[Endometrial survey during phytoestrogens therapy in postmenopausal women]. / La sorveglianza endometriale in corso di terapia con fitoestrogeni in postmenopausa.

AIM: The aim of this study was to verify the effects on endometrium of short-term phytoestrogens therapy in postmenopausal women. METHODS: This randomized study compared two groups of 50 patients undergone respectively to phytoestrogens therapy or placebo. An endometrial survey was performed on the study groups by ultrasound and hysteroscopy at baseline and at 6 and 12 months. RESULTS: The ultrasonographic findings and the hysteroscopic biopsies in the 47 women submitted to phytoestrogens therapy that completed the follow-up showed an atrophic and/or inactive endometrial mucosa less than in one patients (2.1%) with endometrial thickness and proliferative endometrium bioptical sample after 12 months of treatment; no cases of endometrial hyperplasia were found. CONCLUSION: In the authors' 12 month experience, phytoestrogens therapy in postmenopausal women was safe for endometrial stimulation because did not cause any significant alteration of the mucosa in a short-term administration.

[Hypercoagulability during pregnancy: evidences for a thrombophilic state]. / Trombofilia in gravidanza: evidenze clinico-sperimentali di uno stato trombofilico.

AIM: The development of thrombotic disorders is a major threat for young women during pregnancy. It is one of the main causes of pregnancy-related disorders, which may also result in harm for the conceptus. Successful pregnancies require an even balance of coagulation and fibrinolysis, in order to secure stabilization of the basal plate as well as adequate placental perfusion. Broad spectrum assays which measure a range of thrombin/fibrin formation in serum have become an established means of identifying activation of blood coagulation and/or fibrinolysis. There is considerable interest in the application of these assays to the diagnosis of other hypercoagulable states, such as thrombophilia during pregnancy. We investigated coagulation/fibrinolysis parameters for significant differences between pregnant women during their gestation (first, second and third trimester) with or without pregnancy loss and healthy nonpregnant women. METHODS: Thirty-nine pregnant women, aged 24-39 years, were studied. They were subdivided according to pregnancy trimester: 15 patients in the first trimester; 13 in the second and 11 in the third. The selection of patients was carried out in cooperation with the Transfusion Center of the Second University of Naples in order to obtain a homogeneous sample group. The control group included 400 healthy patients. Biochemical and blood coagulation tests were performed for each patient and the results obtained were compared with the control group. RESULTS: A decrease in free protein S (PS) and fibrinolysis (t-PA/PAI-1) activities and an increase in Factor VII, Factor VIII, prothrombin fragment 1+2 (F1+2), D-dimer (D-dimer) were observed in pregnant women during the follow-up of gestation. However, there were statistical differences between the groups of women with one or more pregnancy loss where it was found the lowest values in t-PA and PAI and the highest values in FVII and F1+2. Among subjects with more than one abortion, coagulation/fibrinolysis derangements before the partum were more prominent. A significant association exists between consecutive recurrent abortions and pregnancy complications such as placental abruption, hypertensive disorders and CS. This association persists after controlling for variables considered to coexist with recurrent abortions. CONCLUSIONS: These findings suggest that an excessive hypercoagulable state is associated with the termination of pregnancy resulting into a moderate risk for thrombosis during the different trimesters of pregnancy. The follow-up of fibrinolytic markers could represent a useful diagnostic tool for termination of pregnancy.

Female adnexal tumor of probable wolffian origin: clinicopathological, immunohistochemical and cytofluorimetric analyses of a 22-year-old virgin. case report.

