A Lalos

Umeå University, Umeå, Västerbotten, Sweden

Are you A Lalos?

Claim your profile

Publications (59)117.33 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Although midurethral slings have become standard surgical methods to treat stress urinary incontinence (SUI), little is known about women who still have urinary incontinence (UI) after surgery. This study assesses and compares the patient-reported outcome 12 months after tension-free vaginal tape (TVT), tension-free vaginal tape-obturator (TVT-O), and transobturator tape (TOT), with a special focus on women who still have urinary leakage postoperatively. This study analyzed preoperative and 12-month postoperative data from 3,334 women registered in the Swedish National Quality Register for Gynecological Surgery. Among the women operated with TVT (n = 2,059), TVT-O (n = 797), and TOT (n = 478), 67 %, 62 %, and 61 %, respectively, were very satisfied with the result at the 1-year follow-up. There was a significantly higher chance of becoming continent after TVT compared with TOT. In total, 977 women (29 %) still had some form of urinary leakage postoperatively. Among the postoperatively incontinent women who expressed a negative impact of UI on family, social, work, and sexual life preoperatively, considerably fewer reported a negative impact in all domains after surgery. Of those in the postoperatively incontinent group who had coital incontinence preoperatively, 63 % reported a cure of coital incontinence. The proportion of women very satisfied with the result of the operation did not differ between the three groups. TVT had a higher SUI cure rate than did TOT. Despite urinary leakage 1-year postoperatively, half of the women were satisfied with the result of the operation.
    International Urogynecology Journal 04/2012; 23(10):1353-9. · 2.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the impact of urinary incontinence and urgency on women's sexual life and the prevalence of urinary leakage during sexual activity. A further aim was to explore factors affecting sexual desire and satisfaction with sexual life. A semi-structured questionnaire study. Sexually active women (n=147) aged 18-74years with urinary incontinence and urgency were recruited from four outpatient clinics. The women completed questionnaires concerning medical history, psychosocial situation, partner relationship and sexual life, and answered the Bristol Female Lower Urinary Tract Symptoms questionnaire. All underwent clinical evaluation. Prevalence of urinary leakage during sexual activity, factors affecting sexual desire and sexual satisfaction. The vast majority considered sexuality to be important in their lives. One-third of the women had urinary leakage during sexual activity. Half reported that sexual life was more or less spoiled due to their urinary incontinence or urgency and they were worried about having urinary leakage during intercourse, and almost two-thirds worried about odor and felt unattractive. The women's dissatisfaction with sexual life was strongly correlated to unsatisfying psychological health, orgasmic disability and worry about urinary leakage during intercourse. Insufficient vaginal lubrication, unsatisfying psychological health and their partners' ill health were significantly correlated with decreased sexual desire. Urinary incontinence and urgency have a negative impact on women's sexual life. Thus, a dialogue about sexual function in women with urinary symptoms should become an integral component in clinical management.
    Acta Obstetricia Et Gynecologica Scandinavica 03/2011; 90(6):621-8. · 1.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the impact of female urinary incontinence (UI) and urgency on women's and their partners' sexual life in sexually active couples and to elucidate the concordance of answers within couples. Women aged 18-74 years with UI and/or urgency (n = 206) were consecutively recruited from four outpatient clinics. Those with a partner (n = 170) completed a questionnaire regarding relationship and sexual life and gave a similar questionnaire to him. The present paper focuses on 99 couples with an active sexual life. Twenty-two percent of the men and 43% of the women stated that the female urinary symptoms impaired their sexual life. Forty-nine percent of the women expressed worries about having urinary leakage during sexual activity, but most of their men, 94%, did not. Twenty-three percent of the men and 39% of the women responded that the woman leaked urine during sexual activity. The majority, 84%, of women considered this a problem, but 65% of their partners did not. Except for this disparity, the rest of the answers were significant concordant within the couples. Female UI and urgency negatively affected sexual life in almost half of the women and in every fifth partner. A need for information and advice concerning sexual issues due to the woman's urinary disorder was found in one fifth of the couples. The majority of women with urinary leakage during sexual activities considered this as a problem, but most of their partners did not. Overall, the concordance of the answers within the couples was high.
