ABSTRACT
Contraception in Adolescents and Women with Disabilities Abstract. Around 1.8 million people with disabilities live in Switzerland, it affects every sixth adult person, every twentieth severely. Nevertheless, there is only little literature about sexuality and contraception in disabled people, it's rarely a topic in medical education and junior doctors are often untrained to deal with the special needs and risks in disabled patients. This article describes in five different cases the complex situations and different options of contraceptive counselling with regard to medical indications and contraindications, questions of hygiene and non-contraceptive benefit of hormonal therapies, but also ethical and legal issues are discussed. This article is intended to contribute to the improvement of the medical care of women with disabilities.
Subject(s)
Disabled Persons , Education, Medical , Adult , Humans , Adolescent , Female , Contraception , Contraindications , SwitzerlandABSTRACT
Objectives Female genital malformations may take the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and adnexa, the clinical picture of malformations may vary greatly. Depending on the extent of the malformation, organs of the urinary system or associated malformations may also be involved. Methods This S2k-guideline was developed by representative members from different medical specialties and professions as part of the guidelines program of the DGGG, SGGG and OEGGG. The recommendations and statements were developed using a structured consensus process with neutral moderation and voted on. Recommendations The guideline is the first comprehensive presentation of the symptoms, diagnosis and treatment options for female genital malformations. Additional chapters on classifications and transition were included.
ABSTRACT
Objectives Female genital malformations may be present in the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and uterine appendages, the clinical picture of malformations varies greatly. Methods This S2k-guideline was developed by representative members from different medical specialties and professions as part of the guidelines program of the DGGG, SGGG and OEGGG. The recommendations and statements were developed and voted on using a structured consensus process with neutral moderation. Recommendations This guideline is the first comprehensive summary of female genital malformations from infancy to adulthood which covers clinical examinations, diagnostic workups and treatment options. Additional chapters have been included on complex urogenital malformations, vascular malformations, psychosomatic care, and tumor risk.
ABSTRACT
The aim of this study was to assess the effects of voluntary pelvic floor contraction and voluntary pelvic floor relaxation on the urethral closure pressure at rest. In 104 consecutive women, three urethral pressure profiles were performed: standard profile at rest, with voluntary pelvic floor contraction and with voluntary pelvic floor relaxation. A low-pressure urethra was defined as a maximum urethral closure pressure of < or =20 cmH(2)O. The age ranged between 24 and 82 years. The maximum urethral closure pressure at rest was significantly augmented during pelvic floor contraction (mean: 18 cmH(2)O). Compared with the first profile, it decreased significantly with pelvic floor relaxation (mean decrement: 8 cmH(2)O). A low-pressure urethra was detected in 5 women during the first profile and in a further 11 during pelvic floor relaxation. Because of the significant influence of pelvic floor activity on the urethral closure pressure at rest, the scientific and clinical credibility of urethral pressure measurements remain questionable.
