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Hachenberg J, Guenther J, Steinkasserer L, Brodowski L, Dueppers AL, Delius M, Chiaie LD, Lobmaier S, Sourouni M, Richter MF, Manz J, Parchmann O, Schmidt S, Winkler J, Werring P, Kraft K, Kunze M, Manz M, Eichler C, Schaefer V, Berghaeuser M, Schlembach D, Seeger S, Schäfer-Graf U, Kyvernitakis I, Bohlmann MK, Ramsauer B, Morfeld CA, Ruediger M, Pecks U, von Kaisenberg C. Evolution of Fetal Growth in Symptomatic Sars-Cov-2 Pregnancies. Z Geburtshilfe Neonatol 2024; 228:57-64. [PMID: 38330960 DOI: 10.1055/a-2224-2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
INTRODUCTION SARS-CoV-2 is a viral disease with potentially devastating effects. Observational studies of pregnant women infected with SARS-CoV-2 report an increased risk for FGR. This study utilizes data from a prospective SARS-CoV-2 registry in pregnancy, investigating the progression of fetuses to fetal growth restriction (FGR) at birth following maternal SARS-CoV-2 and evaluating the hypothesis of whether the percentage of SGA at birth is increased after maternal SARS-CoV-2 taking into account the time interval between infection and birth. MATERIALS & METHODS CRONOS is a prospective German registry enrolling pregnant women with confirmed SARS-CoV-2 infection during their pregnancy. SARS-CoV-2 symptoms, pregnancy- and delivery-specific information were recorded. The data evaluated in this study range from March 2020 until August 2021. Women with SARS-CoV-2 were divided into three groups according to the time of infection/symptoms to delivery: Group I<2 weeks, Group II 2-4 weeks, and Group III>4 weeks. FGR was defined as estimated and/or birth weight<10% ile, appropriate for gestational age (AGA) was within 10 and 90%ile, and large for gestational age (LGA) was defined as fetal or neonatal weight>90%ile. RESULTS Data for a total of 2,650 SARS-CoV-2-positive pregnant women were available. The analysis was restricted to symptomatic cases that delivered after 24+0 weeks of gestation. Excluding those cases with missing values for estimated fetal weight at time of infection and/or birth weight centile, 900 datasets remained for analyses. Group I consisted of 551 women, Group II of 112 women, and Group III of 237 women. The percentage of changes from AGA to FGR did not differ between groups. However, there was a significantly higher rate of large for gestational age (LGA) newborns at the time of birth compared to the time of SARS-CoV-2 infection in Group III (p=0.0024), respectively. CONCLUSION FGR rates did not differ between symptomatic COVID infections occurring within 2 weeks and>4 weeks before birth. On the contrary, it presented a significant increase in LGA pregnancies in Group III. However, in this study population, an increase in the percentage of LGA may be attributed to pandemic measures and a reduction in daily activity.
