[Comparison of 2 therapeutic strategies in severe endometriosis, in young women consulting for sterility or pain. II. In the case of infertility, value of ovarian stimulation with intrauterine insemination after surgery].

Aim Of The Study: Define the best medico surgical strategy in infertile women with stage III-IV endometriosis.

Material And Methods: Two groups, A (N26) and B (N 37), treated for infertility associated or not with pelvic pain, due to stage AFS III or IV endometriosis, were compared. They had similar surgical procedure: operative laparoscopy including resection of endometriotic lesions, more particularly endometriomas and rectovaginal septum nodules.

[Comparison of 2 therapeutic strategies for severe endometriosis, in young women counsulting for sterility or pain. Results in cases of chronic pelvic pain].

Aim Of The Study: Compare two medical strategies associated to surgery in women requiring for chronic pelvic pain due to stage III-IV endometriosis.

Material And Methods: Two different patient groups, A (N 27) and B (N 41), requiring for chronic pelvic pain, associated with AFS stage III-IV endometriosis, operated on from 1992 to 1997, were compared. The medium age was 35 and 34 years, respectively.

Correlation between an early sexual debut, and reproductive health and behavioral factors: a multinational European study.

Objective: To investigate whether women who made an early sexual debut differ from those with a later debut regarding genital signs and symptoms.

Methods: The study included women who considered themselves gynecologically healthy and who attended 17 family planning centers in 13 European countries for contraceptive advice. There were 629 women who made their sexual debut at the age of 16 years or earlier (study population) and 927 women who had their first sexual intercourse at the age of 19 years or later (comparison group).

PID: clinical and laparoscopic aspects.

Clinical signs of pelvic inflammatory disease (PID) are not constant and are often limited to slight pelvic pain. Laparoscopy can lead to a rapid and correct diagnosis of PID. Intrapelvic bacteriologic samples can be obtained so as to administer the proper antibiotic.

Hormonal contraception and pelvic inflammatory disease.

Estrogen-progestogen contraception (OC) is significantly associated with a high prevalence of Chlamydia trachomatis in the lower genital tracts of young women. In contrast, pelvic inflammatory disease is less frequent and is associated with milder pelvic lesions in OC users than in non-users. A recent study suggests that OC use can be associated with silent endometritis and salpingitis.

Circulating antibodies to a conserved epitope of the Chlamydia trachomatis 60 kDa heat shock protein (hsp60) in infertile couples and its relationship to antibodies to C.trachomatis surface antigens and the Escherichia coli and human HSP60.

To evaluate the relationship between immunity to specific regions of the Chlamydia trachomatis 60 kDa heat shock protein (hsp60), autoimmunity to human HSP60 and infertility, sera from 50 women and 45 men seen for an infertility evaluation were tested. Humoral immunity to human HSP60 was detected in 18% of women and 8.9% of men while antibodies to the Escherichia coli hsp60 were detected in 12% of women and 4.

[Chlamydia trachomatis: should it be systematically be screened or treated? Literature review and cost/benefit estimation in France].

Chlamydia trachomatis is a primary cause of acute or silent salpingitis leading to infertility and ectopic pregnancy. The C. trachomatis epidemic, undiscovered in most cases, spreads, mostly in adolescents, during the years following the onset of sexual activity.

Chlamydia trachomatis screening in family planning centers: a review of cost/benefit evaluations in different countries.

Chlamydia trachomatis is a primary cause of acute or silent salpingitis leading to infertility and ectopic pregnancy. The C. trachomatis epidemic, undiscovered in most cases, spreads, mostly in adolescents, during the years following the onset of sexual activity.

[Uterine rupture during labor following surgical hysteroscopy].

Two cases of obstetrical uterine rupture after operative hysteroscopy without perforation are described. One was treated for uterus septus, the other one for synechia. However, the uterus could have been fragilized in both cases: one had been perforated by a uterine device, the other case had a past history of repeated curetage.

