Introduction: Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. Methods: From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: “aorta”, “gallbladder”, “kidney” and “lung”) was measured, and a theory test on the same subject areas (“pathology recognition”) was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and “attitude to ultrasound training in the curriculum”. Results: Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. Conclusions: Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.

Background: Pelvic organ prolapse constitutes a prevalent condition associated with a considerable impact on the quality of life. The utilization of transvaginal mesh surgery for managing POP has been a subject of extensive debate. Globally, trends in TVM surgery experienced significant shifts subsequent to warnings issued by the FDA. Methods: This study aims to explore temporal patterns in transvaginal mesh surgery in the German healthcare system. A comprehensive analysis was conducted on in-patient data from the German Federal Statistical Office spanning 2006 to 2021. A total of 1,150,811 operations, each associated with specific codes, were incorporated into the study. Linear regression analysis was employed to delineate discernible trends. Results: The trends in transvaginal mesh surgery within the anterior compartment exhibited relative stability (p = 0.147); however, a significant decline was noted in all other compartments (posterior: p < 0.001, enterocele surgery: p < 0.001). A subtle increasing trend was observed for uterine-preserving transvaginal mesh surgery (p = 0.045). Conclusion: Surgical trends over the specified timeframe demonstrate how POP management has evolved globally. Notably, despite observed fluctuations, transvaginal mesh surgery remains a viable option, particularly for specific cases with a high risk of relapse and contraindications to alternative surgical approaches.

Background: Enhanced Recovery After Surgery (ERAS) protocols improve postoperative outcomes and promote multidisciplinary, evidence-based perioperative care. However, ERAS adoption in gynecological departments remains inconsistent, and the underlying implementation challenges are poorly understood. Objective: To identify key barriers, facilitators, and preferred implementation strategies influencing ERAS adoption in German gynecological departments, and to assess whether clinicians’ ERAS knowledge or institutional certification shapes these perceptions. Methods: We conducted a nationwide, web-based cross-sectional survey of gynecologic clinicians in Germany. The questionnaire assessed ERAS-related knowledge, current implementation status, and perceived barriers, facilitators, and strategies. Statistical analyses included equality of proportions tests, logistic regression, and internal consistency measurement. Results: A total of 116 clinicians participated; 66 provided data on barriers and 64 on facilitators and strategies. Only 37.9% reported routine ERAS use. The most frequently identified barriers were limited ERAS knowledge (40.9% “very important”) and insufficient personnel resources (40.9%). The strongest facilitators were improved patient well-being, reduced morbidity, and higher patient satisfaction (each >60% “very important”). High-impact implementation strategies included informational materials, workshops, and online training. Well-informed clinicians had significantly higher odds of reporting a positive professional impact of ERAS (OR = 9.0, p = 0.001). Conclusions: ERAS implementation in gynecological settings remains restricted by staff knowledge gaps and personnel limitations. Patient-centered benefits and interactive educational strategies serve as powerful facilitators. Enhanced staff education and multidisciplinary support structures may substantially improve ERAS uptake and contribute to greater professional satisfaction among clinicians.

Introduction: The trinational survey project conducted by the young forums of the German, Austrian, and Swiss societies for gynecology and obstetrics aims to evaluate the preferences of prospective and practicing gynecologists regarding various working time models, training systems, career pathways, and the reconciliation of professional and family life. Materials and methods: Between October 2023 and May 2024, 1364 participants completed the FARBEN survey. The questionnaire comprised 62 items addressing aspects such as general workplace conditions, working time models, training priorities, team structures, and professional aspirations. Participation was voluntary and anonymous. The present analysis constitutes a national sub-analysis focusing on the preferences of German respondents, stratified by their current workplace setting (university hospitals, non-university hospitals, or outpatient care facilities). Results: Among the 1008 German respondents, 26.3% were employed in university hospitals, 55.4% in non-university hospitals, and 10.8% in outpatient care. Respondents working in university hospitals were significantly more likely to pursue an academic career (68.0% held a doctoral degree, and 7.5% held a habilitation—the highest academic qualification in German-speaking countries—or a professorship; 38.5% aspired to a habilitation, compared to 6.6% in non-university hospitals). Female respondents employed in university hospitals tended to have children at a later stage and returned to work earlier following parental leave. Institutional childcare was reported to be more accessible and flexible at university hospitals (20.4%) compared to non-university hospitals (9.6%) and outpatient care (8.4%). Furthermore, 34.1% of university hospital respondents indicated that their department head was female, in contrast to 19.2% in non-university hospitals ( p < 0.001). Conclusions: Work–life balance and the compatibility of family life with a medical career are essential for most gynecologists in training, irrespective of their workplace setting. Respondents employed in academic institutions were more inclined to pursue scientific careers and reported greater flexibility and better childcare support. In light of the growing shortage of medical professionals, employment policies should prioritize these aspects. Initiatives such as the guideline “Safe Surgery During Pregnancy” can support the alignment of clinical training with family planning and help prevent career disadvantages related to parenthood.