    Neurourology and Urodynamics 02/2011; 30(7):1276-80. · 2.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To gain knowledge about the male partner's experience of being present during an induced home abortion. Twenty-three couples, whose male partner had been present when the woman aborted at home, were interviewed one to two weeks post-abortion. Each of the men supported his partner in her decision to have a home abortion, as this gave him the possibility of being near and of caring for her needs on the expulsion day. All the men were present and all their partners confirmed that they had been supportive. Half the men had been anxious prior to the expulsion, but most considered that their experiences during the expulsion had been 'easier than expected' and their dominant feeling was one of relief. Abortion is an important life event. When taking place at home, it increases the possibility for the couple to share the experience. Sharing an abortion may have a positive impact on those men who lack a sense of responsibility regarding reproductive issues, such as contraceptive use. This could facilitate society's efforts to involve men as a target group in this field. Designing an abortion policy that caters for the needs of both partners is a challenge.
    The European Journal of Contraception and Reproductive Health Care 08/2010; 15(4):264-70. · 1.81 Impact Factor
  • The European Journal of Contraception and Reproductive Health Care 04/2010; 15(2):150-1. · 1.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Nine women who had been subjected to severe intimate partner violence during pregnancy narrated their ambiguous and contradictory feelings and the various balancing strategies they used to overcome their complex and difficult situations. Because allowing anyone to come close posed a threat, the women mostly denied the situation and kept up a front to hide the violence from others. Three women disclosed ongoing violence to the midwives, but only one said such disclosure was helpful. This article highlights the complexity of being pregnant when living with an abusive partner and challenges antenatal care policies from the perspective of pregnant women.
    Violence Against Women 02/2010; 16(2):189-206. · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prospective studies elucidating the impact of the treatment of cervical cancer on urinary and climacteric symptoms and sexual life are relatively rare. The aim of this study was to seek information about the occurrence of urinary, climacteric and sexual symptoms in women with cervical cancer before and 1 year after treatment without brachytherapy. This prospective study evaluated 39 women treated for cervical cancer. Data were collected by two questionnaires (before and 1 year after treatment). In order to supplement the data from the questionnaires, some data were selected from the patient's medical records. The number of voluntary micturitions, urgency, urinary incontinence and climacteric symptoms had not increased 1 year after treatment. Vaginal dryness and dyspareunia had increased and sexual desire was reduced 1-year post-treatment. This study has shown that urinary and climacteric symptoms are not frequent 1 year after treatment of cervical cancer without brachytherapy. However, there is an increased occurrence of vaginal dryness and sexual disorders 1-year post-treatment, mainly in the form of dyspareunia and reduced sexual desire. Taken together these symptoms affect the women's quality of life and it is, therefore, crucial that the medical providers become more aware of and skilled to deal with these conditions before and after treatment.
    Journal of Psychosomatic Obstetrics & Gynecology 12/2009; 30(4):269-74. · 1.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To gain knowledge about women's experiences, views and reactions regarding having a home abortion (medical abortion with the use of misoprostol at home). One hundred women were interviewed one week post-abortion; this yielded both quantitative and qualitative data. The overwhelming majority of the women experienced wellbeing and were satisfied with their choice of abortion method. They appreciated the privacy and the comfort of being at home which also allowed the presence of a partner. The intake of mifepristone at the clinic was described by many in existential terms as an emotionally charged act, experienced by some as more difficult than expulsion at home. However, relief was the predominant emotional feeling during the expulsion day. Most women did not find it especially dramatic to see and handle the products of conception although some felt uncomfortable at the sight. Given that they choose this method themselves and are well informed, women are able to handle the abortion process by themselves outside a clinical setting. The option to choose home abortion implies a radical change in empowerment for women. Also allowing them the possibility to take mifepristone at home would increase their privacy and personal integrity even more.
