Clinical study of curative effects of partial sigmoidectomy and pelvic floor repair for treatment of pelvic floor dysfunction with dolichasigmoid / 中国实用妇科与产科杂志

OBJECTIVE: To explore the curative effects of the combined therapy of laparoscopic partial sigmoidectomy and anterior and posterior vaginal wall repair for the treatment of severe pelvic floor dysfunction(PFD).METHODS: The clinical data of 14 severe PDF patients(uterine prolapse in stage Ⅲ-Ⅳ）with dolichasigmoid were studied retrospectively from May 2017 to August 2018 in Shanghai Traditional Chinese Medical University. The surgical way was laparoscopic partial sigmoidectomy and anterior and posterior vaginal wall repair. The objective effects were assessed by comparing the position of each indication points of the preoperative and postoperative pelvic organs' prolapse(in POP-Q scale).Subjective effects were also assessed by comparing Clevel score of constipation,pelvic floor distress inventory-short form 20(PFDI-20),pelvic floor impact questionnaire short form(PFIQ-7)between preoperation and 6 months and 1 year after operation.RESULTS: All 14 patients were successfully operated on without any intra-operative and post-operative complications. The comparion of positions of the POP-Q indication points(AA,Ba,C,D,AP,BP)between preoperation and 1 year after operation showed the difference was statistically significant(P<0.01). PFDI-20,PFIQ-7 and Clevel constipation scores were also significantly different respectively(P<0.01).CONCLUSION: Laparoscopic partial sigmoidectomy combined with pelvic floor repair is an optional method in the treatment for pelvic floor dysfunction, which could effectively improve the constipation caused by dolichasigmoid and pelvic floor defect. It is also with low postoperative morbidity.

Clinical observations of sequential therapy with Chinese medicine and hysteroscopic mechanical stimulation of the endometrium in infertile patients with repeated implantation failure undergoing frozen-thawed embryo transfer / 中国结合医学杂志

<p><b>OBJECTIVES</b>To investigate the clinical effect of sequential therapeutic intervention Yupei Qisun [compensating for weakness by invigorating Kidney (Shen) and Spleen (Pi) in advance] in Chinese medicine (CM) and hysteroscopic endometrial mechanical stimulation on the treatment of infertile patients with repeated implantation failure (RIF); and to study the differences in patients' endometrial thickness and type on the day of embryo transfer, serum hormone levels on embryo transfer day and clinical pregnancy outcomes.</p><p><b>METHODS</b>In the clinical study, 168 frozen-thawed embryo transfer (FET) cycles for couples with RIF conforming to the research protocol were randomly divided into three groups: a CM group with 56 cycles (CM combined with FET), a hysteroscopy group with 55 cycles (hysteroscopic endometrial mechanical stimulation), and a control group with 57 cycles (conventional FET). Differences in endometrial thickness on the embryo transfer day, levels of serum estradiol (E2) and progesterone (P) on the embryo transfer day, the E2/P ratio on the embryo transfer day, biochemical and clinical pregnancy rates, implantation rate, abnormal pregnancy rate and other indices were compared among the three groups.</p><p><b>RESULTS</b>Endometrial thickness, E2 and P levels, and the E2/P ratio on embryo transfer day and other factors had no significant differences among groups. The biochemical pregnancy, clinical pregnancy, and implantation rates of the CM and hysteroscopy groups were significantly higher than the control group (P<0.05), and there were no significant differences between these two groups. The abnormal pregnancy rate had no significant difference among the three groups.</p><p><b>CONCLUSIONS</b>Sequential therapy of Yupei Qisun could significantly improve the clinical outcomes of rif-fet cycles, being equivalent to hysteroscopic endometrial mechanical stimulation, and provided a reliable method to treat such infertile couples.</p>