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A 1-year follow up of psychological wellbeing after subtotal and total hysterectomy--a randomised study.

https://arctichealth.org/en/permalink/ahliterature98373
Source
BJOG. 2010 Mar;117(4):479-87
Publication Type
Article
Date
Mar-2010
Author
Persson, P
Brynhildsen, J
Kjølhede, P
Author Affiliation
Department of Obstetrics and Gynaecology, University Hospital, Uppsala, Sweden. par.persson@akademiska.se
Source
BJOG. 2010 Mar;117(4):479-87
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - etiology
Depressive Disorder - etiology
Female
Follow-Up Studies
Health status
Humans
Hysterectomy - adverse effects - methods - psychology
Mental health
Middle Aged
Patient satisfaction
Postoperative Complications - psychology
Prospective Studies
Psychometrics
Quality of Life
Abstract
OBJECTIVE: To compare subtotal abdominal hysterectomy (SH) and total abdominal hysterectomy (TH) regarding influence on postoperative psychological wellbeing and surgical outcome measurements. DESIGN: A prospective, open, randomised multicentre trial. SETTING: Seven hospitals and one private clinic in the south-east of Sweden. POPULATION: Two-hundred women scheduled for abdominal hysterectomy for benign conditions were enrolled in the study; 179 women completed the study (94 SH and 85 TH). METHODS: Four different psychometric tests were used to measure general wellbeing, depression and anxiety preoperatively, and at 6 and 12 months postoperatively. Statistical analysis of variance and covariance were used. MAIN OUTCOME MEASURES: Effects of operating method on psychological wellbeing postoperatively. Analysis of demographic, clinical and surgical data, including peri- and postoperative complications and complaints at follow up. RESULTS: No significant differences were observed between the two groups in any of the psychometric tests. Both surgical methods were associated with a significantly higher degree of psychological wellbeing at 6 and 12 months postoperatively, compared with preoperatively. No significant differences were found in the clinical measures including complications. A substantial number of women experienced persistent cyclic vaginal bleedings after SH. Neither minor or major postoperative complications, nor serum concentration of sex hormones, were associated with general psychological wellbeing 12 months after the operation. CONCLUSIONS: General psychological wellbeing is equally improved after both SH and TH within 12 months of the operation, and does not seem to be associated with the occurrence of peroperative complications or serum concentration of sex hormones.
PubMed ID
20074265 View in PubMed
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"A challenge" - healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis.

https://arctichealth.org/en/permalink/ahliterature277305
Source
Sex Reprod Healthc. 2016 Mar;7:65-9
Publication Type
Article
Date
Mar-2016
Author
Hanna Grundström
Preben Kjølhede
Carina Berterö
Siw Alehagen
Source
Sex Reprod Healthc. 2016 Mar;7:65-9
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Delivery of Health Care - standards
Dysmenorrhea - diagnosis - etiology
Dyspareunia - diagnosis - etiology
Endometriosis - complications - diagnosis
Female
Gynecology
Humans
Male
Menstruation
Middle Aged
Nurse Midwives
Ovulation
Pelvic Pain - diagnosis - etiology
Physicians
Professional Competence
Professional-Patient Relations
Sweden
Abstract
The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.
Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.
Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.
Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as "normal" menstruation pain, making it hard to satisfy the needs of this patient group.
PubMed ID
26826048 View in PubMed
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Adverse Neonatal Outcomes in Overweight and Obese Adolescents Compared with Normal Weight Adolescents and Low Risk Adults.

