Episodes

  • Ep. 97 Tubo-Ovarian Abscess Management: Interventions & Outcomes with Dr. Katherine Smith

    Ep. 97 Tubo-Ovarian Abscess Management: Interventions & Outcomes with Dr. Katherine Smith
    Nov 25 2025
    Everything you need to know about tubo-ovarian abscesses (TOAs): breaking the stigma, safer treatment, fertility preservation, and better outcomes. This episode of BackTable OBGYN features Dr. Katherine Smith, an assistant professor and MIGS Fellowship Program director at UT Southwestern. With hosts Dr. Amy Park and Dr. Mark Hoffman, Dr. Smith provides an extensive overview of contemporary TOA management, emphasizing the significance of early intervention and the evolving understanding of TOAs beyond traditional STI etiologies. --- SYNPOSIS The conversation delves into the management of TOAs, both non-ruptured and ruptured, and the underexplored connection to the female reproductive tract microbiome. They also touch on the integration of AI in clinical practice, particularly in streamlining administrative tasks. The episode underscores the need for updated guidelines and more research into the microbiological aspects of TOAs to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 02:20 - Understanding TOAs: Early Interventions and Challenges04:43 - Clinical Management of TOAs08:06 - Surgical Approaches and Considerations22:25 - Microbiome and Infection Insights32:10 - Discussing Patient Reactions and Education32:47 - Teaching Practices and Medical Education34:18 - Clinical Observations and Data36:55 - Surgical Management of Ruptured TOAs40:50 - Challenges in Treating Infected Endometriomas50:13 - Exploring the Role of AI in Medical Practice54:23 - Concluding Remarks --- RESOURCES ACOG Recommends Concurrent Sexual Partner Treatment for Recurrent Bacterial Vaginosis for the First Timehttps://www.acog.org/news/news-releases/2025/10/acog-recommends-concurrent-sexual-partner-treatment-recurrent-bacterial-vaginosis-first-time Strange Bedfellows, Ina Park MD, MS https://www.inapark.net/the-book
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    57 mins
  • Ep. 96 Reproductive Surgery & Fertility: Endometriosis & Fibroids with Dr. Jim Robinson

    Ep. 96 Reproductive Surgery & Fertility: Endometriosis & Fibroids with Dr. Jim Robinson
    Nov 11 2025
    Endometriosis and fibroids don't have to block your patient’s path to pregnancy. In this episode of BackTable OBGYN, host Dr. Mark Hoffman welcomes Dr. Jim Robinson, Director of Reproductive Surgery at Shady Grove Fertility in Maryland, to share his guidance on reproductive surgery applications and reproductive health. --- SYNPOSIS The conversation explores the management of endometriosis and fibroids, the use of office hysteroscopy, and the intricacies of hysteroscopic and laparoscopic procedures. Dr. Robinson covers the importance of individualized patient care, the latest advancements in reproductive technology, and insights from his unique career blending academic medicine with a focus on enhancing fertility outcomes. Listeners will gain a comprehensive understanding of the critical role surgical interventions play in reproductive endocrinology and the nuanced approach required to optimize patient outcomes. --- TIMESTAMPS 00:00 - Introduction 05:17 - Understanding Reproductive Surgery08:51 - Hysteroscopy in Reproductive Surgery16:28 - Endometriosis and Infertility23:50 - Diagnosing and Treating Adenomyosis28:10 - Surgical Interventions for Reproductive Health33:52 - Balancing Endometrioma Removal and Fertility35:49 - Surgical Approaches and Patient Goals36:46 - Complexities of Fertility Consultations42:48 - Impact of Fibroids on Reproductive Health45:33 - Adhesion Prevention in Myomectomy48:33 - Innovations in Fibroid Ablation52:10 - Understanding Isthmoceles and Their Impact58:11 - Concluding Thoughts --- RESOURCES ReceptivaDx: What does it mean to test positive for high levels of bcl6https://receptivadx.com/what-does-it-mean-to-test-positive-for-high-levels-of-bcl6/ Impact of hysteroscopic surgery for isthmocele associated with cesarean scar syndrome: https://pubmed.ncbi.nlm.nih.gov/28892298/
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    1 hr and 2 mins
  • Ep. 95 Gynecology Practice Insights in Australia & New Zealand with Dr. Michael Wynn-Williams

