Steven D Kleeman

Good Samaritan Hospital, Cincinnati, Ohio, United States

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Publications (70)171.79 Total impact

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    ABSTRACT: Currently, there is a paucity of literature on caregiver burden among postoperative geriatric patients. This is of particular interest to the field of urogynecology, as many of these patients are 65 or older. Objective: Given the growing volume of geriatric patients and their utilization of health care resources, this study was conducted to characterize the burden of geriatric urogynecologic surgery patients on their caregivers. Materials and Methods: Using a prospective double cohort design for the study, researchers enrolled female patients (≥65 years) undergoing pelvic surgery and their caregivers. Patients were administered questionnaires, including the Short Form Health Survey-12 (SF-12) consisting of physical (PCS) and mental composites (MCS) at baseline, 2, 6, and 12 weeks postoperatively. Caregivers received the SF-12, Zarit Burden Inventory (ZBI), and Caregiver Burden Inventory (CBI) at the same intervals. Results: Forty-eight pairs were analyzed. The majority of caregivers were white (96.6%) and male (65.5%), and were spouses (54.2%). In patients, SF-12 PCS scores declined from 44.98±1.74 at baseline to 31.47±1.22 (p=0.0001) at 2 weeks, with a return by 12 weeks (45.92±1.66; p<0.0001), reflecting their recovery. As patient physical health temporarily declined, caregiver burden temporarily increased. In caregivers, ZBI scores worsened from 7.05±1.0 to 9.09±1.09 (p=0.002) and CBI from 4.66±0.76 to 8.74±0.78 (p=0.0001) at 2 weeks following surgery, suggesting a greater burden at that time. Nevertheless, resolution was noted by 12 weeks in ZBI scores (8.08±1.18; p=0.03) and CBI scores (5.68±0.95; p=0.0002), indicating improvement of these constraints. Among caregivers, there were no associations noted between total ZBI or CBI and demographics. Conclusions: Informal caregivers of urogynecologic surgery patients experience temporary burden postoperatively which is likely to resolve by 12 weeks. This information enables physicians to provide counseling to caregivers by including them in the patients' surgical consultations. (J GYNECOL SURG 31:155)
    Journal of Gynecologic Surgery 06/2015; 31(3):155-161. DOI:10.1089/gyn.2014.0118
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    ABSTRACT: Dexamethasone is a corticosteroid with minimal side effects that may improve quality of recovery (QOR). We sought to evaluate standard use of this medication prior to vaginal reconstructive surgery. This was a double-blind-randomized-placebo-controlled trial of women undergoing vaginal reconstructive surgery for pelvic organ prolapse. Patients scheduled for an intraperitoneal vaginal vault suspension, with general anesthesia and an overnight stay were enrolled. The intervention arm received dexamethasone 60 minutes prior to surgery, controls received placebo. Postoperative pain medications, antiemetics, and voiding trials were standardized. Our primary outcome was difference in Quality of Recovery (QoR- 40) scores postoperative day one. Secondary measures included Postoperative Nausea and Vomiting Intensity scores (PONV), and Visual Analog Scales (VAS) for nausea/vomiting, and pain. Our power calculation demonstrated 31 subjects in each group would be necessary to document difference in QoR-40 scores; to allow for attrition a goal was 74 subjects was set. Seventy-four women were enrolled and randomized. Two withdrew, 9 were excluded, and 63 analyzed (36 placebo, 27 dexamethasone). The mean age was 63 years. No significant differences were noted among demographics other than American Society for Anesthesiologists class; there were greater numbers of dexamethasone subjects that were class 3 (5 vs 11; p=0.030). Postoperatively, more patients in the placebo group required promethazine as a rescue antiemetic for control of their nausea/vomiting (11 vs 2; p=0.029). Placebo subjects also failed their voiding trials more frequently, which remained following a logistic regression controlling for suburethral sling (30 vs 15; p=0.037). Regarding the QoR-40 following surgery, the emotional state domain declined less in dexamethasone patients (-14.3 IQR 16.8 vs -4.6 IQR 20.1; p=0.042), indicating better symptoms. While pain scales were similar, the VAS for nausea/vomiting was lower in dexamethasone subjects (0.7 IQR 4.1 vs 0.4 IQR 1.4; p=0.042). PONV scores were not significantly different, nevertheless twice as many placebo subjects had severe range symptoms (4 vs 2; p=0.47). No adverse effects from the dexamethasone were noted. Use of dexamethasone prior to vaginal reconstructive surgery was associated with less nausea/vomiting and need for antiemetics as well as greater success with voiding trials. Furthermore, QOR was enhanced, suggesting use of dexamethasone should be considered for these patients. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of obstetrics and gynecology 05/2015; DOI:10.1016/j.ajog.2015.05.061 · 4.70 Impact Factor
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    ABSTRACT: To characterize male preferences of vulvar appearance, their awareness of labiaplasty, and their knowledge of genital anatomy. Males 18 to 80 years old were recruited via emails sent by an Internet provider (Infogroup®) to participate in a 27 question web-based survey. The questionnaire included images and queried demographics, men's familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty. Two deployments to over 150,000 email addresses were sent. Demographic data was described using frequencies for categorical variables and mean measures of central tendency for continuous variables. Logistic regression models were used to analyze associations between demographics and responses. 2,403 males responded to the survey. After excluding incomplete and ineligible surveys, 1,847 were analyzed. The median age of respondents was 55 years. The majority was White (87%), married (68%), employed (69%), and completed high school or beyond (97%). A third of respondents lived in the South, with the other regions nearly equally represented. A significant majority, 95%, reported having been sexually active with women, and 86% felt comfortable labeling the vulvar anatomy. With regard to preferences, more respondents considered smaller labia attractive compared to large labia, yet 36% remained neutral. Men also showed a preference for partially or completely groomed genitals compared to natural hair pattern. Whereas 51% of participants felt the appearance of a woman's labia influenced their desire to engage in sexual activity, 60% denied it affected sexual pleasure. Only 42% of men were familiar with labiaplasty, and 75% of all respondents would not encourage a female partner to change her genital appearance. Multivariable analysis revealed younger age to be associated with preferences for small labia and complete genital hair removal, as well as familiarity with labiaplasty. In this national survey, men demonstrated familiarity with the female anatomy, but many did not feel it impacted sexual desire or pleasure. Moreover, the majority lacked strong preferences for a specific vulvar appearance and would not encourage a female partner to surgically alter her genital appearance. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of obstetrics and gynecology 05/2015; 110. DOI:10.1016/j.ajog.2015.05.063 · 4.70 Impact Factor

