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Instructional Course

Instructional Course - Available with the Platinum and Silver packages or Individual Course Ticket

041IC - Women's Health Update: Gynecologic Considerations for the Urologist

Saturday, May 14, 2022

4:00 PM – 6:00 PM

Location: Room 211

Instructional Course Director(s)

Ariana L. Smith, MD (she/her/hers)

Professor of Urology
University of Pennsylvania

Instructional Course Faculty(s)

NR

Nirit Rosenblum (she/her/hers)

Associate Professor
NYU Langone Medical Center
Una Jeanie Lee, MD (she/her/hers)

Section Head, Section of Urology and Renal Transplantation
Virginia Mason Medical Center

Learning Objectives:

Describe the management of menopause and role of hormone replacement therapy
Define the genitourinary syndrome of menopause, including symptoms and treatment, and understand the differential diagnoses of other vaginal and vulvar symptoms
Interpret relevant gynecologic literature as it pertains to the surgical management of women with pelvic organ prolapse and urologic disease
Determine the impact PAP smear testing results on surgical management of the cervix and perform current standard screening for uterine pathology
Review the considerations in surgical management of the adnexa when operating in the pelvic cavity

This course is intended to utilize the flipped classroom course format where participants view the course material online prior to attending. During the in-person session, participants and course faculty will engage in an interactive discussion on important women’s health issues and gynecologic considerations in the evaluation and management of women with urologic conditions. Small group discussions and opportunities for participants to present their tough cases are planned.

This online course material will focus on an evidence-based and clinical discussion 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 challenging cases in 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 followup requirements for women undergoing hysterectomy and supracervical hysterectomy will be presented. Interactive discussions on challenging clinical scenarios including 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 are planned.