1
|
Hsiao SM. Predictors of non-persistence in women with overactive bladder syndrome. Sci Rep 2024; 14:7499. [PMID: 38553529 PMCID: PMC10980757 DOI: 10.1038/s41598-024-58036-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
Persistence is important for the success in the treatment of women with overactive bladder syndrome (OAB). We aimed to identify the predictors of non-persistence in women with OAB after first-line medical treatment. All consecutive women with OAB (n = 608), who underwent urodynamic studies and received first-line medical treatment (5 mg of solifenacin or 25 mg of mirabegron per day) in a referral medical center, were reviewed. Mirabegron (hazard ratio [HR] = 0.711) was associated with a higher persistence rate, compared to solifenacin. Mirabegron treatment (HR = 0.269) was less likely to switch medication; however, a high Urogenital Distress Inventory score (HR = 1.082) was more likely to switch medication. Furthermore, old age (HR = 1.050, especially for ≥ 75 years) and high voided volume (dL, HR = 1.420, especially for voided volume ≥ 250 ml) were associated with added medication at follow-up. Additionally, women with low parity (HR = 0.653, especially for parity ≤ 3) and a low Incontinence Impact Questionnaire (IIQ-7) score (HR = 0.828, especially for IIQ-7 score ≤ 7) were associated with improvement without medication. In conclusion, mirabegron can be considered as the first frontline treatment to increase the persistence rate and decrease the rate of switched medications, compared to solifenacin. In addition, combination therapy or higher-dose monotherapy could be used as the first front-line treatment for women ≥ 75 years of age or with ≥ 250 ml of voided volume.
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, Taiwan.
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
2
|
Hsiao SM, Liao SC. Effect of tibolone vs hormone replacement therapy on climacteric symptoms and psychological distress. J Chin Med Assoc 2024; 87:189-195. [PMID: 37882059 DOI: 10.1097/jcma.0000000000001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The objective was to elucidate the effect of tibolone vs hormone replacement therapy (HRT) on climacteric symptoms and psychological distress. METHODS All consecutive women with climacteric symptoms were allocated to receive tibolone (2.5 mg) or estradiol valerate (1 mg) plus medroxyprogesterone acetate (2.5 mg). RESULTS The improvement in "feeling dizzy or faint" after tibolone treatment was more prominent than that after HRT (-0.7 ± 0.8 vs -0.0 ± 0.9, p = 0.004). In addition, other climacteric symptoms, including anxiety, depression, somatic symptoms, and vasomotor symptoms, and sexual function improved after tibolone and HRT, but there were no between-group differences. Psychological distress assessment demonstrated that somatic complaints, obsessive-compulsive symptoms, depressive symptoms, hostility, additional symptoms, and the General Symptom Index improved after tibolone treatment and HRT, but there were no between-group differences. Personality traits assessment revealed that neuroticism improved after tibolone treatment. CONCLUSION Tibolone seems more beneficial than HRT in treating symptoms of dizziness and faintness. Both tibolone and HRT could improve psychological distress.
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan, ROC
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC
| |
Collapse
|
3
|
Sun HD, Peng FH, Hsiao SM, Wang PH. A small mature cystic ovarian teratoma associated with anti-NMDA receptor encephalitis and acute respiratory failure: A case report. Taiwan J Obstet Gynecol 2023; 62:765-768. [PMID: 37679011 DOI: 10.1016/j.tjog.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE To report a rare case of anti-N-Methyl-d-aspartate receptor encephalitis (anti-NMDARE) presented by mental and behavioral changes and seizures accompanied with respiratory failure. CASE REPORT A 37-year-old multiparous woman was initially presented with abnormal mental behavior and the diagnosis of schizophrenia was made, but the disease progressed rapidly to general convulsion and acute respiratory failure. Although active treatment, including steroids, intravenous immunoglobulins (IVIGs) and plasma exchange was applied, no significant improvement was obtained. Transvaginal ultrasound and pelvic magnetic resonance image (MRI) were arranged and the results showed a suspicious cystic lesion (3 × 2.3 cm) at the right ovary. Laparoscopic unilateral salpingo-oophorectomy was performed and final pathology reported a matured cystic teratoma, suggesting that this patient had anti-NMDARE secondary to ovarian mature teratoma. After surgery, the clinical condition was dramatically improved and she recovered completely without sequelae. CONCLUSION Although it is well-known about the relation between anti-NMDARE and ovarian mature teratoma, this small tumor may result in the missing diagnosis. Remind us to consider the possibility of any small ovarian cystic lesion-related anti-NMDARE in women with autoimmune encephalitis.
Collapse
Affiliation(s)
- Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Fu-Hsiang Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan
| | - Peng-Hui Wang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Female Cancer Foundation, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
4
|
Huang RYJ, Huang KJ, Chen KC, Hsiao SM, Tan TZ, Wu CJ, Hsu C, Chang WC, Pan CY, Sheu BC, Wei LH. Immune-Hot tumor features associated with recurrence in early-stage ovarian clear cell carcinoma. Int J Cancer 2023; 152:2174-2185. [PMID: 36629283 DOI: 10.1002/ijc.34428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/03/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
Ovarian clear cell carcinoma (OCCC) is a distinct histotype of ovarian cancer, which usually presages a worse prognosis upon recurrence. Identifying patients at risk for relapse is an unmet need to improve outcomes. A retrospective cohort analysis of 195 early-stage OCCC patients diagnosed between January 2011 and December 2019 at National Taiwan University Hospital was conducted to identify prognostic factors for recurrence, progression-free survival (PFS) and overall survival (OS). Molecular profiling of tumors was performed in a case-controlled cohort matched for adjuvant therapy for biomarker discovery. Multivariate Cox proportional hazard model revealed that paclitaxel-based chemotherapy was associated with better PFS than nonpaclitaxel chemotherapy (HR = 0.19, P = .006). The addition of bevacizumab was associated with better PFS, compared to no bevacizumab (HR = 0.09, P = .02). Neither showed significant improvement in OS. Recurrence is associated with an Immune-Hot tumor feature (P = .03), the CTLA-4-high subtype (P = .01) and increased infiltration of immune cells in general. The Immune-Hot feature (HR = 3.39, P = .005) and the CTLA-4-high subtype (HR = 2.13, P = .059) were associated with worse PFS. Immune-Hot tumor features could prognosticate recurrence in early-stage OCCC.
Collapse
Affiliation(s)
- Ruby Yun-Ju Huang
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Hospital Yunlin Branch, Douliu City, Taiwan
| | - Ko-Chen Chen
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Tuan Zea Tan
- Cancer Science Institute of Singapore, National University of Singapore, Center for Translational Medicine, Singapore
| | - Chin-Jui Wu
- National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Ching Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chen-Yu Pan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Lin-Hung Wei
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|
5
|
Ting WH, Hsiao SM, Sun HD. Conservative management of Cesarean scar pregnancy with two-doses systemic methotrexate and hysteroscopy. Asian J Surg 2022; 46:2239-2240. [PMID: 36509598 DOI: 10.1016/j.asjsur.2022.11.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan; Department of industrial Management, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan
| | - Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
| |
Collapse
|
6
|
Wu CY, Tseng LM, Chen HH, Hsieh CH, Hsiao SM. Fatal rectovaginal fistula in post-radiotherapy locally advanced cervical cancer patients. Taiwan J Obstet Gynecol 2022; 61:1069-1072. [DOI: 10.1016/j.tjog.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/23/2022] Open
|
7
|
Wu LC, Peng FS, Leung C, Lu HF, Lin HH, Hsiao SM. Comparison of cesarean section rates between obstetricians preferring labor induction at early versus late gestational age. Taiwan J Obstet Gynecol 2022; 61:847-853. [PMID: 36088054 DOI: 10.1016/j.tjog.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To compare the cesarean section (CS) rates of obstetricians with a preference of labor induction at early versus late gestational age. MATERIAL AND METHODS Medical records of women who were low risk, nulliparous, singleton pregnancy, and >37 weeks and delivered their babies, were reviewed. Obstetricians, who preferred labor induction at<41 weeks, were allocated to the early induction group; and the other obstetricians were allocated to the late induction group. RESULTS The late induction group had a higher percentage of labor induction at ≥41 weeks, compared with the early induction group (21% vs. 8%, p = 0.007). The late induction group had a lower CS rate (11.0% vs. 19.1%, p < 0.001). Multivariable Cox proportional hazard model revealed that the early induction group (hazard ratio [HR] = 2.14, p < 0.001), maternal age (HR = 1.04, p = 0.001), premature rupture of membranes (HR = 1.59, p = 0.006), and birth body weight (kg, HR = 2.13, p < 0.001) were independent predictors of CS. In women receiving labor induction (n = 312), birth body weight (kg, HR = 1.72, p = 0.04) was the sole predictor of CS; and there is a trend that the early induction group (HR = 1.54, p = 0.051) has a higher CS rate, compared with the late induction group. However, gestational age at labor induction was not a predictor of CS. CONCLUSION In low-risk pregnancies, obstetricians preferring labor induction at early gestational age seem to be associated with a higher CS rate, compared with obstetricians preferring labor induction at late gestational age. Nonetheless, the above finding seems to be associated with physician's factor, instead of gestational age at labor induction.