  • Journal of Minimally Invasive Gynecology 04/2015; 22(3). DOI:10.1016/j.jmig.2014.12.011 · 1.83 Impact Factor

  • Journal of Minimally Invasive Gynecology 04/2015; 22(3). DOI:10.1016/j.jmig.2014.12.012 · 1.83 Impact Factor

  • Journal of Minimally Invasive Gynecology 03/2015; 22(3):S55. DOI:10.1016/j.jmig.2014.12.112 · 1.83 Impact Factor
  • C.C. Crisp · C.V. Herfel · R.N. Pauls · L.B. Westermann · S.D. Kleeman ·

    Journal of Minimally Invasive Gynecology 03/2015; 22(3):S5-S6. DOI:10.1016/j.jmig.2014.12.019 · 1.83 Impact Factor

  • Journal of Minimally Invasive Gynecology 03/2015; 22(3):S48. DOI:10.1016/j.jmig.2014.12.099 · 1.83 Impact Factor
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    ABSTRACT: Female sexual dysfunction (FSD) is a common disorder with limited data investigating relationships with psychological influences, such as personality traits and coping mechanisms. To investigate the relationship and impact of personality traits and coping strategies on female sexual function. A web-based survey was distributed to a sample of women representative of the area's demographic distribution. Participants completed the Female Sexual Function Index (FSFI), the Ten Item Personality Index (TIPI), and the Brief COPE. Five hundred twenty-six females responded. The mean total FSFI score was 24.56 (SD 6.77) with lowest scores in the desire domain. Personality scores were similar to published normative values. Subjects displaying stronger tendencies for introversion (r = 0.246, P < 0.001), not being open to new experiences (r = 0.159, P = 0.008), and emotional instability (r = 0.244, P < 0.001) were found to have significantly worse sexual function. Conscientiousness was significantly associated with better desire, orgasm, satisfaction, and total FSFI score (P = 0.029, P = 0.002, P = 0.005, P = 0.003). Moreover, the utilization of negative coping strategies such as self-blame, self-distraction, and behavioral disengagement, significantly correlated with poor sexual function (r = −0.298, P < 0.001, r = −0.360, P < 0.001, r = −0.398, P < 0.001, respectively). Personality and coping are linked to sexual function with introversion, not being open to new experiences, emotional instability, and the utilization of negative coping strategies being significantly associated with poor sexual function. Women presenting with sexual function complaints may need further evaluation of their personality and coping strategies in order to mitigate any negative impact of these tendencies. Crisp C, Vaccaro C, Fellner A, Kleeman S, and Pauls R. The influence of personality and coping on female sexual function: A population survey. J Sex Med 2015;12:109–115.
    Journal of Sexual Medicine 12/2014; 12(1). DOI:10.1111/jsm.12735 · 3.15 Impact Factor
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    ABSTRACT: Objective: To evaluate systemic markers of collagen metabolism and vitamin C in female smokers with pelvic organ prolapse (POP). Secondary aims were to compare these levels in women based on prolapse or smoking history alone. Study design: This was a cross-sectional study with four groups: smokers with POP, non-smokers with POP, smokers without POP and non-smokers without POP. Subjects were age-matched based on smoking history and presence of POP. All underwent a fasting blood panel, including plasma procollagen 1-N propeptide (P1NP), matrix metalloproteinase 9 (MMP-9), and vitamin C. Results: Ninety-six subjects were enrolled. There were no differences for any demographics other than stage of prolapse, which was highest in non-smokers with POP. Significant variations in the levels of vitamin C and MMP-9 were noted among the four groups. Smokers with POP had lower levels of vitamin C and higher levels of MMP-9, compared to non-smokers with POP, but this relationship was not statistically significant. However, when contrasting smokers without POP to non-smokers without POP, significant differences in both vitamin C and MMP-9 were documented, confirming an impact of smoking on these markers. Notwithstanding, when evaluated independent of smoking status, vitamin C and MMP-9 levels in women with POP were similar to those of women without POP. Conclusion: Lower vitamin C and higher MMP-9 among smokers confirms the usefulness of such markers in documenting the smoking's impact on collagen. However, the lack of a difference based on POP suggests these are poor measures for understanding the pathophysiology of this disorder.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 11/2014; 184. DOI:10.1016/j.ejogrb.2014.11.009 · 1.70 Impact Factor
