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SGS showcases gyn surgeons’ impact on innovation, education, equity, and enterprise
The theme of the 49th Annual Scientific Meeting of the Society of Gynecologic Surgeons was Impact Factor—an allusion to scientific journal impact factor, as well as how we as gynecologic surgeons have a societal impact through our innovation, education, equity, and enterprise-level efforts. This theme and the diverse roster of speakers and presentations on contemporary and controversial issues impacting today’s gynecologic surgeons clearly resonated, breaking the prior registration record with more than 200 additional attendees than the previous year.
As always, the preconference postgraduate courses delivered relevant content that spanned the educational and surgical spectrum, including: “Innovations in training gynecologic surgeons”; “Urologic surgery for the gynecologic surgeon”; the social media workshop “Gynfluencing: Using social media to find your digital voice”; and “The sim factor: Making an impact in surgical education.” This also marked the first year of offering a specific SGS Fellows/Young Attendings’ course. The featured speaker of the SGS Equity Council was Patty Brisben, philanthropist, CEO, and founder of Pure Romance.
Dr. Beri Ridgeway, Cleveland Clinic Chief of Staff, delivered the Mark D. Walters Lecture, “Surgeon in the C-suite,” on leading approximately 5,000 physicians and the importance of surgeons and specifically ObGyns having a seat at the table. The TeLinde lecturer, Dr. Pam Moalli, Professor and Division Director for Urogynecology at the University of Pittsburgh Magee Womens Hospital, spoke on “Biomaterials for gynecologic surgeons: Toward bioinspired biomimetic devices.” The panel on the “Ergonomics of gynecologic surgery” was moderated by Dr. Amanda Fader and Dr. Kim Kho, who shared their experiences with work-related musculoskeletal injury, and featured esteemed panelists Dr. Noor Abu-Alnadi from UNC, Dr. Sue Hallbeck from Mayo Clinic, and Dr. Ladin Yurteri-Kaplan from Columbia University.
The conference also featured a new format of Ted Med Talks:
- Dr. Jason Wright, Editor-in-Chief, Obstetrics & Gynecology, and Division Director of Gynecologic Oncology at Columbia University, who spoke on “Surgical volume and outcomes for gynecologic surgery: Is more always better?”
- Dr. Kelly Wright, Division Director, Minimally Invasive Gynecologic Surgery, Cedars Sinai, on “Climate change starts at 7:15”
- Dr. Ebony Carter, Associate Editor, Equity, Obstetrics & Gynecology, and Division Director, Maternal Fetal Medicine, Washington University, on “Centering equity in reproductive health research.”
In this special section, several of these talks are presented. Additionally, Dr. Laura Homewood and her coauthors will discuss gender and racial biases in a large multi-institutional sample of more than 15,000 Press Ganey patient satisfaction surveys.
Dr. Cheryl Iglesia, SGS former president, and I hope that you will consider attending #SGS2024 in Orlando, Florida, led by Dr. Suzie As-Sanie, program chair, and Dr. Rosanne Kho, current SGS president, which promises to be another exciting meeting. ●
The theme of the 49th Annual Scientific Meeting of the Society of Gynecologic Surgeons was Impact Factor—an allusion to scientific journal impact factor, as well as how we as gynecologic surgeons have a societal impact through our innovation, education, equity, and enterprise-level efforts. This theme and the diverse roster of speakers and presentations on contemporary and controversial issues impacting today’s gynecologic surgeons clearly resonated, breaking the prior registration record with more than 200 additional attendees than the previous year.
As always, the preconference postgraduate courses delivered relevant content that spanned the educational and surgical spectrum, including: “Innovations in training gynecologic surgeons”; “Urologic surgery for the gynecologic surgeon”; the social media workshop “Gynfluencing: Using social media to find your digital voice”; and “The sim factor: Making an impact in surgical education.” This also marked the first year of offering a specific SGS Fellows/Young Attendings’ course. The featured speaker of the SGS Equity Council was Patty Brisben, philanthropist, CEO, and founder of Pure Romance.
Dr. Beri Ridgeway, Cleveland Clinic Chief of Staff, delivered the Mark D. Walters Lecture, “Surgeon in the C-suite,” on leading approximately 5,000 physicians and the importance of surgeons and specifically ObGyns having a seat at the table. The TeLinde lecturer, Dr. Pam Moalli, Professor and Division Director for Urogynecology at the University of Pittsburgh Magee Womens Hospital, spoke on “Biomaterials for gynecologic surgeons: Toward bioinspired biomimetic devices.” The panel on the “Ergonomics of gynecologic surgery” was moderated by Dr. Amanda Fader and Dr. Kim Kho, who shared their experiences with work-related musculoskeletal injury, and featured esteemed panelists Dr. Noor Abu-Alnadi from UNC, Dr. Sue Hallbeck from Mayo Clinic, and Dr. Ladin Yurteri-Kaplan from Columbia University.
