The renaissance of female urethrovesical function

This paper constitutes a brief review of the physiological progress in female urethrovesical function which has occurred since the early 1950s. Special emphasis has been placed upon stress urinary incontinence. While progress has been made, the whole subject of female urethrovesical function needs to be re-explored with studies performed on adult females and not inferred from studies done upon adult males.Formerly of Department of Gynecology and Obstetrics, Henry Ford Hospital, Detroit, Michigan, USA     

脂源性间质细胞在压力性尿失禁中的研究进展

压力性尿失禁在女性人群中的发病率越来越高,各种各样的治疗方法层出不穷.脂肪来源的间充质细胞具有骨髓来源多能干细胞的功能,在一定条件下能向多种组织细胞分化,同时它还具有基因载体的功能.对于将其作为干细胞联合转基因技术的细胞治疗应用于盆底及尿道的功能重建可能成为治疗女性压力性尿失禁的新方法.该文将从脂源性间质细胞的特性、分离培养、鉴定等方面对其在压力性尿失禁的治疗前景上作以综述.     

民国金陵四大名医及其学术传承

我国近代史不仅是中华民族浴血奋战的历史,也是中医界志士仁人为中医药的救亡图存努力奋争的历史。南京作为民国首都,中医药界的医家们无论在政事上还是临床方面都十分活跃,其中以张简斋、张栋梁、杨伯雅和随翰英为代表,后世也将他们并称为金陵四大名医。在群体作为方面,金陵四大名医积极参与了中医药的存亡斗争和中央国医馆的建设,大力兴办中医教育创建南京国医传习所,并且自身在中医临床方面也颇有建树。在中医药的发展方面,金陵四大名医在沿袭先祖嫡系传承和私淑传承的同时也吸纳了新型的院校传承模式,传承方式具有新时代中西合璧的特征。     

基于流固耦合模型的SUI患者尿液动力学研究

目的针对当前压力型尿失禁(stress urinary incontinence,SUI)疾病严重影响中老年女性患者身体健康和生活质量的问题,开展女性盆底尿路系统尿液动力学的数值研究。方法依据尿液-盆底组织间相互作用的耦合特征,结合计算流体力学(computational fluid dynamics,CFD)技术,建立SUI疾病的尿液动力学模型,分析软组织结构的应变、应力和变形以及尿路系统中尿液流动的压力场、速度场分布。结果尿路系统弹性结构的应力、应变和位移随时间呈波浪形变化,是SUI疾病形成的力学要素。结论开展基于流固耦合模型的尿动力学研究不仅必要,而且可行,能为临床SUI疾病的手术治疗提供理论基础及技术分析手段。     

女性压力性尿失禁的治疗进展

压力性尿失禁（ SUI）是中老年妇女的常见病,且随着个体年龄增加而增加,全球妇女该病患病率为10％～23％,中国成年女性患病率为18．9％。严重影响女性身心健康和生活质量,已成为社会公共卫生问题。随着我国人口老龄化,SUI发病率逐步增高,人们对生活质量的要求逐渐提高,SUI的诊治正日益受到重视。目前治疗SUI的方法分为保守治疗和手术治疗,本文就女性压力性尿失禁的治疗进展进行综述。     

The Effect of Medical Consultation on Patients' Concerns Regarding Vaginal Mesh Use in Pelvic Reconstructive Surgery

Objective

This study sought to determine patients' background knowledge and attitudes towards the use of mesh in pelvic floor reconstructive surgery (PFRS) and the effect of medical consultation on their knowledge and attitudes about mesh use.

Management of complications of mesh surgery

Polypropylene mesh (PPM) has been used in abdominal sacrocoplopexies since the 1990's however following a patient led campaign controversy surrounds its use incontinence procedures, midurethral slings (MUS) and vaginal mesh prolapse repairs. The complication rates following mesh surgery may be as high as 10%. NHS England paused the vaginal insertion of polypropylene mesh in July 2018 pending a review by Baroness Cumberledge. This review will outline the assessment and basic management of complications of polypropylene mesh. This is a relatively new area of urogynaecological practice which non-specialist obstetric and gynaecology clinicians and GPs need to be aware of. Symptoms which could be due to mesh complications are vaginal discharge or bleeding, recurrent urinary tract infection, haematuria, dyspareunia and pelvic pain. Women presenting with any of the above symptoms should be asked if they have had previous surgery for stress incontinence or prolapse. The women may not recall having mesh inserted and may use different terms “sling” “net” or “tape”. They should be examined to both look and feel for PPM. Mesh complications should be managed by the designated mesh centres which are listed on the BAUS and BSUG websites. All mesh complications should be reported to the Medicines & Healthcare products Regulatory Agency (MHRA) by the yellow card system. All mesh complications requiring further surgical intervention should be recorded on the British Society of Urogynaecology (BSUG) national database.