[The sociological approach to vasectomized patient trajectories at the Buenos Aires University Clinical Hospital "José de San Martín"].

According to the Argentinian Ministry of Health records the number of patients requesting vasectomy increased twelve times in public hospitals in 2015-2019. The physicians and specialists account for this change in recent years, arguing, among other reasons, cultural change when male assumes active position in contraceptive methods. The article addresses vasectomized patient trajectory at the Buenos Aires University Clinical Hospital "José de San Martín". The purpose of the study was to define from sociological point of view if we are actually witnessing cultural change. While considering last ten years (2012-2022), through diachronic analysis of patient demand at the Male Fertility Laboratory (n=1136) it was found that although main motivation is fertility, minority (6%) consulting to confirm absence of sperm in the ejaculate following vasectomy increased significantly in 2022 (Pearson's chi-squared test p<0.0001). After qualitative/quantitative interviews of former patient group (n=36) two sub-populations were distinguished: childless (42%; Median age: 30 years old; range: 24-35) and those having a family (58%; Median age: 39 years old; range: 35-54). Most of them had University degree (67%) and learned about this anti-contraceptive method by the Internet. It is remarkable that 94% of them were not aware of the the Argentinian Law № 236139 of 2006 that grants their right to vasectomy. Among all patients randomly interviewed in 2022 (n=200) condom anti-contraceptive method was the best known (67%). The conclusion was made that in the meantime developed New Trend that comprises high educational level segment of population of Argentina that in the future can become the germ of Cultural Change encompassing the whole society.

A case of ovarian fibromatosis as an incidental finding in an acute ovarian torsion: Differential diagnosis and management.

Ovarian fibromatosis (OF) is a rare non-neoplastic condition, more frequent in young females and characterised by ovarian enlargement with proliferation of collagen-producing spindle cells in the stroma. It usually presents with abdominal pain, menstrual disorders or as a solid mass. Hirsutism and virilisation are possible. The relevance of this subject remains in the usual misdiagnosis as a malignant tumour, which may lead to unnecessary oophorectomies. We report the case of a 17-year-old female who presented with acute intense pain in the right iliac fossa and vomits. On examination, she complained of intense pain without any signs of peritonism. An abdominal ultrasound was performed, finding an enlarged right adnexal containing a heterogenic cyst without flow to the ovary. A Pfannenstiel laparotomy showed a right ovarian torsion. The haemorrhagic cyst was drained and the ovary was detorsed. Bilateral ovarian biopsies were performed as both ovaries showed an indurated and cerebroid surface, suggestive of malignancy. Tumoural markers were negative. Histological examination confirmed OF. After 3 months, the magnetic resonance imaging showed an enlarged right ovary with a fibrous capsule surrounding both ovaries. In conclusion, OF can also be found incidentally in the context of an ovarian torsion. Since its appearance may be dismissed as malignant, it is important to recognise it and remain conservative. Biopsies can be taken to make the differential diagnosis.