International Urogynecological Association Research Articles

Preserving Essential Skills: The Future of Vaginal Hysterectomy Training in Urogynaecology.

This study aimed to evaluate the training and self-assessed proficiency of surgeons in the surgical management of pelvic organ prolapse (POP). We focused on the factors that influence decision-making, the surgical techniques employed, the training received, and the management of complications. A cross-sectional survey. An electronic questionnaire. European Urogynaecological Association (EUGA) and International Urogynecological Association (IUGA) members. A total of 33 questions evaluating surgeon preference regarding vaginal surgeries. Demographics, surgical selection, proficiency and technique, and training methods. There were 471 respondents, of which 273 (58%) dedicated more than 50% of their week to urogynaecology. 250 (53%) had completed a fellowship, with 215 (86%) of those fellowships being in urogynaecology and pelvic floor reconstruction. A preference for hysterectomy in cases of uterine descent was noted by 297 (63%) respondents, influenced mainly by patient preference, age, and prolapse anatomical score. A total of 443 (94%) were proficient in vaginal hysterectomy, with two-thirds performing 30 or fewer procedures annually; 212 (45%) reporting a decrease in the number of procedures over the last decade. Additionally, 373 (79%) respondents believed that 10-30 cases were needed to achieve and maintain proficiency. Vaginal hysterectomy remains a key component in uterine prolapse repair. However, with the rise of uterine-sparing prolapse repairs, the decision-making process may be influenced by multiple factors, including surgical training. Emphasis should be placed on training and maintaining proficiency in both traditional and novel techniques.

A Roadmap for Training in Urogynecology: IUGA International Initiative.

Training in urogynecology is an important mission of the International Urogynecological Association (IUGA). Promoting official training programs in countries around the world is an integral part of this mission. The IUGA established the Fellowship Development Committee to develop a roadmap to assist countries to develop a professional training program in urogynecology. Two focus groups were created: the curricula topics focus group and the survey focus group. The curricula topics focus group is aimed at developing a list of subjects that can be the basis for a training syllabus. The survey focus group is aimed at understanding the main steps and the difficulties in establishing an official training program by interviewing representatives from both accredited and non-accredited countries and developing a roadmap for an official training program recognized by the local authorities. The fellowship development committee included 13 members. The curricula topics focus group developed a format for the description of each included topic. Each topic had to include a description of the required related skills and procedures. Two curricula topics lists were created: one for basic training and a second for advanced training. The survey focus group conducted two table discussions with representatives from countries with accredited training programs and countries without accredited training programs. The comments of these meetings were summarized in documents submitted to the IUGA board of directors. The fellowship development committee studied the main hurdles to developing an official training program in urogynecology. The roadmap document should form the basis of the IUGA international initiative to assist countries around the world to develop an official training program in urogynecology recognized by the local authority.

The Future of Basic Science: Development of the Next Generation of Mechanistic Researchers in Female Pelvic Medicine.

The International Urogynecological Association (IUGA) brought together senior and junior members actively engaged in scholarly and educational activities for a consensus conference centered on developing a strategy for sustainable training of the next generation of mechanistic researchers in female pelvic medicine. Four a priori identified major foci were explored in a half-day virtual consensus conference. Participants included representatives from various countries and disciplines with diverse backgrounds-clinicians, physician-scientists, and basic scientists in the fields of urogynecology, biomechanical engineering, and molecular biology.Following a keynote address, each focus area was first tackled by a dedicated breakout group, led by the Chair(s) of the most relevant IUGA committees. The break-out sessions were followed by an iterative discussion among all attendees to identify mitigating strategies to address the shortage of mechanistic researchers in the field of female pelvic medicine. The major focus areas included: research priorities for IUGA basic science scholar program; viable strategies for sustainable basic science mentorship; core competencies in basic science training; and the challenges of conducting complex mechanistic experiments in low-resource countries. Key gaps in knowledge and core competencies that should be incorporated into fellowship/graduate training were identified, and existing training modalities were discussed. Recommendations were made for pragmatic approaches to increasing the exposure of trainees to learning tools to enable sustainable training of the next generation of basic science researchers in female pelvic medicine worldwide. The attendees presented multiple perspectives to gain consensus regarding critical areas of need for training future generations of mechanistic researchers. Recommendations for a sustainable Basic Science Scholar Program were developed using IUGA as a platform. The overarching goal of such a program is to ensure a successful bench-to-bedside-and-back circuit in Urogynecology and Pelvic Reconstructive Surgery, ultimately improving lives of millions of women worldwide through scientifically rational effective preventative and therapeutic interventions.

