A novel objective evaluation method, shear wave elastography, in the treatment of atrophic vaginitis by nonablative intravaginal Er:YAG laser, a randomized-sham controlled pilot study.

OBJECTIVE: The aim of the study was to investigate the effectiveness of intravaginal Er:YAG laser for treating atrophic vaginitis in postmenopausal women utilizing shear wave elastography. METHODS: In this prospective randomized sham-controlled double-blind pilot study, 20 participants were included (laser group [n = 12] / sham-control group [n = 8]). A nonablative (Smooth mode) Er:YAG laser with a wavelength of 2,940 nm was used. Objective evaluation of laser treatment efficacy was conducted using a special ultrasonic technique: shear wave elastography. Ultrasonic velocity measurements were taken from the anterior and posterior vaginal walls. Mean elasticity (E mean ) was expressed in kilopascals (kPa). Additional outcome parameters were vaginal pH, Vaginal Health Index (VHI), Female Sexual Function Index (FSFI), and visual analog scale (VAS) scores for dyspareunia. RESULTS: Baseline clinical characteristics, vaginal pH, VHI, VAS and FSFI scores, and E mean values were comparable between the laser and sham-control groups. Statistically significant differences were observed in the final E mean values of the anterior vaginal wall (13.1 ± 6.3 vs 20.0 ± 3.3 kPA, P = 0.01) and posterior vaginal wall (12.7 ± 10.3 vs 19.4 ± 6.9 kPA, P = 0.04) between the laser and sham-control group. Despite comparable baseline E mean values, significant differences in vaginal wall stiffness posttreatment indicated a notable increase in tissue elasticity following laser treatment. Statistically significant differences were also observed in final vaginal pH values, VHI, VAS scores, and FSFI score improvement in favor of laser treatment. CONCLUSIONS: Shear wave elastography may be considered as a reliable and objective technique for evaluating the efficacy of Er:YAG laser treatment in women with atrophic vaginitis. However, additional studies with larger sample sizes are necessary to establish conclusive evidence.

The concern about the educational quality of online videos on laparoscopic myomectomy.

OBJECTIVE: The aim of this study was to analyze the surgical content of the 50 most-viewed laparoscopic myomectomy videos on YouTube while evaluating the educational quality and accuracy of the videos. METHODS: In this cross-sectional study, the keyword "laparoscopic myomectomy" was searched in publicly available content on YouTube, and the videos were sorted by view count using YouTube's advanced search options. Out of the first 66 videos, only 50 were eligible according to our selection criteria. One associate professor of gynecology and one gynecology resident watched these videos independently and evaluated the quality and surgical aspects. Our primary outcome was the scores of the Quality Criteria for Consumer Health Information and Global Quality Score and the features of the surgical technique. RESULTS: The 50 most-viewed laparoscopic myomectomy videos were uploaded between 2010 and 2021. They had a mean of 66636.6±103772.2 views. According to the Quality Criteria for Consumer Health Information criteria, 78% of the videos were categorized as "poor," 12% of them were "fair," and 10% of them were "very poor." The indication of the surgery was not specified in 27 (54%) of them. The surgeons in 39 (79.6%) of the videos did not use any containment system for the power morcellation, even though it was restricted by the United States Food and Drug Administration. The preoperative and perioperative precautions to minimize blood loss were underemphasized. There was no scientific evidence in 49 (98%) of the videos. CONCLUSION: Laparoscopic myomectomy videos on YouTube are limited in terms of providing evidence-based and well-organized scientific knowledge.

The concern about the educational quality of online videos on laparoscopic myomectomy

SUMMARY OBJECTIVE: The aim of this study was to analyze the surgical content of the 50 most-viewed laparoscopic myomectomy videos on YouTube while evaluating the educational quality and accuracy of the videos. METHODS: In this cross-sectional study, the keyword "laparoscopic myomectomy" was searched in publicly available content on YouTube, and the videos were sorted by view count using YouTube's advanced search options. Out of the first 66 videos, only 50 were eligible according to our selection criteria. One associate professor of gynecology and one gynecology resident watched these videos independently and evaluated the quality and surgical aspects. Our primary outcome was the scores of the Quality Criteria for Consumer Health Information and Global Quality Score and the features of the surgical technique. RESULTS: The 50 most-viewed laparoscopic myomectomy videos were uploaded between 2010 and 2021. They had a mean of 66636.6±103772.2 views. According to the Quality Criteria for Consumer Health Information criteria, 78% of the videos were categorized as "poor," 12% of them were "fair," and 10% of them were "very poor." The indication of the surgery was not specified in 27 (54%) of them. The surgeons in 39 (79.6%) of the videos did not use any containment system for the power morcellation, even though it was restricted by the United States Food and Drug Administration. The preoperative and perioperative precautions to minimize blood loss were underemphasized. There was no scientific evidence in 49 (98%) of the videos. CONCLUSION: Laparoscopic myomectomy videos on YouTube are limited in terms of providing evidence-based and well-organized scientific knowledge.