The Experts below are selected from a list of 19902 Experts worldwide ranked by ideXlab platform
Daniel Altman - One of the best experts on this subject based on the ideXlab platform.
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genetic influence on stress urinary incontinence and Pelvic Organ Prolapse
European Urology, 2008Co-Authors: Daniel Altman, Christian Falconer, Mats Forsman, Paul LichtensteinAbstract:Abstract Objectives To determine the genetic and environmental influence on the liability for stress urinary incontinence and Pelvic Organ Prolapse surgery. Methods We used the Swedish Twin Registry to identify all same-sex female twin pairs with known zygosity born from 1926 to 1958. Occurrence of stress urinary incontinence and Pelvic Organ Prolapse surgery was determined by cross-linkage to the Swedish Inpatient Registry. By comparing mono- and dizygotic female twins, we determined twin similarity and the relative proportions of phenotypic variance resulting from genetic and environmental factors. Using statistical modelling, the liability for Pelvic floor surgery explained by heritability versus shared and non-shared environmental effects was estimated. Results We identified 3376 complete monozygotic and 5067 dizygotic same-sex female twin pairs. There was greater twin similarity among monozygotic compared with dizygotic twins, which indicates the influence of a genetic component to the aetiology of both stress urinary incontinence and Pelvic Organ Prolapse surgery. For both disorders, genetic and non-shared environmental factors equally contributed about 40% of the variation in liability. Shared environment accounted for approximately one fifth of the total variance for the two disorders. Conclusions Genetic effects contribute to the occurrence of both stress urinary incontinence and Pelvic Organ Prolapse, but the influence of environmental factors is substantial. Significant environmental effects suggest that the liability for benign Pelvic floor surgery is amenable to intervention.
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Pelvic Organ Prolapse surgery following hysterectomy on benign indications
American Journal of Obstetrics and Gynecology, 2008Co-Authors: Daniel Altman, Christian Falconer, Sven Cnattingius, Fredrik GranathAbstract:Objective The objective of the study was to determine the risk for Pelvic Organ Prolapse surgery attributed to hysterectomy on benign indications Study Design In a nationwide longitudinal study, 162,488 women with hysterectomy from 1973 through 2003 were matched to 470,519 population-based control women. Hazard ratios (HR) with 95% confidence interval (CI) were calculated using Cox regression analyses. Results In all, 3.2% (n = 5270) of women with hysterectomy had Pelvic Organ Prolapse surgery, compared with 2.0% (n = 9437) in nonhysterectomized controls. Compared with nonhysterectomized controls, the overall HR for Prolapse surgery was 1.7 (95% CI, 1.6 to 1.7) with the highest risks observed in women having had a vaginal hysterectomy (HR 3.8; 95% CI, 3.1 to 4.8). Compared with hysterectomized women with no vaginal births, the HR for Prolapse surgery was 2.0 (95% CI, 0.9 to 4.1) among women with 1 vaginal childbirth and 11.3 (95 % CI, 6.0. to 21.1) among women with at least 4 vaginal births. Conclusion Hysterectomy is associated with an increased risk for subsequent Pelvic Organ Prolapse surgery with multiparous women at particular risk.
Stephen Jeffery - One of the best experts on this subject based on the ideXlab platform.
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Management of recurrent Pelvic Organ Prolapse after sacrocolpopexy. A video case series
International Urogynecology Journal, 2020Co-Authors: Esther Ruess, Jan-paul Roovers, Stephen JefferyAbstract:Introduction The aim of this video case series is to demonstrate our experience with the surgical management of recurrent Pelvic Organ Prolapse after sacrocolpopexy. Methods This is a series of seven patients who developed recurrent Pelvic Organ Prolapse stage 2 or greater after sacrocolpopexy. The video shows short clips on the individualized surgical management using a laparoscopic approach. Conclusion The surgical management of patients with recurrent Pelvic Organ Prolapse poses a great challenge. In our cases the laparoscopic approach gave us the opportunity to diagnose the reason for surgical failure, to optimally restore the anatomy and function of the Pelvic floor, and to limit the morbidity that is often seen in repeat surgery. Laparoscopic revision of sacrocolpopexy for recurrent Pelvic Organ Prolapse is feasible but needs to be individualized. As the number of cases is limited, and available evidence is scarce, we recommend the use of a registry to prospectively follow up these patients and identify best practices.
Paul Lichtenstein - One of the best experts on this subject based on the ideXlab platform.
