One-year cohort of abdominal, vaginal, and laparoscopic hysterectomies: complications and subjective outcomes

Meltomaa, Seija; Mäkinen, Juha; Taalikka, Mikko; Helenius, Hans

doi:10.1016/s1072-7515(99)00170-2

Cited by 46 publications

(24 citation statements)

References 28 publications

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“…Studies comparing vaginal hysterectomy (VH) with transabdominal and laparoscopic hysterectomies have had conflicting results. One such study found that there is a higher rate of infectious complications associated with VH: 39% versus 24% and 3%, respectively [3]. However, another reports no difference in morbidity between transabdominal and VH [4].…”

Section: Discussionmentioning

confidence: 99%

Women’s positive perception of transvaginal NOTES surgery

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Women’s positive perception of transvaginal NOTES surgery

et al. 2008

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“…One study measured subjective outcomes by questionnaire survey at 4 -6 weeks and 1 year after hysterectomy. 106 Although subjective complaints (including abdominal pain, urinary incontinence, menopausal symptoms, and genital prolapse) increased significantly at the 1-year questionnaire (P Ͻ 0.001), 95% of patients reported being satisfied with the procedure.…”

Section: Is Risk-reducing Hysterectomy With Bilateral Salpingooophorementioning

confidence: 94%

EGAPP supplementary evidence review: DNA testing strategies aimed at reducing morbidity and mortality from Lynch syndrome

Palomaki

McClain

Melillo

et al. 2009

Genetics in Medicine

436

492

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EXECUTIVE SUMMARYAn original evidence review examined screening and diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC) and the subsequent outcomes in a population of newly diagnosed cases of colorectal cancer (CRC). This supplementary evidence review focuses on five issues of further interest to the Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group (EWG), as summarized below. Clarifying how to define the clinical disorder-Lynchsyndrome. In this supplementary review, Lynch syndrome refers to individuals with a predisposition to CRC and certain other malignancies as a result of a germline mismatch repair (MMR) gene mutation-including those with an existing cancer and those who have not yet developed cancer. This definition allows planned analyses of clinical validity and utility to be more straightforward. Several recent editorials and publications recommend that the ambiguous term HNPCC be abandoned and that this clarified definition of Lynch syndrome should be used instead. Removing family history from consideration as a preliminary test.A previous evidence review showed that screening performance of both the Amsterdam and the Bethesda criteria to identify individuals with Lynch syndrome were highly heterogeneous, possibly due to differences among the populations tested. In a general population, Amsterdam criteria are associated with relatively low sensitivity (28 -45%), but high specificity (99%), whereas Bethesda criteria are associated with higher sensitivity (73-91%), but at the cost of lower specificity (82-77%). Neither provides the necessary high sensitivity/specificity in a reliable and consistent manner. There are also gaps in knowledge relating to the time required to collect family history, the consistency with which it is collected, and the accuracy of the information. Inadequate evidence was available to determine the distribution of mutations in the MMR genes, but the limited data suggest 32% will be in MLH1, 38% in MSH2, 14% in MSH6, and 15% in PMS2. Adequate evidence was available to estimate sensitivity (69%) and specificity (point estimate of 100%) for identifying Lynch syndrome using a specific mutation in the BRAF gene among those with absent IHC staining for MLH1. An alternative to BRAF mutation testing might be direct testing of MLH1 methylation status, but this was not evaluated. Benefits and harms to probands and relatives with Lynchsyndrome. Between 2 and 12 first-degree relatives of probands (newly diagnosed CRC cases with Lynch syndrome, or index cases) can be contacted, based on resources and methodology. There was adequate evidence to document uptake of counseling among these firstdegree relatives who were contacted (52%) and subsequently targeted for MMR gene mutation testing (95% however, may be subject to family history bias. The U.S. Multisociety Task Force on Colorectal Cancer recommends colonoscopy every 1 or 2 years for first-degree relatives of individuals diagnosed with Lynch syndrome, and uptake among this group is about 80%. Th...

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“…30,31 The LNG-IUS discontinuation rate also was relatively high. However, this is in line with other recent studies also showing a relatively high discontinuation rate after 2 years (34%), 32 or after 4 to 5 years (50%).…”

Section: Commentmentioning

confidence: 99%

Clinical Outcomes and Costs With the Levonorgestrel-Releasing Intrauterine System or Hysterectomy for Treatment of Menorrhagia

Hurskainen¹,

Teperi²,

Rissanen³

et al. 2004

JAMA

306

183

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ENORRHAGIA IS AN IMPORtant cause of ill health in women worldwide. A b o u t o n e t h i r d o f women report heavy menstrual bleeding at some time in their lives. 1 Menorrhagia is the presenting symptom among the majority of women who undergo hysterectomy, 2,3 and recent data suggest that menorrhagia is an increasingly common health problem. 4 The levonorgestrel-releasing intrauterine system (LNG-IUS) (Schering Co, Turku, Finland) has been advocated for the treatment of menorrhagia as an alternative to surgery. 5 The LNG-IUS is an intrauterine system that releases 20 µg of levonorgestrel every 24 hours over 5 years. The LNG-IUS was developed during the 1980s and licensed first for contraception in Finland in 1990. The estimated number of current LNG-IUS users worldwide is

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One-year cohort of abdominal, vaginal, and laparoscopic hysterectomies: complications and subjective outcomes

Cited by 46 publications

References 28 publications

Women’s positive perception of transvaginal NOTES surgery

Women’s positive perception of transvaginal NOTES surgery

EGAPP supplementary evidence review: DNA testing strategies aimed at reducing morbidity and mortality from Lynch syndrome

Clinical Outcomes and Costs With the Levonorgestrel-Releasing Intrauterine System or Hysterectomy for Treatment of Menorrhagia

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