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E Darai

Publications and source records attributed to E Darai.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Mechanical and metabolic complications of hysteroscopic surgery: report of a retrospective study of 352 procedures].

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.

Adult↗
PubMed1998

Expression of integrins during liver organogenesis in humans.

Integrins play a pivotal role in organogenesis, by mediating the interactions between differentiating cells and the extracellular matrix. We analyzed the expression of integrins and their ligands during human liver organogenesis. The expression of beta1, beta3, and beta4 integrins and the distribution of several extracellular matrix proteins were studied by immunoperoxidase in fetal liver samples from 5 to 40 weeks' gestation. Hepatoblasts expressed only the beta1, alpha1, alpha5, alpha6, and alpha9 integrin chains. Fetal hepatocytes, emerging at the 8th week of gestation, initially retained the same combination of integrins, but presented a progressive decrease in their expression levels. After 15 weeks' gestation, the expression levels of beta1, alpha1, alpha5, and alpha9 reached levels comparable to those observed in the adult state. Alpha6 expression became undetectable after 30 weeks' gestation. As compared to hepatoblasts, intrahepatic biliary epithelial cells, differentiating at the 8th week of gestation in the ductal plate, were characterized by the progressive loss of alpha1, the marked induction of alpha6, and the de novo acquisition of the beta4, alpha2, and alpha3 integrin chains. The disappearance of integrin receptors for laminin on hepatocytes was associated with the rarefaction of laminin in the perisinusoidal matrix, whereas their induction on biliary epithelial cells was associated with laminin deposition at the point of contact with the ductal plate. In conclusion, integrins likely play an important role in the differentiation of the epithelial and endothelial cell populations of the liver.

Collagen↗
PubMed1998

CD31 expression in benign, borderline, and malignant epithelial ovarian tumors: an immunohistochemical and serological analysis.

OBJECTIVE: To evaluate (a) the expression of CD31 in benign, borderline, and maligant ovarian tumors; (b) the correlation between CD31 expression and the clinicopathological parameters; and (c) the diagnostic interest of serological soluble CD31 (sCD31) in patients with ovarian tumors. METHODS: The intratumoral microvessel density was evaluated by an immunohistochemical technique with the monoclonal antibody JC70 against CD31 at two dilutions in 20 benign, 20 borderline, and 20 malignant tumors of the ovary. Serological determinations of sCD31 with ELISA technique was performed in 35 patients with ovarian tumors (24 benign, 5 borderline, and 6 malignant tumors). RESULTS: The expression of CD31 was higher in ovarian carcinomas than in borderline and benign tumors (P < 0.001) irrespective of the dilutions of the antibody used. In ovarian carcinomas, a correlation was observed between CD31 expression and the stage of the disease, the histologic type, the degree of histological differentiation, and the survival of the patients. In borderline tumors, no correlation was noted between CD31 expression and the clinicopathologic parameters. No difference in serological levels of sCD31 was noted according to histologic types. CONCLUSION: CD31 immunostaining may have a prognostic relevance in ovarian carcinoma but seems to be of limited value in borderline tumors. Serological levels of sCD31 have no diagnostic interest in ovarian tumors.

Enzyme-Linked Immunosorbent Assay↗
PubMed1998

Ki 67 expression in 35 borderline ovarian tumours: relations with clinicopathologic parameters and ploidy.

OBJECTIVE: To test the diagnostic and prognostic interest of Ki 67 expression and DNA ploidy in ovarian tumours. METHODS: The reactivity of tumour cells with the monoclonal antibody MIB 1 against Ki 67, was assessed by an indirect immunoperoxidase staining technique applied to 25 benign, 35 borderline and 20 malignant tumours of the ovary. In each cases, ploidy was analyzed by DNA flow cytometry. RESULTS: Ki 67 immunopositivity was detected in three benign tumours (12%), 14 borderline tumours (40%) and 14 ovarian carcinomas (70%). The mean and standard deviation of Ki 67 positive cells in benign, borderline and malignant tumours were: 1% +/- 8, 5% +/- 9.6 and 44.5% +/- 31 respectively. A difference in Ki 67 immunostaining was found between carcinomas and benign tumours (P < 0.0001), and between borderline and carcinomas (P = 0.001) but not between benign and borderline tumours. Evaluable DNA histograms from flow cytometry were generated in 77 cases (96.2%) of ovarian tumours. All 25 benign, 97.1% of 35 borderline and 44.5% of 20 malignant ovarian tumours were diploid. A difference was found between borderline and carcinomas (P = 0.001), but not between borderline and benign tumours. CONCLUSION: Ki 67 labelling was correlated with neither histologic and prognostic parameters, nor with survival, nor with DNA ploidy in borderline ovarian tumours.

