Research projects
Surgical treatment for various forms of prolapse is common. An analysis of cost-effectiveness and a clinical evaluation of more severe cases in relation to surgical techniques involving mesh are currently underway.
A study is also underway to investigate whether an improved surgical technique using the patient’s own tissues, with or without uterine suspension, can achieve results as good as those of mesh surgery. This applies to patients with more severe prolapse (total prolapse, uterine prolapse and/or recurrence following previous prolapse surgery). Concurrent urinary incontinence and previous birth-related injuries are treated during the same surgical procedure.
If you are due to undergo surgery for certain types of prolapse or for urinary incontinence using the so-called TVT procedure, you can take part in a study in which you will be monitored over several years regarding complications and the effectiveness of the surgery. You will then receive regular, free follow-up appointments as part of the study.
Selected publications
Association between surgical volumes and real-world healthcare cost when using a mesh capturing device for pelvic organ prolapse: A 5-years comparison between single- versus multicenter use.
Morcos E, Falconer C, Grip ET, Geale K, Hellgren K, Poutakidis G, Altman D
Int Urogynecol J 2021 Nov;32(11):3007-3015
Ultrasound evaluation of anterior transvaginal mesh for pelvic organ prolapse: correlation to 5-year clinical outcomes.
Poutakidis G, Marsk A, Altman D, Falconer C, Morcos E
Int Urogynecol J 2022 Jul;33(7):1907-1915
Long-term outcomes of pelvic organ prolapse repair using a mesh-capturing device when comparing single- versus multicenter use.
Falconer C, Altman D, Poutakidis G, Rahkola-Soisalo P, Mikkola T, Morcos E
Arch Gynecol Obstet 2021 Jan;303(1):135-142
Comparison of single- versus multicenter outcomes for pelvic organ prolapse repair using a mesh-capturing device.
Morcos E, Altman D, Hunde D, Falconer C,
Int Urogynecol J 2018 Jan;29(1):91-97
A generic health-related quality of life instrument for assessing pelvic organ prolapse surgery: correlation with condition-specific outcome measures.
Altman D, Geale K, Falconer C, Morcos E
Int Urogynecol J 2018 Aug;29(8):1093-1099
The clinic is currently conducting studies into microwave treatment for uterine fibroids and adenomyosis, two conditions that can cause heavy and sometimes painful periods. The aim is to be able to offer uterus-preserving treatment for these conditions when medical treatment has not been effective.
Selected publications
Long term follow-up of uterine fibroids treated with microwave ablation: an up to 3-year observational study of volume, regrowth, and symptoms.
Beermann M, Jonsdottir G, Cronisoe A, Hasselrot K, Kopp Kallner H
Int J Hyperthermia 2022 ;39(1):1158-1163
Ultrasound guided microwave ablation compared to uterine artery embolization treatment for uterine fibroids - a randomized controlled trial.
Jonsdottir G, Beermann M, Lundgren Cronsioe A, Hasselrot K, Kopp Kallner H
Int J Hyperthermia 2022 ;39(1):341-347
In recent years, there have been significant developments in laparoscopic and robot-assisted surgery. Several of the clinic’s doctors are involved in various studies evaluating these methods. A long-term study is monitoring the effects of hysterectomy (surgical removal of the uterus) on patients’ pelvic floor and sexual function.
In spring 2024, a multicentre study into patient-reported quality of life following day-case robot-assisted hysterectomy will commence.
Selected publications
Pelvic floor and sexual function 3 years after hysterectomy - A prospective cohort study.
Johannesson U, Amato M, Forsgren C
Acta Obstet Gynecol Scand 2024 Mar;103(3):580-589
Effects of hysterectomy on pelvic floor function and sexual function-A prospective cohort study.
Forsgren C, Amato M, Johannesson U
Acta Obstet Gynecol Scand 2022 Oct;101(10):1048-1056
Peri- and postoperative outcomes in patients with endometriosis undergoing hysterectomy.
Brunes M, Johannesson U, Häbel H, Forsgren C, Moawad G, Ek M
Eur J Obstet Gynecol Reprod Biol 2022 May;272():104-109
Recurrent surgery in uterine prolapse: A nationwide register study.
Brunes M, Johannesson U, Drca A, Bergman I, Söderberg M, Warnqvist A, Ek M
Acta Obstet Gynecol Scand 2022 May;101(5):532-541
Vaginal vault prolapse and recurrent surgery: A nationwide observational cohort study.
