[Fertility after ectopic pregnancy: the population-based register of the urban area around Lille, Northern France].

The aims of this work were the evaluation of the reproductive outcome after ectopic pregnancy, and the assessment of the role of infertility risk factors and treatment's strategy. All patients in the population-based register of the urban area around Lille, Northern France, were followed-up. 345 women treated between April 1994 and March 1997, who were trying to become pregnant were interviewed by telephone every 6 months and then every year.

[Surgical cure of stress urinary incontinence with vaginal tissue sling: technique, results, indications].

Objectives: Describe a new surgical technique of sling procedure using a vaginal sling and report complications and mid-term functional results. According to these results, it's necessary to discuss the best indications.

Material And Methods: Retrospective study of the first 75 patients operated for urinary stress incontinence.

Dienogest is as effective as triptorelin in the treatment of endometriosis after laparoscopic surgery: results of a prospective, multicenter, randomized study.

Objective: To compare the efficacy of Dienogest versus Decapeptyl at 3.75 mg as consolidation therapy for surgery in the treatment of endometriosis.

Design: Multicenter, open, randomized, parallel-group clinical trial.

Modified radical vaginal hysterectomy with or without laparoscopic nerve-sparing dissection: a comparative study.

Objective: Nerve-sparing dissection of the lateral portion of the cardinal ligament (paracervical lymphadenectomy) has been recently developed with the goal of reducing the late urinary adverse effects of radical hysterectomy without impairing the outcome. This work has been carried out in order to investigate the influence of additional paracervical lymph node dissection at the time of laparoscopically assisted modified radical hysterectomy on outcome and urinary sequelae.

Methods: A total of 95 patients underwent a modified radical hysterectomy using a combined laparoscopic and vaginal approach since 1991.

[Ovarian cyst: surgical indications and access].

Laparoscopic treatment of adnexal masses is indicated when all criteria of a benign lesion are present: transvaginal ultrasound demonstrates a mass < 5 cm, with liquid or dermoid content, with less than 3 fine partitions (< 3 mm), a thin wall (< 3 mm), no vegetations, normal Doppler. Laparoscopy is also indicated for "benign" cysts measuring 5 to 10 cm if laparoscopy is feasible. Peroperative exploration is the rule.

[Hysterectomy for benign lesions: what remains for the abdominal route?].

Objective: We conducted a prospective study to assess what indications remain for abdominal hysterectomy for benign conditions.

Patients And Methods: Four hundred fifty-three hysterectomies were performed for benign conditions between April 4, 1996 and December 14, 1998 in our unit. Abdominal hysterectomy was chosen for large uteri, when vaginal access was unusable, or in case of suspected post-operative pelvic adhesions.

Vaginal, laparoscopic, or abdominal hysterectomies for benign disorders: immediate and early postoperative complications.

Objective: hysterectomy for benign disorders is usually well tolerated, but complications do occur. The aim of this retrospective study is to document such complications.

Patients And Methods: between March 1991 and December 1998, 1604 patients (mean age: 46 years) underwent hysterectomy for benign disorders.

Anatomic study of arcus tendineus fasciae pelvis.

Objective: To describe the anatomy of the arcus tendineus fasciae pelvis.

Material And Methods: Two fixed female cadaver pelvises (88 and 66 years old) were dissected.

Results: The arcus tendineus fasciae pelvis is a 10-cm-long fibrous thickening of the pelvic fascia which is medial to the obturator internus muscle and lateral to the peritoneum.

[Vaginal hysterectomy in nulliparous women: indications and limitations].

Objective: The aim of our study was to determine whether nulliparity is a limiting factor for vaginal hysterectomy performed for benign lesions.

Patients And Methods: We conducted a prospective study in 1604 patients who underwent hysterectomy for a benign lesion between 1991 and 1998. We studied a subgroup of this population constituted by 128 nulliparous women, i.

[Cure of cystocele with vaginal patch].

Objective: To describe an original technique for transvaginal cystocele repair and to report the anatomical and functional results of the first 47 patients operated by this technique. The operation combines suspension, by six sutures to the tendinous arches of the pelvic fascia, of a vaginal patch measuring 6 to 8 cm long by about 4 cm wide left in contact with the cystocele. The vaginal patch is then buried under the anterior colporraphy suture.

[Surgical treatment of stress incontinence using a new vaginal tissue sling: short-term feasibility and complications].

Objective: Many operative techniques have been proposed for urinary stress incontinence, a common finding in women. The goal of operating solely via a vaginal approach using autologous material has led to the development of a sling technique using a band of vaginal tissue.

Methods: We described the operative technique and analyzed outcome in the first 35 patients operated with the new vaginal tissue sling technique.