Adult↗
PubMed1998

Analysis of CD44 expression in serous and mucinous borderline tumours of the ovary: comparison with cystadenomas and overt carcinomas.

AIMS: To determine the diagnostic and prognostic value of the immunohistochemical analysis of CD44 variants in benign borderline and malignant tumours of the ovary. METHODS AND RESULTS: The reactivity of tumour cells with three monoclonal antibodies, respectively, directed to all CD44 variants, CD44-v3 isoform and CD44-v6 isoform, was assessed by using an indirect immunoperoxidase technique applied to formalin-fixed, paraffin-embedded samples of 36 cases of borderline, as compared to 20 cases of benign tumours and 20 cases of carcinomas. CD44 variants were detected in 97% of borderline tumours, as compared to 60% of benign tumours and 100% of carcinomas. CD44-v3 was detected in 25% of borderline tumours, as compared to 0% of benign tumours (P = 0.003) and 55% of carcinomas (P = 0.065). The expression of CD44-v6 was detected in 28% of borderline tumours, as compared to 20% of benign tumours and 30% of carcinomas. In borderline tumours, as in carcinomas, CD44-v6, but not CD44-v3, expression was correlated with an increased proliferative index and with a higher incidence of p53 expression. CONCLUSION: Borderline tumours of the ovary present frequent quantitative and qualitative alterations in the pattern of expression of CD44 proteins. However, these alterations are unlikely to represent useful diagnostic or prognostic markers.

Adult↗
PubMed1998

[Anatomical study of Cooper's ligament. Value in the surgical cure of urinary incontinence in women].

The objective of the study was to measure Cooper's ligament thickness in the middle and at 1, 2, 3, 4 cm and to find the best place to fix the stitches of colposuspension. This study was performed on fresh cadavers. Sixteen Cooper's ligaments were studied (8 women, mean age 78 +/- 6 years). The length, the width and thickness of Cooper's ligament at 0, 1, 2, 3, 4 cm from the middle were measured. The limits of Cooper's ligament are indefinite. This ligament is significantly thicker (p < 0.01) in the middle and at 4 cm from the middle (2.2 +/- 0.4 mm) than 1 cm (1.4 +/- 0.5), 2 cm (1.4 +/- 0.5 mm) and at 3 cm (1.9 +/- 0.3 mm) from the middle. Cooper's ligament is used to fix the stitches for colposuspension derived from Burch colposuspension (non-incision percutaneous colposuspension to Cooper's ligament, laparoscopic colposuspension...) and sometime help to fix meshes in frondes procedures and the vagina in the Bologna procedure. This study showed the best point to fix the stitches (by its thickness) for colposuspension on this ligament at 4 cm from the middle (the fixation at the origin exposing to periostitis).

Aged↗
PubMed1998

Management and outcome of borderline ovarian tumors incidentally discovered at or after laparoscopy.

BACKGROUND: To evaluate in a series of patients with borderline ovarian tumors the clinical findings and the outcome after laparoscopic management. METHODS: Retrospective study of 25 patients with borderline ovarian tumors first treated by laparoscopic approach. RESULTS: Thirteen patients had mucinous tumors and 12 had serous tumors. Twenty-one patients had ultrasound examination which detected 24 ovarian cysts including multilocular cysts in 50% of cases and unilocular sonolucent cysts in 25% of cases. The serum CA 125 and CA 199 levels were elevated in 30.7% and 23% respectively. Among the 25 patients first treated by laparoscopic approach, 24 had stage I disease: six of them had cystectomy, seven unilateral salpingo-oophorectomy, two bilateral salpingo-oophorectomy and two laparoscopic hysterectomy with bilateral salpingo-oophorectomy. Seven patients had laparoconversion for presumption of ovarian cancer (5) and failure of laparoscopic procedure (2). One patient with stage III disease had laparoscopic biopsies and subsequent laparotomy. Among the 25 patients, 15 had conservative treatment and 10 had radical treatment. Three recurrences occurred after cystectomy. The mean follow-up was 41 months. Twenty-three patients were alive without evidence of disease, one died of intercurrent disease and one patient was lost to follow-up. CONCLUSION: Our data suggest that the laparoscopic approach to borderline ovarian tumors is possible in early stage disease but associated with a high risk of recurrence after cystectomy.

