[Lower urinary tract dysfunction following nerve sparing radical hysterectomy: A systematic review]. / Complications urinaires fonctionnelles de la colpohystérectomie totale avec préservation nerveuse : revue systématique de la littérature.

INTRODUCTION: Radical hysterectomy represents the cornerstone in the management of localized cervical cancer. Despite its oncologic efficacy, radical hysterectomy is associated with a significant amount of complications and a negative impact on quality of life. Surgical technique seems to influence the functional outcomes. AIM OF THE STUDY: A systematic review to provide an update on the lower urinary tract dysfunction following nerve sparing radical hysterectomy. METHODS: An initial search was carried out to identify articles for further review, using Cochrane reviews and PubMed and Embase databases. The search terms used were: "nerve sparing" and "cervical cancer" or "radical hysterectomy". The Preferred Reporting Items for Systematic Reviews and Meta-Analyses process for reporting included and excluded studies was followed, with the recommended flowchart showing the numbers of papers identified and included or excluded at each stage. RESULTS: Twenty-nine clinical studies were included. The absence of a standardized surgical technique for nerve sparing radical hysterectomy and the poor methodological quality of the studies assessing lower urinary tract dysfunction after such intervention limited clear conclusions. However, all studies reported lower incidence of urinary tract dysfunction, urodynamic abnormalities and clean intermittent catheterization following nerve sparing radical hysterectomy compared to conventional technique. CONCLUSION: Nerve sparing radical hysterectomy is associated with reduced lower urinary tract dysfunction. A standardization of the surgical technique for nerve sparing radical hysterectomy, tailored to each individual is necessary to allow its wide spread diffusion.

[Uterine necrosis following pelvic arterial embolisation for postpartum haemorrhage: case report]. / Nécrose utérine après embolisation pelvienne pour hémorragie du postpartum : à propos d'un cas.

We report a case of uterine necrosis in a 38 year-old patient, who underwent a caesarean section for placenta praevia and an embolisation of the uterine arteries for postpartum haemorrhage. The pelvic embolisation was performed with absorbable gelatine sponge pledgets. This woman presented with abdominal pain and fever three weeks after delivery and a computed tomography scan revealed the presence of gas in the myometrium and endometrium and allowed the diagnosis of uterine necrosis. A total abdominal hysterectomy was performed with adnexal conservation and the diagnosis of uterine necrosis was confirmed histologically. The complications of pelvic embolization and the risks of surgical procedures for the management of intractable obstetric hemorrhage are described.

[Segmental variations of great saphenous vein diameters in a coronary triple vessel disease population]. / Variations des diamètres segmentaires des veines saphènes internes chez une population coronaire tritronculaire.

BACKGROUND: Great saphenous vein is one of the most used grafts in cardiovascular surgery. There is little amount of data in the medical literature describing dimensions of this vein. This series describes dimensions of the great saphenous vein in a coronary population and their variations. PATIENTS AND METHODS: Retrospective series of patients admitted to the cardiovascular surgery department of Hotel-Dieu de France Hospital - Beirut, between January 2003 and June 2006 for elective coronary artery bypass grafting and having a preoperative Doppler ultrasound of the saphenous veins according to a standardized protocol. Great saphenous vein dimensions were analyzed with regard to patients' characteristics using multivariable analysis of variance. RESULTS: Four hundred and two subjects were included with a mean age 64.4+/-9.3 years and a mean body mass index 27.9+/-4.5 kg/m(2). Women presented 22.6% of the series. Great saphenous vein dimensions' variations according to gender were significant (Multivariate Pillay trace=0.001) below the knee. Dimensions' variations were also significant as function of body mass index (P=0.001) and body surface (P=0.001). Age and cardiovascular risk factors did not influence GSV diameters. CONCLUSION: This series allowed constructing reference tables of the great saphenous vein segmental diameters in patients admitted for coronary artery surgery. Female sex is associated with lower segmental diameters below the knee and body mass index and body surface are linearly associated with segmental diameters at all levels.