2024
Effects of Obesity on Urogynecologic Prolapse Surgery Outcomes: A Systematic Review and Meta-Analysis
Ringel N, Lenger S, High R, Alas A, Houlihan S, Chang O, Pennycuff J, Singh R, White A, Lipitskaia L, Behbehani S, Sheyn D, Kudish B, Nihira M, Sleemi A, Grimes C, Gupta A, Balk E, Antosh D. Effects of Obesity on Urogynecologic Prolapse Surgery Outcomes: A Systematic Review and Meta-Analysis. Obstetrical & Gynecological Survey 2024, 79: 409-411. DOI: 10.1097/ogx.0000000000001302.Peer-Reviewed Original ResearchSexual Harassment, Abuse, and Discrimination in Obstetrics and Gynecology
Gupta A, Thompson J, Ringel N, Kim-Fine S, Ferguson L, Blank S, Iglesia C, Balk E, Secord A, Hines J, Brown J, Grimes C. Sexual Harassment, Abuse, and Discrimination in Obstetrics and Gynecology. JAMA Network Open 2024, 7: e2410706. PMID: 38717770, PMCID: PMC11079690, DOI: 10.1001/jamanetworkopen.2024.10706.Peer-Reviewed Original ResearchConceptsOB-GYN rotationOb-gynsSexual harassmentSurgical specialtiesPrevalence of sexual harassmentObstetrics and GynecologyPerpetrators of harassmentIncidents of harassmentFear of retaliationFrequency of sexual harassmentCertainty of evidenceAssociated with improved recognitionRisk of biasGynecologic oncologistsDecreased incidenceHarassing behaviorsOperating room staffSexual coercionHarassmentEligible studiesMedical studentsFull-text articlesWorkplace discriminationGender harassmentSexual attentionViews and values of the uterus across the united states – a multicenter mixed-methods analysis (VUterus)
Chang O, Huynh A, Ringel N, Hudson P, Halder G, Winkelman W, Ton J, Davidson E, Meriwether K. Views and values of the uterus across the united states – a multicenter mixed-methods analysis (VUterus). American Journal Of Obstetrics And Gynecology 2024, 230: s1162-s1163. DOI: 10.1016/j.ajog.2024.02.042.Peer-Reviewed Original ResearchSexual harassment, bullying, abuse, and discrimination among obgyn physicians and trainees: a systematic review
Gupta A, Thompson J, Ringel N, Kim-Fine S, Ferguson L, Blank S, Iglesia C, Balk E, Secord A, Hines J, Brown J, Grimes C. Sexual harassment, bullying, abuse, and discrimination among obgyn physicians and trainees: a systematic review. American Journal Of Obstetrics And Gynecology 2024, 230: s1273-s1274. DOI: 10.1016/j.ajog.2024.02.198.Peer-Reviewed Original ResearchEffects of Obesity on Urogynecologic Prolapse Surgery Outcomes
Ringel N, Lenger S, High R, Alas A, Houlihan S, Chang O, Pennycuff J, Singh R, White A, Lipitskaia L, Behbehani S, Sheyn D, Kudish B, Nihira M, Sleemi A, Grimes C, Gupta A, Balk E, Antosh D. Effects of Obesity on Urogynecologic Prolapse Surgery Outcomes. Obstetrics And Gynecology 2024, 143: 539-549. PMID: 38330397, DOI: 10.1097/aog.0000000000005525.Peer-Reviewed Original ResearchBody mass indexPelvic organ prolapseProlapse recurrenceProlapse repairSurgical outcomesSurgical approachSurgery outcomesOutcomes of pelvic organ prolapseMeta-analysisCategories of body mass indexPelvic organ prolapse repairVaginal prolapse repairAssociated with increased likelihoodFull-text screeningEffect of obesityPOP repairOrgan prolapseMesh exposureObese categoryMesh complicationsMass indexNonrandomized studiesIncreased oddsSubjective outcomesCochrane Database
2023
Estimated National Cost of Pelvic Organ Prolapse Surgery in the United States
