Contraception, fertilite, sexualite (1992)最新文献

A survey was conducted in May-June 1998 among 394 French menopausal women in order to better understand opinions, attitudes and habits of HRT users. Matters such as information, importance of a concerted choice between doctor and patient and treatment improvement were also mentioned for a better compliance.

Numerous reports have described ocular complications of sex hormone preparations, particularly after the appearance of the oral contraceptive pill. The most serious complications are vascular occlusions such as central retinal vein or artery occlusion and acute ischemic optic neuropathy. In these cases, permanent visual loss may occur. Combined oral contraceptives have been reported to increase the incidence of these complications but it remains very low. It seems to lessen with the decrease in the estrogen dosage and the use of third-generation progestins. Conversely, post-menopausal hormone replacement therapy seems to have a protective effect for retinal vascular complications. Other ocular involvements have been described with sex hormone preparations but remain not yet confirmed, such as the effect on cataract, lacrymal secretion, diabetic retinopathy, age-related macular degeneration.

Screening has led to the earlier detection of non palpable ductal or lobular carcinoma in situ microinvasive carcinoma and invasive breast cancer 1 cm or less in size (minimal breast cancer). Formerly, most of these cancers were cured by mastectomy but the dramatic change in frequency has prompted interest in the role of conservation treatment. Minimal breast cancer is a heterogeneous group of lesions, no single approach will be appropriate for all form of these diseases and methods must be developed to determine the most appropriate treatment for each patient.

Objective: To appreciate the real sexual practice among students.

Population and methods: From 29th April to 10th May 1997, 1,867 students from lower and upper schools have accepted to take part in the investigation being carried on their practice of sexuality.

Results: 1,333 students, that is 72% of the group, have already had sexual intercourse. The average age of the very first sexual intercourse was 17 years and the extreme ages range from 8 to 24 years. 72.7% of the students have already had sexual intercourse less once a month, mostly it is by love in 68.6% or by desire in 21.1%. Among more than half of the girl students, that is 59.5%, their partners was students. 31.3% were at least once pregnant.

Conclusion: The outcome of this study revealed that sexual activity among students is rare and sporadic. It is motivated by love.

Study objective: To investigate the alternative routes for hysterectomy for benign disease and the appropriate role of laparoscopic surgery.

Design: Retrospective study of hysterectomies performed between August 1991 and July 1997.

Setting: University hospital.

Patients: Hysterectomy for benign disease without prolapse, pelvic floor relaxation.

Intervention: 359 hysterectomies: vaginal (n = 211), laparoscopically-assisted vaginal (n = 56), and abdominal (n = 92).

Measurements and main results: Uterine volume was the principal indication for laparotomy. Laparoscopy was required only in cases of adnexal disorders or when the vaginal access was limited or associated with extensive adhesions. The rate of laparotomies and laparoscopies dropped steadily over the six-year study period: during the last two years, 75% of all hysterectomies were vaginal, and 90% of those for patients without a previous vaginal birth.

Conclusion: With experienced surgeons, the number of cases in which there appears to be poor vaginal accessibility experience decreases, and indications for vaginal hysterectomies increase.

Our objective was to determine, in a retrospective study of 352 operative hysteroscopies: (a) the rates and the types of complications and (b) the risk factors of peroperative perforations. The most important complications represented 1.7% including two haemorrhage, one symptomatic metabolic abnormalities and three uterine perforations with bowel injuries (0.8%). Furthermore, minor complications were observed in 9.3% including non symptomatic metabolic abnormalities (5.5%) and uterine perforations without visceral injury. Among mechanical complications, the majority were uterine perforations (4%). No relation was found between menopausal status of the patients and the occurrence of uterine perforation. In contrast, the perforation rate was statistically greater in patients treated for synechia than those found for myoma (p < 0.0001). Furthermore, the perforation rate was statistically higher for resection of myomas as compared with endometrial resection (p < 0.0001) or polyp resection (p < 0.0008). Moreover, in our experience, the perforation rate depended on hysteroscopic experience of surgical operators.