Matti Grönroos

Supra Vaginal Uterine Amputation VS. Hysterectomy: Effects on libido and orgasm

Postoperative symptoms of hysterectomy have received relatively little attention. In the present study, the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation preoperatively and 6 weeks, 6 months and 12 months postoperatively. Participation in the follow-up study was 99.5% (211/212) at one year. This paper deals with the effects of the two operations on libido and the frequency of orgasms. In the statistical analysis, McNemars test of symmetry and the Fisher exact test were used. Weak or absent libido was reported preoperatively by 28.0% of hysterectomy patients and by 26.4% of amputation patients. One year postoperatively the corresponding figures were 35.4% and 31.4%. No statistical changes were observed between the two groups or within either group. In the frequency of orgasms a highly significant (p less than 0.001) reduction from the situation before operation to one year postoperatively was detected after hysterectomy. In the supravaginal amputation group no statistically significant decrease was detected. Preoperatively the two groups were alike; one year postoperatively the difference was almost significant (p less than 0.05). The reductions in orgasms after hysterectomy as compared with supravaginal amputation appears to result from the greater radicality of the former; at hysterectomy, the autonomous innervation of the proximal vagina and cervix is damaged more than in supravaginal amputation, the anatomy of the vagina is altered and scar tissue forms in the vagina. It is probable that these changes and subconscious psychological reactions due to total removal of the uterus explain why supravaginal uterine amputation gives better results than hysterectomy.

An Interpersonal Circumplex Model of Children's Social Goals: Links With Peer-Reported Behavior and Sociometric Status

The objective of the present research was to develop an assessment model for childrens social goals. The aims were (a) to fit childrens social goals to a circumplex model and to examine links between goals and peer-reported social behaviors (aggression, withdrawal, and prosocial behavior) in a sample of 276 participants (134 girls, 11- to 12-year-olds) and (b) to replicate these findings and examine whether social behavior mediates the relationship between goals and sociometric status in an independent cross-validation sample of 310 participants (143 girls, 11- to 13-year-olds). Results showed a satisfactory fit to the circumplex model and adequate psychometric properties of the goal scales of the new measure, the Interpersonal Goals Inventory for Children. Other findings included significant and meaningful relations between goals and peer-reported behavior. Social behavior mediated the relations between goals and sociometric status.

Screening for endometrial cancer in asymptomatic postmenopausal women with conventional and colour Doppler sonography.

Objective To evaluate endometrial thickness and uterine arterial flow measurement as predictors of endometrial cancer.

Evaluation of ovarian findings in asymptomatic postmenopausal women with color Doppler ultrasound.

Background. To evaluate the prevalence and significance of abnormal ovarian findings in asymptomatic postmenopausal women, screening for ovarian cancer with color Doppler ultrasound was performed.

Supra-vaginal uterine amputation vs. abdominal hysterectomy: The effects on urinary symptoms with special reference to pollakisuria, nocturia and dysuria

Post-operative symptoms of hysterectomy have received relatively little attention in the literature. In the present study the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation pre-operatively and thrice post-operatively. At one year the follow-up percentage was 99.5 (211/212). In the statistical analysis McNemars test of symmetry and Fishers exact test were used. Loglinear models were developed where applicable. A number of patients had urinary symptoms pre-operatively: 27.6% of the abdominal hysterectomy and 48.6% of the supra-vaginal amputation patients suffered from pollakisuria; preoperative nocturia and dysuria were present in about 10% of patients in each group. These urinary symptoms disappeared more frequently in patients who underwent supra-vaginal amputation; with regard to pollakisuria the difference is statistically significant. Twelve months post-operatively pollakisuria was present in 10.3% of supra-vaginal amputation and 13.5% of hysterectomy patients. The advantage of supra-vaginal amputation over abdominal hysterectomy with regard to these symptoms may result from the considerably less extensive manipulation of the bladder during supra-vaginal amputation. Possibly the support provided by the remaining stump and the round ligaments fixed to it also help to reduce urinary symptoms in these patients. However, further urodynamic studies are needed.

Mass screening for endometrial cancer directed in risk groups of patients with diabetes and patients with hypertension.