St Martin B, Markowitz M, Myers E, Lundsberg L, Ringel N. Estimated National Cost of Pelvic Organ Prolapse Surgery in the United States. Obstetrics And Gynecology 2023, 143: 419-427. PMID: 38128098, DOI: 10.1097/aog.0000000000005485.Peer-Reviewed Original ResearchPelvic organ prolapse surgeryPOP surgeryProlapse surgeryAnnual national costNational costTenth Revision diagnosis codesUtilization Project National Inpatient SampleCurrent Procedural Terminology codesPopulation-based studyRevision diagnosis codesNational Inpatient SampleAge 50 yearsProcedural Terminology codesHealth care professionalsTotal national costMajority of casesCost-effectiveness analysisConcomitant hysterectomySurgical characteristicsTotal surgeriesDiagnosis codesInpatient SampleSurgical correctionSurgical casesTerminology codesHealth Care Disparities in Patients Undergoing Hysterectomy for Benign Indications
Wieslander C, Grimes C, Balk E, Hobson D, Ringel N, Sanses T, Singh R, Richardson M, Lipetskaia L, Gupta A, White A, Orejuela F, Meriwether K, Antosh D. Health Care Disparities in Patients Undergoing Hysterectomy for Benign Indications. Obstetrics And Gynecology 2023, 142: 1044-1054. PMID: 37826848, DOI: 10.1097/aog.0000000000005389.Peer-Reviewed Original ResearchConceptsHealth care disparitiesBenign indicationsCare disparitiesVaginal hysterectomyMedicare insuranceHysterectomy complicationsPatient-level outcomesMultivariable regression analysisInvasive hysterectomy proceduresHealth care systemPrior hysterectomyStrength of associationLaparoscopic hysterectomyBlack patientsMultivariable analysisSurgical outcomesPoor outcomeInsurance statusRisk markersIndependent associationEligible studiesSTUDY SELECTIONHysterectomy proceduresHysterectomyHispanic ethnicityThe effect of 12-month postoperative weight change on outcomes following midurethral sling for stress urinary incontinence: a secondary analysis of the ESTEEM and TOMUS randomized trials
Getaneh F, Ringel N, Kolm P, Iglesia C, Dieter A. The effect of 12-month postoperative weight change on outcomes following midurethral sling for stress urinary incontinence: a secondary analysis of the ESTEEM and TOMUS randomized trials. International Urogynecology Journal 2023, 34: 2809-2816. PMID: 37750917, DOI: 10.1007/s00192-023-05654-7.Peer-Reviewed Original ResearchConceptsMixed urinary incontinenceStress urinary incontinencePostoperative weight changeMidurethral slingUrinary incontinenceSUI curePrimary outcomeUUI episodesWeight changeBody weightHigher baseline body mass indexTreatment of SUISecondary analysisBaseline body mass indexWeight gainWeight lossSUI cure ratesMulticenter Randomized TrialImpact of obesityBody mass indexHigh smoking ratesMethodsThis secondary analysisGreater improvementMUS placementPerioperative variables
2022
Exploring Patient Perspectives Surrounding Telemedicine Versus In-Person Preoperative Visits
Davenport A, Brunn E, Creswell M, Sholklapper T, Ringel N, Gutman R. Exploring Patient Perspectives Surrounding Telemedicine Versus In-Person Preoperative Visits. Urogynecology 2022, 29: 545-551. PMID: 36701389, DOI: 10.1097/spv.0000000000001310.Peer-Reviewed Original ResearchConceptsTelemedicine visitsPreoperative visitPerson visitsVisit contentPreoperative physical examinationSingle academic institutionRole of telemedicineInvasive gynecologic surgeonsHigh satisfactionSurgical severityPreoperative appointmentOffice visitsGynecologic surgeryPhysical examinationSurgical preparednessUrogynecologic surgeonsPatient's perspectiveSurgical experiencePatient experienceGynecologic surgeonsVisitsSurgical specialtiesSurgeons' perceptionsPhone interviewsSurgeryAssociation of Artificially Sweetened Beverage Consumption and Urinary Tract Cancers in the Women’s Health Initiative Observational Study
