ABSTRACT
Vesicouterine fistula (VUF) represents a rare urogenital complication. It is considered to be the least common type of urogenital fistulae. Surgical repair remains the mainstay of treatment. Transabdominal repair is the most common surgical method and transvaginal route is rarely reported. Herein, we presented the successful transvaginal repair of 3 cases of VUF in our center, including 2 cases of vesicocervical fistula and 1 case of high vesico-uterine body fistula.All the 3 VUF cases were repaired through vagina and followed up for 6 months, 1 year and 2 years, respectively. There was no vaginal leakage or hematuria postoperatively. VUF was cured. Transvaginal repair of VUF was shown to be a feasible, safe and effective procedure with small trauma.
ABSTRACT
Objective To compare the efficacy of transvaginal and transabdominal repair surgery for the treatment of vesicovaginal fistula(VVF).Methods The data of 39 patients undertaken VVF repair in our department between January 2005 and December 2016 was retrospectively reviewed.The patients aged 19 to 69 years (median 45 years),and the median duration of the condition was 22 months (range:1 month to 20 years).The etiologies were all iatrogenic injuries.Thirty-nine patients underwent a total of 43 surgical repairs including 26 transabdominal approach(group 1)and 17 transvaginal approach(group 2).There was no significant difference in terms of the patients' age,fistula size,location and the proportion of patients undergoing repairs previously between the two groups.The operative and outcome data of the two groups was compared.Results The surgical time of group 2 was shorter than that of group 1 (median 85 min vs.178 min,Z =-4.436,P ＜ 0.01).The median blood loss was 20 (5-100) ml in group 2 and 50 (20-800) ml in group 1,and there was statistically significant difference (Z =-3.767,P ＜ 0.01).The postoperative hospital stay of group 2 was also shorter than that of group 1 (median 7 d vs.12 d,Z =-3.076,P ＜ 0.01).The follow-up period was 3 to 120 months (median 26 months).The success rate was 82.4％ (14/17) in group 2 and 80.8％ (21/26) in group 1,and there was no significant difference between the two groups (x2 =0.017,P ＞ 0.05).Conclusion Compared with transabdominal repair,transvaginal repair of VVF is a preferred surgical procedure in respect that it is more simple,less invasive and has similar success rate with transabdominal repair.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the current status of research on human papillomavirus (HPV)-associated head and neck cancers in China using national and international references.</p><p><b>METHODS</b>We searched for bibliographies in the electronic databases of Sichuan University, including Chinese Biological and Medical Database (CBM), China Science and Technology Journal Database (VIP), and Wanfang Journal Database. Then, data was selected and extracted to analyze the basic characteristics of HPV-related head and neck cancers, the general prevalence of HPV, and the effects of various clinic pathological indicators on HPV patients.</p><p><b>RESULTS</b>The general prevalence of HPV was 34.05% among civil patients with head and neck cancers. Our analysis of different clinical and pathological indices that affect HPV-associated oral squamous cell carcinomas revealed that non-smoking and non-drinking groups had higher HPV infection rates compared with smoking (P=0.002) and drinking (P< 0.005) groups. In addition, N2-N3 stage patients had higher detectable rates than N0-N1 stage patients (P=0.027).</p><p><b>CONCLUSIONS</b>The majority of civil research studies on HPV-associated head and neck cancers are concentrated on clinical studies. Thus, the molecular neuropathology and signaling pathway of HPV should be further explored in the future to advance prognostic methods. Moreover, the perspective view of therapeutic vaccines and molecular-targeting treatments should receive close attention. .</p>