ABSTRACT
Recent developments in the treatment of impotence and studies on the results of psychological methods for its treatment seem to indicate that the number of individuals who suffer from impotence of purely psychogenic origin is less than was reported in literature of the last decade. It is undoubtedly true, however, that psychological factors play an important role in the pathogenesis of this disorder. This review looks at psychological factors involved in impotence from three perspectives. Beginning with a historical review, those theoretical bases which formed the premise for psychological therapies are described. Second, diagnostic issues are explored in some detail. Finally, the variety of treatment modalities which have been used, with varying degrees of success, is described. It appears that whatever psychological treatment method is used, the patients who have the best prognosis are those in whom the disorder has lasted for less than two years, who have a strong motivation for psychotherapy, persisting sexual desire, and who are without significant psychopathology.
Subject(s)
Erectile Dysfunction/psychology , Behavior Therapy , Erectile Dysfunction/diagnosis , Erectile Dysfunction/etiology , Erectile Dysfunction/therapy , Humans , Hypnosis , Male , Psychoanalytic Therapy , Psychotherapy, BriefSubject(s)
Gynecology/education , Pelvis , Physical Examination , Clinical Competence , Female , Humans , TeachingABSTRACT
Autotransfusion was used in 38 patients with ruptured ectopic pregnancy. There was no mortality in this series. Transfusion-related morbidity occurred in six patients; two developed clinical coagulopathy; two, pulmonary edema; and two had minor transfusion reactions to concomitantly used banked blood. The procedure is safe and efficient and represents less risk to the patient than does the use of banked blood. The savings of the large amount of banked blood is certainly in keeping with a more salutary use of this valuable resource.
Subject(s)
Blood Transfusion, Autologous , Pregnancy, Ectopic/surgery , Blood Transfusion, Autologous/adverse effects , Female , Humans , Intraoperative Period , Pregnancy , Rupture, SpontaneousABSTRACT
Cryosurgery was used to treat patients with cervical dysplasia and cervicitis during a 44-month period. The course of dysplasia following cryosurgery in these patients has been evaluated and compared to the course of dysplasia in similar patients who were untreated or treated with biopsy only. When the groups with moderate and severe dysplasia are combined, a significantly greater number of patients treated with cryosurgery had progression of dysplasia in comparison to those patients in the untreated group. The disadvantages of cryosurgery are discussed, and criteria for evaluation of dysplasia prior to cryosurgery are outlined.
Subject(s)
Cervix Uteri/surgery , Cryosurgery/adverse effects , Uterine Cervical Dysplasia/surgery , Uterine Cervical Neoplasms/surgery , Adolescent , Adult , Aged , Colposcopy , Female , Humans , Middle AgedABSTRACT
During a 44-month period the introduction of colposcopy to a metropolitan dysplasia clinic resulted in 1, 144 colposcopic examinations on 442 patients. Agreement between colposcopically directed biopsy and final diagnosis was found in 84%, and directed biopsy revealed the most advanced lesion in 42.5%. Satisfactory colposcopy was performed on 93% of patients, and some degree of histologic abnormality was obtained in 86% of patients with colposcopic abnormalities. Undetected invasive cervical cancer occurred in both cervical conization and colposcopic examinations with equal frequency. Endocervical curettage detected two cases of occult invasive cancer, and increased use of this procedure is recommended. Guidelines for management of cervical neoplasia are suggested.
Subject(s)
Colposcopy , Uterine Cervical Diseases/pathology , Uterine Cervical Neoplasms/pathology , Biopsy , Cytodiagnosis , Female , Humans , Hysterectomy , Uterine Cervical Diseases/surgery , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/surgeryABSTRACT
Forty percent hyperosmolar urea solution was used intraamniotically to induce midtrimester pregnancy termination in 508 patients. The mean injection-abortion interval was 43.4 hours in those patients aborting within 7 days (85.8% of the total group); 76% of the group aborted within 72 hours. Complications from the procedure included endometritis, hemorrhage, and nausea and vomiting; 29.3% of the patients required operative completion of the abortion (placental removal 12 hours after passage of the fetus). There were no cases of hypernatremia, cardiac arrest or collapse, clinically evident coagulopathies, nor cervical lacerations. This study supports the conclusion that urea is a safer intraamniotic solution than hypertonic saline for midtrimester pregnancy termination.