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Affiliation(s)
- Jens Hachenberg
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Julia Guenther
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Lena Steinkasserer
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Lars Brodowski
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
- Frauenklinik, Medizinische Hochschule Hannover, Hannover, Germany
| | | | - Maria Delius
- Obstetrics and Gynecology, LMU, München, Germany
| | - Loredana Delle Chiaie
- Department of Gynecology and Obstetrics, City of Stuttgart Hospitals, Stuttgart, Germany
| | - Silvia Lobmaier
- Frauenheilkunde und Geburtshilfe, Klinikum rechts der Isar der Technischen Universitat München, München, Germany
| | - Marina Sourouni
- Department of Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | | | - Jula Manz
- Department of Gynecology and Obstetrics, Darmstadt Hospital, Darmstadt, Germany
| | - Olaf Parchmann
- Department of Gynecology and Obstetrics, HELIOS Klinik Sangerhausen, Sangerhausen, Germany
| | - Saskia Schmidt
- Department of Gynecology and Obstetrics, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Jennifer Winkler
- Department of Gynecology and Obstetrics, Dresden University Hospital, Dresden, Germany
| | - Pia Werring
- Department of Gynecology and Obstetrics, Christophorus-Kliniken GmbH Betriebsstätte Sankt-Vincenz-Hospital Coesfeld, Coesfeld, Germany
| | - Katrina Kraft
- Department of Gynecology and Obstetrics, München Klinik Harlaching, München, Germany
| | - Mirjam Kunze
- Frauenklinik, Universitätsklinik Freiburg, Freiburg, Germany
| | - Maike Manz
- Department of Obstetrics and Gynaecology, Klinikum Darmstadt, Darmstadt, Germany
| | - Christian Eichler
- Department of Obstetrics and Gynecology, St Franziskus-Hospital Münster GmbH, Münster, Germany
| | - Viola Schaefer
- Department of Gynecology and Obstetrics, University Hospital Marburg Department of Gynaecology and Obstetrics, Marburg, Germany
| | - Martin Berghaeuser
- Department of Gynecology and Obstetrics, Florence-Nightingale-Krankenhaus, Düsseldorf, Germany
| | | | - Sven Seeger
- KH St. Elisabeth und St. Barbara Halle, Klinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum, Halle/Saale, Germany
| | - Ute Schäfer-Graf
- Klinik für Geburtshilfe, St Joseph Krankenhaus Berlin-Tempelhof, Berlin, Germany
| | - Ioannis Kyvernitakis
- Dept. of Obstetrics and Gynecology, Philipps-University of Marburg, Marburg, Germany
| | - Michael K Bohlmann
- Frauenheilkunde und Geburtshilfe, St Elisabethen-Krankenhaus Lörrach gGmbH, Lörrach, Germany
| | - Babette Ramsauer
- Department of Gynecology and Obstetrics, Vivantes Klinikum Neukölln, Berlin, Germany
| | | | - Mario Ruediger
- Department of Neonatology, Dresden University Hospital, Dresden, Germany
| | - Ulrich Pecks
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany
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Hachenberg J, Gundermann J, Fritsch H, Malter W, Steinkassserer L, Hillemanns P, Eichler C. A Retrospective Multicenter Analysis of Diagon/Gel ® 4Two Implant in 209 Cases of Reconstructive Breast Surgery. In Vivo 2024; 38:380-384. [PMID: 38148063 PMCID: PMC10756432 DOI: 10.21873/invivo.13449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM Breast cancer was the most common cancer in women in 2020. Breast reconstruction is an elementary component of modern breast surgery. This is especially important after oncological treatments. This is a retrospective multicenter study comparing Diagon\Gel® 4Two implants with different implants chosen by the treating surgeon. Diagon\Gel® 4Two (Polytech Health & Aesthetics, Germany) are anatomical silicone implants. PATIENTS AND METHODS A total of 209 patients underwent surgery. All patients were treated in the period from 2001 to 2019. All procedures were subcutaneous mastectomies. The surgical techniques used were either skin-sparing mastectomies or nipple-sparing mastectomies. Surgery was performed with Diagon/Gel® 4Two implant or treatment of choice implant by the treating physician. Endpoints were major and minor complication rates. The average follow-up time was 5 years. In total, 110 subjects were asked about their satisfaction with the treatment. RESULTS A total of 155 procedures were performed in the Diagon/Gel® 4Two implant group. One hundred and sixty procedures were done in the comparison group. Concerning either minor or major complications, there were no significant differences between both groups. The postoperative patient survey showed high satisfaction scores for both. There was significantly higher patient satisfaction among the study participants in the Diagon/Gel® 4Two implant group compared to the comparison group (p<0.01). CONCLUSION The Diagon/Gel® 4Two implants are safe alternatives in direct comparison to previously used breast implants. Our study even demonstrated a slight superiority concerning patient satisfaction. Based on this study, further implants can be compared concerning both the direct perioperative complication rate and patient satisfaction.
