BACKGROUND: After radical hysterectomy for cervical cancer, the most common complication is lower urinary tract symptoms. Post-operatively, bladder capacity can alter bladder function for a prolonged period. This study aimed to identify factors affecting bladder storage function. METHODS: A multicenter, retrospective cohort study was conducted. Information of patients with stages IA2 to IIB cervical cancer with urodynamic study results were retrospectively collected from nine hospitals between June 2013 and June 2018 according to the inclusion criteria. Demographic, surgical, and oncological data were collected. The univariate and multivariate logistic regression was used to identify clinical factors associated with bladder storage function. RESULTS: Two hundred and three patients with cervical cancer had urodynamic testing post-operatively. Ninety-five (46.8%) patients were diagnosed with stress urinary incontinence (SUI). The incidence of low bladder compliance (LBC) was 23.2%. Twenty-seven (13.3%) patients showed detrusor overactivity (DO). Fifty-seven patients (28.1%) presented with a decreased maximum cystometric capacity (DMCC). The probability of composite bladder storage dysfunction was 68.0%. Multivariate analysis confirmed that laparoscopy represents a protective factor for SUI with an odds ratio of 0.498 (P = 0.034). Patients who underwent a nerve-sparing procedure were less odds to experience SUI (P = 0.014). A significant positive correlation between LBC and DO was observed (P < 0.001). A greater length of the resected vagina and chemoradiotherapy were common risk factors for LBC and DO, while radiotherapy exerted a stronger effect than chemotherapy. Additionally, patients who received chemoradiotherapy frequently developed a DMCC. The follow-up time was not correlated with bladder storage function. CONCLUSION A nerve-sparing procedure without longer resected vagina is recommended for protecting the bladder storage function.

Helicobacterpylori (H.pylori) infection is associated with various gastric and extra-gastric diseases.Importantly,this infection is the strongest known risk factor for gastric cancer (GC).H.pylori eradication can effectively prevent H.pylori infectionassociated diseases in H.pylori-positive patients,including children and elderly subjects.However,a limited selection of antibiotics,a higher reinfection rate,and certain spontaneous clearance rates,to some extent,restrict the choice ofH.pylori treatments in pediatrics.In addition,it is imperative to perform an accurate diagnosis of H.pylori infection in children by determining the presence of the H.pylori infection and the underlying cause of symptoms.In elderly patients,poor tolerance to drugs and higher sensitivity to adverse effects are major concerns during H.pylori therapy.Recent studies have demonstrated that H.pylori eradication could significantly lower the GC risk in the elderly population.The benefit and risk of H.pylori eradication in elderly patients should be comprehensively considered and balanced.If available,susceptibility-based tailored therapies may be preferable in eradicating H.pylori.In addition,to increase the eradication rate and reduce adverse effects,new therapeutic strategies (e.g.,probiotic supplementation,berberine supplementation,dual therapy) for H.pylori infection are being extensively investigated.The impact ofH.pylori eradication with antibiotics on the microbiota in children has been explored,but further high-quality studies are crucial to delineate the extent ofH.pylori eradication affecting the microbial community in children.In this review,we summarize the current understanding of H.pylori diagnosis and treatment in children and the elderly population and aim to provide insights into the efficient management and treatment implementation in these populations.

Helicobacterpylori (H.pylori) infection is associated with various gastric and extra-gastric diseases.Importantly,this infection is the strongest known risk factor for gastric cancer (GC).H.pylori eradication can effectively prevent H.pylori infectionassociated diseases in H.pylori-positive patients,including children and elderly subjects.However,a limited selection of antibiotics,a higher reinfection rate,and certain spontaneous clearance rates,to some extent,restrict the choice ofH.pylori treatments in pediatrics.In addition,it is imperative to perform an accurate diagnosis of H.pylori infection in children by determining the presence of the H.pylori infection and the underlying cause of symptoms.In elderly patients,poor tolerance to drugs and higher sensitivity to adverse effects are major concerns during H.pylori therapy.Recent studies have demonstrated that H.pylori eradication could significantly lower the GC risk in the elderly population.The benefit and risk of H.pylori eradication in elderly patients should be comprehensively considered and balanced.If available,susceptibility-based tailored therapies may be preferable in eradicating H.pylori.In addition,to increase the eradication rate and reduce adverse effects,new therapeutic strategies (e.g.,probiotic supplementation,berberine supplementation,dual therapy) for H.pylori infection are being extensively investigated.The impact ofH.pylori eradication with antibiotics on the microbiota in children has been explored,but further high-quality studies are crucial to delineate the extent ofH.pylori eradication affecting the microbial community in children.In this review,we summarize the current understanding of H.pylori diagnosis and treatment in children and the elderly population and aim to provide insights into the efficient management and treatment implementation in these populations.