Stress urinary incontinnce (SUI) is a common condition among women. The usual approach to treatment of SUI is a stepwise plan from conservative to surgical procedures. A vaginal pessary is one of the commonly used conservative treatments that offer symptomatic improvement for women with incontinence. This review provides a critical analysis of the benefits and shortcomings offered by vaginal pessaries to patients affected by SUI, with a particular focus on indications, advantages, quality of life, patient satisfaction, and potential complications. To obtain the required information, an extensive search of PubMed and Cochrane databases was performed, covering the time frame from January 2000 to December 2016. We also surveyed the published guidelines of American Urological Association, Canadian Urological Association, American Urogynecological Society, National Institutes of Health (USA), and National Institute for Health and Care Excellence (UK). A total of 192 original research papers, review articles, and clinical trials were identified. The analysis of retrieved data provides evidence that vaginal pessaries constitute an effective nonsurgical option for SUI. The satisfaction rate with pessary use is high and only minor complications, if any, occur, vaginal discharge being the most common. The reviewed studies document that vaginal pessaries provide an adequate control of SUI if they are fit properly and managed by frequent replacements and regular checkups. They should be considered among the first line of treatment for SUI associated with exercise and increased intra-abdominal pressure.

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Reactive oxygen species (ROS) is excessively generated during tumor development yielding the oxidatively modified products of proteins and DNA. These DNA alterations could contribute to the development of cancer through the activation of oncogenes and inactivating tumor suppressor genes (TSGs). Therefore, 8-OHdG DNA oxidative damage and TP53 protein expression were evaluated amongst HCV-Chronic liver disease patients to explore their possible role in hepatocarcinogenesis and to predict HCC development at early stages. A total of 141 patients with HCV-related liver diseases; 69 with hepatocellular carcinoma and 72 with liver cirrhosis were enrolled in this study in addition to 56 healthy subjects. Serum 8-OHdG and TP53 expression by ELISA were markedly elevated in HCC patients compared to LC and healthy individuals (p<0.0001). A significant correlation was noted for 8-OHdG and TP53 with disease progression and tumor differentiation but not with tumor site. 8-OHdG and TP53 were highly (p<0.05) predicting for HCC at early stages and the diagnostic performance for discriminating HCC from LC by ROC curve showed the best AUC was recorded for 8-OHdG (0.745) followed by TP53 (0.667) with accuracy (87.2% and 82% respectively). Therefore, HCV-induced oxidative DNA damage could increase the carcinogenic potential of HCC development through the activation of TP53.