The term female adnexal tumor of probable Wolffian origin "FATWO" designs this tumor wich arises by the rare persisting remnants of the mesonephric duct (Wolffian duct). About 40 cases have been reported in literature. Few cases of recurrence have been reported, FATWO usually shows no signs of hormonal activity. We report a case of the youngest patient affected by FATWO in October 2002. At laparotomy the left adnexa were deformed by a well-capsulated mass, totally removed and sent to the pathologist with a specimen of peritoneal fluid and of the omentum. The histological examination showed a prevalent tubular structure with focal retiform area, without intraluminal mucines. Immunohistochemical findings of the case reported are similar to those described by other authors, except for inhibin which has not been detected by us. The cytofluorimetry showed the low presence of aneuploid cells, with a very low prolifing component (< 1%).

[The effects of phytoestrogen therapy on the endometrium in postmenopausal women]. / Effetti della terapia con fitoestrogeni sulla mucosa endometriale in postmenopausa.

AIM: The purpose of the present study was to carry out a comparative histological analysis of the endometrium in postmenopausal women who made use of phytoestrogens in order to assess the efficacy and possible side effects of this therapy. METHODS: This study was carried out by forming 2 groups in order to compare the results. One group was given a dietary supplement of phytoestrogens for 24 months, whereas the other was given a placebo for the same period of time. At the beginning of this study endometrial bioptical samples were taken from those patients who had been previously selected at our University Centre. This study was started only with those postmenopausal patients whose bioptical sample was histologically suitable, and it was neither hyperplastic, nor cancerous and nor secretive. During these 24 months there have been frequent contacts aimed at verifying the standard therapeutic behaviour, symptoms and appearance of side effects. At the end of the study new and final bioptical samples of endometrium were taken from both groups. RESULTS: One-hundred and forty-one patients completed the study. Five patients (3.4%) who were submitted to phytoestrogens therapy showed a weak proliferative endometrium bioptical sample. All the other biopsies at the beginning and at the end of the study showed an atrophic and inactive sample. Hot flushes, night sweats, vaginal dryness and dyspareunia improved at the end of the study for the group treated with phytoestrogens as compared to the one treated with a placebo. Although there have not been very significant differences ias to symptoms and side effects, it was noted that insomnia was the most common symptom in the group treated with non-hormonal therapy based on phytoestrogens. CONCLUSIONS: Phytoestrogens did not cause any sensitive and worrisome stimulation of the endometrial mucosa. Insomnia was more frequent in the group treated pharmacologically in the 24 months of the study, whereas hot flushes, night sweats, vaginal dryness and dyspareunia persisted or increased as compared to the beginning of the study in the group treated with a placebo, but this did not occur for the group treated with phytoestrogens.

[Thrombophilic syndrome associated to phenotypic resistance to activated protein C in postmenopausal women]. / Sindrome trombofilica associata a resistenza fenotipica alla proteina C attivata in donne in postmenopausa.