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Affiliation(s)
- Jens Hachenberg
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany;
| | - Johanna Gundermann
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
| | - Hannah Fritsch
- Breast Center, St. Franziskus-Hospital, Münster, Germany
| | - Wolfram Malter
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
| | - Lena Steinkassserer
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Christian Eichler
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
- Breast Center, St. Franziskus-Hospital, Münster, Germany
- Department of Gynecology and Obstetrics, Frauenklinik Holweide, Kliniken der Stadt Köln, Cologne, Germany
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Kutle I, Polten R, Hachenberg J, Klapdor R, Morgan M, Schambach A. Tumor Organoid and Spheroid Models for Cervical Cancer. Cancers (Basel) 2023; 15:cancers15092518. [PMID: 37173984 PMCID: PMC10177622 DOI: 10.3390/cancers15092518] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Cervical cancer is one of the most common malignant diseases in women worldwide. Despite the global introduction of a preventive vaccine against the leading cause of cervical cancer, human papillomavirus (HPV) infection, the incidence of this malignant disease is still very high, especially in economically challenged areas. New advances in cancer therapy, especially the rapid development and application of different immunotherapy strategies, have shown promising pre-clinical and clinical results. However, mortality from advanced stages of cervical cancer remains a significant concern. Precise and thorough evaluation of potential novel anti-cancer therapies in pre-clinical phases is indispensable for efficient development of new, more successful treatment options for cancer patients. Recently, 3D tumor models have become the gold standard in pre-clinical cancer research due to their capacity to better mimic the architecture and microenvironment of tumor tissue as compared to standard two-dimensional (2D) cell cultures. This review will focus on the application of spheroids and patient-derived organoids (PDOs) as tumor models to develop novel therapies against cervical cancer, with an emphasis on the immunotherapies that specifically target cancer cells and modulate the tumor microenvironment (TME).
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Affiliation(s)
- Ivana Kutle
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Robert Polten
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Jens Hachenberg
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany
| | - Rüdiger Klapdor
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany
| | - Michael Morgan
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Polten R, Kutle I, Hachenberg J, Klapdor R, Morgan M, Schambach A. Towards Novel Gene and Cell Therapy Approaches for Cervical Cancer. Cancers (Basel) 2022; 15:cancers15010263. [PMID: 36612258 PMCID: PMC9818159 DOI: 10.3390/cancers15010263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Cervical cancer is one of the most common malignancies in women, and the majority of cases are caused by infection with high-risk human papilloma virus (HPV) subtypes. Despite effective preventative measures, such as vaccinations against HPV, over 300,000 women die world-wide from cervical cancer each year. Once cervical cancer is diagnosed, treatment may consist of radial hysterectomy, or chemotherapy and radiotherapy, or a combination of therapies dependent upon the disease stage. Unfortunately, overall prognosis for patients with metastatic or recurrent disease remains poor. In these cases, immunotherapies may be useful based on promising preclinical work, some of which has been successfully translated to the clinic. For example, approaches using monoclonal antibodies directed against surface proteins important for control of immune checkpoints (i.e., immune checkpoint inhibitors) were shown to improve outcome in many cancer settings, including cervical cancer. Additionally, initial clinical studies showed that application of cytotoxic immune cells modified to express chimeric antigen receptors (CAR) or T cell receptors (TCR) for better recognition and elimination of tumor cells may be useful to control cervical cancer. This review explores these important topics, including strengths and limitations of standard and developing approaches, and how some novel treatment strategies may be optimally used to offer the best possible treatment for cervical cancer patients.
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Affiliation(s)
- Robert Polten
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Ivana Kutle
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Jens Hachenberg
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany
| | - Rüdiger Klapdor
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany
| | - Michael Morgan
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Correspondence: (M.M.); (A.S.); Tel.: +49-511-532-6067 (A.S.)
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Division of Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: (M.M.); (A.S.); Tel.: +49-511-532-6067 (A.S.)
