[Acquired vaginal stenosis: about a case and literature review]. / Sténose vaginale acquise: à propos d'un cas et revue de littérature.

Vaginal stenosis or gynatresia is a congenital disease and it is part of Mayer-Rokitansky-Kustner-Hauser syndrome. Acquired vaginal stenosis is a rare complication of vaginal delivery and may be caused by an infection, charlatans, birth injury or postpartum hypoestrogeny. We report a case of postpartum complete vaginal stenosis secondary to vaginal injuries as a result of medical negligence. The study involved a 19 year old patient, who had had dead child born vaginally at home, presenting with a two-year history of secondary amenorrhea associated with chronic pelvic pain. The patient reported the occurrence of multiple not sutured vaginal tears. Pelvic MRI showed complete extended vaginal stenosis of about 25mm with upstream haematological retention and bilateral hematosalpinx. The patient underwent release of vaginal adhesions followed by regular vaginal dilation. Only two cases have been reported in the literature. Pain and dyspareunia were the most common symptoms. All cases were treated by a release of the synechias and vaginal dilation.

Myoma praevia and pregnancy.

The association of myoma and pregnancy is becoming more frequent due to the increasing age of first pregnancy. It may affect the outcome of fertility, pregnancy, labor and peripartum course. A 37 years old patient was referred to our unit for discovering uterine leiomyoma at 37 weeks of pregnancy. Ultrasound screening showed a praevia isthmic leiomyoma measuring 16cm. A caesarean delivery was scheduled and a large interstitial isthmic uterine myoma measuring 25cm was found. Hysterectomy was corporeal. The post-operative and puerperium course was normal.

[Clinical and radiological features of gestational trophoblastic tumors]. / Tumeurs trophoblastiques gestationnelles: aspects cliniques et radiologiques.

Gestational trophoblastic disease incorporates a group of diseases which differ from each other by their regressive evolution, their evolution to metastasis and to recurrence. It is a severe disease that affects women of childbearing age. Gestational trophoblastic tumors (GTT) are the malignant forms of gestational trophoblastic diseases. They are always a result of pregnancy, more often molar pregnancy (hydatidiform mole). The most common type of gestational trophoblastic tumors (GTT) is the invasive mole because, in most cases, the diagnosis is made when cancer is still confined to the uterus. Choriocarcinoma is a more rare type of tumor, often developing distant metastases. When there is a progression to a trophoblastic tumor, the assessment of locoregional extension and distant metastases is essential to establish an appropriate treatment protocol. We here report three clinical cases of GTT by describing their clinical presentations and the use of imaging techniques in the diagnosis and management of these disorders.