AIM: Hormone replacement therapy (HRT) may reduce the risk of cardiovascular events in healthy postmenopausal women. However recent studies suggest a 2-4 fold increased risk of idiopathic venous thromboembolism (VTE) among users of HRT. Our aim was to evaluate the overall effect of HRT on hemostatic variables probably related to increased VTE risk reported in epidemiological studies. METHODS: Therefore, 100 healthy postmenopausal women aged 45-60 years divided into 50 HRT non-users and 50 HRT users were examined. The authors assayed on the automated coagulometer ACL7000 (Instrumentation Laboratory, Milan) the procoagulant proteins: factor VIII (VIII:C) and factor VII (VII:C); the natural anticoagulant proteins: antithrombin (ATIII), protein C (PC), protein S (PS) and the resistance to anticoagulant action of activated protein C (APC-Resistance). The free tissue factor pathway inhibitor (TFPI) was measured with an ELISA method (Diagnostica Stagò; France, Roche). The in vivo coagulation and fibrinolysis activation was evaluated by the assays of prothrombin fragment 1+2 (F1+2) and plasmin- antiplasmin complexes (PAP) using ELISA techniques. RESULTS: Increased levels of FVIII:C and FVII:C were observed in HRT users and HRT non-users women compared to controls (FVIII:C= 126+/-58%, 120+/-59% vs 85+/-15% p=0.0001; FVII: C 113+/-23%, 103+/-19% vs 90+/-16% p=0.0001). The activation peptides were significantly different compared to those found in control subjects; higher values were observed in HRT users compared to HRT non-users (F1+2=1.11+/-0.44 nM, 077+/-0.31 nM vs 0.45+/-0.35 p=0.00001; P-AP= 606+/-406 ng/ml, 514+/-205 ng/ml vs 235+/-59 p=0.0001). The ATIII and the PC were similar among the 3 different groups of subjects, but reduced levels of PS were observed in HRT users (PS 93+/-23%, 105+/-22% vs 109+/-12 p=0.0001). The mean normalized APC sensitivity ratio (APC-SR) was lower in the two populations of women as compared with that of controls (nAPC-SR 1.02+/-0.7, 1.02+/-0.8 vs 1.1+/-25 p=0.02). The values of free TFPI were reduced in HRT users compared to HRT non-users (9.1+/-1.9 ng/ml, 10.1+/-2.3 ng/ml vs 4.6+/-1.5 ng/ml p<0.0001). CONCLUSION: HRT appears to be associated to a shift in the procoagulant-anticoagulant balance towards a procoagulant state. The changes in hemostatic system could explain the increased risk of VTE in healthy postmenopausal women during HRT, nevertheless this risk could be higher in women known to have a congenital or acquired thrombophilic state.

Fertility after laparoscopic myomectomy of large uterine myomas: operative technique and preliminary results.

OBJECTIVE: The purpose of this study was to evaluate indications and complications of laparoscopic myomectomy with regard to the reproductive outcome of infertile women with a large leiomyomatous uterus. METHODS: From January 1997 to July 1999, 144 patients underwent laparoscopic myomectomy for a myoma measuring > or = 5 cm in diameter. Indications for surgery were increase in size of myoma in infertile patients (70.8%), pain (44.4%) or abnormal bleeding (68%). Average size of myomas were 7.8 cm with a range of 5 cm to 18 cm. The myomas were intramural/submucosal (n = 108), subserosal (n = 15), intraligamentous (n = 14) and peduncolated (n = 7). The laparotomy conversion rate was 1.39% (n = 2); one case required a blood transfusion. Operating time ranged from 58 to 180 minutes with an average of 95 minutes. Average hospital stay was 2.6 days and the overall complication rate was 2.08%. Eighteen patients (12.5%) underwent second-look laparoscopy. The rate of postoperative adhesion was 33.3%; there were no adnexal adhesions. In all cases ultrasonography was done one day after the operation and five weeks postoperatively to compare wound healing, the last control showed an irregular hypodense area in only 14 patients (9.7%). RESULTS: Twenty-six patients operated on in 1997 went on to conceive: nine vaginal deliveries, 12 Caesarean sections, four miscarriages and one ectopic pregnancy. No uterine rupture was observed. The pregnancy rate for patients submitted to laparoscopic myomectomy in 1997 (n = 38) was 34.21% at six months (n = 13) and 55.26% (n = 21) at 12 months after the procedures. CONCLUSIONS: Our preliminary results confirm that conception occurs in the majority of infertile women with a large leiomyomatous uterus who undergo myomectomy and second-look laparoscopy leads to a low complication rate.

Antenatal diagnosis and obstetric management of cystic hygroma occurring in twin pregnancies. A case report.

The lymphatic system has an early development in the embryo. Usually, its development is complete by the 40th postconceptional day. If this connection fails to develop, lymphatic stasis and dilatation of the lymphatic channels may occur, causing a number of pathologies such as: lymphangiomas, lymphangiectasis and cystic hygromas. Prenatal diagnosis can be made during the first trimester of pregnancy by ultrasonographic examination. A case of a twin pregnancy associated with cystic hygroma and bilateral hypoplasia of lower and upper limbs of both foetuses without chromosomal abnormalities is reported.