Collapse
Affiliation(s)
- Liu-Ching Wu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Fu-Shaing Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Cheung Leung
- Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Hsin-Fen Lu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
8
|
Wu PC, Hsiao SM, Chang TC, Chen CH, Lin HH. Clinical outcome and urodynamic changes of tailored transvaginal mesh surgery for pelvic organ prolapse: A mid-term 40 Months follow-up. J Formos Med Assoc 2022; 121:2424-2429. [PMID: 35987746 DOI: 10.1016/j.jfma.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate the changes in clinical outcome and urodynamic parameters after tailored anterior transvaginal mesh (ATVM) surgeries in a mid-term follow-up. METHODS Between November 2011 and December 2015, women with ≥stage II pelvic organ prolapse (POP) who underwent ATVM surgeries were retrospectively reviewed. The data-reviewing timeframe was until December 2021. Clinical and urodynamic diagnoses regarding urinary symptoms were evaluated before and after the operation. RESULTS A total of 160 women were included. Stress urinary incontinence decreased significantly after the operation (99% (159/160) vs. 43% (68/160), p < 0.01), as well as the pad weight (20.5 ± 2.7 vs. 9.4 ± 2.0, p < 0.001) and diagnosis of urodynamic stress incontinence (83% (132/160) vs. 51% (82/160), p < 0.01). Overactive bladder syndrome increased significantly after the operation (18% (29/160) vs. 28% (45/160), p = 0.03), even though the objective parameters, such as first and strong desire to void, bladder oversensitivity, and detrusor overactivity, were all improved after the operation. The pad weight was mostly improved significantly within the first postoperative 2 years. Eighteen (11%) women had global recurrent POP, and only one (0.6%) woman had true recurrence of cystocele. Twenty-four (15%) women had mesh extrusion, and two-thirds of them could be managed in an office setting. CONCLUSIONS In women with advanced cystocele, the ATVM surgery provides a favorable anatomic reduction outcome with an acceptable mesh extrusion rate. The ATVM provides an anti-incontinence effect, both in subjective symptoms and objective parameters, but this effect might decline after postoperative 2 years.
Collapse
Affiliation(s)
- Pei-Chi Wu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Ting-Chen Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
| |
Collapse
|
9
|
Huang PH, Tsai MC, Ting WH, Chen HH, Lin HH, Hsiao SM. Predictors of surgical outcomes of laparoscopic myomectomy with barbed sutures: Comparison of V-Loc and Quill barbed sutures. Int J Gynaecol Obstet 2022; 158:757-759. [PMID: 35598148 DOI: 10.1002/ijgo.14276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Peng-Hsuan Huang
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Meng-Chieh Tsai
- Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Industrial Management, Asia Eastern University of Science and Technology, New Taipei, Taiwan
| | - Hui-Hua Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| |
Collapse
|
10
|
Yu Q, Chae HD, Hsiao SM, Xie J, Blogg M, Sumarsono B, Kim S. Prevalence, severity, and associated factors in women in East Asia with moderate-to-severe vasomotor symptoms associated with menopause. Menopause 2022; 29:553-563. [PMID: 35231007 PMCID: PMC9060817 DOI: 10.1097/gme.0000000000001949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To understand prevalence, severity, impact, and treatment of vasomotor symptoms associated with menopause, using cross-sectional survey data. METHODS This online, two-part survey was conducted in East Asia among women 40-65 years recruited from established online panels (Edelman, Beijing; Hankook Research, Seoul; Rakuten Insight, Taipei) using stratified sampling. Part I collected demographics/disease characteristics, including menopausal status and vasomotor symptom severity. Women with moderate-to-severe vasomotor symptoms completed Part II, including clinical characteristics, health-related quality of life, and healthcare-seeking behavior. Primary endpoints included vasomotor symptom prevalence and severity and proportions of women eligible and willing to take hormone therapy. Results are presented for each of the three online panels separately and as a pooled total. All analyses are descriptive with no formal hypothesis testing across groups. RESULTS Numbers of peri- versus postmenopausal women completing Part I were Edelman, 1,588 (55.1% vs 44.9%); Hankook Research, 1,000 (43.6% vs 56.4%); Rakuten Insight, 773 (61.7% vs 38.3%). Vasomotor symptom prevalence was =80% in each region; overall moderate-to-severe vasomotor symptom prevalence was 55%; >50% of women were untreated. Most of those treated used non-prescription treatments. Menopausal hormone therapy use was reported by 11.6% of peri- and 7.2% of postmenopausal women. In peri- and postmenopausal women with moderate-to-severe vasomotor symptoms, 8.6% and 3.4%, respectively, were hormone therapy-willing, 19.3% and 16.8% hormone therapy-contraindicated, 25.4% and 23.0% hormone therapy-cautious, and 10.2% and 8.3% hormone therapy-averse. Women experienced significant burden on health-related quality of life and substantial impairment of work productivity and daily activities. CONCLUSIONS Vasomotor symptoms associated with menopause affected =80% of women aged 40 to 65 years. A substantial proportion of women are unsuitable for, or choose not to take, menopausal hormone therapy, resulting in an unmet need for nonhormonal treatment options.
Collapse
Affiliation(s)
- Qi Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Hee-Dong Chae
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital
| | | | | | | | | |
Collapse
|
11
|
Huang PH, Chen YY, Chen HH, Ting WH, Lin HH, Chen KH, Hsiao SM. Factors affecting clinical outcomes in women with non-gastric gastrointestinal stromal tumors. Taiwan J Obstet Gynecol 2022; 61:306-311. [DOI: 10.1016/j.tjog.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 11/26/2022] Open
|
12
|
Yang SP, Chen HH, Peng FH, Hsiao SM. Obstetric measures to decrease the spread of SARS-CoV-2 infection during labor in a conventional labor room. Taiwan J Obstet Gynecol 2022; 61:568-569. [PMID: 35595466 PMCID: PMC8958154 DOI: 10.1016/j.tjog.2022.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Shin-Ping Yang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Hui-Hau Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Fu-Hsiang Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
13
|
Liu HM, Lin HH, Hsiao SM. Predictors of cure and overactive bladder syndrome after a mid-urethral sling procedure in women with stress urinary incontinence. Maturitas 2022; 156:18-24. [PMID: 35033229 DOI: 10.1016/j.maturitas.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/01/2021] [Accepted: 10/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine predictive factors for the cure of stress urinary incontinence (SUI) or persisting or de novo overactive bladder syndrome (OAB) after a mid-urethral sling procedure (MUS) for women with SUI, especially for menopausal women. STUDY DESIGN All women who had consecutively received MUS for SUI between January 2008 and July 2019 in a tertiary referral center were reviewed. MAIN OUTCOME MEASURES Multivariable Cox proportional hazards model or logistic regression analysis was used to assess the predictors of cure and persisting or de novo OAB after MUS. RESULTS A total of 385 women had undergone MUS, of whom 265 (68.8%) were menopausal. The multivariable Cox proportional hazards model revealed that age (hazard ratio = 1.04), and preoperative detrusor overactivity (hazard ratio = 2.26) were independent predictors of persisting/recurrent SUI. Among the 216 women with preoperative OAB, 109 (50.5%) experienced resolution of their OAB after MUS; and among 169 women without preoperative OAB, twenty-five (14.8%) women developed de novo OAB after MUS (p < 0.0001). Preoperative OAB (hazard ratio = 3.97), small voided volume (hazard ratio = 0.83), and preoperative detrusor overactivity (hazard ratio = 1.62) were predictors of postoperative OAB. In addition, six (1.6%) women had mesh extrusion. Parity (odds ratio = 2.08) was the sole predictor of mesh extrusion. Menopause (hazard ratio = 1.69) was a predictor of postoperative OAB in the univariate analysis. However, menopause was not a predictor of cure or OAB in the multivariable analysis. CONCLUSIONS Age and preoperative detrusor overactivity were independent predictors of persisting/recurrent SUI. In addition, preoperative OAB, small voided volume, and preoperative detrusor overactivity were predictors of postoperative OAB. These findings could serve as a guide for preoperative consultation for MUS.
Collapse
Affiliation(s)
- Hsin-Mei Liu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
14
|
Wu PC, Hsiao SM, Lin HH. Prevalence and predictors of nocturnal polyuria in females with overactive bladder syndrome. World J Urol 2021; 40:519-527. [PMID: 34762173 DOI: 10.1007/s00345-021-03865-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/12/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To describe the prevalence and predictors of nocturnal polyuria (NP) in women with overactive bladder syndrome (OAB). METHODS Between July 2009 and January 2018, women with OAB were enrolled. NP was defined when the nocturnal polyuria index (NPI) (nighttime voided volume over 24-h voided volume) was > 33% (NPI33) in women ≥ 65 years-old and > 20% (NPI20) in women < 65 years old. Repeated analysis was also performed for NP defined by the NPI33 definition at all ages. RESULTS A total of 1071 women with OAB were analyzed. The overall prevalence of NP was 30% (319/1071), with the highest prevalence in women in the perimenopausal period (46-50 years old), while NP was diagnosed by age-dependent NPI. The overall prevalence of NP was 12% (128/1071), with an increasing trend with increasing age, while NP was diagnosed by the NPI33 definition only. Daytime frequency and nocturia episodes were both predictors for NP in both definitions. Receiver operating characteristic curve analysis revealed that more than 5 nocturia episodes noted in the 3-day bladder diary were an optimal cutoff value to predict nocturnal polyuria [(sensitivity = 85.6%, specificity = 61.0%; area = 0.80, 95% CI 0.77-0.82) and (sensitivity = 88.3%, specificity = 65.9%; area = 0.83, 95% CI 0.80-0.85), respectively, in the two definitions]. CONCLUSIONS NP is common in women with OAB, especially in women with more than 5 nocturia episodes in their 3-day bladder diaries, and adjuvant therapy for better treatment efficacy is needed.
