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02 May 2022, Volume 38 Issue 5 Previous Issue    Next Issue

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Prevention and treatment of recurrent vulvovaginal candidiasis.  WANG Chen, WANG Ying-mei, XUE Feng-xia 2022, 38(5): 487-491.  DOI: 10.19538/j.fk2022050103 Abstract ( )   Recurrent vulvovaginal candidiasis （RVVC） is difficult to cure due to repeated attacks，which seriously affects women's physical and mental health. To prevent RVVC effectively，high-risk factors should be found and corrected，the fungal strains should be identified，and mixed infections should be recognized. Besides，the development of antifungal vaccines is expected to be a new approach to preventing RVVC. Antifungal induction and maintenance with selective drugs according to the drug susceptibility test is the main treatment. In addition，other treatments may have certain adjuvant therapeutic effects，including microecological regulators，Chinese patent medicine，etc. In the future，new antifungal preparations need to be developed and their clinical efficacy requires verification.

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Management of recurrent ovarian endometriosis. PENG Chao, ZHOU Ying-fang 2022, 38(5): 491-495.  DOI: 10.19538/j.fk2022050104 Abstract ( )   Endometriosis is a chronic recurrent and systemic disease with an annual recurrence rate of about 10%. Recurrent ovarian endometriosis generally refers to the recurrence of ovarian endometrioma， which is the most common recurrence type of endometriosis and the main reason for reoperation. The treatment principle basically follows the initial treatment， but should be individualized. Treatment includes both medical and surgical treatment. The drugs commonly used include progestins， gonadotropin releasing hormone agonist（GnRH-a）， compound oral contraceptives and traditional Chinese medicine. Some drugs， such as dienogest， can significantly reduce the size recurrent ovarian endometrioma or even make it disappear， thus avoiding the risk of reoperation，which has been widely recommended in recent years.Reoperation has a greater negative impact on ovarian reserve function，and it is still very likely to have relapse after reoperation. Some patients can also choose ultrasound-guided puncture therapy. IVF is first recommended for patients with infertility. Drug maintenance therapy and long-term management are the key to reducing the recurrence of ovarian endometrioma. It has been proved that long-term use of progestins，GnRH-a and compound oral contraceptives can prevent the recurrence of ovarian endometrioma.

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Prevention and management of recurrent pelvic organ prolapse after surgery.  LU Yong-xian 2022, 38(5): 495-499.  DOI: 10.19538/j.fk2022050105 Abstract ( )   There is an urgent need for resolving the high recurrence rate of pevic organ prolaps（POP）after suryery.Severity，location and bother some symptom of POP should be assessed before the surgery. Modifying risk factors and choosing the correct procedures are the preventive measures for reducing the recurrent rate.For the treatment of recurrent POP，there are two methods.One is conservative measures，and the other is surgery.The former can relieve the symptoms and postpone POP progression，and the latter can solve and correct recurrent POP.The operation for recurrent POP is difficult.The individual procedure based on the characteristics of recurrent POP should be designed.The mesh may be needed to reinforce the repairment.Any surgical procedure should be carried out by subspecialty-trained and experienced surgeons with an adequate clinical experience and good results.

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Comprehensive treatment for recurrent cervical cancer. XIE Peng, GUO Qiu-fen, ZHANG Shi-qian. 2022, 38(5): 499-503.  DOI: 10.19538/j.fk2022050106 Abstract ( )   Cervical cancer is a common disease threatening the life and health of women.The treatment for tecurrent cervical cancer is the last line of defense to improve the prognosis of patients. With the improvement of various treatment methods and the emergence of new treatment methods，the therapeutic effect of treatment for recurrent cervical cancer has been improved to some extent，with radical treatment becoming possible，and patients are expected to achieve long-term survival.

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Treatment for recurrent platinum-resistant epithelial ovarian carcinoma. LI Yi-fan, LI Ning, WU Ling-ying 2022, 38(5): 503-507.  DOI: 10.19538/j.fk2022050107 Abstract ( )   The case fatality rate of epithelial ovarian cancer is the highest among gynecological malignancies. Platinum resistance is a key clinical problem difficult to deal with. The efficacy of non-platinum chemotherapy is only 10%-20%. There have been many clinical trials about chemotherapy combined with anti-vascular agents，PARP inhibitors or immune checkpoint inhibitors in platinum-resistant recurrent ovarian cancer, which have brought us new choices. However, there are still some problems，such as the low overall response rate and the lack of effective markers for efficacy prediction.

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Progress of therapy for recurrent endometrial cancer.  XU Xing-yuan, WANG Dan-bo 2022, 38(5): 507-511.  DOI: 10.19538/j.fk2022050108 Abstract ( )   The diagnosis，assessment and multidisciplinary treatment （MDT）of recurrent endometrial cancer are significant for the selection of treatment options，and the previous treatments and the situation of recurrence are the main items for evaluation. For local recurrences，radiotherapy or surgery can be used，while for extensive recurrences，chemotherapy is the main treatment. Routine methods include chemotherapy，radiotherapy and surgery. Furthermore，molecular classification-based endocrine therapy，immune checkpoint inhibitor therapy and targeted therapy are of great significance as well.

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Management of refractory trophoblastic neoplasia. SU Hao, FENG Feng-zhi 2022, 38(5): 511-514.  DOI: 10.19538/j.fk2022050109 Abstract ( )   All patients with refractory gestational trophoblastic neoplasia （GTN） require re-assessment of the extent of disease before initiating another treatment. Salvage chemotherapy with multiagent combination is still the main treatment option at present. For the patients with resectable lesions，it is crucial to perform a complete surgical excision of tumors simultaneously during salvage chemotherapy. In addition，these patients may also benefit from the emerging immunotherapy. After remission is achieved，serum human chorionic gonadotrophin （hCG） should be monitored regularly in a long term.