Brunes M, Ek M, Drca A, Söderberg M, Bergman I, Warnqvist A, Johannesson U
Acta Obstet Gynecol Scand 2022 May;101(5):542-549
Laparoscopic Virtual Reality Simulation Combined with Live Animal Model Training: A Clinical Experience
Ulrika Johannesson, Sophia Ehrstrom , Tomas Askerud and Magnus Kjellman
Clinics in Surgery, 2020 Feb; 3
Effects of Obesity on Peri- and Postoperative Outcomes in Patients Undergoing Robotic versus Conventional Hysterectomy.
Brunes M, Johannesson U, Häbel H, Söderberg MW, Ek M
J Minim Invasive Gynecol 2021 Feb;28(2):228-236
Assessment of surgeon and hospital volume for robot-assisted and laparoscopic benign hysterectomy in Sweden.
Brunes M, Forsgren C, Warnqvist A, Ek M, Johannesson U
Acta Obstet Gynecol Scand 2021 Sep;100(9):1730-1739
Injuries to the pelvic floor muscles, known as levator injuries, are common following vaginal delivery. However, it is unclear what symptoms these injuries cause, which is now being investigated in a study. Two groups of women underwent 3D ultrasound scans of the pelvic floor one year after giving birth – one group with pelvic floor symptoms and one group without. We will investigate whether symptoms affecting the bowel, bladder and vagina are more common in women with levator injuries compared with women without such injuries.
In a separate study, we will also investigate whether there are factors during childbirth that increase the risk of levator injuries.
Selected publications
Fecal incontinence and associated pelvic floor dysfunction during and one year after the first pregnancy.
Jansson MH, Franzén K, Tegerstedt G, Brynhildsen J, Hiyoshi A, Nilsson K
Acta Obstet Gynecol Scand 2023 Aug;102(8):1034-1044
Stress and urgency urinary incontinence one year after a first birth-prevalence and risk factors. A prospective cohort study.
Jansson MH, Franzén K, Tegerstedt G, Hiyoshi A, Nilsson K
Acta Obstet Gynecol Scand 2021 Dec;100(12):2193-2201
Risk factors for perineal and vaginal tears in primiparous women - the prospective POPRACT-cohort study.
Jansson MH, Franzén K, Hiyoshi A, Tegerstedt G, Dahlgren H, Nilsson K
BMC Pregnancy Childbirth 2020 Dec;20(1):749
Since the early 2000s, the Women’s Clinic has run a clinic for vulvovaginal disorders, which serves as a referral centre for the whole of Sweden. Several research projects are currently underway, focusing on young women with pain during sexual intercourse, known as provoked vulvodynia (formerly vestibulitis), and the vagina’s immune response to recurrent yeast infections.
A randomised study on botulinum toxin A (Botox) as a potential treatment for provoked vulvodynia (vestibulitis) has been completed and the first part has been published. A 12-month follow-up of the study results is currently being compiled.
With funding from the Swedish Social Insurance Agency, a large registry study is evaluating the link between events during the neonatal period and the first year of life and the development of pain conditions (including provoked vulvodynia) and mental health problems later in life.
We are also participating in a new registry study funded by the NIH in collaboration with Boston University. The study will investigate a possible link between immunological factors and provoked vulvodynia.
Studies on the vagina’s immune defence in recurrent yeast infections have been published, and the results form the basis for a randomised treatment trial in which a new treatment for recurrent yeast infections will be evaluated.
A major study is currently underway at the abortion clinic to investigate how effective and safe very early abortions are. Women are randomly assigned to have the abortion immediately or after one week.
For abortions after week 12, a randomised study is underway in which women can start treatment at home or in hospital. The aim is to avoid women having to stay overnight in hospital.
For those of you who have not given birth and wish to have an IUD fitted, a study is underway into a pain relief method. You will be randomly assigned to receive either the active medication or a saline solution via a previously tested method. In this study, we are testing the method using a higher dose of medication. The aim is to enable more women to have an IUD fitted with less pain.
At the abortion clinic, a study is underway into IUD insertion within 48 hours of a medical abortion or at the follow-up appointment after 2–3 weeks. The aim is to investigate whether early IUD insertion can lead to more women using an IUD six months after the abortion. Read more about the INTRAM study (in Swedish).
The unit is also conducting several epidemiological projects aimed at examining how contraceptive use differs across different groups.