Collapse
Affiliation(s)
- Pei-Chi Wu
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, No. 8, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, No. 8, Chung-Shan South Road, Taipei, 100, Taiwan. .,Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
| |
Collapse
|
15
|
Hsiao SM, Kuo HC. Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders. J Formos Med Assoc 2021; 120:1464-1477. [PMID: 33468403 DOI: 10.1016/j.jfma.2020.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/PURPOSE The impact of neurologic disorders on the clinical outcome of suburethral sling procedures has seldom been studied. Our aim is to elucidate factors predicting further anti-incontinence interventions or transvaginal urethrolysis after a re-adjustable pubovaginal sling procedure (PVS), especially in patients with neurologic disorders. METHODS Medical records of all consecutive women who underwent re-adjustable PVS for stress urinary incontinence (SUI) were reviewed. RESULTS A total of 589 women were enrolled, 152 (25.8%) women were found to have persistent or recurrent SUI after surgery, and 39 (6.6%) women underwent further anti-incontinence interventions. Postoperative voiding dysfunction was found in 46 (7.8%) women, and 23 women (3.9%) underwent transvaginal urethrolysis. Low body mass index (hazard ratio = 0.92) and low functional bladder capacity (dL, hazard ratio = 0.83) were factors predicting the presence of persistent/recurrent SUI. However, the presence of spinal cord disorder (hazard ratio = 8.91) and a history of prior surgery for pelvic organ prolapse (hazard ratio = 2.51) were factors predicting further anti-incontinence interventions. A high post-void residual volume (PVR, dL, hazard ratio = 1.52) and preoperative bladder outlet obstruction (BOO, hazard ratio = 5.39) were factors predicting postoperative voiding dysfunction. Similarly, a high PVR (dL, hazard ratio = 1.50) and preoperative BOO (hazard ratio = 5.38) were factors predicting transvaginal urethrolysis. A PVR >1.51 dL was an optimal cut-off value for predicting transvaginal urethrolysis. CONCLUSION The presence of spinal cord disorder and prior surgery for pelvic organ prolapse were predictors of further anti-incontinence interventions after re-adjustable PVS. In addition, a large PVR and preoperative BOO were predictors of transvaginal urethrolysis after re-adjustable PVS.
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
| |
Collapse
|
16
|
Chen HH, Ting WH, Sun HD, Wei MC, Lin HH, Hsiao SM. Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy. Int J Environ Res Public Health 2020; 17:ijerph17165941. [PMID: 32824293 PMCID: PMC7459621 DOI: 10.3390/ijerph17165941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023]
Abstract
Background: to elucidate the predictors of progression-free survival (PFS) and overall survival (OS) in high-risk endometrial cancer patients. Methods: the medical records of all consecutivewomen with high-risk endometrial cancer were reviewed. Results: among 92 high-risk endometrial cancer patients, 30 women experienced recurrence, and 21 women died. The 5-year PFS and OS probabilities were 65.3% and 75.9%, respectively. Multivariable Cox regression revealed that body mass index (hazard ratio (HR) = 1.11), paraaortic lymph node metastasis (HR = 11.11), lymphovascular space invasion (HR = 5.61), and sandwich chemoradiotherapy (HR = 0.15) were independently predictors of PFS. Body mass index (HR = 1.31), paraaortic lymph node metastasis (HR = 32.74), non-endometrioid cell type (HR = 11.31), and sandwich chemoradiotherapy (HR = 0.07) were independently predictors of OS. Among 51 women who underwent sandwich (n = 35) or concurrent (n = 16) chemoradiotherapy, the use of sandwich chemoradiotherapy were associated with better PFS (adjusted HR = 0.26, 95% CI = 0.08-0.87, p = 0.03) and OS (adjusted HR = 0.11, 95% CI = 0.02-0.71, p = 0.02) compared with concurrent chemoradiotherapy. Conclusion: compared with concurrent chemoradiotherapy, sandwich chemoradiotherapy was associated with better PFS and OS in high-risk endometrial cancer patients. In addition, high body mass index, paraaortic lymph node metastasis, and non-endometrioid cell type were also predictors of poor OS in high-risk endometrial cancer patients.
Collapse
Affiliation(s)
- Hui-Hua Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan; (H.-H.C.); (W.-H.T.); (H.-D.S.); (M.-C.W.); (H.-H.L.)
| | - Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan; (H.-H.C.); (W.-H.T.); (H.-D.S.); (M.-C.W.); (H.-H.L.)
| | - Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan; (H.-H.C.); (W.-H.T.); (H.-D.S.); (M.-C.W.); (H.-H.L.)
| | - Ming-Chow Wei
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan; (H.-H.C.); (W.-H.T.); (H.-D.S.); (M.-C.W.); (H.-H.L.)
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan; (H.-H.C.); (W.-H.T.); (H.-D.S.); (M.-C.W.); (H.-H.L.)
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and the Hospital, Taipei 100225, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220409, Taiwan; (H.-H.C.); (W.-H.T.); (H.-D.S.); (M.-C.W.); (H.-H.L.)
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and the Hospital, Taipei 100225, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan 320315, Taiwan
- Correspondence: ; Tel.: +886-8-966-7000 (ext. 1424); Fax: +886-8-966-5567
| |
Collapse
|
17
|
Ting WH, Hsiao CH, Chen HH, Wei MC, Lin HH, Hsiao SM. Comparisons of Clinical Outcomes in Women with Advanced Ovarian Cancer Treated with Frontline Intraperitoneal versus Dose-Dense Platinum/Paclitaxel Chemotherapy without Bevacizumab. Int J Environ Res Public Health 2020; 17:ijerph17103603. [PMID: 32443934 PMCID: PMC7277334 DOI: 10.3390/ijerph17103603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
Background: We aimed to compare the clinical outcomes between intraperitoneal chemotherapy and dose-dense chemotherapy for the frontline treatment of advanced ovarian, fallopian tube and primary peritoneal cancer in women not receiving bevacizumab. Methods: All consecutive women with stage II~IV cancer treated with either frontline intraperitoneal or dose-dense platinum/paclitaxel chemotherapy and not receiving bevacizumab between March 2006 and June 2019 were reviewed. Results: A total of 50 women (intraperitoneal group, n = 22; dose-dense group, n = 28) were reviewed. Median progression-free survival (32.6 months versus 14.2 months; adjusted hazard ratio = 0.38; 95% CI = 0.16 to 0.90, p = 0.03) and overall survival (not reached versus 30.7 months; adjusted hazard ratio = 0.23, 95% CI = 0.07 to 0.79, p = 0.02) were significantly higher in the intraperitoneal group than in the dose-dense group. A multivariable Cox proportional-hazards model also indicated that the number of frontline chemotherapy cycles (adjusted hazard ratio = 0.66, 95% CI 0.47 to 0.94, p = 0.02) was a predictor of better overall survival. Nausea/vomiting and nephrotoxicity occurred more frequently in the intraperitoneal group (p = 0.02 and <0.0001, respectively). Conclusions: Intraperitoneal chemotherapy seems to be superior in progression free survival and overall survival to dose-dense chemotherapy in the frontline treatment of women with optimally resected advanced ovarian, fallopian tube or primary peritoneal cancer and not receiving bevacizumab.
Collapse
Affiliation(s)
- Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei 220409, Taiwan; (W.-H.T.); (H.-H.C.); (M.-C.W.); (H.-H.L.)
| | - Chi-Huang Hsiao
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei 220409, Taiwan;
| | - Hui-Hua Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei 220409, Taiwan; (W.-H.T.); (H.-H.C.); (M.-C.W.); (H.-H.L.)
| | - Ming-Chow Wei
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei 220409, Taiwan; (W.-H.T.); (H.-H.C.); (M.-C.W.); (H.-H.L.)
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei 220409, Taiwan; (W.-H.T.); (H.-H.C.); (M.-C.W.); (H.-H.L.)
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei 220409, Taiwan; (W.-H.T.); (H.-H.C.); (M.-C.W.); (H.-H.L.)