Adult↗
PubMed1998

Expression of p53 protein in borderline epithelial ovarian tumors: a clinicopathologic study of 39 cases.

OBJECTIVE: To evaluate the expression of p53 protein in borderline ovarian tumors and its correlations with the clinicopathological parameters. STUDY DESIGN: p53 protein was detected by immunoperoxidase in 79 ovarian tumors (39 borderline, 20 malignant, 20 benign). p53 expression was compared to histological type, FIGO stage, age, presence of ascites, recurrence and patient survival. RESULTS: The median value of quantitative p53 immunopositivity was: 0.80+/-0.42 in ovarian cancers, 0+/-0.24 in borderline tumors and 0+/-0.16 in benign tumors (p=0.001). In borderline tumors, no correlation existed between p53 expression and the histological or clinical parameters. In malignant tumors, no correlation existed between the expression of p53 and patient survival. CONCLUSION: We found no correlation between p53 immunopositivity and clinicopathological parameters in carcinomas and borderline tumors of the ovary. p53 immunopositivity may help in distinguishing borderline tumors from ovarian cancers.

Adenocarcinoma, Mucinous↗
PubMed1997

Percutaneous needle colposuspension to Cooper's ligament for the treatment of stress incontinence in women: a report of 82 cases.

We describe a procedure for the treatment of genuine stress urinary incontinence by percutaneous needle colposuspension of the bladder neck to Cooper's ligament. The procedure was performed in 82 patients and was associated with other procedures in 75 cases (91.5%). The mean operative time was 19 min (range 15 to 30). One peroperative hemorrhagic complication (1.2%) was noted. Nine postoperative complications were observed (10.9%) including seven urinary infections, one retropubic hematoma and one fever of unknown etiology. The mean follow-up was 13 months (range 6 to 22). Eight patients had a failure of the technique. All failures were diagnosed during the two first postoperative months. They included five cases of detrusor instability and three of persistent urinary incontinence. No additional failure was noted among the 53 patients having a follow-up greater than 12 months, suggesting a good stability of this new technique of colposuspension with a success rate of 85%.

Adult↗
PubMed1997

[Treatment of ovarian cysts by laparoscopy].

OBJECTIVE: to define limits, risks and results in the long term of laparoscopic treatment of ovarian tumors. METHOD: retrospective study of adnexal tumors managed initially by laparoscopy from January 1986 to December 1992, among which 9 cancers, 25 borderline tumors, and 769 benign lesions. The ultrasonographic appearance was known for 698 of 803 lesions. 86 patients were postmenopausal (92 lesions). RESULTS: we treated 191 functional cysts, 160 serous cystadenomas, 178 endometriomas, 105 dermoid cysts, 39 mucinous cystadenomas and 96 miscellaneous lesions among which fibrothecomas, paraadnexal cysts, ovarian pregnancies, ovarian abscess. There is a great diversity of ultrasonographic patterns for a same histological type, specially for functional cysts and borderline tumors. Laparoscopic exploration has misdiagnosed two cancers and 10 borderline tumors and considered wrongly as suspects 19 benign lesions. 714 procedures have been led to term by laparoscopy, 89 have been ended by laparotomy, 26 for suspicion of malignancy and 50 for dissection failure. 27 postoperative complications have been counted among which 2 grafts on trocard sites after non protected extraction of one dermoid cyst and one borderline tumor. CONCLUSION: ultrasonographic appearance could not predict reliably the organic or functional nor benign or malignant character of an adnexal mass. Even careful laparoscopic examination can underestimate early stage ovarian cancer or borderline tumors. When diagnosed during or after laparoscopic procedure an ovarian cancer should always be managed by laparotomy. On the other hand, some borderline tumors can be treated by exclusive laparoscopy. When malignancy is suspected, an adnexectomy can be performed laparoscopically as a biopsy and allows a quick and appropriate treatment after paraffin-embedded sections. Both intraperitoneal and transparietal techniques have a minimal morbidity and allow a feasibility of more than 90%. The management of postmenopausal ovarian tumors differs only by the use of systematic oophorectomy if surgical procedure is indicated.

