A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse / 中华医学杂志(英文版)

BACKGROUND@#It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.@*METHODS@#A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).@*RESULTS@#The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).@*CONCLUSIONS@#The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.@*TRIAL REGISTRATION NUMBER@#NCT03620565, https://register.clinicaltrials.gov.

Clinical efficacy of Gengxueting and its effect on estrogen receptor and progesterone receptor in patients with hysteromyoma / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the clinical efficacy of Gengxueting (GXT) in treating hysteromyoma and its effects on estrogen receptor (ER) and progesterone receptor (PR).</p><p><b>METHODS</b>Sixty-four hysteromyoma patients with surgical indication were equally assigned to the treated group and the control group. Patients in the treated group were treated with GXT one capsule every day for 90 consecutive days before surgical operation, while those in the control group were treated with surgery alone. Serum levels of reproductive hormones were determined in the follicular phase before medication and one day before operation by RIA, and colored Doppler ultrasound examination was conducted for measuring the size of uterus and myoma. Moreover the protein expressions of ER and PR in tumor and uterine muscular tissues were detected by immunohistochemistry assay with streptomycin avidin-biotin peroxidase complex method.</p><p><b>RESULTS</b>In the treated group after medication, the serum level of estradiol was (167.0 +/- 85.9) pmol/L, progesterone (1.9 +/- 1.0) nmol/L, follicle-stimulating hormone (10.4 +/- 2.1) IU/L, and luteinizing (12.0 +/- 9. 8) IU/L, all reached the levels of early follicular phase, with the maximal size of myoma significantly decreased from (380.4 +/- 21.0) cm3 to (162.3 +/- 14. 8) cm3 (P < 0.01); and the ER and PR expressions in tumor tissue were significantly lower than those in the control group respectively (P < 0.01).</p><p><b>CONCLUSION</b>Expressions of ER and PR in hysteromyoma tissue could be significantly reduced by medication of GXT, which leads to significant shrinkage of tumor size and improvement of clinical symptoms.</p>

Influence of Xianglingwan on dysmenorrhea and serum CA125 in treating patients with endometriosis / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the influence of Xianglingwan on dysmenorrhea and serum CA125 in treating patients with endometriosis.</p><p><b>METHOD</b>A total of 54 patients with endometriosis and without medical complications were random selected. Xianglingwan was administered from the fifth day of the menstrual cycle for 3 weeks every month as a therapeutic course, and three months for a therapeutic period. Pelvic type B ultrasonograph and blood CA125 were detected before and after treatment. Visual analogue scale was admitted to evaluate the dysmenorrhea.</p><p><b>RESULT</b>The serum CA125 reduced obviously after therapy. There was a significant difference between them (P < 0.01). The symptom of dysmenorrhea also reduced obviously after treatment. There was a significant difference between them (P < 0.05).</p><p><b>CONCLUSION</b>Xianglingwan can treat edometriosis effectively, and has less adverse reactions, it can also reduce the symptom of dysmenorrheal and the serum CA125.</p>

Clinical analysis of anomalies of female reproductive system associated with urinary system / 中华妇产科杂志

Objective To determine the association of anomalies of female reproductive system with that of urinary system. Methods Two hundred and eighty-nine cases, including 59 with congenital vaginal inclined septum syndrome, 135 with septate uterus, 4 with unicornuate uterus, 13 with rudimentary horn of uterus, 58 with congenital absence of the uterus and vagina, 14 with imperforated hymen, and 6 with atresia of vagina, treated during the past 4 years, were analysed retrospectively. Results Anomalies of urinary system were more frequently found in patients with anisomerous anomalies of reproductive system(85. 53% , 65/76 cases). In 59 cases of congenital vaginal inclined septum syndrome, 43 had ipsilateral renal agenesis, 2 had one single pelvic kidney, 1 had bilateral horseshoe kidneys, 1 had left-side horseshoe kidney, 1 had one pair of renal pelvis and renal calices with ureters incorporated at middle and inferior segments on both sides. Ipsilateral renal agenesis was also seen in patients with rudimentary horn of uterus(14/14 cases) and unicornuate uterus(4/4 cases). However, there was no urinary system malformation seen in septate uterus patients (0/135 cases), imperforated hymen (0/16) and atresia of vagina (0/4 cases). Only 1 case of congenital absence of the uterus and vagina associated with ipsilateral renal agenesis. Conclusion Anomalies of reproductive ducts associated with renal malformations, especially anisomerous anomalies of reproductive system are not unusual. Early recognition and diagnosis is very important to prevention and treatment of such diseases.