Changes in lower urinary tract function after minimally invasive nerve-sparing for complete excision of endometriosis: An observational study.

The objective of this paper is to evaluate changes in lower urinary tract symptoms (LUTS), severity of pain and urodynamic parameters after minimally invasive nerve-sparing surgery for patients with endometriosis. We analyzed 143 patients undergoing minimally invasive nerve-sparing surgery for endometriosis excision (laparoscopy/robot-assisted). The endometriosis was confirmed by preoperative clinical evaluation, magnetic resonance imaging (MRI) showing at least one lesion deeper than 5 mm, and histological confirmation after laparoscopy. We evaluated three points prior and after surgery: LUTS parameters according to the International Urogynecological Association; urodynamic measures of storage and voiding and the severity of the dyspareunia, dyschezia and dysmenorrhea assessed on a self-reported 11-point numeric rating scale. The Wilcoxon signed rank and McNemar tests were used for statistical analyses (p < 0.05). We observed significant improvements in LUTS after the surgery with postoperative symptom-free probabilities in urgency (64.5%), daytime frequency (38.5%), and dysuria (87.1%). However, slow stream prevalence increased significantly postsurgery (p = 0.022), with a 20.5% risk of asymptomatic patients developing this symptom. Urodynamic responses varied; for instance, maximum cystometric capacity improved significantly (p = 0.004), while postvoiding residual worsened (p = 0.006). Significant worsening in postvoiding residual occurred in women with normal preoperative values (p = 0.002), with a 17.7% risk of normal values becoming abnormal. Compliance or maximum cystometric capacity not considered normal preoperatively showed significant improvements (p < 0.001), but the risk of normal values becoming abnormal after surgery was 14.5%. The minimally invasive nerve-sparing surgery for endometriosis excision shows improvement in lower urinary tract symptoms, urodynamics parameters and severity of pain. The majority of patients became asymptomatic in the postoperative period. When compared to the benefits of the patients' surgical treatment, particularly when considering the reduction of pain, the risks of the lower urinary tract treatment seem to be acceptable. The surgical intervention seems to be a safe alternative in patients with endometriosis, although studies with larger samples are needed to confirm these findings.

Management of mixed urinary incontinence: IUGA committee opinion

Introduction and hypothesisMixed urinary incontinence (MUI) is defined by the International Urogynecology Association (IUGA) and International Continence Society as the complaint of involuntary leakage of urine associated with urgency and also with exertion, effort, sneezing or coughing. It therefore implies the coexistence of both stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). MUI is a heterogeneous diagnosis that requires an assessment of its individual components of SUI and UUI. Management requires an individualised approach to the symptom components. The aim of this review is to identify the assessment/investigations and management options for MUI.MethodsA working subcommittee from the IUGA Research & Development (R&D) Committee was created and volunteers invited from the IUGA membership. A literature review was performed to provide guidance focused on the recommended assessment and management of MUI. The document was then evaluated by the entire IUGA R&D Committee and IUGA Board of Directors and revisions made. The final document represents the IUGA R&D Committee Opinion.ResultsThe R&D Committee MUI opinion paper provides guidance on the assessment and management of women with MUI and summarises the evidence-based recommendations.ConclusionsMixed urinary incontinence is a complex problem and successful management requires alleviation of both the stress and urge components. Care should be individualised based on patient preferences. Further research is needed to guide patients in setting goals and to determine which component of MUI to treat first. The evidence for many of the surgical/procedural treatment options for MUI are limited and needs to be explored in more detail.