    The European Journal of Contraception and Reproductive Health Care 10/2009; 14(5):324-33. · 1.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The crisis of infertility has been studied in 30 women with tubal damage and the manner in which it affected their partners over a period of 2 years. Altogether, 4 interviews were carried out with the women, and two with the men. The partners of each couple were interviewed individually on the same day a few weeks before and 2 years after a reconstructive tubal operation. Furthermore, the women were interviewed on the first postoperative day, and 1 month later at the second-look laparoscopy. Most of the symptoms recorded during the interviews could be classified in terms of depression, guilt and isolation. The women generally manifested more depressive symptoms than the men who often suppressed or even denied emotional reactions. Feelings of guilt were more common among the women than among the men. Relatives and friends did not give genuine support — according to the majority of the couples. Pregnant women and other people's children often evoked negative feelings. Social isolation often developed among the infertile women and their partners. In most cases, the crisis of infertility was found to be prolonged, especially among the women. The study indicates that in order to cope with the crisis of infertility, couples require supportive counseling in parallel to the investigation and medical treatment. This counseling should be designed both for the couple as an entity and for the partners separately.
    07/2009; 5(3):197-206.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the impact of female urinary incontinence, urgency and frequency on quality of life, and partner relationship in women (18-74 years) and their partners, and make comparisons with the corresponding age groups in a Swedish population-based study. Women with urinary incontinence, urgency and frequency (n = 206) completed specific questionnaires concerning medical history and the Bristol Female Lower Urinary Tract Symptoms questionnaire. Women who had a stable relationship (n = 170) also answered a questionnaire regarding psychosocial situation, partner relationship and sexual life, and were asked to give a similar questionnaire to their partner. Totally, 109 partners participated. The vast majority of the women considered that their urinary problems affected their physical activities negatively and almost half reported negative consequences for social life and joint activities. One third of both women and men experienced a negative impact on their relationship and about every fifth felt it had a harmful influence on physical proximity, intimacy, affection, and warmth. Compared to the older women, the younger were less satisfied with their psychological health, sexual life, leisure and financial situation, and compared to the younger men, the young women were less content with their somatic health. Overall, women with urinary problems and their partners were less satisfied with their somatic health than the corresponding age groups in the national population-based study. Female urinary incontinence, urgency and frequency significantly impair the quality of life in both younger and older women, and also have negative effects on the partner relationship and the partner's life.
    Neurourology and Urodynamics 03/2009; 28(8):976-81. · 2.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In Sweden, human immunodeficiency virus (HIV) is included among the venereal diseases covered by the Law of Communicable Diseases Act. HIV-positive (HIV(+)) people are required to inform their sexual partners about their infection and adopt safe sex behaviours. However, it is unclear how the law is perceived. This study explores how HIV(+) youth in Sweden perceive the law, handle their sexuality and disclose their HIV diagnosis to sexual partners. Ten HIV(+) women and men between 17 and 24 years of age were recruited from three different HIV infection clinics. These participants were interviewed in depth. The interviews were tape-recorded, transcribed verbatim and analysed according to a grounded theory approach. The core category-cultured to take responsibility-illuminates the informants' double-edged experiences regarding the law and how they handle disclosure to sexual partners. The legislation implies both support and burden for these HIV(+) youth; they feel that they have a great deal of responsibility, sometimes more than they can handle. 'Switch off lust', 'balancing lust, fear and obedience' and 'switch off the disease' are strategies that describe how the informants manage sexuality and disclosure. Young HIV(+) people have a difficult time informing partners of their HIV diagnosis and discussing safe sex strategies. These are challenges that health care providers need to take seriously. HIV(+) youth need better communication strategies to negotiate safer sex. Staff with extended education on sexuality should be a part of HIV health care.
