[Ureteral endometriosis: three cases. Diagnostic and therapeutic management. Literature review]. / Endométriose urétérale: à propos de 3 cas. Conduite diagnostique et thérapeutique. Revue de la littérature.

Ureteral endometriosis is a rare but serious entity because of its insidious evolution which can lead to the loss of kidney function. Three cases are reported: two patients have received a medical and endoscopic management and the third one has undergone a surgical procedure. According to the literature, the authors suggest a diagnostic and therapeutic tree.

[Surgical treatment of genitourinary prolapse by the abdominal approach. Apropos of a series of 232 cases]. / Traitement chirurgical des prolapsus génito-urinaires par voie abdominale. A propos d'une série de 232 cas.

Two hundred and thirty two patients with genitourinary prolapse were operated via an abdominal incision between 1981 and 1994. The technique consisted of retroperitoneal promontofixation, systematically associated with a retropubic colposuspension, levator myorrhaphy, Douglassectomy and uterosacral ligamentoplasty. The mean age of operated patients was 52.57 years (30-85 years), the mean follow-up was 17.8 months (1-105). 65 patients (27.7%) had a history of foetal macrosomy, 125 women (53.4%) were delivered without forceps or expression, and 2 patients (0.8%) had never procreated. The main presenting complaint was prolapse in 197 patients (84.4%), while 140 patients complained of urinary incontinence (60.3%). A urodynamic assessment was systematically performed before the operation and revealed defective transmission in 160 cases (71%); sphincter incompetence in 62 cases (62/228 cases, i.e. 27%); a combination of sphincter incompetence and defective transmission in 40 cases (17.7%). The results were assessed in terms of anatomical and functional parameters. The anatomical results revealed 21 recurrences, the majority of which were posterior recurrences, and the functional results were marked by urinary functional disorders such as urinary incontinence (30%), urgent micturition (14%) and dyspareunia (21%).

[Does asymptomatic amniotic infection in the second trimester really exist?]. / L'infection amniotique asymptomatique au 2e trimestre existe-t-elle réellement?

OBJECTIVE: Our purpose was to evaluate the incidence of asymptomatic amniotic fluid infection. STUDY DESIGN: One hundred fifty-four amniotic fluid samples obtained at the second trimester between 14 and 27 weeks gestation were studied by Gram stain with bacteriological cultures and detection of mycoplasm species and Chlamydiae trachomatis. Transabdominal amniocentesis for caryotyping were carried out in 151 health patients with intact membranes and without preterm labor or signs of infectious (3 dizygotic twin pregnancies). RESULTS: One hundred forty-seven complete microbiologic examinations were performed (Gram stain examination white-cell count, quantitative aerobic and anaerobic cultures). Commercial texts for Mycoplasma hominis, Ureaplasma urealyticum and Chlamydiae trachomatis were negative. Three patients had rare microorganisms, coagulase negative staphylococcus (30 and 50 bacteria per ml) and alpha-hemolytic streptococcus (5 x 10(2) bacteria per ml). White cell count on amniotic fluids in 50 cases (32%) was less than 30 per ml. CONCLUSION: These findings appear to be in contradiction with recent data, suggesting the existence of intraamniotic infection in the early phase of the second trimester. Our data confirm the need for a cut-off level for white cell count to improve test sensibility.