| 1. |
- Campbell, Jennifer, et al.
(författare)
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Patient-reported outcomes after sacrospinous fixation of vault prolapse with a suturing device : a retrospective national cohort study
- 2018
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Ingår i: International Urogynecology Journal. - : Springer. - 0937-3462 .- 1433-3023. ; 29:6, s. 821-829
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and hypothesis: Innovations in suturing devices have facilitated sacrospinous ligament fixation (SSF) for the correction of vaginal vault prolapse. It is uncertain if outcomes using suturing devices differ from those using a traditional suturing technique. We hypothesize that no difference exists in the efficacy and safety 1 year after SSF for vault prolapse performed with suturing devices or using a traditional technique. The objective was to compare SSF using a suturing device with traditional SSF for the treatment of vault prolapse, regarding symptoms of prolapse recurrence, patient satisfaction, incidence of re-operation, and complications 1 year postoperatively.Methods: We carried out a retrospective cohort study using register-based national data from 2006 to 2013. The Swedish Quality Register of Gynecological Surgery includes assessments pre-operatively, at hospital admittance, surgery, discharge, and questionnaires at 8 weeks and 1 year after surgery. Demographic variables and surgical methods were included in multivariate logistic regression analyses.Results: In the suturing device group (SDG, n = 353), 71.5% were asymptomatic of recurrence after 1 year compared with 78.7% in the traditional SSF group (TSG, n = 195); risk difference - 7.3% (95%CI -15.2%; 0.7%). Adjusted odds ratio (aOR) for being asymptomatic 1 year postoperatively was 0.56 (95%CI 0.31; 1.02, p = 0.057). Patient satisfaction was similar in SDG and TSG (78.1% vs 78.4%). Reoperation occurred in 7.4% in the SDG compared with 3.6% in the TSG, risk difference 3.8% (95%CI 0.0%; 7.5%), aOR 3.55 (95%CI 1.10; 11.44, p = 0.03).Conclusions: Patient satisfaction was similar 1 year after SSF, despite symptoms of recurrence being more likely and reoperation more common after using a suturing device compared with a traditional technique. The methods did not differ with regard to surgical complications.
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| 2. |
- Pedroletti, Corinne, 1967-
(författare)
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Tension-free Vaginal Tape at a Medium Sized Hospital in Sweden : Short- and Long-term Results in Different Patient Groups
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the years 1995 to 2001, 970 women with urinary incontinence underwent surgery with tension-free vaginal tape (TVT) at the Department of Obstetrics and Gynecology, Falun Hospital. In 2002 the charts of all these women were reviewed and a questionnaire was sent in 2004. 760 women (78,4%) answered the questions. The mean time since surgery was 5.7 years. The mean age at surgery was 58.7 years. Of all patients, 580 had pure stress urinary incontinence (SUI) and 112 had mixed urinary incontinence (MUI) prior to surgery. Of the women with SUI, 85 % were subjectively and persistently cured. Of the women with MUI, 60 % were subjectively cured up to 3 years after the TVT operation. However this figure declined to 30 % among women operated on 6-8 years previously. The increasing incontinence was due to urgency symptoms and urge urinary incontinence (UUI).The IIQ-7 and UDI-6 questionnaires were used for measuring quality of life. The women showed dramatic improvement after TVT surgery irrespective of time since surgery. Women with chronic diseases also had relative improvement in QOL scores. Sixty-seven of the women with pure SUI preoperatively (14.5%) reported persistent de novo urgency symptoms postoperatively and 51 of the women also had UUI. Old age, history of cesarean section, increasing parity and BMI were risk factors for developing de novo urgency after TVT procedure. Among women ≥ 75 years 55.7% reported cure after TVT, compared to 79.7% of women < 60 years. The overall cure rate in the very overweight women (BMI ≥ 35) was 52.1%, compared to 81.2% in women of normal weight (BMI < 25). Conclusions. The subjective results after TVT surgery for SUI are very good even after 8 years. Short-term effect of TVT on MUI is acceptable, but declines after 3 years. Improvements in measures of quality of life after TVT surgery are dramatic and persistent in both the SUI and MUI groups. Women who developed de novo urgency symptoms after TVT surgery reported poorer quality of life. The TVT procedure is simple and safe, but the results in the oldest or most overweight women are not as good as in the younger or normal weight women.
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| 3. |
- Pong, Joanna, et al.
(författare)
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Does anesthetic method influence vaginal bulge symptoms and patient satisfaction after vaginal wall repair surgery?