Evaluation of readability levels of online patient education materials for female pelvic floor disorders

Most women hesitate to seek help from healthcare providers as they find it difficult to share complaints of involuntary leakage or vaginal prolapse. Hence, they often refer to the websites of national and/or international bodies’ patient education materials (PEMs), which are considered the most reliable sources. The crucial factor that determines their usefulness is their readability level, which makes them “easy” or “difficult” to read, and is recommended, not to exceed the sixth grade level. In this study, we aimed to assess the readability levels of Turkish translated PEMs from the websites of the International Urogynecological Association and the European Association of Urology and the PEMs originally written in Turkish from the website of the Society of Urological Surgery in Turkey. All the PEMs (n = 52) were analyzed by online calculators using the Atesman formula, Flesch-Kincaid grade level, and Gunning Fog index. The readability parameters, number of sentences, words, letters, syllables, and readability intervals of these methods were compared among the groups using the Kruskal-Wallis test, or ANOVA test, with post hoc comparisons where appropriate. The readability level of all PEMs is at least at an “averagely difficult” interval, according to both assessment methods. No significant differences were found among the PEM groups in terms of readability parameters and assessment methods (P &gt; .05). Whether original or translated, international or national societies’ PEMs’ readability scores were above the recommended level of sixth grade. Thus, the development of PEMs needs to be revised accordingly by relevant authorities.

Establishing urogynecology subspecialty in Armenia: The Armenia project.

It is well known that there are many countries in the world where Urogynecology is not an existing subspecialty, and women are not receiving appropriate care for their pelvic floor disorders (PFD). One of these countries is the Republic of Armenia. Given the lack of expertise in the field of Urogynecology in Armenia, we conducted a study on the prevalence of PFDs and the degree of bother among women of all ages across the country, which was published in 2020. This led to the creation of the International Urogynecology Association for Armenia, comprising seven physicians from different countries: five from the USA, one urogynecologist from Lebanon, and one urologist from Russia. We implemented hybrid teaching based on Zoom lectures, case presentations, journal clubs, and live visits of mentors to Armenia on a regular basis to see patients and operate with our five fellows. We introduced our fellows to research and statistics by assigning research topics for different projects. Our fellows presented evidence-based presentations and extensive literature reviews on a regular basis. Our program will continue to grow the next 2-3years. The success of this project holds significance for governmental, public, and healthcare entities in Armenia and across the world, where this subspecialty is non-existent, in preparing future female pelvic surgeons to care for the growing needs of women with these conditions. Replicating this program in other parts of the world will compound the benefits and successes of Urogynecology care across different societies, cultures, and people around the globe.

Incontinence of urine in women. Diagnosis and treatment

Urinary incontinence is the involuntary loss of urine. The condition occurs in both sexes, but is most commonly observed in women (twice as often), and is more frequently encountered with advancing age. According to the International Continence Society, urinary incontinence is defined as "the complaint of any involuntary loss of urine that represents a social or hygienic problem and is objectively demonstrable." In general, according to the Terminology Standardization Committee, urinary incontinence is "the complaint of any involuntary loss of urine under conditions of social embarrassment." [1] In female patients, urinary incontinence is usually related to dysfunction of the bladder or pelvic floor muscles, which often appears during pregnancy or childbirth and/or menopause. There are two main subtypes of urinary incontinence: stress urinary incontinence (SUI) and urge urinary incontinence (UUI). According to the International Urogynecological Association (IUGA) and the International Continence Society (ICS), stress urinary incontinence is defined as the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing, while urge urinary incontinence is the complaint of involuntary leakage accompanied by or immediately preceded by urgency. These two types are so common that they frequently coexist as a combination of symptoms called mixed urinary incontinence. Most women with urge urinary incontinence also receive a diagnosis of overactive bladder syndrome, in which urge urinary incontinence is a possible component.[1,2]

MP37-16 A NOVEL DEVICE FOR SELECTIVE EXTRACORPOREAL MAGNETIC INNERVATION: RESULTS ON WOMEN WITH STRESS URINARY INCONTINENCE