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genetic influence on stress urinary incontinence and Pelvic Organ Prolapse
European Urology, 2008Co-Authors: Daniel Altman, Christian Falconer, Mats Forsman, Paul LichtensteinAbstract:Abstract Objectives To determine the genetic and environmental influence on the liability for stress urinary incontinence and Pelvic Organ Prolapse surgery. Methods We used the Swedish Twin Registry to identify all same-sex female twin pairs with known zygosity born from 1926 to 1958. Occurrence of stress urinary incontinence and Pelvic Organ Prolapse surgery was determined by cross-linkage to the Swedish Inpatient Registry. By comparing mono- and dizygotic female twins, we determined twin similarity and the relative proportions of phenotypic variance resulting from genetic and environmental factors. Using statistical modelling, the liability for Pelvic floor surgery explained by heritability versus shared and non-shared environmental effects was estimated. Results We identified 3376 complete monozygotic and 5067 dizygotic same-sex female twin pairs. There was greater twin similarity among monozygotic compared with dizygotic twins, which indicates the influence of a genetic component to the aetiology of both stress urinary incontinence and Pelvic Organ Prolapse surgery. For both disorders, genetic and non-shared environmental factors equally contributed about 40% of the variation in liability. Shared environment accounted for approximately one fifth of the total variance for the two disorders. Conclusions Genetic effects contribute to the occurrence of both stress urinary incontinence and Pelvic Organ Prolapse, but the influence of environmental factors is substantial. Significant environmental effects suggest that the liability for benign Pelvic floor surgery is amenable to intervention.
Christian Falconer - One of the best experts on this subject based on the ideXlab platform.
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genetic influence on stress urinary incontinence and Pelvic Organ Prolapse
European Urology, 2008Co-Authors: Daniel Altman, Christian Falconer, Mats Forsman, Paul LichtensteinAbstract:Abstract Objectives To determine the genetic and environmental influence on the liability for stress urinary incontinence and Pelvic Organ Prolapse surgery. Methods We used the Swedish Twin Registry to identify all same-sex female twin pairs with known zygosity born from 1926 to 1958. Occurrence of stress urinary incontinence and Pelvic Organ Prolapse surgery was determined by cross-linkage to the Swedish Inpatient Registry. By comparing mono- and dizygotic female twins, we determined twin similarity and the relative proportions of phenotypic variance resulting from genetic and environmental factors. Using statistical modelling, the liability for Pelvic floor surgery explained by heritability versus shared and non-shared environmental effects was estimated. Results We identified 3376 complete monozygotic and 5067 dizygotic same-sex female twin pairs. There was greater twin similarity among monozygotic compared with dizygotic twins, which indicates the influence of a genetic component to the aetiology of both stress urinary incontinence and Pelvic Organ Prolapse surgery. For both disorders, genetic and non-shared environmental factors equally contributed about 40% of the variation in liability. Shared environment accounted for approximately one fifth of the total variance for the two disorders. Conclusions Genetic effects contribute to the occurrence of both stress urinary incontinence and Pelvic Organ Prolapse, but the influence of environmental factors is substantial. Significant environmental effects suggest that the liability for benign Pelvic floor surgery is amenable to intervention.
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Pelvic Organ Prolapse surgery following hysterectomy on benign indications
American Journal of Obstetrics and Gynecology, 2008Co-Authors: Daniel Altman, Christian Falconer, Sven Cnattingius, Fredrik GranathAbstract:Objective The objective of the study was to determine the risk for Pelvic Organ Prolapse surgery attributed to hysterectomy on benign indications Study Design In a nationwide longitudinal study, 162,488 women with hysterectomy from 1973 through 2003 were matched to 470,519 population-based control women. Hazard ratios (HR) with 95% confidence interval (CI) were calculated using Cox regression analyses. Results In all, 3.2% (n = 5270) of women with hysterectomy had Pelvic Organ Prolapse surgery, compared with 2.0% (n = 9437) in nonhysterectomized controls. Compared with nonhysterectomized controls, the overall HR for Prolapse surgery was 1.7 (95% CI, 1.6 to 1.7) with the highest risks observed in women having had a vaginal hysterectomy (HR 3.8; 95% CI, 3.1 to 4.8). Compared with hysterectomized women with no vaginal births, the HR for Prolapse surgery was 2.0 (95% CI, 0.9 to 4.1) among women with 1 vaginal childbirth and 11.3 (95 % CI, 6.0. to 21.1) among women with at least 4 vaginal births. Conclusion Hysterectomy is associated with an increased risk for subsequent Pelvic Organ Prolapse surgery with multiparous women at particular risk.
Esther Ruess - One of the best experts on this subject based on the ideXlab platform.
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Management of recurrent Pelvic Organ Prolapse after sacrocolpopexy. A video case series
International Urogynecology Journal, 2020Co-Authors: Esther Ruess, Jan-paul Roovers, Stephen JefferyAbstract:Introduction The aim of this video case series is to demonstrate our experience with the surgical management of recurrent Pelvic Organ Prolapse after sacrocolpopexy. Methods This is a series of seven patients who developed recurrent Pelvic Organ Prolapse stage 2 or greater after sacrocolpopexy. The video shows short clips on the individualized surgical management using a laparoscopic approach. Conclusion The surgical management of patients with recurrent Pelvic Organ Prolapse poses a great challenge. In our cases the laparoscopic approach gave us the opportunity to diagnose the reason for surgical failure, to optimally restore the anatomy and function of the Pelvic floor, and to limit the morbidity that is often seen in repeat surgery. Laparoscopic revision of sacrocolpopexy for recurrent Pelvic Organ Prolapse is feasible but needs to be individualized. As the number of cases is limited, and available evidence is scarce, we recommend the use of a registry to prospectively follow up these patients and identify best practices.