Danish Journal of Obstetrics and Gynaecology最新文献

{"title":"Urethral diverticulum and periurethral cyst: symptoms, diagnostics, treatment and outcome.","authors":"M. Topp, P. Sander","doi":"10.56182/djog.v1i1.22","DOIUrl":"https://doi.org/10.56182/djog.v1i1.22","url":null,"abstract":"Objectives. In order to contribute to better diagnostic and treatment, we compared the symptomatology, diagnostics, treatment and outcome in women with a urethral diverticulum or a periurethral cyst.\u0000Methods. We performed a retrospective extraction of data from medical records including 70 women with a urethral diverticulum or a periurethral cyst, operated at our department from January 2010 until December 2013. Fischer’s exact test and t-test were used for statistical analyses.\u0000Results. In total, 31 women were diagnosed with a diverticulum and 39 with a periurethral cyst.  Women with a diverticulum had significantly more often voiding pain (45 % vs 8 %, p=0.001), urethral/vaginal pain (45% vs 15 %, p=0.01), recurrent urinary tract infection (23 % vs. 5 %, p=0.01), urinary incontinence (45 % vs. 21 %, p=0.04), and urethral discharge (39 % vs. 15 %, p=0.03) compared to women with a periurethral cyst. The only symptom less frequent in the diverticulum group was a bulky feeling (42 % vs. 74 %, p=0.01). In the diverticulum group, 87% had resections and 13% marsupialization, while in the cyst group 59 % had resections and 41 % marsupialization (p=0.02). In the diverticulum group four (13%) experienced recurrence compared to none in the cyst group (p=0.03). Furthermore, one patient referred as a diverticulum had urethral cancer.  \u0000Conclusions. Urethral diverticula and periurethral cysts should be considered in women with lower urinary tract symptoms and pain. Urethral diverticula are more complicated to diagnose and to treat.\u0000Tweetable abstract: \u0000Urethral diverticula and periurethral cysts should be considered in women with lower urinary tract symptoms and pain","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124019641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four-year follow-up on a gynecologic laparoscopic skills curriculum and discussion of its implementation","authors":"Nynne Dose, J. Sørensen, J. Strandbygaard","doi":"10.56182/djog.v1i1.18","DOIUrl":"https://doi.org/10.56182/djog.v1i1.18","url":null,"abstract":"Introduction\u0000Simulation-based training of surgical skills is transferable to the operating room, but implementation of a specific skills curricula is still challenging. Ongoing efforts serve to identify and implement the optimal curriculum for ensuring patient safety. In 2013 the validated ‘basic laparoscopic skills curriculum’ was introduced for first-year residents in obstetrics and gynecology in Eastern Denmark. The aim of this study was to follow-up on implementation of the curriculum through a four-year period and identify facilitators and barriers.\u0000Material and method\u0000The ‘basic laparoscopic skills curriculum’ comprises four steps encompassing theoretical education (step 1 & 2) , proficiency-based technical skills training on virtual reality simulators (step 3), and a one-day surgical course with participants practicing procedures on sedated pigs (step 4) . All participants were first-year residents in obstetrics and gynecology in Eastern Denmark from September 2014 to August 2018. The ‘basic laparoscopic skills curriculum’ was administered by the Copenhagen Academy for Medical Education and Simulation (CAMES). Dropouts were asked to complete an electronic questionnaire on why they did not finish the curriculum.\u0000Results\u0000During the four-year follow-up, 107 first-year residents participated in the curriculum. One-hundred completed step three (93%) and 99 (92.5%) step 4. Participants spent a median of 249, IQR 164 minutes (min. 64, max. 630) on the virtual reality simulator. Median time for completing all four steps of the curriculum was 56 days, IQR 98 (min. 14, max 253).\u0000Conclusions\u0000Completion rates were continuously high over four years in this basic laparoscopic skills curriculum for residents. One likely reason is that the curriculum was partially mandatory, combined with a supportive management that allotted participation time. Self-directed learning, self-study and flexible booking are also considered as playing a crucial role.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129796770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Measurement in Pregnancy – Interarm Differences and The Necessity of Multiple Consecutive Measurements","authors":"Karoline Hedetoft, F. Lihme, J. Lykke","doi":"10.56182/djog.v1i1.12","DOIUrl":"https://doi.org/10.56182/djog.v1i1.12","url":null,"abstract":"Objective: To investigate multiple blood pressure measurements and interarm differences in a pregnant population.