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Jan-Henrik Stjerndahl

Publications and source records attributed to Jan-Henrik Stjerndahl.

4 recordsLinked to original sources
PubMed2006

Hysterectomy and incontinence: a study from the Swedish national register for gynecological surgery.

BACKGROUND: Hysterectomy is one factor that has been suggested to be a risk factor for developing stress incontinence. In Sweden, with a population of 8.86 million, a national register was set up in 1997 in order to have data for assessing the quality of gynecological surgery for benign disorders. METHODS: Data in the Swedish national register for gynecological surgery during the period 1997-2002 were investigated. Surgical methods compared during this time period were: total hysterectomy (abdominal/laparoscopic, n=198/116), subtotal hysterectomy (abdominal/laparoscopic, n=163/86), and total hysterectomy (vaginal/laparoscopic assisted vaginal, n=265/7). Patients who underwent endometrial destruction (endometrial ablation, endometrial balloon treatment, n=187) were used as a control group. Only patients with no preoperative complaints were included. Outcome measures were answers to subjective questions asked pre- and postoperatively regarding urinary problems and incontinence. RESULTS: De novo symptoms of stress incontinence, urgency and urgency incontinence, and/or mixed incontinence were noted in all groups. No differences were found among the groups. CONCLUSION: Factors other than hysterectomy should be discussed causing stress incontinence in women.

Adult↗
PubMed2005

A three-armed randomized trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using sutures and laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence.

OBJECTIVE: To compare open Burch colposuspension using sutures (OC) with laparoscopic colposuspension using sutures (LCS) and laparoscopic colposuspension using mesh and staples (LCM) in women with stress urinary incontinence. DESIGN: Prospective randomized trial. SETTING: Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. POPULATION: Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component attending the Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. METHODS: The women were assessed objectively using a 48-h frequency-volume chart, a 48-h pad test and a standardized stress test. Subjectively, the women were assessed by a questionnaire including influence on quality of life. The women were randomized to OC using sutures (n = 79), LCS (n = 53) or LCM (n = 79). Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared. Main outcome measures. Objective and subjective cure rate. RESULTS: Objective cure rates 1 year after surgery were significantly higher in the OC and LCS groups compared to the LCM group analyzed by a standardized stress test. Subjective findings were in concordance with the objective results. Performing an OC was less time consuming than performing a LCS and resulted in more blood loss compared to the two laparoscopic techniques. Patients in the LCM group had a shorter duration of catheter use and hospital stay. CONCLUSION: The use of sutures, irrespective of whether the surgical approach was laparoscopic or open surgery, was superior to the laparoscopic mesh and staple technique.

Adult↗
PubMed2004

A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence.

OBJECTIVE: To compare open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. DESIGN: Multicentre, prospective randomised trial. SETTING: Departments of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Borås County Hospital and Orebro University Hospital, Sweden. POPULATION: Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component were included, and were randomised to either open colposuspension (n= 120) or laparoscopic colposuspension (n= 120). METHODS: Women were randomised to open colposuspension with sutures or laparoscopic colposuspension with polypropylene mesh and staples. Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared. MAIN OUTCOME MEASURES: Objective and subjective cure rates from 48-hour frequency-volume chart, a 48-hour pad test and a subjective assessment of the woman's incontinence and quality of life performed one year after surgery. RESULTS: Objective and subjective cure rates were higher after open compared with laparoscopic colposuspension (P < 0.001). Quality of life was improved following surgery in both groups (P < 0.0001) and the improvement was significantly greater in the open colposuspension group (P < 0.05) with regard to physical activity. Performing an open colposuspension was less time consuming (P < 0.0001), resulted in more blood loss (P < 0.0001), longer catheterisation time (P < 0.01), greater risk of urinary retention (P < 0.01) and a longer hospital stay (P < 0.0001) compared with performing a laparoscopic colposuspension. The rate of serious complications was low in both groups. CONCLUSION: Open colposuspension had a higher objective and subjective cure rate one year after surgery but with a greater blood loss, greater risk of urinary retention and a longer hospital stay than laparoscopic colposuspension.

Adult↗