Background. The interest in mass screening programs for the early detection of endometrial cancer (EC) has grown with the rising incidence of this disease. Preliminary programs directed at asymptomatic women with only one risk factor, i.e. age, have not been cost‐effective.

Peroperative Electrocoagulation of Endocervical Mucosa and Later Carcinoma of the Cervical Stump

Abstract. The incidence of carcinoma of the cervical stump is, according to literature, 0.3—1.9%. During the years 1952–78, 2712 subtotal hysterectomies for benign conditions were performed in the Department of Obstetrics and Gynecology in Turku. During the operation the endocervical mucosa was electrocoagulated before closing the stump. Of these patients, 3 have since developed carcinoma of the cervical stump; thus the incidence in our material is 0.11%. It has been supposed that subtotal hysterectomy might have certain benefits in some cases. If so, and in view of the cancer risk being so low in our material, we feel that subtotal hysterectomy is still an applicable method.

Gender-Specific Risk Factors for Intimate Partner Homicide: A Nationwide Register-Based Study

The present study examined gender differences in intimate partner homicide (IPH) and offender characteristics with the focus on putative gender-specific risk factors in a nationwide consecutive sample of homicide offenders. Data on all offenders (N = 642; 91 females, 551 males) convicted of homicide and subjected to a forensic psychiatric examination in Finland were obtained for the years 1995 and 2004. IPH offenders, 39 female and 106 male, were compared for risk factors with female and male offenders whose victims were not spouses. The forensic psychiatric examination reports were retrospectively analyzed, and the Hare Psychopathy Checklist–Revised (PCL-R) was rated. Significant gender differences were found in four risk factors: employment, intoxication of victim, self-defense, and quarrel, mostly related to alcohol as a factor of the offense. The findings support the notion that female IPH is linked to defensive reactions resulting from prior abuse, and that IPH offenders resemble the general population more than offenders of other types of homicide.

Examination of psychopathy in female homicide offenders--confirmatory factor analysis of the PCL-R.

The construct of psychopathy is essential in explaining criminal behavior, but unfortunately the empirical research on psychopathy in women has been inconsistent. In this study the underlying structure of psychopathy in women was examined by testing the two-factor model by Hare (2003) and the three-factor solution by Cooke and Michie (2001) using confirmatory factor analysis. We replicated the study by Warren et al. (2003) using a nationwide sample of 97 female homicide offenders in order to facilitate the comparison of results. The prevalence of psychopathy in the present study was 9.3% with a cut-off of >or=30 and 21.6% with a cut-off of >or=25. The best fit for the data out of the tested models was the three-factor model with six testlets. The two-factor model proved to be too simple a model for the female homicide data. The findings regarding comorbidity of psychopathy with personality disorders show that the concept of psychopathy includes diagnostic criteria of several personality disorders, but further research is needed to establish a possible superordinate dimension. Further research on the PCL-R and putative gender differences in the expression of psychopathy in women and men as well as on the putative impact of cultural differences on the instrument is clearly needed.

Analysis of Intrapartum Fetal Deaths: Their decline with increasing electronic fetal monitoring

Abstract. Over a 12‐year period, from 1970 to 1981, 30600 babies were born at the Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland. During that period, the use of electronic fetal monitoring increased remarkably, being involved in 9, 12, 33 and 95% of all vaginal deliveries during four consecutive 3‐year periods. The number of intrapartum deaths during the same 12‐year period was 52, giving an overall rate of 1.7 per thousand. When 15 lethally malformed infants are excluded, the rate becomes 1.2 per thousand. In the four consecutive 3‐year periods, the death rates were 1.7, 1.9, 1.0 and 0.3 per thousand. Electronic fetal monitoring was not undertaken in any of the cases leading to fetal death. The main factor leading to fetal death could be considered to be hypoxia in approximately 90% of the deaths of normally formed babies. The most common reasons for hypoxia were placental abruption and cord entanglement, yet in many cases only the decreased placental perfusion could be suggested to have caused the hypoxia. The mean weight of those babies that died intra‐partally decreased significantly, being approximately 1 250 g during the last 3‐year period.