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23 records – page 1 of 3.

A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature272920
Source
BJOG. 2016 Jan;123(1):136-42
Publication Type
Article
Date
Jan-2016
Author
M. Rudnicki
E. Laurikainen
R. Pogosean
I. Kinne
U. Jakobsson
P. Teleman
Source
BJOG. 2016 Jan;123(1):136-42
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Collagen
Denmark - epidemiology
Dyspareunia - epidemiology - etiology
Female
Finland - epidemiology
Follow-Up Studies
Gynecologic Surgical Procedures - instrumentation - methods
Humans
Norway - epidemiology
Pelvic Organ Prolapse - epidemiology - surgery
Prospective Studies
Quality of Life
Surgical Mesh
Surveys and Questionnaires
Sweden - epidemiology
Treatment Outcome
Vagina - surgery
Abstract
To compare the 1-year (previously published) and 3-year objective and subjective cure rates, and complications, related to the use of a collagen-coated transvaginal mesh for anterior vaginal wall prolapse against a conventional anterior repair.
Randomised controlled study.
Six departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark.
A total of 138 women, of 55 years of age or older, admitted for stage =2 anterior vaginal wall prolapse.
The women scheduled for primary anterior vaginal wall prolapse surgery were randomised between conventional anterior colporrhaphy and surgery with a collagen-coated prolene mesh. All patients were evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) assessment before and after surgery. Symptoms related to pelvic organ prolapse were evaluated using the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic Floor Distress Inventory (PFDI-20).
Objective cure, defined as POP-Q stage
PubMed ID
26420345 View in PubMed
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Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation.

https://arctichealth.org/en/permalink/ahliterature185342
Source
Acta Obstet Gynecol Scand. 2003 May;82(5):471-8
Publication Type
Article
Date
May-2003
Author
Kari Nieminen
Heini Huhtala
Pentti K Heinonen
Author Affiliation
Department of Obstetrics and Gynecology, Tampere University Hospital and Medical School and School of Public Health, University of Tampere, Tampere, Finland. kn37975@uta.fi
Source
Acta Obstet Gynecol Scand. 2003 May;82(5):471-8
Date
May-2003
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Antibiotic Prophylaxis
Broad Ligament - surgery
Female
Finland
Gynecologic Surgical Procedures - adverse effects - methods
Humans
Middle Aged
Multivariate Analysis
Pelvic Floor - surgery
Proportional Hazards Models
Pulmonary Embolism - etiology
Quality of Life
Recurrence
Retrospective Studies
Risk factors
Sacrococcygeal Region - physiopathology - surgery
Time Factors
Urinary Tract Infections - etiology
Uterine Prolapse - physiopathology - surgery
Vagina - surgery
Abstract
To identify risk factors in recurrence and to evaluate anatomic and functional results of vaginal sacrospinous ligament fixation and pelvic floor reconstruction for genital prolapse.
One hundred and thirty-eight women underwent surgery for uterovaginal or vault prolapse. Follow-up data were available for 122 cases; 83% were examined and others were interviewed by telephone. The median (range) follow-up was 24 (1-141) months. Cox regression was used to identify risk factors associated with recurrence; uni- and multivariate regression was used to identify risk factors underlying postoperative infections because infections were found to be a risk factor of recurrence. Recurrence-free survival was estimated using the Kaplan-Meier method.
Seven (5%) patients suffered severe cardiopulmonary complications including one postoperative death due to a pulmonary embolism. Twenty-six (21%) patients suffered a recurrence, 14 with cystocele. Ten patients with recurrence were symptomatic and six underwent a re-operation. The Cox regression model showed that vaginal cuff infection raised the odds ratio (OR) for recurrence to 6.13 [confidence interval (CI) 1.80-20.83] and urinary tract infection to 3.65 (CI 1.40-9.47). In both uni- and multivariate analysis, lack of intravenous antibiotic prophylaxis, age less than 73 years and vaginal ulcerations were statistically significant risk factors for postoperative infection. Eleven (33%) out of 33 sexually active women reported improvement and three (9%) complained of dyspareunia.
Transvaginal sacrospinous ligament fixation with pelvic floor repair is an effective means of correcting both vault prolapse and uterine procidentia. Women who wish to preserve coital function will also benefit from this operation. Postoperative infection is an independent and most important individual risk factor underlying recurrence. Prophylactic antibiotics seem to be effective in reducing the rate of postoperative infections.