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Jansen AK, Ludwig S, Malter W, Sauerwald A, Hachenberg J, Pahmeyer C, Wegmann K, Rudroff C, Karapanos L, Radosa J, Trageser N, Eichler C. Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model. Arch Gynecol Obstet 2021; 305:631-639. [PMID: 34842976 PMCID: PMC8918131 DOI: 10.1007/s00404-021-06343-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/18/2021] [Indexed: 12/01/2022]
Abstract
Purpose There is a novel surgical procedure, called cervicosacropexy (CESA) and vaginosacropexy (VASA) to treat pelvic organ prolapse and a concomitant urgency and mixed urinary incontinence. As there is little experience with the tapes so far and literature is scanty, the aim of this study was to investigate biomechanical properties for the fixation of the PVDF-tapes with three different fixation methods in context of apical fixations. Methods Evaluation was performed on porcine, fresh cadaver sacral spines. A total of 40 trials, divided into 4 subgroups, was performed on the anterior longitudinal ligament. Recorded biomechanical properties were displacement at failure, maximum load and stiffness in terms of the primary endpoints. The failure mode was a secondary endpoint. Group 4 was a reference group to compare single sutures on porcine tissue with those on human tissue. Biomechanical parameters for single sutures on the human anterior longitudinal ligament were evaluated in a previous work by Hachenberg et al. Results The maximum load for group 1 (two single sutures) was 65 ± 12 N, for group 2 (three titanium tacks arranged in a row) it was 25 ± 10 N and for group 3 (three titanium tacks arranged in a triangle) it was 38 ± 12 N. There was a significant difference between all three groups. The most common failure mode was a “mesh failure” in 9/10 trials for groups 1–3. Conclusion The PVDF-tape fixation with two single sutures endures 2.6 times more load than titanium tacks arranged in a row and 1.7 times more load than titanium tacks arranged in a triangle. The presacral fixation with titanium tacks reduced surgical time compared to the fixation with sutures, nevertheless sutures represent the significantly stronger and cheaper fixation method.
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Affiliation(s)
- Alina Katharina Jansen
- Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany.
| | - Sebastian Ludwig
- Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany
| | - Wolfram Malter
- Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany
| | - Axel Sauerwald
- Department of Gynecology and Obstetrics, St. Marien Hospital Düren, Düren, Germany
| | - Jens Hachenberg
- Department of Gynacology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Caroline Pahmeyer
- Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany
| | - Kilian Wegmann
- Faculty of Medicine and University Hospital Cologne, Department for Trauma, Hand and Elbow Surgery, University of Cologne, Cologne, Germany
| | - Claudia Rudroff
- Department of General Surgery, Evangelisches Krankenhaus Köln-Weyertal, Cologne, Germany
| | - Leonidas Karapanos
- Department of Urology, Uro-Oncology, Robot-Assisted and Reconstructive Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Radosa
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Homburg, Germany
| | - Nadja Trageser
- Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany
| | - Christian Eichler
- Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany
- Breast Cancer Center, St. Franziskus- Hospital Münster, 48145, Münster, Germany
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Hillemanns P, Kampers J, Hachenberg J, Jentschke M. [Vaccination against human papillomavirus]. Internist (Berl) 2021; 62:816-826. [PMID: 34259907 DOI: 10.1007/s00108-021-01102-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/25/2022]
Abstract
Vaccination against human papillomavirus (HPV), which has been proven to be highly effective and safe, is recommended as part of standard vaccination by the German Standing Committee on Vaccination (STIKO) for 9‑ to 14-year-old girls and boys. Up to 90% of cervical cancer and its precancerous lesions can be prevented with timely vaccination (before first intercourse). In addition, the effectiveness extends to the primary prevention of HPV-associated neoplasms of the vulva, vagina, anus, penis and oropharynx. The HPV vaccination is the focus of the global initiative of the WHO calling on German health policymakers to significantly increase the immunization coverage of the German population, which is currently only 45-60%. Due to the high immunogenicity and the convincing long-term effects, the goals of eliminating cervical cancer and significantly reducing other HPV-associated cancers are theoretically achievable.
