively, P value < 0.001). There was no significant difference between patients in either group regarding pain scores at rest and cough except at 6-h postoperatively when patients in the RB group experienced lower pain scores (P value < 0.001). The RB group showed better respiratory functions at the first hour, 6 h and 12 h postoperatively. There was no significant statistical difference between both groups regarding the incidence of postoperative complications. Conclusions: Surgical RS block provided more favourable outcomes than surgical TAP block concerning postoperative analgesia in morbid obese patients with similar incidence of postoperative complications. Trial registration: We carried out this trial at Ain-Shams University Hospitals, Cairo, Egypt, between October 2018 and January 2020. The study was approved by the Research Ethics Committee at the Faculty of Medicine, Ain Shams University (code number: FMASU R55/2018), and then registered in the ClinicalTrials.gov (registration no. NCT03732027) https://clinicaltrials.gov/ct2/show/NCT03732027. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Health literacy underpins informed consent and shared decision-making. In gynaecology, this includes understanding of normal anatomy and urogenital disease. This study evaluated public knowledge of external female genital anatomy and pelvic organ prolapse (POP). Methods: A questionnaire study asked participants for their demographics and to label a female external genitalia diagram and included free-text questions on POP, its symptoms and treatment. Questionnaires were distributed at general outpatient (OPD) and urogynaecology (UG) departments at a UK teaching hospital. Differences in the number of correct anatomy labels between participant genders were assessed via chi-squared tests and, within female participants, multivariable linear and logistic regressions assessed associations with increasing correct anatomical labels and an understanding (versus no understanding) of POP, respectively. Results: Within 191 (n = 160 OPD, n = 31 UG), 9/103 (9%) labelled all anatomical structures correctly. Females had more correct labels (median 1, IQR 0,3) versus males (median 0, IQR 0,1), P = 0.022). Higher education (vs. < secondary) and white ethnicity were associated with greater numbers of correct labels [coefficient (95% CI): 1.05 (0.14, 1.96), P = 0.024, 1.45 (0.58, 2.33), P = 0.001 respectively]. Fifty-three per cent understood POP. POP understanding increased with increasing age, white ethnicity (OR: 4.38, 95% CI: 1.36, 14.08, P = 0.013) and more correct anatomy labels (OR: 1.43, 95% CI 1.14, 1.79, P = 0.002). Of those who understood POP, only 35% identified "bulge" as a symptom and 7% physiotherapy as a treatment option. Conclusion: There was poor public understanding of external female genital anatomy and POP, which may have significant implications for health-seeking, shared decision-making and informed consent. [ABSTRACT FROM AUTHOR]

Purpose: The pandemic SARS-CoV-2 poses new and unprecedented challenges for health care systems on a national and global level. Although the current situation has been going on for more than 1 year, there is limited data on the impact of the pandemic on general hospital and medical practice care. This survey captures the perspective of patients with gynaecological diseases of this impact. Methods: Using a paper-based questionnaire, 327 patients were asked about medical care and their experiences during the pandemic at the University Hospital Bonn and the University Hospital Charité Berlin. The study was performed from the 1st June to 30th September 2020. Results: A total of 327 patients participated in the study: 156 stated to have been tested for coronavirus, and 1 patient reported a positive test. 41.3% of the patients felt insecure about the current situation, 30.4% were concerned about the risk of infection during the hospital stay. The pandemic-specific measures in hospitals and medical practices unsettled 6.8% of patients. 18.1% of patients feared that their gynaecological disease would not be treated adequately due to the pandemic. 55.7% of patients reported that their confidence in their physicians has increased during the pandemic. Conclusion: The results show that patients' confidence in the healthcare system and the physicians acting significantly increased during the COVID-19 crisis. Transparent and comprehensive information policy regarding actions and restrictions within the COVID-19 crisis eases patients concerns and improves patients' confidence in their physicians, which is crucial for a successful treatment's outcome. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to determine the additional time needed to perform an endometriosis transvaginal ultrasound (eTVUS) compared to routine transvaginal ultrasound (rTVUS). Methods: A retrospective case–control study was performed. The study group included 199 eTVUS performed between September 2019 and September 2020. The control group comprised 105 consecutive rTVUS studies performed in the same time period. The time stamps on the ultrasound images of all cases in both groups were reviewed to determine the time taken to perform each study. Mean, median, minimum and maximum scan times for both groups were calculated as was percentage difference between scan times. A two‐tailed, unpaired t‐test of the normalised data and a Mann–Whitney U test assessing time difference of scans between two groups were performed with P value <0.05 considered statistically significant. Results: Performing eTVUS took significantly longer than rTVUS with increases in the mean (8.4 vs 13.8 min, 64%), median (7 vs 12 min, 71%), minimum (4 vs 7 min, 75%) and maximum (19 vs 42 min, 121%) scan times. The Mann–Whitney U test indicated a statistically significant difference in the median scan times (5.0, CI 4.0–6.0), P < 0.001. An independent t‐test of the normalised data revealed a significantly larger mean scan time for eTVUS than rTVUS, Mean = 9.05 95%CI [13.17–4.94], t(302) = 4.327, P < 0.001. R2 = 0.583. Conclusion: Endometriosis transvaginal ultrasound added an average 5.4 min to rTVUS, which is statistically significant. For ultrasound departments wanting to offer this technique, doubling the scan time allocated to perform a transvaginal ultrasound (TVUS) is suggested. [ABSTRACT FROM AUTHOR]