PubMed ID
12752079 View in PubMed
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Anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature106735
Source
BJOG. 2014 Jan;121(1):102-10; discussion 110-1
Publication Type
Article
Date
Jan-2014
Author
M. Rudnicki
E. Laurikainen
R. Pogosean
I. Kinne
U. Jakobsson
P. Teleman
Author Affiliation
Department of Obstetrics and Gynaecology, Roskilde University Hospital, Roskilde, Denmark.
Source
BJOG. 2014 Jan;121(1):102-10; discussion 110-1
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Collagen
Cystocele - surgery
Denmark
Female
Finland
Humans
Middle Aged
Norway
Quality of Life
Questionnaires
Sexuality
Surgical Mesh
Sweden
Treatment Outcome
Vagina - surgery
Abstract
To investigate the anatomical cure rate and complications related to collagen-coated mesh for cystocele, compared with a conventional anterior colporrhaphy.
A randomised controlled study.
Six departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark.
Women aged 55 years or older, referred for surgery with a prolapse of the anterior vaginal wall of stage 2 or higher.
Women scheduled for primary cystocoele surgery were randomised to either anterior colporrhaphy or a collagen-coated Prolene mesh. Power analysis indicated that 130 patients had to be randomised. All patients were evaluated using the Pelvic Organ Prolapse-Quantification (POP-Q) measurement. Quality of life, symptoms, and sexual function were evaluated using the Pelvic Floor Impact Questionnaire, the Pelvic Floor Distress Inventory, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire.
The primary outcome was objective cure, defined as prolapse below POP-Q stage 2 at the 12-months follow-up. Secondary outcomes were quality of life, symptoms, and presence (or not) of complications.
In total, 161 women were randomised to either anterior colporrhaphy or mesh (participant ages 64.9 ± 6.4 years versus 64.7 ± 6.6 years, respectively; mean ± SD). The objective cure rate was 39.8% (95% CI 28.6-50.9%) in the anterior colporrhaphy group, compared with 88.1% (95% CI 80.7-95.6%) in the mesh group (P
PubMed ID
24118844 View in PubMed
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Can the PFDI (Pelvic Floor Distress Inventory) or PFIQ (Pelvic Floor Impact Questionnaires) be used to predict outcome in pelvic reconstructive surgery?

https://arctichealth.org/en/permalink/ahliterature107420
Source
Prog Urol. 2013 Sep;23(11):940-5
Publication Type
Article
Date
Sep-2013
Author
V. Letouzey
G. Mercier
S. Adjoussou
E. Bohoussou
P. Mares
R. de Tayrac
Author Affiliation
Gynecology and obstetrics department, Caremeau university hospital, place Pr R.-Debré, 30900 Nimes, France. Electronic address: Vincent.go@wanadoo.fr.
Source
Prog Urol. 2013 Sep;23(11):940-5
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Aged
Canada
Colposcopy - methods
Female
Follow-Up Studies
Humans
Middle Aged
Pelvic Floor - physiopathology - surgery
Pelvic Organ Prolapse - diagnosis - physiopathology - surgery
Predictive value of tests
Prospective Studies
Quality of Life
Questionnaires
Reconstructive Surgical Procedures - methods
Reproducibility of Results
Retrospective Studies
Sensitivity and specificity
Severity of Illness Index
Surgical Mesh
Treatment Outcome
Uterine Prolapse - physiopathology - surgery
Vagina - surgery
Abstract
To determine a syndrome score threshold on PFDI or PFIQ predictive of a significant improvement in post-operative functional results.
A retrospective case review (Canadian Task Force Classification II-2).
University and research hospital.
Women diagnosed with pelvic organ prolapse and repaired with synthetic vaginal mesh.
Quality of life was arbitrarily considered to have improved significantly if the score decreases by more than 50% between pre-operatively and 36 months post-operatively. We investigated the pre-operative cut-off score predictive of no quality of life improvement at M36 from a prospective trial for surgical pelvic organ prolapse treatment.
The most accurate pre-operative cut-off score predicting a failure to improve quality of life at 36 months post-operatively was 62/300 (PFDI Score). This cut-off value had a positive predictive value of 83.6% and specificity of 62.1%. No significant threshold was obtained from the PFIQ score.