    Vulnerable Children and Youth Studies 12/2008; 3(3):234-242.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article deals with discourses of intimate partner violence and is based on interviews with professionals who meet violent men. The professionals emphasized the importance of men taking unreserved responsibility for their violent behavior. Intimate partner violence was viewed not only as "power and control" but as the result of complex situations and interplays. The discourses presented an ambivalent explanation of violent men as both ordinary and deviant. They were understood as having a strained background, but to be rather ordinary, often functioning well at work and in society. Yet, they have nonstandard views of women, act deviant in their communication and interplay with others, and cannot cope with certain situations in intimate relationships. Based on the interviews, men inclined to partner violence may be generalized as those who: attack immediately, explode unexpectedly, or ultimately become aggressive. The discussion challenges unreflected discourses as means for change when counteracting violence.
    Journal of Interpersonal Violence 03/2008; 23(2):225-44. · 1.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In order to gain knowledge about midwives' clinical and emotional experiences of working with termination of pregnancy (TOP) and their perception of women's motives for having an abortion questionnaires were mailed to a representative sample of Swedish midwives (n = 258), and 84% responded. Responses to 17 statements were studied and interpreted. It was found that every third midwife had not at all worked with TOP, and every fifth had not done so in the preceding two years. Among those who had experienced this work, few midwives had considered changing their job or had had misgivings or feelings of inadequacy caused by encountering women seeking an abortion. Both working currently with TOP and for a longer period of time were found to evoke positive experiences in every other midwife. Midwives' perception of motives for abortion corresponded very well to motives provided by women themselves. Half the midwives had had misgivings concerning late abortions and somewhat fewer regarding surgical abortions. In general, religious belief did not influence midwives' views of TOP. Those midwives who had themselves had an abortion reported fewer misgivings about late abortions than those without personal experience of TOP.
    Journal of Psychosomatic Obstetrics & Gynecology 01/2008; 28(4):231-7. · 1.59 Impact Factor
  • Source
    A Lalos, C Gottlieb, O Lalos
    [Show abstract] [Hide abstract]
    ABSTRACT: In Sweden, a child born as a result of donor insemination (DI) has the right to receive information both about the DI and the identity of the donor. The present study aimed to elucidate parents' thoughts regarding these possibilities, and whether, how and when they had told their offspring about the DI. An additional aim was to examine the parents' experiences of the attitudes of healthcare providers. A follow-up study using semi-structured telephone interviews with 19 couples, including 19 women and 17 men. More than half of the parents (61%) had told all their child/ren about the DI, but almost everyone had told another person. Mean age for disclosure was 5 years for the first child. Reasons given for disclosure were to avoid accidental discovery, a desire for openness and a persons' fundamental right to know his/her genetic origin. Parents who did not intend to tell their child/ren considered DI a private matter and were afraid of other people's attitudes. Sixty-one percent of the parents had not yet told their children about the possibility of identifying the donor. Healthcare staff had impacted on the parents' thinking, and a majority of those who had been encouraged to tell their child/ren about the DI had done so. There was a discrepancy between the intentions of the legislation and how parents act in relation to them. To improve compliance, it is crucial to organize education, support and ethical discussion among professionals, and to offer parents, and parents-to-be, counselling, support and group sessions with other DI families.