- 2015
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Ingår i: International urogynecology journal. - : Springer Science and Business Media LLC. - 1433-3023 .- 0937-3462. ; 26:9, s. 1361-7
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Tidskriftsartikel (refereegranskat)abstract
- Surgery for pelvic organ prolapse (POP) under local anesthesia has been advocated for several reasonssuch as lower costs and application in multimorbid patients. The aim of this study was to investigate how the anesthetic method influences the rate of recurrent prolapse and patient satisfaction with POP surgery.
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| 4. |
- Stenström Bohlin, Katja, et al.
(författare)
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The influence of the modifiable life-style factors body mass index and smoking on the outcome of mid-urethral sling procedures for female urinary incontinence
- 2015
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Ingår i: International Urogynecology Journal. - : Springer Science and Business Media LLC. - 0937-3462 .- 1433-3023. ; 26:3, s. 343-351
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and hypothesis: The aim of this observational study was to investigate the influence of body mass index (BMI) smoking and age on the cure rate, rate of complications and patient satisfaction with mid-urethral sling (MUS) procedures.Methods: Pre-, peri- and postoperative (8 weeks and 1 year) data were retrieved from the Swedish National Register for Gynecological Surgery of MUS procedures (retropubic procedures, n = 4,539; transobturator procedures, n =1,769) performed between January 2006 and December 2011. Multiple logistic regression analyses were performed between the outcome variables and BMI and smoking, presented as adjusted odds ratios (adjOR) with 95 % confidence interval (CI).Results: Subjective 1-year cure rate was 87.4 % for all MUS procedures (88.3 % with the retropubic technique and 85.2 % with the transobturator technique (p = 0.002). Preoperative daily urinary leakage and urgency were more common with increasing BMI, but surgery reduced symptoms in all BMI groups. Lower cure rate was seen in women with a BMI >30 (0.49; CI 0.33–0.73), in diabetics (0.50; CI 0.35–0.74) and women aged > 80 years (0.18; CI 0.06–0.51). Perioperative complications were more common in the retropubic group (4.7 % vs 2.3 % in the transobturator group, p=0.001) and in women with BMI < 25. Smoking did not influence any of the outcome variables.Conclusions: The overall 1-year cure rate for MUS procedures was 87 %, but was negatively influenced by BMI >30, diabetes and age > 80 years. Perioperative complications were more common with the retropubic procedure than with the transobturator technique, and in women with a BMI < 25. Smoking did not impact on any of the studied outcome variables.
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| 5. |
- Stridsman, Caroline, et al.
(författare)
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The Swedish National Airway Register (SNAR): development, design and utility to date
- 2020
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Ingår i: European Clinical Respiratory Journal. - : Informa UK Limited. - 2001-8525. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Swedish National Airway Register (SNAR) was initiated in 2013 to ensure and improve the quality of care for patients with asthma and COPD. Aim: To describe the development and design of SNAR, and to study the 2019 data to evaluate its potential utility related to improvement of quality of care. Methods: SNAR includes data from patients with asthma (both children and adults) and COPD from primary, secondary and tertiary care, and also, for COPD inpatient care. Data on diagnostic investigations (e.g. spirometry, blood sample, skin prick test), symptom-scores, comorbidities and prescribed treatments are registered. The registrations are entered manually by healthcare professionals, or directly transferred from electronic medical records to a web-based platform. Results: In 2019, 1000 clinics participated and data were directly transferred by about 88% of them. The register included data on 205,833 patients with asthma and 80,372 with COPD (of these, 5% had both diagnoses). Registrations of new patients and follow-up visits from primary and secondary/tertiary care in 2019 were completed for 75,707 patients with asthma (11,818 children <12 yr, 6545 adolescents 12-17 yr, and 57,344 adults >17 yr) and 38,117 with COPD. Depending on age and disease group, 43-77% had performed spirometry, 36-65% Asthma Control Test, and 60% COPD Assessment Test. The prevalence of current smoking was about 2% in adolescents, 10% in adults with asthma, and 34% in COPD. For these, smoking cessation support was offered to 27%, 38% and 51%, respectively. Overall, limited data were available on investigation of allergy, 6-min walk test, patient education and written treatment plans. Regarding asthma, sex-differences in disease management were evident. Conclusion: SNAR has cumulatively registered data from over 270,000 individuals, and the register is important for patients, caregivers, authorities, politicians and researchers to evaluate the effect of treatment and to ensure high and equal quality of care nationwide.
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