University of Calgary

Research Spotlight


Research Highlights

  • Dr. Erin Brennand is one of the co-PIs on the GROWW (Guiding interdisciplinary Research on Women's and girls health and Wellbeing) project which is a $2.4M team grant funded by the CIHR. This is a University of Calgary led national health research training program focusing on girls and women's health from a life-course perspective. Co-PIs also include Dr. Amy Metcalfe (U of Calgary), Dr. Jennifer Gorden (U of Regina) and Dr. Ryan van Leishout (McMaster), as well as 57 investigators from 23 academic institutions, representing 8 provinces and 1 territory, as well as multiple partners from government, industry and the not-for-profit sector. This program will develop capacity for women's health research in Canada by training the next generation of graduate students and clinical trainees. (The Section of FPMRS at U of Calgary was a valued stakeholder in the proposal's development and is a formal stakeholder).
  • The O’Brien Institute for Public Health at the University of Calgary is also in the midst of developing a Sex, Gender and Women's Health Research Unit which will be headed by Dr. Erin Brennand. Stay tuned for more interesting research from this group.

Featured Publications
Kim-Fine S, Antosh DD, Balk EM, Meriwether KV, Kanter G, Dieter AA, Mamik MM, Good M, Singh R, Alas A, Foda M, Rahn DD, Rogers RG. Relationship of postoperative vaginal anatomy and sexual function: a systematic review with meta-analysis. Int Urogynecol J. 2021 Aug;32(8):2125-2134. doi: 10.1007/s00192-021-04829-4. Epub 2021 May 14. PMID: 33988785

  • Dr. Kim-Fine (FPMRS, University of Calgary) led this esteemed group of international FPMRS specialists in a planned secondary analysis of a systematic review by the Society of Gynecologic Surgeons Systematic Review Group (2020). This secondary review sought to describe the relationships between vaginal anatomic measures and sexual function outcomes before and following POP surgery. The primary aim of this systematic review was to determine whether pre- and post-operative TVL and GH were related to sexual function scores and dyspareunia after POP repair.
  • For the primary systematic review, randomized controlled trials and prospective nonrandomized comparative studies that compared different POP surgeries and evaluated sexual function as measured with either validated questionnaires or dyspareunia outcomes in women undergoing POP surgery were included.
  • In the original search in 2018, 3124 studies were screened and 74 papers representing 67 original studies were accepted. PISQ-12 was the most commonly reported validated questionnaire (in 26 studies). Nine studies reported TVL and dyspareunia outcomes, eight studies reported GH and PISQ-12 outcomes, and seven studies reported GH and dyspareunia outcomes.
  • Associations of PISQ-12 and total vaginal length: Across studies change in PISQ-12 after POP surgery was significantly associated with pre-operative TVL (adjusted β = −2.4, 95% CI –4.6 to −0.2, p = 0.033). In studies with shorter mean TVL preoperatively, patients had larger increases in PISQ-12, and better sexual function after surgery. However, change in PISQ-12 was not associated with postoperative TVL or change in TVL.
  • Associations of dyspareunia and total vaginal length: Neither pre- nor post-operative TVL was associated with total or de novo dyspareunia.
  • Associations of PISQ-12 and genital hiatus: Neither pre- nor post-operative GH was associated with PISQ-12.
  • Associations of dyspareunia and genital hiatus: The mean pre-operative GH was not associated with pre- or post-operative dyspareunia or de novo dyspareunia. There were insufficient observations to meta-analyze for associations between post-operative dyspareunia/de novo dyspareunia and post-operative GH or change in GH.
  • CONCLUSION: Evidence does not support an association between vaginal anatomic measurements and sexual function scores and dyspareunia following POP surgery. Future studies should aim to report pre- and post-operative outcome measures according to the most recent IUGA/ICS joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction.

Cummings S, RamageK, Scime NV, Ahmed SB, Brennand EA. Gender expression is associated with selection of uterine preservation or hysterectomy for pelvic organ prolapse surgery: Novel methodology for sex- and gender-based analysis in gynecologic research. Int J Gynaecol Obstet. 2022 Mar 8. doi: 10.1002/ijgo.14169. Epub ahead of print. PMID: 35262193.

