Publications by authors named "Tunn R"

Article Synopsis
  • Vasa praevia is a serious obstetric condition where fetal vessels are unprotected and can lead to high perinatal mortality if not detected before birth.
  • A study in the UK found that the incidence of diagnosed vasa praevia was 6.64 per 100,000 maternities, with significant improvement in outcomes for those diagnosed antenatally compared to those diagnosed during labor.
  • The research highlighted that active screening programs in hospitals were crucial for early detection, resulting in better management and lower risks of perinatal death and complications like hypoxic ischaemic encephalopathy.
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Pain after vaginal prolapse repair surgery with mesh is generally attributed to the mesh fixation, particularly to mesh erosion, dislocation or the development of hematoma. However, once all the causes have been excluded, the urinary system, bladder and ureters should be accurately examined by means of endovaginal ultrasound. This report concerns the case of a 72-year-old woman who had undergone mesh-supported prolapse surgery 3 months prior, with no other relevant diseases, who visited the emergency department complaining of dull, right-sided colic pain.

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Introduction: Changes in surgical practice patterns to cure stress urinary incontinence (SUI) became evident after FDA warnings regarding vaginal mesh were issued. The primary aim was to describe nationwide numbers of suburethral alloplastic slings (SAS) inserted in 2010, 2015, 2018 and 2021 in Germany. Secondary, numbers were related to SUI specific non-alloplastic alternatives and bulking agents.

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Objectives: To describe, and explain the rationale for, the methods used and decisions made during development of the updated SPIRIT 2024 and CONSORT 2024 reporting guidelines.

Methods: We developed SPIRIT 2024 and CONSORT 2024 together to facilitate harmonization of the two guidelines, and incorporated content from key extensions. We conducted a scoping review of comments suggesting changes to SPIRIT 2013 and CONSORT 2010, and compiled a list of other possible revisions based on existing SPIRIT and CONSORT extensions, other reporting guidelines, and personal communications.

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Article Synopsis
  • - This revised S2k-guideline, published in December 2021, consolidates previous guidelines on female urinary incontinence, including stress and urge incontinence, and the use of ultrasonography in diagnosis.
  • - Coordinated by the German Society for Gynecology and Obstetrics, it utilized a structured consensus process involving experts from various medical fields and is aligned with the European Association of Urology's guidelines.
  • - The guideline provides comprehensive recommendations on the epidemiology, diagnosis, and treatment options for female urinary incontinence, addressing both uncomplicated and complicated cases with specific therapeutic strategies.
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This completely revised interdisciplinary S2k-guideline on the diagnosis, therapy, and follow-up care of female patients with urinary incontinence (AWMF registry number: 015-091) was published in December 2021. This guideline combines and summarizes earlier guidelines such as "Female stress urinary incontinence," "Female urge incontinence" and "Use of Ultrasonography in Urogynecological Diagnostics" for the first time. The guideline was coordinated by the German Society for Gynecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) and the Working Group for Urogynecology and Plastic Pelvic Floor Reconstruction (Arbeitsgemeinschaft für Urogynäkologie und plastische Beckenbodenrekonstruktion e.

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Background: In many countries, such as France, England, USA, Canada, Australia, and New Zealand, alloplastic material in prolapse surgery has been paused due to the US Food and Drug Administration (FDA) warning, and restricted in other countries like the Netherlands and Sweden. For Europe and thus Germany, the SCENIHR report allows alloplastic material to be used for prolapse repair after recurrence and in other special situations.

Question: Which established and innovative prolapse surgeries without alloplastic material are currently available?

Methods: A literature search was carried out on established, guideline-compliant pelvic floor surgeries without alloplastic material as well as innovative new approaches.

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Background: Pelvic floor disorders are common, especially in pregnancy and after delivery, in the postmenopausal period, and old age, and they can significantly impact on the patient's quality of life.

Methods: This narrative review is based on publications retrieved by a selective search of the literature, with special consideration to original articles and AWMF guidelines.

Results: Pelvic floor physiotherapy (evidence level [EL] 1), the use of pessaries (EL2), and local estrogen therapy can help alleviate stress/urge urinary incontinence and other symptoms of urogenital prolapse.

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Article Synopsis
  • The study aims to evaluate the differences in online health information about pelvic organ prolapse (POP) from various platforms like Google, Facebook, Instagram, LinkedIn, and YouTube to improve how patients access reliable information.
  • YouTube was found to have the most useful content, while LinkedIn featured mostly ads and misleading information, with both platforms highlighting emotional issues related to POP that are often overlooked in clinical settings.
  • Only a small percentage of websites had the Health On the Net (HON) seal, indicating they are reliable, and the overall readability of the information was found to be challenging, suggesting a need for clearer and more comprehensive online resources from professionals.
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Purpose: Obstetric anal sphincter injuries (OASIs) complicate about 5% of vaginal births. The risk of anal incontinence is increased. OASI detection rates improve with knowledge and experience.

