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Biomedical subjects

A Urnes

Publications and source records attributed to A Urnes.

16 recordsLinked to original sources
PubMed1997

[Follow-up of a procedure of antibiotic prophylaxis in cesarean section].

In order to assess the quality of the treatment given in our department, we studied the use of antibiotic prophylaxis in cases of cesarean section in relation to the implementation of a standard protocol. The records of 606 patients who underwent a cesarean section in 1989 and 1992 were studied retrospectively with regard to risk factors for postoperative infection, antibiotic prophylaxis and infections during hospitalisation. While the use of the antibiotic prophylaxis increased from 1989 to 1992, the number of postoperative infections remained relatively stable, 17% in 1989 and 14% in 1992. 55% of patients who were regarded as candidates for prophylaxis in this study were given antibiotic prophylaxis in 1992 (93 of 169 patients). 49 (53%) of these patients received an antibiotic prophylaxis in accordance with the protocol, whereas 44 (47%) were given other antibiotic regimens. The effect of treatment, as assessed by the number of postoperative infections, remained unchanged, while the use of antibiotic prophylaxis increased in the period after the protocol was implemented. The protocol was not followed as intended.

Adult↗
PubMed1996

Abdominal hysterectomy should not be considered as a primary method for uterine removal. A prospective randomised study of 100 patients referred to hysterectomy.

OBJECTIVE: The present study is a prospective randomized comparison of laparoscopically assisted vaginal hysterectomy (LH) with total abdominal hysterectomy (TAH). METHODS: 100 patients referred for uterine removal were included in the study, 46 undergoing LH and 54 TAH, at two teaching hospitals in Norway. RESULTS: In the LH group, the duration of surgery was longer while duration of hospitalization and time from operation to return to normal activity were shorter as compared to the TAH group. Postoperative pain, assessed by the need for analgesics, was less in the LH group. All these differences were statistically significant. There were two ureteral lesions in the LH group, and one center withdrew early from the study for this reason. CONCLUSIONS: In expert hands, LH as a primary method for uterine removal is superior to TAH.

Female↗
PubMed1995

The laparoscopic Burch procedure. A preliminary report.

Laparoscopic retropubic colposuspension (Burch procedure) is now being performed in our department as the treatment for genuine stress urinary incontinence. This study presents the first eight cases. Our experience with the laparoscopic approach seems promising. The operative technique has been developed, and the method provides better visualization of the space of Retzius, the patients experienced minimal blood loss and a shorter hospital stay than with the laparotomy approach. Although short follow-up, all the patients except one were continent after three months. This preliminary report demonstrates that laparoscopic Burch procedure may be a valuable addition to the new procedures in 'minimal invasive surgery'.

Adult↗
PubMed1993

Fertility outcome after treatment of tubal pregnancy by laparoscopic laser surgery.

In 150 women with tubal pregnancy consecutively treated over a two year period by laparoscopic techniques, 74 were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases non-conservatively through the laparoscope by salpingectomy. Between 15 and 37 months later all patients were contacted by means of questionnaires to evaluate subsequent fertility outcome. Sixty-six percent (38/58) of those women who desired pregnancy after conservative laparoscopic treatment achieved an intrauterine pregnancy. The corresponding rate for women who desired pregnancy after salpingectomy was 45% (18/40). The recurrent ectopic pregnancy rates in the two groups were 7% (4/58) and 10% (4/40), respectively. This study confirms that tubal pregnancy can be appropriately managed by laparoscopic laser surgery with the advantages of minimal invasive techniques.

Female↗
PubMed1992

[Examination and treatment of gynecological bleeding disorders].

The investigation and treatment of gynaecological dysfunctional bleeding has remained largely unchanged since the problem was dealt with in a special issue of the Journal of the Norwegian Medical Association in 1976, in spite of the advent of modalities like endometrial cytology, hysteroscopy and vaginal ultrasonography, as well as knowledge about the relative lack of efficiency of dilatation and curettage in the investigation and treatment of the condition. We describe a modern programme for investigation and treatment of gynaecological dysfunctional bleeding. The programme relies on clinical assessment combined with medical therapy, with optional use of modern investigative modalities when indicated. In a strictly controlled outpatient programme the need for dilatation and curettage can be greatly reduced without jeopardizing the safety of the patient.