Adolescent↗
PubMed1997

[Borderline ovarian tumors: a series of 43 patients].

Our objective was to evaluate the sonographic features, serum tumor markers in a series of 43 patients with borderline ovarian tumors. At sonographic examination, the majority of borderline tumors were multilocular. Serum CA-125 levels were elevated in 32.1%, CA-19-9 in 17.4%. In contrast, ACE levels were constantly normal. Twenty-four out of 43 patients (55.8%) had serous tumors, 18 (41.9%) had mucinous tumors and 1 (2.3%) had endometrioid tumor. Among, the 43 patients, 9 (20.9%) had first laparotomic approach and 34 had first laparoscopic treatment. Seven out of 34 patients treated by first laparoscopic approach had a laparoconversion (2 for presumption of invasive carcinoma and 5 for failure of laparoscopic procedure). Therefore, 27 had exclusive laparoscopic management. Among the 43 patients, 22 had conservative treatment and 21 radical surgery. The mean follow-up of patients was 41 months. Thirty-seven patients (86.1%) were alive without recurrence, 4 had a recurrence (9.3%), 1 patient (2.3%) was lost to follow-up and the last died of intercurrent disease. The mean delay of recurrence was 22 months (range 6 to 36). Three out of 4 recurrences occurred after cystectomy (2 ipsilateral and 1 controlateral). The fourth recurrence occurred after unilateral salpingo-oophorectomy. All 10 second look procedures were negative. Our results point out about the feasibility of laparoscopic management of borderline tumors. However, cystectomy is associated with a high risk of recurrence.

Adolescent↗
PubMed1996

Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment.

OBJECTIVE: To evaluate medical treatment of interstitial pregnancy. METHODS: This series was a retrospective study of medical treatment of interstitial pregnancies which was managed in two French Departments of Obstetrics and Gynecology (Bichat public Hospital. Paris and A. Béclère public Hospital, Clamart, France). Fifteen patients with clear evidence of an unruptured interstitial pregnancy were treated by injection of methotrexate (MTX) or potassium chloride (KCL) without surgery since January 1988. The diagnosis was established either by sonography and laparoscopic confirmation in eight cases or by only transvaginal ultrasound in seven cases. Three out of 15 cases in this series, had a heterotopic pregnancy who were treated by transvaginal ultrasound-guided injection of KCL. Others received systemic MTX injection in four cases, and local MTX injection in eight cases under either laparoscopy or transvaginal ultrasound guidance. Four different protocols of MTX (Ledertrexate) administration was performed in this series with time: at the beginning of our experience, MTX1 protocol, 15 mg i.m. daily for 5 days was used; and after MTX2 protocol, 1 mg/kg body weight i.m. daily for 4 days; MTX3 protocol, 1 mg/kg body weight intratubal associated with 1 mg/kg body weight i.m. daily for 3 days; and now MTX4 protocol, only intratubal 1 mg/kg body weight is especially used. The success was defined as declining serum human chorionic gonadotropin (hCG) to undetectable levels, and no further surgical management was required. Outcome of subsequent fertility was also evaluated. RESULTS: Complete resolution was obtained in 13 (86.6%) out of 15 interstitial pregnancies. Two out of 15 patients, with medical treatment's failure required secondary surgery. No severe side effects of medical treatment were observed. Follow-up hysterosalpingography was performed in 12 patients showing 91.7% tubal patency on the side of interstitial pregnancy. Outcome of intra-uterine pregnancy of the three patients who had heterotopic gestation, was two miscarriages and one delivery at term. Out of the other 12 patients in this series, nine became pregnant within 1 year: eight pregnancies at term, and one induced abortion. At present, among the last three patients, two have no desire to conceive. CONCLUSION: Our results suggest that unruptured interstitial pregnancies now can be managed with local MTX administration of 1 mg/kg body weight under transvaginal ultrasound or under laparoscopy procedure. This approach is particularly attractive in these patients, where the only alternative to therapy is laparotomy with cornual resection.

Adult↗
PubMed1996

Epithelial ovarian carcinoma of low malignant potential.

