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Lundström, Karl-Johan
Publications (10 of 16) Show all publications
Bobjer, J., Gerdtsson, A., Abrahamsson, J., Baseckas, G., Bergkvist, M., Bläckberg, M., . . . Liedberg, F. (2023). Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma: results from a prospective lymph node mapping study. European Urology Open Science, 57, 37-44
Open this publication in new window or tab >>Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma: results from a prospective lymph node mapping study
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2023 (English)In: European Urology Open Science, ISSN 2666-1691, E-ISSN 2666-1683, Vol. 57, p. 37-44Article in journal (Refereed) Published
Abstract [en]

Background: There is limited information on the distribution of retroperitoneal lymph node metastases (LNMs) in upper tract urothelial carcinoma (UTUC).

Objective: To investigate the location of LNMs in UTUC of the renal pelvis or proximal ureter and short-term complications after radical nephroureterectomy (RNU) with lymph node dissection (LND).

Design, setting, and participants: This was a prospective Nordic multicenter study (four university hospitals, two county hospitals). Patients with clinically suspected locally advanced UTUC (stage >T1) and/or clinical lymph node–positive (cN+) disease were invited to participate. Participants underwent RNU and fractionated retroperitoneal LND using predefined side-specific templates.

Outcome measurements and statistical analysis: The location of LNMs in the LND specimen and retroperitoneal lymph node recurrences during follow-up was recorded. Postoperative complications within 90 d of surgery were ascertained from patient charts. Descriptive statistics were used.

Results and limitations: LNMs were present in the LND specimen in 23/100 patients, and nine of 100 patients experienced a retroperitoneal recurrence. Distribution per side revealed LNMs in the LND specimen in 11/38 (29%) patients with right-sided tumors, for whom the anatomically larger, right-sided template was used, in comparison to 12/62 (19%) patients with left-sided tumors, for whom a more limited template was used. High-grade complications (Clavien grade ≥3) within 90 d of surgery were registered for 13/100 patients. The study is limited in size and not powered to assess survival estimates.

Conclusions: The suggested templates that we prospectively applied for right-sided and left-sided LND in patients with advanced UTUC included the majority of LNMs. High-grade complications directly related to the LND part of the surgery were limited.

Patient summary: This study describes the location of lymph node metastases in patients with cancer in the upper urinary tract who underwent surgery to remove the affected kidney and ureter. The results show that most metastases occur within the template maps for lymph node surgery that we investigated, and that this surgery can be performed with few severe complications.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Lymph node dissection, Lymph node metastases, Urinary tract cancer
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-215860 (URN)10.1016/j.euros.2023.09.010 (DOI)001086147000001 ()2-s2.0-85173799586 (Scopus ID)
Funder
Swedish Cancer Society, 2020/0709Swedish Research Council, 2021-00859Region Skåne, REGSKANE-622351Stiftelsen Gösta Jönssons forskningsfondStiftelsen Hillevi Fries forskningsfond
Available from: 2023-11-02 Created: 2023-11-02 Last updated: 2023-11-02Bibliographically approved
Jakobsson, E., Lundström, K.-J., Holmberg, H., De La Croix, H. & Nordin, P. (2022). Chronic Pain After Groin Hernia Surgery in Women: A Patient-reported Outcome Study Based on Data From the Swedish Hernia Register. Annals of Surgery, 275(2), 213-219
Open this publication in new window or tab >>Chronic Pain After Groin Hernia Surgery in Women: A Patient-reported Outcome Study Based on Data From the Swedish Hernia Register
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2022 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 275, no 2, p. 213-219Article in journal (Refereed) Published
Abstract [en]

Objective:The aim of this study was to evaluate chronic pain 1 year after surgery, and risk factors for chronic pain after groin hernia repair in women.Background:Groin hernia surgery in women is less frequently studied than in men. Chronic pain is common after groin hernia surgery and remains an important area with room for improvement. Previous studies are small or inconclusive. Guidelines recommend timely repair of all female groin hernias.

