Transvaginal repair for vesicovaginal fistulas / 中国医师杂志

Vesicovaginal fistulas are the common complications of gynecologic and obstetric procedure,which could be repaired through vaginal approach (Laztko procedure) or abdominal approach (O'Conor procedure).However,the vaginal approach of vesicovaginal fistulas repair should be the preferred one,because the transvaginal repairs is mini-invasive and achieve comparable success rates compared to abdominal repairs.In addition,surgeon could transvaginal repair recurrent fistula easily.Now,most vesicovaginal fistulas are iatrogenic with sever scar tissue surrounding fistulous tract.Therefore,based on the previous experience of transvaginal operation,we recommend usingShen Modification of Laztko's Procedure to improve the success rate of first transvaginal repair.

Quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension / 中国医师杂志

Objective To investigate the quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension.Methods Case-control and questionnairebased methods were used in this study.Forty patients of early-stage (Ⅰ b 1 ～ Ⅰ b2) cervical cancer who had undergone vaginal extension following classic radical hysterectomy were included in the observation group,while 40 patients with matching factors and radical hysterectomy only during the same period were included in the control group.The quality of marriage and sexual function were compared with OLSON marriage prolapse and incontinence sexual function questionnaire Shon Fonn (PISQ-12).Results The operation time and postoperative vaginal length in the observation group were higher than those in the control group (P ＜ 0.05 or P ＜ 0.01).The emotional,physical,and total scores during postoperation were lower than those during preoperation (P ＜ 0.01).The emotional,physical,and total scores in the control group were lower than those in the observation group (P ＜ 0.01).The marital satisfaction,husband and wife communication,conflict resolution methods,extracurricular activities and sex scores in the observation group were higher than those in the control group (P ＜ 0.05 or P ＜ 0.01).Conclusions Patients with peritoneovaginoplasty following radical hysterectomy had much longer vagina and less self-perceived short vagina.Vaginal extension following radical hysterectomy does not worsen the pelvic floor symptoms.