The intensity of symptoms before surgery may interfere as a predictive factor for outcome.
PubMed ID
24010925 View in PubMed
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Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free vaginal tape procedure.

https://arctichealth.org/en/permalink/ahliterature187864
Source
Acta Obstet Gynecol Scand. 2002 Nov;81(11):1066-73
Publication Type
Article
Date
Nov-2002
Author
Jan Persson
Pia Teleman
Christina Etén-Bergquist
Pål Wølner-Hanssen
Author Affiliation
Department of Obstetrics and Gynecology, University Hospital Lund, Lund, Sweden. jan.persson@gyn.lu.se
Source
Acta Obstet Gynecol Scand. 2002 Nov;81(11):1066-73
Date
Nov-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Costs and Cost Analysis
Female
Hospital Costs
Hospitals, University - economics
Humans
Laparoscopy - economics
Middle Aged
Prospective Studies
Prostheses and Implants - economics
Sweden
Time Factors
Treatment Outcome
Urinary Incontinence, Stress - surgery
Urologic Surgical Procedures - economics
Vagina - surgery
Abstract
The aim of this study was to compare laparoscopic colposuspension with tension-free vaginal tape (TVT) in terms of costs to the county.
In a prospective, randomized study, we approached 270 consecutive women presenting for evaluation of stress urinary incontinence symptoms at one university hospital. Preoperatively, and at 1-year follow-up, the women underwent urodynamic evaluation, an ultra-short pad-test and completed a lower urinary tract symptoms questionnaire. We randomized 79 consenting, eligible women to either procedure; a 1-year follow-up examination was performed on 68/71 (96%) women that were available. The procedures were performed as described previously. Main outcome measures were all relevant costs for goods and services associated with the procedures.
The baseline characteristics of the two groups were similar. The TVT procedure was performed significantly faster than the laparoscopic colposuspension, i.e. 44.9 +/- 14.2 min compared with 60.5 +/- 13.4 min (p
PubMed ID
12421176 View in PubMed
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A cost-effectiveness analysis of tension-free vaginal tape versus laparoscopic mesh colposuspension for primary female stress incontinence.

https://arctichealth.org/en/permalink/ahliterature165431
Source
Acta Obstet Gynecol Scand. 2006;85(12):1485-90
Publication Type
Article
Date
2006
Author
Antti Valpas
Pekka Rissanen
Erkki Kujansuu
Carl-Gustaf Nilsson
Author Affiliation
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland. antti.valpas@ekshp.fi
Source
Acta Obstet Gynecol Scand. 2006;85(12):1485-90
Date
2006
Language
English
Publication Type
Article
Keywords
Colposcopy - economics - methods
Cost-Benefit Analysis
Female
Finland
Follow-Up Studies
Health Care Costs
Humans
Length of Stay
Postoperative Complications - economics - epidemiology
Quality of Life
Surgical Mesh - economics
Surgical Tape - economics
Treatment Outcome
Urinary Incontinence, Stress - economics - surgery
Vagina - surgery
Abstract
Evaluation of cost-effectiveness of new surgical techniques is important. As the data on incontinence procedures are scarce, we evaluated the cost-effectiveness of tension-free vaginal tape procedure and laparoscopic mesh colposuspension as a primary surgical treatment for female stress urinary incontinence.
In four university teaching hospitals and two central hospitals 128 stress incontinent women were randomized to tension-free vaginal tape procedure (n=70) or laparoscopic mesh colposuspension (n=51) in order to investigate the clinical performance of these two procedures. Primary objective clinical outcome measures were: stress test and 48-h pad test. Secondary subjective outcome measures were health-related quality of life measured in terms of visual analogue scale and Urinary Incontinence Severity Score. Alongside the clinical trial, a cost-effectiveness analysis for the main outcome measures was performed.
The changes in the 48-h pad test result did not reach statistical significance (p=0.105). When the visual analogue scale or Urinary Incontinence Severity Score are used as the outcome measure, the tension-free vaginal tape is more cost-effective than laparoscopic mesh colposuspension over a follow-up period of one year (p
PubMed ID
17260226 View in PubMed
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Cost-minimisation analysis of vaginal wall repair in an inpatient or outpatient regimen.

