[Anatomic and functional results after surgical treatment of uro genital prolapse: prospective study about 93 cases]. / Résultats anatomiques et fonctionnels après cure chirurgicale de prolapsus uro-génital : étude prospective. A propos de 93 cas.

BACKGROUND: genital polapse is a frequent olisease several techniques were described. AIM: To evaluate the anatomical and functional results of surgery for genital prolapse by vaginal and abdominal approach. METHODS: Prospective study on 93 patients operated for urogenital prolapse (50 by high and 43 vaginal approach) in the department of obstetrics and gynecology of Sfax. Anatomic results and postoperative patient satisfaction was assessed. Quality of life was assessed using the French versions of the questionnaires Pelvic Floor Distress Inventory (PFDI 20), Pelvic Floor Impact Questionnaire (PISQ 7). RESULTS: The mean age of patients was 59 years. 85.9% of our population consisted of postmenopausal women. The results of the postoperative visit, after a mean of 28.7 months, showed about the anatomical level, a success rate for the treatment of prolapse by high 82% against 72.1% for vaginal delivery, but the difference is not significant (P = 0.45). For prolapse of grades 1 and 2, surgical treatment by high and low has corrected all the elements of prolapse. For prolapse of grades 3 and 4, high surgery has resulted in a satisfactory anatomical result in 86%, while the lower channel yielded a significant result in 76.5%, and recurrence were interested mainly the anterior stage. The questionnaire PFDI 20, showed an improvement in the quality of life after surgery significantly in both groups (p<0.003). The improvement was more significant PFDI 20 after surgery by high versus vaginal surgery (p <0.002). Regarding PFIQ 7, improved quality of life was observed after surgery without significant differences between the two groups. CONCLUSION: The treatment of urogenital prolapse is mainly based on surgical and reconstructive surgery to restore anatomical and functional surgery also in order to improve the quality of life of patients.

Acquired lymphangioma circumscriptum of the vulva.

Lymphangiomas are rare benign proliferations of the lymphatic system. Acquired lymphangioma circumscriptum of the vulva is induced by impaired lymph flow. We describe a new case of lymphangioma circumscriptum resulting from tuberculosis involving a lymph node. A 45-year-old female presented with swelling of the vulva for the past 8 years. She had a history of multiple left inguinal swellings successfully treated with four antituberculosis drugs. Her vulval swelling did not respond and was diagnosed as acquired lymphangioma circumscriptum. She becomes the fifth reported case of acquired lymphangioma circumscriptum of the vulva with tubercular lymphadenitis. The single antituberculosis treatment is insufficient to control lymphangioma. Ablative methods seem encouraging.

[Premature ovarian insufficiency. Analysis of 30 cases]. / Insuffisances ovariennes prematurees. Etude analytique de 30 cas.

Premature menopause is a relatively rare disease but it has delicate consequences dominated by infertility problems. Most often, etiologic investigation is disappointing. Helped in some cases by the association to some auto-immune diseases or a previous treatment with chemotherapy or an irradiation may be useful to understand the origin of the premature ovarian failure. We analyse in this paper 30 cases of premature menopause to try to precise its etiologic factors, its diagnosis tools, the fertility prognostic and the therapeutic possibilities

[Male breast cancer]. / Le cancer du sein chez l'homme.

This study has been realized to determine epidemiological profile and clinico-pathologic aspects of male breast cancer in the south of Tunisia. We has counted and analysed all male breast cancers diagnosed in the general surgery department of the Sfax university teaching hospital with proof pathologic or to defect cytologic of malignancy, between 1989 and 2000. In the court of these years 23 new cases of mammary cancer has been diagnosed at the man. The average patient age was 68 years (extremes 40 and 95 years). According to TNM classification of 1988, 4.3% were classified T1, 26.1% T2, 8.6% T3 and 61% T4; 22% of tumors were M1. Histology found: 3 in-situ carcinomas (13%), 18 ductular infiltrating carcinomas (79%), 1 papillary cystadenocarcinoma, and 1 neuro-endocrin tumor. The clinic profile of male breast cancer in our country rest again relatively little frequent and its clinic profile resist alarming. To get better prognosis it is important to increase information and to promote early detection.