Objective These recommendations from the AGG (Committee for Obstetrics, Department of Maternal Di... more Objective These recommendations from the AGG (Committee for Obstetrics, Department of Maternal Diseases) on how to treat thyroid function disorder during pregnancy aim to improve the diagnosis and management of thyroid anomalies during pregnancy. Methods Based on the current literature, the task force members have developed the following recommendations and statements. These recommendations were adopted after a consensus by the members of the working group. Recommendations The following manuscript gives an insight into physiological and pathophysiological thyroid changes during pregnancy, recommendations for clinical and subclinical hypo- and hyperthyroidism, as well as fetal and neonatal diagnostic and management strategies.
Purpose To investigate whether a training program on breast ultrasound skills including core-need... more Purpose To investigate whether a training program on breast ultrasound skills including core-needle biopsies to undergraduate students can improve medical knowledge and learning satisfaction. Methods Medical students attending mandatory classes at the Medical School of the University of Saarland received a supplemental theoretical and hands-on training program on ultrasound (US) breast screening and on US-guided core-needle biopsy using an agar–agar phantom. Experienced breast specialists and ultrasound examiners served as trainers applying Peyton’s 4-step training approach. The students’ theoretical knowledge and hands-on skills were tested before and after the training program, using a multiple-choice questionnaire (MCQ), the Objective Structured Clinical Examination (OSCE) and a student curriculum evaluation. Results The MCQ results showed a significant increase of the student’s theoretical knowledge (50.2–75.2%, p < 0.001). After the course, the OSCE showed a mean total of 17...
Purpose Teaching ultrasound procedures to undergraduates has recently been proposed to improve th... more Purpose Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized ultrasound teaching to our undergraduates. Methods Medical students received an additional theoretical and practical course involving hands-on ultrasound screening during their mandatory practical training week in obstetrics and gynecology. The students' theoretical knowledge and fetal image recognition skills were tested before and after the course. After the course, the students were asked to answer a course evaluation questionnaire. To standardize the teaching procedure, we used Peyton's 4-Step Approach to teach the skills needed for a German Society of Ultrasound in Medicine Level 1 ultrasound examiner. The multiple-choice question scores after the course showed statistically significant improvement (50 vs. 80 %; P \ 0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased their ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both obstetrics and gynecology and other medical fields. Conclusion Using practical, hands-on medical teaching is an emerging method for undergraduate education that should be further evaluated, standardized, and developed.
Introduction: The aim of this study was to assess whether the preoperative decision-making proces... more Introduction: The aim of this study was to assess whether the preoperative decision-making process might influence treatment success in premenopausal women undergoing hysterectomy for benign uterine pathologies Materials and Methods: All premenopausal women treated with hysterectomy for benign uterine pathologies between April 2011 and June 2013 at a tertiary university center were enrolled in this prospective observational cohort study. Five parameters of the preoperative decision-making process were assessed upon their correlation with postoperative quality of life, sexual function and patients' satisfaction. These outcome measures were assessed for the pre- and postoperative (six months after surgery) status using two validated questionnaires (EQ-5D and "female sexual function index" (FSFI). Patients' satisfaction with the postoperative outcome was assessed with a self-developed questionnaire. Results: 255 of 402 (63 %) patients completed the study. A correlatio...
Cornual pregnancy is a rare condition that accounts for approximately 2–4% of ectopic pregnancies... more Cornual pregnancy is a rare condition that accounts for approximately 2–4% of ectopic pregnancies worldwide. Herein, we report an unstable case of a 32‐year‐old woman with a history of oophorectomy and salpingectomy who was admitted for a ruptured cornual pregnancy in the left cornu, which was successfully managed by laparotomy.
These statements and recommendations should provide appropriate information about maternal and fe... more These statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards.
This position paper describes clinically important, practical aspects of cervical pessary treatme... more This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.