Methods:From the Swedish Hernia Register 4021 female and 37,542 male patients operated between September 1, 2012 and August 30, 2017 responded to a patient-reported outcome questionnaire (response rate 70.0%) 1 year after primary groin hernia surgery. Multivariable analysis was performed to compare chronic postoperative pain in women with men as a control group, and to evaluate risk factors for chronic pain in women.

Results:Among women operated for groin hernia, 18% suffered chronic postoperative pain. The risk for chronic pain was significantly higher for women [odds ratio 1.3 (95% confidence interval 1.16-1.46). Three risk factors for chronic pain in women were found: High body mass index, high American Society of Anesthesiologists classification, and femoral hernia. No differences in chronic pain in women were seen when comparing surgical methods or emergency versus elective surgery.

Conclusions:Almost one-fifth of women suffered of chronic pain affecting daily activity after groin hernia repair. Chronic pain was more common for women than men. In view of the high-rate chronic postoperative pain, further research on management strategies in female groin hernia is warranted.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022
Keywords
chronic pain, femoral hernia, inguinal hernia, women
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-192081 (URN)10.1097/SLA.0000000000005194 (DOI)000740824400004 ()35007224 (PubMedID)2-s2.0-85123222296 (Scopus ID)
Available from: 2022-02-02 Created: 2022-02-02 Last updated: 2024-04-09Bibliographically approved
Wagenius, M., Oddason, K., Utter, M., Popiolek, M., Forsvall, A., Lundström, K.-J. & Linder, A. (2022). Factors influencing stone-free rate of Extracorporeal Shock Wave Lithotripsy (ESWL); a cohort study. Scandinavian journal of urology, 56(3), 237-243
Open this publication in new window or tab >>Factors influencing stone-free rate of Extracorporeal Shock Wave Lithotripsy (ESWL); a cohort study
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2022 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 56, no 3, p. 237-243Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the success rate of Extracorporeal Shock Wave Lithotripsy (ESWL) therapy and identify relevant treatment-specific factors affecting stone-free rate (SFR) after ESWL.

Materials and methods: All ESWL treatments in the years 2016–2019, in Ängelholm Hospital, Skåne, Sweden were analysed retrospectively. Primary outcome was stone-free rate (SFR) at 3 months. Univariate logistic regression was used followed by multivariable regression. Lasso analysis was made to adjust for treatment-specific factors such as age, stone size, skin-to-stone distance (SSD), stone attenuation, number of treatments, stone location and presence of a urinary stent.

Results: Factors affecting successful ESWL treatment were lower age (p < 0.001), smaller stone size and volume (both p = 0.001). SSD, stone attenuation, sex, laterality and drainage did not have an effect on SFR in this study. After the first ESWL treatment session, 46.7% of the patients were stone-free.

Conclusion: Results indicate that stone size and age are the most predictive factors for ESWL outcome. Based on this, we present a simple model for prediction of SFR after ESWL, to be used when counseling patients before ESWL treatment.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Extracorporeal shock-wave lithotripsy, infection, monotherapy, outcome, stone free rate, ureteric stone, ureteroscopy
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-194914 (URN)10.1080/21681805.2022.2055137 (DOI)000779955500001 ()35400281 (PubMedID)2-s2.0-85129170267 (Scopus ID)
Available from: 2022-06-01 Created: 2022-06-01 Last updated: 2023-05-09Bibliographically approved
Holm, A., Lindgren, H., Blackberg, M., Augutis, M., Jakobsson, P., Tell, M., . . . Styrke, J. (2021). Patients' perspective on prostatic artery embolization: A qualitative study. SAGE Open Medicine, 9, 1-6, Article ID 20503121211000908.
Open this publication in new window or tab >>Patients' perspective on prostatic artery embolization: A qualitative study
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2021 (English)In: SAGE Open Medicine, E-ISSN 2050-3121, Vol. 9, p. 1-6, article id 20503121211000908Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to describe the patients' experience of undergoing prostatic artery embolization.