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei 100225, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan 320315, Taiwan
| |
Collapse
|
18
|
Hsiao SM. Letter to the Editor on "A retrospective study comparing the efficacy of dose-dense chemotherapy, intraperitoneal chemotherapy and dose-dense chemotherapy". Eur J Obstet Gynecol Reprod Biol 2020; 247:257. [DOI: 10.1016/j.ejogrb.2020.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/24/2020] [Indexed: 10/25/2022]
|
19
|
Chang TC, Huang SH, Chao HY, Chen BL, Chen C, Chen CH, Chen TR, Chin CY, Chiu CP, Chiu FP, Chou J, Chyr CY, Chu SY, Hsiao SM, Hsieh YM, Huang A, Huang WI, Hung SS, Ko HC, Lin LP, Lin PY, Liu CB, Liu FC, Sheu YI, Shie JS, Tai TF, Tsai SJ, Wang SJ, Wen SC, Wong HC, Yan LP, Yeh T. Efficacy of a Latex Agglutination Test for Rapid Identification of Staphylococcus aureus: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/79.3.661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Fifteen laboratories completed a collaborative study comparing the efficacy of a latex agglutination kit (Aureus Test) with that of AOAC Official Method 987.09 (coagulase test for identification of Staphylococcus aureus). Each laboratory analyzed 240 strains of bacteria, including 160 isolates of S. aureus and 80 isolates of other bacteria. Upon receipt of cultures, collaborators subcultured each isolate on both tryptic soy agar (TSA) and Baird-Parker agar medium (BPA) to determine whether the growth medium has any effect on either method. For cultures grown on TSA, the latex test had sensitivity and specificity rates of 99.2 and 97.1 %, respectively, whereas the coagulase test had respective rates of 98.4 and 92.5%. For cultures able to grow on BPA, the latex test had sensitivity and specificity rates of 99.2 and 96.6%, respectively, while the coagulase test had respective rates of 98.3 and 91.3%. By using the McNemar pairwise comparison test of the 2 methods, the falsepositive and false-negative rates of the latex test were significantly lower (p < 0.01) than those of the coagulase test for strains grown either on TSA or BPA. The latex agglutination test for identification of S. aureus isolated from foods has been adopted by AOAC INTERNATIONAL.
Collapse
Affiliation(s)
- Tsung C Chang
- Food Industry Research and Development Institute, PO Box 246, Hsinchu 300, Taiwan, Republic of China
| | - Su H Huang
- Food Industry Research and Development Institute, PO Box 246, Hsinchu 300, Taiwan, Republic of China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Wu PC, Hsiao SM, Chen CH, Lin HH. Comparison of the vault prolapse rate after vaginal hysterectomy with or without residual uterine ligament ligations: A retrospective cohort study. J Formos Med Assoc 2019; 119:805-812. [PMID: 31813655 DOI: 10.1016/j.jfma.2019.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To evaluate the post-hysterectomy vault prolapse (PHVP) rates performed using different methods of vaginal total hysterectomy (VTH). METHODS A total of 251 women who underwent VTH with/without concomitant surgeries between January 1986 and December 2001 in a tertiary center. Thirty-eight women were excluded due to not only a vaginal approach. Of the remaining 213 women, 129 and 84 underwent VTH via the Tsuzi method with residual uterine ligament ligations (ligations group) and traditional VTH (without ligations group), respectively. The χ2 and Mann-Whitney U tests were applied appropriately. The cumulative percentages of women without PHVP were calculated over time and compared using Kaplan-Meier curves and log-rank tests. A p value of less than 0.05 was considered statistically significant. RESULTS Compared to the without ligations group, women in the ligations group had longer operation time (115.9 ± 37.1 vs. 103.3 ± 41.4 min, p = 0.002) and more blood loss (217.4 ± 137.8 vs. 148.2 ± 149.0 mL, p < 0.001). When focusing on women with uterine prolapse, only operation time and grade of uterine prolapse were different between the groups (117.3 ± 24.8 vs. 107.9 ± 40.5 min, p = 0.025, and 21% vs. 41%, p = 0.018, respectively). The rate of PHVP was significantly lower in the ligation group than in the without ligations group (0 vs. 5, p = 0.005). CONCLUSION VTH via the Tsuzi method with residual uterine ligament ligations resulted in fewer cases of PHVP than occurred in traditional VTH. If native tissue repair is planned in pelvic reconstruction surgery, VTH with residual uterine ligament ligations should be considered.
Collapse
Affiliation(s)
- Pei-Chi Wu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
| |
Collapse
|
21
|
Chen HH, Chou YH, Lin HH, Hsiao SM. Disastrous delayed postpartum hemorrhage after 3 days of Shenghua decoction treatment. Tzu Chi Med J 2019; 32:298-300. [PMID: 32955527 PMCID: PMC7485675 DOI: 10.4103/tcmj.tcmj_192_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/08/2019] [Accepted: 09/20/2019] [Indexed: 11/04/2022] Open
Abstract
Taiwanese women frequently receive Shenghua decoction treatment for uterus involution. However, prolonged Shenghua decoction treatment can be detrimental. Herein, we report the case of a woman with disastrous postpartum hemorrhage after prolonged Shenghua decoction treatment. A 36-year-old woman underwent scheduled cesarean delivery due to cephalopelvic disproportion. On the 8th postpartum day, she started taking Shenghua decoction twice per day. Massive vaginal bleeding was noted after 3 days of Shenghua decoction treatment. Emergency hysterectomy was performed due to severe hypotension and refractory postpartum hemorrhage. Despite being rare, disastrous delayed postpartum hemorrhage could occur after 3 days of Shenghua decoction treatment. Further research might be needed to clarify the relationship between prolonged Shenghua decoction treatment and delayed postpartum hemorrhage.
Collapse
Affiliation(s)
- Hui-Hua Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yueh-Hung Chou
- Department of Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, National Taiwan University, College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, National Taiwan University, College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| |
Collapse
|
22
|
Chang TC, Hsiao SM, Wu PC, Chen CH, Wu WY, Lin HH. Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse. J Formos Med Assoc 2019; 118:1623-1632. [DOI: 10.1016/j.jfma.2019.08.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 08/22/2019] [Accepted: 08/29/2019] [Indexed: 11/27/2022] Open
|
23
|
Chen CJ, Yeoh SC, Yeh HT, Hsiao SM, Kuo HC. Surgical results in women with detrusor underactivity and stress urinary incontinence undergoing suburethral sling procedure-Predictive factors for successful outcome. Low Urin Tract Symptoms 2019; 12:143-149. [PMID: 31691485 DOI: 10.1111/luts.12293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To elucidate the treatment results and predictors for successful outcome in women with detrusor underactivity (DU) and stress urinary incontinence (SUI) undergoing suburethral sling procedure. METHODS Medical records of women with coexistent SUI and DU treated with a suburethral sling were retrospectively reviewed and we analyzed the association between treatment outcome and baseline demographics including etiology of DU and urodynamic variables. Patients who were dry and could urinate spontaneously were considered successful. Treatment failure was considered in those who were dry but needing clean intermittent catheterization (CIC) and patients who were still wet. Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) scores were used to assess the impact of surgery on the quality of life. RESULTS Among 71 patients, a successful outcome was noted in 39 (55%), failed outcome with CIC in 15 (21%), and totally treatment failure in 17 (24%). Treatment outcome did not differ among the etiology subgroups. Overall, UDI-6 and IIQ-7 scores significantly improved after surgery. Multivariable logistic regression analysis revealed that the IIQ-7 and maximum flow rate (Qmax) were two independent predictors for improvement after surgery. An IIQ-7 score ≤6, and Qmax ≥6 mL/s can predict improvement by receiver operating characteristic analysis. Qmax ≤6 mL/s can predict needing CIC after surgery. CONCLUSIONS For women with SUI and coexistent DU who underwent suburethral sling procedure, low IIQ-7 (≤6) scores and higher Qmax (≥6 mL/s) are predictors for improvement of surgical outcome. A Qmax of <6 mL/s was the only predictor for CIC after surgery.
Collapse
Affiliation(s)
| | | | - Hsin-Tzu Yeh
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hann-Chorng Kuo
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
24
|
Abstract
The process for blood donation is considered safe, but some adverse events have been reported. Risk factors for adverse events were assessed in this study.A retrospective case-control study was conducted to investigate the risk factors for adverse events after blood donation between 2010 and 2013. Variables such as gender, age, body mass index (BMI), donation status, donation volume, donation site, pre-donation systolic blood pressure (SBP), and pre-donation diastolic blood pressure were compared between donors with and without adverse events. Multiple logistic regression analysis was performed to assess the joint effects of age, gender, and donation status on adverse events.The incidence of adverse events among adult blood donations was 1287/1,253,678 (0.1%). On multivariate logistic regression analysis, blood donors aged <35 years (odds ratio [OR], 2.99, 95% confidence interval [CI], 2.57-3.48), of female gender (OR, 3.30, 95% CI, 2.62-4.15), and with first-time donor status (OR, 6.40, 95% CI, 5.17-7.93), donation of 500 mL (OR, 2.22, 95% CI, 1.83-2.69), predonation SBP <124 mm Hg (OR, 1.25, 95% CI,1.05-1.48) and BMI <24 kg/m (OR, 1.67, 95% CI, 1.42-1.96) were associated with increased likelihood of adverse event. Further analysis with joint effects method revealed that first-time female donors aged <35 years are associated with the highest odds of adverse events when compared with repeat male donors aged ≧35 years (OR, 100.57, 95% CI, 48.45-208.75).The findings of our study should prove useful in identifying donors at risk and planning appropriate strategies for the prevention of adverse effects.
