Gynecologie Obstetrique Fertilite & Senologie最新文献

Objectives: This systematic review aims to evaluate the various tools used to clinically assess aesthetic outcomes following breast reconstruction (BR) after mastectomy. It builds upon the most recent synthesis published in 2015, in a context where post-breast cancer quality of life, particularly with regard to aesthetic results, has become a major concern.

Methods: The review was conducted following the PRISMA-COSMIN guidelines. A comprehensive search was carried out across PubMed, Elsevier, Web of Science, Springer, and Google Scholar databases for studies published between 2015 and 2025. Only studies focusing on objective tools used to evaluate aesthetic outcomes after breast reconstruction were included. The analysis was based on established methodological criteria, including conceptual framework, reliability, validity, interpretability, responsiveness, user burden, and concordance with patient perceptions.

Results: Six articles met the inclusion criteria. While some tools demonstrated good reliability or convergent validity, none fully satisfied all methodological standards. Key aspects such as validity, responsiveness, and user burden were seldom assessed, and only a few tools showed strong concordance between professional assessments and patient-reported outcomes. The highest score among the tools reviewed was 4 out of 7.

Conclusions: Since 2015, several evaluation scales have been developed, but none meet all the essential criteria for optimal clinical application. There remains a need for a more rigorous, reliable, and patient-aligned tool for assessing aesthetic outcomes after mastectomy. Such a tool would facilitate more meaningful comparisons between surgical techniques and support shared decision-making focused on patient expectations.

Sexual violence against women remains a major public health issue, with nearly 15% of women in France reporting having experienced sexual violence during their lifetime. These traumatic experiences can have significant repercussions on both physical and psychological health. Chronic pelvic pain, genito-pelvic pain, and penetration disorders are frequently associated with a history of sexual violence. Their management often requires a multidisciplinary approach, in which pelvic floor physical therapy plays an important role. Some rehabilitation techniques involve intravaginal interventions, raising specific challenges in this population. Given the documented links between gynecological examinations, anxiety, and pain in women with such histories, it is essential to reflect on how best to assess and manage these patients in physiotherapy. This review focuses on women presenting with genito-pelvic pain and penetration disorders in the context of a history of sexual violence.

This article examines contemporary demands expressed by certain women for a less medicalized approach to childbirth. Rather than rejecting medicine or technology as such, these claims call into question the current organization of obstetric care, often perceived as overly standardized, impersonal, or inattentive to subjective experience. Drawing on a philosophical analysis informed in particular by the thought of Canguilhem and Bergson, we argue for moving beyond the traditional opposition between nature and technology. Childbirth is thereby conceived as a normative biological process that integrates medical techniques while simultaneously respecting the singularity of women's lived experiences. The objective is to envision an obstetrics that reconciles safety requirements with the subjective and existential experiences of those giving birth.