Methods: A retrospective qualitative interview study was undertaken with 15 patients of mean age 73 years who had undergone prostatic artery embolization with a median duration of 210 min at two medium sized hospitals in Sweden. The reasons for conducting prostatic artery embolization were clean intermittent catheterization (n = 4), lower urinary tract symptoms (n = 10) or haematuria (n = 1). Data were collected through individual, semi-structured telephone interviews 1-12 months after treatment and analysed using qualitative content analysis.

Results: Four categories with sub-categories were formulated to describe the results: a diverse experience; ability to control the situation; resumption of everyday activities and range of opinions regarding efficacy of outcomes. Overall, the patients described the procedure as painless, easy and interesting and reported that while the procedure can be stressful, a calm atmosphere contributed to achieving a good experience. Limitations on access to reliable information before, during and after the procedure were highlighted as a major issue. Practical ideas for improving patient comfort during the procedure were suggested. Improved communications between treatment staff and patients were also highlighted. Most patients could resume everyday activities, some felt tired and bruising caused unnecessary worry for a few. Regarding functional outcome, some patients described substantial improvement in urine flow while others were satisfied with regaining undisturbed night sleep. Those with less effect were considering transurethral resection of the prostate as a future option. Self-enrolment to the treatment and long median operation time may have influenced the results.

Conclusions: From the patients' perspective, prostatic artery embolization is a well-tolerated method for treating benign prostate hyperplacia.

Place, publisher, year, edition, pages
SAGE Open, 2021
Keywords
Prostatic artery embolization, benign prostate hyperplacia, health care users' experiences, doctor-patient, nurse-patient communication, patient education
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-187353 (URN)10.1177/20503121211000908 (DOI)000629311300001 ()33786178 (PubMedID)2-s2.0-85105760440 (Scopus ID)
Available from: 2021-09-09 Created: 2021-09-09 Last updated: 2023-03-24Bibliographically approved
Lundström, K.-J., Garmo, H., Gedeborg, R., Stattin, P. & Styrke, J. (2021). Short-term ciprofloxacin prophylaxis for prostate biopsy and risk of aortic aneurysm: nationwide, population-based cohort study. Scandinavian journal of urology, 55(3), 221-226
Open this publication in new window or tab >>Short-term ciprofloxacin prophylaxis for prostate biopsy and risk of aortic aneurysm: nationwide, population-based cohort study
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2021 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 55, no 3, p. 221-226Article in journal (Refereed) Published
Abstract [en]

Introduction: The use of quinolones has recently been questioned due to reports on side effects including an increased risk of aortic aneurysm. The aim of the study was to examine the risk of aortic aneurysm (AA) after short-term ciprofloxacin as prophylaxis for prostate biopsy.

Materials and Methods: We used the Prostate Cancer data Base Sweden and investigated 192,024 prostate biopsy exposures vs. 554,974 non-exposures for risk of AA. Prostate biopsy was used as a proxy for quinolone use as short-term ciprofloxacin is the recommended and documented prophylaxis in Sweden for this procedure. The outcome was the hazard ratio (HR) of AA in men who underwent a biopsy vs. those that did not.

Results: The absolute risk of AA was small, 39/10,000 person years for all AÁs and for ruptured AÁs 3.5/10,000 person years. In multivariate analyses, there were small, non-significant increases in risk of all AA’s (adjusted HR = 1.13, 95% CI: 0.91 to 1.39) and ruptured AÁs (adjusted HR = 1.05, 95% CI: 0.52 to 2.15) in men who underwent biopsy. A significantly increased risk of AA was observed in men diagnosed with high-risk prostate cancer on biopsy (HR = 1.50, 95% CI: 1.15–2.21). The use of prostate biopsy as a proxy for exposure to ciprofloxacin was a limitation of the study.

