(Press-News.org) A Nordic multicentre study, headed by researchers from Karolinska Institutet in Sweden, shows that pelvic organ prolapse surgery using synthetic mesh can be more effective than traditional surgery. The advantages indicated by the study mainly concern restored genital anatomy and more efficient symptom relief, although there is an associated greater risk of complications. The study is published in the renowned scientific periodical The New England Journal of Medicine.
Prolapse is a common post-childbirth condition and involves the loss of support for the vagina and pelvic organs, which descend and in some cases protrude through the vaginal opening. In recent years it has been observed that traditional prolapse surgery often fails to produce the desired results. In Sweden an estimated 7-8,000 prolapse operations are performed annually, and in the US approximately 300,000 procedures are performed each year.
The present study compared traditional prolapse surgery with a new method based on the surgical implantation of a polypropylene mesh to provide permanent support for the weakened pelvic floor. The same type of mesh is used routinely for other surgical interventions, such as hernias and incontinence. The study included 389 women with pelvic organ prolapse; of these, 200 were randomly selected for mesh surgery while the others were operated on in the conventional manner.
The results of the study showed that mesh surgery reduced the risk of relapse, and the patients experienced a significantly better outcome with respect to prolapse symptoms. However, it was also observed that the mesh implant caused additional complications during surgery as well as several cases of mesh-related problems up to a year afterwards.
"The new surgical method has distinct advantages over traditional surgery," says Christian Falconer, Associate Professor at Karolinska Institutet and Senior Consultant at Danderyd Hospital. "But the fact that the risk of complications increases means that we must be careful to inform the patient and weigh up the pros and cons of the two methods in every individual case."
Dr Falconer also notes that the study is important as it confirms a new treatment principle and establishes the use of a permanent vaginal support as an alternative method of prolapse surgery. However, work still needs to be done on material and method development in order to reduce the risk of complications and to identify patients for whom the method can bring particular benefits.
###
The article in The New England Journal of Medicine is the result of a Nordic collaboration involving 53 clinics in Sweden, Norway, Finland and Denmark. Associate professor and senior consultant Daniel Altman and Dr Falconer, both from Karolinska Institutet's department at Danderyd Hospital (KI DS) headed the study. The study was supported by grants from the Swedish Society of Medicine, the Karolinska Institutet research foundations, the Stockholm County Council, and the medical technology company Ethicon.
Publication: "Anterior Colporraphy versus Transvaginal Mesh for Pelvic Organ Prolapse", Daniel Altman et al., The New England Journal of Medicine, online 12 May 2011.
For further information, please contact:
Daniel Altman, Associate Professor and Senior Consultant
Division of Obstetrics and Gynecology, Department of Clinical Sciences, Danderyd Hospital
Karolinska Institutet
Tel: +46 (0)8-524 822 97 or +46 (0)70-742 40 62
Email: daniel.altman@ki.se
Contact the KI Press Office and download photographs: http://ki.se/pressrum
Karolinska Institutet is one of the world's leading medical universities. It accounts for over 40 per cent of the medical academic research conducted in Sweden and offers the country's broadest range of education in medicine and health sciences. Since 1901 the Nobel Assembly at Karolinska Institutet has selected the Nobel laureates in Physiology or Medicine.
Synthetic mesh can improve outcome of prolapse surgery
2011-05-13
ELSE PRESS RELEASES FROM THIS DATE:
Lack of exercise linked to higher heart disease risk in healthy children as young as 9
2011-05-13
Even healthy children as young as nine-years-old can start to show an increased risk of future heart problems if they are physically inactive, according to a study in the May issue of Acta Paediatrica.
A team of researchers from Sweden and Denmark studied 223 children – 123 boys and 100 girls – with an average age of 9.8 years, assessing their physical activity levels over four days.
They found that the children who were more physically active had a lower composite risk factor score for cardiovascular disease (CVD) than the children with lower amounts of moderate ...
New X-ray method for understanding brain disorders better
2011-05-13
Researchers including members from the Niels Bohr Institute at the University of Copenhagen have developed a new method for making detailed X-ray images of brain cells. The method, called SAXS-CT, can map the myelin sheaths of nerve cells, which are important for conditions such as multiple sclerosis and Alzheimer's disease. The results have been published in the scientific journal, NeuroImage.
