BackTable OBGYN

Human trafficking is a complex health issue, with many providers unsure how best to detect, counsel, and care for victims and survivors of human trafficking. In this episode of the BackTable OBGYN Podcast, hosts Dr. Amy Park and Dr. Mark Hoffman are joined by Dr. Julia Geynisman-Tan, a urogynecologist at Northwestern, to discuss signs of human trafficking and resources for caring for this patient population.

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SYNPOSIS

Dr. Geynisman-Tan shares her extensive experience in caring for survivors of human trafficking and discusses the complexities surrounding this issue. She emphasizes the importance of trauma-informed care, recognizing signs of trafficking, and providing support to survivors. The conversation covers her journey into this field, the challenges faced by survivors, and practical steps that healthcare professionals can take to aid these vulnerable patients. The episode underscores the need for multidisciplinary approaches and the critical role of healthcare providers in identifying and assisting those affected by human trafficking.

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TIMESTAMPS

00:00 - Introduction

05:08 - Identifying Signs of Human Trafficking in Patients

09:14 - Referral and Support Systems for Trafficking Survivors

11:31 - Common Health Issues Among Trafficking Survivors

13:17 - Understanding the Complexities of ‘The Life’

18:13 - Immigration and Human Trafficking

20:48 - Providing Trauma-Informed Care

25:55 - Identifying Resources for Victims

29:23 - Healthcare Protocols

32:50 - Addressing Needs and Building Trust

36:58 - Psychosomatic Effects of Trauma

40:50 - Impact on Pregnancy

42:55 - Supporting Survivors and Long-Term Rehabilitation

48:30 - Conclusions

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RESOURCES

Human Trafficking Hotline:

https://humantraffickinghotline.org/en

HEAL Trafficking:

https://healtrafficking.org/

Surgical approaches to endometriosis continue to move towards greater levels of precision and efficacy as we learn more about the intricacies of this complex condition. Still, endometriosis continues to challenge gynecologic surgeons worldwide. How has endometriosis surgery evolved, and how can we apply what we’ve learned to continue to improve patient outcomes? In this episode of BackTable OBGYN, Dr. Tommaso Falcone, a renowned surgeon and expert in reproductive endocrinology and fertility, discusses the past, present, and future of endometriosis surgery.

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SYNPOSIS

Dr. Falcone shares his journey from McGill University to his current roles at the Cleveland Clinic, offering insights into advancements in minimally invasive surgery, the role of teamwork in medical innovation, and the complexities of treating endometriosis. The episode covers the evolution of surgical techniques, postoperative care, and fertility strategies, emphasizing the importance of managing patient expectations and the future directions for research and treatment.

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TIMESTAMPS

00:00 - Introduction

02:09 - Dr. Falcone’s Journey and Career

08:09 - Evolution of REI and MIGS

13:35 - Innovations in Endometriosis Treatment

20: 45 - Excision vs Ablation

25:30 - Challenges and Future Directions in Endometriosis Research

32:39 - Understanding the Placebo Effect in Chronic Pain

34:18 - Exploring Fibrosis in Endometriosis

35:31 - Challenges in Diagnosing and Treating Endometriosis

40:57 - Innovations in Surgical Techniques

53:56 - Managing Patient Expectations and Complications

56:06 - Concluding Thoughts

Endometriosis is a very difficult disease to diagnose and manage, but effective imaging can make all of the difference. In this episode of the BackTable OBGYN podcast, Mayo Clinic radiologist Dr. Wendaline VanBuren and gynecologist Dr. Tatnai Burnett discuss the complexities of diagnosing, imaging, and surgically treating endometriosis.

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SYNPOSIS

The doctors delve into the importance of advanced imaging techniques such as MRI and dedicated protocols, the critical need for a multidisciplinary approach with radiologists and GYN surgeons, and the future potential of imaging in improving endometriosis diagnosis, treatment, and surgical planning. The discussion also covers the upcoming International Endometriosis Imaging Congress aimed at advancing standardized care and collaboration in the field.

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TIMESTAMPS

00:00 - Introduction

05:15 - Dr. VanBuren’s Journey to Endometriosis Imaging

08:24 - Dr. Burnett’s Surgical Training and Insights

11:57 - Challenges in Diagnosing and Understanding the Pathophysiology of Endometriosis

13:24 - The Role of Imaging in Surgical Planning

25:51 - Imaging Follow-Up, Monitoring for Malignant Transformation

32:03 - Protocol for MRI Imaging of Endometriosis

34:47 - The Role of Radiologists in Endometriosis

36:12 - The Complexity of Bowel Endometriosis

48:02 - The Future of Endometriosis Imaging

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RESOURCES

International Endometriosis Imaging Congress-March 8-9, 2025

https://eice.ltd/international-endometriosis-imaging-congress/

Stay up to date on the latest advancements in gynecologic surgery. In this episode of the BackTable OBGYN Podcast, hosts Dr. Amy Park and Dr. Mark Hoffman invite Dr. Johnny Yi, a pioneer in the field of minimally invasive surgery and urogynecology, to discuss the latest advancements in, benefits of, and challenges with single port robotic gynecologic surgery.

