Publications by authors named "Eija Tomas"

Background: Robotic-assisted laparoscopy has become a widely and increasingly used modality of minimally invasive surgery in the treatment of endometrial cancer. Due to its technical advantages, robotic-assisted laparoscopic surgery offers benefits, such as a lower rate of conversions compared to conventional laparoscopy. Yet, data on long-term oncological outcomes after robotic-assisted laparoscopy is scarce and based on retrospective cohort studies only.

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Purpose: Hysterectomy may be a risk factor for pelvic organ prolapse (POP). We assessed the risk of recurrent POP (operations and visits) after hysterectomy among women with previous POP. We also studied patient and operation related risk factors for POP recurrence.

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Introduction: Hysterectomy may have an effect on the pelvic floor. Here, we evaluated the rates and risks for pelvic organ prolapse (POP) surgeries and visits among women with a history of hysterectomy for benign indication excluding POP.

Material And Methods: In this retrospective cohort study 3582 women who underwent hysterectomy in 2006 were followed until the end of 2016.

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Introduction: Hysterectomy has been one of the most common surgical procedures in women in Finland. We studied the population-based trends of hysterectomy and its indications from 1986 to 2017.

Material And Methods: A retrospective population-based cohort was created from the Care Register for Health Care by identifying women who had a hysterectomy from 1986 to 2017 and calculating the number of women from the Digital and Population Data Services Agency.

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Objective: To evaluate the relationship between cesarean scar defect and abnormal uterine bleeding at one year after cesarean section (CS).

Study Design: A prospective observational cohort study was conducted in 401 women who delivered by CS between January 2016 and January 2017. Women were screened for isthmocele with sonohysterography six months after CS and followed by electronic questionnaires at 12, 13 and 14 months after CS.

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Background: Cesarean scar defect (isthmocele) is a known complication after cesarean delivery. It has become more common due to a rising cesarean delivery rate. Isthmocele has been associated with various gynecological and obstetric problems such as uterine rupture, cesarean scar pregnancy, and bleeding disorders.

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Introduction: The aim of this study was to investigate the prevalence of post-cesarean isthmocele and to measure agreement between transvaginal ultrasonography and saline contrast sonohysterography in assessment of isthmocele.

Material And Methods: A prospective observational cohort study was carried out at Tampere University Hospital, Finland. Non-pregnant women delivered by cesarean section (n = 371) were examined with transvaginal ultrasonography (TVUS) and sonohysterography (SHG) six months after cesarean section.

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Objective: Mini-invasive surgery has essentially replaced open laparotomy in surgery for endometrial and cervical carcinoma. Of the procedures needed for a complete staging, especially para-aortic lymphadenectomy (PALND) is challenging to perform. The present study was undertaken to investigate the technical and surgical outcomes of robotic-assisted PALND for gynecological cancers in the setting of a tertiary university hospital in Finland.

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Article Synopsis
  • The study aimed to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in treating endometrial cancer, analyzing 101 patients from 2010 to 2013.
  • The results showed that robotic-assisted laparoscopy had a total cost that was €2160 higher than traditional laparoscopy, primarily due to increased expenses for instruments and equipment.
  • Overall, robotic laparoscopy was found to be 37% more expensive, mainly due to the amortization costs associated with the robotic system and its tools.
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Background: Previous studies comparing robotic-assisted laparoscopic surgery to traditional laparoscopic or open surgery in gynecologic oncology have been retrospective. To our knowledge, no prospective randomized trials have thus far been performed on endometrial cancer.

Objective: We sought to prospectively compare traditional and robotic-assisted laparoscopic surgery for endometrial cancer.

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Objectives: The aim of this follow-up study was to explore the long-term effects of a 6-month trial of exercise training on hot flushes. The follow-up was 4 years after the exercise intervention ended.

Study Design: A cohort study after a randomised controlled trial.

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Objectives: The aim of the study was to explore the long-term effects of physical activity intervention on quality of life (QoL) 4 years after an original randomised controlled trial (RCT).

Design: Cohort study after an RCT.

Setting: 95 of the 159 women from the original RCT participated in weight, height and waist circumference measurements, performed the UKK 2 km Walk Test and completed the SF-36 Health Survey questionnaire.