Collapse
Affiliation(s)
- Hsuan-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung
- Taichung Blood Center, Taiwan Blood Services Foundation
| | - Po-Ming Chen
- Institute of Medicine, Chung Shan Medical University, Taichung
| | - Chi-Ling Lin
- Taichung Blood Center, Taiwan Blood Services Foundation
| | | | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan
| | - Jiunn-Liang Ko
- Institute of Medicine, Chung Shan Medical University, Taichung
- Department of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
25
|
Hsiao SM, Chang TC, Lin HH. The probability of re-treatment after discontinuation of a 3-month versus a 6-month course of solifenacin for female overactive bladder: A prospective randomized controlled study. Maturitas 2019; 126:11-17. [PMID: 31239111 DOI: 10.1016/j.maturitas.2019.04.216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/17/2019] [Accepted: 04/14/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study is to compare the re-treatment probabilities after a 3-month versus a 6-month course of antimuscarinic treatment for women with overactive bladder syndrome (OAB). STUDY DESIGN A prospective randomized controlled study. MAIN OUTCOME MEASURES Between-group differences in the probability of re-treatment for OAB between the 3-month and 6-month groups. METHODS Women with OAB were randomly allocated to receive solifenacin (5 mg per day) for a treatment interval of either 3 or 6 months. RESULTS Ninety-one patients were treated in each group. The probability of re-treatment did not differ between the 3-month and 6-month groups (P = 0.11). Parity (hazard ratio = 1.81, P = 0.001), number of incontinence episodes (hazard ratio = 1.09, P = 0.008) and suboptimal response (hazard ratio = 3.56, P = 0.006) were independent predictors of re-treatment of OAB. Physical limitation, as indicated on the King's Health Questionnaire, was the only independent factor predicting completion of the scheduled treatment period (odds ratio = 1.01, P = 0.008). CONCLUSIONS Prolonged antimuscarinic treatment does not decrease the need for re-treatment of OAB. Nonetheless, female patients with increased parity, more severe incontinence and a suboptimal response to antimuscarinic treatment are more likely to seek re-treatment of OAB due to recurrence of symptoms. In addition, patients with more serious physical limitation related to OAB are more likely to complete the scheduled treatment period. These findings could serve as a guide in clinical consultations regarding antimuscarinic treatment and if taken into consideration in future studies could lower the dropout rate.
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Chen Chang
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
26
|
Chen PL, Lin HH, Hsiao SM. Predictors of subsequent pregnancy in women who underwent laparoscopic cornuostomy or laparoscopic wedge resection for interstitial pregnancy. J Chin Med Assoc 2019; 82:138-142. [PMID: 30839505 DOI: 10.1097/jcma.0000000000000016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The ideal surgical procedure for interstitial pregnancy remains undetermined. The aim of this study was to assess whether surgical method is a factor in predicting subsequent pregnancy in women with interstitial pregnancy who underwent laparoscopic cornuostomy or laparoscopic wedge resection. METHODS Medical records of all women with interstitial pregnancy who underwent laparoscopic cornuostomy or laparoscopic wedge resection between March 2008 and October 2017 in a medical center were reviewed. Cox regression analysis was performed to identify factors predicting subsequent pregnancy. RESULTS Forty patients underwent laparoscopic cornuostomy (n = 14) or laparoscopic wedge resection (n = 26) for the treatment of interstitial pregnancy. Twelve women become pregnant during follow-up. Laparoscopic cornuostomy was associated with shorter operation time (coefficient = -19.1 minutes, 95% CI = -36.9 to -1.3 minutes, p = 0.04, multivariable analysis) than that of laparoscopic wedge resection. Furthermore, laparoscopic cornuostomy (hazard ratio = 6.3, p = 0.03), parity (hazard ratio = 0.18, p = 0.008), and preoperative rupture of the cornus (hazard ratio = 13.3, p = 0.005) were independent predictors of subsequent pregnancy. CONCLUSION Laparoscopic cornuostomy was associated with a higher probability of subsequent pregnancy and a shorter operation time. Thus, compared with laparoscopic wedge resection, laparoscopic cornuostomy might be a better surgical procedure for women with interstitial pregnancy, particularly for women who wish to become pregnant later. However, because of the retrospective nature and small sample size of this study, some well-defined/designed prospective studies including more patients are needed to verify our results.
Collapse
Affiliation(s)
- Pei-Ling Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan, ROC
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan, ROC
| |
Collapse
|
27
|
Chen YC, Lin HH, Hsiao SM. Comparison of robotic assisted laparoscopic myomectomy with barbed sutures and traditional laparoscopic myomectomy with barbed sutures. Taiwan J Obstet Gynecol 2019; 57:709-712. [PMID: 30342656 DOI: 10.1016/j.tjog.2018.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To elucidate whether robotic assisted laparoscopic myomectomy (RALM) with barbed sutures is superior to traditional laparoscopic myomectomy (TLM) with barbed sutures. MATERIAL AND METHODS Medical records of all women with symptomatic uterine myomas who underwent RALM with barbed sutures or TLM with barbed sutures were reviewed. The patients were allocated into the two groups based on their financial considerations. RESULTS Between July 2012 and March 2016, 78 patients underwent TLM (n = 52) or RALM (n = 26). Younger age, low parity, larger diameter of myoma and weight of removed myoma, and low incidence of prior histories of cesarean section were found in the RALM group, compared with TLM. An increase of surgical time (coefficient = 51.9 min, P < 0.001), length of hospital stay (coefficient = 0.47 days, P = 0.04) and duration of abdominal drain placement (coefficient = 0.53 days, P = 0.04) were found in the RALM group, compared with TLM. Nonetheless, there was no statistical difference in postoperative day 1 abdominal drainage between the RALM and TLM groups (median 95 mL vs. 110 mL, P = 0.21). CONCLUSION Despite longer surgical time of RALM, RALM with barbed sutures did not show a significant decrease in postoperative abdominal drainage, compared with TLM with barbed sutures; and this hints that the use of barbed suture in TLM might diminish the superiority of RALM about the decrease of postoperative blood loss. Thus, TLM with barbed sutures remains a good alternative for laparoscopic myomectomy in the era of robot.
Collapse
Affiliation(s)
- Yen-Cheng Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
28
|
Hsiao SM, Chang TC, Chen CH, Li YI, Shun CT, Lin HH. Risk factors for coexistence of cervical elongation in uterine prolapse. Eur J Obstet Gynecol Reprod Biol 2018; 229:94-97. [DOI: 10.1016/j.ejogrb.2018.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 07/12/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
|
29
|
Hsiao SM, Lin HH. Medical treatment of female overactive bladder syndrome and treatment-related effects. J Formos Med Assoc 2018; 117:871-878. [DOI: 10.1016/j.jfma.2018.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 10/18/2022] Open
|
30
|
Lee CF, Huang YC, Chi LK, Lin HM, Lin CJ, Hsiao SM. Constructing and applying an exercise counseling model for pregnant women: A preliminary study. Nurse Educ Pract 2018; 33:77-83. [PMID: 30261361 DOI: 10.1016/j.nepr.2018.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/24/2018] [Accepted: 09/11/2018] [Indexed: 11/18/2022]
Abstract
Pregnant women tend to exercise less than women who have not yet been pregnant. In the present study, which involves two studies, we aimed to construct an effective, individualized exercise counseling model for pregnant women. In study 1, a three-round session that involved 10 multidisciplinary health care experts reached a consensus via the Delphi method. In the preliminary study, two healthy pregnant women were recruited from the prenatal outpatient departments of hospitals in Taipei, Taiwan. Both of them were 32 years old and primipara. The results of study 1, the established five stages of the individualized exercise counseling model for pregnant women were as follows: assessment, defining barriers that interfere with achieving the target, planning, implementation and monitoring, and evaluation. In the preliminary study, we applied this counseling model of study 1 to 2 healthy pregnant women. The 5-stage counseling model can encourage pregnant women to begin to exercise or to continue exercising. We believe that this exercise counseling model can potentially be used by nurses. It can help them to encourage pregnant women to regularly exercise, and to promote exercise as part of a healthy lifestyle.
Collapse
Affiliation(s)
- Ching-Fang Lee
- Department of Nursing, Mackay Medical College, New Taipei, Taiwan.
| | - Yao-Chung Huang
- Physical Education Office, National Taipei University of Technology, Taipei, Taiwan.
| | - Li-Kang Chi
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan.
| | - Hsien-Ming Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
| | - Chen-Ju Lin
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei, Taiwan.