https://arctichealth.org/en/permalink/ahliterature77776
Source
Acta Obstet Gynecol Scand. 2007;86(4):473-9
Publication Type
Article
Date
2007
Author
Sørensen Jan
Axelsen Susanne Maigaard
Author Affiliation
Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, Denmark. jas@cast.sdu.dk
Source
Acta Obstet Gynecol Scand. 2007;86(4):473-9
Date
2007
Language
English
Publication Type
Article
Keywords
Ambulatory Surgical Procedures - economics
Cohort Studies
Cost Savings
Costs and Cost Analysis
Denmark
Female
Health Care Costs
Hospitalization - economics
Humans
Middle Aged
Postoperative Complications - economics - epidemiology
Treatment Outcome
Vagina - surgery
Abstract
BACKGROUND: The study's objective was to compare the cost of vaginal wall repair under local anesthesia, undertaken in either an inpatient or an outpatient regimen. The perspective used was that of a department of gynecology over the short and medium term. METHODS: The analysis was based on 2 consecutive cohorts of inpatients and outpatients treated in a Danish university hospital. Data on resource use were collected from clinical records and via a patient telephone survey. Salary and drug costs were estimated from national sources. Costs for consumables, complications and overnight stays were estimated from local data. The analysis compared the costs of inpatient and outpatient surgery relating to staff time, anesthesia, operation, recovery, overnight stays and complications. Multiple regression was employed to adjust for confounding variables. RESULTS: The average cost was estimated to be 10,400 DKK per inpatient and 6,100 DKK per outpatient (2004 price level: 1 euro = 7.50 DKK). Costs relating to overnight stays and staff costs during operation were the largest contributors to the cost difference. Total cost was significantly associated with type of regimen (in- or outpatient), type of operation and complications. After adjustment for confounding variables, the cost difference was estimated at 3,700 DKK (95% bootstrap confidence interval: 2,500-5,000 DKK). The risk of complication was similar for the 2 regimens. CONCLUSION: Vaginal wall repair under local anesthesia, undertaken in an outpatient regimen, appears to be less costly than in an inpatient regimen.
PubMed ID
17486471 View in PubMed
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Effects of anterior trocar guided transvaginal mesh surgery on lower urinary tract symptoms.

https://arctichealth.org/en/permalink/ahliterature144871
Source
Neurourol Urodyn. 2010 Nov;29(8):1419-23
Publication Type
Article
Date
Nov-2010
Author
Marion Ek
Daniel Altman
Christian Falconer
Sigurd Kulseng-Hanssen
Gunilla Tegerstedt
Author Affiliation
Division of Obstetrics and Gynaecology, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. marion.ek@sodersjukhuset.se
Source
Neurourol Urodyn. 2010 Nov;29(8):1419-23
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Aged
Chi-Square Distribution
Female
Gynecologic Surgical Procedures - adverse effects - instrumentation
Humans
Middle Aged
Prospective Studies
Risk assessment
Risk factors
Scandinavia
Surgical Instruments
Surgical Mesh
Time Factors
Treatment Outcome
Urinary Bladder Neck Obstruction - etiology - physiopathology - prevention & control
Urinary Bladder, Overactive - etiology - physiopathology - prevention & control
Urinary Incontinence, Stress - etiology - physiopathology
Urodynamics
Urologic Diseases - etiology - physiopathology - prevention & control
Uterine Prolapse - complications - physiopathology - surgery
Vagina - surgery
Abstract
To assess the effects of trocar guided transvaginal mesh on lower urinary tract symptoms after anterior vaginal wall prolapse repair.
One hundred twenty-one patients undergoing anterior transvaginal mesh surgery was prospectively evaluated at baseline and 1 year after surgery using the urogenital distress inventory (UDI).
Overall UDI scores declined from 91 before surgery to 31 one year after surgery (P?
PubMed ID
20229504 View in PubMed
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Evaluation of total laparoscopic hysterectomy with and without the use of barbed suture.

https://arctichealth.org/en/permalink/ahliterature107441
Source
J Obstet Gynaecol Can. 2013 Aug;35(8):718-22
Publication Type
Article
Date
Aug-2013
Author
Ali Bassi
Togas Tulandi
Author Affiliation
Department of Obstetrics and Gynecology, McGill University, Montreal QC.