BJOG: An International Journal of Obstetrics & Gynaecology, 2019
Article type : Randomised controlled trial Impact of different intraoperative CO 2 pressure level... more Article type : Randomised controlled trial Impact of different intraoperative CO 2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO 2 : a prospective randomised controlled clinical trial
Purpose The high prevalence of Pelvic Organ Prolapse (POP) along with the demographic trend of th... more Purpose The high prevalence of Pelvic Organ Prolapse (POP) along with the demographic trend of the ageing population raises the value of sacropexy in the treatment of POP. Thus, efforts to decrease risks associated with this procedure have the potential for public health impact. We examined the perioperative morbidity of laparoscopic sacropexy regarding the surgical access and compared it with the morbidity of one of the most common gynecological procedure, the laparoscopic hysterectomy. Our aim was to prove the safety of laparoscopic sacropexy. Methods A retrospective evaluation of 80 consecutive laparoscopic sacropexies performed from Sept. 2012 until Oct. 2014 and 126 laparoscopic hysterectomies for a benign indication were undertaken. We assessed the anatomical outcome and the intra-and postoperative complications using the classification system according to Clavien-Dindo (CD). Results Apical success rate after sacropexy was 100% and global success rate was 95% (POP-Q stage B1). The decline in hemoglobin was low in both groups and showed no statistically significant differences. Both operative time (P \ 0.001) and the duration of hospitalization (P \ 0.001) were longer in case of a sacropexy. Although overall intraoperative complications seemed more frequent during a sacropexy, differences were not statistically significant. Both early and late postoperative complications showed a higher rate of mild complications (CD-I/II) and a lower rate of severe complications (CD-IIIa/IIIb) after a sacropexy. The differences were not statistically significant. Conclusion The laparoscopic sacropexy represents a safe procedure with good anatomical outcome. Despite higher technical severity, it doesn't seem to bare higher risks for perioperative morbidity than the laparoscopic hysterectomy does.
Einfuhrung: Das myxoide Leiomyosarcom des Uterus ist eine seltene Neoplasie, welche nur schwer vo... more Einfuhrung: Das myxoide Leiomyosarcom des Uterus ist eine seltene Neoplasie, welche nur schwer vom Leiomyom abgrenzbar ist. Die Datenlagen zum Wachstumsmuster und der klinischen Manifestation sind begrenzt. Fallvorstellung: Wir berichten von einer 50-jahrige Patientin, welche konsiliarisch aus der Klinik fur Pulmologie vorgestellt wurde. Die Patientin war dort stationar mit Verdacht auf ausgedehnte Lungenarterienembolie bds. Ein durchgefuhrtes CT zeigte den V.a. eine Uterus-Neoplasie, DD Uterus myomatosus. Im transvaginalen Ultraschall zeigte sich im Douglas eine echoarme, unscharfe begrenzte 10 × 4 x 7 cm Raumforderung ohne Vaskularisation. In der durchgefuhrten MR-Angiografie zeigte sich ein Tumorzapfen von der rechten V. iliaca interna ausgehend bis in beide Lungenflugel reichend. Weiterhin wurde hierbei eine grose inhomogene, kontrastmittelaffine, infiltrativ wachsende, maligne Raumforderung im Becken, mutmaslich ausgehend vom rechten Ovar mit Infiltration der Vena iliaca interna rechts, festgestellt. Bei Verdacht auf uterines Leiomyosarkom erfolgte eine Langsschnittlaparotomie mit Hysterektomie, Adnexektomie beidseits, ein Tumorexstirpation Beckenwand rechts, sowie eine pelvine und paraaortale Lymphonodektomie und infracolische Omentektomie. Im intraoperativen Schnellschnitt konnten ein Sarkom nicht sicher ausgeschlossen werden. Zwei Tage spater erfolgte in der Herz-Thorax-Chirurgie eine erneute Operation mit Exstirpation des endovaskularen Tumorzapfens. In der endgultigen Histologie ergab sich ein finales Tumorstadium von pT2b pN0 (0/26) L0 V2 Pn0 R0 FNCLCC-Grad 1. Die Patientin erholte sich gut von der Operation und konnte am 12. postoperativen Tag entlassen werden. Bei R0-Resektion wurde die regelmasige Nachsorge empfohlen. Bisher ist die Patientin sechs Monate rezidivfrei. Zusammenfassung: Auch bei Vorliegen einer ausgedehnten intravasalen Ausbreitung ist eine R0-Resektion bei interdisziplinarer Herangehensweise moglich.
