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Publications (10 of 112) Show all publications
Tjust, A. E., Hellman, U., Giannopoulos, A., Winsnes, A., Strigård, K. & Gunnarsson, U. (2024). Evaluation of extracellular matrix remodeling in full-thickness skin grafts in mice. Journal of Histochemistry and Cytochemistry, 72(2), 79-94
Open this publication in new window or tab >>Evaluation of extracellular matrix remodeling in full-thickness skin grafts in mice
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2024 (English)In: Journal of Histochemistry and Cytochemistry, ISSN 0022-1554, E-ISSN 1551-5044, Vol. 72, no 2, p. 79-94Article in journal (Refereed) Published
Abstract [en]

Abdominal hernia is a protruding weakness in the abdominal wall. It affects abdominal strength and life quality and can lead to complications due to intestinal entrapment. Autologous full-thickness skin graft (FTSG) has recently become an alternative material for reinforcement in the surgical repair of large abdominal hernias instead of synthetic mesh. FTSG eventually integrates with the abdominal wall, but the long-term fate of the graft itself is not fully understood. This has implications as to how these grafts should be optimally used and handled intraoperatively. This study investigates the remodeling of FTSG in either the onlay or the intraperitoneal position 8 weeks after FTSG transplantation in an experimental mouse model. There was a significant presence of fibroblasts, indicated by vimentin and S100A4 staining, but there were significant variations among animals as to how much of the graft had been remodeled into dense connective tissue. This correlated significantly with the proportion of vimentin-positive cells in the dense connective tissue. We also found that collagen hybridizing peptide staining intensity, a marker of active remodeling, was significantly associated with the proportion of S100A4-positive cells in the dense connective tissue of the FTSG.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
collagen, extracellular matrix, fibroblasts, hernia, hyaluronan, mouse model, S100A4, vimentin
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-221051 (URN)10.1369/00221554231225995 (DOI)001147995400001 ()38264898 (PubMedID)2-s2.0-85184511984 (Scopus ID)
Funder
Swedish Research Council, 2021-00972Region Västerbotten, RV-927121Region Västerbotten, RV-965797
Available from: 2024-02-21 Created: 2024-02-21 Last updated: 2024-02-21Bibliographically approved
Gkekas, I., Novotny, J., Kaprio, T., Beilmann-Lehtonen, I., Fabian, P., Tavelin, B., . . . Gunnarsson, U. (2024). Sporadic deficient mismatch repair in colorectal cancer increases the risk for non-colorectal malignancy: a European multicenter cohort study. Journal of Surgical Oncology
Open this publication in new window or tab >>Sporadic deficient mismatch repair in colorectal cancer increases the risk for non-colorectal malignancy: a European multicenter cohort study
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2024 (English)In: Journal of Surgical Oncology, ISSN 0022-4790, E-ISSN 1096-9098Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and Objectives: Disparities between tumors arising via different sporadic carcinogenetic pathways have not been studied systematically. This retrospective multicenter cohort study evaluated the differences in the risk for non-colorectal malignancy between sporadic colorectal cancer (CRC) patients from different DNA mismatch repair status.

Methods: A retrospective European multicenter cohort study including in total of 1706 CRC patients treated between 1996 and 2019 in three different countries. The proficiency (pMMR) or deficiency (dMMR) of mismatch repair was determined by immunohistochemistry. Cases were analyzed for tumor BRAFV600E mutation, and BRAF mutated tumors were further analyzed for hypermethylation status in the promoter region of MLH1 to distinguish between sporadic and hereditary cases. Swedish and Finish patients were matched with their respective National Cancer Registries. For the Czech cohort, thorough scrutiny of medical files was performed to identify any non-colorectal malignancy within 20 years before or after the diagnosis of CRC. Poisson regression analysis was performed to identify the incidence rates of non-colorectal malignancies. For validation purposes, standardized incidence ratios were calculated for the Swedish cases adjusted for age, year, and sex.