Conclusions: Short-term ciprofloxacin was not associated with an increased risk of aortic aneurysm and the increased risk in men with high-risk prostate cancer was likely due detection bias caused by imaging more commonly performed in these men.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2021
Keywords
aortic aneurysm, ciprofloxacin, prophylaxis, Prostate biopsy
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-183575 (URN)10.1080/21681805.2021.1916072 (DOI)000667306600001 ()33908321 (PubMedID)2-s2.0-85105230378 (Scopus ID)
Funder
Swedish Research Council, 2017-00847
Available from: 2021-06-02 Created: 2021-06-02 Last updated: 2022-01-12Bibliographically approved
Styrke, J., Resare, S., Lundström, K.-J., Masaba, P., Lagerros, C. & Stattin, P. (2020). Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy: a national survey to all urology clinics in Sweden. F1000 Research, 9, Article ID 58.
Open this publication in new window or tab >>Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy: a national survey to all urology clinics in Sweden
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2020 (English)In: F1000 Research, E-ISSN 2046-1402, Vol. 9, article id 58Article in journal (Refereed) Published
Abstract [en]

Background: The risk of infection after transrectal ultrasound (TRUS)-guided prostate biopsies is increasing. The aim of the study was to assess the use of antibiotic prophylaxis for prostate biopsy in Sweden. Methods: All public and private urology clinics reporting to the National Prostate Cancer Register of Sweden received a survey on TRUS-biopsy prophylaxis. Results: Of the 84 clinics surveyed, 76 replied (90%). If no risk factors for infection were present, a single dose of ciprofloxacin 750 mg was used by 50 clinics (66%). Multiple doses of ciprofloxacin 500 or 750 mg (n=14; 18%) or a single dose of trimethoprim-sulfamethoxazole 160/800 mg (n=7; 9%) were other common prophylaxes. Most clinics gave the prophylaxes immediately before the biopsy (n=41; 54%). Urine dipstick was used by 30 clinics (39%) and rectal enema by six (8%). In patients with high risk of infection, the survey mirrors a large variety of regiments used. Conclusions: The preference to use a single dose of ciprofloxacin 750 mg is in accordance with the Swedish national guidelines for patients with a low risk of infection. Better compliance to the guideline recommendation to use a urine dipstick would probably increase the number of patients classified as having an increased risk of infection. Being classified as a high-risk patient should lead to an extended duration of antibiotic prophylaxis, however, the variety of regimens used in the high-risk group reflects an inability to treat these patients in a standardized fashion and also highlights a need for more clear-cut guidelines. Pre-biopsy identification of high-risk patients is an important issue to tackle for the urologic clinics in order to reduce the number of infections.

Place, publisher, year, edition, pages
F1000 Research Ltd, 2020
Keywords
Antibiotic prophylaxis, Prostate biopsy, Prostate cancer diagnostics, Survey
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-177380 (URN)10.12688/f1000research.19260.1 (DOI)32399200 (PubMedID)2-s2.0-85084606058 (Scopus ID)
Available from: 2020-12-08 Created: 2020-12-08 Last updated: 2023-03-24Bibliographically approved
Lundström, K.-J., Söderstrom, L., Jernow, H., Stattin, P. & Nordin, P. (2019). Epidemiology of hydrocele and spermatocele; incidence, treatment and complications. Scandinavian journal of urology, 53(2-3), 134-138
Open this publication in new window or tab >>Epidemiology of hydrocele and spermatocele; incidence, treatment and complications
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 53, no 2-3, p. 134-138Article in journal (Refereed) Published
Abstract [en]

Objectives: To estimate the incidence of men seeking specialized care and receiving treatment for hydro or spermatocele complaints. Also, to determine the risk of complications of treatment.

Materials and methods: The total number of men living in Sweden each year from 2005 to 2014 was used to calculate incidence and age distribution of adult (≥18 years) men seeking specialized healthcare with either hydro or spermatocele. This was done by using nationwide registries, mandatory by law. They contain information on primary or discharge diagnosis, procedure codes and antibiotic prescriptions. Also, complication rates comparing aspiration (with or without sclerotherapy) and conventional surgery were analysed.