Ultraschall in der Medizin - European Journal of Ultrasound, 2014
Problemstellung: Assoziation lateraler fetaler Halszysten mit NT-Erweiterungen, Chromosomenanomal... more Problemstellung: Assoziation lateraler fetaler Halszysten mit NT-Erweiterungen, Chromosomenanomalien und fetalen Fehlbildungen. Patienten und Methode: In einem konsekutiven Kollektiv von Untersuchungen von 2009 – 2014 zwischen 11 – 17 SSW fanden sich 24 Feten mit lateralen Halszysten. Untersucht wurde die Assoziation zu erweiterter Nackentransparenz, Chromosomenanomalien und kindlichen Fehlbildungen. Ergebnisse: 23 Feten hatten bilaterale Halszysten, 1 Fetus eine unilaterale. 7 von 24 Feten wiesen eine Trisomie 21 auf (29%), 5 Feten eine Trisomie 18 (21%), 12 Feten einen unauffalligen Karyotyp (50%). Alle 7 Feten mit Trisomie 21 hatten eine NT-Erweiterung > 95. Perzentile, 4 mit assoziierten schwerwiegenden Fehlbildungen, 3 mit begleitenden multiplen Softmarkern fur Chromosomenanomalien. Alle 5 Feten mit Trisomie 18 hatten eine erweiterte Nackentransparenz, 4 assoziierte schwerwiegende Fehlbildungen. 7 der 12 Feten mit unauffalligem Karyotyp hatten eine NT-Erweiterung, kombiniert entweder mit zystischem Hygrom, Hydropszeichen oder 1 Softmarker. 3 der 12 Feten hatten eine komplexe, 1 Fet eine lebensfahige Fehlbildung, 8 Feten ein unauffalliges Outcome. 1 Kind mit unilateraler Halszyste und auffalliger Biochemie hatte ein gutes Outcome. Schlussfolgerungen: Feten mit lateralen Halszysten sind haufig mit NT-Erweiterungen, Chromosomenanomalien und fetalen Fehlbildungen assoziiert. Bei isoliertem Auftreten findet sich jedoch oft ein gutes Outcome, auch bei NT-Erweiterung.
This position paper describes clinically important, practical aspects of cervical pessary treatme... more This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.Dieses Positionspapier beschreibt klinisch wichtige pra...
Introduction Uterine leiomyomas are the most common benign gynecologic tumors. To date laparoscop... more Introduction Uterine leiomyomas are the most common benign gynecologic tumors. To date laparoscopy myomectomy is the gold standard for treatment of symptomatic fibroids in reproductive-aged women. Detailed counseling about the effects of this procedure on postoperative sexuality and quality of life is important in these patients. However, available data on these subjects are limited and contradictory. The aim of this study was to assess sexual function and quality of life in premenopausal women undergoing laparoscopic myomectomy for symptomatic uterine fibroids. Material and Methods All premenopausal women who underwent laparoscopic myomectomy for symptomatic fibroids between April 2012 and August 2014 at a tertiary university center were enrolled in this prospective observational cohort study. Sexual function and quality of life were assessed for the pre- and postoperative (six months post-operatively) state using two validated questionnaires, the Female Sexual Function Index (FSFI...
Objective These recommendations from the AGG (Committee for Obstetrics, Department of Maternal Di... more Objective These recommendations from the AGG (Committee for Obstetrics, Department of Maternal Diseases) on how to treat thyroid function disorder during pregnancy aim to improve the diagnosis and management of thyroid anomalies during pregnancy. Methods Based on the current literature, the task force members have developed the following recommendations and statements. These recommendations were adopted after a consensus by the members of the working group. Recommendations The following manuscript gives an insight into physiological and pathophysiological thyroid changes during pregnancy, recommendations for clinical and subclinical hypo- and hyperthyroidism, as well as fetal and neonatal diagnostic and management strategies.
Purpose To investigate whether a training program on breast ultrasound skills including core-need... more Purpose To investigate whether a training program on breast ultrasound skills including core-needle biopsies to undergraduate students can improve medical knowledge and learning satisfaction. Methods Medical students attending mandatory classes at the Medical School of the University of Saarland received a supplemental theoretical and hands-on training program on ultrasound (US) breast screening and on US-guided core-needle biopsy using an agar–agar phantom. Experienced breast specialists and ultrasound examiners served as trainers applying Peyton’s 4-step training approach. The students’ theoretical knowledge and hands-on skills were tested before and after the training program, using a multiple-choice questionnaire (MCQ), the Objective Structured Clinical Examination (OSCE) and a student curriculum evaluation. Results The MCQ results showed a significant increase of the student’s theoretical knowledge (50.2–75.2%, p < 0.001). After the course, the OSCE showed a mean total of 17...
Purpose Teaching ultrasound procedures to undergraduates has recently been proposed to improve th... more Purpose Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized ultrasound teaching to our undergraduates. Methods Medical students received an additional theoretical and practical course involving hands-on ultrasound screening during their mandatory practical training week in obstetrics and gynecology. The students' theoretical knowledge and fetal image recognition skills were tested before and after the course. After the course, the students were asked to answer a course evaluation questionnaire. To standardize the teaching procedure, we used Peyton's 4-Step Approach to teach the skills needed for a German Society of Ultrasound in Medicine Level 1 ultrasound examiner. The multiple-choice question scores after the course showed statistically significant improvement (50 vs. 80 %; P \ 0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased their ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both obstetrics and gynecology and other medical fields. Conclusion Using practical, hands-on medical teaching is an emerging method for undergraduate education that should be further evaluated, standardized, and developed.