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Affiliation(s)
- Peter Hillemanns
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Johanna Kampers
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Jens Hachenberg
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Matthias Jentschke
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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Hachenberg J, Acis E, Auer-Schmidt MM, Warm M, Malter W, Thangarajah F, Eichler C. Preoperative Octenidine Application in Breast Reconstruction Surgery. In Vivo 2021; 35:549-554. [PMID: 33402508 DOI: 10.21873/invivo.12290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/21/2020] [Accepted: 11/28/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Postoperative infection in implant-based reconstructive breast surgery is a common problem. The preoperative application of a disinfecting washing agent may reduce postoperative infection rates. This retrospective analysis aimed to evaluate whether preoperative Octenisan® application yields a reduction in postoperative complications or infection rates in breast reconstructive surgery. PATIENTS AND METHODS Between 2016 and 2019, 127 women received implant-based breast reconstruction at the municipal hospital of Cologne, Holweide, Germany. A total of 197 treatments were performed. After giving consent, patients were asked to use Octenisan® wash lotion for five days before breast reconstructive surgery. All patients were asked by a simple questionnaire whether they performed showering and washing according to the proposed protocol. In 96 cases patients did adhere to the protocol. In 101 cases they did not. Patient cohorts were then divided into patients who had applied Octenisan® wash lotion and patients who had not. Endpoints were defined as minor complications with no implant loss and major complications with consecutive implant loss. RESULTS Patient adherence to the application regimen was 48.7%. Overall minor complications occurred in 34.4% with preoperative Octenidine usage and 36.6% without preoperative Octenidine usage. Major complications happened in 7% with preoperative Octenidine and 5% without Octenidine. Overall, there was no significant difference concerning minor or major complication rates. CONCLUSION Preoperative washing protocols involving the Octenisan® wash lotion is relatively cheap and easy to follow. There is evidence that washing protocols result in a reduction of S. aureus infections leading to a better perioperative outcome. Octenisan® is safe to use in implant-based breast reconstructive surgery and is not associated with higher risks for patients. Our study did not yield any significant reduction in perioperative and postoperative complication and infection rates. This is attributed to a relatively low study population. Wash lotion compliance was only 48.7%. Proper patient education is crucial. With those preliminary data, it is now possible to design a larger analysis since patient adherence to washing protocol with Octenisan® wash lotion has been established.
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Affiliation(s)
- Jens Hachenberg
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany;
| | - Ellen Acis
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
| | | | - Mathias Warm
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.,Department of Gynecology and Obstetrics, Frauenklinik Holweide, Kliniken der Stadt Köln, Cologne, Germany
| | - Wolfram Malter
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
| | - Fabinshy Thangarajah
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
| | - Christian Eichler
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.,Department of Gynecology and Obstetrics, Frauenklinik Holweide, Kliniken der Stadt Köln, Cologne, Germany.,German Center for Material Science in Gynecology and Senology (DZMGS), Cologne, Germany
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Hachenberg J, Sauerwald A, Brunke H, Ludwig S, Scaal M, Prescher A, Eichler C. Suturing methods in prolapse surgery: a biomechanical analysis. Int Urogynecol J 2021; 32:1539-1544. [PMID: 33263782 PMCID: PMC8203505 DOI: 10.1007/s00192-020-04609-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/10/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Pelvic organ prolapse is a common problem in urogynecological surgery. Abdominal and laparoscopic sacrocolpopexy is currently considered to be the gold standard of treatment. The main problem remains the anatomical point of fixation as well as how sutures are placed. We evaluated the biomechanical difference between an in-line ligament suture versus an orthogonal ligament suture and a single suture versus a continuous suture at the anterior longitudinal ligament in an in-vitro, sacrocolpopexy model. METHODS Biomechanical in-vitro testing was performed on human, non-embalmed, female cadaver pelvises. An Instron test frame (tensinometer) was used for load/ displacement analysis. The average patient age was 75 years. Ligament preparation yielded 15 ligaments available for testing. Recorded parameters were the ultimate load, failure displacement, and stiffness. RESULTS This in-vitro analysis of different suturing methods showed the difference between an orthogonal and an in-line approach to be the ultimate load. Orthogonal sutures displayed an ultimate load of 80 N while in-line suturing yielded only 57 N (p < 0.05). For the anterior longitudinal ligament, this study demonstrated that continuous suture is significantly superior to a single suture regarding failure displacement (p < 0.05). CONCLUSION We established baseline biomechanical parameters for the sacrospinous ligament and anterior longitudinal ligament. An orthogonal suture is superior to an in-line suture in an in-vitro model. A continuous suture is superior to a single suture at the anterior longitudinal ligament. Clinical trials might be able to evaluate whether any clinical significance can be established from these findings.
