Transvaginal / TVT [Tension-Free Vaginal Tape] and Stress Urinary Incontinence in Women

Objective: Evaluation of the efficacy and the safety of the TVT as a surgical treatment for the female stress incontinence. Material and methods: Prospective non-randomized study undertaken between January 1999 and December 2000 concerning 40 women admitted to the Hotel-Dieu de France Hospital, with specific inclusion criteria. The surgical procedure used is the TVT as described by Ulmsten. Patients' evaluation is made through valid criteria shown in the literature. Results: The mean follow-up is 12 months. The mean operation time is 37 minutes. The mean duration of hospitalization is 2.6 days. Postoperative complications were transient urinary retention in 17.5% of cases, and lower urinary tract infection in 10% of patients. One case of bladder perforation was noted. The mean difference between the numbers of protections used daily before and after TVT is 2.03 +/- 1.89 [p < 10[-4]]. 87.5% of patients were totally and objectively continent. The mean post-voiding residue is 85 +/- 91 ml. Bladder instability symptoms were significantly reduced [RR = 0.37]. 97.5% of patients are cured or improved by the operation. Conclusion: The TVT is an effective procedure and easy to perform. The results obtained so far are promising. The failure rate is about 2.5%. A standardization of the indications is preferred for future studies

clinical implications of angiogenesis in the treatment of cancer

Angiogenesis, the formation of new blood vessels from pre-existing ones, is a very well controlled multistep process under physiologic conditions. It involves a balance between several positive and negative regulators. Pathologic angiogenesis, both-excessive and insufficient, plays a role in the pathophysiology of many diseases including cancer. It has been proven that tumor growth and metastasis are angiogenesis-dependent. Endothelial cells and tumor cells also provide a mutual support to each other via the secretion of several substances. Targeting tumor blood vessels is a new approach to the treatment of cancer. Clinical trials are currently underway and the results appear to be very promising

traitement chirurgical radical du cancer epidermoide de la vulve

During an eighteen-year period, forty nine patients with invasive epidermoid carcinoma of the vulva were treated by a radical vulvectomy at the Hotel-Dieu de France hospital in Beirut. The age, the clinical presentation, and the lymph nodes involvement were close to what was published in the literature. The overall five-year survival rate was 72%. Those with stage I disease lesions had an excellent survival rate.A review of the literature would indicate that a conservative approach in the treatment of early invasive lesions can give satisfactory results, and that adjuvant radiotherapy is more beneficial than pelvic lymph nodes dissection when there is a high risk of pelvic involvement