Introduction: The aim of this study was to assess whether the preoperative decision-making proces... more Introduction: The aim of this study was to assess whether the preoperative decision-making process might influence treatment success in premenopausal women undergoing hysterectomy for benign uterine pathologies Materials and Methods: All premenopausal women treated with hysterectomy for benign uterine pathologies between April 2011 and June 2013 at a tertiary university center were enrolled in this prospective observational cohort study. Five parameters of the preoperative decision-making process were assessed upon their correlation with postoperative quality of life, sexual function and patients' satisfaction. These outcome measures were assessed for the pre- and postoperative (six months after surgery) status using two validated questionnaires (EQ-5D and "female sexual function index" (FSFI). Patients' satisfaction with the postoperative outcome was assessed with a self-developed questionnaire. Results: 255 of 402 (63 %) patients completed the study. A correlatio...
Cornual pregnancy is a rare condition that accounts for approximately 2–4% of ectopic pregnancies... more Cornual pregnancy is a rare condition that accounts for approximately 2–4% of ectopic pregnancies worldwide. Herein, we report an unstable case of a 32‐year‐old woman with a history of oophorectomy and salpingectomy who was admitted for a ruptured cornual pregnancy in the left cornu, which was successfully managed by laparotomy.
These statements and recommendations should provide appropriate information about maternal and fe... more These statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards.
This position paper describes clinically important, practical aspects of cervical pessary treatme... more This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.
BJOG: An International Journal of Obstetrics & Gynaecology, 2019
Article type : Randomised controlled trial Impact of different intraoperative CO 2 pressure level... more Article type : Randomised controlled trial Impact of different intraoperative CO 2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO 2 : a prospective randomised controlled clinical trial
Purpose The high prevalence of Pelvic Organ Prolapse (POP) along with the demographic trend of th... more Purpose The high prevalence of Pelvic Organ Prolapse (POP) along with the demographic trend of the ageing population raises the value of sacropexy in the treatment of POP. Thus, efforts to decrease risks associated with this procedure have the potential for public health impact. We examined the perioperative morbidity of laparoscopic sacropexy regarding the surgical access and compared it with the morbidity of one of the most common gynecological procedure, the laparoscopic hysterectomy. Our aim was to prove the safety of laparoscopic sacropexy. Methods A retrospective evaluation of 80 consecutive laparoscopic sacropexies performed from Sept. 2012 until Oct. 2014 and 126 laparoscopic hysterectomies for a benign indication were undertaken. We assessed the anatomical outcome and the intra-and postoperative complications using the classification system according to Clavien-Dindo (CD). Results Apical success rate after sacropexy was 100% and global success rate was 95% (POP-Q stage B1). The decline in hemoglobin was low in both groups and showed no statistically significant differences. Both operative time (P \ 0.001) and the duration of hospitalization (P \ 0.001) were longer in case of a sacropexy. Although overall intraoperative complications seemed more frequent during a sacropexy, differences were not statistically significant. Both early and late postoperative complications showed a higher rate of mild complications (CD-I/II) and a lower rate of severe complications (CD-IIIa/IIIb) after a sacropexy. The differences were not statistically significant. Conclusion The laparoscopic sacropexy represents a safe procedure with good anatomical outcome. Despite higher technical severity, it doesn't seem to bare higher risks for perioperative morbidity than the laparoscopic hysterectomy does.
