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Objective: To evaluate operative and nonoperative therapies for cesarean scar defects (CSDs).Methods: A prospective study was conducted among patients who underwent treatment of CSDs at a hospital in Shanghai, China, between April 1, 2010, and December 31, 2014. Treatment included laparoscopy (group 1), vaginal surgery (group 2), hysteroscopy (group 3), combined oral contraceptives (group 4), and the levonorgestrel intrauterine system (group 5).Results: Among 142 participants, 119 patients underwent surgical repair and 23 received nonsurgical (conservative) treatment. Operation time, blood loss, and length of hospital stay reported for patients in group 3 (n=19) were all lower than those reported for patients in group 1 (n=86) and group 2 (n=14; P<0.001 for all comparisons). Patients who underwent surgery and those in group 4 (n=18) experienced shortened menstrual periods after treatment (P<0.001 for all comparisons). For group 5 (n=5), the duration of menstruation was similar before and after therapy (P=0.89). All 32 women who desired fertility underwent laparoscopy; 12 (37.5%) became pregnant after this procedure.Conclusion: All treatments for CSDs other than the levonorgestrel intrauterine system shortened menstrual periods. Laparoscopic surgery was effective for patients with fertility requirements. [ABSTRACT FROM AUTHOR]

Objective: To compare the specific effects of 2 female sterilization methods: the modified Uchida technique and the application of silver clips.Methods: A total of 2198 women living in rural areas who were still of reproductive age but opting for sterilization were enrolled. The participants were randomly divided into 2 groups, and underwent sterilization by either modified Uchida technique or silver clips. Information on acceptability, operation conditions, effectiveness, adverse effects, and complaints was collected 3, 6, and 12 months after the procedure.Results: No significant difference in effectiveness, adverse effects or chief complaints between the 2 procedures was found. Differences in operative outcome, bleeding volume during the procedure, and operation time were found.Conclusion: A shorter operation time and less bleeding for the silver clip method indicated that female sterilization by this technique was as safe as that by modified Uchida technique. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of the tension-free vaginal tape (TVT) and transobturator suburethral tape (TVT-O) procedures for the treatment of mild and moderate stress urinary incontinence (SUI).Methods: A total of 56 women were randomly selected to undergo the TVT-O or the TVT procedure. In some patients, vaginal repair or vaginal hysterectomy was done simultaneously for associated indications.Results: Mean blood loss and hospital stay duration were the same for the 2 groups, but mean +/- SD operative time was significantly shorter in the TVT-O than in the TVT group (16+/-4 min vs 27+/-6 min; P<0.001). On the second day following surgery a residual urine volume less than 100 mL was noted in 86% and 89% of the patients in the TVT-O and TVT groups, respectively; cure was achieved in 92.9% and 92.6% of the patients. No serious complications occurred in either group. Outcome was subjectively assessed, with the patients followed-up for a mean of 27.6 months.Conclusion: No significant differences in rates of cure, postoperative urine retention, or operative complications were found following the TVT-O or the TVT procedure. [ABSTRACT FROM AUTHOR]