Rebecca G Rogers

University of New Mexico | UNM · Departments of Obstetrics and Gynecology and Surgery

Routine preoperative type and screen (T&S) is often ordered prior to urogynecological surgery but is rarely used. We aimed to assess the cost effectiveness of routine preoperative T&S and determine transfusion and transfusion reaction rates that make universal preoperative T&S cost effective. A decision tree model from the health care sector perspe...

There is a need for cost effective interventions that increase surgical preparedness in urogynecology. We performed an ancillary prospective economic evaluation of the Telehealth Intervention to Increase Patient Preparedness for Surgery (TIPPS) Trial, a randomized multicenter trial that evaluated the impact of a preoperative telehealth call on surg...

This manuscript of Chapter 4 of the International Urogynecological Consultation (IUC) on Pelvic Organ Prolapse (POP) reviews the literature and makes recommendations on the definition of success in the surgical treatment of pelvic organ prolapse. An international group containing seven urogynecologists performed an exhaustive search of the literatu...

Background On June 24, 2022, the Supreme Court of the United States in the case of Dobbs v Jackson Women's Health Organization ended constitutional protection for abortion, thus severely restricting access to reproductive health care for millions of individuals. Concerns have arisen about the potential impact on medical students, residents, and fel...

Objective: To describe the psychometric properties of existing patient-reported outcome measures for women with prolapse using the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) framework. Additional objectives were to describe the patient-reported outcome scoring method or interpretation, methods of adminis...

Chronic pelvic pain (CPP) is associated with a history of trauma and symptoms of somatoform dissociation. We aimed to describe how somatoform dissociation impacts CPP symptoms, surgical treatment, and health-related quality of life (HRQOL). Patients (N = 133) diagnosed with CPP presenting for an appointment at a women's health clinic between Novemb...

Importance: Patients highly value surgeon counseling regarding the first sexual encounters after pelvic reconstructive surgery. Objectives: We performed a qualitative analysis of usual surgeon counseling regarding return to sexual activity after surgery for pelvic organ prolapse and/or urinary incontinence. Methods: Participating surgeons prov...

Introduction and hypothesisWe sought to further develop and validate the Surgical Preparedness Assessment (SPA) scale to evaluate patient preparedness for urogynecological surgery.Methods This was a planned ancillary analysis of a randomized controlled trial (RCT) evaluating the impact of a preoperative telehealth call on patient preparedness for u...

Importance: The impact of language discordance on care for Spanish-speaking patients with pelvic floor disorders is unknown. Objective: The aim of this study was to compare the impact of language concordance with the impact of language discordance on the patient experience and trust in their provider. Methods: This cross-sectional cohort study...

Introduction and hypothesis: Microscopic hematuria (MH) has many etiologies in women and requires specific gynecologic evaluation. We created a standardized MH pathway to serve as an evidence-based decision aid for providers in our practice. Methods: Using a modified Delphi process, a multidisciplinary team reviewed existing guidelines for MH di...

Background High betrayal trauma (HBT), or interpersonal trauma perpetrated by someone close, is linked to dissociation and shame, while trauma perpetrated by someone less close, low betrayal trauma (LBT) is associated with post-traumatic stress disorder (PTSD). Objective Child interpersonal trauma is common among women with chronic pelvic pain (CP...

Introduction and hypothesisPatient-reported outcome measure instruments include patient-reported outcomes (PROs) and patient-reported goals (PRGs), which allow practitioners to measure symptoms and determine outcomes of treatment that matter to patients.Methods This is a structured review completed by the International Urogynecology Consultation (I...

This is about terminology usage in Genitourinary Fistula which has been termed as Pelvic Floor Fistula

Introduction and hypothesisEvidence-based care pathways improve care standardization and patient outcomes. We created pelvic organ prolapse (POP) and stress urinary incontinence (SUI) care pathways as decision aids for our multidisciplinary team to use when counseling patients.Methods Using a modified Delphi process, an expert team reviewed existin...

(Abstracted from Am J Obstet Gynecol 2021;224:498.e1–498.e10) Involuntary urine loss associated with a sudden sense of urgency, known as urgency urinary incontinence (UUI), affects millions of women and significantly impairs quality of life. Altered perceptual awareness has been theorized to play a role in UUI, with functional magnetic resonance im...

Introduction and hypothesisThe objective was to compare body image and sexual activity and function changes up to 3 years after sacrospinous ligament fixation with graft hysteropexy or vaginal hysterectomy with uterosacral ligament suspension (hysterectomy).Methods This was a planned secondary analysis of a multi-center randomized trial of women un...