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Menopause is a period that may predispose one to a decrease in muscle strength, cardiorespiratory fitness, and quality of life. A study was carried out to evaluate the cost-effectiveness of physical activity among women displaying symptoms of menopause. The cost-effectiveness analysis was based on data from a six-month randomised controlled trial (n = 151).

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Objective: To assess trends for hysterectomy methods in the Nordic countries and to compare outcomes of hysterectomies in Finland done by trainees with those done by specialists.

Design: Register-based study.

Setting: NOMESCO database for the Nordic countries and the Finnish Hospital Discharge Register.

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Article Synopsis
  • The study reviews the initial experiences of robotic-assisted laparoscopic surgery in gynecologic oncology, focusing on a cohort of 300 patients over four years.
  • The most common procedures performed were hysterectomies and lymphadenectomies, with a notable decrease in operation time observed after the first 20 surgeries, indicating a short learning curve.
  • Overall, the robotic-assisted surgeries demonstrated a low complication rate, minimal blood loss, and a short postoperative hospital stay, suggesting they are a safe alternative to traditional surgical techniques.
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Background: Physical exercise during leisure time is known to increase physical capacity; however, the long-term effects on work ability and work strain are inconclusive. The aim of this study was to investigate the effects of a 6-month physical exercise program on work ability and work strain after 6 months and 30 months, among women with menopausal symptoms at baseline.

Methods: A questionnaire including questions on work ability and work strain was mailed in the beginning, at 6 months and after 30 months after the intervention to occupationally active women participating in a randomized controlled study on physical exercise and quality of life.

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The purpose of our study was to find out whether transurethral injections of autologous adipose stem cells (ASCs) are an effective and a safe treatment for female stress urinary incontinence (SUI). We treated five SUI patients with ASCs combined with bovine collagen gel and saline. Prior to the treatment, the ASCs were isolated from subcutaneous fat and expanded for 3 weeks in a good manufacturing practice-level laboratory.

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Objectives: To study the outcome of various hysterectomies in 2 years 1996 (N =10110) and 2006 (N=5279). The hypothesis was that the change in operative practices in 10 years has resulted in improvements.

Design: 2 prospective nationwide cohort evaluations with the same questionnaire.

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Objective: Menorrhagia is a common problem impairing the quality of life (QOL) of many women. Both levonorgestrel-releasing intrauterine system (LNG-IUS) and hysterectomy are effective treatment modalities but no long-term comparative studies of QOL and costs exist. The objective of this study was to compare QOL and costs of LNG-IUS or hysterectomy in the treatment of menorrhagia during 10-year follow-up.

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Background: Menopause related symptoms modify quality of life and may also have an impact on work ability.

Objective: The aim of this study was to investigate the effects of physical exercise on work ability and daily strain among women with menopausal symptoms.

Methods: Occupationally active symptomatic menopausal women (n=123) were randomized into 24-week aerobic exercise intervention and control groups.

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Background: Menopause is associated with poor sleep quality and daytime sleepiness, which may lead to impaired quality of life and impaired functioning in daily activities.

Objective: To study whether exercise training improves sleep quality or decreases the amount of night time hot flushes among menopausal women with vasomotor symptoms.

Study Design: A randomized controlled trial.

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Objective: The aim of this study was to assess whether aerobic training affects menopausal symptoms in recently postmenopausal sedentary women.

Methods: Symptomatic women aged 45 to 63 years (N = 176; 3-36 months since last menstruation) were randomly assigned to an aerobic training or a control group. The intervention included unsupervised aerobic training for 50 minutes four times weekly for 24 weeks, whereas the control group attended health lectures twice a month.

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Histopathological diagnostics of gynecological malignancies continues to be challenging despite the well established criteria. For example, the morphological distinction of uterine leiomyosarcoma from certain variants of benign leiomyoma can be difficult. Herein, we investigated the expression of Carbonic anhydrase (CA) II, IX, and XII in the normal endometrium, leiomyomas, uterine sarcomas, and endometrial adenocarcinomas using immunohistochemistry.

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Small surgical wounds are just one of the benefits of laparoscopic surgery. Laparoscopic surgery is, however, technically challenging for the surgeon. Learning requires extensive practice, and working postures are tiring.

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Background And Objective: To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life.

Design: A randomized controlled trial.

Participants And Setting: Symptomatic, sedentary women (n = 176), 43-63 years, no current use of hormone therapy.

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