https://arctichealth.org/en/permalink/ahliterature299300
Source
J Pediatr Adolesc Gynecol. 2019 Apr; 32(2):139-145
Publication Type
Comparative Study
Journal Article
Date
Apr-2019
Author
Anna Ramö Isgren
Preben Kjølhede
Marie Blomberg
Author Affiliation
Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Source
J Pediatr Adolesc Gynecol. 2019 Apr; 32(2):139-145
Date
Apr-2019
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Adolescent
Body mass index
Body Weight
Cohort Studies
Female
Gestational Age
Humans
Infant, Newborn
Pediatric Obesity - complications
Pregnancy
Pregnancy Complications - etiology
Pregnancy Outcome - epidemiology
Pregnancy in Adolescence - statistics & numerical data
Registries
Retrospective Studies
Risk factors
Sweden
Young Adult
Abstract
To evaluate the association between maternal body mass index and neonatal outcomes in adolescents and to compare neonatal outcomes between overweight and obese adolescents and obstetric low-risk adult women.
Retrospective cohort study using data from the Swedish Medical Birth Register.
Sweden.
All 31,386 primiparous adolescents younger than 20 years of age and 178,844 "standard" women, defined as normal weight, obstetric low-risk adult women who delivered between 1992 and 2013. The adolescents were categorized according to weight and height in early pregnancy into body mass index groups according to the World Health Organization classification. Logistic regression models were used.
Neonatal outcomes in relation to maternal body mass index groups.
In the adolescents, 6109/31,386 (19.5%) and 2287/31,386 (7.3%) were overweight and obese, respectively. Compared with normal weight adolescents, overweight adolescents had a lower risk of having small for gestational age neonates, and higher risks for having neonates with macrosomia, and being large for gestational age and with Apgar score less than 7 at 5 minutes. The obese adolescents had increased risk for having neonates being large for gestational age (3.8% vs 1.3%; adjusted odds ratio [aOR], 2.97 [95% confidence interval (CI), 2.30-3.84]), with macrosomia (>4500 g) (4.6% vs 1.4%; aOR, 2.95 [95% CI, 2.33-3.73]), and with Apgar score less than 7 at 5 minutes (2.2% vs 1.1%; aOR, 1.98 [95% CI, 1.43-2.76]) than normal weight adolescents. Compared with the standard women, overweight and obese adolescents had overall more adverse neonatal outcomes.
Overweight and obese adolescents had predominantly increased risks for adverse neonatal outcomes compared with normal weight adolescents and standard women.
PubMed ID
30453030 View in PubMed
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Attitudes to mode of hysterectomy--a survey-based study among Swedish gynecologists.

https://arctichealth.org/en/permalink/ahliterature89890
Source
Acta Obstet Gynecol Scand. 2009;88(3):267-74
Publication Type
Article
Date
2009
Author
Persson Pär
Hellborg Thomas
Brynhildsen Jan
Fredrikson Mats
Kjølhede Preben
Author Affiliation
Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, Faculty of Health Sciences, University Hospital, 581 85 Linköping, Sweden. par.persson@akademiska.se
Source
Acta Obstet Gynecol Scand. 2009;88(3):267-74
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Attitude of Health Personnel
Cross-Sectional Studies
Female
Gynecology
Humans
Hysterectomy - methods - statistics & numerical data
Hysterectomy, Vaginal - utilization
Laparoscopy - utilization
Logistic Models
Male
Middle Aged
Physicians - psychology
Questionnaires
Sex Factors
Sweden
Abstract
OBJECTIVE: To determine gynecologists' attitudes to mode of hysterectomy on benign indication. DESIGN: Cross-sectional study. SETTING: Sweden. POPULATION: Members of the Swedish Society of Obstetrics and Gynecology. METHODS: A postal questionnaire. Questions examined attitudes to mode of hysterectomy based on three clinical scenarios with different conditions of the uterus. Gynecologists were also asked to estimate how the distribution of the different modes of benign hysterectomy should be overall. The modes to choose were total abdominal, subtotal abdominal, laparoscopic or vaginal hysterectomy (VH). Analyses were performed with multiple logistic regression and multivariate analysis of covariance. MAIN OUTCOME MEASURES: Preferred mode of hysterectomy in the three scenarios and distribution of modes of hysterectomy. RESULTS: VH was the most preferred method in general as well as when the uterus was of normal size, whereas subtotal and total abdominal hysterectomy were the most favored methods when the uterus was enlarged. VH was more often preferred by male compared to female gynecologists as a personal preference. The choice and distribution of mode varied significantly between place of work, seniority and in the quantity of yearly performed hysterectomies. The minimal invasive methods, vaginal and laparoscopic hysterectomy, were recommended in more than 50% of the overall suggested distribution. CONCLUSION: Personal choice of mode of hysterectomy does not seem to strictly follow evidence-based recommendations, but varies significantly between gynecologist's gender, type of clinical setting in which the gynecologist works, seniority and by how many hysterectomies the gynecologist does annually.
PubMed ID
19241224 View in PubMed
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Data quality in the Swedish Quality Register of Gynecologic Cancer - a Swedish Gynecologic Cancer Group (SweGCG) study.