    Human Reproduction 07/2007; 22(6):1759-68. · 4.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To explore why young adults test for HIV, how they construct the HIV risk, and what implications testing has for them. Six tape-recorded focus-group interviews were transcribed verbatim and analysed according to a grounded theory approach. Women and men between 18 and 24 years of age were recruited from a youth clinic in northern Sweden in 2004-05 after being tested and found to be HIV negative. A core category--reconsidering risk and four categories--HIV: a distant threat; the risk zone; responsibility: a gendered issue; a green card-- emerged. HIV was described as being far away. Stereotypical images of risk actors emerged but were perceived to be clichés. "Ordinary" people including themselves were also considered at risk. Many had event-driven reasons for testing for HIV, multiple partners being one. One closer risk zone was "the bar"; a dating milieu that often was expected to include "one-night stands" for both women and men. Responsibility for testing was a gendered issue: it was "natural" for women, while men rather "escaped from responsibility". A resistance towards testing was revealed among young men. Receiving a negative HIV test result was "a green card", confirming healthiness and providing relief. Most informants felt "clean" and discussed how to restart with renewed ambitions. As participating in focus-group interviews was apparently an "eye-opener" for many, a counselling conversation reconsidering risk following an HIV test might be a good idea. Liberal HIV testing among young men and women could evoke insights and maturation and start a process of reflections concerning their sexual risk-taking behaviour.
    Scandinavian Journal of Primary Health Care 04/2007; 25(1):38-43. · 1.91 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study explores the long-term experience of involuntary childlessness among 14 Swedish women 20 years after their infertility treatment. In-depth interviews were conducted. The childlessness had had a strong impact on all the women's lives and was for all a major life theme. The effects were experienced both on a personal level and on interpersonal and social levels. Half of the women were separated, and in all but one, sexual life was affected in negative and long-lasting ways. The effects of childlessness were especially increased at the time the study was conducted, as the women's peer group was entering the 'grandparent phase'. Many coped with their childlessness by caring for others, such as the children of friends or relatives, elderly parents or animals. These findings represent a small sample, but they point towards the need for developing models of counselling and support that stimulate self-reflection and strengthen personal resources and empowerment for individuals and couples experiencing involuntary childlessness.
    Human Reproduction 03/2007; 22(2):598-604. · 4.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study explores the perception of sexual risk-taking behaviour in young HIV+ women and men in Sweden and their understanding of why they caught HIV. In-depth interviews were conducted with 10 HIV+ women and men aged 17-24 years, 7 born in Sweden and 3 immigrants. Interviews were tape-recorded, transcribed verbatim, and analysed according to the stages of grounded theory. The core category varying agency in the gendered sexual arena illustrated a spectrum of power available to these informants during sexual encounters. Two subcategories contextualized sexual practice: sociocultural blinds and from consensual to forced sex. Lack of adult supervision as a child, naïve views, being in love, alcohol and drugs, the macho ideal, and cultures of silence surrounding sexuality both individually and structurally all blinded them to the risks, making them vulnerable. Grouping narratives according to degree of consensus in sexual encounters demonstrated that sexual risks happened in a context of gendered power relations. This pioneering study reveals mechanisms that contribute to vulnerability and varied agency that may help in understanding why and how young people are at risk of contracting HIV. Public health strategies, which consider the role of gender and social background in the context of risky behaviours, could be developed from these findings.
    Scandinavian Journal of Public Health 02/2007; 35(1):55-61. · 1.97 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Qualitative research interviews were conducted with professionals working with men inclined to violence. The aim was to explore professional discourses about intimate partner violence with special reference to gender and to the partner's period of pregnancy. Three major findings are presented. Firstly, the professionals had a rather fixed understanding of opposite gender positions as well as a split picture of the violent man as both weak and tough, thus violence may result from poor self-confidence combined with a desire for power and control and the fear of losing it. Secondly, the pregnancy was identified as a stressor that, together with other circumstances, could trigger violence. Thirdly, the topic of pregnancy and other relational topics were typically omitted from the conversations with men inclined to violence. This study discusses inconsistencies that might counteract the professionals' intentions of building an alternative masculinity in men inclined to violence.