Einfuhrung: Das myxoide Leiomyosarcom des Uterus ist eine seltene Neoplasie, welche nur schwer vo... more Einfuhrung: Das myxoide Leiomyosarcom des Uterus ist eine seltene Neoplasie, welche nur schwer vom Leiomyom abgrenzbar ist. Die Datenlagen zum Wachstumsmuster und der klinischen Manifestation sind begrenzt. Fallvorstellung: Wir berichten von einer 50-jahrige Patientin, welche konsiliarisch aus der Klinik fur Pulmologie vorgestellt wurde. Die Patientin war dort stationar mit Verdacht auf ausgedehnte Lungenarterienembolie bds. Ein durchgefuhrtes CT zeigte den V.a. eine Uterus-Neoplasie, DD Uterus myomatosus. Im transvaginalen Ultraschall zeigte sich im Douglas eine echoarme, unscharfe begrenzte 10 × 4 x 7 cm Raumforderung ohne Vaskularisation. In der durchgefuhrten MR-Angiografie zeigte sich ein Tumorzapfen von der rechten V. iliaca interna ausgehend bis in beide Lungenflugel reichend. Weiterhin wurde hierbei eine grose inhomogene, kontrastmittelaffine, infiltrativ wachsende, maligne Raumforderung im Becken, mutmaslich ausgehend vom rechten Ovar mit Infiltration der Vena iliaca interna rechts, festgestellt. Bei Verdacht auf uterines Leiomyosarkom erfolgte eine Langsschnittlaparotomie mit Hysterektomie, Adnexektomie beidseits, ein Tumorexstirpation Beckenwand rechts, sowie eine pelvine und paraaortale Lymphonodektomie und infracolische Omentektomie. Im intraoperativen Schnellschnitt konnten ein Sarkom nicht sicher ausgeschlossen werden. Zwei Tage spater erfolgte in der Herz-Thorax-Chirurgie eine erneute Operation mit Exstirpation des endovaskularen Tumorzapfens. In der endgultigen Histologie ergab sich ein finales Tumorstadium von pT2b pN0 (0/26) L0 V2 Pn0 R0 FNCLCC-Grad 1. Die Patientin erholte sich gut von der Operation und konnte am 12. postoperativen Tag entlassen werden. Bei R0-Resektion wurde die regelmasige Nachsorge empfohlen. Bisher ist die Patientin sechs Monate rezidivfrei. Zusammenfassung: Auch bei Vorliegen einer ausgedehnten intravasalen Ausbreitung ist eine R0-Resektion bei interdisziplinarer Herangehensweise moglich.
Ultraschall in der Medizin - European Journal of Ultrasound, 2014
Problemstellung: Assoziation lateraler fetaler Halszysten mit NT-Erweiterungen, Chromosomenanomal... more Problemstellung: Assoziation lateraler fetaler Halszysten mit NT-Erweiterungen, Chromosomenanomalien und fetalen Fehlbildungen. Patienten und Methode: In einem konsekutiven Kollektiv von Untersuchungen von 2009 – 2014 zwischen 11 – 17 SSW fanden sich 24 Feten mit lateralen Halszysten. Untersucht wurde die Assoziation zu erweiterter Nackentransparenz, Chromosomenanomalien und kindlichen Fehlbildungen. Ergebnisse: 23 Feten hatten bilaterale Halszysten, 1 Fetus eine unilaterale. 7 von 24 Feten wiesen eine Trisomie 21 auf (29%), 5 Feten eine Trisomie 18 (21%), 12 Feten einen unauffalligen Karyotyp (50%). Alle 7 Feten mit Trisomie 21 hatten eine NT-Erweiterung > 95. Perzentile, 4 mit assoziierten schwerwiegenden Fehlbildungen, 3 mit begleitenden multiplen Softmarkern fur Chromosomenanomalien. Alle 5 Feten mit Trisomie 18 hatten eine erweiterte Nackentransparenz, 4 assoziierte schwerwiegende Fehlbildungen. 7 der 12 Feten mit unauffalligem Karyotyp hatten eine NT-Erweiterung, kombiniert entweder mit zystischem Hygrom, Hydropszeichen oder 1 Softmarker. 3 der 12 Feten hatten eine komplexe, 1 Fet eine lebensfahige Fehlbildung, 8 Feten ein unauffalliges Outcome. 1 Kind mit unilateraler Halszyste und auffalliger Biochemie hatte ein gutes Outcome. Schlussfolgerungen: Feten mit lateralen Halszysten sind haufig mit NT-Erweiterungen, Chromosomenanomalien und fetalen Fehlbildungen assoziiert. Bei isoliertem Auftreten findet sich jedoch oft ein gutes Outcome, auch bei NT-Erweiterung.
This position paper describes clinically important, practical aspects of cervical pessary treatme... more This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.Dieses Positionspapier beschreibt klinisch wichtige pra...
Introduction Uterine leiomyomas are the most common benign gynecologic tumors. To date laparoscop... more Introduction Uterine leiomyomas are the most common benign gynecologic tumors. To date laparoscopy myomectomy is the gold standard for treatment of symptomatic fibroids in reproductive-aged women. Detailed counseling about the effects of this procedure on postoperative sexuality and quality of life is important in these patients. However, available data on these subjects are limited and contradictory. The aim of this study was to assess sexual function and quality of life in premenopausal women undergoing laparoscopic myomectomy for symptomatic uterine fibroids. Material and Methods All premenopausal women who underwent laparoscopic myomectomy for symptomatic fibroids between April 2012 and August 2014 at a tertiary university center were enrolled in this prospective observational cohort study. Sexual function and quality of life were assessed for the pre- and postoperative (six months post-operatively) state using two validated questionnaires, the Female Sexual Function Index (FSFI...
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