https://arctichealth.org/en/permalink/ahliterature294452
Source
Acta Oncol. 2018 Mar; 57(3):346-353
Publication Type
Journal Article
Date
Mar-2018
Author
Per Rosenberg
Preben Kjølhede
Christian Staf
Maria Bjurberg
Christer Borgfeldt
Pernilla Dahm-Kähler
Kristina Hellman
Elisabet Hjerpe
Erik Holmberg
Karin Stålberg
Bengt Tholander
Elisabeth Åvall Lundqvist
Thomas Högberg
Author Affiliation
a Department of Oncology , Linköping University , Linköping , Sweden.
Source
Acta Oncol. 2018 Mar; 57(3):346-353
Date
Mar-2018
Language
English
Publication Type
Journal Article
Keywords
Data Accuracy
Female
Genital Neoplasms, Female
Humans
Registries - standards
Sweden
Abstract
The aim of this study is to evaluate the quality of data on endometrial (EC) and ovarian, fallopian tube, peritoneal, abdominal or pelvic cancers (OC) registered in the Swedish Quality Register of Gynecologic Cancer (SQRGC).
A random sample of 500 patients was identified in the SQRGC and their medical charts were reviewed for re-abstraction of 31 selected core variables by an independent validator. The data in the SQRGC and the re-abstracted data were compared. The data were collected from 25 hospitals evenly distributed throughout Sweden. The main outcomes were comparability, timeliness, completeness and validity. Coverage was compared with the National Cancer Register (NCR). Timeliness was defined as the speed of registration i.e. when patients were registered in the SQRGC relative to date of diagnosis. Internationally accepted coding systems for stage, grading and histologic type were used ensuring a high degree of comparability. Correlations were estimated using Pearson's correlation coefficient and Cohen´s kappa coefficient.
The completeness was 95%. The timeliness was 88-91% within 12 months of diagnosis. The median degree of agreement between re-abstracted data and data in the SQRGC was 82.1%, with a median kappa value of 0.73 for ordinate variables and a median Pearson's correlation coefficient of 0.96. The agreements for the type of surgery were 76% (95% CI 70-81%; kappa 0.49) and type of primary treatment 90% (95% CI 87-94%; kappa 0.85) in OC and in EC 88% (95% CI 84-93%; kappa 0.84). The agreements for the FIGO stage were in OC and EC 74% (95% CI 68-80%; kappa 0.69) and 87% (95% CI 82-91%; kappa 0.79), respectively.
The data in the Swedish Quality Register for Gynecologic Cancer are of adequate quality in order to be used as a basis for research and to evaluate possible differences in treatment, lead times and treatment results.
PubMed ID
28828920 View in PubMed
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Deliveries among teenage women - with emphasis on incidence and mode of delivery: a Swedish national survey from 1973 to 2010.

https://arctichealth.org/en/permalink/ahliterature106259
Source
BMC Pregnancy Childbirth. 2013;13:204
Publication Type
Article
Date
2013
Author
Rasmus Birch Tyrberg
Marie Blomberg
Preben Kjølhede
Author Affiliation
Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, S - 581 85 Linköping, Sweden. Preben.Kjolhede@liu.se.
Source
BMC Pregnancy Childbirth. 2013;13:204
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Apgar score
Cesarean Section - statistics & numerical data
Female
Fetal Distress - epidemiology
Humans
Infant, Small for Gestational Age
Meconium Aspiration Syndrome - epidemiology
Obstetric Labor Complications - epidemiology
Perineum - injuries
Placenta Previa - epidemiology
Postpartum Hemorrhage - epidemiology
Pregnancy
Pregnancy in Adolescence - statistics & numerical data
Premature Birth - epidemiology
Retrospective Studies
Sweden - epidemiology
Young Adult
Abstract
Since the 1970-ies Sweden has actively developed strategies in social care, education and health care in order to counteract the negative consequences of adolescent parenthood. The aims of this study are to determine the annual incidence of singleton delivery among adolescents 1973-2010 and analyse obstetric and neonatal outcomes.
A retrospective cohort study, using data from the Swedish Medical Birth Register was conducted. All singleton deliveries in Sweden between 1973 and 2010 were included. Totally 1,941,940 women had 3,761,576 deliveries during the period. Analyses of obstetric and neonatal outcome were restricted to 1992-2010. Adolescents were subdivided into three groups: ?1000 ml and perineal rupture were significantly lower among teenagers. Although the rate with Apgar score
Notes
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PubMed ID
24207112 View in PubMed
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Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study.