You have accessJournal of UrologyCME1 Apr 2023MP37-16 A NOVEL DEVICE FOR SELECTIVE EXTRACORPOREAL MAGNETIC INNERVATION: RESULTS ON WOMEN WITH STRESS URINARY INCONTINENCE Serena Maruccia, Marta Barba, Alice Cola, Silvia Volontè, Giuseppe Marino, Tomaso Melocchi, Desirè de Vicari, Stefano Terzoni, and Matteo Frigerio Serena MarucciaSerena Maruccia More articles by this author , Marta BarbaMarta Barba More articles by this author , Alice ColaAlice Cola More articles by this author , Silvia VolontèSilvia Volontè More articles by this author , Giuseppe MarinoGiuseppe Marino More articles by this author , Tomaso MelocchiTomaso Melocchi More articles by this author , Desirè de VicariDesirè de Vicari More articles by this author , Stefano TerzoniStefano Terzoni More articles by this author , and Matteo FrigerioMatteo Frigerio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003275.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The international guidelines include conservative and surgical treatments for stress urinary incontinence on women. Extracorporeal magnetic stimulation (EMS) is a conservative option for pelvic floor disorders. MS is a non-invasive therapeutic device that interacts with the neuromuscular tissue through an electromagnetic field, thus inducing intense contractions that stimulate pelvic floor muscles. Recently, the TOP Flat Magnetic Stimulation (TOP FMS) has been developed as new generation of traditional magnetic chairs. This new technology generates electromagnetic fields with a homogenous profile optimized for the stimulation of the pelvic area, allowing greater recruitment of muscle fibres without creating areas of uneven stimulation intensity. We sought to assess the short-term outcomes, both subjective and objective, in women suffering from SUI. METHODS: In this non-randomized trial, a clinical interview was performed to investigate the presence of isolated or predominant stress urinary incontinence (SUI), subsequently confirmed by a stress test. Urogenital examination was used to exclude significant prolapse (POP-Q stage >2 or higher). Patients could choose to receive the new treatment (eight sessions of 25 minutes of TOP FMS in one month) or home-based, unsupervised, non-personalized pelvic floor muscles training (PFMT) according to the International Urogynecological Association leaflets for one month. At baseline (T0) and at the end of the treatments (T1) the International Consultation on Incontinence Questionnaire-Short Form questionnaire (ICIQ-SF) and the Incontinence Impact Questionnaire (IIQ-7- SF) were administered. The stress test was performed again after treatment and the Patient Global Impression of Improvement (PGI-I) questionnaire was administered. RESULTS: 50 patients were enrolled (1:1 allocation ratio). Improved PGI-I scores were reported by 72% intervention patients vs 20% controls (p<0.001) after 1 month. According to the stress test at T1 (1 month), the objective cure rate resulted 40% for TOP FMS and 0% for PFMT (p<0.001). Significant improvements were observed in the TOP FMS, IIQ-7 and ICIQ-SF scores (p<0.05) but not in the FSFI-19 scores. No adverse events were reported either with TOP FMS or PFMT. CONCLUSIONS: The TOP FMS appears promising in patients with isolated or predominant SUI, compared to than unsupervised, non-individualized PFMT, in treating SUI in women. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e520 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Serena Maruccia More articles by this author Marta Barba More articles by this author Alice Cola More articles by this author Silvia Volontè More articles by this author Giuseppe Marino More articles by this author Tomaso Melocchi More articles by this author Desirè de Vicari More articles by this author Stefano Terzoni More articles by this author Matteo Frigerio More articles by this author Expand All Advertisement PDF downloadLoading ...

Nonoperative Management of Pelvic Organ Prolapse.

Pelvic organ prolapse (POP) is defined as the descent of one or more of the anterior, posterior, or apical vagina. It is a common condition, with up to 50% of women having prolapse on examination in their lifetimes. This article provides an overview of the evaluation and discussion of nonoperative management of POP for the obstetrician-gynecologist (ob-gyn), with consideration of recommendations from the American College of Obstetricians and Gynecologists, the American Urogynecologic Society, and the International Urogynecological Association. The initial evaluation of POP requires a history documenting whether the patient is experiencing symptoms and what they are, and discovery of which symptoms they believe are attributable to prolapse. Examination determines the vaginal compartment(s) and to what degree prolapse exists. In general, only patients who have symptomatic prolapse or medical indication should be offered treatment. Although surgical options exist, all patients who are symptomatic and desire treatment should be offered nonsurgical treatment first, including pelvic floor physical therapy or a pessary trial. Appropriateness, expectations, complications, and counseling points are reviewed. Educational opportunities between the patient and the ob-gyn include disentangling common beliefs that the bladder is dropping or that concomitant urinary or bowel symptoms are necessarily caused by prolapse. Improving patient education can lead to a better understanding of their condition and better alignment of treatment goals and expectations.