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Affiliation(s)
- J Hachenberg
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany.
| | - A Sauerwald
- Department of Gynecology and Obstetrics, St. Marien Hospital Düren, Düren, Germany
| | - H Brunke
- Department of Gynecology and Obstetrics, Frauenklinik Holweide, Kliniken der Stadt Köln, Cologne, Germany
| | - S Ludwig
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
| | - M Scaal
- Department of Anatomy II, University of Cologne, Cologne, Germany
| | - A Prescher
- Department of Anatomy, RWTH Aachen University, Aachen, Germany
| | - C Eichler
- Department of Gynecology and Obstetrics, St. Marien Hospital Düren, Düren, Germany
- Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany
- DZMGS (German Center for Material Science in Gynecology and Senology), Cologne, Germany
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Findeklee S, Hachenberg J, Kienast K. In vitro Maturation of Oocytes with Consecutive Clinical Pregnancy after Accidental Premature Ovulation Induction-A Rescue Strategy in Art. Acta Endocrinol (Buchar) 2021; 17:106-110. [PMID: 34539917 PMCID: PMC8417485 DOI: 10.4183/aeb.2021.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The implementation of assisted reproductive techniques (ART) is a complex treatment requiring both a good cooperation between various professional groups in the fertility centre, and the patient's and her partner's cooperation. Accordingly, there are many sources of failure, such as using the wrong medication or not considering optimal times. If there is an artificial application of the ovulation induction injection, the success of the treatment is endangered and in some cases the cycle is discontinued, if the patient failed to administer the drug correctly. An alternative to cycle cancellation might be the maturation of the oocytes in vitro. WE REPORT on a 31-year-old patient in whom we performed an oocyte retrieval procedure 24 hours after triggering ovulation followed by in vitro maturation of the immature oocytes over a period of more than 12 h. The treatment resulted in a healthy, ongoing pregnancy.
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Affiliation(s)
- S. Findeklee
- MVZ Fertility Center Hamburg GmbH - Reproductive Medicine, Homburg, Saarland, Germany
- Saarland University Hospital Homburg - Gynaecology, Obstetrics and Reproductive Medicine, Homburg, Saarland, Germany
| | - J. Hachenberg
- MVZ Fertility Center Hamburg GmbH - Reproductive Medicine, Homburg, Saarland, Germany
| | - K. Kienast
- MVZ Fertility Center Hamburg GmbH - Reproductive Medicine, Homburg, Saarland, Germany
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Berger B, Rösing B, Beier F, Hachenberg J, Neulen J. Partus eines gesunden Kindes in der 30. SSW nach Rezidiv eines M. Hodgkin in der 20. SSW. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- B Berger
- Uniklinik Aachen, Gynäkologische Endokrinologie und Reproduktionsmedizin, Aachen, Deutschland
| | - B Rösing
- Uniklinik Aachen, Gynäkologische Endokrinologie und Reproduktionsmedizin, Aachen, Deutschland
| | - F Beier
- Uniklinik Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Aachen, Deutschland
| | - J Hachenberg
- Uniklinik Aachen, Klinik für Geburtshilfe und Gynäkologie, Aachen, Deutschland
| | - J Neulen
- Uniklinik Aachen, Gynäkologische Endokrinologie und Reproduktionsmedizin, Aachen, Deutschland
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