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    ABSTRACT: Objectives: Pelvic floor physical therapy (PFPT) is often used as a treatment of pelvic floor disorders and may improve function after pelvic reconstructive surgery. However, the long-term impact of this modality is not understood. Methods: This randomized controlled trial compared PFPT to the standard care in women undergoing vaginal reconstruction. The intervention group received PFPT biweekly until 12 weeks postoperatively, in conjunction with a physician assessment. Control subjects underwent a physician assessment alone at all postoperative intervals. The final follow-up was at 24 weeks. Physical examinations (pelvic organ prolapse quantification assessment), intravaginal electromyography, voiding diaries, and validated questionnaires were completed by all subjects. The primary outcome was change in the World Health Organization Quality of Life-BREF. Results: Forty-nine women completed the study, 24 in the PFPT group and 25 in the control group. Although electromyography measures showed better muscular function in PFPT subjects after 12 weeks, at 6 months after surgery, this was no longer noted. However, quality of life parameters improved for the entire sample at 24 weeks, with no difference between groups. Positive change from 12 to 24 weeks was also documented in scores on the Pelvic Floor Distress Inventory-20 (P = 0.04) and Pelvic Floor Impact Questionnaire-7 (P = 0.018), corresponding with continued improvement in bladder symptoms. Finally, Prolapse and Incontinence Sexual Questionnaire-12 and Female Sexual Function Index scores improved between 12 and 24 weeks, suggesting better sexual function overall with time elapsed from surgery. Conclusions: Quality of life improves in all subjects after vaginal reconstructive surgery, with ongoing benefit between 3 and 6 months. Nevertheless, standardized PFPT was not associated with differences at 24 weeks in this cohort of women.
    09/2014; 20(6). DOI:10.1097/SPV.0000000000000090
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    ABSTRACT: In 2011, the Accreditation Council for Graduate Medical Education implemented work restrictions for interns (Postgraduate Year [PGY] 1) to combat potential physical and emotional burdens. We hypothesized resident burnout remains high despite these limitations. This web-based survey queried Ohio-based residents in general surgery, obstetrics-gynecology, family medicine, and internal medicine using general questions, Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression scale, and Maslach Burnout Inventory. One hundred forty-nine residents responded: 39 general surgery (26.2%), 37 obstetrics-gynecology (24.8%), 27 family medicine (18.1%), and 46 internal medicine (30.9%). The majority was PGY-1 (36.2%), female (55%), aged 20-29 years (57.7%), and married (52.3%) with no children (75%). Many reported 5-6 hours of sleep per night (55.7%) and 0-3 days per week of exercise (81.9%). There were no differences between junior and senior residents regarding demographics, sleep, or activity; however, seniors had a higher Maslach Burnout Inventory personal accomplishment domain mean (standard deviation) score (39.0 [5.2] compared with 37.1 [7.2], P=.07). Factors associated with an increased score on the Maslach Burnout Inventory depression domain were more residents per year (P=.015) and graduation from a U.S. medical school (P<.001). Decreased physical activity was related to higher Maslach Burnout Inventory emotional exhaustion (P<.001). Increased Epworth Sleepiness Scale sleepiness and higher Center for Epidemiologic Studies Depression scale depression were associated with more work (P=.03; P=.019) and less sleep (P=.013; P=.007). Although the Accreditation Council for Graduate Medical Education restricts work hours for interns, we found no differences based on PGY level regarding Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression scale, or Maslach Burnout Inventory except for the personal accomplishment domain score. At all levels, programs should encourage and teach coping strategies for sleepiness and depression.
    Obstetrics and Gynecology 05/2014; 123 Suppl 1:117S-8S. DOI:10.1097/01.AOG.0000447069.63200.d8 · 5.18 Impact Factor