Results: The incidence of men with either hydro or spermatocele diagnosis in specialized healthcare was ∼100/100,000 men. The treatment incidence was 17/100,000 men. Orchiectomy was used as primary treatment in 2.4% of cases. The risk of experiencing a complication was clinically and statistically significantly increased with conventional surgery as compared with aspiration, 17.5% (1607/9174) vs 4.6% (181/3920), corresponding to relative risk of 3.79 (95% CI = 3.27–4.40). Hematoma and infections were the most common complications.

Conclusion: Hydro and spermatoceles are common, affecting elderly men. Aspiration seems advantageous with respect to complications and can be recommended due to the benign course of the disease. The indication for conventional surgery might be questioned such as the use of orchiectomy as primary treatment.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Testicular hydrocele, spermatocele, incidence, postoperative complications
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-158954 (URN)10.1080/21681805.2019.1600582 (DOI)000465949700001 ()30990342 (PubMedID)2-s2.0-85064609438 (Scopus ID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2023-03-24Bibliographically approved
Lundström, K.-J., Holmberg, H., Montgomery, A. & Nordin, P. (2018). Patient-reported rates of chronic pain and recurrence after groin hernia repair. British Journal of Surgery, 105(1), 106-112
Open this publication in new window or tab >>Patient-reported rates of chronic pain and recurrence after groin hernia repair
2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 105, no 1, p. 106-112Article in journal (Refereed) Published
Abstract [en]

Background: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear.

Methods: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least "pain present, cannot be ignored, and interferes with concentration on everyday activities' in the past week was the primary outcome. Reoperation for recurrence recorded in the register was the secondary outcome.

Results: In total, 22 917 patients (response rate 75.5 per cent) who had an elective unilateral groin hernia repair were analysed. Persistent pain present 1 year after hernia repair was reported by 15.2 per cent of patients. The risk was least for endoscopic total extraperitoneal (TEP) repair (adjusted odds ratio (OR) 0.84, 95 per cent c.i. 0.74 to 0.96), compared with open anterior mesh repair. TEP repair had an increased risk of reoperation for recurrence (adjusted OR 2.14, 1.52 to 2.98), as did open preperitoneal mesh repair (adjusted OR 2.34, 1.42 to 3.71) at 2.5-year follow-up. No other methods of repair differed significantly from open anterior mesh repair.

Conclusion: The risk of significant pain 1year after groin hernia repair in routine surgical practice was 15.2 per cent. This figure was lower in patients who had surgery by an endoscopic technique, but at the price of a significantly higher risk of reoperation for recurrence.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-143624 (URN)10.1002/bjs.10652 (DOI)000418390500012 ()29139566 (PubMedID)2-s2.0-85038595880 (Scopus ID)
Available from: 2018-01-30 Created: 2018-01-30 Last updated: 2024-04-09Bibliographically approved
Fridriksson, J. Ö., Folkvaljon, Y., Lundström, K.-J., Robinson, D., Carlsson, S. & Stattin, P. (2017). Long-term adverse effects after retropubic and robot-assisted radical prostatectomy: Nationwide, population-based study. Journal of Surgical Oncology, 116(4), 500-506
Open this publication in new window or tab >>Long-term adverse effects after retropubic and robot-assisted radical prostatectomy: Nationwide, population-based study
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2017 (English)In: Journal of Surgical Oncology, ISSN 0022-4790, E-ISSN 1096-9098, Vol. 116, no 4, p. 500-506Article in journal (Refereed) Published
Abstract [en]

Background and Objectives: Surgery for prostate cancer is associated with adverse effects. We studied long-term risk of adverse effects after retropubic (RRP) and robot-assisted radical prostatectomy (RARP).