Objective: To describe the timing, quality and patient concerns regarding the first sexual encounter after surgery for pelvic organ prolapse (POP) or urinary incontinence (UI). Methods: Women scheduled to undergo POP or UI surgery who self-identified as sexually active were recruited to this qualitative study. Routine counseling regarding the re...

Background The urogenital microbiome is associated with urgency and mixed urinary incontinence symptoms and differential treatment response to pharmacotherapy for urgency urinary incontinence. Objective To describe whether the preoperative urinary and vaginal microbiomes were associated with treatment response 12-months after mid-urethral sling su...

Objective Women consider preservation of sexual activity and improvement of sexual function as important goals following pelvic organ prolapse (POP) surgery. The aim of this systematic review is to compare sexual activity and function before and after prolapse surgery between specific approaches to POP surgery including native tissue (NT) repairs,...

Introduction and hypothesisMethods to increase surgical preparedness in urogynecology are lacking. Our objective was to evaluate the impact of a preoperative provider-initiated telehealth call on surgical preparedness.Methods This was a multicenter randomized controlled trial. Women undergoing surgery for pelvic organ prolapse and/or stress urinary...

Introduction and hypothesisThis was a planned secondary analysis of a systematic review that described sexual function outcomes following pelvic organ prolapse (POP) surgery. We aimed to describe the relationship of pre- and postoperative vaginal anatomic measures with sexual function outcomes. Data Sources included the Medline, Embase, and clinica...

Objectives: Colocated services in a team-based integrated practice unit (IPU) optimize care of pelvic floor disorders. Our goal was to compare ancillary service utilization in a multidisciplinary IPU between patients covered by a bundled payment model (BPM) versus a traditional fee-for-service model (FFSM). Methods: Medical records of women attend...

Women with pelvic floor disorders (PFDs) report rates of sexual activity that are similar to those of women without PFDs. Nonetheless, rates of sexual dysfunction are thought to be higher than in the general population. The contribution of pelvic floor disorders to sexual dysfunction is unknown, but women with more symptomatic pelvic floor disorder...

Objective: We aimed to systematically review the literature to describe sexual activity and function before and after prolapse surgery. Data sources: We searched MEDLINE, EMBASE, and ClinicalTrials.gov databases from inception to April 2018. Methods of study selection: Prospective, comparative studies of reconstructive pelvic organ prolapse (P...

Introduction and hypothesisFecal incontinence treatment goals are understudied and are not described for women presenting to care. Our objective was to explore patient-reported goals for fecal incontinence management among women presenting for care at a pelvic floor disorders clinic and develop a conceptual framework that captures the range of desi...

Introduction: The terminology for female pelvic floor fistulas (PFF) needs to be defined and organized in a clinically based consensus Report. Methods: This Report combines the input of members of the International Continence Society (ICS) assisted at intervals by external referees. Appropriate core clinical categories and a sub‐classification were...

Background Prior study of patients with urgency urinary incontinence by functional magnetic resonance imaging showed altered function in areas of the brain associated with interoception and salience and with attention. Our randomized controlled trial of hypnotherapy for urgency urinary incontinence demonstrated marked improvement in urgency urinary...

Nine percent of adult women experience episodes of fecal incontinence at least monthly. Fecal incontinence is more common in older women and those with chronic bowel disturbance, diabetes, obesity, prior anal sphincter injury, or urinary incontinence. Fecal incontinence negatively affects quality of life and mental health and is associated with inc...

Objectives: To evaluate if age and medical comorbidities are associated with progression to implantation of sacral neuromodulation devices in women with symptomatic chronic urinary retention. Methods: This multisite retrospective cohort included women with symptomatic chronic urinary retention who had a trial phase of sacral neuromodulation. The...

Introduction and hypothesisWe describe the responsiveness and minimally important difference (MID) of the Accidental Bowel Leakage Evaluation (ABLE) questionnaire.Methods Women with bowel leakage completed ABLE, Patient Global Impression of Improvement, Colo-Rectal Anal Distress Inventory, and Vaizey questionnaires pretreatment and again at 24 week...

Ineffective healthcare delivery and expenditures associated with traditional fee for service in-person models have turned attention towards alternative payment models as a means of enhancing healthcare quality in the United States. Bundled Care Payment Models are a form of alternate payment models that provide a single reimbursement for all service...

Objectives: The aim of this study was to determine if a perineorrhaphy at the time of apical pelvic organ prolapse surgery positively affects women's body image. Methods: This is a randomized controlled trial of women undergoing apical suspension procedures in which women (GH ≥2 cm to ≤6 cm) received either perineorrhaphy or no perineorrhaphy. T...