  • Journal of Minimally Invasive Gynecology 03/2014; 21(2):S39. DOI:10.1016/j.jmig.2013.12.061 · 1.83 Impact Factor
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    ABSTRACT: Introduction: The female sexual response is dynamic; anatomic mechanisms may ease or enhance the intensity of orgasm. Aim: The aim of this study is to evaluate the clitoral size and location with regard to female sexual function. Methods: This cross-sectional TriHealth Institutional Board Review approved study compared 10 sexually active women with anorgasmia to 20 orgasmic women matched by age and body mass index (BMI). Data included demographics, sexual history, serum hormone levels, Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12), Female Sexual Function Index (FSFI), Body Exposure during Sexual Activity Questionnaire (BESAQ), and Short Form Health Survey-12. All subjects underwent pelvic magnetic resonance imaging (MRI) without contrast; measurements of the clitoris were calculated. Main outcome measures: Our primary outcomes were clitoral size and location as measured by noncontrast MRI imaging in sagittal, coronal, and axial planes. Results: Thirty premenopausal women completed the study. The mean age was 32 years (standard deviation [SD] 7), mean BMI 25 (SD 4). The majority was white (90%) and married (61%). Total PISQ-12 (P < 0.001) and total FSFI (P < 0.001) were higher for orgasmic subjects, indicating better sexual function. On MRI, the area of the clitoral glans in coronal view was significantly smaller for the anorgasmic group (P = 0.005). A larger distance from the clitoral glans (51 vs. 45 mm, P = 0.049) and body (29 vs. 21 mm, P = 0.008) to the vaginal lumen was found in the anorgasmic subjects. For the entire sample, larger distance between the clitoris and the vagina correlated with poorer scores on the PISQ-12 (r = -0.44, P = 0.02), FSFI (r = -0.43, P = 0.02), and BESAQ (r = -0.37, P = 0.04). Conclusion: Women with anorgasmia possessed a smaller clitoral glans and clitoral components farther from the vaginal lumen than women with normal orgasmic function.
    Journal of Sexual Medicine 02/2014; 11(4). DOI:10.1111/jsm.12450 · 3.15 Impact Factor
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    ABSTRACT: The objective of this study was to measure and model the passive biomechanics of cadaveric levator ani muscle in the fiber direction at low strains with a moderately slow deformation rate. Nine levator ani samples, extracted from female cadavers aged 64 to 96 years, underwent preconditioning and uniaxial biomechanical analysis on a tensile testing apparatus after the original width, thickness, and length were measured. The load extension data and measured dimensions were used to calculate stress-strain curves for each sample. The resulting stress-strain curves up to 10% strain were fit to four different constitutive models to determine which model was most appropriate for the data. A power-law model with two parameters was found to fit the data most accurately. Constitutive parameters did not correlate significantly with age in this study; this may be because all of the cadavers were postmenopausal.
    Journal of Biomechanics 11/2013; 47(2). DOI:10.1016/j.jbiomech.2013.11.033 · 2.75 Impact Factor
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    ABSTRACT: The objective of this study was to compare the effect of virtual reality simulation training plus robotic orientation versus robotic orientation alone on performance of surgical tasks using an inanimate model. Surgical resident physicians were enrolled in this assessor-blinded randomized controlled trial. Residents were randomized to receive either (1) robotic virtual reality simulation training plus standard robotic orientation or (2) standard robotic orientation alone. Performance of surgical tasks was assessed at baseline and after the intervention. Nine of 33 modules from the da Vinci Skills Simulator were chosen. Experts in robotic surgery evaluated each resident's videotaped performance of the inanimate model using the Global Rating Scale (GRS) and Objective Structured Assessment of Technical Skills-modified for robotic-assisted surgery (rOSATS). Nine resident physicians were enrolled in the simulation group and 9 in the control group. As a whole, participants improved their total time, time to incision, and suture time from baseline to repeat testing on the inanimate model (P = 0.001, 0.003, <0.001, respectively). Both groups improved their GRS and rOSATS scores significantly (both P < 0.001); however, the GRS overall pass rate was higher in the simulation group compared with the control group (89% vs 44%, P = 0.066). Standard robotic orientation and/or robotic virtual reality simulation improve surgical skills on an inanimate model, although this may be a function of the initial "practice" on the inanimate model and repeat testing of a known task. However, robotic virtual reality simulation training increases GRS pass rates consistent with improved robotic technical skills learned in a virtual reality environment.