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Introduction And Hypothesis: Anterior colporrhaphy (AC) exhibits high recurrence rates, and this issue is not appropriately addressed by alloplastic material, which often necessitates reoperation. Aiming to improve the anatomical cure rate, we implemented double-layered anterior colporrhaphy (DAC). With a retrospective investigation, precise description and video of the surgical technique, we want to contribute to the development of native tissue anterior repair.

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Objective: The international Charité-MAYO Conference aims to promote international dialog on diagnostics, management, scientific breakthroughs, and state-of-the-art surgical procedures in gynecology and gynecologic oncology and senology. Live surgeries are a fundamental tool of interdisciplinary and international exchange of experts in their respective fields. Currently, there is a controversial and emotional debate about the true value, risks, and safety of live surgical broadcasts.

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Introduction And Hypothesis: The purpose of the study was to analyze anatomical and functional outcomes after sacrocolpopexy (SCP) for vaginal vault prolapse pelvic organ prolapse quantification (POPQ) II-III by random use of absorbable (Vicryl) and non-absorbable sutures (Ethibond) for vaginal mesh fixation.

Methods: This study was designed as a two-center randomized controlled study (RCT). The primary objective was to evaluate the anatomical outcome.

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Introduction And Hypothesis: To evaluate the performance of mesh-augmented repair of anterior pelvic organ prolapse (POP) with or without apical vaginal wall involvement in women with recurrent or complex prolapse.

Methods: This multicenter cohort study included women undergoing surgery with Calistar S (Promedon, Argentina) for anterior POP between 2016 and 2018. The SCENIHR opinion was considered for patient selection, surgeon's experience and choice of implant.

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Article Synopsis
  • Urogenital fistulas are uncommon in developed countries, often resulting from surgical or radiation complications, and can be repaired using various minimally invasive techniques, with the vaginal approach being the least invasive.
  • A study analyzing 50 patients treated between 2008 and 2018 found that 96% underwent vaginal repairs with a high success rate of 96% achieved in one operation using the modified Sims-Simon technique.
  • The median surgery lasted 40 minutes with a complication rate of 14%, highlighting the effectiveness and benefits of this approach for benign gynecological fistulas.
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Article Synopsis
  • Midurethral slings are a common treatment for stress urinary incontinence, and this study compares the effectiveness of two types (TVT exact vs. RetroArc) using different insertion methods.
  • The study involved 303 women and assessed outcomes like cure rates, patient satisfaction, and complications over 3 to 12 months post-surgery.
  • Results showed that while both methods were effective, the TVT exact had better subjective outcomes compared to RetroArc, indicating that the choice of technique and material can significantly impact patient experiences.
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Purpose: It was the aim to evaluate the personal preference of mode of delivery and to analyze differences between medical professionals and non-medical professionals. Interest in participating in a risk stratification system was evaluated. We hypothesized that gaining information about risk stratification provided in the survey could potentially change participants' decision regarding the preferred mode of delivery; therefore, subjects were asked twice (before and after providing information).

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Introduction And Hypothesis: Stabilization of the vaginal apex (level 1) is an important component of operations to correct pelvic organ prolapse (POP). We report functional and anatomical results and patient-reported outcomes of our technique of vaginal vault fixation at the time of vaginal hysterectomy.

Methods: One hundred and nine patients-mean 69 years, range 50.

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Introduction: Currently, almost every third child in Germany is delivered by caesarean section. Apart from straightforward and clear indications for caesarean section which account for approx. 10%, the large proportion of relative indications in particular needs to be critically reviewed if the current C-section rate is to be effectively lowered.

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Purpose: Clinical relevance of neurological evaluation in patients suffered urinary retention in the absence of subvesical obstruction. Determining whether (1) women complaining residual bladder volume without prolapse and obstruction always suffer pudendal nerve damage; (2) neurogenic damage can be linked to patients history/clinical examination; (3) therapy alters regarding to neurological findings; and (4) electromyography (EMG) of musculus sphincter ani externus (MSAE) can be omitted with electronically stimulated pudendal nerve latency (ESPL) as the standard investigation.

Methods: Women with urinary retention without ≥stage 2 prolapse or obstruction have neurological investigation including vaginally and anally pudendal terminal nerve latency (PTNL) (>2.

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Pelvic floor protection is an issue of increasing relevance. This article sought to summarize the session at last year's annual meeting of the German Society of Gynecology and Obstetrics (DGGG) in Stuttgart (10/2016) called "Urogynecology 2020-what is the optimal rate of cesarean section-does urogynecology have to deal with Obstetrics?". The main focus was set on the two important anatomical structures, the levator ani muscle and the anal sphincters.

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The aim was to establish an official interdisciplinary guideline, published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). The guideline was developed for use in German-speaking countries. In addition to the Germany Society of Gynecology and Obstetrics, the guideline has also been approved by the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG).

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