PubMed Health⌕ Search

Biomedical subjects

Y Pitkänen

Publications and source records attributed to Y Pitkänen.

10 recordsLinked to original sources
PubMed2004

The Rosti sling: a new, minimally invasive, tension-free technique for the surgical treatment of female urinary incontinence-the first 217 patients.

PURPOSE: We evaluated the outcome of a new, innovative, inexpensive tension-free technique, the Rosti sling (RS), for female urinary incontinence. MATERIALS AND METHODS: RS was performed in 217 patients under local (45%), spinal (52%) or general (3%) anesthesia. A 1.5 x 33 cm strip of polypropylene mesh was inserted under the mid urethra from above through small suprapubic stabs down and out through a 1.5 cm midline vaginal incision using the Stamey needle. Of the women 76% had stress urinary incontinence and 24% had mixed incontinence. Patient age was 24 to 90 years (mean 56) and parity was 0 to 6 (mean 2). The diagnosis of incontinence was based on history and physical examinations with a cough stress test. Mean followup was 23 months. RESULTS: Mean operative time was 25 minutes (range 15 to 45) and mean hospital stay was 3 days (range 1 to 12). Perioperative complications were bladder and urethral perforations in 2 and 1 cases, respectively (1.4%), and hematoma in 3 (1.4%). There was postoperative retention with a variable duration in 49 patients (23%), of whom 41 underwent Hegar dilation. Altogether 186 of 215 patients (86.5%) were cured of incontinence. Two patients were lost to followup and 14 (16.3%) had de novo urge incontinence. The cure rates were 87% for stress urinary incontinence and 91% for mixed incontinence. The cure rate in patients treated under local and spinal anesthesia were 82% and 91%, respectively (p = 0.1084). The rates for RS with recurrent vs primary incontinence were 84% vs 87% (p = 0.5800) and for RS with vs without Hegar dilation 80% vs 88% (p = 0.2094). CONCLUSIONS: The technique described is simple, safe and inexpensive. The cure rates are comparable to those of tension-free vaginal tape. However, because of the relatively high rate of postoperative voiding difficulties compared to tension-free vaginal tape, this technique can be criticized. To avoid these problems special attention should be focused on applying the mesh without tension and with precision.

Adult↗
PubMed1994

Comparison of two suture materials, Dexon Plus and Maxon, in abdominal hysterectomy.

The performance and handling capacities of two synthetic absorbable sutures, the monofilament suture Maxon and the multifilament suture Dexon Plus, were compared to study if these sutures are acceptable as all-purpose suture materials in abdominal hysterectomy. Four senior gynecological surgeons performed altogether 102 hysterectomies and made an assessment of handling qualities. Fifty one patients were sutured with Maxon and 51 age-matched controls with Dexon Plus. Maxon proved to be superior to Dexon Plus in terms of knot rundown, tissue drag and knot repositioning whereas, in terms of suppleness, tensile strength and knot security both suture materials were comparable. Vaginal granulation was seen in five patients operated on with Dexon Plus and only in one patient in the Maxon group. According to this study Maxon is as safe and efficacious as Dexon Plus for abdominal hysterectomy and its handling properties were even better than those of Dexon Plus.

Adult↗
PubMed1993

Effects of abdominal hysterectomy on urinary and sexual symptoms.

A prospective study of 102 women undergoing abdominal hysterectomy for benign conditions was performed in order to evaluate pre- and post-operative urinary and sexual symptoms. The mean age of the patients was 44.9 years (range 30-65). Urinary disorders such as urgency, dysuria, frequency, nocturia, slow bladder emptying, sensation of residual urine as well as stress and urge incontinence were observed pre-operatively and 2, 6 and 12 months post-operatively. Dyspareunia, libido and the number of orgasms were evaluated as disorders affecting sexual life. At follow-up 12 months post-operatively a statistically significant decrease in stress incontinence, frequency and nocturia was observed. Dyspareunia was also significantly less frequent and increased libido was experienced. It was concluded that abdominal hysterectomy does not provoke adverse urinary or sexual symptoms and that it can have beneficial effects.

Adult↗
PubMed1993

Modified Burch colposuspension for stress urinary incontinence in females.

Modified Burch colposuspension was performed upon 186 women having clinically and urodynamically verified stress urinary incontinence (SUI). After two years, 91 percent of the patients were cured or markedly improved. The success rate was as much as 95 percent among the patients who underwent Burch colposuspension as a first operative treatment for incontinence. In the patients with recurrent SUI, the cure rate was 82 percent. Failures appeared mostly during the first six months. There were no significant differences in cure rates between the patients who underwent concomitant hysterectomy and those who did not. The comparison of two different suture materials, Dexon (polyglycolic acid) and Maxon (polyglyconate monofilament absorbable) did not produce any significant differences. Temporary urinary retention was the most common postoperative complaint. During the six to 12 postoperative months, 19 percent of the patients experienced urgency and 9 percent had mild voiding difficulties. After one year, 12 percent of the patients had rectocele or enterocele, or both, which were surgically corrected. We conclude that modified Burch colposuspension is a safe and effective primary surgical method for the treatment of stress urinary incontinence in women.

Adult↗
PubMed1987

Placental transfer of flunitrazepam following intramuscular administration during labour.

After a single intramuscular dose of flunitrazepam 0.015 mg kg-1 (n = 14) in women 37 to 41 weeks pregnant, the concentrations in the umbilical artery and amniotic fluid were significantly lower than in maternal venous plasma. Although the difference between the maternal venous and umbilical venous plasma concentrations was not significant, the mean fetomaternal ratio was 0.7. The plasma protein binding of flunitrazepam was 80 +/- 4% in the mother and 79 +/- 5% in the umbilical circulation. Both mothers and midwives subjectively estimated intramuscular flunitrazepam as a valuable sedative-anxiolytic agent during the first stage of labour.

Adult↗
PubMed1982

[An iatrogenic epidemic of ophthalmia neonatorum (author's transl)].

Report on an epidemic of five cases of ophthalmia neonatorum caused by pseudomonas aeruginosa. The patients represented about 8% of the infants born and treated in one department during a period of six weeks. In four cases the ON was protracted in two patients it was complicated by dacryostenosis. At first all the patients were treated with locally administered chloramphenicol, to which pseudomonas aeruginosa was resistant. The three cases the serous secretion ended after opening of the lacrimal ducts together with local treatment with polymyxin, neomycin and gramicidin. In one case the pseudomonas aerginosa, together with S. aureus found in the secretion in vitro, was found to be sensitive to a combination of trimethoprim and sulfamethoxazole, given perorally, which terminated the secretion. The epidemic was evidently caused by the use of contaminated water in the nursery room.

Anti-Bacterial Agents↗
PubMed1976

Changes in the cervical blood flow during labour.

The cervical blood flow changes during labour in pregnant women (15 cases) have been studied by local injection of 133Xe into the cervix. The blood flow changes were compared with the external uterine pressure which was measured with a tocograph. During contractions the radioactivity decreased temporarily, but increased again between contractions. The overall decrease was greater in the control group (4 cases) than during spontaneous contractions. The conclusion is, that relative cervical blood circulation is rapidly changed during labour.

Cervix Uteri↗