Quality of Obstetric Services: Perspectives of Patients, Obstetricians, and Midwives

Objective. The aim of this study was to compare the perspectives of patients and health care staff on the quality of obstetric services in an obstetric department. Material and Methods. This study was carried out at the Department of Obstetrics, Hospital of Lithuanian University of Health Sciences, where 68 obstetricians and midwives and 334 female patients completed anonymous questionnaires. Two different versions of the questionnaire for patients and health care staff were prepared with the aim to compare the results of both groups. Results. Patients evaluated technical quality of services significantly better than health care staff. Other items were showed to have no significant differences with the exception of sterility of equipment and premises and appearance of physicians. Patients and health care staff had similar opinions about professional relationship between patients and physicians: patients can expect representation of their interests and evaluation of treatment progress. Evaluation of external efficiency revealed that respondents were satisfied with health care and would recommend the current health care institution to their friends and relatives or would use it again when needed. Conclusions. Patients evaluated technical quality of services significantly better than health care staff. The different perceptions of patients and health care staff about functional quality and external effectiveness of services in most aspects were insignificant

A comparative analysis of hysterectomies

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P0.05). Conclusions. Abdominal hysterectomy [...]

Female pelvic organ prolapse (POP) surgery. Results at 24-month follow-up

Background: PROLIFT (anterior, posterior, total) is a type of the surgical procedure during which synthetic implants are used. PROLIFT procedure involves the use of porous, non-absorbable polypropylene mesh and fixation of the uterine fascia and its ligaments. The aim of this study: to evaluate the efficacy, outcomes and complications of the PROLIFT procedure and evaluate the changes in the patients sexual function (before and after surgery). Material and methods: a prospective study based on observation of clinical outcomes of the PROLIFT procedure performed by one surgeon during the period of 4 years (01/05/2008 -01/05/2012). Patients were observed and examined after 3, 6, 12 and 24 months. Our studied women responded to the FSFI questionnaire and special 4 questions before and after surgery about quality of their sexual life. Results: Analysis of 51 PROLIFT procedures was performed. Mean age of women – 52.19 years. All women reported having active sexual life. 70.6% of women were menopausal. The mean number of births – 2.21. The following factors for POP were distinguished: birth weight over 4kg in 37 cases (72.5%), BMI above 30kg/m2 (37.3%) in 19 women, and manual work was reported by 8 women (15.7%). Three types of the PROLIFT procedures were carried out: anterior – for 45 women (88.2%), posterior - 5 women (9.8%) and total - 1 woman (2%). PROLIFT procedure was combined with colpoperineoplasty in 45 cases (88.2%), with amputation of the uterine cervix in 5 cases (9.8%), and in 1 case (2%) with TVT operation. Spinal anesthesia was administered in 43 cases (84.3%), general anesthesia - in 6 cases, (11.8%) and in 2 cases (3.9%) - intravenous anesthesia. Mean PROLIFT procedure time – 43.2 minutes. Mean hospital stay – 2.7 days. Mean amount of blood loss during procedure - 131ml. Efficacy of the procedure was evaluated after 24 months and showed a 98.0% success rate. There was 1 case of recurrence (2%), thus the procedure was repeated. Conclusions: PROLIFT procedure as minimally invasive surgical treatment for POP is shown to be effective in 98.0 % of cases after 24 months. With aging and pelvic organ prolapse stage, a number of early complications increases. Women have significantly better sexual life after PROLIFT procedure

The link between thyroid autoimmunity, depression and bipolar disorder

Depression and bipolar disorder are two major psychiatric illnesses whose pathophysiology remains elusive. Newly emerging data support the hypothesis that the dysfunction of the immune system might be a potential factor contributing to the development of these mental disorders. The most common organ affected by autoimmunity is the thyroid; therefore, the link between autoimmune thyroid disorders and mental illnesses has been studied since the 1930s. The aim of this review is to discuss the associations between thyroid autoimmunity, depression and bipolar disorder

Affective Symptoms and Health-Related Quality of Life Among Women with Stress Urinary Incontinence: Cross-Sectional Study

Purpose: To evaluate the relationship between affective symptoms, clinical variables of uro-gynaecological history and health-related quality of life (QoL) among women with stress urinary incontinence (SUI) in comparison to healthy controls

Surgical treatment of female pelvic organ prolapse at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine

Objective. To compare surgical methods, complications, and outcomes in the treatment of female pelvic organ prolapse at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine, and to disclose the risk factors that influence female pelvic organ prolapse. Material and methods. A retrospective analysis of surgeries for pelvic organ prolapse performed during the period of 2003–2007 was carried out. A total 823 women were operated on for pelvic organ prolapse. Results. During 2003–2007, 823 surgical procedures for the correction of female pelvic organ prolapse were performed at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine. Eighty (9.7%) patients underwent vaginal hysterectomy; 372 (45.3%), vaginal plastic operations (out of them, 23 were combined with TVT and 47 with TVT-O procedure); 360 (43.7%), vaginal hysterectomy with vaginal plastic surgeries; and 11 (1.3%), Prolift operations. The mean age of females was 62 years. Mean blood loss during operations was 162.1 mL. Patients undergoing vaginal plastic operations lost significantly less blood than those undergoing vaginal hysterectomy or combined operations (P<0.05). Mean time in surgery was 60.3 min. The duration of Prolift operations and vaginal plastic operations was significantly shorter than that of vaginal hysterectomy or combined procedures (vaginal hysterectomy + vaginal plastic surgery) (P<0.05). Mean hospital stay was 8.1 days. Hospital stay after vaginal plastic operations was significantly shorter than after vaginal hysterectomy or combined operations. The shortest hospital stay was after Prolift operation (P<0.05). Complications were related to the type of operation performed. Conclusions. The most common operations in the surgical treatment of female pelvic organ prolapse were vaginal plastic operations and combined operations. The shortest time in surgery and lowest blood loss was in case of vaginal plastic operations. The shortest hospital stay was after Prolift operations. The highest rate of complications was observed in patients who underwent vaginal hysterectomies, the lowest – after Prolift operations