Source
J Obstet Gynaecol Can. 2013 Aug;35(8):718-22
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood Loss, Surgical - prevention & control
Blood volume
Canada
Comparative Effectiveness Research
Female
Humans
Hysterectomy - adverse effects - instrumentation - methods
Laparoscopy - adverse effects - instrumentation - methods
Length of Stay
Middle Aged
Operative Time
Organ Size
Polydioxanone
Postoperative Complications - classification - epidemiology - prevention & control
Retrospective Studies
Suture Techniques - standards
Uterus - pathology - surgery
Vagina - surgery
Abstract
To evaluate the outcome of total laparoscopic hysterectomy with and without the use of barbed suture.
We conducted a retrospective study among patients who underwent total laparoscopic hysterectomy between February 2008 and August 2012. The parameters evaluated were age, BMI, operative time, hospital stay, pre- and postoperative hemoglobin levels, uterine weight, intraoperative blood loss, and postoperative complications.
A total of 202 women underwent total laparoscopic hysterectomy; barbed suture (V-Loc) was used in 63 women, and polydioxanone (PDS) in 139. Estimated blood loss, difference in hemoglobin level before and after surgery, operative time, and the duration of hospital stay were comparable between the two groups of patients. The incidence of postoperative fever was higher in the V-Loc group than in the PDS group (P = 0.003). Multiple linear regression analysis showed that the incidence of postoperative fever was related to BMI (P = 0.02, r = 0.22) and estimated blood loss (P = 0.004, r = 0.28) and not to age, operative time, or uterine weight.
The use of barbed suture to close the vaginal vault after laparoscopic hysterectomy, compared with standard suture, results in similar operative time, blood loss, and duration of hospital stay. The use of barbed suture is technically less demanding than the use of regular sutures.
PubMed ID
24007707 View in PubMed
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Source
Acta Obstet Gynecol Scand. 2002 Feb;81(2):138-46
Publication Type
Article
Date
Feb-2002
Author
Marianne Ottesen
Mette Sørensen
Yvonne Rasmussen
Steen Smidt-Jensen
Henrik Kehlet
Bent Ottesen
Author Affiliation
Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark.
Source
Acta Obstet Gynecol Scand. 2002 Feb;81(2):138-46
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Comparative Study
Confidence Intervals
Denmark
Female
Follow-Up Studies
Humans
Hysterectomy, Vaginal - adverse effects - methods
Intraoperative Complications - therapy
Length of Stay - trends
Middle Aged
Odds Ratio
Patient satisfaction
Postoperative Care - methods
Postoperative Complications - therapy
Probability
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Treatment Outcome
Uterine Prolapse - surgery
Vagina - surgery
Abstract
OBJECTIVE: Our aim was to describe the need for postoperative hospitalization after vaginal surgery for utero-vaginal prolapse with well-defined charts for postoperative care. DESIGN: A prospective, descriptive study. Consecutive women admitted for first-time vaginal surgery for utero-vaginal prolapse at a public university hospital in Copenhagen, Denmark, underwent surgery and postoperative care in a fast track setting from September 15, 1999 to June 15 2000. METHODS: A multimodal rehabilitation model with emphasis on information, standardized general anesthesia, reduced surgical distress, optimized pain-relief, early oral nutrition and ambulation, minimal use of indwelling catheter and vaginal packing. OUTCOME MEASURES: Postoperative hospital stay, complications, re-admission, success rate, patients' satisfaction and acceptability. RESULTS: Forty-one women with a median age of 69 years (range, 44-88 years) were included. All underwent anterior and/or posterior vaginal repair. Nineteen (46.3%) underwent vaginal hysterectomy, and eight (19.5%) underwent the Manchester procedure. Postoperative hospital stay was median 24 hr. Only three (7.3%) were discharged later than 48 hr. No re-admissions occurred. The most frequent complications were urinary retention exceeding 450 ml, and urinary tract infection (12.2%, and 9.8%, respectively). Short-term success rate was 97.6%. Patients' satisfaction rates were 85.4-95.1%. The median score of acceptability was 10 on a 0-10 points scale. CONCLUSION: The need for postoperative hospitalization was median 24 hr after vaginal surgery in a fast track setting, independently of the complexity of the procedure performed. Short-term success rate, satisfaction rates, and acceptability were all excellent. Follow up has been established to evaluate long-term success rates and recurrence.
PubMed ID
11942904 View in PubMed
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23 records – page 1 of 3.