Surgeries for pelvic organ prolapse (POP) are common, but standardization of surgical terms is needed to improve the quality of investigation and clinical care around these procedures. The American Urogynecologic Society and the International Urogynecologic Association convened a joint writing group consisting of 5 designees from each society to st...

Background: Questionnaires assessing accidental bowel leakage lack important patient-centered symptoms. Objective: We aimed to create a valid measure of accidental bowel leakage symptoms. Design: We previously created a conceptual framework capturing patient-centered accidental bowel leakage symptoms. The framework included bowel leakage type,...

Female genital cosmetic surgery (FGCS) aims to alter the structure and appearance of female genitalia to attain the desired shape, size or look, or to decrease labial interference during intercourse, relieve pain and discomfort with clothing and exercise or decrease vaginal caliber and laxity. In the last 5 years, the number of labiaplasty surgerie...

(Abstracted from JAMA 2019;322:1054–1065) Two surgical options for patients with uterovaginal prolapse are vaginal hysterectomy with suture apical suspension or transvaginal mesh hysteropexy, a uterine preservation procedure. An analysis of a US database from 2007 to 2011 estimated that 13% of women underwent pelvic organ prolapse surgery by the ag...

Purpose: Sacral neuromodulation and intradetrusor injection of onabotulinumtoxinA are therapies for refractory urgency-urinary incontinence. Sacral neuromodulation involves surgical implant of a device that can last 4-6 years, while onabotulinumtoxinA involves serial office injections. Objective was to assess cost-effectiveness of 2-stage implanta...

Objective: Defecatory symptoms, such as sense of incomplete emptying and straining with bowel movements, are paradoxically present in women with fecal incontinence (FI). Treatments for FI, such as loperamide and biofeedback, can worsen or improve defecatory symptoms, respectively. The primary aim of this study was to compare changes in constipatio...

Objectives: Peer counseling may improve upon provider counseling and enhance patient preparedness for midurethral sling (MUS) surgery. We aimed to compare the impact of peer-centered versus standard preoperative video counseling by assessing patient preparedness for MUS surgery. Methods: Women undergoing MUS were randomized to view either a peer...

Importance Vaginal hysterectomy with suture apical suspension is commonly performed for uterovaginal prolapse. Transvaginal mesh hysteropexy is an alternative option. Objective To compare the efficacy and adverse events of vaginal hysterectomy with suture apical suspension and transvaginal mesh hysteropexy. Design, Setting, Participants At 9 clin...

Introduction and hypothesis The benefits of peer support for pelvic floor disorders are unclear. We hypothesize that perioperative peer support might be associated with greater preoperative preparedness compared with usual care in women undergoing pelvic reconstruction. Methods A multicenter prospective cohort study of women undergoing pelvic reco...

Background: Well designed, large comparative effectiveness trials assessing the efficacy of primary interventions for faecal incontinence are few in number. The objectives of this study were to compare different combinations of anorectal manometry-assisted biofeedback, loperamide, education, and oral placebo. Methods: In this randomised factorial t...

Objective: To evaluate the effects of Mind Over Matter: Healthy Bowels, Healthy Bladder, a small-group intervention, on urinary and bowel incontinence symptoms among older women with incontinence. Methods: In this individually randomized group treatment trial, women aged 50 years and older with urinary, bowel incontinence, or both, were randomly...

Background: Although the vaginal and urinary microbiomes have been increasingly well-characterized in health and disease, few have described the relationship between these neighboring environments. Elucidating this relationship has implications for understanding how manipulation of the vaginal microbiome may affect the urinary microbiome and treat...

Background: Urgency urinary incontinence afflicts many adults, and most commonly affects women. Medications, a standard treatment, may be poorly tolerated, with poor adherence. This warrants investigation of alternative interventions. Mind-body therapies such as hypnotherapy may offer additional treatment options for individuals with urgency urina...

Introduction To explore the effect of prepregnancy body mass index (BMI) and gestational weight gain on postpartum weight retention in nulliparous women and weight‐for‐length percentiles of offspring to 2 years following birth. Methods A retrospective secondary analysis of a large, prospective longitudinal study of women conducted during pregnancy...

Background: Well designed, large comparative effectiveness trials assessing the efficacy of primary interventions for faecal incontinence are few in number. The objectives of this study were to compare different combinations of anorectal manometry-assisted biofeedback, loperamide, education, and oral placebo. Methods: In this randomised factoria...