Results: Of the 1706 CRC patients included in the analysis, 819 were female [48%], median age at surgery was 67 years [interquartile range: 60–75], and sporadic dMMR was found in 188 patients (11%). Patients with sporadic dMMR CRC had a higher incidence rate ratio (IRR) for non-colorectal malignancy before and after diagnosis compared to patients with a pMMR tumor, in both uni- (IRR = 2.49, 95% confidence interval [CI] = 1.89–3.31, p = 0.003) and multivariable analysis (IRR = 2.24, 95% CI = 1.67–3.01, p = 0.004). This association applied whether or not the non-colorectal tumor developed before or after the diagnosis of CRC in both uni- (IRR = 1.91, 95% CI = 1.28–2.98, p = 0.004), (IRR = 2.45, 95% CI = 1.72–3.49, p = 0.004) and multivariable analysis (IRR = 1.67,95% CI = 1.05–2.65, p = 0.029), (IRR = 2.35, 95% CI = 1.63–3.42, p = 0.005), respectively.

Conclusion: In this retrospective European multicenter cohort study, patients with sporadic dMMR CRC had a higher risk for non-colorectal malignancy than those with pMMR CRC. These findings indicate the need for further studies to establish the need for and design of surveillance strategies for patients with dMMR CRC.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
colorectal cancer, non-colorectal malignancy, sporadic deficient mismatch repair
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:umu:diva-223081 (URN)10.1002/jso.27619 (DOI)001182569800001 ()38470492 (PubMedID)2-s2.0-85187434806 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, LP16‐2131Visare Norr
Available from: 2024-04-15 Created: 2024-04-15 Last updated: 2024-04-15
Renman, D., van Guelpen, B., Anderson, F., Axelsson, J., Riklund, K., Strigård, K., . . . Gylling, B. (2023). Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer. International Journal of Colorectal Disease, 38(1), Article ID 239.
Open this publication in new window or tab >>Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer
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2023 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 38, no 1, article id 239Article in journal (Refereed) Published
Abstract [en]

Purpose: Sarcopenia and myosteatosis, quantified via computed tomography (CT), are associated with poor colorectal cancer outcomes. These body composition estimates can be influenced by physical exercise. We explored the correlation between pre-diagnostic physical exercise, body composition close to diagnosis, and the combined prognosis impact of these factors.

Methods: We studied 519 stage I–III colorectal cancer (CRC) cases diagnosed 2000–2016 with pre-diagnostic self-reported recreational physical exercise data collected in the prospective, population-based Northern Sweden Health and Disease Study, and CT-estimated skeletal muscle index (SMI) or skeletal muscle density (SMD). Risk estimates were calculated by multivariable logistic regression and Cox proportional hazards models.

Results: No association was seen between low pre-diagnostic physical exercise and sarcopenia/myosteatosis in the multivariable model adjusted for age, sex, educational level, tumor stage, and tumor location. In multivariable Cox regression models, the combination of low pre-diagnostic physical exercise and either sarcopenia or myosteatosis at the time of diagnosis was associated with cancer-specific mortality compared to the reference group of high physical exercise combined with no sarcopenia/myosteatosis (adjusted HR 1.94 95% CI 1.00–3.76 for sarcopenia and adjusted HR 2.39 95% CI 1.16–4.94 for myosteatosis).

Conclusions: The combined presence of low pre-diagnostic physical exercise and sarcopenia or myosteatosis was associated with increased CRC-specific mortality. Despite the positive effect on prognosis, physical exercise did not alter body composition estimates at diagnosis, which could indicate attenuation from other factors.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Colorectal cancer, Exercise, Myosteatosis, Physical activity, Sarcopenia
National Category
Cancer and Oncology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-215081 (URN)10.1007/s00384-023-04536-0 (DOI)37755537 (PubMedID)2-s2.0-85172659066 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, AMP 20-999Visare Norr, 967732Region Västerbotten, ALF RV-968855Region Västerbotten, ALF RV-982739
Available from: 2023-10-13 Created: 2023-10-13 Last updated: 2024-02-08Bibliographically approved
Almkvist, L., Gunnarsson, U. & Strigård, K. (2023). Improved assessment of fecal incontinence in women with previous obstetric injury combining Low Anterior Resection Syndrome and Wexner scores. International Journal of Gynecology & Obstetrics, 161(3), 839-846
Open this publication in new window or tab >>Improved assessment of fecal incontinence in women with previous obstetric injury combining Low Anterior Resection Syndrome and Wexner scores
2023 (English)In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 161, no 3, p. 839-846Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of the current study was to assess whether Low Anterior Resection Syndrome (LARS) score could provide additional unique information to the Wexner score when assessing fecal incontinence (FI) in women with previous obstetric injury, thus providing a better foundation for treatment decisions.

