Episode 12.2 Cuff Dehiscence and Classic Papers

Howard Herrell and Stuart Winkler question long-standing OB-GYN habits that feel “routine” but do not add value, then replace them with evidence and practical decision-making. We move from hysterectomy follow-up and cuff dehiscence management to the data behind cesarean sutures, endometrial cancer evaluation in postmenopausal bleeding, and the ongoing shift to HPV-based cervical cancer screening. • why routine 6 to 8 week vaginal cuff exams after hysterectomy may not prevent or predict dehiscence • how telehealth post-op care can improve access while keeping symptom-driven safety nets • four tips for evaluating and managing vaginal cuff dehiscence, including when laparoscopy matters • what Ethicon discontinuing chromic and plain gut could mean for cesarean technique choices • how the CORONIS trial informs chromic vs Vicryl decisions and why transfusion risk is part of the conversation • where the 4 mm endometrial stripe rule came from and why it can fail in real-world care • why persistent postmenopausal bleeding still warrants endometrial biopsy despite reassuring ultrasound • how race, tumor subtype, and fibroids affect endometrial cancer detection and counseling • the arc from Pap smear cytology to HPV DNA testing, vaccines, and primary HPV screening • why self-collected HPV testing may raise screening uptake for patients avoiding speculum exams Be sure to check out thinking about obgyn.com for more information, and be sure to follow us on Instagram.0:00 Welcome And Today’s Game Plan0:35 Rethinking The Six-Week Pelvic Exam13:25 Four Practical Tips For Cuff Dehiscence24:42 Chromic Gut Is Disappearing35:40 CORONIS Trial And Cesarean Sutures42:22 Postmenopausal Bleeding And The 4 mm Rule53:12 HPV Testing Takes Over ScreeningFollow us on Instagram @thinkingaboutobgyn.