[Vaginoplasty from peritoneal tube of Douglas' poutch for androgen insensitivity syndrome (two case reports)]. / Vaginoplastie utilisant le péritoine du cul-de-sac de Douglas pour le traitement du syndrome d'instabilité aux androgènes (à propos deux observations).

The androgen insensitivity syndrome (AIS) formerly known as testicular feminization is transmitted on a recessive X-linked. Its diagnosis is usually made at puberty if primary amenorrhea is present because the external genitalia are female. We report the case of two sisters aged 30 and 18 years, with testicular feminization syndrome discovered during the exploration of primary amenorrhea. Clinical examination found fairly well developed mammary glands, an hypertrophied clitoris, two formations in the labia majora corresponding to the testicles and agenesia of vagina. The uterus has not been seen on pelvic ultrasound and computed tomography scan of the pelvis. Cytogenetic analysis has objectified the chromosomal formula: 46 XY. We performed a vaginoplasty using peritoneum from the pouch of Douglas, a clitoroplasty and bilateral orchiectomy. The result was excellent. A neovagina with a depth of 6 cm was created. After 6 months of follow-up, the two sisters keep beautiful vaginal cavities with regular digital dilation. Peritoneum vaginoplasty is a simple and easy method for creating a neovagina with minimal complications. Its anatomical and functional results are satisfactory.

Migration intravesicale du dispositif intra-uterin a propos de cinq cas

La migration intravesicale du dispositif intra-uterin (DIU) par perforation uterine est une complication rare. Dans cette etude retrospective monocentrique; nous presentons notre experience de 5 cas colliges au sein de notre etablissement entre 2004 et 2009. L'age moyen de nos patientes est de 39 ans (32-48 ans). La symptomatologie clinique revelatrice etait dominee par le syndrome irritatif vesical. Le diagnostic a ete evoque sur le couple echo/AUSP; puis confirme par la cystoscopie. Le traitement a consiste en une lithotritie balistique du calcul avec extraction du sterilet par voie endoscopique chez 4 patientes et extraction chirurgicale chez une seule