Consensus Definitions and Interpretation Templates for Dynamic Ultrasound Imaging of Defecatory Pelvic Floor Disorders: Proceedings of the Consensus Meeting of the Pelvic Floor Disorders Consortium of the American Society of Colon and Rectal Surgeons, the Society of Abdominal Radiology, the International Continence Society, the American Urogynecologic Society, the International Urogynecological Association, and the Society of Gynecologic Surgeons.

Consensus Definitions and Interpretation Templates for Dynamic Ultrasound Imaging of Defecatory Pelvic Floor Disorders: Proceedings of the Consensus Meeting of the Pelvic Floor Disorders Consortium of the American Society of Colon and Rectal Surgeons, the Society of Abdominal Radiology, the International Continence Society, the American Urogynecologic Society, the International Urogynecological Association, and the Society of Gynecologic Surgeons.

Addressing Gender-Related Inequality in Continence Care

Addressing Gender-Related Inequality in Continence Care

An International Continence Society (ICS)/ International Urogynecological Association (IUGA) joint report on the terminology for the assessment and management of obstetric pelvic floor disorders

Aims:The terminology of obstetric pelvic floor disorders should be defined and reported as part of a wider clinically oriented consensus. Methods:This Report combines the input of members of two International Organizations, the International Continence Society (ICS) and the International Urogynecological Association (IUGA). The process was supported by external referees. Appropriate clinical categories and a sub-classification were developed to give coding to definitions. An extensive process of 12 main rounds of internal and 2 rounds of external review was involved to exhaustively examine each definition, with decision-making by consensus. Results:A terminology report for obstetric pelvic floor disorders, encompassing 357 separate definitions, has been developed. It is clinically-based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it usable by different specialty groups and disciplines involved in the study and management of pregnancy, childbirth and female pelvic floor disorders. Clinical assessment, investigations, diagnosis, conservative and surgical treatments are major components. Illustrations have been included to supplement and clarify the text. Emerging concepts, in use in the literature and offering further research potential but requiring further validation, have been included as an appendix. As with similar reports, interval (5–10 year) review is anticipated to maintain relevance of the document and ensure it remains as widely applicable as possible. Conclusion:A consensus-based Terminology Report for obstetric pelvic floor disorders has been produced to support clinical practice and research.

An International Continence Society (ICS)/ International Urogynecological Association (IUGA) joint report on the terminology for the assessment and management of obstetric pelvic floor disorders

AimsThe terminology of obstetric pelvic floor disorders should be defined and reported as part of a wider clinically oriented consensus.MethodsThis Report combines the input of members of two International Organizations, the International Continence Society (ICS) and the International Urogynecological Association (IUGA). The process was supported by external referees. Appropriate clinical categories and a sub-classification were developed to give coding to definitions. An extensive process of 12 main rounds of internal and 2 rounds of external review was involved to exhaustively examine each definition, with decision-making by consensus.ResultsA terminology report for obstetric pelvic floor disorders, encompassing 357 separate definitions, has been developed. It is clinically-based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it usable by different specialty groups and disciplines involved in the study and management of pregnancy, childbirth and female pelvic floor disorders. Clinical assessment, investigations, diagnosis, conservative and surgical treatments are major components. Illustrations have been included to supplement and clarify the text. Emerging concepts, in use in the literature and offering further research potential but requiring further validation, have been included as an Appendix. As with similar reports, interval (5–10 year) review is anticipated to maintain relevance of the document and ensure it remains as widely applicable as possible.ConclusionA consensus-based Terminology Report for obstetric pelvic floor disorders has been produced to support clinical practice and research.

AUGS-IUGA Joint clinical consensus statement on enhanced recovery after urogynecologic surgery.