Depot leuprorelin acetate versus danazol in the treatment of infertile women with symptomatic endometriosis.

PURPOSE OF INVESTIGATION: Endometriosis is a common finding in women with infertility, but the mechanism by which it renders a woman infertile remains unclear. The medical treatment of pelvic endometriosis includes hormonal therapy that directly attacks endometriosis lesions or indirectly by inhibiting endometrial proliferation through estrogenic deprivation. The aim of this study was to compare the efficacy and safety of leuprorelin acetate depot and danazol for endometriosis in infertile women. METHODS: This randomized trial involved 81 women 19-41 years old with regular menses and known pelvic endometriosis who were recruited from the Fertility Center of the Second University of Naples between 1992 and 1999. Fifty-four women were given 3.75 mg of leuprolide acetate depot every 28 days for 24 weeks and the remaining 27 took 200 mg of danazol three times daily for 24 weeks. Efficacy assessments were based on pre-admission and end-of-treatment laparoscopic scores and subjective symptoms scores at 4-week intervals during and after treatment. Safety was evaluated by adverse events and clinical laboratory tests. RESULTS: In each group, endometriosis growth and symptoms significantly improved during treatment (p < 0.001). Significantly fewer patients randomized to leuprorelin acetate (5.5%) withdrew during treatment compared with 18.5% randomized to danazol (p < 0.05). After treatment symptoms returned in each group, but severity was less than at admission at all time points (p < 0.02). Hypoestrogenic side-effects were more common in those receiving leuprorelin, particularly hot flushes, but anabolic/androgenic side-effects of weight gain and acne were more common in those receiving danazol. CONCLUSION: Both leuprorelin acetate depot and danazol are effective in the treatment of endometriosis in infertile patients. The hypoestrogenic side-effects of leuprorelin may be better tolerated than the androgenic, anabolic effects of danazol.

Immunological variations in women suffering from ovarian cancer. Influence of radical surgical treatment.

BACKGROUND: The immune system includes all the innate or acquired mechanisms, that the organism uses for protecting itself from the aggression of external pathogens or neoplasia. About the control of the tumor growth, the immune mechanisms implicated are quite a lot: the cytotoxicity against the tumor cells by cytotoxic T lymphocyte, macrophages, NK cells; simil-NK cells (ADCC). Tumors have generally antigenic marked potential, for which numerous antigens have been identified, but none of these has revealed a correlated specificity to the neoplasia. Only a glycoprotein at elevated molecular weight, the CA125, presents an elevated specificity and sensibility. The objective of this study was to examine immunological variations in the peripheral blood of patients with ovarian carcinoma before and after radical surgical treatment. METHODS: In the Institute of Obstetrics and Gynaecology of Second University of Studies of Naples the immunological variations in 8 women (mean age: 59.5; range: 49-70 years) suffering from ovarian cancer, have been evaluated before and after radical surgical treatment (when the stage of the tumor made possible the surgery) and compared to 8 normal volunteers of comparable age (control group), in the period January 1994-June 1998. The patients were followed in average for two years and subjected to a immunological screening with blood drawings effected at the hospitalisation and later 1, 6, 12, 18, 24 months from surgical treatment. The immune evaluation were effected with: proliferation tests on the monocytes of the peripheral blood, evaluation of the production of Interleukin 1 and 2 with the leukocyte phenotyping, evaluation of NK cells activity. The patients were followed in average for two years. RESULTS: The radical surgery decidedly improves the immune response. The ability to produce IL-1 by the lymphocytes of the patients object of our study, appeared constantly falling (with reduction of about 50%) before the surgery and it meaningfully increases in the post-surgery period. The surgery doesn't modify the lymphocytes T helper and T inducer. The surgery delays the diminution of the NK cells in a little meaningful way. The periodic dosage of the CA125 does not give the same results: in the 60% a progressive increase was realised and in the 40% it remained constant. CONCLUSIONS: The surgery constantly improved the physical state of the patient, determining an increase of the immune response toward the neoplasia, and therefore achieving a meaningful increase of survival.

