Instructional Course - Requires Course Pass or Individual Course Ticket, Additional Registration Required
Ariana Smith, MD
University of Pennsylvania
Una Lee, MD
M.D.
Virginia Mason Medical Center
Nirit Rosenblum, MD
Associate Professor of Urology and OB/GYN
NYU Langone Medical Center
This course is intended to present important women’s health issues and gynecologic considerations in the evaluation and management of women with urologic conditions.
This course will focus on an evidence based and clinical review of:
1. Menopause and hormone replacement therapy
2. Genitourinary syndrome of menopause
3. Gynecologic evaluation prior to urologic pelvic surgery or pelvic organ prolapse surgery
There is an increasing appreciation for the unique needs of women patients, and urologists as specialists in the genitourinary tract are often faced with clinical scenarios that intersect with current issues in women’s health. We will review current strategies for menopause management, and provide a literature based update on hormonal replacement therapy. In addition, we will discuss the evaluation and management of vaginal and vulvar concerns, with a focus on the genitourinary syndrome of menopause.
We will also provide an update on uterine, cervical, and ovarian cancer screening relevant to urologic pelvic surgery and pelvic prolapse surgery. Although gynecologic malignancy is uncommon in women with pelvic organ prolapse and other urologic diseases such as bladder cancer, urologists caring for women should be acquainted with the relevant gynecologic literature as it pertains to the surgical care of women. Caring for women undergoing urologic or pelvic reconstructive surgery involves understanding their gynecologic history and risk factors for gynecologic malignancy. While advanced gynecologic testing is rarely needed in preparation for surgery, urologists should be aware of prior cervical cancer screening results (i.e. Papanicolaou (PAP) smear testing), discuss the role of prophylactic oophorectomy and/or salpingectomy during pelvic surgery, and ask about post menopausal vaginal bleeding, a potential sign of uterine cancer. Understanding PAP smear testing results and follow up requirements for women undergoing hysterectomy and supracervical hysterectomy will be presented. Considerations of future uterine pathology in the setting of uterine sparing prolapse and urologic surgery as well as appropriately managing the adnexa in women undergoing surgery in the pelvic cavity will be discussed.