Variables Associated With Resolution and Persistence of Ovarian Cysts.

OBJECTIVE: To estimate surveillance intervals of incident ovarian cysts, and describe variables associated with cyst resolution times. METHODS: The UK-OCST (University of Kentucky Ovarian Cancer Screening Trial) was a prospective cohort that enrolled 47,762 individuals over 30 years, including 2,638 individuals with incident cysts. Cyst diameter and structure and patient age, body mass index, use of hormone therapy (HT), family history of ovarian cancer, and menopausal status were examined as variables associated with cyst resolution using t tests, χ 2 test, Kaplan Meier, and Cox multiple regression. RESULTS: Of 2,638 individuals with incident cysts, 1,667 experienced resolution (63.2%) within 1.2 years, and 971 experienced persistence (36.8%). Within 1 year, unilocular and septated cysts had similar resolution rates (35.4% and 36.7%, respectively, P >.05), but time to resolution was shorter for unilocular cysts compared with septated cysts (mean 1.89 years vs 2.58 years, respectively, P <.001). Both unilocular and septated cysts smaller than 3 cm resolved faster than cysts larger than 6 cm ( P <.001). Variables associated with percent resolution included being of younger age, premenopausal status (but not for synchronous bilateral cysts), and those reporting a family history of ovarian cancer ( P <.05). Variables associated with a faster cyst resolution rate included being older than age 70 years and not using hormone therapy. Body mass index and family history were not associated with cyst resolution time. CONCLUSION: Different surveillance times may be appropriate depending on cyst structure and size and patient age and HT use. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov , NCT04473833.

Does Mid-Urethral Sling Surgery in the Treatment of Stress Urinary Incontinence Affect Weight Changes in Women? A Retrospective Cohort Study Using Internal Controls.

OBJECTIVE: Stress urinary incontinence (SUI) is a common disorder among women. This is particularly bothersome to physically active women, such as those who serve in the Armed Forces. With the documented success of the midurethral sling (MUS) in the treatment of SUI, more women are electing to undergo surgical treatment. Studies document that women have less inhibition about exercise as a result of decreased incontinence following MUS surgery. We sought to determine if MUS surgery is associated with a change in weight postoperatively resulting from increased levels of activity following surgery. We hypothesized that women, particularly active duty (AD) women, would experience a decrease in weight and body mass index (BMI) in the year following the MUS procedure. METHODS: This retrospective cohort study used the military electronic medical record system. The subjects included AD military and civilian (CV) patients who underwent MUS surgery at tertiary care centers between July 2006 and March 2013. Weight and BMI were recorded for three distinct time periods: 1-year preoperatively, at time of surgery, and 1-year postoperatively. RESULTS: A total of 207 women met inclusion criteria, 76 of which were AD women in the U.S. military. For the group as a whole, we found no significant difference in mean weight or BMI among the three time points examined; however, decreases in BMI and weight were noted in the year following surgery for the subgroups of AD and obese women. Analysis of covariance showed that age, parity, preoperative weight, and concomitant hysterectomy were not significant determinants for change in weight postoperatively. CONCLUSION: Despite its effective treatment of SUI, MUS surgery did not significantly affect the weight of patients postoperatively in our retrospective cohort.