    Ep. 95 Gynecology Practice Insights in Australia & New Zealand with Dr. Michael Wynn-Williams
    Oct 28 2025
    Ever wondered what it’s like to train and practice obstetrics and gynecology across New Zealand and Australia? In this episode of BackTable OBGYN, Dr. Amy Park sits down with Dr. Michael Wynn-Williams, a renowned gynecologist and endometriosis specialist. Dr. Wynn-Williams discusses his extensive training across New Zealand, Australia, the UK, and Scotland, emphasizing his role in minimally invasive gynecology.---SYNPOSISThe conversation covers the nuances of gynecology and obstetrics training in Australia and New Zealand, the balance between public and private healthcare systems, and the cultural differences in medical practice. Dr. Wynn-Williams also sheds light on issues like medical-legal environments, insurance, the impact of geography on healthcare delivery, and the integration of advanced ultrasound practices in endometriosis care. The episode provides valuable insights for those considering a career in gynecology in these regions.---TIMESTAMPS00:00 - Introduction07:35 - Training in Australia and New Zealand15:05 - Public and Private Healthcare Systems20:25 - Challenges and Equity in Healthcare24:39 - Balancing Public and Private Practice28:48 - Inpatient Services and Day Case Hysterectomy29:46 - City vs. Rural Practices and Equity Issues31:55 - Staffing Challenges in New Zealand33:57 - Living and Working in New Zealand and Australia35:25 - Navigating Medical Practice Transfers40:10 - Medical-Legal Environment in Australia and New Zealand43:31 - Gender-Based Reimbursement and Training Challenges51:41 - Endometriosis Ultrasound Scanning and Collaboration52:27 - Final Thoughts---RESOURCESThe Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the professional body responsible for training, accreditation, and standards in obstetrics and gynecology in both countrieshttps://ranzcog.edu.au/
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    56 mins
  • Ep. 94 Chronic Pelvic Pain: Evaluation & Treatment Options with Dr. Aakriti R. Carrubba

    Ep. 94 Chronic Pelvic Pain: Evaluation & Treatment Options with Dr. Aakriti R. Carrubba
    Oct 21 2025
    Not all pain is visible and not all solutions are obvious, especially in chronic pelvic pain. In this episode of BackTable OBGYN, host Dr. Mark Hoffman welcomes Dr. Aakriti Carrubba, an expert in minimally invasive gynecological surgery and pelvic pain from the Mayo Clinic, to talk through the evaluation and treatment of chronic pelvic pain.---SYNPOSISDr. Carrubba shares her journey from Kentucky to Florida, detailing her extensive training and interest in managing pelvic pain. The discussion covers the evaluation of pelvic pain, the significance of a thorough patient history and systematic pelvic exams, and the role of interdisciplinary approaches, including physical therapy and pain management. Dr. Carrubba emphasizes the importance of addressing central sensitization and chronic pain syndromes, explaining that not all pain can be attributed solely to structural abnormalities. The episode also touches on the integration of advanced AI tools in medical practice to enhance patient documentation and overall care.---TIMESTAMPS00:00 - Introduction01:09 - Dr. Carrubba’s Background and Journey03:54 - Fellowship Experience and Pelvic Pain Focus06:44 - Approach to Chronic Pelvic Pain14:04 - Detailed Pelvic Pain Exam Techniques17:14 - Trigger Point Injections and Their Role21:33 - Challenges in Pain Management and Education26:34 - Role of Central Sensitization in Chronic Pelvic Pain29:35 - Approach to Central Sensitization and Screening33:13 - Approaches to Excision Surgery36:04 - Post-Surgery Management and Hormonal Suppression38:19 - Teaching and Training in Pelvic Pain Management41:35 - Pain Rehabilitation Clinic for Central Sensitization44:59 - Teaching Pelvic Pain Anatomy to Trainees48:24 - Advancements in AI for Medical Documentation52:26 - Reflections on Pelvic Pain Training and Education56:00 - Final Thoughts
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    1 hr
  • Ep. 93 How to Optimize RVUs & Billing in Gynecology with Dr. Jon Hathaway