[Small ovarian cysts in postmenopause: assessment of their malignant potential with vaginal ultrasonography and tumor marker Ca125 titration]. / Piccole cisti ovariche in postmenopausa: valutazione del loro potenziale maligno mediante l'uso di ultrasonografia vaginale e titolazione del marcatore tumorale Ca125.

BACKGROUND: The aim of this study was to determine the risk of malignancy in cystic ovarian tumors < 10 cm in diameter in asymptomatic postmenopausal women. METHODS: All cystic ovarian tumors, detected by abdominal and transvaginal sonography screening, in asymptomatic postmenopausal women were evaluated with respect to size and morphology. Follow-up data were available both on patients undergoing surgery and on those who elected to be followed without operative intervention. Titration of the tumoral marker Ca125 was carried out, too. RESULTS: Unilocular cystic tumors were detected in 32 of 352 postmenopausal patients (9%), of 45-65 years of age arrived at the "Centre for diagnosis and therapy of menopausal diseases" of the III Divisione di Ginecologia e Ostetricia della Seconda Università degli Studi di Napoli from the 1st January to the 31st December 1999. All tumors were < 10 cm in diameter and 98% were < 5 cm in diameter; just one tumor was hardly > 5 cm in diameter (5.8), 14 of these cystic ovarian tumors (49%) resolved spontaneously within 60 days while 18 (51%) persisted. Seven patients with persistent cystic ovarian tumors underwent operative tumor removal. Five of these patients had serous cystadenoma and 2 other women had cystoadenofibroma. Not even one case of ovarian carcinoma was found in this group. The remaining 11 patients with unilocular cystic ovarian tumors underwent sonography control every 3 months for one year and no one of these patients developed ovarian carcinoma. In all these patients the dosage of the tumoral marker Ca125 remained under the suspicious threshold of malignant ovaric tumor (Ca125 = 35 U/ml). CONCLUSIONS: Unilocular cystic ovarian tumors < 5 cm in diameter in asymptomatic postmenopausal women were associated with minimal risk for ovarian cancer. In contrast, complex ovarian cysts wall abnormalities or solid areas are associated with a significant risk for malignancy. These date are important in determining therapeutic optimal strategies in these patients.

Ovarian cancer screening by transvaginal color Doppler ultrasonography.

BACKGROUND: The need for the early detection of ovarian cancer continues to be one of the most important issue in women's health care. The ovarian neoplasia characteristically have a scarce symptomatology for which it tries to create a sensitive and specific screening test so that the diagnosis could precociously be made and, consequently, improve the prognosis with a timely therapy. Our purpose was to assess the performance of transvaginal color Doppler ultrasonography in ovarian cancer screening. METHODS: In the Institute of Obstetrics and Gynaecology of Second University of Studies of Naples, in the period between January 1997 and December 1998, 60 women, divided into two groups (the 1st group included 30 women in fertile age with standard uterine dimensions, the 2nd group included 30 menopausal women), were submitted to transvaginal color Doppler ultrasonography. Color Doppler ultrasonography was performed with an ESAOTE ANSALDO AU5 HARMONIC ultrasound machine provided with a 6.5 MHz real-time sector electronic array endovaginal probe with a 5 MHz pulsed Doppler system and equipped with the color velocity imaging system for the color blood flow codification. The score used in the evaluation of the ovary are us follows: volume of the adnexa (from 1 to 5); presence of papillas and septa (from 1 to 5); wall thickness (from 1 to 5). An high score (> 12) corresponds to probability of presence of neoplasia. For the flow modifications the following parameters were considered: RI (Index of resistance); PI (Pulse Index); Vmax (Maximum Speed). CD was considered as suspicious when flow was detected and the lowest RI found was < or = 0.45, PI < or = 0.58 Vmax < or = 60. RESULTS: Sonographic morphology evaluation and CD were suspicious in 11 cases and 9 of these were positive on histopathological analysis (true positive = 15%, false positive = 5%). All the women that had morphologically normal ovaries observed on ultrasound examination and were not suspicious on CD analysis, were also negative on histopathological analysis (true negative = 80%). CONCLUSIONS: The color Doppler ultrasonography revealed a decidedly valid method of screening of the first level, being non-invasive examination, painless, therefore well accepted by the patients, even if in some women, especially if in fertile age, the physiological modifications calls for repeated investigations and compare its parameters.

