[Adnexal masses in the Surgical Clinic of the University Hospital Center of Dakar, 74 cases]. / Les masses annexielles à la Clinique Chirurgicale du CHU de Dakar à propos de 74 cas.

The aim of this study was to assesss epidemiological, clinical and the therapeutic aspects of annexial masses. We have performed a retrospective study from 15/09/1994 up to 31/12/1997 including 74 patients. The prevalence rate was 18.40% of the overall gynecologic surgery in our department. Mean age was 36 years old. The range 30-41 years represented 40.5% of our cases. The mean gestity was 4 and the average parity 4. The most common clinical features were pelvic pains (75.57%) and hypogastric masses (50%). The duration of the disease ranged from 1 to 10 years. The general status was good in 94.59% of cases, bad with ascites in 5.41%. The annexial masses were cystic in 87.83%. The ovarian cysts were located at the both sides in 45.94, and bilateral in 8.10%. The annexial masses were solid in 9.45%. An abscess was found in 6.75%. We have performed an annexectomy in 66.1% and a cystectomy in 16.21%. The post operative complications were wound suppuration in 13.51%. The mortality rate was 1.35%. At the long-term follow up we have noticed an eventration in 1.35% and a recurrence with need of reintervention in 16.21%. The pathologic exam found a benign tumor in 95.16% and a carcinoma in 4.84%. The annexial masses are very common in our practice. They involve young multipare women. The main clinical outcome is pelvic pains. Annexectomy is the principal treatment.

[Total vaginal hysterectomy for genital prolapse apropos of 10 cases]. / L'hystérectomie totale par voie vaginale pour prolapsus génital à propos de 10 cas.

There are many variants in vaginal hysterectomy procedures owing to precises indications. We have performed a total vaginal hysterectomy procedure which technique is described herein. Our procedure was using the preexisting anatomic structures. It allows a solid cure adapted to each compound of the genital prolapse. Among a series of 10 cases, we report few complications. An important peroperative bleeding occurred in one case. The postoperative morbidity included 1 case of genital infection and 1 case of urinary fistula. One patient died from a cause not reliable to the procedure. The mean duration of the hospital stay was 10 days. After 2 years follow up, 9 of our patients have good anatomical and functional results. The shortness of this series does not allow us to concluded definitively. However, our results are comparable with those reported in the literature.

A propos d'une preparation medicamenteuse traditionnelle a activite antihypertensive

L'extrait de feuilles seches de Persea americana; traditionnellement utilise pour ses proprietes antihypertensives a ete teste par le suivi biologique et clinique de 5 malades qui ont volontairement choisi cette forme de therapeutique. L'efficacite therapeutique de l'extrait a ete jugee remarquable. Cependant; quelques effets secondaires ont ete releves (une asthenie liee a l'hypokaliemie induite et la chute des cheveux) qui ont contraint a l'arret du traitement chez les 3 patients ages de moins de 45 ans. Ces resultats; tout en confirmant l'activite pharmacologique de certains extraits; doivent inciter a une recherche plus approfondie afin d'eviter de possibles desagrements en rapport avec une toxicite chronique