Contraception, fertilite, sexualite (1992)最新文献

The authors report the results of a retrospective series concerning 121 patients who presented abnormal uterine bleeding resistant to progestogen therapy. These patients were adenomyosis carriers and who underwent loop endometrial ablation. Over a maximum period of 8 years, the success rate was 56% following one endometrial resection and 67% following one or two resections. The study recorded a repeat resection level of 11%. Seventeen hysterectomies (19%) were performed because of the recurrence of abnormal uterine bleeding. These results are comparable to those observed in endometrial ablation performed for menorrhagia, all benign etiology included. Adenomyosis does not appear to be a factor in the failure of endometrial ablation, except in the case of deep adenomyosis which is difficult to diagnose pre-operatively.

After the diagnosis of breast epithelial hyperplasia or carcinoma in situ, the clinical follow-up must take into account several parameters. First, the adequacy of the diagnostic and the therapeutic approach is to be evaluated. Second, the patient must be informed of her risk of subsequent breast cancer. In such a protocol, one can recommend a program of close follow-up in an attempt at early detection. An annual clinical examination combined with a mammographic and a sonographic exam is considered as the method of choice. In between annual check-ups, clinical exam is encouraged. The potential benefits of magnetic-resonance imaging in these circumstances is currently evaluated. In rare instances, the absolute risk of breast cancer is so high that a prophylactic mastectomy can be considered.

The pipelle has become the sampling tool of choice for histological detection of endometrial adenocarcinoma. Some practitioners still prefer cytological sampling. The distal extremity of the pipelle has been modified to allow removal of both types of samples simultaneously. The aim of this preliminary study was to evaluate the feasibility of this method. A positive agreement between histological and cytological results was found in 10 out of the 12 cases examined, among which an adenocarcinoma was positively detected. A prospective study on larger size must confirm these first findings. The new modified pipelle (Pipelle Mark II) offers a possible approach for reduction of false negatives.

The mother-daughter link is more complex than at first appears. Its influence is in fact so crucial as to be able to determine factors such as access of daughter to fertility and the gender of the children she will bear.

In a review of the literature the authors describe the complications encountered during gynecological laparoscopy, insisting on the preparation phase, the conversion to laparotomy and the death cases. Vascular, digestive and urinary lesions, as well as anesthetic difficulties are discussed, aiming at a better prevention. Early recognition of the problem is an important prognostic factor for these patients.

SERMs are developed in HRT in order to provide the beneficial effects of estradiol on bone and the cardiovascular system. SERMs are antiestrogens and their properties depend upon the pharmacological class they belong to. Tibolone is a progestin with mixed properties. Our studies on breast cells in vitro demonstrated that it behaves as a progestin in these cells. The clinical data obtained with these various therapies on breast are presented.

The present study investigates why some women, before and during delivering, request peridural analgesia or, on the contrary, refuse it. On the basis of a literature review and of an empiricial study involving 57 women, a psychological differentiation is attempted to discriminate users from non-users of peridural analgesia. Pain perceptions, health locus of control, when internal (IHLC), family and couple adaptability appear to be discriminating factors. Our results indicate a higher chance locus of control (externality) in non-users then in users, as well as a more rigid couple functioning. The incidence of Internal Health Locus of Control of pain perception is outlined.