[Role of Ca 125 in pelvic masses. Our experience]. / Ruolo del Ca 125 nelle masse pelviche. Nostra esperienza.

BACKGROUND: The goal of our study is to plan a screening program for early detection of ovarian cancer through clinical examination, pelvic ultrasonography and serum Ca 125 dosage. METHODS: Between January 1993 and June 1999, 436 patients have been submitted to ovarian cancer screening at the Obstetrics and Gynecology Institute of the Second University of Naples. All women were in postmenopausal period, older than 50 years and didn't show any gynecologic disease. RESULTS: Clinical examination selected 41 patients (9.4%) with a pelvic mass; pelvic ultrasonography revealed ovarian or uterine mass (only subserous myoma) in 87 cases (19.9%). These patients were submitted to Ca 125 serum dosage; in three cases Ca 125 was higher than 65 U/ml and in 26 cases its value was between 35 and 65 U/ml. The remaining 58 patients showed Ca 125 values lower than 35 U/ml. Four patients with ovarian cancer have been detected with our screening program. CONCLUSIONS: The authors conclude that pelvic ultrasonography and serum Ca 125 dosage are useful for the assessment of an early screening program of ovarian cancer.

[Role of echo-guided aspiration of ovarian cysts. Our experience]. / Ruolo dell'aspirazione eco-guidata delle cisti ovariche. Nostra esperienza.

BACKGROUND: Ultrasound-guided puncture is a simple and easy to perform procedure. This study was undertaken to verify the role of fine-needle aspiration (FNA) followed by cytological examination as a possible alternative to surgery in case of cystic pelvic masses. Ovarian cysts are conventionally managed by laparoscopy or laparotomy. METHODS: From January 1993 to December 1997, 224 patients with a proven cystic pelvic mass underwent surgical intervention and have been retrospectively analysed for FNA under sonographic guidance. The sediment aspirated was examined by a cytological method and when possible it was also correlated to a histological test. RESULTS: Eight patients (34.8%) had been submitted to one needle cyst aspiration before surgical intervention and 15 (65.2%) to more than one aspiration. Patients with an history of only one aspiration were submitted to surgical intervention with urgency statistically more than the group with an history of more than one aspiration. Anatomo-pathologic examination showed a significative relevance of serous and endometriotic cysts. CONCLUSIONS: We conclude that FNA might be proposed in young women with a unilocular ovarian cyst to avoid a surgical procedure. In all instances the ultrasonographic appearance of the cyst and the characteristics of aspirated fluid are the most important findings.

Contraception with the latest estroprogestagens in women suffering from systemic lupus erythematosus.