Methods: In the National Prostate Cancer Register of Sweden, men who had undergone radical prostatectomy (RP) between 2004 and 2014 were identified. Diagnoses and procedures indicating adverse postoperative effects were retrieved from the National Patient Register. Relative risk (RR) of adverse effects after RARP versus RRP was calculated in multivariable analyses adjusting for year of surgery, hospital surgical volume, T stage, Gleason grade, PSA level at diagnosis, patient age, comorbidity, and educational level.

Results: A total of 11 212 men underwent RRP and 8500 RARP. Risk of anastomotic stricture was lower after RARP than RRP, RR for diagnoses 0.51 (95%CI = 0.42-0.63) and RR for procedures 0.46 (95%CI = 0.38-0.55). Risk of inguinal hernia was similar after RARP and RRP but risk of incisional hernia was higher after RARP, RR for diagnoses 1.48 (95%CI = 1.01-2.16), and RR for procedures 1.52 (95%CI = 1.02-2.26).

Conclusions: The postoperative risk profile for RARP and RRP was quite similar. However, risk of anastomotic stricture was lower and risk of incisional hernia higher after RARP.

Keywords
adverse effects, cancer of prostate, long-term, prostatectomy
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-140946 (URN)10.1002/jso.24687 (DOI)000408642900010 ()28591934 (PubMedID)2-s2.0-85020307637 (Scopus ID)
Funder
Swedish Research Council, 825-2012-5047Swedish Cancer Society, 11 0471
Available from: 2017-11-17 Created: 2017-11-17 Last updated: 2023-03-23Bibliographically approved
Lundström, K.-J. (2017). Outcomes and complications in surgical and urological procedures. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Outcomes and complications in surgical and urological procedures
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background:

Minor procedures in surgery and urology such as groin hernia and hydrocele repair, as well as prostate biopsies are very frequently done in routine practice. Complications and insufficient outcomes thus affecting many patients and the cumulative effect of this are of major importance in a population perspective.

Aim:

To explore complications and outcomes of surgical or diagnostic procedures and possible risk factors or predictors for adverse effects. Methods: By using both national quality and administrative registers, and by complementing registers with patient reported outcome measures, examine outcomes such as complications, persistent pain and recurrences. Also, in the case of hydro and spermatoceles, report incidence numbers. Further, by using a randomized trial, explore minimally invasive procedure such as sclerotheraphy compared to conventional surgery in respect to cure and adverse events.

Results:

When comparing with the open anterior mesh repair, endoscopic technique is advantageous in respect to the patient reported outcome of persistent pain. The drawback was an increased risk of postoperative complications and reoperation for recurrence. Incidence numbers for hydro and spematocele were 100/100000 men. Aspiration (± sclerotherapy) had a significantly lower rate of complications as compared to conventional surgery. In the interim analysis of the randomized trial, comparing sclerotherapy to Lord´s procedure for hydroceles, the cure rate was similar between treatments. Definite conclusions cannot be made due to the risk of type 2 errors, and the study will thus continue. In the case of trans-rectal prostate biopsy, the rates increased every year during the study time frame, up to an approximate risk of two per cent in 2012 for hospital readmission within 30 days, without an increased mortality within 30 days.

Conclusions:

The open anterior mesh procedure is still the preferred method for groin hernia repair in routine surgical practice. Hydro and spermatocele surgery is associated with high rates of complications, and the indication for repair should be scrutinized. The rates of infection after prostate biopsy is increasing and methods to reduce unnecessary biopsies as well as improved prophylaxis should be investigated.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2017. p. 66
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1899
Keywords
Hydrocele, Spermatocele, Groin hernia, prostate biopsy, complication, infection, chronic pain
National Category
Urology and Nephrology
Research subject
Urology; Surgery
Identifiers
urn:nbn:se:umu:diva-135046 (URN)978-91-7601-717-3 (ISBN)
Public defence
2017-06-09, Hörsalen, Östersunds sjukhus, Östersund, 09:00 (English)
Opponent
Supervisors
Available from: 2017-05-19 Created: 2017-05-17 Last updated: 2018-06-09Bibliographically approved
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