Methods: This was a retrospective cohort study with intraindividual comparison of two scoring systems. Women with previous obstetric injury and diagnosed with FI between January 1, 2015, and December 31, 2018, with valid LARS and Wexner scores were included. Statistical methods used were Spearman rank correlation, Kendall τ, scatterplot, and ratios.

Results: Seventy women were included. Correlation coefficients varied from 0.42 to 0.66 (Spearman rank correlation) and 0.44 to 0.51 (Kendall τ). Cohen κ values varied from 0.33 to 0.67. No strong association was seen in the correlation analyses or the scatterplot.

Conclusion: LARS score was shown to provide extra relevant information when assessing FI in women with previous obstetric injury. All symptoms should be considered relevant when assessing FI since it is a complex condition and should be approached accordingly. The authors suggest a combination of LARS and Wexner scores when assessing FI among women with previous obstetric injury.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
colorectal surgery, fecal incontinence, gynecology, obstetrics, questionnaires, scoring methods, surgery
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-204750 (URN)10.1002/ijgo.14673 (DOI)000923561500001 ()36637255 (PubMedID)2-s2.0-85147520630 (Scopus ID)
Available from: 2023-02-21 Created: 2023-02-21 Last updated: 2024-02-08Bibliographically approved
Ringblom, C., Odensten, C., Strigård, K., Gunnarsson, U. & Näsvall, P. (2023). No reduction in parastomal hernia rate 3 years after stoma construction with prophylactic mesh: Three-year follow-up results from stomamesh-a multicenter double-blind randomized controlled trial. Annals of Surgery, 277(1), 38-42
Open this publication in new window or tab >>No reduction in parastomal hernia rate 3 years after stoma construction with prophylactic mesh: Three-year follow-up results from stomamesh-a multicenter double-blind randomized controlled trial
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2023 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 277, no 1, p. 38-42Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The primary objective was to compare rates of parastomal hernia (PSH) 3 years after stoma construction with prophylactic mesh or no mesh. A secondary objective was to compare complications requiring reintervention within 3 years.

BACKGROUND: Recent studies have shown that a prophylactic mesh does not reduce the rate of PSH contrary to older studies. Long-term data on efficacy and safety is however scarce.

METHODS: A randomized controlled double-blind multicenter trial. Patients planned for permanent end colostomy were randomized to either prophylactic mesh in the retromuscular position around the stoma site or no mesh. They were evaluated for PSH clinically and with computed tomography (CT) 3 years after stoma construction. Medical records of all patients included were also reviewed at 3 years to detect any abdominal or abdominal wall surgery during that period.

RESULTS: A total of 232 patients were randomized. At 3 years, 154 patients were available for clinical evaluation and 137 underwent a CT scan. No significant difference in PSH rates was seen between the treatment allocation arms (clinical: P=0.829 and CT: P=0.761, respectively), nor was there a significant difference in the number of reinterventions, but 2 patients had their mesh removed at emergency surgery.

CONCLUSIONS: Prophylactic mesh does not reduce the rate of PSH and cannot be recommended for routine use.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
Keywords
parastomal hernia, mesh, prevention, prophylaxis
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-202661 (URN)10.1097/SLA.0000000000005537 (DOI)000905219700014 ()35837972 (PubMedID)2-s2.0-85145304565 (Scopus ID)
Funder
Swedish Research Council, 214-7196Region Västerbotten, VLL-545001Norrbotten County Council
Available from: 2023-01-12 Created: 2023-01-12 Last updated: 2024-02-08Bibliographically approved
Näverlo, S., Strigård, K., Gunnarsson, U. & Edin-Liljegren, A. (2023). Patients’ experiences of living with a stoma in rural areas in Northern Sweden. International Journal of Circumpolar Health, 82(1), Article ID 2221767.
Open this publication in new window or tab >>Patients’ experiences of living with a stoma in rural areas in Northern Sweden
2023 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 82, no 1, article id 2221767Article in journal (Refereed) Published
Abstract [en]

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma.

Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed.

Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems.

Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Chronic illness, Quality of life, Rural health service, Rural nursing, Stoma care
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-211997 (URN)10.1080/22423982.2023.2221767 (DOI)001003462100001 ()37300840 (PubMedID)2-s2.0-85163149340 (Scopus ID)
Funder
Umeå University, VLL-545001Region Västerbotten, VLL-545001Visare Norr, 732841Cancerforskningsfonden i Norrland, AMP-18-956
Available from: 2023-07-12 Created: 2023-07-12 Last updated: 2024-02-08Bibliographically approved
Almkvist, L., Gunnarsson, U. & Strigård, K. (2023). Response: improved assessment of fecal incontinence in women with previous obstetric injury combining low anterior resection syndrome and wexner scores [Letter to the editor]. International Journal of Gynecology & Obstetrics, 163(3), 1057-1058
Open this publication in new window or tab >>Response: improved assessment of fecal incontinence in women with previous obstetric injury combining low anterior resection syndrome and wexner scores
2023 (English)In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 163, no 3, p. 1057-1058Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-215369 (URN)10.1002/ijgo.15194 (DOI)37800980 (PubMedID)2-s2.0-85173488468 (Scopus ID)
Available from: 2023-10-31 Created: 2023-10-31 Last updated: 2024-01-05Bibliographically approved
Huber, M., Larsson, C., Lehmann, J.-P., Strigård, K., Lindam, A. & Tunón, K. (2023). Sonographic postpartum anal sphincter defects and the association with pelvic floor pain and dyspareunia. Acta Obstetricia et Gynecologica Scandinavica, 102(10), 1290-1297
Open this publication in new window or tab >>Sonographic postpartum anal sphincter defects and the association with pelvic floor pain and dyspareunia
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2023 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 102, no 10, p. 1290-1297Article in journal (Refereed) Published
Abstract [en]

Introduction: Pelvic floor pain and dyspareunia are both important entities of postpartum pelvic pain, often concomitant and associated with perineal tears during vaginal delivery. The association between postpartum sonographic anal sphincter defects, pelvic floor pain, and dyspareunia has not been fully established. We aimed to determine the prevalence of postpartum anal sphincter defects using three-dimensional endoanal ultrasonography (3D-EAUS) and evaluate their association with symptoms of pelvic floor pain and dyspareunia.

Material and methods: This prospective cohort study followed 239 primiparas from birth to 12 months post delivery. Anal sphincters were assessed with 3D-EAUS 3 months postpartum, and self-reported pelvic floor function data were obtained using a web-based questionnaire distributed 1 year after delivery. Descriptive statistics were compared between the patients with and without sonographic defects, and the association between sonographic sphincter defects and outcomes were analyzed using logistic regression.

Results: At 3 months postpartum, 48/239 (20%) patients had anal sphincter defects on 3D-EAUS, of which 43 (18%) were not clinically diagnosed with obstetric anal sphincter injury at the time of delivery. Patients with sonographic defects had higher fetal weight than those without defects, and a perineum <2 cm before the suture was a risk factor for defects (odds ratio [OR], 6.9). Patients with sonographic defects had a higher frequency of dyspareunia (OR, 2.4), and pelvic floor pain (OR, 2.3) than those without defects.

Conclusions: Our results suggest an association between postpartum sonographic anal sphincter defects, pelvic floor pain, and dyspareunia. A perineal height <2 cm, measured by bidigital palpation immediately postdelivery, was a risk factor for sonographic anal sphincter defect. We suggest offering pelvic floor sonography around 3 months postpartum to high- risk women to optimize diagnosis and treatment of perineal tears and include perineum <2 cm prior to primary repair as a proposed indication for postpartum follow-up sonography.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
anal sphincter defect, dyspareunia, pelvic floor, perineal pain
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-211824 (URN)10.1111/aogs.14606 (DOI)001011883200001 ()37350333 (PubMedID)2-s2.0-85162689073 (Scopus ID)
Funder
Region Jämtland HärjedalenVisare Norr
Available from: 2023-07-11 Created: 2023-07-11 Last updated: 2024-02-08Bibliographically approved
Blind, N., Gunnarsson, U., Strigård, K. & Brännström, F. (2023). The impact of a patient's social network on emergency surgery for colon cancer. European Journal of Surgical Oncology, 49(2), 440-444
Open this publication in new window or tab >>The impact of a patient's social network on emergency surgery for colon cancer
2023 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 49, no 2, p. 440-444Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to investigate if patients with a weak social network and colon cancer are more likely to be operated as an emergency than those with a strong social network.

