[Prolactinoma: from quest of pregnancy to delivery]. / Adénome à prolactine : du désir de grossesse à l'accouchement.

Prolactinoma is the most frequent hormone-secreting pituitary tumor (100 for million patients) and a major cause of both female and male reproductive function disorders. Physician, gynecologist, urologist and sexologist can face this situation during their career. As part of the fertility restoration, treatment gives very satisfactory results. With adequate management, most women are expected to achieve successful pregnancies. The natural history of these tumors during pregnancy depends on their size with a risk of a clinically relevant estimate between 5 to 30 %. Their management is complex, requiring finding balance between effects of pregnancy on tumor growth and potential risks of overtreatment on fetal development. The aim of this study is to discuss the management of prolactinoma on woman before, during and after pregnancy, and to evaluate the medical and surgical alternatives regarding the actual literature.

[A recurrent cutaneous fistula secondary to the migration of a clip: report of a complication of tubal sterilization]. / Fistule cutanée récidivante secondaire à la migration d'un clip de Filshie : une complication de stérilisation tubaire.

The tubal sterilization is a safe and recognized sterilization method. The complications of this intervention are rare and mainly concern failure of surgical procedure or clip migrations. We report the first case of spontaneous migration of a clip behind the psoas followed by a chronic osteitis.

[Is there a real place for robotics in proximal tubal surgery?]. / Y a-t-il une réelle place à la robotique pour la chirurgie tubaire proximale ?

Tubal surgery requires a fine gesture. Its complexity, the difficulty of learning, the low recognition at the time of T2A and the success of Assisted Reproductive Technology (ART) could have announced the obituary of this surgery. However, in well-trained hands, tubal surgery avoids unnecessary ARTs and even allows pregnancies when medical technology fails. In this context, it is legitimate to ask whether the contribution of new technologies in the operating theatre, such as robotic surgery, can lead to an easy realization of microsurgery on a particularly complex portion of Fallopian tubes: the proximal segment.

[Who limit vaginal birth for breech presentation: medical practice or Law? Discussion between a medical doctor, a lawyer and the head chief of an university hospital]. / Qui limite l'apprentissage obstétrical et la pratique de l'accouchement de la présentation du siège par voie basse : la médecine ou le droit? Discussion entre un praticien, un avocat et un responsable de service universitaire.

The mode of delivery of breech presentation still remains a debate in France. Despite the medical arguments, themselves in debate, exists a legal pressure felt by medical practitioners. Our study highlights the different opinions of medical practitioners, lawyers and medical teachers faced with breech presentation.

[Contribution of new MRI sequences in the exploration of the pelvic gynaecological disease]. / Apport des nouvelles séquences d'IRM dans l'exploration de la pathologie gynécologique pelvienne.

MRI has emerged for several years as the imaging examination of second-line indications in the majority of female pelvic imaging, after ultrasonography. Recent technical advances have allowed the widespread use of new MRI sequences, allowing a morphological and functional analysis of the pelvic organs. Diffusion weighted-imaging has a definite interest for the detection, characterization and staging of uterine and adnexal lesions. Dynamic contrast-enhanced imaging is an essential tool for characterizing adnexal lesions and to optimize the staging of uterine cancers. The 3D morphological imaging allows multiplanar reconstructions and is particularly useful in mapping fibroids, uterine malformations and in endometriosis.

[Comparison between two analgesic protocols on IVF success rates]. / Comparaison de deux protocoles antalgiques utilisés au cours de la ponction folliculaire sur les taux de réussite en fécondation in vitro.

OBJECTIVES: Analgesic protocols administered before a follicular puncture under local anesthesia are well tolerated when using NSAIDs, but we still do not know their possible impacts on in vitro fertilization (IVF) outcomes. MATERIAL AND METHODS: A retrospective monocentric study using two consecutive temporal cohorts of patients was conducted to compare two analgesic protocols: paracetamol/alprazolam (P/A), then nefopam/ketoprofen (N/K). RESULTS: We demonstrated that biochemical pregnancy rate and the others outcomes of IVF are not significantly influenced by the type of analgesic protocol used. CONCLUSION: The protocol N/K enhances patient comfort without jeopardizing the IVF success rates.

[A role of robotic-assisted surgery to preserve female fertility? Comments about the first paratubal cystectomy performed with the "Da Vinci S" robotic system in a young girl]. / Un rôle de la chirurgie robot-assistée pour préserver la fertilité féminine? Réflexion à propos d'une première exérèse de kyste paratubaire par cœliochirurgie robot-assistée "Da Vinci S" chez une jeune fille.

In the field of adnexal surgeries in children, robotic surgery seems to make easier the realization of minimal invasive surgery. It could lead to a decrease of post-surgical adherences and therefore preserve the fertility of young patients. We report the first paratubal cystectomy performed using robotic assistance on a child in order to preserve her future fertility and discuss advantages and disadvantages of this technology.