Ringel N, Hovey K, Andrews C, Mossavar-Rahmani Y, Shadyab A, Snetselaar L, Howard B, Iglesia C. Association of Artificially Sweetened Beverage Consumption and Urinary Tract Cancers in the Women’s Health Initiative Observational Study. European Urology Open Science 2022, 47: 80-86. PMID: 36601047, PMCID: PMC9806707, DOI: 10.1016/j.euros.2022.11.016.Peer-Reviewed Original ResearchWomen's Health Initiative Observational StudyUrinary tract cancerTract cancerHigh riskBeverage consumptionObservational studyKidney cancerPostmenopausal womenFrequent consumptionSecondary analysisCancer diagnosisCox regression modelLongitudinal prospective studySweetened Beverage ConsumptionMean followHazard ratioRegression modelsProspective studyPotential confoundersBladder cancerClinical centersBeverage intakeCancer incidenceInclusion criteriaSubsequent visitsArtificially sweetened beverages and urinary incontinence—a secondary analysis of the Women's Health Initiative Observational Study
Ringel N, Hovey K, Andrews C, Mossavar-Rahmani Y, Shadyab A, Snetselaar L, Howard B, Iglesia C. Artificially sweetened beverages and urinary incontinence—a secondary analysis of the Women's Health Initiative Observational Study. Menopause The Journal Of The North American Menopause Society 2022, 30: 283-288. PMID: 36515559, PMCID: PMC9974739, DOI: 10.1097/gme.0000000000002129.Peer-Reviewed Original ResearchConceptsUrinary incontinence symptomsWomen's Health Initiative Observational StudyUrgency urinary incontinence symptomsMixed urinary incontinenceUrinary incontinenceIncontinence symptomsObservational studyBeverage consumptionSecondary analysisMultivariable logistic regression modelLogistic regression modelsAnalytic cohortMultivariable analysisPotential confoundersUnadjusted oddsBeverage intakeHigh prevalenceHigher oddsIncontinenceGreater oddsRare consumersSymptomsWeeksDemographic characteristicsWomenPostprocedural Pain Associated With 5 Versus 20 Intradetrusor Injections of OnabotulinumtoxinA for Treatment of Overactive Bladder: A Multicenter Randomized Clinical Trial
Chang E, Ringel N, Woodburn K, Tanner J, Bassaly R, Greene K, Wyman A, Iglesia C. Postprocedural Pain Associated With 5 Versus 20 Intradetrusor Injections of OnabotulinumtoxinA for Treatment of Overactive Bladder: A Multicenter Randomized Clinical Trial. Obstetrical & Gynecological Survey 2022, 77: 650-651. DOI: 10.1097/ogx.0000000000001102.Peer-Reviewed Original ResearchOveractive bladderNonneurogenic overactive bladderThird-line therapyΒ-agonist therapyAmerican Urological AssociationFemale pelvic medicineSociety of UrodynamicsIntradetrusor injectionsPain AssociatedTreatment episodesClinical trialsUrological AssociationPelvic medicineBladderTherapyBehavioral changesInjectionWide variationMulticenterOnabotulinumtoxinACholinergicUrodynamicsTrialsPostprocedural Pain Associated With 5 Versus 20 Intradetrusor Injections of onabotulinumtoxinA for Treatment of Overactive Bladder: A Multicenter Randomized Clinical Trial