    Ep. 93 How to Optimize RVUs & Billing in Gynecology with Dr. Jon Hathaway
    Oct 14 2025
    No money, no mission. Understanding coding is the key to funding care and making your practice sustainable. In this episode of BackTable OBGYN, host, Dr. Mark Hoffman, chats with Dr. Jon Hathaway, associate professor at IU School of Medicine and coding specialist. They discuss the intricacies of medical billing, the impact of coding knowledge on revenue, and the systemic gaps in residency training regarding financial literacy. ---SYNPOSISDr. Hathaway shares his journey from mastering coding to becoming a national expert, providing a crash course on CPT, RVU, and ICD codes, and emphasizing the importance of accurate billing for the sustainability of healthcare practices. The episode offers valuable insights into the challenges and opportunities in medical coding and the broader financial aspects of healthcare.---TIMESTAMPS00:00 - Introduction 02:03 - Dr. Hathaway's Journey into Coding04:11 - Understanding the Financial Side of Healthcare07:10 - The Disconnect in Healthcare Payments11:26 - The Complexity of Medical Billing18:11 - The Role of CPT, RVU, and ICD Codes24:03 - The Process of Approving New Procedures32:38 - Understanding the Value Update Process33:47 - Case Study: Cystoscopy in Hysterectomy Codes35:26 - Survey Participation and Its Impact36:12 - Roles and Responsibilities in ACOG38:12 - Challenges of RVU-Based Compensation42:08 - Specialty-Specific RVU Valuation48:42 - Comparing OB and GYN Reimbursements50:02 - Envisioning an Ideal Healthcare System55:10 - Maximizing Billing Efficiency59:46 - Final Thoughts
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    1 hr and 2 mins
  • Intrauterine Adhesions & Hysteroscopy: Management & Advancements with Dr. Noam Smorgick

    Intrauterine Adhesions & Hysteroscopy: Management & Advancements with Dr. Noam Smorgick
    Oct 7 2025
    The future of gynecologic surgery is less invasive, more precise, and closer than you think. In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman welcomes Dr. Noam Smorgick, Director of Minimally Invasive Gynecologic Surgery at Shamir Hospital in Israel. They discuss Dr. Smorgick’s journey into the field of OBGYN and her innovative approaches to intrauterine adhesion management and hysteroscopic surgery for complex pathologies.---SYNPOSISTopics include the advantages of hysteroscopic management over traditional methods, the importance of maintaining fertility, the nuances of the Israeli healthcare system, and the development of new surgical instruments and procedures. The episode also highlights shared decision-making in patient care and looks ahead to the future direction of gynecologic surgery. Dr. Smorgick shares insights from recent studies and her experiences, making it a valuable listen for practitioners and anyone interested in gynecologic surgery advancements.---TIMESTAMPS00:00 - Introduction02:05 - Dr. Smorgick’s Journey to Medicine05:01 - Insights into Israeli Healthcare System10:20 - Intrauterine Adhesions and Hysteroscopic Management11:28 - Research on Retained Products of Conception15:07 - Comparing Management of Pregnancy Loss22:02 - Future Directions in Hysteroscopic Surgery23:46 - Infertility Treatments in Israel25:50 - Managing Uterine Septums and Adhesions28:03 - Shared Decision Making in Surgery32:03 - Techniques and Tools for Metroplasty33:08 - Adhesion Prevention Strategies35:35 - Postoperative Care and Follow-Up36:59 - Office Hysteroscopy Procedures38:05 - Reusable vs. Disposable Instruments45:51 - Future of Hysteroscopy---RESOURCESNetherlands Publication: Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/28390688/ Dr. Smorgick’s Publications: A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception: https://pubmed.ncbi.nlm.nih.gov/24997472/ Hysteroscopy-assisted suction curettage for early pregnancy loss: does it reduce retained products of conception and postoperative intrauterine adhesions?: https://pubmed.ncbi.nlm.nih.gov/37782418/
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    56 mins
  • BackTable Brief: Endometriosis Treatment: The Role of MRI & Multidisciplinary Planning with Dr. Wendaline VanBuren and Dr. Tatnai Burnett