Enhanced recovery after surgery (ERAS) evidence-based protocols for perioperative care can lead to improvements in clinical outcomes and cost savings. This article aims to present consensus recommendations for the optimal perioperative management of patients undergoing urogynecological surgery. A review of meta-analyses, randomized clinical trials, large nonrandomized studies, and review articles was conducted via PubMed and other databases for ERAS and urogynecological surgery. ERAS protocol components were established, and then quality of the evidence was both graded and used to form consensus recommendations for each topic. These recommendations were developed and endorsed by the writing group, which is comprised of the American Urogynecologic Society and the International Urogynecological Association members. All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly. The components of ERAS with a high level of evidence to support their use include fasting for 6 h and taking clear fluids up to 2 h preoperatively, euvolemia, normothermia, surgical site preparation, antibiotic and antithrombotic prophylaxis, strong antiemetics and dexamethasone to reduce postoperative nausea and vomiting, multimodal analgesia and restrictive use of opiates, use of chewing gum to reduce ileus, removal of catheter as soon as feasible after surgery and avoiding systematic use of drains/vaginal packs. The evidence base and recommendations for a urogynecology-relevant ERAS perioperative care pathway are presented in this consensus review. There are several elements of ERAS with strong evidence of benefit in urogynecological surgery.

Counseling for stress urinary incontinence in the era of adverse publicity around mesh usage: Results from a large-sample global survey.

To investigate doctors' opinions of the use of synthetic mesh for the treatment of stress urinary incontinence (SUI) and the effect on patient's attitude following recent adverse publicity and legal findings. Electronic survey approved by International Urogynecological Association (IUGA) and American Urogynecologic Society (AUGS), distributed to their members. A total of 593 respondents completed the survey. The preferred initial surgical treatment for SUI was retropubic midurethral sling (MUS) (62%), followed by trans-obturator MUS (19%), mini-slings (10%), and then bulking agents (5%). Despite prolongation of consultation, most respondents (87%) believed that clinicians should provide a patient information leaflet (PIL) for their patients. However, only 70% of respondents were doing this. Most participants would use either the IUGA PIL or their institution PIL (61%). Only 8% felt that patients have a positive preconception of synthetic mesh for SUI. Eighty-three per cent of respondents had not changed their recommendations for treatment and the consent process. A logistic regression model identified preferences of certain geographic areas as predictors of consenting practices. Despite the negative publicity and the current medicolegal litigation involving MUS for SUI treatment, the majority of respondents still prefer this as the initial surgical treatment. Most clinicians value PIL in the surgical consent process.

International Urogynecology Consultation: Patient Reported Outcome Measures (PROs) use in the evaluation of patients with pelvic organ prolapse.

Patient-reported outcome measure instruments include patient-reportedoutcomes (PROs) and patient-reported goals (PRGs), which allow practitioners to measure symptomsand determine outcomes of treatment that matter to patients. This is a structured review completed by the International Urogynecology Consultation (IUC),sponsored by the International Urogynecological Association (IUGA). The aim of this working group wasto evaluate and synthesize the existing evidence for PROs and PRGs in the initial clinical work-up/evaluation and research arena for patients with pelvic organ prolapse (POP). The initial search generated 3589 non-duplicated studies. After abstract review by 4 authors,211 full texts were assessed for eligibility by 2 writing group members, and 199 studies were reviewed indetail. Any disagreements on abstract or full-text articles were resolved by a third reviewer or duringvideo meetings as a group. The list of POP PROs and information on PRGs was developed from thesearticles. Tables were generated to describe the validation of each PRO and to provide currentlyavailable, validated translations. All patients presenting for POP should be evaluated for vaginal, bladder, bowel and sexualsymptoms including their goals for symptom treatment. This screening can be facilitated by a validatedPRO; however, most PROs provide more information than needed to provide clinical care and weredesigned for research purposes.

Does Partner Matter in Sexual Activity?