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
31
|
Liu YJ, Wu WY, Hsiao SM, Ting SWH, Hsu HP, Huang CM. Efficacy of pelvic floor training with surface electromyography feedback for female stress urinary incontinence. Int J Nurs Pract 2018; 24:e12698. [DOI: 10.1111/ijn.12698] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 04/16/2018] [Accepted: 06/30/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Ying-Ju Liu
- Department of Obstetrics and Gynecology; Far Eastern Memorial Hospital; New Taipei Taiwan
- Cardinal Tien Junior College of Healthcare and Management; New Taipei Taiwan
| | - Wen-Yih Wu
- Department of Obstetrics and Gynecology; Far Eastern Memorial Hospital; New Taipei Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology; Far Eastern Memorial Hospital; New Taipei Taiwan
- College of Medicine; National Taiwan University; Taipei Taiwan
- Graduate school of Biotechnology and Bioengineering; Yuan Ze University; Taoyuan Taiwan
| | - Stella Wan-Hua Ting
- Department of Obstetrics and Gynecology; Far Eastern Memorial Hospital; New Taipei Taiwan
| | - Hsiao-Pei Hsu
- School of Nursing; National Yang-Ming University; Taipei Taiwan
| | - Chiu-Mieh Huang
- Institute of Clinical Nursing; National Yang-Ming University; Taipei Taiwan
- Department of Nursing; National Yang-Ming University Hospital; Yilan Taiwan
| |
Collapse
|
32
|
Yen MS, Chen TH, Ke YM, Hsu KF, Chen JR, Yu MH, Fu HC, Huang CY, Chiang AJ, Chen CY, Hsiao SM, Kan YY, Liu FS. Clinicopathologic Features and Treatment Outcomes in Patients with Stage I, High-Risk Histology or High-Grade Endometrial Cancer after Primary Staging Surgery: A Taiwanese Gynecologic Oncology Group Study. J Clin Med 2018; 7:jcm7090254. [PMID: 30181460 PMCID: PMC6162812 DOI: 10.3390/jcm7090254] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 01/25/2023] Open
Abstract
To investigate the clinicopathological features and treatment outcomes in patients with stage I, high-risk endometrial cancer. Patients with International Federation of Gynecology and Obstetrics stage I, papillary serous, clear cell, or grade 3 endometrioid carcinoma treated between 2000 and 2012 were analyzed for the clinical and pathological factors in relation to prognosis. A total of 267 patients (stage IA; n = 175, stage IB; n = 92) were included. Among the clinicopathological features, stage and age were significant prognostic factors. The recurrence rate and overall survival for stage IB versus IA were 22.8% versus 9.1% (p = 0.003) and 149.7 months versus 201.8 months (p < 0.001), respectively. The patients >60 years of age also had a higher recurrence rate (21.7% versus 9.7%, p = 0.008) and poorer survival (102.0 months versus 196.8 months, p = 0.001) than those ≤60 years of age. Distant recurrence (64.9%) occurred more frequently than local recurrence (24.3%) and local combined with distant recurrence (10.8%) (p < 0.001). The postoperative treatment modality had no impact on tumor recurrence rate, recurrence site, or overall survival. Distant recurrence is a major cause of treatment failure in patients with stage I, high-risk endometrial cancer. However, current adjuvant treatment appeared to have little effect in preventing its occurrence.
Collapse
Affiliation(s)
- Ming-Shyen Yen
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan.
| | - Tze-Ho Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua 500, Taiwan.
| | - Yu-Min Ke
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
| | - Keng-Fu Hsu
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan 704, Taiwan.
| | - Jen-Ruei Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan.
| | - Mu-Hsien Yu
- Department of Obstetrics and Gynecology, Tri Service General Hospital, Taipei 114, Taiwan.
| | - Hung-Chun Fu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
| | - Chia-Yen Huang
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei 106, Taiwan.
| | - An-Jen Chiang
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
| | - Chao-Yu Chen
- Department of Obstetrics and Gynecology, ChiaYi Chang Gung Memorial Hospital, ChiaYi 613, Taiwan.
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan.
| | - Yuen-Yee Kan
- Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung 802, Taiwan.
| | - Fu-Shing Liu
- Department of Obstetrics and Gynecology, Show Chwan Memorial Hospital, Changhua 500, Taiwan.
| |
Collapse
|
33
|
Chan LM, Lin HH, Hsiao SM. Successful treatment of maternal listeria monocytogenes bacteremia in the first trimester of pregnancy: A case report and literature review. Taiwan J Obstet Gynecol 2018; 57:462-463. [PMID: 29880186 DOI: 10.1016/j.tjog.2018.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To report detailed clinical history and management of maternal listeria infection in the first trimester. CASE REPORT A 34-year-old woman at 11 gestational weeks was infected by Listeria monocytogenes with clinical symptoms of acute onset of a fever with subsequent headache and neck stiffness, and was treated with intravenous ampicillin at 2 g every 4 h for 3 weeks. A healthy, unaffected male baby was delivered at term. Histopathologic examination of the placenta did not reveal any chorioamnionitis, granulomas, microabscesses or vasculitis. The neonate developed well without any neurologic compromise at a six-week postnatal follow-up visit. CONCLUSION A favorable outcome of maternal listeria infection in the first trimester may be anticipated. Besides, intravenous ampicillin with or without gentamicin should be a reasonable treatment option for maternal listeria infection in the first trimester.
Collapse
Affiliation(s)
- Lai-Man Chan
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
34
|
Sun HD, Horng HC, Liu CH, Hsiao SM, Chen YJ, Chang WH, Wang PH. Comparison of single-port and three-port laparoscopic salpingectomy in the management for tubal pregnancy. J Chin Med Assoc 2018; 81:469-474. [PMID: 29233482 DOI: 10.1016/j.jcma.2017.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 10/17/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND To compare the short-term outcome of patients undergoing single-port laparoscopic salpingectomy (SP-LS) and conventional three-port laparoscopic salpingectomy (C-LS). METHODS A retrospective evaluation of 112 patients with tubal pregnancies treated by one surgeon at a single teaching hospital. Among these, 47 patients were treated with SP-LS and the remaining 65 were treated with C-LS. RESULTS The characteristics of patients were similar in both groups. There were no statistically significant differences in operative time, estimated blood loss, intraoperative and immediate postoperative complications, and length of hospital stay between both groups. Time to bowel recanalization (6.2 ± 1.0 vs. 7.2 ± 1.4 h, p < 0.05) and postoperative visual analog scale for pain scores (3.0 ± 0.5 vs. 3.6 ± 0.6, p < 0.005) were significantly lower in the SP-LS group compared with those in the C-LS group. CONCLUSION Our study demonstrated the feasibility to use the single-port laparoscopic salpingectomy in the management of women with tubal pregnancy, which showed the similar or better outcome compared with the use of conventional three-port laparoscopic salpingectomy.
Collapse
Affiliation(s)
- Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC; Department of Obstetric and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Huann-Cheng Horng
- Department of Obstetric and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chia-Hao Liu
- Department of Obstetric and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
| | - Yi-Jen Chen
- Department of Obstetric and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Department of Obstetric and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC.
| |
Collapse
|
35
|
Chen PL, Jhuang JY, Lin HH, Hsiao SM. Successful treatment of gestational trophoblastic neoplasia in the uterine cornus with laparoscopic cornuostomy and postoperative methotrexate injection. Taiwan J Obstet Gynecol 2017; 56:261-263. [PMID: 28420522 DOI: 10.1016/j.tjog.2016.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Management of cornual gestational trophoblastic neoplasia (GTN) has never been reported. Here, we describe the first case of cornual GTN. CASE REPORT A 32-year-old woman was diagnosed with left cornual GTN after evacuation of a complete mole. Laparoscopic cornuostomy was performed with intramural vasopression injection and barbed sutures. Histopathology revealed hydropic chorionic villi. Complete hydatidiform mole was diagnosed, and treated with adjuvant methotrexate, to address the poor decline of β-human chorionic gonadotropin levels during follow-up. The β- human chorionic gonadotropin levels declined to < 1 mIU/mL 9 months after cornuostomy. She successfully conceived 16 months after cornuostomy, and underwent cesarean section at 37 gestational weeks due to concomitant severe preeclampsia. CONCLUSION Cornual GTN can be successfully managed with laparoscopic cornuostomy and adjuvant methotrexate.
Collapse
Affiliation(s)
- Pei-Ling Chen
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jie-Yang Jhuang
- Department of Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
36
|
Ting WH, Peng FS, Lin HH, Hsiao SM. The impact of situation-background-assessment-recommendation (SBAR) on safety attitudes in the obstetrics department. Taiwan J Obstet Gynecol 2017; 56:171-174. [PMID: 28420502 DOI: 10.1016/j.tjog.2016.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2016] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Previous studies evaluating the situation-background-assessment-recommendation (SBAR) have been shown to increase effective nurse-physician communication and collaboration. The purpose of this study is to evaluate the impact of the SBAR technique on safety attitudes in the obstetrics department. MATERIALS AND METHODS This study implemented the SBAR Collaborative Communication Education course and was conducted in a medical center from February 2012 to March 2015, which included an educational session on fetal heart rate monitoring, a case-based discussion, and a video demonstration on traditional and SBAR communication. The nurses in the obstetrics department were requested to report their clinical findings and recommendations using a novel SBAR list when abnormal fetal heart beat tracings occurred. All obstetric nurses were requested to complete the Chinese-version of the Safety Attitudes Questionnaire before and after the SBAR educational course. The primary outcome was to evaluate the effect of the SBAR technique on the safety attitudes of the obstetrics department. The secondary outcome was to evaluate the effect of the SBAR technique on the 5-minute Apgar score for neonates. RESULTS Most values, including teamwork climate, safety climate, job satisfaction, and working conditions, significantly improved at both postintervention surveys compared with the preintervention survey. There were no significant differences in the number of the neonates with less than seven 5-minute Apgar scores between the pre- and postintervention periods. CONCLUSION The SBAR technique, which uses a novel structured handover list, is a feasible tool for nurse-obstetrician communication, and it may improve most dimensions of safety attitudes in the obstetrics department.