Antiphospholipid syndrome and recurrent miscarriages.

Sixty percent of recurrent spontaneous abortions are unexplained. Antiphospholipid syndrome is a multisystem disease with the predominant features of venous and arterial thrombosis, recurrent pregnancy loss, foetal death and the presence of antiphospholipid antibodies. Many epidemiological studies focus on antiphospholipid autoantibodies syndrome (APS) as a cause of recurrent spontaneous abortion (RSA).

Theories of endometriosis.

Endometriosis is characterised by the presence of abnormally located tissue resembling the endometrium with glands and stroma. Several hypotheses have attempted to explain the development of such tissue. The oldest theory, that of metaplasia, suggests that under diverse influences coelomic tissue could be transformed into endometrium.

The vaginal patch plastron for vaginal cure of cystocele. Preliminary results for 47 patients.

Objective: We describe a new surgical technique (the vaginal plastron) for the treatment of cystocele by the vaginal route. The technique is based on bladder support by a vaginal strip (6-8cm in length and 4cm in width), isolated from the anterior colpocele, left attached to the bladder, associated with a suspension of this strip by its fixation to the tendinous arch of the pelvic fascia by six lateral sutures (three on each side of the plastron). The vaginal plastron is then covered by tucking it under the anterior colporraphy.

Survival analysis of fertility after ectopic pregnancy.

Objective: To evaluate the reproductive outcome after ectopic pregnancy and to assess the contribution of risk factors to future fertility.

Design: Prospective follow-up in a population-based sample.

Setting: Register of ectopic pregnancies established in an urban area around Lille, France.

Long term complications of vaginal hysterectomy: a case control study.

Objective: Our purpose was to evaluate the long term sequelae after vaginal hysterectomy.

Study Design: A retrospective case control study to evaluate the long term complications after vaginal hysterectomy compared with control patients who had during the same period undergone cholecystectomy for benign pathology. Excluded were hysterectomies during which adnexectomy or treatment of prolapse, stress incontinence or genital cancer was also effected.

[Laparoscopic sacral colpopexy: short-term results and complications in 83 patients].

We retrospectively studied 77 laparoscopic sacral colpopexies performed from June 1996 to May 1998. Suspension was reinforced with two strips of synthetic mesh. Five patients had previously undergone hysterectomy and 4 others had experienced failure of surgery for prolapse of the uterus.

[Arcus tendineus fascia pelvis: anatomical study].

Objective: To reveal the anatomy of arcus tendineus fascia pelvis.

Material: and methods. 2 fixed female cadaver pelvises (88 and 66 years old) were dissected.

[Burch laparoscopic colposuspension. Results of 30-month follow-up].

Unlabelled: Burch colpo-suspension, which is the present gold standard for treatment of stress urinary incontinence, may be performed laparoscopically.

Study Aim: The aim of this retrospective study was to report the results of laparoscopic Burch colpo-suspension with a 30-month follow-up and to assess the reason for the unsuccessful results.

Patients And Method: From 1990 to 1999, 118 patients (mean age: 46 years) were operated on for stress urinary incontinence with laparoscopic colpo-suspension.

[Laparoscopic treatment of symptomatic uterine retroversion].

Study Aim: The aim of this retrospective study was to demonstrate the feasibility of laparoscopic Jamain-Letessier procedure and to report its results.

Patients And Methods: Between August 1993 and September 1997, 19 patients (mean age: 29.7 years, range: 20-39 years) with painful uterine retroversion were operated on according to a laparoscopic Jamain-Letessier procedure.

[Hysterectomy for benign lesions: peroperative and early postoperative complications].

Objective: Although hysterectomy for benign disorders is a routine and usually well-tolerated procedure, complications do occur, and the resulting morbidity rates are not negligible. The aim of this prospective study was to report perioperative and early postoperative complications observed after hysterectomy, regardless of the route or the operator.

Patients And Methods: Between March 31, 1991 and December 14, 1998, 1,604 patients (mean age: 46.

[Prophylactic and therapeutic vaccine therapy in papillomavirus infections].

HPV types are carcinogenic in cervical cancer. This view is supported by epidemiological and biological evidence. Knowledges of HPV gene expression, of natural history of cervical HPV infection and neoplasia and of tumoral antigenic expression have lead to develop two strategies for vaccine development: 1-Prophylactic vaccines of HPV infections.

Is endometriosis an endometrial disease?

Endometriosis is characterised by the presence of abnormally located tissue resembling the endometrium with glands and stroma. Several hypotheses have attempted to explain the development of such tissue. The most often cited theory, that of implantation, proposes that the physiological phenomenon of endometrial reflux in the fallopian tubes during menstruation may, in certain conditions, overcome local defense mechanisms, implant, and proliferate.