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A laparoscopic approach to a program of gamete intrafallopian transfer.

Gamete intrafallopian transfer (GIFT) provides an effective method of achieving pregnancy in infertile women with normal fallopian tubes. Laparoscopic approach to ovum pickup and tubal catheterization provides a simple and rapid means of performing the operation. Equipment used to facilitate this process is described, and techniques of tubal catheterization are discussed. A clinical pregnancy rate of 27% is reported in a series of 71 treatment cycles. The application of GIFT in conjunction with in vitro fertilization is discussed, especially the use of excess gametes to provide embryos for freezing. The use of GIFT as a research and investigative tool may provide further insight into the causes for idiopathic infertility.

Catheterization↗

Sexual function in adults with myelomeningocele.

During the last 25 years more myelomeningocele patients have survived to adulthood and there is increasing interest in their sexual function. Little has been written on this subject. Of 108 patients 16 or more years old with myelomeningocele 47 were interviewed regarding sexual function. Of the 35 female patients 24 were sexually active and 12 of the 17 having actual sexual intercourse had become pregnant. Of the latter 12 patients 10 had ileal conduit urinary diversions, and neither they nor their children experienced any major complications from pregnancy and delivery. Among the 12 male patients 10 were sexually active, with erection and ejaculation present in 9. Six male patients were having sexual intercourse and 1 had become a father. Most of our adults with myelomeningocele had satisfactory sexual function.

Adolescent↗

Common sexual problems of children and adolescents.

The pediatrician is often expected by families to deal with sexual problems of children and adolescents. The physician should be able to identify problems and to guide parents in more meaningful communication and education of their children. Hopefully, he will be able to identify family conflicts and make the appropriate intervention or referral. He should be aware of his own sexual attitudes so as to avoid having his bias interfere with treatment. The childs behavior should not be isolated, but considered in the context of his family, his peers, and his own growth and development. Often, it is more useful to advise the family than to work with a young child. Adolescents present particular problems because of their conflicts over sexual identity, their reluctance to admit to problems, and frequently a mistrust of adults. They often feel a need for a trusting relationship with an adult, however, and are able to relate to a sensitive, non-judgmental professional.

Adolescent↗

Spermatorrhoea.

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Ejaculation↗

Tourniquet syndrome caused by metallic bands: a new tool for removal.

Reported are two cases of metallic constricting devices presenting to our emergency department. A 40-year-old man was unable to remove a steel ring from his engorged penile shaft after autostimulation, and a 22-year-old man riveted a metallic nut onto his right index finger proximal to his distal interphalangeal joint. Both metallic devices were successfully removed by a new, easily managed, and readily available tool called the "Dremel Moto-Tool Kit" Cat. #280. Constricting devices around digits or the penis are not uncommon problems. Because of the inherent dangers and sequelae of delay in treatment, it is imperative that the removal of these devices is expedited.

Accidents, Occupational↗