Introduction and hypothesis Patient perception of adverse events (AEs) after pelvic floor disorder surgery is incompletely understood and may differ from providers’ views of AEs. Our objective is to describe patient perceptions of AEs related to pelvic floor disorder surgery and how perceptions change over time. Methods Mixed-method study of longi...

(Abstracted from Am J Obstet Gynecol 2019;220:185.e1–185.e10) Surgical adverse events (AEs) following urogynecological surgery are common. The incidence of any AEs in surgical studies ranges from 30% to 76%, and serious AEs range from 3% to 17%.

Objective: This study aimed to describe the association between patient ethnicity/race and desire to continue using a pessary for the treatment of pelvic floor disorders. Methods: We performed a secondary analysis of a randomized trial among women presenting for pessary fitting. The primary outcome was the desire to continue using a pessary at 3...

Introduction and hypothesis Our aim was to determine whether postoperative telephone follow-up was noninferior to in-person clinic visits based on patient satisfaction. Secondary outcomes were safety and clinical outcomes. Methods Women scheduled for pelvic surgery were recruited from a single academic institution and randomized to clinic or telep...

Background: Utility preference scores are standardized, generic, health-related quality of life (HRQOL) measures that quantify disease severity and burden and summarize morbidity on a scale from 0 (death) to 1 (optimal health). Utility scores are widely used to measure HRQOL and in cost-effectiveness research. Objective: To determine the respons...

Background: The Institute for Healthcare Improvement defines an adverse event as an unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization or that results in death. The majority of research has focused on adverse events from the provider's perspective. Objecti...

Background: More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI. Methods: We conducted a cross-sectional electronic survey of PCPs within a Midwest academic instit...

Introduction and hypothesis Rectopexy and sacrocolpopexy can be performed concurrently to treat rectal and vaginal prolapse. We hypothesized that concurrent procedures might be associated with more complications than rectopexy and sacrocolpopexy alone. Methods Patients undergoing laparoscopic sacrocolpopexy or rectopexy, or concurrent laparoscopic...

Introduction & hypothesis Previous studies have suggested that women with urinary incontinence have an altered urinary microbiome. We hypothesized that the microbiome in women with mixed urinary incontinence (MUI) differed from controls and tested this hypothesis using bacterial gene sequencing techniques. Methods This multicenter study compared t...

(Abstracted from Obstet Gynecol 2018;131:469–474) The criterion standard surgery for stress urinary incontinence (SUI) is the midurethral sling procedure. Since its introduction in 1997, this procedure has been widely used for pelvic reconstructive surgery.

(Abstracted from Obstet Gynecol 2018;131:475–483) The incidence of posthysterectomy prolapse ranges from 6% to 8%. Many surgeons treat posthysterectomy or vault prolapse differently than uterovaginal prolapse in women planning to undergo surgery for apical pelvic organ prolapse (POP), because they believe that a previous hysterectomy increases both...

Introduction and hypothesis: We compared treatment success and adverse events between women undergoing open abdominal sacrocolpopexy (ASC) vs vaginal repair (VAR) using data from women enrolled in one of three multicenter trials. We hypothesized that ASC would result in better outcomes than VAR. Methods: Participants underwent apical repair of s...

Introduction Chronic pelvic pain (CPP) affects an estimated 30% of women Veterans. Previous research shows high rates of narcotic abuse in the women Veteran population. Narcotics are not recommended for the treatment of CPP. Understanding how CPP impacts narcotic prescribing in the women Veteran population is critical to addressing the public healt...

Objective: The objective of this study was to compare women with a known diagnosis of interstitial cystitis (IC) to a population that might be at risk for the diagnosis of IC, women with diagnoses of both chronic pelvic pain (CPP) and overactive bladder (OAB). Methods: We conducted a retrospective study of data from the Veterans Affairs Corporat...

Introduction and hypothesis: The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus rep...

Aims: The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. Methods: This re...

Objective: To assess whether there is any association between the implantation of synthetic polypropylene mesh slings for the treatment of stress urinary incontinence (SUI) and risk of cancer. Methods: We performed a nationwide cohort study based on the general female population in Sweden. All women entered the observational period as unexposed...

Objective: To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II-IV prolapse. Methods: Women in one of three Pelvic Floor Disorders Network prolapse surgical trials were included. Absence of bothersome bulge sympt...

Objective: To evaluate the association between pharmacologic therapy for urgency urinary incontinence (UUI) and sleep quality. Methods: We conducted a planned secondary data analysis of sleep outcomes in a previously conducted multicenter, double-blind, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence among...