ABSTRACT Introduction A woman's sexual activity is a challenging topic to discuss for both provider and patient. Common questions about sexual activity imply that a woman is having partnered sexual activity with vaginal penetration. Discussion about masturbation or solo sexual experiences tend to be even more uncomfortable and considered a societal taboo. Nevertheless, solo sexual activity is an important part of physical and emotional health. Objective The aim of this pilot study is to examine the differences in sexual health, pelvic floor health and overall wellness among women with predominantly partnered sexual activity (PSA) compared to solo sexual activity (SSA). Methods This is a prospective pilot study of sexually active women with PSA and SSA age 18 to 99 years who presented for consultation to our Female Pelvic Medicine and Reconstructive Surgery clinic with a pelvic floor complain between May 2021 and August 2021. Participants were given validated questionnaires for 1) sexual health: Female Sexual Function Index (FSFI) and The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire International Urogynecological Association (IUGA) Revised (PISQ-IR); 2) pelvic floor function: The Pelvic Floor Distress Inventory Questionnaire (PFDI), Genitourinary Pain Index (GUPI), Interstitial cystitis/Painful bladder syndrome (IC/PBS), and 3) overall health: (Self-reported quality of life (SF-12), Patient Health Questionnaire (PHQ-9)). Physical exam and interview on sexual practices were performed. Demographics and health information were recorded. All data were analyzed with descriptive statistics, comparisons were made using Fisher Exact Test and Wilcoxson Rank Sum Tests. Results Among 23 women recruited in the pilot study, 13 had PSA and ten women had SSA. Among PSA, six women were also masturbating. Those who were sexually active with a partner were younger (p=0.021), and less likely to have neurologic disorders (p=0.022). No significant differences in demographics, comorbidities, hormonal therapies, pelvic floor disorders, or overall well-being were found between two groups. Women involved in PSA had significantly higher total FSFI score (p=0.035), sexual satisfaction (p=0.012). Interestingly, women with PSA had higher scores on ICSI (p=0.046) and less likely used a vibrator or sex toy ever in their lives (p=0.02). Conclusions No significant differences in pelvic health and overall wellness were noted between women with PSA and SSA. Satisfaction from sexual activity is higher among younger women involved in partnered sex, in spite of no significant differences present in desire and orgasm domains. Sexual activity is more than just vaginal penetrative intercourse thus solo sexual practices should be assessed by medical providers especially in older women who might not have available partners. Disclosure No

Joint Report on Terminology for Cosmetic Gynecology.

The current terminology used to describe cosmetic gynecologic procedures includes many nondescriptive, trademarked, or informal names, which contributes to substantial ambiguity about their aims and specific techniques. The development of clear, uniform descriptive terminology for cosmetic gynecology is needed for patients, researchers, and practitioners across multiple specialties. This document was developed from a collaboration of selected members from the International Urogynecological Association (IUGA) and the American Urogynecologic Society (AUGS). Wide-ranging literature reviews were performed to identify the breadth of currently used terms and tools for measuring efficacy and safety. After extensive internal review the adoption of each definition was ratified by group consensus. A terminology report for elective cosmetic gynecology procedures, anatomical classification, outcome metrics, and reporting of complications has been developed. This document seeks to provide clear descriptive guidance for patients, researchers, and practitioners across multiple specialties. This document will be subject to internal review by IUGA and AUGS to incorporate and adopt evidence-based changes in the field. A consensus-based document establishing clear terminology for cosmetic gynecology procedures has been created. Use of these terms should be encouraged to provide clarity to patients seeking these procedures and to facilitate future research to establish the safety and efficacy of these procedures.

Joint Report on Terminology for Cosmetic Gynecology.

The current terminology used to describe cosmetic gynecologic procedures includes many nondescriptive, trademarked, or informal names, which contributes to substantial ambiguity about their aims and specific techniques. The development of clear, uniform descriptive terminology for cosmetic gynecology is needed for patients, researchers, and practitioners across multiple specialties. This document was developed from a collaboration of selected members from the International Urogynecological Association (IUGA) and the American Urogynecologic Society (AUGS). Wide-ranging literature reviews were performed to identify the breadth of currently used terms and tools for measuring efficacy and safety. After extensive internal review the adoption of each definition was ratified by group consensus. A terminology report for elective cosmetic gynecology procedures, anatomical classification, outcome metrics, and reporting of complications has been developed. This document seeks to provide clear descriptive guidance for patients, researchers, and practitioners across multiple specialties. This document will be subject to internal review by IUGA and AUGS to incorporate and adopt evidence-based changes in the field. A consensus-based document establishing clear terminology for cosmetic gynecology procedures has been created. Use of these terms should be encouraged to provide clarity to patients seeking these procedures and to facilitate future research to establish the safety and efficacy of these procedures.