The conference also featured a new format of Ted Med Talks:
- Dr. Jason Wright, Editor-in-Chief, Obstetrics & Gynecology, and Division Director of Gynecologic Oncology at Columbia University, who spoke on “Surgical volume and outcomes for gynecologic surgery: Is more always better?”
- Dr. Kelly Wright, Division Director, Minimally Invasive Gynecologic Surgery, Cedars Sinai, on “Climate change starts at 7:15”
- Dr. Ebony Carter, Associate Editor, Equity, Obstetrics & Gynecology, and Division Director, Maternal Fetal Medicine, Washington University, on “Centering equity in reproductive health research.”
In this special section, several of these talks are presented. Additionally, Dr. Laura Homewood and her coauthors will discuss gender and racial biases in a large multi-institutional sample of more than 15,000 Press Ganey patient satisfaction surveys.
Dr. Cheryl Iglesia, SGS former president, and I hope that you will consider attending #SGS2024 in Orlando, Florida, led by Dr. Suzie As-Sanie, program chair, and Dr. Rosanne Kho, current SGS president, which promises to be another exciting meeting. ●
The theme of the 49th Annual Scientific Meeting of the Society of Gynecologic Surgeons was Impact Factor—an allusion to scientific journal impact factor, as well as how we as gynecologic surgeons have a societal impact through our innovation, education, equity, and enterprise-level efforts. This theme and the diverse roster of speakers and presentations on contemporary and controversial issues impacting today’s gynecologic surgeons clearly resonated, breaking the prior registration record with more than 200 additional attendees than the previous year.
As always, the preconference postgraduate courses delivered relevant content that spanned the educational and surgical spectrum, including: “Innovations in training gynecologic surgeons”; “Urologic surgery for the gynecologic surgeon”; the social media workshop “Gynfluencing: Using social media to find your digital voice”; and “The sim factor: Making an impact in surgical education.” This also marked the first year of offering a specific SGS Fellows/Young Attendings’ course. The featured speaker of the SGS Equity Council was Patty Brisben, philanthropist, CEO, and founder of Pure Romance.
Dr. Beri Ridgeway, Cleveland Clinic Chief of Staff, delivered the Mark D. Walters Lecture, “Surgeon in the C-suite,” on leading approximately 5,000 physicians and the importance of surgeons and specifically ObGyns having a seat at the table. The TeLinde lecturer, Dr. Pam Moalli, Professor and Division Director for Urogynecology at the University of Pittsburgh Magee Womens Hospital, spoke on “Biomaterials for gynecologic surgeons: Toward bioinspired biomimetic devices.” The panel on the “Ergonomics of gynecologic surgery” was moderated by Dr. Amanda Fader and Dr. Kim Kho, who shared their experiences with work-related musculoskeletal injury, and featured esteemed panelists Dr. Noor Abu-Alnadi from UNC, Dr. Sue Hallbeck from Mayo Clinic, and Dr. Ladin Yurteri-Kaplan from Columbia University.
The conference also featured a new format of Ted Med Talks:
- Dr. Jason Wright, Editor-in-Chief, Obstetrics & Gynecology, and Division Director of Gynecologic Oncology at Columbia University, who spoke on “Surgical volume and outcomes for gynecologic surgery: Is more always better?”
- Dr. Kelly Wright, Division Director, Minimally Invasive Gynecologic Surgery, Cedars Sinai, on “Climate change starts at 7:15”
- Dr. Ebony Carter, Associate Editor, Equity, Obstetrics & Gynecology, and Division Director, Maternal Fetal Medicine, Washington University, on “Centering equity in reproductive health research.”
In this special section, several of these talks are presented. Additionally, Dr. Laura Homewood and her coauthors will discuss gender and racial biases in a large multi-institutional sample of more than 15,000 Press Ganey patient satisfaction surveys.
Dr. Cheryl Iglesia, SGS former president, and I hope that you will consider attending #SGS2024 in Orlando, Florida, led by Dr. Suzie As-Sanie, program chair, and Dr. Rosanne Kho, current SGS president, which promises to be another exciting meeting. ●
Q Is urodynamic testing reliable?
However, reliability was only moderate for diagnoses of detrusor overactivity, and interobserver consistency was only fair. Thus, urodynamic testing may not be as informative for this diagnosis.