Clinical consequences of immune response to CT upper genital tract infection in women.

C. TRACHOMATIS (CT) infections of the upper genital tract in women are either acute, sub acute or chronic. CT infection has a tendency to be chronic, latent and persistent as a consequence of the host immune reaction to CT major outer membrane protein, 57 Kd heat shock protein and lipopolysaccharide.

[Adolescents and chlamydia: cervix microbiology among adolescents; the first statistics of the family planning centers according to the Calmat law].

Infertility due to Chlamydia trachomatis infection can be prevented by systematic screening of low genital tract infection. This screening is to be done systematically in women < 25 years old in Family Planning Centers. In France, according to Calmat's low, screening and treatment are anonymous and free of charges for adolescents and people without National Health care.

Role of laparoscopy in the management of pelvic adhesions and pelvic sepsis.

Operative laparoscopy in pelvic sepsis is useful in acute cases: (a) for diagnosis, as there are 20-30% false positive and false negative diagnoses based on clinical and laboratory data alone; and (b) for treatment in severe cases and mainly in tubo-ovarian abscesses, laparoscopy allows aspiration of purulent discharge and, in recent cases, removal of fresh adhesions. In most cases, rapid and complete recovery is associated with treatment with an effective polyvalent antibiotic. Fertility is also preserved in most cases as assessed by a small series of bilateral abscesses with long-term follow-up.

Post-therapeutic evolution of serum chlamydial antibody titers in women with acute salpingitis and tubal infertility.

Objective: To determine if serologic data and, more particularly, antichlamydial immunoglobulin (Ig) M can be used for diagnosis of current chlamydial intrapelvic gynecologic infection.

Design: Forty-two women with acute salpingitis (group A), 131 women with tubal factor infertility (group B), and 98 pregnant women (control group C) were studied.

Setting: Hôpital Jean Rostand, Sèvres (patients), Laboratories Magenta and Eylau, Paris (serology), Institut Pasteur, Paris (cultures).

Detection of Chlamydia trachomatis in fallopian tube tissue in women with postinfectious tubal infertility.

Objective: Biopsy tissues from women with postinfectious tubal infertility were studied for the presence of Chlamydia trachomatis.

Study Design: Tubal biopsy specimens from 25 women with postinfectious tubal infertility undergoing laparoscopy for repair of fallopian tubes were evaluated by culture, in situ hybridization. Immunocytochemistry, and transmission electron microscopy for the presence of Chlamydia trachomatis.

[A new therapeutic strategy using a ofloxacin-amoxicillin-clavulanic acid combination in the treatment of upper gynecologic infections. Apropos of 123 cases].

Objective: To evaluate a new antibiotic strategy with a combination of ofloxacin + co-amoxiclav in the treatment of pelvic infectious diseases.

Design: An open-non-comparative multicentre (10) study.

Subjects: 123 patients (118 salpingitis and 5 endometritis) were included clinical, laparoscopic and bacteriological assessments were performed before treatment and a laparoscopic control was done in 35% of cases.

[Clinical and colposcopic aspects of bacterial vaginosis].

Bacterial vaginosis is characterized by an uniform, malodorous, white-grey discharge. The presenting symptom is generally the unpleasant smell of the vaginal discharge, particularly following the menses or intercourse. Other functional signs, such as pruritus, dysuria and dyspareunia are rare.

[Synergic effect of Dextran 70 at 32% and an antibiotic in the prevention of peritoneal adhesions. Experimental study in rats].

In an experimental study we evaluate the anti-adherential effect of four different solutions: physiological serum, Chloramphenicol, Dextran 70 (32%) and the association of these last two solutions. Synergic effect is shown when using an antibiotic (Chloramphenicol) with a non-bactericid solution (Dextran). Comparing our results with current literature, we are confident on the efficacity of similar association concerning other solutions than Dextran 70 (32%).