The aim of this study is to evaluate the efficacy and feasibility of concomitant pelvic reconstructive surgery with tension-free vaginal tape (TVT) procedure to treat pelvic organ prolapse women with urodynamic stress incontinence (USI) or occult USI. Seventy-five women with pelvic organ prolapse and diagnosed as USI or occult USI were enrolled in this study. All patients with USI or occult USI underwent TVT treatment under general anesthesia, combined with transvaginal total hysterectomy (VTH), anterior-posterior colporrhaphy (APC), and/or right sacrospinous ligament suspension (SSS) reconstructive surgeries. The subjective assessment was evaluated by using a visual analog scale (VAS) score and a urinary symptomatic questionnaire. The objective assessment was carried out with a 1-h pad test, cough stress test, and urodynamic examination. Of the 75 patients, 35 patients with grade III uterine prolapse underwent VTH and APC, 30 patients with grade IV uterine prolapse underwent VTH, SSS, and APC, and the other 10 patients who had previous hysterectomy with total vaginal vault prolapse underwent SSS and APC. The mean follow-up interval was 25 months (12-42 months). The mean hospitalization was 5.9 days and the mean catheterization time was 3.8 days. The subjective success rate for the treatment of urine incontinence was 88%, and the objective complete cure rate was 84%. The rate of postoperative complications with persistent urinary urgency, de novo detrusor overactivity, dysfunctional voiding, and tape erosion were 50, 8, 12, and 1.3%, respectively. There were no bladder perforations during the TVT procedure and no perioperative complications requiring conversion to laparotomy. Pelvic organ prolapse women with USI or occult USI can be treated by reconstructive surgeries combined with a TVT procedure to treat and prevent postoperative USI.

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Traditional lecture-based learning (LBL) can increase cancer awareness in undergraduates. However, because of the rapidly changing knowledge base in medicine, undergraduates must develop skills required for lifelong self-directed learning (SDL). Problem-based learning (PBL) has been suggested as an SDL approach. This study used a nonequivalent control group with a pretest-posttest design for comparing PBL and LBL for their effectiveness in increasing cancer awareness and SDL among nonmedicine or nonnursing major undergraduates in a health-related general education course. Experimental groups 1 and 2 were instructed using PBL while the control group was instructed using LBL. Cancer educational programs were offered to experimental group 1 and the control group but not to experimental group 2. Among the 325 undergraduates who completed a questionnaire regarding cancer awareness and SDL in the pretest, 223 completed the 12-week follow-up survey of the posttest. Cancer awareness significantly improved between the pretest and posttest in the control group (P < 0.001). No significant difference in cancer awareness improvement was observed between experimental group 1 and the control group (P = 0.934). Cancer awareness improvement in experimental group 2 was significantly less than in the control group (P = 0.010). No statistically significant change in SDL was observed in the control group during the study (P = 0.897). However, the SDL of experimental groups 1 and 2 improved more significantly than that of the control group (P = 0.049 and 0.023, respectively). Therefore, PBL is an effective method of increasing cancer awareness and SDL in undergraduates.