https://arctichealth.org/en/permalink/ahliterature71110
Source
Acta Obstet Gynecol Scand. 2004 Apr;83(4):383-9
Publication Type
Article
Date
Apr-2004
Author
Eva Uustal Fornell
Gun Wingren
Preben Kjølhede
Author Affiliation
Department of Molecular and Clinical Medicine, Faculty of Health Sciences, University Hospital, Linköping, Sweden. Eva.Fornell@sergelgruppen.se
Source
Acta Obstet Gynecol Scand. 2004 Apr;83(4):383-9
Date
Apr-2004
Language
English
Publication Type
Article
Keywords
Abdomen - physiopathology
Adult
Cross-Sectional Studies
Fecal Incontinence - epidemiology - etiology
Female
Genital Diseases, Female - epidemiology - etiology
Health Surveys
Humans
Middle Aged
Pelvic Floor - physiopathology
Pressure
Prolapse
Random Allocation
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Urinary Incontinence - epidemiology - etiology
Abstract
OBJECTIVE: To describe a general population of women with regard to factors associated with urinary and fecal incontinence and genital prolapse symptoms. METHODS: A questionnaire about medical background, urinary and fecal incontinence and genital prolapse symptoms was mailed to 100040-year-old and 100060-year-old Swedish women. Associations were described by odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Sixty-seven percent answered the questionnaire. Multivariate analysis showed urinary incontinence to be associated with anal sphincter rupture [OR 4.4 (95% CI 1.0-18.8)], pelvic heaviness [3.8 (2.1-7.0)], body mass index (BMI) >or=30 kg/m2[3.7 (2.0-6.7)], multiparity [1.8 (1.0-3.4)], varicose veins surgery [1.9 (1.2-3.2)] and age [1.9 (1.2-3.2)]. Univariate analyses revealed statistically significant associations between urinary incontinence and incontinence for flatus [4.8 (3.0-7.8)], for liquid stool [5.0 (2.9-8.6)] and for solid stool [5.9 (2.4-14.2)]. Chronic bronchitis [5.7 (1.7-18.9)] was strongly associated with urinary incontinence but was only reported by the older age group. Prolapse symptoms were strongly associated with both urinary and fecal incontinence. Prolapse symptoms as opposed to urinary and fecal incontinence seemed to be associated more with injuries at delivery than with chronic pelvic floor strain. CONCLUSIONS: Women with urinary incontinence are also likely to suffer from fecal incontinence and prolapse and vice versa. Other associated factors for pelvic floor dysfunction were overweight, and especially obesity, chronic bronchitis, vaginal delivery and multiparity, age, heredity and diseases suggestive of collagen disorders. A multidisciplinary management of women with pelvic floor symptoms is suggested and possible prevention is discussed.
PubMed ID
15005787 View in PubMed
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Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study.

https://arctichealth.org/en/permalink/ahliterature264243
Source
BMJ Open. 2014;4(11):e005840
Publication Type
Article
Date
2014
Author
Marie Blomberg
Rasmus Birch Tyrberg
Preben Kjølhede
Source
BMJ Open. 2014;4(11):e005840
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Cohort Studies
Female
Humans
Infant, Newborn
Maternal Age
Parity
Pregnancy
Pregnancy outcome
Prospective Studies
Registries
Sweden
Young Adult
Abstract
To evaluate the associations between maternal age and obstetric and neonatal outcomes in primiparous women with emphasis on teenagers and older women.
A population-based cohort study.
The Swedish Medical Birth Register.
Primiparous women with singleton births from 1992 through 2010 (N=798,674) were divided into seven age groups:
Notes
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PubMed ID
25387756 View in PubMed
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Impact of Pelvic Pain and Endometriosis on Patient-Reported Outcomes and Experiences of Benign Hysterectomy: A Study from the Swedish National Register for Gynecological Surgery.