\u0000Method: Pregnant women attending routine antenatal ultrasound scans in gestational weeks 11-13 or week 20 had three consecutive blood pressure measurements on each arm conducted according to international guidelines. Mean and mean difference between the 1st measurement (BP-A) and 2nd + 3rd measurements combined (BP-B) as well as between right and left arm, respectively, were calculated and compared by paired t-test. Bland-Altman plots illustrate means and mean-differences of systolic and diastolic pressure between BP-A and BP-B.\u0000Results: One-hundred women were included. Mean systolic, diastolic and arterial blood pressure for BP-A were 112.1 mmHg, 70.6 mmHg and 84.4 mmHg, respectively, while mean BP-B were 109.8 mmHg, 69.2 mmHg and 82.8 mmHg. Mean differences in systolic, diastolic and mean arterial pressure (MAP) between BP-A and BP-B were 2.5 mmHg (P<0.001, 95% Confidence interval (CI) 1.7;3.2), 1.5 mmHg (P<0.001, 95% CI 1.0;2.0) and 1.8 mmHg (P<0.001, 95% CI 1.4;2.2). Mean interarm differences in systolic, diastolic and MAP were 3.1 mmHg (P<0.001, 95% CI 1.9;4.3), 0.75 mmHg (P=0.019, 95%CI 0.1;1.4) and 2.4 mmHg (P=0.01, 95% CI 0.6;4.2).\u0000Conclusion: In pregnancy, the first blood pressure measurement of three consecutive is significantly higher than the following two. Blood pressure on the right arm is significantly higher compared to the left arm. International guidelines on blood pressure measurements should apply to pregnant women.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114664693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tubo-ovarian abscesses and the effect of transvaginal ultrasound guided drainage – a retrospective cohort study","authors":"Julie Plougmann Gislinge, Therese Faurschou Nielsen, Helle V. Clausen","doi":"10.56182/djog.v1i1.14","DOIUrl":"https://doi.org/10.56182/djog.v1i1.14","url":null,"abstract":"Objective:Tubo-ovarian abscesses (TOA) are a serious complication to pelvic inflammatory disease with long-term complications such as infertility and chronic pain. Treatment consists of intravenous antibiotics combined with laparoscopic or transvaginal ultrasound-guided drainage (TVULD), but the evidence regarding optimal treatment are scarce, and evaluation of short- and long-term effects have yielded inconsistent results. Our aim was to evaluate the effect of transvaginal ultrasound-guided drainage with antibiotic treatment on both short- and long-term outcomes for patients admitted with a tubo-ovarian abscess.  \u0000Methods:All women admitted with a TOA to our department were included from March 2017- May 2020. They were evaluated with a gynecological examination, TVUL, white blood cell count (WBC) and CRP. All received intravenous antibiotics and were evaluated for possible TVULD. All received orally administered antibiotics upon discharge, and follow-up was with a 1-3-month interval until patients were without symptoms or underwent laparoscopic surgery.\u0000Results:Forty patients were included, 30 (75%) premenopausal. Mean size of TOA were 6.3 cm (SD 2.3), and 35 (87.5%) patients received both antibiotics and drainage. Eighteen (45%) patients underwent secondary surgery following the TOA, and comparing the surgery vs. non-surgery group, we found that at admission temperature, WBC count at admission, aspirated material in ml and need of more than one drainage predicted undergoing laparoscopy following discharge. However, when performing multivariate analysis comparing the two groups regarding the abovementioned factors as well as age, admission time, antibiotic treatment time and follow-up, we did not find any statistically significant difference (p=0.072). Finally, we found that more than one drainage increased the risk of undergoing laparoscopy (OR 8, CI 1.43-44.92). \u0000Conclusion:TVULD combined with antibiotics are a safe and effective treatment for TOAs. We found a trend supporting that patients needing laparoscopy following initial TVULD present with a more severe clinical picture and that different clinical and paraclinical factors could be used as predictors for undergoing secondary laparoscopy. Finally, we saw that patients with more than one drainage, have an increased risk of requiring secondary laparoscopy. These findings and predictors need to be tested and confirmed in larger prospective studies.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"156 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115108310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}