Expert Commentary
Urodynamic testing has traditionally been used to evaluate and distinguish between different types of urinary incontinence. Weidner and colleagues1 demonstrated that subjective symptoms may not always predict the ultimate diagnosis and recommended urodynamic evaluation prior to initiation of therapy or surgical intervention.
Urodynamic testing is not without limitations:
Interobserver agreement was moderate
METHODS Six physicians reviewed the records (ie, blinded study packets that retained key portions of the patient’s history and urodynamic findings) of 100 women who presented to a urogynecology or female urology practice and were referred for urodynamic testing. The 6 physician reviewers assigned both clinical and International Continence Society diagnoses to each record and reviewed the packets again at least 4 months later.
RESULTS Reviewers were consistent in their own evaluations of urodynamic tracings and diagnoses. Nor was there much intra-observer difference between female urologists and urogynecologists.
However, interobserver agreement varied with the diagnosis, and also was lower when a particular sign or symptom was present, suggesting that the absence of symptoms and signs was used to rule out diagnoses, as opposed to ruling them in.
Detrusor overactivity a more elusive diagnosis?
These results are consistent with earlier studies that showed stress incontinence to be more reliably diagnosed on both simple cystometry and multichannel cystometry, and which showed that symptoms alone are not a sufficient basis for surgical management.
However, the interpretation of detrusor overactivity appears to be less reliable and less consistent. The demonstration of urge incontinence with office cystometry has been shown to predict detrusor overactivity, but its absence does not preclude this diagnosis.4
Urodynamic testing is most useful for diagnosing stress incontinence
This study occurred at a single institution without standardized guidelines for interpretation of urodynamic test results. A multicenter study by Zimmern et al5 for the Urinary Incontinence and Treatment Network demonstrated excellent inter-rater reliability for urodynamics between both central and local-site reviewers—after establishing uniform certification standards.
Thus, it seems clear that standardized guidelines and modules would assist in the interpretation of urodynamic tests. Until then, urodynamic testing should entail a concerted effort to standardize the interpretation of urodynamic diagnoses.
1. Weidner AC, Myers ER, Visco AG, Cundiff GW, Bump RC. Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol. 2001;184:20-27.
2. Weber AM, Taylor RJ, Wei JT, et al. The cost-effectiveness of preoperative testing (basic office assessment vs urodynamics) for stress urinary incontinence in women. BJU Int. 2002;89:356-363.
3. Weber AM, Walters MD. Cost-effectiveness of urodynamic testing before surgery for women with pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol. 2000;183:1338-1347.
4. Wall LL, Wiskind AK, Taylor PA. Simple bladder filling with a cough stress test compared with subtracted cystometry for the diagnosis of urinary incontinence. Am J Obstet Gynecol. 1994;171:1472-1479.
5. Zimmern P, Nager CW, Albo M, Fitzgerald MP, McDermott S. For the Urinary Incontinence Treatment Network. Interrater reliability of filling cystometrogram interpretation in a multicenter study. J Urol. 2006;175:2174-2177.
However, reliability was only moderate for diagnoses of detrusor overactivity, and interobserver consistency was only fair. Thus, urodynamic testing may not be as informative for this diagnosis.
Expert Commentary
Urodynamic testing has traditionally been used to evaluate and distinguish between different types of urinary incontinence. Weidner and colleagues1 demonstrated that subjective symptoms may not always predict the ultimate diagnosis and recommended urodynamic evaluation prior to initiation of therapy or surgical intervention.
Urodynamic testing is not without limitations:
Interobserver agreement was moderate
METHODS Six physicians reviewed the records (ie, blinded study packets that retained key portions of the patient’s history and urodynamic findings) of 100 women who presented to a urogynecology or female urology practice and were referred for urodynamic testing. The 6 physician reviewers assigned both clinical and International Continence Society diagnoses to each record and reviewed the packets again at least 4 months later.
RESULTS Reviewers were consistent in their own evaluations of urodynamic tracings and diagnoses. Nor was there much intra-observer difference between female urologists and urogynecologists.
However, interobserver agreement varied with the diagnosis, and also was lower when a particular sign or symptom was present, suggesting that the absence of symptoms and signs was used to rule out diagnoses, as opposed to ruling them in.
Detrusor overactivity a more elusive diagnosis?
These results are consistent with earlier studies that showed stress incontinence to be more reliably diagnosed on both simple cystometry and multichannel cystometry, and which showed that symptoms alone are not a sufficient basis for surgical management.