Purpose: To investigate sexual health in breast cancer survivors and their partners, focusing on sexual satisfaction, changes in satisfaction with partner sexuality before vs. after the diagnosis, and unmet informational needs on sexual health in the context of breast cancer. Methods: Breast cancer patients and their partners were surveyed at a single time point 1–5 years after having completed primary therapy for breast cancer as part of a cross-sectional study. Study participants completed self-report-questionnaires covering personal characteristics, a question on satisfaction with partner sexuality before (retrospective assessment) versus after the diagnosis (based on the Sexual Medicine Questionnaire for Chronic Diseases (SFCE)), the EORTC (European Organisation for Research and Treatment of Cancer) Sexual Health Questionnaire (EORTC QLQ-SH22) together with the EORTC Quality of Life Core Questionnaire (EORTC QLQ-C30), and a questionnaire assessing sexual health care. Descriptive statistics were used to summarize demographic and clinical data. For group comparisons, dyadic dependencies were accounted for, applying paired t tests when normality (Shapiro–Wilk test) was met and Wilcoxon signed-rank test otherwise. Results: A total of 128 participants (64 patients, 64 partners) were enrolled. Sexual satisfaction did not differ between patients ( M = 55, SD = 20.9) and partners ( M = 56.7, SD = 20) ( t test, p = 0.46). A positive correlation was found between patients’ and partners’ sexual satisfaction ( r = 0.62, p < 0.0001). Satisfaction with partner sexuality was lower after diagnosis ( p < 0.001, r = 0.54)—with both patients and partners being less satisfied after the diagnosis (M = 2.58, SD = 0.95) than before ( M = 3.14, SD = 0.74). Overall, 75% of the study participants reported not having received information about sexual health issues related to breast cancer, while 64% expressed a desire for more information. Conclusion: The findings of this study highlight the importance of considering couple dynamics in breast cancer care. Patients and partners have unmet needs concerning sexual health in the context of breast cancer. Addressing sexuality may improve quality of life and psychosocial adjustment. Future research should include larger, more diverse samples and focus on assessing sexuality and sexual health as multidimensional constructs in line with WHO (World Health Organization) definitions.

Background: Laparoscopic surgery has a flatter learning curve compared to traditional open surgery. Therefore, structured programs and realistic training models are imperative to ensure patients’ safety. However, commercially available models are often too expensive or technically unrealistic for continuous surgical training. Objective: The aim of this trial was to develop a cost-efficient and highly realistic uterus model to perform a total laparoscopic hysterectomy (TLH) and evaluate its applicability. Methods: A training model (MaiSurge) for a TLH with salpingectomy or adenectomy was developed using a 3D printer and different cast materials. Polyvinyl alcohol was used to allow for the use of electrosurgery. To gather the first validity evidence, novice and expert gynecologists performed a TLH on the model. Operative time as well as surgical performance scores (Hysterectomy–Objective Structured Assessment of Technical Skills) were compared between both groups. Results: A total of 12 participants in the novice group and 18 participants in the expert group completed the simulation. The experts obtained significantly better modified Hysterectomy–Objective Structured Assessment of Technical Skills scores (mean 74.0, SD 12.9 vs mean 60.3, SD 14.9; P =.049) and performed significantly faster (median 69.5, IQR 49.5-74.3 minutes vs median 37.5, IQR 30.5-38.8 minutes; P <.001). An excellent interrater reliability was observed (intraclass correlation coefficient=0.91). Approximately 92% (11/12) of novices felt that they had improved their surgical performance after training on the MaiSurge uterus model. Overall, all participants agreed that the new MaiSurge uterus model should be integrated into training curricula to improve the performance of residents on TLHs. Conclusions: A new highly realistic and cost-effective training model (MaiSurge) to perform a TLH was developed. The model distinguishes between good and poor laparoscopic performances and, thus, can be used in training as well as assessment of surgical skills. The possibility of simulating even complex laparoscopic procedures in a realistic environment may be an opportunity to train a future generation of gynecologists without compromising patient safety or exhausting the limited availability of operating room time.