    Journal of Pelvic Medicine and Surgery 08/2013; 19(5):266-70. DOI:10.1097/SPV.0b013e3182a09101 · 1.09 Impact Factor
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    ABSTRACT: Although pelvic floor physical therapy (PFPT) can be beneficial for complaints after vaginal reconstructive surgery, it is not routinely offered to all patients. We sought to evaluate the role of perioperative PFPT in improving quality of life and function after prolapse repairs. This randomized controlled trial compared PFPT to standard care after vaginal reconstructive surgery. The intervention group received PFPT 2 weeks preoperatively and 2, 4, 6, 8, and 12 weeks postoperatively, as well as a physician assessment. Control subjects underwent a physician's assessment alone at the same time points postoperatively. Both groups completed pelvic organ prolapse quantification examinations, intravaginal electromyography (EMG), voiding diaries, and validated questionnaires at baseline and 12 weeks. The primary outcome was change in the World Health Organization Quality of Life-BREF scale after surgery. Forty-nine women completed the study: 24 women in the PFPT group and 25 women in the control group. At 12 weeks, condition-specific questionnaires improved for the entire sample, confirming effectiveness of surgery. Nevertheless, no significant differences were noted between the groups despite therapy with PFPT. However, intravaginal EMG measures were notably affected by the intervention. The PFPT group showed significantly lower averages across all measurements of rest, indicating positive impact on muscle function. Pearson correlations revealed associations with better scores on the World Health Organization Quality of Life-BREF physical domain and greater EMG relaxation, supporting effects from PFPT on quality of life. Pelvic symptoms improved in all subjects after vaginal reconstructive surgery. Whereas PFPT did not result in detectable subjective differences in this short-term study, superior muscular function suggested benefit from the intervention.
    Journal of Pelvic Medicine and Surgery 08/2013; 19(5):271-7. DOI:10.1097/SPV.0b013e31829c64ea · 1.09 Impact Factor
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    ABSTRACT: Despite its central role in sexual function, we lack a description of the nerve distribution and histology for the central components of the clitoris. This study aims to characterize microscopic anatomy of the clitoral-urethral complex (CUC) and aid our understanding of sexual sensation METHODS: The CUC was excised from three female fresh-frozen cadavers en bloc and prepared in 5-μm longitudinal sections with hematoxylin and eosin and S100 immunohistochemistry for neural elements. Approximately 20 sections were obtained from each specimen. On low power microscopy, the 30 most innervated fields on each section were identified. On high power, the total number of nerves per field was quantified, then was averaged. The histologic characteristics of each clitoral component were described. Two investigators evaluated all specimens. Descriptives of large (≥3 fibers) and small nerves based on location in the CUC. Nerve quantification revealed the glans to be the most populated by small nerves (52.1, standard deviation [SD] 26.2). As slices through each specimen moved caudad toward the urethra, the number of small nerves dramatically decreased from 40.4 (SD 10.8) in the body and 29.8 (SD 8.8) (superior CUC) near the bulb to 23.7 (SD 9.8) in the middle CUC and 20.5 (SD 10.4) (inferior CUC) near the urethra. Although the variation in small nerves was striking, large nerves were somewhat uniform and comprised a minority of the overall quantity. Neuroanatomy was consistent for all cadaver specimens. Our study provided a description of the nerve distribution throughout the central CUC. Increased density of small nerves in the glans suggests this is the location of heightened sensation. Decreasing quantity of nerves in segments closer to the urethra may indicate these zones are less important for sexual sensation. Knowledge of human clitoral innervation is important for understanding the complexities of the female sexual response cycle. Oakley SH, Mutema GK, Crisp CC, Estanol MV, Kleeman SD, Fellner AN, and Pauls RN. Innervation and histology of the clitoral-urethal complex: A cross-sectional cadaver study. J Sex Med **;**:**-**.