  • This is a study out of the Calgary Women's Pelvic Health Research Group, led by Dr. Brennand, and was supported through a CIHR Women's Health Clinical Mentorship Grant and M.S.I. Foundation Grant. 
  • This study specifically aimed to determine if gender expression is associated with patients' choice of whether to have the uterus preserved or removed during POP surgery. This is the first known study to investigate gender expression in a clinical gynecologic study.
  • Data was collected from a prospective cohort of patients undergoing their first POP surgery. Patients were able to self-select their study group, either the uterine-preserving or hysterectomy-based groups for POP procedure.
  • Gender expression was measured through self-report before surgery. Using a framework set by Magliozzi et al (a short gender expression tool), participants ranked how they saw themselves on a scale of 0 (not at all) and 6 (very) for both femininity and masculinity. 
  • Baseline scores were collected in 177 patients, all of whom were cisgender, and 165 patients underwent surgery with 58 patients in the uterine-preserving group and 107 in the hysterectomy group. 
  • In the multivariable model adjusting for sociodemographic characteristics and patient reported outcomes based on POP symptoms, women with non-polar gender scores had higher odds of selecting uterine-preserving surgery (OR of 2.53 (95% CI 1.06–6.09)). 
  • Key findings of this study included: (1) variation in gender scores and the concept of gender expression exist even within a group of cisgender, nearly all heterosexual, women, (2) gender score was not strongly associated with sociodemographic variables, and (3) gender expression is associated with a women's decision making to have their uterus preserved or removed at the time of POP surgery. 
  • CONCLUSION: Women with masculine traits (non-polarity) in gender expression were more likely to choose uterine-preservation over hysterectomy to treat POP. This is an important finding and suggests that uterine-preserving surgeries should be widely offered to those seeking POP surgery. This study also demonstrated the feasibility of using a short gender expression tool and advocates for further gender expression research in gynecologic health.

2021-2022 Publication List

Edwards A, Carter Ramirez A, Scime NV, Kim-Fine S, Brennand EA. Authors' Reply (RE. Does Size Matter? Opioid Use after Laparoscopy for Apical Pelvic Organ Prolapse Using an 8 mm versus 10-12 mm Accessory Port. J Minim Invasive Gynecol. 2021 Dec 17:S1553-4650(21)01325-X. doi: 10.1016/j.jmig.2021.12.007. ) J Minim Invasive Gynecol. 2022 Jan 31:S1553-4650(22)00041-3. doi:10.1016/j.jmig.2022.01.013. Epub ahead of print. PMID: 35101630.

Chaikof M, McDermott CD, Brennand E, Sanaee M. Patients Seeking "Vaginoplasty" Deserve Assessment and Treatment by Experts in Female Pelvic Medicine and Reconstructive Surgery. Aesthet Surg J. 2021 Mar 12;41(4):NP148-NP149. doi: 10.1093/asj/sjaa286. PMID: 33165577; PMCID: PMC7954535.

Walter JE, Brennand EA, Lemos N, Cundiff GW; Canadian Society of Pelvic Medicine Mesh Complications Writing Group. Letter: Canadian Society of Pelvic Medicine Response to the Collège des Médecins du Québec Rapport d'Enquête. J Obstet Gynaecol Can. 2021 Mar;43(3):298-299. doi: 10.1016/j.jogc.2020.10.004. Erratum in: J Obstet Gynaecol Can. 2021 May;43(5):650. PMID: 33640099.

Scime NV, Brown HK, Metcalfe A, Brennand EA. Prevalence of Hysterectomy by Self-Reported Disability Among Canadian Women: Findings from a National Cross- Sectional Survey. Womens Health Rep (New Rochelle). 2021 Nov 29;2(1):557-565. doi: 10.1089/whr.2021.0069. PMID: 34909762; PMCID: PMC8665278.

Walter JE, Brennand EA, Lemos N, Cundiff GW; Canadian Society of Pelvic Medicine Mesh Complications Writing Group. Corrigendum to 'Canadian Society of Pelvic Medicine Response to the Collège des Médecins du Québec Rapport d'Enquête' [Journal of Obstetrics and Gynaecology Canada 43/3 (2021) 298-299]. J Obstet Gynaecol Can. 2021 May;43(5):650. doi: 10.1016/j.jogc.2021.03.008. Erratum for: J Obstet Gynaecol Can. 2021 Mar;43(3):298-299. PMID: 33992128.

Scime NV, Ramage K, Brennand EA; Calgary Women’s Pelvic Health Research Group. Protocol for a prospective multisite cohort study investigating hysterectomy versus uterine preservation for pelvic organ prolapse surgery: the HUPPS study. BMJ Open. 2021 Oct 4;11(10):e053679. doi: 10.1136/bmjopen-2021-053679. PMID: 34607873; PMCID: PMC8491422.