    Men and Masculinities 01/2007; 11(3):307-324. · 0.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: When postmenopausal women are treated with sequential hormone therapy (HT), cyclical mood swings similar to symptoms seen in the premenstrual dysphoric disorder (PMDD) are described. Women with a history of premenstrual symptoms (PMS) seem to respond differently to the addition of a progestin to estrogen than women without previous PMS. This study aimed to investigate personality traits and daily mood symptoms in women with a history of PMS and women without, while treated with estrogen and sequential progestin. A total of 106 women, who participated in clinical trials designed to evaluate mood and physical responses to sequential estrogen and progestin therapy, filled out the Karolinska Personality Scale (KSP) form, before entering the studies. The treatment consisted of 2 mg estradiol valerate continuously, with an addition of 10 mg medroxyprogesterone acetate (MPA) during the last 12 days of the 28-day cycle. Subjects kept daily symptom ratings using a validated symptom scale during these two treatment cycles, and these were used for the analyses. The study-groups were stratified for a history of PMS or not, appearance of progestin-induced adverse mood effects or not, and symptom cyclicity or not. There was a significant co-variation between the women who reported the highest negative mood scores during the addition of progestin to estrogen and a history of PMS. Women with PMS history reported different personality characteristics as having higher scores of anxiety symptoms of muscular tension, feeling more indirect aggression and lack of impulse control, and being less satisfied with their lives or childhood, compared to women without a PMS history. Women who reported the most intense negative mood symptoms during the progestin phase reported more somatic anxiety, an aim to avoid monotony, a lower satisfaction with life or childhood, and higher scores of indirect aggression and irritability. Women with a history of PMS and women with a high anxiety-related personality might respond with adverse mood effects to a combination of estrogen and sequential progestin and therefore a thorough evaluation should be made, at the consultation for hormone therapy, of mood benefits or disadvantages before initiation of treatment and there should be a close follow-up after.
    Climacteric 09/2006; 9(4):290-7. · 1.96 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Legal abortion is a recurrent part of gynecologists' work. The aim of the study was to describe Swedish gynecologists' clinical and emotional experiences when working in abortion care. Further aims were to elucidate their perception of women's motives for having an abortion as well as looking for possible demographic and gender differences. A questionnaire comprising both structured and semi-structured questions was sent to a random sample of 269 Swedish gynecologists. The response rate was 85%. The female gynecologists were younger (27-59 years) and more numerous than the males (33-66 years). Almost all believed that gynecologists should be involved in abortion care, and half were opposed to the privilege of refusing to work with termination of pregnancy. The gynecologists supported the shift from surgical to medical abortions but not to their being managed in primary healthcare. A few gynecologists (n = 42) had considered changing their job because of termination of pregnancy being part of their work. Misgivings occurred sometimes in connection with surgical and late abortions (n = 60 and n = 108 respectively). Few gynecologists (n = 33) had felt inadequate when encountering abortion patients and more than half thought that working with termination of pregnancy was a positive experience. The gynecologists believed that continuing professional development and ongoing guidance of termination of pregnancy matters were important. In general, Swedish gynecologists have no doubts about taking part in and performing termination of pregnancy. Their clinical and emotional experience, as expressed in this study, as well as their perception of women's motives for abortions, indicate that they have gained deep insights and developed their professionalism in their work with termination of pregnancy.
    Acta Obstetricia Et Gynecologica Scandinavica 02/2006; 85(2):229-35. · 1.85 Impact Factor

Publication Stats

654 Citations
117.33 Total Impact Points

Institutions

  • 1985–2012
    • Umeå University
      • Department of Clinical Sciences
      Umeå, Västerbotten, Sweden
  • 2010
    • Institute for Clinical Social Work
      Georgia, United States
  • 2007
    • Lund University
      • Department of Psychology
      Lund, Skane, Sweden
  • 2005
    • Canterbury Christ Church University
      Cantorbery, England, United Kingdom
  • 2001
    • Norrlands universitetssjukhus
      Umeå, Västerbotten, Sweden
    • Ersta Sköndal University College
      Tukholma, Stockholm, Sweden