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SYNPOSIS

The discussion covers evolutionary strides in robotic-assisted surgeries such as sacral colpopexy and myomectomies, the transition from traditional laparoscopy, and the intricacies of handling large uteri procedures. The episode also navigates the global adoption of these technologies, particularly in South Korea and Japan, and the varying applications in different specialties. Key topics include surgical skill requirements, training needs, innovative techniques, FDA approvals, and the future potential of single port surgeries. Overall, this discussion provides a well-rounded perspective on the current state and forward-looking innovations in the field of gynecologic surgery.

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TIMESTAMPS

00:00 - Introduction

03:57 - Single Port Robotic Surgery

08:27 - Benefits of Robotics with Sacral Colpopexy

11:37 - Technical Aspects of Single Port Surgery

14:40 - Training for Single Port Surgery

19:43 - Global Adoption and Future Potential of Single Port Surgery

25:35 - Access into the Abdomen

29:39 - Challenges and Innovations in Single Port Surgery

31:34 - Evaluating Risks and Success Rates

33:16 - Cost Analysis

35:16 - Training and Simulation for Single Port Surgery

39:35 - Future of Single Port and vNOTES Surgery

45:05 - Patient Reactions and Satisfaction

46:34 - Closing Techniques

52:14 - Future Prospects and Final Thoughts

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RESOURCES

Oh S, Yi J, Song AY, Jee J, Bae N, Shin JH. Intraoperative Complications and Perioperative and Surgical Outcomes of Single-Port Robotics-Assisted Sacrocolpopexy. Int Urogynecol J. 2024 Jul; 35 (7):1521-1526 Epub 2024 June 20.

How can we address barriers to care for women with genitourinary syndrome of menopause? In this episode, host Dr. Suzette Sutherland and Dr. Rachel Rubin discuss the challenges and misconceptions around Genitourinary Syndrome of Menopause (GSM).

They identify the severity of symptoms such as pain, urinary issues, and recurrent infections that are often inadequately addressed. Dr. Rubin advocates for the use of vaginal estrogen, emphasizing that its benefits outweigh any perceived risks, contrasting it with other treatments like tamoxifen. The discussion includes the efforts to create guidelines for GSM through the American Urological Association (AUA) to standardize care, and the use of systemic and localized hormonal therapies, particularly in cancer patients. The session highlights the importance of updated medical practices and shared decision-making in treating GSM and related conditions.

TIMESTAMPS

00:00 - Understanding Genitourinary Syndrome of Menopause (GSM)

01:33 - Challenges, Misconceptions, and Advocacy

02:31 - Developing GSM Guidelines

04:34 - Hormonal Replacement Therapy and GSM

05:46 - Vaginal Rings

06:59 - Cancer Survivors and Vaginal Estrogen

09:17 - Shared Decision Making

CHECK OUT THE FULL EPISODE

OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic

https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic

How can we educate women about vaginal estrogen for genitourinary syndrome of menopause, especially given the black box warning? In this Brief, Dr. Rachel Rubin and host Dr. Suzette Sutherland discuss misconceptions around the use of estrogen creams and suppositories, particularly focusing on dosage and application for safe, effective treatment.

They address common factors leading to inadequate results and the safety of low-dose vaginal estrogen. The doctors emphasize the importance of patience with treatment, correct understanding of hormone products, and education of patients to combat misinformation. Dr. Rubin and Dr. Sutherland also challenge misleading black box warnings associated with vaginal estrogen and stress the necessity for advocacy to update these labels and educate patients.

TIMESTAMPS

00:00 - Introduction

00:20 - Debunking Myths About Estrogen Cream Usage

04:10 - Safety and Proper Usage/Dosage of Estrogen Products

05:48 - Patient Education and Compliance

08:23 - Addressing the Black Box Warning on Vaginal Estrogen

10:48 - Conclusion

CHECK OUT THE FULL EPISODE

OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic

https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic

Everyone knows about the dangers of opioids, but how can physicians provide quality postoperative pain control without opioids? This episode of the BackTable OBGYN podcast, hosted by Dr. Amy Park, features a discussion with experts Dr. Steven McCarus and Dr. Paula Bilica on non-opioid pain control in obstetric and gynecologic surgery.

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This podcast is supported by:

Pacira

https://www.pacira.com/

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SYNPOSIS

Highlighting the use of Exparel, a liposomal bupivacaine formulation, the discussion addresses how it has transformed post-operative pain management by reducing opioid exposure. The episode covers techniques for Exparel application in surgeries such as hysterectomies and C-sections, with positive patient outcomes noted. The conversation also emphasizes the importance of collaboration among healthcare professionals to advocate for better pain management protocols and patient satisfaction, spotlighting upcoming initiatives like the No Pain Act.