However, the interpretation of detrusor overactivity appears to be less reliable and less consistent. The demonstration of urge incontinence with office cystometry has been shown to predict detrusor overactivity, but its absence does not preclude this diagnosis.4
Urodynamic testing is most useful for diagnosing stress incontinence
This study occurred at a single institution without standardized guidelines for interpretation of urodynamic test results. A multicenter study by Zimmern et al5 for the Urinary Incontinence and Treatment Network demonstrated excellent inter-rater reliability for urodynamics between both central and local-site reviewers—after establishing uniform certification standards.
Thus, it seems clear that standardized guidelines and modules would assist in the interpretation of urodynamic tests. Until then, urodynamic testing should entail a concerted effort to standardize the interpretation of urodynamic diagnoses.
However, reliability was only moderate for diagnoses of detrusor overactivity, and interobserver consistency was only fair. Thus, urodynamic testing may not be as informative for this diagnosis.
Expert Commentary
Urodynamic testing has traditionally been used to evaluate and distinguish between different types of urinary incontinence. Weidner and colleagues1 demonstrated that subjective symptoms may not always predict the ultimate diagnosis and recommended urodynamic evaluation prior to initiation of therapy or surgical intervention.
Urodynamic testing is not without limitations:
Interobserver agreement was moderate
METHODS Six physicians reviewed the records (ie, blinded study packets that retained key portions of the patient’s history and urodynamic findings) of 100 women who presented to a urogynecology or female urology practice and were referred for urodynamic testing. The 6 physician reviewers assigned both clinical and International Continence Society diagnoses to each record and reviewed the packets again at least 4 months later.
RESULTS Reviewers were consistent in their own evaluations of urodynamic tracings and diagnoses. Nor was there much intra-observer difference between female urologists and urogynecologists.
However, interobserver agreement varied with the diagnosis, and also was lower when a particular sign or symptom was present, suggesting that the absence of symptoms and signs was used to rule out diagnoses, as opposed to ruling them in.
Detrusor overactivity a more elusive diagnosis?
These results are consistent with earlier studies that showed stress incontinence to be more reliably diagnosed on both simple cystometry and multichannel cystometry, and which showed that symptoms alone are not a sufficient basis for surgical management.
However, the interpretation of detrusor overactivity appears to be less reliable and less consistent. The demonstration of urge incontinence with office cystometry has been shown to predict detrusor overactivity, but its absence does not preclude this diagnosis.4
Urodynamic testing is most useful for diagnosing stress incontinence
This study occurred at a single institution without standardized guidelines for interpretation of urodynamic test results. A multicenter study by Zimmern et al5 for the Urinary Incontinence and Treatment Network demonstrated excellent inter-rater reliability for urodynamics between both central and local-site reviewers—after establishing uniform certification standards.
Thus, it seems clear that standardized guidelines and modules would assist in the interpretation of urodynamic tests. Until then, urodynamic testing should entail a concerted effort to standardize the interpretation of urodynamic diagnoses.
1. Weidner AC, Myers ER, Visco AG, Cundiff GW, Bump RC. Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol. 2001;184:20-27.
2. Weber AM, Taylor RJ, Wei JT, et al. The cost-effectiveness of preoperative testing (basic office assessment vs urodynamics) for stress urinary incontinence in women. BJU Int. 2002;89:356-363.
3. Weber AM, Walters MD. Cost-effectiveness of urodynamic testing before surgery for women with pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol. 2000;183:1338-1347.
4. Wall LL, Wiskind AK, Taylor PA. Simple bladder filling with a cough stress test compared with subtracted cystometry for the diagnosis of urinary incontinence. Am J Obstet Gynecol. 1994;171:1472-1479.
5. Zimmern P, Nager CW, Albo M, Fitzgerald MP, McDermott S. For the Urinary Incontinence Treatment Network. Interrater reliability of filling cystometrogram interpretation in a multicenter study. J Urol. 2006;175:2174-2177.
1. Weidner AC, Myers ER, Visco AG, Cundiff GW, Bump RC. Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol. 2001;184:20-27.
2. Weber AM, Taylor RJ, Wei JT, et al. The cost-effectiveness of preoperative testing (basic office assessment vs urodynamics) for stress urinary incontinence in women. BJU Int. 2002;89:356-363.
3. Weber AM, Walters MD. Cost-effectiveness of urodynamic testing before surgery for women with pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol. 2000;183:1338-1347.
4. Wall LL, Wiskind AK, Taylor PA. Simple bladder filling with a cough stress test compared with subtracted cystometry for the diagnosis of urinary incontinence. Am J Obstet Gynecol. 1994;171:1472-1479.
5. Zimmern P, Nager CW, Albo M, Fitzgerald MP, McDermott S. For the Urinary Incontinence Treatment Network. Interrater reliability of filling cystometrogram interpretation in a multicenter study. J Urol. 2006;175:2174-2177.