The myelin sheaths of nerve cells are lamellar membranes surrounding the neuronal axons. The myelin layers are important to the central nervous system as they ensure the rapid ...
Sharing musical instruments means sharing germs
2011-05-13
BOSTON (May 12, 2011) — Germs survive for several days in wind instruments including the clarinet, flute, and saxophone, according to a pilot study published in the International Journal of Environmental Health Research. The researchers, led by Stuart Levy, MD, of Tufts University School of Medicine, urge proper cleaning of these instruments. The data suggest a need for additional research to determine the conditions for survival of germs on shared musical instruments, especially those with wooden reeds.
"Thousands of children share musical instruments in elementary ...
Study: Most at-risk patients don't adhere to statin treatment, despite real benefits
2011-05-13
A new study from North Carolina State University shows that the vast majority of patients at high risk for heart disease or stroke do a poor job of taking statins as prescribed. That's especially unfortunate, because the same study shows that taking statins can significantly increase the quality and length of those patients' lives.
"We found that only 48 percent of patients who have been prescribed statins are taking their prescribed dose on a regular basis after one year – and that number dips to approximately 27 percent after 10 years," says Jennifer Mason, a Ph.D. ...
Movement without muscles
2011-05-13
This release is available in German.
All animals move – cheetahs faster, snails more slowly. Muscle contractions are the basis of all movements, at least according to general opinion. But there are animal groups, that don't have any muscles at all, as they branched off from the evolutionary path before muscle cells evolved. However these animal groups, for instance the sea sponges, are not immovable. Sponges are able to contract without muscles. These contractions were already known to sponge divers in ancient Greece, as Aristotele described in 350 BC.
A group of ...
Reining in nicotine use
2011-05-13
A person's vulnerability to nicotine addiction appears to have a genetic basis, at least in part. A region in the midbrain called the habenula (from Latin: small reins) plays a key role in this process, as Dr. Inés Ibañez-Tallon and her team from the Max Delbrück Center for Molecular Medicine (MDC) Berlin-Buch, Germany, have now shown. They also shed light on the mechanism that underlies addiction to nicotine (Neuron, May,12, 2011, Vol. 70, Issue 3, pp: 522-535; DOI 10.1016/j.neuron.2011.04.013)*.
According to the World Health Organization WHO in Geneva, it is estimated ...
Eucalyptus tree genome deciphered
2011-05-13
The key to the survival of forestry in South Africa as well as many new possibilities for renewable bioproducts like biofuels and biopolymers may now be available with the click of a mouse.
This follows on a team of international researchers, led by Prof Zander Myburg from the Department of Genetics and the Forestry and Agricultural Biotechnology Institute (FABI) at the University of Pretoria (UP) – in collaboration with the US Department of Energy (DOE) Joint Genome Institute (JGI) – making available the complete genome sequence of the forest tree species, Eucalyptus ...
Shaking down frozen helium: In a 'supersolid' state, it has liquid-like characteristics
2011-05-13
ITHACA, N.Y. – In a four-decade, Holy Grail-like quest to fully understand what it means to be in a "supersolid" state, physicists have found that supersolid isn't always super solid. In other words, this exotic state of frozen helium appears to have liquid-like properties, says a new paper published in the journal Science (May 13, 2011).
Why is this important? Understanding supersolid helium brings us closer to understanding its close cousins superconductivity and superfluidity.
Physicists had long thought that the unusual behavior of torsion oscillators containing ...
Perfect welds for car bodies
2011-05-13
This release is available in German.
As if controlled by an invisible hand, the welding head on the robot's arm races along the sheet metal parts. Where the laser hits, sparks fly and the metal glows red hot. The process lasts just a few seconds. The outer door panel and the door frame are now welded together perfectly. A thin weld seam extends along the join, but it can only be seen on one side. From the other side of the welded car door the join is invisible. This is a perfect weld – the kind every car manufacturer dreams of, because it could be used anywhere on the ...
Water for Mongolia
2011-05-13
This release is available in German.
Mongolia is a country of contrasts – in summer boiling hot, in winter freezing cold; in the north damp, in the south bone dry. One million of its three million inhabitants live tightly packed together in the capital Ulaanbaatar, while the rest of the huge country is largely populated by nomads and their cattle. Providing a clean supply of drinking water across the entire country is a difficult challenge – beginning with the need to lay freeze-proof water pipes over an area of 1.5 million square kilometers. The people in the countryside ...