BACKGROUND: This study was performed to evaluate, in women suffering from Systemic Lupus Erythematosus (SLE), the relationship between the assumption of oral contraceptives and the evolution of the disease. METHODS: In the Institute of Obstetrics and Gynaecology in collaboration with the Institute of Dermosyphilopathical Clinic of Second University of Studies of Naples, 20 women in fertile age suffering from SLE with specific cutaneous manifestations were studied for the year 1999. All the patients requested to take, at contraceptive purpose, low-dosage estroprogestagens. The contraceptives we prescribed have, as active substance, the gestodene at the dose of 0.075 mg and the etinilestrdiol at the dose of 0.02 mg per day. Patients' group in object was compared for a year with a similar control group of women suffering from SLE not subjected to any pharmacological therapy. RESULTS: Only 5 patients out 20 have had to suspend therapy after 4 or 5 months, because a relapse of the illness was experienced while the others 15 patients did not lament a relapse of the illness. In the control group a more or less similar percentage of patients, during the months of the observation, spontaneously had episodes of relapse of the illness. CONCLUSIONS: The results of our brief study have shown that the administration of hormonal contraceptives in reality doesn't constantly produce immediate and remarkable exacerbations of the illness in women suffering from SLE. In our opinion the contraception with the latest estroprogestagens can comfortably be effected under strict medical control, probably because the medicines at low dosage are quickly metabolized and in the majority of the cases they don't have capacity to influence the course of such chronic connectivitis.

[Ovarian function after total simple hysterectomy]. / La funzionalità ovarica dopo isterectomia totale semplice.

BACKGROUND: The aim of this prospective study is to evaluate the ovarian function and its duration after total simple hysterectomy. METHODS: This research was carried out on thirty regularly menstruating patients who underwent simple hysterectomy. Ovarian function has been evaluated by measuring FSH, E2, PP at 6 and 24 months from hysterectomy or from the first observation at the beginning of the study. RESULTS: None of the patients showed ovarian failure at 6 months. Nine patients (average age: 48,8 years) showed ovarian failure at 24 months. CONCLUSIONS: The conclusion is drawn that the cessation of ovarian activity is not influenced by hysterectomy: it rather depends on the age of the patient.

Induced abortion and contraception: survey of 576 young women in Naples.

The aim of the study was to investigate the link between induced abortion and contraceptive methods. Five hundred and seventy-six women who underwent induced abortions at the Obstetrics and Gynecology Institute of the Second University of Naples were interviewed. They were asked about their knowledge of contraception methods; age, school attendance rate and marital status were also considered. The women were 27.8 (mean age) years old, high school educated (58.5%), married (41%), nulliparous (63%). Twenty-four percent of the women admitted a previous induced abortion. Withdrawal (176 women), condoms (104) and oral contraceptives (74 women) were the most widely used contraceptive methods. Withdrawal (37%) resulted in being the most utilized method during the cycle in which conception occurred; no method had been employed by 31% of the women. We found that 35% of the women had used their contraceptive method in a regular way but become pregnant nevertheless. Another group of 40% had forgotten to use their contraceptives for a few days and became pregnant by accident. In the last group of 25% of the women had not used any contraceptive methods. The diffusion of modern methods of fertility regulation influences the number of induced abortions as shown by its reduction since 1982. Our data confirm that induced abortion is the consequence of an insufficient use of modern contraceptives. Therefore more information is necessary to get women and men to use contraceptive methods regularly.

[Evaluation of partners of women with HPV infection]. / Controllo dei partners di donne con infezione da HPV.

BACKGROUND: The authors report the results of a clinical-peniscopic study of the genital regions in the male sexual partners of woman with proven genital Human Papilloma Virus (HPV) infection because of its contagiousness, incidence rate and relation with premalignant lesions. METHODS: From January 1998 to March 1999, 137 sex partners of women with HPV genital infection were investigated by clinical evaluation, cytologic examination of a urethral brushing and peniscopy at the Cervico-vaginal Pathology Center of the Gynecology and Obstetrics Institute of the Second University of Naples. All patients with a clinical and/or peniscopic evidence of infection were submitted to biopsy for histologic examination. RESULTS: On peniscopy 29.9% (41 patients) of men presented lesions either typical of suspicious for HPV infection at the first and/or at the second control. CONCLUSIONS: These data confirm that HPV infection, as all sexually transmitted diseases, needs a prevention and control program involving male and female to obtain a good recovery rate and a lowest diffusion.