Chang E, Ringel N, Woodburn K, Tanner J, Bassaly R, Greene K, Wyman A, Iglesia C. Postprocedural Pain Associated With 5 Versus 20 Intradetrusor Injections of onabotulinumtoxinA for Treatment of Overactive Bladder: A Multicenter Randomized Clinical Trial. Urogynecology 2022, 28: 518-525. PMID: 35543540, DOI: 10.1097/spv.0000000000001199.Peer-Reviewed Original ResearchConceptsUrgency urinary incontinenceOveractive bladderProcedure timeIntradetrusor injectionsAdverse eventsUrinary incontinenceClinical trialsSubjective efficacyAverage pain scoreGlobal response assessmentRefractory overactive bladderIdiopathic overactive bladderVisual analog scalePain scoresOnabotulinumtoxinA treatmentPain AssociatedPain levelsWeeks postprocedurePostprocedure complicationsAnalog scaleProcedure durationResponse assessmentPatient experiencePatientsInjection paradigmPostoperative Urinary Incontinence in Diabetic Patients Undergoing Pelvic Reconstructive Surgery
Siddique M, Ringel N, de Winter K, Marczak T, Kisby C, Rutledge E, Soriano A, Samimi P, Schroeder M, Handler S, Chou J, Gutman R. Postoperative Urinary Incontinence in Diabetic Patients Undergoing Pelvic Reconstructive Surgery. Urogynecology 2022, 28: 372-378. PMID: 35113049, DOI: 10.1097/spv.0000000000001137.Peer-Reviewed Original ResearchConceptsStress urinary incontinencePelvic organ prolapsePelvic reconstructive surgeryUrgency urinary incontinencePostoperative urinary incontinenceAnti-incontinence surgeryUrinary incontinenceReconstructive surgeryDe novo urgency urinary incontinenceMulticenter retrospective cohort studyPostoperative stress urinary incontinencePersistent stress urinary incontinenceMixed urinary incontinenceRetrospective cohort studyHemoglobin A1c levelsIndependent risk factorCohort of womenDiverse medical centersPostoperative incontinenceSUI surgeryCohort studyIncontinence proceduresA1c levelsDiabetes mellitusDiabetic patients
2021
Disparities in Complications After Prolapse Repair and Sling Procedures: Trends From 2010-2018
Ringel NE, Brown O, Moore KJ, Carey ET, Dieter AA. Disparities in Complications After Prolapse Repair and Sling Procedures: Trends From 2010-2018. Urology 2021, 160: 81-86. PMID: 34800479, DOI: 10.1016/j.urology.2021.11.001.Peer-Reviewed Original ResearchConceptsVascular complication ratesComplication rateProlapse repairVascular complicationsProlapse repair proceduresHigher oddsSling procedureHispanic womenBlack womenPostoperative complication rateHigh complication rateMultivariable logistic regressionNon-black womenRepair proceduresEthnic groupsPostoperative complicationsFemale patientsComplicationsLogistic regressionWomenOddsSlingRepairGroupPatientsSurgical Outcomes in Urogynecology—Assessment of Perioperative and Postoperative Complications Relative to Preoperative Hemoglobin A1c—A Fellows Pelvic Research Network Study
Ringel NE, de Winter KL, Siddique M, Marczak T, Kisby C, Rutledge E, Soriano A, Samimi P, Schroeder M, Handler S, Zeymo A, Gutman RE. Surgical Outcomes in Urogynecology—Assessment of Perioperative and Postoperative Complications Relative to Preoperative Hemoglobin A1c—A Fellows Pelvic Research Network Study. Urogynecology 2021, 28: 7-13. PMID: 33886510, DOI: 10.1097/spv.0000000000001057.Peer-Reviewed Original ResearchConceptsPelvic reconstructive surgeryMultivariate logistic regressionPostoperative complicationsOverall complicationsSevere complicationsReconstructive surgeryMulticenter retrospective cohort studyLogistic regressionUrinary incontinence surgeryRetrospective cohort studyResearch Network StudyFemale pelvic medicineReconstructive surgery programsHbA1c thresholdPreoperative HbA1cPreoperative hemoglobinUrogynecology populationAverage HbA1cIncontinence surgeryCohort studyMesh exposureDiabetes mellitusDiabetic patientsSurgery typeDiabetic cohortAnticholinergic prescribing pattern changes of urogynecology providers in response to evidence of potential dementia risk