Adult↗
PubMed1992

Laparoscopic hysterectomy. Initial experience.

Laparoscopic hysterectomy is now being performed in our department in cases where no malignancy is suspected. This study presents the first 10 cases. Indications for hysterectomy were myomas, meno- and metrorrhagia resistant to medical and hysteroscopic treatment, and patients with pain and suspicion of having adenomyosis. No complications have been encountered during the laparoscopic operations, but one patient had a second laparoscopy on the first postoperative day due to postoperative bleeding. Another patient had a postoperative infection leading to a compression of the ureter. This report demonstrates that laparoscopic hysterectomy is a valuable addition to the new procedures in 'minimal invasive surgery', but only after long and appropriate training.

Adult↗
PubMed1991

Treatment of tubal pregnancy by laparoscopic laser surgery.

We present 150 consecutive cases of tubal pregnancy treated by laparoscopic techniques. A three-puncture technique was used. 74 cases were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases were treated nonconservatively through the laparoscope by salpingectomy or tubal resection. Contra-indications to laparoscopic surgery were haemodynamically unstable patient and interstitial pregnancy. Seventy-five per cent of all tubal pregnancies were treated by laparoscopy in the period studied. No complications were encountered during the laparoscopic operations. Two patients needed a second laparoscopy, while 2 others underwent a subsequent laparotomy. This study has shown that tubal ectopic pregnancies can in most cases be effectively managed by laparoscopic techniques.

Adolescent↗
PubMed1991

Laparoscopic adnexectomy.

We are now performing laparoscopic adnexectomy in selected cases of benign pathology of the adnexa. This report is presented to show that even fairly large tumors may be removed by this technique. It involves 30 cases of tumors having a diameter more than 4 cm that were operated on over a period of 12 months. Cystectomies and cystotomies were not included in this study. Patients were excluded if there was any suspicion of malignancy. Indications for laparoscopy were functional and organic cysts, tubo-ovarian abscesses, and adnex torsions due to large hydrosalpinx. No complications have been encountered during the laparoscopic operation or during the follow-up period of 6-18 months.

Abscess↗
PubMed1989

[Laser endoscopy in gynecology].

Today endoscopic laser is applied gastroenterology, urology and otorhinolaryngology, and the technique is being steadily developed. In the gynecological field the most commonly used technique is the CO2-laser, but the ND: YAG-laser is also being applied through the hysteroscope. At our department we have done 16 laparoscopic operations using the CO2 laser. The method is described and discussed.

Adult↗
PubMed1989

[An epidemic of ectopic pregnancies in Ostre Akershus. Looking for possible causes].

During the period 1969 to 1985, 640 women with a confirmed diagnosis of ectopic pregnancy were admitted to Sentralsykehuset i Akershus. The case histories were reviewed for possible predisposing factors. From 1969 to 1985 the frequency of ectopic pregnancy increased threefold in relation to the number of conceptions in the same region. Until 1978 the major part of this increase was observed among women with IUCD in situ. Women who had previously undergone surgery on the uterine tubes accounted for the greater part of the increase in extrauterine pregnancies after 1976. A large year-to-year variation was found among women with neither of the above predisposing factors. However, a rising frequency of ectopic pregnancies was also observed in this group. It appears that the risk of ectopic pregnancy is greater among women using IUCD than among women using other methods of contraception.

Female↗
PubMed1981

Chlamydia trachomatis as a cause of acute perihepatitis associated with pelvic inflammatory disease.

Of four cases of acute salpingitis and perihepatitis confirmed by laparoscopy Chlamydia trachomatis was cultured from the cervix only in two and from both the cervix uteri and the Fallopian tubes in two; the latter finding has not been reported from cases with combined salpingitis and perihepatitis (Fitz-Hugh-Curtis syndrome). Since gonococci, other aerobic, or anaerobic bacteria were not isolated from the Fallopian tubes, an aetiological relationship between C trachomatis and the Fitz-Hugh-Curtis syndrome is suggested.

Acute Disease↗