OBJECTIVE: The aim of this study was to evaluate the interest of sonographic features, serum marker tumors and conservative treatment especially by laparoscopic approach of epithelial ovarian tumors of low malignant potential (or borderline tumors). STUDY DESIGN: Thirty-four patients with 40 epithelial ovarian tumors of low malignant potential treated at Bichat Claude Bernard hospital were reviewed. Of these patients, 29 had preoperative sonographic control (85.2%), 19 (55.8%) had pretreatment serum CA 125 determination, 17 (50%) serum CA 199 determination and 19 CEA serum levels. Twenty patients (58.8%) had serous tumor and 14 (41.2%) had mucinous tumor. Six out of the 20 serous lesions were bilateral. Of the patients 31 (91%) had a stage I disease, one had stage II (3%) disease and two had stage III (6%) disease. Nine patients (26.5%) had laparotomic management, 25 (73.5%) had first laparoscopic management with seven laparoconversions (28%). RESULTS: The majority of borderline tumors (67.7%) exhibited multilocular aspects and seven patients had benign features (unilocular smooth sonolucent). Seven out of the 19 CA 125 serum levels were up to 35 U/ml; 4/17 CA 199 serum levels were above 40 U/ml but the CEA serum levels were always normal. Eighteen patients (52.9%) had radical surgery and 16 patients (47.1%) had conservative surgery including 7 cystectomies. Seven patients (20.6%) had subsequent laparotomic treatment, (five after laparoscopic management, one after laparoconversion management and another one after laparotomic surgery) and no residual disease was found. Fourteen patients (41.1%) had preoperative cyst rupture (13 during laparoscopic management). Four recurrences in stage I disease occurred; one after unilateral salpingo-oophorectomy, three after cystectomy but only one recurrence was in ipsilateral ovary. All four recurrences were diagnosed by sonographic control and one was associated with CA 125 serum level elevation. Ten laparoscopic second look were negative. CONCLUSION: No specific sonographic aspect exists for borderline tumors but it is the best way to detect recurrence. The preoperative CA 125 serum levels was elevated in 36.8% of patients. The conservative treatment including laparoscopic procedure in borderline ovarian tumors appears to have a high risk of peroperative rupture but the rate of recurrence is similar to laparotomic treatment.

Adolescent↗
PubMed1996

Is maternal serum creatine kinase actually a marker for early diagnosis of ectopic pregnancy?

OBJECTIVE: Our purpose was to investigate whether serum creatine kinase (CK) levels could be used as an early marker of ectopic pregnancy. Student's t-test was used for statistical analysis. STUDY DESIGN: In a prospective study we therefore measured serum progesterone, beta hCG and CK levels in 30 women with ectopic pregnancies, 30 women with ongoing pregnancies and 30 women with missed abortion. RESULTS: The mean serum CK concentration for patients with an ectopic pregnancy, ongoing pregnancy, and the women with missed abortion was 81.4 +/- 66.2, 81.5 +/- 40.3, 84.8 +/- 49.3, respectively. No relationship was found between CK level and the location of the pregnancy. CONCLUSION: Conversely to the first report of Lavie et al. (Am J Obstet Gynecol 1993; 169: 1149), our data suggest that serum CK level is not discriminative in the early diagnosis of tubal pregnancy.

Abortion, Missed↗
PubMed1996

Transvaginal intratubal methotrexate treatment of ectopic pregnancy. Report of 100 cases.

