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Objective To discuss the correlation between female chronic pelvic pain and pelvic floor anatomy.Methods The female patiems of chronic pelvic pain 179 cases,age 28-67 years,average 49.4 years;pelvic pain history 8 months-9 years,average 2.8 years;167 cases has childbirth history,43 cases has surgery history,which gynecological surgery 31 cases,and urinary surgery 7 cases,and anus surgery 5 cases.Results High incidence of female pelvic pain were 30-60 age (incidence of 54.8％),93.3％ has birth history,24％ has operation history,the myofascial tissue pain higher than the organ,were 87.4％ than 12.6％ (P ＜ 0.01),the front of pelvic pain higher than back,were 65.6％ than 21.8％ (P ＜ 0.01).Conclusions Female chronic pelvic pain associated with the particularity of the pelvic anatomy and physiological,with the tissue of pelvic floor and urogenital diaphragm of primary injure and chronic inflammation is an important cause of chronic pelvic pain.
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Radical cystectomy surgery is the main surgery for muscle invasive bladder caner and some high-risk non-invasive bladder cancer.It is the most complex surgery in Urology and is accompanied by the most of complications.Enhanced recovery after surgery aims to mitigate the surgical stress response,which can reduce the morbidity of complications,hospital stay time and the cost.This article is to summarize the enhanced recovery after surgery protocols in radical cystectomy surgery.
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Objective To study the treatment effect of joint nitric acid imidazole and itraconazole on recurrent candida vaginitis.Methods 200 confirmed cases of patients with recurrent candida vaginitis in our hospital during October 2014 to June 2015 were selected and divided into research group and the control group with random indicator method,with 100 cases in each group.The control group were treated by nitric acid imidazole vaginal soft capsule,with vaginal drug delivery,which shoud put suppository in vaginal depths after washing,for one times a night and one soft capsule every time,and a week was a period of treatment.The patients in the research group received basis treatment of the control group adding itraconazole capsules(200mg per day,oral).8 weeks after treatment,the patients in this process were reviewed to analyzed clinical efficacy and adverse reactions occured.Results The total effective rate of the research group was 98%,which of the control group was 73%,the difference was statistically significant(χ2 =25.21,P 0.05 ).Conclusion The curative effect of itraconazole joint miconazole nitratet to recurrent monilial vaginitis is superior to the use of miconazole nitrate alone, with less adverse reaction,and is easy to use.It is worth clinical application.
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Objective To investige the risk factors of urosepsis after percutaneous nephrolithotomy (PCNL).Methods We retrospectively analyzed 204 renal calculi or proximally ureter calcui patients,who underwent ultrasound-guided PCNL,from January 2013 to January 2014.Among them,there were 140 men and 64 women,whose mean age was 49 years (range from 29 to 75 years).Eighty-four operations were performed via standard channel and 120 operations were performed via micro channels.Fifty one patients had staghorn stones.Before operation,the urine culture positive rate was 14.7％ (30/204).The creatinine level ranged from 46 to 340 μmol/L [mean (87.9±33.9) μmol/L].Average stone diameter was (2.3±0.8) cm (range 1.0-7.0 cm).Mean operative time was (68.4±26.9) min (range 23-219 min).The chi-square test and a logistic regression model were used to identify key risk factors.Results The operation duration ranged from 23 to 219 min,mean (68.4±26.9) min.Of 204 patients,9 (4.4％) suffered septic shock,including 7 female patients and 2 male patients.Their mean age was (52.6± 15.2) years (20-73 years).Five operations were performed via standard channels and four operations were performed via micro channels.Five patients had staghorn stones.Urine culture positive rate was 77.8％ (7/9).The average stone diameter was (2.5±0.6) cm (range 1.8-3.5 cm).Mean operative time was (86±53) min (range 47-219 min).In univariate analysis,significant associations was observed between female gender (P =0.005),positive urine culture (P＜0.01),staghorn calculi (P =0.035),operative duration＞90 min (P =0.042) and sepsis after PCNL.While in multivariate analysis,female gender (OR=6.001,95％CI=1.190-30.276,P=0.03) and positive urine culture pre-operation (OR=19.647,95％CI=3.918-98.562,P＜0.01) were identified as independent risk factors for post-MPCNL septic shock.Conclusions Female gender and positive urine culture before operation are the key risk factors of urosepsis after percutaneous nephrolithotomy.
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Objective To access the safety and efficacy of balloon dilation in percutaneous nephrolithotomy for staghorn stones.Methods Clinical data of 64 patients with staghorn stone according to the inclusion criteria in our institution from April 2013 to April 2014 were collected and analyzed retrospectively.According to the dilation methods,the patients were divided into balloon dilation group (dilated to 24 F by balloon dilator,31 cases) and fascial dilation group (dilated to 16 F by Amplatz fascial dilator,33 cases).There was no significant difference in sex,age,body mass index between the 2 groups.The data of duration of percutaneous access,one-attempt success rate of dilation,puncture complications (kidney calices fracture,perinephric fluid collection and postoperative delayed hemorrhage etc.),removing stones time,stone free rate,hemoglobin drop after surgery and number of patients who experienced postoperative fever ＞37.5 ℃ were recorded.Results Compare to fascial dilation group,balloon dilatation group had significant differences in terms of duration of percutaneous access [(5.6± 2.1) min versus (9.4± 1.7) min],oneattempt success rate of dilation[100％ (31/31) versus 88％ (29/33)],removing stone time[(32.4±3.4) min versus (49.5±3.7) min],stone free rate [84％ (26/31) versus 61％ (20/33)],hemoglobin drop after surgery [(16.7±3.3) g/L versus (28.4±2.6) g/L],renal intrapelvic pressure[(19±3) mmHg versus (25±6) mmHg] and rate of patients who experienced postoperative fever ＞37.5 ℃ [16％ (5/31) versus 39％(13/33)] (P＜0.05).No injury of adjacent organs,including pleura,liver,spleen,or bowel was noted in all patients.Conclusions Balloon dilation is quick and safe with less hemorrhage when building percutaneous renal channel.And it has higher stone free rate and less complication rate in percutaneous nephrolithotomy with staghorn stones.