[Transposition of a tube and transposition of an ovary in the treatment of sterility]. / Transposition d'annexe et transposition d'ovaire dans le traitement de la stérilité.

The transposition of an ovary or of a tube is a simple procedure and it is valuable in certain kinds of tubal pathology. In the four cases here presented this technique allowed three pregnancies to occur. It can however only be used in certain types of lesions.

[Obstetric and neonatal consequences of urinary infection during pregnancy]. / Conséquences obstétricales et néonatales de l'infection urinaire gravidique.

In this article, the authors study the real obstetrical and neonatal effects of urinary infection in pregnant women. Basing themselves on 225 cases of gravidic urinary infection, the authors discuss asymptomatic bacteriuria, the need of early diagnosis in risk patients, and the use of regular post-treatment monitoring, in view of the fact that, even when well-treated, this complaint is apt to recur.

[Idiopathic thrombopenic purpura and pregnancy]. / Purpura thrombopénique idiopathique et grossesse.

Idiopathic thrombocytopenic purpura occurring in pregnancy has a risk for the fetus of severe thrombocytopenia. The handling of these cases obstetrically is controversial. Our experience and that derived from reading the literature suggests that counting the number of maternal platelets does not reflect on the risk for the fetus and the neonate. On the other hand it does seem that estimating the levels of circulating platelet antibodies in the maternal plasma does give an indication of platelet destruction in the fetus. Corticosteroid treatment improves greatly the number of maternal platelets and is probably good treatment for the fetus in utero. Giving gamma-globulins intravenously to the pregnant woman or to the newborn is an interesting therapeutic measure seeing how it is free of danger. How useful this treatment is in pregnancy has yet to be determined.

[Digestive complications of radiotherapy of gynecologic cancers: therapeutic possibilities]. / Les complications digestives de la radiothérapie des cancers gyécologiques : possibilités thérapeutiques.

It appears that there are a certain number of complications in the digestive tract that still occur in spite of improvements in techniques of irradiation therapy. They may only appear a few months or even a few years after the treatment, and sometimes they only appear when the initial growth is considered to have been cured. The clinical picture is dominated by the appearance of fistulae, of adhesions and of stenoses which give rise to sub-acute or sometimes acute obstructions. From the anatomical point of view all elements of the digestive tube are affected with a predominance of the fibro-hyaline elements of the muscles and the arteries. The possibilities for surgical treatment are limited. Excision with anastomosis would seem to be more risky than diversion. We have had to operate on ten of our eleven patients, of whom six died and only one of these directly because of recurrence of the initial growth. Only prevention can lessen the mortality of these severe complications.

[Digestive endometriosis. Current concepts]. / L'endométriose digestive. Conceptions actuelles.

Endometriosis involving the digestive tract accounts for 1% of all cases of the disease. There is a marked predominance in the recto-sigmoid and terminal ileal loops. Symptomatology is dominated by disturbances in intestinal transit, sub-occlusion or acute obstruction, pain worsening at the time of menstruation and by a haemorrhagic rectal discharge again accompanying menstruation. Apart from classical aetiopathogenic theories such as grafting onto the digestive tract by tubal, lymph vessel or venous propagation, it would appear that prostaglandins and in particular a change in the (formula; see text) ratio may play a large role. Operative resection of localised stenosis combined with oophorectomy, if the latter is possible in view of the patient's age, or prolonged medical treatment with progestational agents or even better Danazol results in cure and avoids recurrences.

[Endometriosis in the abdominal wall (author's transl)]. / Endométriose de la paroi abdominale.

The authors give 9 case histories of endometriosis localised to the abdominal wall : 3 of them in the umbilicus, 3 in laparotomy incisions (2 of those were Caesareans), 2 of them in the round ligaments at the external opening of the inguinal canal and 1 of them in the right rectus muscle sheath in the abdomen. The functional symptomatology is rhythmical according to menstruation; it is associated with a burning type of pain, a tumour and blood loss. Over and above the theories of aetiology that are now classical, namely tubal retrograde spill, and lymphatic or venous spread, it would seem that prostaglandins and in particular the ratio of P.G.E. divided by P.D.F2 alpha can play a big role. Although Danazol is an effective treatment for endometriosis, the treatment of choice is, in these lesions that are superficial in localisation and easily accessible, to cut them out surgically. This makes it possible on the one hand to look for other intra-abdominal lesions and also on the other hand to confirm the anatomy and pathology (this was done in 7 out of 9 of our cases).