Collapse
Affiliation(s)
- Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei, Taiwan
| | - Fu-Shiang Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
37
|
Tsai KH, Hsiao SM, Lin HH. Tolterodine treatment of women with overactive bladder syndrome: Comparison of night-time and daytime dosing for nocturia. J Obstet Gynaecol Res 2017; 43:1719-1725. [PMID: 28714288 DOI: 10.1111/jog.13438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 05/03/2017] [Accepted: 05/28/2017] [Indexed: 11/29/2022]
Abstract
AIM We aimed to clarify the impact of night-time dosing with tolterodine extended release (ER) on nocturia. METHODS The bladder diaries, urodynamic studies, and medical records of female patients with overactive bladder syndrome who were diagnosed between January 2005 and December 2015, and treated with tolterodine ER 4 mg once per day (night-time or daytime dosing) for 12 weeks in the urogynecology outpatient clinics of two tertiary referral centers were reviewed retrospectively. RESULTS A total of 72 female patients were reviewed. Thirty-six patients were in the daytime dosing group, and the other 36 patients were in the night-time dosing group. In the daytime dosing group, a decrease in the volume of fluid intake was found at 06.00-12.00, 12.00-18.00, and 18.00-24.00 hours, and a decrease in total voided volume was found at 12.00-18.00, 18.00-24.00, and 24.00-06.00 hours with a between-group difference at 18.00-24.00 hours (coefficient = 542 mL, P = 0.01). In the night-time dosing group, an increase in voided volume per micturition was found at 06.00-12.00 and 24.00-06.00 hours with a between-group difference at 24.00-6.00 hours (coefficient = 92 mL, P = 0.003) compared with the daytime dosing group. Nonetheless, pre-treatment proportions of nocturnal polyuria did not differ from post-treatment proportions (night-time: 20% vs 20%, P = 1.00; daytime: 48% vs 42%, P = 0.48). Decreases in the number of voiding and urgency episodes at nearly all time periods and increases in the volumes at strong desire to void were also found in both groups. CONCLUSION Night-time dosing of tolterodine ER may benefit female patients suffering from nocturia due to a greater voided volume per micturition at midnight.
Collapse
Affiliation(s)
- Ko-Hsin Tsai
- Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan
| |
Collapse
|
38
|
Chen MW, Yang ST, Chien MH, Hua KT, Wu CJ, Hsiao SM, Lin H, Hsiao M, Su JL, Wei LH. The STAT3-miRNA-92-Wnt Signaling Pathway Regulates Spheroid Formation and Malignant Progression in Ovarian Cancer. Cancer Res 2017; 77:1955-1967. [PMID: 28209618 DOI: 10.1158/0008-5472.can-16-1115] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 12/22/2016] [Accepted: 01/09/2017] [Indexed: 11/16/2022]
Abstract
Ovarian cancer spheroids constitute a metastatic niche for transcoelomic spread that also engenders drug resistance. Spheroid-forming cells express active STAT3 signaling and display stem cell-like properties that may contribute to ovarian tumor progression. In this study, we show that STAT3 is hyperactivated in ovarian cancer spheroids and that STAT3 disruption in this setting is sufficient to relieve chemoresistance. In an NSG murine model of human ovarian cancer, STAT3 signaling regulated spheroid formation and self-renewal properties, whereas STAT3 attenuation reduced tumorigenicity. Mechanistic investigations revealed that Wnt signaling was required for STAT3-mediated spheroid formation. Notably, the Wnt antagonist DKK1 was the most strikingly upregulated gene in response to STAT3 attenuation in ovarian cancer cells. STAT3 signaling maintained stemness and interconnected Wnt/β-catenin signaling via the miR-92a/DKK1-regulatory pathways. Targeting STAT3 in combination with paclitaxel synergistically reduced peritoneal seeding and prolonged survival in a murine model of intraperitoneal ovarian cancer. Overall, our findings define a STAT3-miR-92a-DKK1 pathway in the generation of cancer stem-like cells in ovarian tumors, with potential therapeutic applications in blocking their progression. Cancer Res; 77(8); 1955-67. ©2017 AACR.
Collapse
Affiliation(s)
- Min-Wei Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Ting Yang
- National Institute of Cancer Research, National Health Research Institute, Zhunan, Miaoli County, Taiwan
| | - Ming-Hsien Chien
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Tai Hua
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chin-Jui Wu
- Department of Obstetrics & Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - S M Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Hao Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Michael Hsiao
- Medical Biology, Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Jen-Liang Su
- National Institute of Cancer Research, National Health Research Institute, Zhunan, Miaoli County, Taiwan. .,Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan.,Department of Biotechnology, Asia University, Taichung, Taiwan.,Center for Molecular Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Lin-Hung Wei
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. .,Department of Obstetrics & Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
39
|
Ting WH, Lin HH, Hsiao SM. Spontaneous transvaginal ileum evisceration: a case report. Int Urogynecol J 2017; 28:1107-1108. [PMID: 28150027 DOI: 10.1007/s00192-017-3274-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 01/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, Taiwan. .,Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan. .,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
| |
Collapse
|
40
|
Twu NF, Ou YC, Liao CI, Chang WY, Yang LY, Tang YH, Chen TC, Chen CH, Chen TH, Yeh LS, Hsu ST, Chen YC, Chang CC, Cheng YM, Huang CY, Liu FS, Lin YS, Hsiao SM, Kan YY, Lai CH. Prognostic factors and adjuvant therapy on survival in early-stage cervical adenocarcinoma/adenosquamous carcinoma after primary radical surgery: A Taiwanese Gynecologic Oncology Group (TGOG) study. Surg Oncol 2016; 25:229-35. [DOI: 10.1016/j.suronc.2016.05.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/20/2016] [Indexed: 11/28/2022]
|
41
|
Hsiao SM, Lin HH, Kuo HC. Treatment Outcome of Overactive Bladder Patients Receiving Antimuscarinic Therapy for More than One Year. Low Urin Tract Symptoms 2016; 10:21-26. [PMID: 27515567 DOI: 10.1111/luts.12136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/01/2016] [Accepted: 03/22/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Details on the therapeutic effects of long-term antimuscarinic therapy have not been reported. Thus, the aim of this study is to evaluate the detailed long-term therapeutic effect of antimuscarinic therapy. METHODS All consecutive patients who visited the urologic outpatient clinics of a medical center for treatment of overactive bladder syndrome and received antimuscarinic therapy of 12 months or more were retrospectively reviewed. All medical records, including the Overactive Bladder Symptom score (OABSS), the modified Indevus Urgency Severity Scale and the International Prostate Symptoms score (IPSS) questionnaires, and uroflowmetry parameters were reviewed at each visit. RESULTS A total of 140 patients had received 12 months or more of antimuscarinic therapy. Sustained therapeutic effects were observed by persistent decreases of IPSS-storage score, IPSS-total score and OABSS score. Moreover, the maximum flow rate did not change over time. A temporary increase in postvoid residual volume and decrease in voiding efficiency were found, but these parameters improved over long-term visits. Side-effects were observed in 81 patients (57.9%) and included dry mouth (n = 58, 41.4%), constipation (n = 48, 34.3%) and blurred vision (n = 4, 2.9%); all side-effects were tolerable. Patients aged 75 years or more (n = 94) had a higher comorbidity rate (n = 46, 48.9%) before treatment but generally exhibited similar therapeutic effects as overall patients; elderly patients could also tolerate side-effects. CONCLUSION Sustained therapeutic effects were observed in patients who received 12 months or more of antimuscarinic therapy, even in elderly patients. In addition, side-effects in patients receiving long-term therapy were also common but tolerable.
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
42
|
Peng FS, Lin HM, Lin HH, Tu FC, Hsiao CF, Hsiao SM. Impact of clinical audits on cesarean section rate. Taiwan J Obstet Gynecol 2016; 55:530-3. [DOI: 10.1016/j.tjog.2014.12.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 10/21/2022] Open
|
43
|
Wang CC, Wu SY, Hsiao SM, Kuo HC. MP65-14 FACTORS ASSOCIATED WITH THERAPEUTIC EFFICACY OF INTRAVESICAL ONABOTULINUMTOXINA INJECTION FOR OVERACTIVE BLADDER SYNDROME. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
44
|
Chen JR, Chang TC, Fu HC, Lau HY, Chen IH, Ke YM, Liang YL, Chiang AJ, Huang CY, Chen YC, Hong MK, Wang YC, Huang KF, Hsiao SM, Wang PH. Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG-2005) Retrospective Cohort Study (A STROBE-Compliant Article). Medicine (Baltimore) 2016; 95:e3330. [PMID: 27082583 PMCID: PMC4839827 DOI: 10.1097/md.0000000000003330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n = 464; stage IV, n = 77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P = 0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P < 0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P < 0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P < 0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P < 0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P < 0.001, and HR 0.14, 95% CI 0.08-0.26; P < 0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P = 0.017, and HR 0.48; 95% CI 0.31-0.75; P = 0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.
