Contraception, fertilite, sexualite (1992)最新文献

The objectives of our study are to assess the prevalence of STD agents in Tunisia and to validate the WHO algorithm of STD management. The most frequent STD agents are Trichomonas vaginalis and Chlamydiae trachomatis, respectively with a prevalence of 5.6% and 1.7%. The assessment of the syndromic approach shows that the sensitivity and specificity of the WHO algorithm can be improved by the introduction of risk factors. The training of health care service providers and the use of an algorithm including risk factors can improve this approach, which is useful when laboratories services are not available.

The prognosis for patients with ovarian serous borderline tumors is generally considered to be excellent. It is worse for women with an advanced stage, especially when invasive peritoneal implants are present. There is no general agreement regarding standard treatment in such cases. To clarify the significance of this invasive peritoneal proliferation and to devise a rational treatment approach, we review the available series. From this review of literature, it appears necessary to emphasize the importance of an initial adequate peritoneal staging of all ovarian tumors. After a complete removal of the lesions, the question of adjuvant therapy must be discussed.

Gynaecological laparoscopy is associated with a patient morbidity rate. Half of the complications occur during the installation stage.

We report a case of migration of an intrauterine contraceptive device (IUCD) detected during pregnancy one year after insertion. The advanced gestation of the pregnancy and the absence of symptoms lead to expectant management. There were no complications during the pregnancy or delivery. A CT Scan in the post-partum period suggested that the IUCD was located in the region of the small bowel. Laparoscopy confirmed that the IUCD was superficially embedded in the intestinal wall but with no mucosal lesion. The device was removed with the aid of a mini-laparotomy. The migration of an IUCD into the abdominal cavity is rare. A literature review spanning the past 18 years revealed 165 reported cases. The IUCD was located in the following sites: omentum 45, rectosigmoid 44, peritoneum 41, bladder 23, appendix eight, small bowel two, adnexa one, iliac vein one. The majority of the authors recommend removal of copper containing devices, because of the potential for inflammatory reactions that can cause bowel obstruction and perforation. Initial laparoscopy has mostly superceded laparotomy but conversion may be necessary if difficulties arise.

Recently, computer-assisted treatment of echographic images has permitted '3D' reconstruction in gynecology. This is achieved by scanning a given volume containing the organ of interest. Two practical options exist. Some ultrasound probes are equipped with an automatic scanning device while others use manual scanning, electronically normalized or not. Both approaches make possible of an electronic matrix, i.e., a pile of '2D' echographic images. Secondary cuts are possible through the electronic matrix, including plans not normally accessible to ultrasound scanning because of anatomical limitations. One of the secondary cuts most clinically useful is the frontal plan of the uterus. This enables one to visualize the organ lying flat as it is commonly drawn on medical sketches. Studying the frontal plan of the uterus acquired electronically from a 3D matrix improves the visualization of possible interactions between structures such as uterine fibroids and the endometrium. The frontal plan of the uterus also offers marked improvements for studying uterine malformations.