Menhaji K, Cardenas-Trowers OO, Chang OH, Hall EF, Ringel NE, Falk KN. Anticholinergic prescribing pattern changes of urogynecology providers in response to evidence of potential dementia risk. International Urogynecology Journal 2021, 32: 2819-2826. PMID: 33683426, DOI: 10.1007/s00192-021-04736-8.Peer-Reviewed Original ResearchConceptsAnticholinergic medicationsOveractive bladder syndrome treatmentMajority of respondentsDevelopment of dementiaRisk of dementiaPrior authorization processPrimary outcomePrescribing practicesResultsA totalSyndrome treatmentDementia riskPractice patternsInsurance barriersInsurance restrictionsMedicationsTreatment planWeb-based surveyImpact of insuranceDementiaRecent literatureAnticholinergicsAgonistsRiskDescriptive statisticsTreatmentHysterectomy Complications Relative to HbA1c Levels: Identifying a Threshold for Surgical Planning
Ringel NE, Morgan DM, Kamdar N, Gutman RE. Hysterectomy Complications Relative to HbA1c Levels: Identifying a Threshold for Surgical Planning. Journal Of Minimally Invasive Gynecology 2021, 28: 1735-1742.e1. PMID: 33617984, DOI: 10.1016/j.jmig.2021.02.010.Peer-Reviewed Original ResearchConceptsOdds of complicationsPreoperative HbAPostoperative complicationsDiabetes diagnosisGroup 1Group 2Michigan Surgical Quality CollaborativeMultivariate logistic regression modelComposite postoperative complicationsRetrospective cohort studyEmergency department visitsRisk of complicationsLogistic regression modelsCohort studyComplication rateDepartment visitsDiabetes controlHemoglobin levelsRisk stratificationSurgical approachIndependent associationLaparoscopic surgeryHysterectomy complicationsAdjusted modelComplicationsPreoperative MRI and LDH in women undergoing intra-abdominal surgery for fibroids: Effect on surgical route
Kim A, Boyd L, Ringel N, Meyer J, Bennett G, Lerner V. Preoperative MRI and LDH in women undergoing intra-abdominal surgery for fibroids: Effect on surgical route. PLOS ONE 2021, 16: e0246807. PMID: 33561167, PMCID: PMC7872248, DOI: 10.1371/journal.pone.0246807.Peer-Reviewed Original ResearchConceptsAbnormal magnetic resonance imagingMagnetic resonance imaging resultsIntra-abdominal surgeryMagnetic resonance imagingPower morcellationSurgical routeAbnormal magnetic resonance imaging resultsOpen approachResonance imagingSerum lactate dehydrogenase levelPost-protocol groupPre-protocol groupRetrospective cohort studyBaseline patient characteristicsSubset of womenPost-menopausal womenLactate dehydrogenase levelsHigh-risk casesPreoperative magnetic resonanceDiffusion-weighted imagingHigh rateImaging resultsSymptomatic fibroidsChart reviewCohort studyRethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options.
Escobar CM, Falk KN, Mehta S, Hall EF, Menhaji K, Sappenfield EC, Brown OE, Ringel NE, Chang OH, Tellechea LM, Barnes HC, Jeney SES, Bennett AT, Cardenas-Trowers OO. Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options. Obstetrics And Gynecology 2021, 137: 454-460. PMID: 33543891, DOI: 10.1097/aog.0000000000004279.Commentaries, Editorials and LettersConceptsOveractive bladderΒ3-adrenoceptor agonistHealth care inequalitiesOral medicationsFavorable side effect profileTreatment of OABAlternative oral treatmentSecond-line therapySide effect profileCare inequalitiesIdiopathic overactive bladderCognitive side effectsHealth care professionalsQuality of lifeProcedural therapiesOral treatmentEffect profileOAB medicationsTreatment algorithmTreatment optionsChronic conditionsCare professionalsSide effectsMedicationsBetter care