https://arctichealth.org/en/permalink/ahliterature295628
Source
J Womens Health (Larchmt). 2018 05; 27(5):691-698
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-2018
Author
Hanna Grundström
Siw Alehagen
Carina Berterö
Preben Kjølhede
Author Affiliation
1 Department of Obstetrics and Gynecology, Vrinnevi Hospital , Norrköping, Sweden .
Source
J Womens Health (Larchmt). 2018 05; 27(5):691-698
Date
05-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Endometriosis - diagnosis - epidemiology - surgery
Female
Humans
Hysterectomy - adverse effects - methods
Length of Stay
Middle Aged
Patient Reported Outcome Measures
Patient satisfaction
Pelvic Pain - epidemiology - etiology
Postoperative Complications - epidemiology
Registries
Retrospective Studies
Sweden - epidemiology
Treatment Outcome
Abstract
The study objective was to analyze and compare patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) after hysterectomy in women with and without a preoperative complaint of pelvic pain associated with and without a confirmed diagnosis of endometriosis.
Retrospective nationwide register study. Data on 28,776 hysterectomies performed on benign indication between 2004 and 2016 were retrieved from the Swedish National Register for Gynecological Surgery. Multivariable logistic regression models were used to compare the PREMs and PROMs items. The results are presented as adjusted odds ratios (aORs) and 95% confidence intervals (CI).
Regardless of the occurrence of pelvic pain preoperatively and a diagnosis of endometriosis, 1 year after surgery, the women were satisfied or very satisfied (>90%) with the hysterectomy, and their medical condition was improved or much improved (>95%). The women with a preoperative complaint of pelvic pain and endometriosis more often reported excessively short hospital stays (aOR 1.45, 95% CI 1.17-1.79), more severe complications after discharge (aOR 2.02, 95% CI 1.59-2.66) at the 8-week follow-up and at the 1-year follow-up (aOR 2.31, 95% CI 1.57-3.39), and more dissatisfaction with the operation (aOR 1.83, 95% CI 1.35-2.48) than preoperative pelvic pain-free women without endometriosis at the 1-year follow-up.
The majority of the women were satisfied after their hysterectomy. The women with pelvic pain and endometriosis were at a higher risk of being dissatisfied. Pelvic pain per se seemed to be the main factor affecting the rating in the PREMs and PROMs, and the endometriosis was a significant contributing factor.
PubMed ID
29148910 View in PubMed
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The influence of preoperative vaginal cleansing on postoperative infectious morbidity in abdominal total hysterectomy for benign indications.

https://arctichealth.org/en/permalink/ahliterature89921
Source
Acta Obstet Gynecol Scand. 2009;88(4):408-16
Publication Type
Article
Date
2009
Author
Kjølhede Preben
Halili Shefqet
Löfgren Mats
Author Affiliation
Department of Clinical and Experimental Medicine, University Hospital, Linkoping, Sweden. Preben.Kjolhede@imk.liu.se
Source
Acta Obstet Gynecol Scand. 2009;88(4):408-16
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Anti-Infective Agents, Local - pharmacology
Blood Transfusion - adverse effects
Chlorhexidine - pharmacology
Cohort Studies
Female
Humans
Hysterectomy - adverse effects - methods
Infection - epidemiology - etiology
Infection Control - methods
Length of Stay
Logistic Models
Middle Aged
Multivariate Analysis
Obesity - complications
Postoperative Complications - epidemiology - etiology - prevention & control
Premedication
Preoperative Care - methods
Prevalence
Registries
Retrospective Studies
Risk assessment
Risk factors
Smoking - adverse effects
Sodium Chloride - adverse effects - pharmacology
Surgical Wound Infection - epidemiology - etiology - prevention & control
Sweden - epidemiology
Abstract
OBJECTIVE: To evaluate whether vaginal cleansing reduces the risk of postoperative infection after abdominal total hysterectomy on benign indications and to analyze risk factors. DESIGN: Retrospective cohort study. SETTING: All clinics including patients in the Swedish National Register for Gynecological Surgery. POPULATION: All 7,193 women who underwent abdominal total hysterectomy for benign indications from 2000 to 2007. METHODS: Information on clinic routines for preoperative vaginal cleansing was obtained retrospectively in a postal survey. Associations between routines for vaginal cleansing and structured data from the Register were analyzed by means of multivariate logistic regression models. The main effect variable was postoperative infections defined as infections treated with antibiotics within six to eight weeks postoperatively, reported by the patient or the physician. MAIN OUTCOME MEASURES: Prevalence and risk factors for postoperative infections. RESULTS: Prevalence of postoperative infections was 14.4%. The prevalence did not differ between those having had vaginal cleansing using chlorhexidine and those without vaginal cleansing, whereas using saline solution was encumbered with a significantly increased risk. Risk factors for postoperative infections were age >60, obesity, smoking, weight of the uterus, duration of hospital stay, blood transfusion, and peroperative injury of the urinary bladder or ureter. CONCLUSION: Vaginal cleansing using chlorhexidine solution did not reduce the risk of postoperative infections, whereas vaginal cleansing using saline solution seemed to increase the risk. Some risk factors for postoperative infectious morbidity seem to be preventable.
PubMed ID
19235564 View in PubMed
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22 records – page 1 of 3.