Clinical research in gynecology has evolved from the management and treatment of pelvic infection to investigating more effective ways to treat well women and diagnose and treat gynecologic disorders.
Involvement in HPV Vaccine
Clinical trials dealing with antibiotic efficacy have been augmented by studies on human papilloma virus (HPV). This effort ultimately led to our participation in scientific trials of HPV vaccinations in the treatment and prevention of HPV infections. Today, the fruits of those trials are available to patients in the form of an HPV vaccine for adolescents and young adults.
Contraception Clinical Trials
In 2005, faculty in the division began participation in a multi-center National Institutes of Health Female Contraceptive Clinical Trials Network to investigate the effectiveness of different contraceptive treatments–such as spermicidal agents and the contraceptive ring. Although funding has been sporadic, the network continues to develop protocols to measure the effectiveness of various contraceptive options.
Focusing on the early detection and prevention of cervical cancer, researchers have participated in studies to facilitate identification and treatment of cervical dysplasia (precancerous abnormalities). They have developed guidelines for cervical cancer screening and medical management of abnormal Pap smears.
In a multi-year study, gynecologists evaluated the use of spectroscopy (lightwave technology) to identify cervical abnormalities. And, in one of the largest studies done to date, they investigated the subsequent risk of preterm birth following the use of loop excision to treat dysplasia.
This focus on dysplasia has led to the development of medical management protocols for vulvar and vaginal dysplasia, and the investigation of anal dysplasia in women with HIV infection.
In another study published in 2009, the addition of a saline solution into the uterine cavity during ultrasound was shown to improve visualization and identification of endometrial polyps in women with postmenopausal bleeding. The enhanced visualization facilitated biopsy and produced a diagnosis 89% of the time as compared to 52% for biopsy without saline-infused sonography.
As our population ages and women live longer, gynecologists recognize the need to better prepare physicians to detect and treat age-related disorders. Physicians in the division have received funding from the Southwestern Aging and Geriatric Education (SAGE) program to develop medical student and resident training modules in the geriatric care of the gynecology patient.