Collapse
Affiliation(s)
- Jen-Ruei Chen
- From the Department of Obstetrics and Gynecology, MacKay Memorial Hospital and MacKay Junior College of Medicine, Nursing and Management, Taipei (J-RC); Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan (T-CC); Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung (H-CF); Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei (H-YL, P-HW); Department of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu (I-HC), Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung (Y-MK), Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan (Y-LL); Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung (A-JC); Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei (C-YH); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (C-YH); Department of Obstetrics and Gynecology, Kaohsiung Medical University Chung-Ho Memorial Hospital and Kaohsiung Medical University, Kaohsiung (Y-CC), Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien (M-KH), Department of Obstetrics and Gynecology, Tri-Service General Hospital and National Defense Medical Center (Y-CW); Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan (K-FH); Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City (S-MH); Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei (H-YL, P-HW); and Department of Medical Research, China Medical University Hospital, Taichung (P-HW), Taiwan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Sun HD, Hsiao SM, Chen YJ, Wen KC, Li YT, Wang PHP. Advanced endocervical adenocarcinoma metastatic to the ovary presenting as primary ovarian cancer. Taiwan J Obstet Gynecol 2016; 54:201-3. [PMID: 25951731 DOI: 10.1016/j.tjog.2014.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2014] [Indexed: 01/19/2023] Open
Affiliation(s)
- Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yi-Jen Chen
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuo-Chang Wen
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yiu-Tai Li
- Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan.
| | - Peng-Hui Peter Wang
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University School of Nursing, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
46
|
Hsiao SM, Lin HH, Kuo HC. Factors Associated with Therapeutic Efficacy of Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Syndrome. PLoS One 2016; 11:e0147137. [PMID: 26824901 PMCID: PMC4732812 DOI: 10.1371/journal.pone.0147137] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 11/16/2015] [Indexed: 01/22/2023] Open
Abstract
Objectives To analyze the predictors of therapeutic efficacy after intravesical botulinum toxin A injection for overactive bladder syndrome (OAB) refractory to antimuscarinic therapy. Methods All consecutively OAB patients, who visited the urologic outpatient clinics of a medical center and refractory to antimuscarinic treatment, were prospectively enrolled. All enrolled patients received intravesical injection of 100 U onabotulinumtoxinA (Botox). The Global Response Assessment (GRA) score ≥ 2 at 3 months after Botox injection was defined as a successful treatment, otherwise failed. Results Overall, 89 patients received intravesical injection. Eighty patients, including 42 men and 38 women, had received follow-up at 3 months. The overall success rate was 63.8%. The global response assessment, urgency severity score, urgency, urgency urinary incontinence and frequency episodes, and functional bladder capacity improved after treatment. However, post-void residual volume (PVR) increased, and voiding efficiency (VE) decreased after treatment. Female gender (odds ratio = 3.75) was the only independent factor associated with the success. Female gender (coefficient = 0.74), low baseline overactive bladder symptoms score (coefficient = -0.12) and the presence of OAB-wet (coefficient = 0.79) were independent factors associated with therapeutic efficacy (i.e., GRA score). VE (odds ratio = 0.062) was the only predictor for a large PVR at 3 months. The optimum cutoff value of VE was <87% with the area under the ROC curve being 0.64 (sensitivity = 63.8%, specificity = 57.1%). Conclusions The therapeutic effects of Botox can persist till 6 months after treatment. Female gender, low overactive bladder symptoms score and OAB-wet are associated better therapeutic efficacy, and low baseline VE is associated with large PVR. These findings can serve as an initial guide or assist in consultation regarding the treatment of OAB patients with Botox injection. Trial Registration ClinicalTrials.gov NCT01657409
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
- * E-mail:
| |
Collapse
|
47
|
Chen CH, Hsiao SM, Chang TC, Wu WY, Lin HH. Clinical and urodynamic effects of baclofen in women with functional bladder outlet obstruction: Preliminary report. J Obstet Gynaecol Res 2016; 42:560-5. [PMID: 27108667 DOI: 10.1111/jog.12932] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/23/2015] [Accepted: 11/22/2015] [Indexed: 11/29/2022]
Abstract
AIM To investigate the efficacy and urodynamic effects of baclofen in women with functional bladder outlet obstruction. METHODS Between January 2011 and December 2012, women who underwent baclofen treatment for functional bladder outlet obstruction, defined as <15 mL/s maximum flow rate and >20 cmH2 O detrusor pressure at maximum flow rate, but without significant anatomic causes, were retrospectively reviewed. Urodynamic variables at baseline and after 12 weeks of treatment were compared. RESULTS Twenty women with functional bladder outlet obstruction underwent 12 weeks of baclofen treatment (oral baclofen 5 mg, three times daily). All patients reported improvement in voiding dysfunction symptoms after treatment, and no significant adverse effects were found on review of medical records. All patients underwent urodynamic studies after 12 weeks' treatment. Voided volume, voiding efficiency and maximum flow rate at voiding cystometry were significantly improved (mean, 273 vs. 368 mL, P = 0.002; 62.8% vs. 73.6%, P <0.001, and 10.3 vs. 11.6 mL/s, P = 0.046; respectively). Moreover, baclofen did not affect continence function, as indicated by non-significant changes in the parameters of urethral pressure profiles. CONCLUSIONS Oral baclofen can improve symptoms of voiding dysfunction, voided volume, voiding efficiency and maximum flow rate in women with functional bladder outlet obstruction. None of the patients experienced intolerable side-effects. Thus, oral baclofen may be used as an initial treatment for women with symptoms of voiding dysfunction.
Collapse
Affiliation(s)
- Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, New Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan
| | - Ting-Chen Chang
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, New Taipei, Taiwan
| | - Wen-Yih Wu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, New Taipei, Taiwan
| |
Collapse
|
48
|
Lu HF, Peng FS, Chen SU, Chiu BC, Yeh SH, Hsiao SM. A Preliminary Report of A Low-Dose Step-Up Regimen of Recombinant Human FSH for Young Women Undergoing Ovulation Induction with IUI. Int J Fertil Steril 2015; 9:436-41. [PMID: 26985331 PMCID: PMC4793164 DOI: 10.22074/ijfs.2015.4600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 06/11/2014] [Indexed: 11/17/2022]
Abstract
Background The aim of this study was to evaluate the efficacy and safety of a recombinant human follicle stimulating hormone (r-FSH) low-dose step-up regimen for
controlled ovarian hyperstimulation in patients undergoing ovulation induction (OI) with
intrauterine insemination (IUI). Materials and Methods The study was conducted in the Department of Obstetrics and
Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan. In this prospective,
observational study, consecutive infertile women (20-35 years) with regular menstrual
cycles and a normal baseline FSH level were prospectively enrolled between January
2010 and September 2010. A starting dose of 112.5 IU/day r-FSH was administered on
day 3 and increased by 37.5 IU/day every 2 days until a follicle ≥11 mm in diameter was
present. Recombinant human chorionic gonadotropin (r-hCG) was administered when a
follicle ≥18 mm was noted. Monifollicular development was defined as only one follicle
with a diameter ≥16 mm. Clinical pregnancy was defined as a pregnancy diagnosed by
ultrasonographic visualization of one or more gestational sacs. Results A total of 29 women and 30 cycles were included. The mean daily dose of
r-FSH to achieve a follicle of ≥11 mm in diameter was 131.3 ± 23.6 IU and the mean
total dose was 1030.0 ± 383.2 IU. Approximately 41% of the cycles were monofollicular. Clinical pregnancy was observed in 9 (30.0%) cycles, and a fetal heart beat
was observed in 7 (23.3%). There were no multiple pregnancies. Mild ovarian hyperstimulation syndrome, which was resolved with conservative management, was
observed in 3 (10.0%) cycles. Conclusion This r-FSH low-dose step-up regimen seems to be a feasible and practical
method for OI in younger infertile women undergoing IUI.
Collapse
Affiliation(s)
- Hsin-Fen Lu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Fu-Shiang Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Shee-Uan Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Bao-Chu Chiu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Szu-Hsing Yeh
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| |
Collapse
|
49
|
Ting WH, Peng FH, Lin HH, Lu HF, Hsiao SM. Factors influencing the abortion interval of second trimester pregnancy termination using misoprostol. Taiwan J Obstet Gynecol 2015; 54:408-11. [DOI: 10.1016/j.tjog.2014.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 10/23/2022] Open
|
50
|
Ting WH, Lin HH, Wu MP, Tu FC, Peng FS, Hsiao SM. Safety and efficacy of manual syringe infusion of distending media for hysteroscopic procedures: a case-control study. Eur J Obstet Gynecol Reprod Biol 2015; 191:112-5. [PMID: 26115055 DOI: 10.1016/j.ejogrb.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/26/2015] [Accepted: 06/03/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Adverse events associated with large volumes of distending media in hysteroscopic procedures can be life-threatening. The aim of this study was to evaluate the safety and efficacy of manual syringe infusion (MI) of distending media for hysteroscopic procedures. STUDY DESIGN Between January 2011 and December 2013, the medical records of all women who underwent hysteroscopic procedures using MI or the conventional pump-infusion method (PI, the control group) were reviewed. The Wilcoxon rank-sum test, the Chi-square test and the multivariate logistic regression analysis were employed for statistical analysis. RESULTS The MI group (n=82) had a significantly lower average volume of infused fluid (1117 ± 712 mL vs. 2216 ± 1502 mL, respectively; p<0.001), less operative time (22.2 ± 9.7 vs. 30.4 ± 9.8 min, respectively; p<0.001) and lower postoperative abdominal pain scores (0.6 ± 0.7 vs. 0.8 ± 0.7, respectively; p=0.04) than the PI group (n=58). Subgroup analysis of women who underwent hysteroscopic myomectomy revealed a significantly lower amount of infused fluid for the MI group than for the PI group (1737 ± 905 mL vs. 3441 ± 1952 mL, respectively; p=0.001). Infused fluid amount (coefficient=0.08, p<0.001) was the only significant independent factor affecting fluid deficit, with a constant of 76.1. CONCLUSION The MI method appears to be a safe and feasible method for delivering distending media during hysteroscopic procedures.
Collapse
Affiliation(s)
- Wan-Hua Ting
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei City, Taiwan
| | - Ming-Ping Wu
- Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Fung-Chao Tu
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan
| | - Fu-Shiang Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan.
| |
Collapse
|