Objective: The objective of this study was to examine the strength and direction of the association between urinary symptoms and both poor quality sleep and daytime sleepiness among women with urgency urinary incontinence. Methods: A planned secondary analysis of baseline characteristics of participants in a multicenter, double-blinded, 12-week...

Objective: To describe women's pain and experiences with immediate postpartum intrauterine device (IUD) insertion (IPPI) following vaginal delivery using a ring forceps insertion technique. Study design: This observational mixed methods study included women who underwent successful IPPI using ring forceps, with and without epidural analgesia. To...

Introduction: Little is known about the impact of MST on chronic pain conditions among female Veterans. The primary objective of this study was to compare the prevalence of chronic pain conditions among U.S. female veterans with a history of military sexual trauma (MST) to those without a history of MST. We anticipated that female Veterans with a...

Introduction and hypothesis: Urinary incontinence (UI)-defined as a complaint of involuntary loss of urine-is common in women, with major public health, financial, and quality of life (QoL) implications. Despite the high toll of UI and the availability of effective conservative treatments, many women with UI do not seek care. Those who do often co...

Objectives: The aims of this study were to describe relationships between women given a diagnosis of nocturnal enuresis (NE) and controls without any urinary complaints and to compare women with NE with those with overactive bladder (OAB). We hypothesized that NE has unique associations with demographics and medical and psychosocial diagnoses. Me...

INTRODUCTION Narcotics are prescribed to treat debilitating pelvic pain without proved efficacy, and with significant harm risk. Our objective was to compare chronic narcotic use (CNU) and average narcotic doses prescribed 5 years prior and following chronic pelvic pain (CPP) diagnosis. METHODS We used the validated Veteran’s affairs corporate dat...

Introduction and hypothesisWe describe pelvic floor function in nulliparous pregnant women. Materials and methodsNulliparous midwifery patients completed the Incontinence Severity Index (ISI), Pelvic Floor Impact Questionnaire (PFIQ-7), Wexner Fecal Incontinence Scale (W), and answered questions about sexual activity and perineal pain at baseline d...

Introduction and hypothesis: Fewer than 30% of women with accidental bowel leakage (ABL) seek care, despite the existence of effective, minimally invasive therapies. We developed and validated a condition-specific instrument to assess barriers to care-seeking for ABL in women. Methods: Adult women with ABL completed an electronic survey about co...

Objective: The aim of this study was to identify clinical and demographic characteristics that moderate response to treatment with fesoterodine among women with a diagnosis of urgency-predominant urinary incontinence. Methods: A multicenter, double-blinded, 12-week randomized controlled trial of pharmacologic therapy for urgency-predominant urin...

Introduction and hypothesis: We describe changes in sexual activity and function among pregnant nulliparous women. Methods: This secondary analysis evaluated sexual activity and function with the Female Sexual Function Index (FSFI) at baseline in the first (T1), second (T2) and early third (T3) trimester. Evaluation was repeated in T3 after 36 c...

Introduction and hypothesisWe describe the rationale and methods of a study designed to compare vaginal and urinary microbiomes in women with mixed urinary incontinence (MUI) and similarly aged, asymptomatic controls. Methods This paper delineates the methodology of a supplementary microbiome study nested in an ongoing randomized controlled trial c...

Introduction and hypothesisWe describe the rationale and methodology for a study comparing mind–body treatment and pharmacotherapy in women with urgency urinary incontinence (UUI). To explore brain associations in UUI, a subset of patients will also undergo functional magnetic resonance imaging (fMRI). We hypothesize that hypnotherapy, a mind–body...

Objectives: The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP). Methods: Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and rec...

Objectives: This study aimed to describe the relationship between genital hiatus (GH) and perineal body (PB) measurements with increasing pelvic organ prolapse (POP) stage in a large cohort of women referred to Urogynecology clinic for pelvic floor disorders. Methods: Retrospective chart review of all new patients seen in an academic Urogynecolo...

Pelvic fistulae are an abnormal communication among the genitourinary tract, the gastrointestinal tract, and the vagina or perineum. Genital tract fistulae have been described in the medical literature for the past several thousand years. Advancements in both the diagnosis and treatment of vaginal fistulae have been obtained over the past century a...

Purpose: Current patient-reported outcomes for female urinary incontinence (UI) are limited by their inability to be tailored. Our objective is to describe the development and field testing of seven item banks designed to measure domains identified as important UI in females (UIf). We also describe the calibration and validation properties of the...