1
|
Manciulli T, Marangoni D, Salas-Coronas J, Bocanegra C, Richter J, Gobbi F, Motta L, Minervini A, Bartoloni A, Zammarchi L. Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature. Infection 2023; 51:1185-1221. [PMID: 37466786 PMCID: PMC10545601 DOI: 10.1007/s15010-023-02060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition. METHODS A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria. MAIN RESULTS In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented. CONCLUSIONS The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.
Collapse
Affiliation(s)
- Tommaso Manciulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Davide Marangoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Cristina Bocanegra
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University Berlin and Berlin Health Institute, Berlin, Germany
| | - Federico Gobbi
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Leonardo Motta
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy.
| |
Collapse
|
2
|
Misiak M, Dworak M, Wyszomirska M, Kurt M, Walędziak M, Różańska-Walędziak A. Gynecological Fistulae-Has Anything Changed in the Diagnosis and Treatment over the Last Decade? A Narrative Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1455. [PMID: 37629745 PMCID: PMC10456619 DOI: 10.3390/medicina59081455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/21/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Gynecological fistulae are a rare but severe complication of radiation therapy, pelvic surgery, prolonged labor, cesarean deliveries, or inflammatory bowel diseases. A gynecological fistula is an abnormal pathway formed between the urinary and gynecological tract, most commonly located between the urinary bladder and vagina. Vesico-uterine and vesicovaginal fistulae are an important health issue, common in women of reproductive age in developing countries with limited access to obstetrical care. Various surgical techniques have been described for VVF repair, depending on the location, severity, and cause of the fistula and the surgeon's experience. The purpose of our review was to evaluate the present state of knowledge about the prevalence and treatment of gynecological fistulae. The PubMed scientific database was searched for original articles on the subject of gynecological fistulae that had been published between 2013 and 2023.
Collapse
Affiliation(s)
- Marek Misiak
- Interdisciplinary Students Association of Metabolic and Systemic Disease “Salus Aegroti” Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland; (M.M.); (M.D.); (M.W.); (M.K.)
| | - Michalina Dworak
- Interdisciplinary Students Association of Metabolic and Systemic Disease “Salus Aegroti” Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland; (M.M.); (M.D.); (M.W.); (M.K.)
| | - Małgorzata Wyszomirska
- Interdisciplinary Students Association of Metabolic and Systemic Disease “Salus Aegroti” Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland; (M.M.); (M.D.); (M.W.); (M.K.)
| | - Maria Kurt
- Interdisciplinary Students Association of Metabolic and Systemic Disease “Salus Aegroti” Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland; (M.M.); (M.D.); (M.W.); (M.K.)
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine—National Research Institute, Szaserów 128 St., 04-141 Warsaw, Poland
| | - Anna Różańska-Walędziak
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland;
| |
Collapse
|
3
|
Shams M, Khazaei S, Ghasemi E, Nazari N, Javanmardi E, Majidiani H, Bahadory S, Anvari D, Fatollahzadeh M, Nemati T, Asghari A. Prevalence of urinary schistosomiasis in women: a systematic review and meta-analysis of recently published literature (2016-2020). Trop Med Health 2022; 50:12. [PMID: 35093180 PMCID: PMC8800356 DOI: 10.1186/s41182-022-00402-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Urinary schistosomiasis is a serious threat in endemic territories of Africa and the Middle East. The status of female urinary schistosomiasis (FUS) in published literature between 2016 and 2020 was investigated. METHODS A systematic search in PubMed, Scopus, Google Scholar, and Web of Science, based on the 'Preferred Reporting Items for Systematic Reviews and Meta-analyses' checklist, and a meta-analysis using random-effects model to calculate the weighted estimates and 95% confidence intervals (95% CIs) were done. RESULTS Totally, 113 datasets reported data on 40,531 women from 21 African countries, showing a pooled prevalence of 17.5% (95% CI: 14.8-20.5%). Most studies (73) were performed in Nigeria, while highest prevalence was detected in Mozambique 58% (95% CI: 56.9-59.1%) (one study). By sample type and symptoms, vaginal lavage [25.0% (95% CI: 11.4-46.1%)] and hematuria 19.4% (95% CI: 12.2-29.4%) showed higher FUS frequency. Studies using direct microscopy diagnosed a 17.1% (95% CI: 14.5-20.1%) prevalence rate, higher than PCR-based studies 15.3% (95% CI: 6.1-33.2%). Except for sample type, all other variables had significant association with the overall prevalence of FUS. CONCLUSIONS More studies are needed to evaluate the true epidemiology of FUS throughout endemic regions.
Collapse
Affiliation(s)
- Morteza Shams
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Sasan Khazaei
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ezatollah Ghasemi
- Department of Medical Parasitology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Naser Nazari
- Department of Parasitology and Mycology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Erfan Javanmardi
- Clinical Research Development Center, "The Persian Gulf Martyrs" Hospital of Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hamidreza Majidiani
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Davood Anvari
- Department of Parasitology, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
- School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Mohammad Fatollahzadeh
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Taher Nemati
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asghari
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|