This prospective study was undertaken to determine the value of manometric studies in predicting postoperative dysphagia in patients undergoing laparoscopic Toupet fundoplication. Two hundred and twenty-nine out of 401 patients (57%) had preoperative dysphagia, and 26 patients had late postoperative dysphagia (6.5%). Eight patients who had no preoperative dysphagia developed dysphagia following surgery. There were no significant differences in esophageal motility for patients without postoperative dysphagia (n = 375) compared with those with postoperative dysphagia (n = 26). Among patients with postoperative dysphagia as a new symptom (n = 8), six had normal preoperative distal esophageal pressures, and none had esophageal hypomotility. In those with both pre- and postoperative dysphagia 15 of 18 had normal esophageal motility and hypomotility was only found in one. The positive predictive values of distal esophageal hypomotility and other measures for postoperative dysphagia are poor. In conclusion, preoperative manometry does not predict postoperative dysphagia following laparoscopic Toupet partial fundoplication.

No abstract

IntroductionIncreasing demand for sexual problems services plus reductions in commissioning have led to a need for high quality services delivered in a low-cost model within sexual health settings. A service redesign utilised a stepped-care model included the use of group therapy interventions as a first line treatment for erectile difficulties and painful sex. These interventions continued alongside existing MDT service provision.MethodsAll patients accessing the service in the first 12 months were given self-report outcome measures at key points of the intervention including quantitative and qualitative aspects of change. Results are compared between those accessing an erection difficulties group, a painful sex group and individual psychosexual therapy sessions.ResultsAbstract P136 Table 1Psychosexual intervention resultsInterventionIndividual(n=32)Erection Group(n=23)Pain Group (n=9)% significant change50%30%22%% change38%70%67%% reporting no change12%0%0%DiscussionFurther efforts to utilise group interventions for sexual problems may support the continued provision of psychosexual services in sexual health settings. Groups were evaluated favourably by service users and demonstrated considerable change. Qualitative feedback suggested distinct benefits of a group intervention over individual care. Those receiving a higher stepped intervention (individual sessions) may have been more complex and for others change in the problem in a traditional sense may not have been possible, however change was reported in other ways (i.e. affect in relation to the problem, relationship satisfaction).

No abstract

No abstract