METHODS: Data from patients living in Västerbotten County, Sweden, who underwent colon cancer surgery between 2007 and 2020 were extracted from the Swedish Colorectal Cancer Registry (SCRCR). Patients identified were matched against the Västerbotten Intervention Program (VIP) and the longitudinal study Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA). These two databases include a survey that includes questions regarding quality and size of the patient's social network. Multivariable logistic regression was used for analysis.

RESULTS: Six items from the questions on social network, and the composite variables availability of social integration (AVSI) and availability of attachment (AVAT) were analysed. Data from 801 patients were analysed. The odds ratio for emergency surgery was significantly higher for divorced patients (OR 2.01 (CI 1.03-3.91)) and for male gender (OR 1.51 (CI 1.02-2.24)). A higher OR was seen amongst those with no-one to share feelings with (OR 1.57 (CI 0.82-3.03)) or to comfort them (OR1.33 (CI 0.78-2.28)). Quantitative aspects of social life such as the number of people greater than 10 that feel relaxed at the patient's home, showed a lower OR (OR 0.71(CI 0.35-1.43)).

CONCLUSION: The impact of social network on the risk for emergency surgery for colon cancer is limited. Divorced status and male gender were associated with an increased risk for emergency surgery.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Colon cancer, Emergency surgery, Social network, Social support
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-202658 (URN)10.1016/j.ejso.2022.09.019 (DOI)001009504400001 ()36243648 (PubMedID)2-s2.0-85139732011 (Scopus ID)
Funder
Bengt Ihres FoundationRegion Västerbotten, VLL-54500
Available from: 2023-01-12 Created: 2023-01-12 Last updated: 2024-02-08Bibliographically approved
Huber, M., Larsson, C., Harrysson, M., Strigård, K., Lehmann, J.-P., Nordin, P. & Tunón, K. (2023). Use of endoanal ultrasound in detecting obstetric anal sphincter injury immediately after birth. Acta Obstetricia et Gynecologica Scandinavica, 102(3), 389-395
Open this publication in new window or tab >>Use of endoanal ultrasound in detecting obstetric anal sphincter injury immediately after birth
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2023 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 102, no 3, p. 389-395Article in journal (Refereed) Published
Abstract [en]

Introduction: Obstetric anal sphincter injury (OASI) complicates around 5% of deliveries in primiparas. The study objective was to assess the utility of three-dimensional endoanal ultrasonography (3D-EAUS) in the diagnosis of OASI.

Material and methods: The present study was designed to mirror screening settings with an unselected cohort of nulliparous women. All enrolled patients underwent clinical examination of the perineum by the caregiver, and 3D-EAUS was conducted. Post-processing of ultrasonography volume data was performed by an experienced colorectal surgeon who was blinded to all other data. The sensitivity, specificity, negative predictive value, and positive predictive value of 3D-EAUS in the diagnosis of OASI was evaluated. The trial is registered at ISCRTN: 18006769.

Results: A total of 680 scans were performed, of which 18.5% were judged as “non-assessable”, resulting in 554 assessable recordings. Sphincter defects were observed in 12.8% of all assessable recordings on 3D-EAUS (n = 71). With clinical examination set as the reference standard, ultrasound sensitivity in the diagnosis of OASI was 30.4%, whereas its specificity was 87.9%. The negative predictive value was 96.7% and the positive predictive value was only 9.9%. Comments were left on 175 examinations, of which 74% referred to the management of the examination.

Conclusions: Using 3D-EAUS in a maternity ward is demanding because staff generally have little experience in endoanal ultrasound, which contributes to difficulties in obtaining good image quality. When 3D-EAUS is performed to mirror screening settings, it adds no convincing diagnostic power to clinical examination in the diagnosis of OASI.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
endoanal ultrasound, feasibility, obstetric anal sphincter injury, pelvic floor, postpartum, three-dimensional endoanal ultrasonography
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-204498 (URN)10.1111/aogs.14514 (DOI)000916695700001 ()36683208 (PubMedID)2-s2.0-85147035441 (Scopus ID)
Funder
Region Jämtland Härjedalen, 8176Västerbotten County CouncilVisare Norr
Available from: 2023-02-08 Created: 2023-02-08 Last updated: 2024-04-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5838-9133

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