ABSTRACT
BACKGROUND@#It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.@*METHODS@#A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).@*RESULTS@#The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).@*CONCLUSIONS@#The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.@*TRIAL REGISTRATION NUMBER@#NCT03620565, https://register.clinicaltrials.gov.
Subject(s)
Female , Humans , China , Gynecologic Surgical Procedures/adverse effects , Pelvic Floor/surgery , Pelvic Organ Prolapse/surgery , Surgical Mesh/adverse effects , Treatment Outcome , VaginaABSTRACT
Chronic hepatitis B virus ( HBV) infection is a principal risk factor for liver cirrhosis and hepatocellular carcinoma in China , representing one of the major public health problems .Horizontal trans-mission of HBV in vaccinated children was greatly reduced due to widespread HBV vaccination in mainland China, which had limited effects on vertical transmission .Thus, vertical transmission became one of the main causes of HBV chronic infection .High HBV load (≥10 6 copies/mL ) and hepatitis B e antigen ( HBeAg )-positivity in maternal peripheral blood were independent risk factors for HBV intrauterine infection .Compared to HBV infection in early childhood and in adult , intrauterine HBV infection was more prone to developing chronic infection .To decrease vertical transmission of HBV , we recommend that young pregnant women with sero-positive for HBeAg and high serum HBV DNA level should receive antiviral treatment with nucleotide analogues since the 28 th gestation weeks .For newborns born to HBeAg-positive mother , hepatitis B immunoglobulin ( HBIG ) injection should be administrated in combination with HBV vaccination .
ABSTRACT
ObjectiveTo evaluate the curative effect difference between Tong's anterior mesh suspension and modified tension-free vaginal tape-obturator (TVT-O). Methods75 SUI cases were random divided into two groups: Group A (35 cases) were accepted Tong's anterior mesh suspension and group B (40cases) were accepted modified tension-free vaginal tape- obturator. Curative effects, operation safety,and complications and so on, were recorded and compared. ResultsThere had no statistical differences between these two groups on operation time, bleeding lose, operation injury, immediate postoperative urinary retention andcure rates, but the operation expense of group A was cheaper than group B [ (980. 74 ±212.45)yuan vs (2879.06 ±467. 13)yuan , P ＜0.05). ConclusionThe curative effect between two methods were similar. It's a little complicated and fit to be popularized in large hospital to modified tensionfree vaginal tape-obturator. Tong's anterior mesh suspension was performed under completely direct vision,not through pelvic cavity, and it was an economic, convenient and easy way, which not only fit to be popularized in basic hospital, but also a surgical remedial measure to the failures who accepted these operations,such as TVT, SPARC, IVS, MONARC, TOT, TVT-O, etc.