Between November 1988 and December 1993, 100 patients with a common, unruptured ectopic pregnancy were treated with 1 mg/kg injection of intratubal methotrexate under transvaginal sonographic control. Patients were not excluded from this series on the basis of the size of the adnexal mass, the term of ectopic pregnancy or initial beta-human chorionic gonadotrophin (HCG) concentrations. Patients were excluded following uncertain diagnosis, signs of a ruptured ectopic pregnancy, or a significant haemoperitoneum on ultrasound scans. The mean age of the patients was 29.5 years (range 20-41). The mean gestational age and initial HCG concentration were 7.5 weeks (5-11) and 11,614 mIU/ml (192-105,000 respectively). Of the 100 patients, 22 (22%) had an ectopic pregnancy with active cardiac activity. Complete resolution was obtained in 78 out of these 100 ectopic pregnancies. Of these, 66 patients (85%) needed only one intratubal methotrexate injection, and 12 patients (15%) required a second i.m. methotrexate injection of 1 mg/kg. In this study, local treatment with one single intratubal methotrexate injection was successful in only 66% of patients. The mean resolution time for reduction of beta-HCG concentrations was 23.5 days (range 7-40). There was no statistically significant correlation between initial beta-HCG concentrations and outcomes after methotrexate treatment of ectopic pregnancy in our study. Where embryonal heart beats were observed, the success rate of the procedure was 40.9% (nine out of 22 cases). In the absence of cardiac activity, or when ultrasound examination showed no embryo, the success rate achieved was 84.6% (66 out of 78 cases) (P < 0.01). In all, 34 patients were considered to be incompletely cured after only one intratubal methotrexate injection: 12 patients required a second i.m. injection, a stagnation of beta-HCG concentrations was observed in 15 patients, abdominal pain occurred in six patients, and one patient suffered tubal rupture with haemoperitoneum. A total of 22 patients required secondary surgical management (salpingectomy). No biochemical or clinical side-effects of methotrexate treatment occurred. Tubal alteration ascribable to methotrexate injection occurred in one patient in our study. Out of 75 patients in this series who wished to conceive, 21 (28%) became pregnant within 1 year with the following outcomes: 11 pregnancies at term, three miscarriages, one induced abortion and six recurrent ectopic pregnancies (four occurred on the same side). Our findings suggest that treatment of common unruptured ectopic pregnancy without prior selection of patients, by a single intratubal methotrexate administration was associated with a 66% success rate. This was dependent only on the presence of embryonal heart beats and there was no correlation between the success rate and initial beta-HCG concentrations. Successful outcome after methotrexate administration for ectopic pregnancy could be perfected by way of an improved selection of patients based on inactive embryonal hearts and absence of a visualized embryo.

Adult↗
PubMed1996

[Percutaneous needle colposuspension to Cooper's ligament: 63 cases].

OBJECTIVE: To evaluate the feasibility, safety and results of a new procedure of treatment of genuine urinary stress incontinence : needle percutaneous colposuspension to Cooper's ligament. STUDY DESIGN: From June 1994 to December 1995, 63 patients had a needle percutaneous Cooper's ligament colposuspension for stress urinary incontinence (USI). The mean age of the patients was 48 years (range : 32 to 80). Fourteen patients were menopausal (22,2 %). The mean parity was 2,7 (range 0 to 10). According to Blaivas and Olsson classification of USI, 6 patients had type 0, 32 type 1, 22 type 2 and 3 type 3. Fifty-eight patients had preoperative urodynamic control. RESULTS: The procedure was performed in 63 patients (100%). The mean operative time was 20 minutes (range 15 to 30). Peroperative complication: hemorrhagic in one case (1,5%). Postoperative complication rate was 12,7% including seven urinary infections. The mean follow-up of the patients was 8 months (range: 6 to 17). By subjective parameters, 55 patients were cured (87,3%). Only 38 patients had postoperative urodynamic control including the 8 patients with failure of the procedure. Among these 8 patients, 1 had clinical failure with normal urodynamic control, 2 had vesical instability and 5 had a persistence of USI confirmed by urodynamic control. CONCLUSION: Needle percutaneous colposuspension to Cooper's ligament appears as feasible and safe technique to cure USI. The interest of this new procedure of colposuspension is its fixation to the Cooper's ligament using the vaginal approach. Preliminary results are good, however longer follow-up is necessary to validate this new technique.

Adult↗
PubMed1996

[Upper genital tract infections in women infected with HIV: epidemiologic, diagnostic and therapeutic aspects].

Fifty seven women hospitalized in the gynecological department of Bichat-Claude Bernard hospital in Paris for pelvic inflammatory disease (PID) proven by laparoscopy from sept. 1992 to nov. 1994 had a serological diagnosis of HIV infection. Three of them (5,2%) were positive (HIV+). Previous publications have shown from 4% to 17% in the USA and as much as 32% in Abidjan. However this prevalence is arising each year. PID in HIV+ seems to have more often a poor symptomatology but require more surgical treatments. Postpartum endometritis in HIV+ were also studied. From 1989 to 1994, we observed 109 delivery in HIV+ patients. Numerous infectious diseases occurred but endometritis were not significantly elevated. Three american studies in HIV+ failed to show an increased risk of postpartum endometritis but a fourth larger study achieved in Abidjan, showed a significantly higher risk of endometritis, associated with decreasing levels of CD4. HIV+ women are at increased risk of upper genital tract infection and could profit from obstetrical antibioprophylaxis.

AIDS-Related Opportunistic Infections↗