    BackTable Brief: Endometriosis Treatment: The Role of MRI & Multidisciplinary Planning with Dr. Wendaline VanBuren and Dr. Tatnai Burnett
    Sep 30 2025
    When radiology meets surgery, endometriosis care becomes more precise, personalized, and proactive. In this BackTable OBGYN Brief, host Dr. Mark Hoffman is joined by Dr. Wendaline VanBuren, an associate professor of radiology at Mayo Clinic, and Dr. Tatnai Burnett, a minimally invasive GYN surgeon at Mayo Clinic, to discuss the complexities of diagnosing and managing endometriosis. The discussion covers the roles of advanced imaging techniques like MRI and ultrasound, the importance of pre-surgical planning, and the need for multidisciplinary collaboration. They share their approach to managing symptomatic and asymptomatic patients, the use of hormonal treatments, and the significance of monitoring potential malignant transformations in endometrioma cases. The episode underscores the critical role of imaging in planning effective surgical interventions for patients while highlighting the progression of endometriosis management protocols. TIMESTAMPS 00:00 - Introduction 01:07 - Discussing Endometriosis Management 02:18 - Imaging Techniques and Their Importance 04:24 - Interdisciplinary Collaboration 05:40 - Advanced Imaging Protocols 08:12 - Monitoring and Follow-Up Strategies 08:50 - Concerns About Malignancy 11:04 - Future Directions CHECK OUT THE FULL EPISODE OBGYN Ep. 69 https://www.backtable.com/shows/obgyn/podcasts/69/imaging-protocols-to-guide-endometriosis-treatment
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    17 mins
  • Ep. 91 Endometrial Sampling: Blind Biopsy vs. Visual Techniques with Dr. Linda Bradley

    Ep. 91 Endometrial Sampling: Blind Biopsy vs. Visual Techniques with Dr. Linda Bradley
    Sep 23 2025
    Blind biopsies leave questions unanswered. In this episode of BackTable OBGYN, host Dr. Mark Hoffman welcomes back Dr. Linda Bradley, an expert in obstetrics, gynecology, and hysteroscopy from the Cleveland Clinic, to discuss the benefits and advancements of direct visualized endometrial sampling over traditional blind biopsy techniques. ---This podcast is supported by:Medtronichttps://www.medtronic.com/en-us/healthcare-professionals/specialties/gynecology/product-portfolio.html---SYNPOSISDr. Bradley emphasizes the importance of hysteroscopy for accurate diagnosis and treatment of various gynecological issues, including abnormal uterine bleeding. They explore the limitations of blind biopsies and the advantages of hysteroscopy in detecting focal lesions, avoiding unnecessary hysterectomies, and ensuring patient safety. The discussion also touches on the economic and procedural challenges in adopting hysteroscopy more widely in clinical practice.---TIMESTAMPS00:00 - Introduction 03:30 - The Evolution of Hysteroscopy at Cleveland Clinic04:49 - Challenges and Innovations in Hysteroscopy06:30 - Clinical Insights: Direct Visualized Endometrial Sampling12:03 - Case Studies and Practical Applications15:46 - The Importance of Visual Examination in Gynecology20:03 - Advocating for Hysteroscopy in Medical Practice31:07 - Patient History and Trauma Considerations31:34 - Cancer Detection and Missed Diagnoses32:14 - Challenges with Unscheduled Bleeding32:56 - Case Study: Blood Transfusions and Hysterectomy33:38 - Importance of Hysteroscopy34:43 - Hysteroscopy Techniques and Best Practices37:41 - Ultrasound and SIS (Saline Infusion Sonohysterography) for Imaging38:45 - Post-Operative Care and Follow-Up47:41 - Environmental and Economic Considerations in Healthcare52:51 - Final Thoughts and Patient Advocacy
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    58 mins