Edwards A, Carter Ramirez A, Scime NV, Kim-Fine S, Brennand EA. Does Size Matter? Opioid Use after Laparoscopy for Apical Pelvic Organ Prolapse Using an 8 mm versus 10-12 mm Accessory Port. J Minim Invasive Gynecol. 2021 Dec 17:S1553-4650(21)01325-X. doi: 10.1016/j.jmig.2021.12.007. Epub ahead of print. PMID: 34929399.

Shah FI, Ramage K, Scime NV, Brennand EA, Walker LM. Pelvic Organ Prolapse Takes Up Space in the Bedroom: A Mixed Method Exploration of the Circular Sexual Response Cycle in Women With Pelvic Organ Prolapse. Female Pelvic Med Reconstr Surg. 2021 Nov 10. doi: 10.1097/SPV.0000000000001123. Epub ahead of print. PMID: 34768257.

Anglim BC, Ramage K, Sandwith E, Brennand EA; Calgary Women’s Pelvic Health Research Group. Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol. BMC Womens Health. 2021 May 11;21(1):195. doi: 10.1186/s12905-021-01330-4. PMID: 33975584; PMCID: PMC8111911.

Cummings S, Ramage K, Scime NV, Ahmed SB, Brennand EA. Gender expression is associated with selection of uterine preservation or hysterectomy for pelvic organ prolapse surgery: Novel methodology for sex- and gender-based analysis in gynecologic research. Int J Gynaecol Obstet. 2022 Mar 8. doi: 10.1002/ijgo.14169. Epub ahead of print. PMID: 35262193.

Kim-Fine S, Greenfield J, Chaput KH, Robert M, Metz LM. Cannabinoids and bladder symptoms in multiple sclerosis. Mult Scler Relat Disord. 2021 Sep;54:103105. doi: 10.1016/j.msard.2021.103105. Epub 2021 Jun 23.

PMID: 34216995

Antosh DD, Dieter AA, Balk EM, Kanter G, Kim-Fine S, Meriwether KV, Mamik MM, Good MM, Singh R, Alas A, Foda MA, Rahn DD, Rogers RG. Sexual function after pelvic organ prolapse surgery: a systematic review comparing different approaches to pelvic floor repair. Am J Obstet Gynecol. 2021 Nov;225(5):475.e1-475.e19. doi: 10.1016/j.ajog.2021.05.042. Epub 2021 Jun 2. PMID: 34087227

Kim-Fine S, Antosh DD, Balk EM, Meriwether KV, Kanter G, Dieter AA, Mamik MM, Good M, Singh R, Alas A, Foda M, Rahn DD, Rogers RG. Relationship of postoperative vaginal anatomy and sexual function: a systematic review with meta-analysis. Int Urogynecol J. 2021 Aug;32(8):2125-2134. doi: 10.1007/s00192-021-04829-4. Epub 2021 May 14. PMID: 33988785  

Sandwith E, Robert M. Rug-pee study: the prevalence of urinary incontinence among female university rugby players. Int Urogynecol J. 2021 Feb; 32(2):281-285. doi: 10.1007/s00192-020-04510-2. Epub 2020 Aug 28. PMID: 32857177.

Flynn MJ, Campbell TS, Robert M, Nasr-Esfahani M, Rash JA. Intranasal oxytocin as a treatment for chronic pelvic pain: A randomized controlled feasibility study. Int J Gynaecol Obstet. 2021 Mar;152(3):425-432. doi:

10.1002/ijgo.13441. Epub 2020 Dec 8. PMID: 33112417.

McLean L, Charette M, Varette K, Brooks K, Harvey MA, Robert M, Baker K, Day A, Della Zazzera V, Sauerbrei E, Brison R. Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial. Int Urogynecol J. 2021 Mar 3. doi: 10.1007/s00192-020-04668-9. Epub ahead of print. PMID: 33660001.

Brooks KCL, Varette K, Harvey MA, Robert M, Brison RJ, Day A, Baker K, Della Zazzera V, Sauerbrei E, McLean L. A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence. Int Urogynecol J. 2021 Mar;32(3):719-728. doi: 10.1007/s00192-020-04583-z. Epub 2020 Nov 25. PMID: 33237355; PMCID: PMC7902568

Rash JA, Campbell TS, Cooper L, Flusk D, MacInnes A, Nasr-Esfahani M, Mekhael AA, Poulin PA, Robert M, Yi Y. Evaluating the efficacy of intranasal oxytocin on pain and function among individuals who experience chronic pain: a protocol for a multisite, placebo-controlled, blinded, sequential, within-subjects crossover trial. BMJ Open. 2021 Sep 23;11(9):e055039. doi: 10.1136/bmjopen-2021-055039. PMID: 34556520; PMCID: PMC8461687.