    Journal of Sexual Medicine 06/2013; 10(9). DOI:10.1111/jsm.12230 · 3.15 Impact Factor
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    ABSTRACT: Introduction and hypothesis: Intra-vaginal diazepam suppositories are commonly prescribed as a treatment option for high-tone pelvic floor myalgia. This triple-blinded placebo-controlled randomized trial sought to determine if 10 mg diazepam suppositories improve resting pelvic floor electromyography (EMG) compared with placebo. Methods: Women ≥18 years of age with hypertonic pelvic floor muscles on examination, confirmed by resting EMG ≥2.0 microvolts (μv), administered vaginal suppositories containing either diazepam or placebo for 28 consecutive nights. Outcomes included vaginal surface EMG (four measurements), the Female Sexual Function Index (FSFI), the Short Form Health Survey 12 (SF-12), four visual analog scales (VAS), the Patient Global Impression of Severity (PGI-S), and the Patient Global Impression of Improvement (PGI-I). A priori sample size calculation indicated that 7 subjects in each group could detect a 2-μv difference in resting EMG tone with 90% power. Results: Twenty-one subjects were enrolled. The mean age was 36.1 (SD 13.9) years, mean body mass index was 28.56 (SD 9.4), and the majority (85.7%) was Caucasian. When evaluating response to therapy, no difference was seen in any of the resting vaginal EMG assessments at any time point within subjects or between groups, nor was an interaction found. Additionally, no differences were noted in any of the validated questionnaires. Conclusions: When used nightly over 4 weeks, 10 mg of vaginal diazepam was not associated with improvement in resting EMG parameters or subjective outcomes compared with placebo. This suggests such that therapy alone may be insufficient in treating high-tone pelvic floor dysfunction.
    International Urogynecology Journal 05/2013; 24(11). DOI:10.1007/s00192-013-2108-9 · 1.96 Impact Factor
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    ABSTRACT: Background/aims: The Accreditation Council for Graduate Medical Education (ACGME) requires that all Ob/Gyn residents accomplish scholarly activity. We hypothesize resident productivity is poor. Methods: This was a web-based two-survey study using SurveyMonkey®. Surveys queried both program directors and residents regarding their adherence to ACGME guidelines. All 233 accredited Ob/Gyn programs were targeted. Results: 70 program directors responded (30.4%). The majority (99%) felt research was a goal of their program and stated their residents are taught to read current literature (99%), design basic studies (99%), and interpret simple statistics (89%). 17% (53/313) of the residents did not agree that their training environment promoted research, 25% did not feel comfortable discussing basic study designs, and 54% did not feel comfortable interpreting basic statistics. Urban programs demonstrated improved resident attitudes toward research (p = 0.025), better research environments (p = 0.007) and curricula (p = 0.001) compared to rural programs. Furthermore, residents intending to pursue an academic career were more likely to be working with a research mentor (p = 0.038). Conclusion: The ACGME clearly delineates residency research requirements. A dichotomy exists between program director perception and resident compliance. Notwithstanding, it is reassuring that the majority of programs appear to promote scholarly activity and provide necessary support.
    Gynecologic and Obstetric Investigation 03/2013; 75(4). DOI:10.1159/000348562 · 1.70 Impact Factor

Publication Stats

1k Citations
171.79 Total Impact Points


  • 2002-2015
    • Good Samaritan Hospital
      Cincinnati, Ohio, United States
  • 2006
    • Good Samaritan Hospital Dayton
      Dayton, Ohio, United States
    • Advocate Lutheran General Hospital
      Chicago, Illinois, United States
  • 2002-2005
    • University of Cincinnati
      • Department of Obstetrics and Gynecology
      Cincinnati, Ohio, United States
  • 2004
    • Bethesda Family Medicine Residency
      Cincinnati, Ohio, United States