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TIMESTAMPS

00:00 - Introduction

04:47 - Introduction to Liposomal Bupivacaine (Exparel)

07:10 - Techniques and Applications of Exparel

20:13 - The No Pain Act

25:07 - Patient Success Stories with Exparel

26:30 - Administrative Hurdles and Solutions

30:24 - Safety and Efficacy of Exparel

32:42 - Educating Staff and Implementing Protocols

38:05 - Final Thoughts

OBGYN Briefs - Managing Genitourinary Syndrome of Menopause

Frequent UTIs and vaginal atrophy/dryness are common signs of genitourinary syndrome of menopause (GSM). In this Brief, Dr. Rachel Rubin discusses the management of GSM and why estrogen is so vital to these tissues.

They address the lack of information and awareness about GSM among urologists and gynecologists while emphasizing its impact on the urinary and genital symptoms experienced by menopausal women. Dr. Rubin details how GSM is not just a matter of vaginal atrophy but involves broader symptoms like urinary tract infections and bladder issues. The doctors also discuss a range of treatment options available, including local vaginal supplementation products like estradiol creams and DHEA suppositories, and their benefits for urinary health.

TIMESTAMPS

00:00 - Introduction

00:20 - Understanding Genitourinary Syndrome of Menopause (GSM)

01:42 - Symptoms and Implications of GSM

03:00 - Vaginal Supplementation Products

05:09 - DHEA and SERM Therapy

08:44 - Estrogen and Vaginal Health

CHECK OUT THE FULL EPISODE

OBGYN Ep. 33 - Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic

https://www.backtable.com/shows/obgyn/podcasts/33/genitourinary-syndrome-of-menopause-gsm-improving-a-dry-topic 

Pregnancy and childbirth have a significant impact on the pelvic floor, often more than patients realize and even more still than most of our current postpartum care models are designed to address. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Lisa Hickman, a urogynecologist and pelvic reconstructive surgeon from The Ohio State University, to discuss peripartum pelvic floor disorders and her dedicated clinic for women with advanced obstetric lacerations.

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This podcast is supported by:

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

The conversation touches on key aspects of pelvic floor health, the impact of pregnancy and childbirth, and effective strategies for preventing and managing pelvic floor disorders. The episode emphasizes the importance of patient education, tailored postpartum care, and multidisciplinary collaboration with pelvic floor physical therapists and other healthcare personnel. Dr. Hickman shares insights on building a sustainable clinical model for peripartum pelvic floor disorders, securing stakeholder support, and implementing standardized processes to enhance patient outcomes.

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TIMESTAMPS

00:00 - Introduction

04:21 - Understanding the Pelvic Floor

05:36 - Impact of Pregnancy and Childbirth

07:48 - Preventing and Managing Tears

22:56 - Postpartum Care and Challenges

28:54 - Starting a Peripartum Clinic: A Roadmap

33:54 - Pelvic Floor PT and Patient Education

40:03 - Impact of Repair Techniques on Long-term Outcomes

50:56 - Sustaining and Expanding the Program

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RESOURCES

Hickman LC, Propst K, Swenson CW, Lewicky-Gaupp C. Subspecialty care for peripartum pelvic floor disorders. Am J Obstet Gynecol. 2020 Nov;223(5):709-714. doi: 10.1016/j.ajog.2020.08.015. Epub 2020 Sep 2. PMID: 32888923; PMCID: PMC7720615.

Thoracic endometriosis occurs in about 12% of patients with advanced endometriosis. Due in part to its lower incidence and inherent diagnostic challenges, many providers are not well-versed in the workup and management of this advanced disease. In this episode of The BackTable OBGYN Podcast, host Dr. Mark Hoffman interviews Dr. Shanti Mohling, a gynecologic surgeon at Northwest Endometriosis and Pelvic Surgery, regarding her approach to thoracic endometriosis.

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CHECK OUT OUR SPONSOR

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

The physicians discuss the embryological and congenital theories of endometriosis etiology, the impacts of retrograde menstruation, and epigenetic factors. Dr. Mohling shares insights into her advanced surgical techniques for treating endometriosis, including diaphragmatic and thoracic disease, and the importance of a comprehensive history, exam, and diagnostic imaging. Her practice patterns, patient care strategies, and interdisciplinary collaborations for optimal outcomes are also highlighted.

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TIMESTAMPS

00:00 - Introduction

06:40 - Pelvic Pain Workup

08:09 - Thoracic Endometriosis

14:12 - Medical Management Post-Surgery

18:48 - In-Office Ultrasound Techniques

23:33 - Collaboration in Surgery

24:59 - Preparing for Thoracic Endometriosis Surgery

36:44 - Managing Postoperative Care

41:13 - Theories on Endometriosis Etiology

46:31 - Concluding Thoughts