[Evaluation of the effect of post-abortion counseling and education among unmarried abortion adolescents].

OBJECTIVE: To find out the requirement and to evaluate the effect of post-abortion counseling and education (PACE) among unmarried abortion adolescents. METHODS: The subjects of the study were unmarried adolescents from 10 to 24 years of age who wanted induced abortion in the Second Affiliated Hospital of Sun Yat-sen University from December 2007 to April 2008. Totally 122 subjects received the intervention of PACE were considered as intervention group. Meanwhile, 67 subjects refused the intervention of PACE were considered as no intervention group. Two groups were both investigated the requirements of PACE before abortion and were followed-up at one year after abortion. RESULTS: 97.4% (184/189) of 189 unmarried abortion adolescents were willing to receive PACE, 48.1% (91/189) of them hoped to receive PACE when saw the doctor, 72.0% (136/189) of them required face-to-face counseling during PACE. During the year after abortion, 74% (57/77) cases in intervention group and 24% (10/41) cases in no intervention group took effective contraception (P < 0.01), while 1% (1/77) of intervention group and 10% (4/41) of no intervention group had unwanted pregnancy. There were significant different for the rate of unwanted pregnancy between two groups (P = 0.034). CONCLUSION: For unmarried abortion adolescents, the intervention of PACE may markedly increase the rate of effective contraception used and decrease the rate of another unwanted pregnancy.

[Modified tubo-uterine implantations for proximal tubal occlusive infertility after femal sterilization with mucilago phenol].

OBJECTIVE: To explore the effects of modified tubo-uterine implantations performed on women with proximal tubal occlusive infertility after femal sterilization with mucilago phenol. METHODS: Two hundred and eight infertile women who were admitted to the Second Affiliated Hospital of Sun Yat-sen University between 1986 and 2004 were included. They all accepted modified tubo-uterine implantation after occlusion of fallopian tubes with mucilago phenol. RESULTS: It was found that the occlusions were all located in the interstitial portion or isthmic portion of the fallopian tubes. Different degrees of pelvic adhesions were found in 65 cases. Fifty-seven cases were slightly adhesive, seven cases were of moderate degree and one case was severe. One hundred and ninety-nine cases were followed up after operations (95.7%). One hundred and ninety-three women accepted hydrotubation in the following month just after the operation and 185 women were found to be unobstructed (95.8%). One hundred and forty-three women became pregnant, the pregnant rate being 71.9% (143/199). One hundred and twenty-five women had term deliveries (87.4%), three women were in early pregnancy and two in midtrimester pregnancy. Eleven women had spontaneous abortion (7.7%). Two women had tubal pregnancy (1.0%). None of the 199 cases had any signs of endometriosis. CONCLUSIONS: Modified tubo-uterine implantations are quite effective for proximal tubal occlusive infertility. It may be a favorable method for such kind of tubal occlusions.

[Study on causes and treatment of repeated vulvovaginitis in girlhood].

OBJECTIVE: To explore the causes and treatment of repeated vulvovaginitis in girlhood in order to improve its prevention and treatment. METHODS: Fifty-one girls with repeated vulvovaginitis (age < or = 10 years) admitted to The Second Affiliated Hospital of Sun Yat-sen University from Jan. 1990 to Nov. 2004 were reviewed retrospectively. RESULTS: We found 28 girls (55%) suffering from non-specific vulvovaginitis and 14 ones (27%) suffering from posterior recto-vaginal fistula with in 51 patients. Five girls (10%) were smitten with vulval ulcer and 3 ones (6%) had been were found with vaginal foreign bodies. One girl (2%) was smitten with adhesion of labia minora. The vaginal discharges taken from 21 girls were cultured. Seventeen cases found bacteria. The positive rate of bacteria culture in the 21 cases reached 81%, in which, E.coli accounted for 5 cases (24%), staphylococcus and streptococcus accounted for 3 cases (14%) respectively. Patients suffering from non-specific vulvovaginitis and vulval ulcer accepted external lotion, antibiotic ointment or combining with antibiotics. Patients suffering from posterior recto-vaginal fistula accepted fistulectomy. Three girls who found vaginal foreign bodies took out of foreign bodies by hysteroscope. Fifty-one girls all were cured after appropriate therapy. CONCLUSIONS: Vulvovaginitis is the most common gynecologic diagnosis in girlhood. The principal cause of repeated invasion is non-specific vulvovaginitis and the secondly one is posterior recto-vaginal fistula. It need overhaul during the diagnosis. It is very availability to use hysteroscopy and do bacteria culture + antibiotic sensitivity test for repeated pediatric vulvovaginitis.

[Diagnosis and treatment of endometriosis in adolescents].

OBJECTIVE: To discuss the clinical feature, diagnosis and treatment options of adolescent endometriosis. METHODS: The records of adolescent patients with endometriosis (11-20 years old) who were admitted to First, Second and Third Affiliated Hospital of Zhongshan University and Guangdong Provincial People's Hospital between 1990 and 2003 were retrospectively reviewed. RESULTS: Forty-three patients were diagnosed as endometriosis either by laparotomy or laparoscopy. The chief symptoms leading to the diagnosis were palpable pelvic mass (18/43), dysmenorrhea (15/43), chronic pelvic mass (10/43) and acute pelvic pain (4/43). The majority of patients (53%) presented with the revised AFS-r classification stage III, 8 cases (19%) presented with stage I, 3 cases (7%) with stage II and 9 cases (21%) with stage IV. Nine cases (21%) had complicated genital tract abnormalities. Conservative operations, including salpingo-oophorectomy ins cases, ovarian cystectomy in 31 cases and laparoscopic vaporization in 8 cases, were performed. Surgeries were followed by hormonal suppression using oral contraceptives in a continuous or cyclic manner. CONCLUSIONS: Adolescent endometriosis may occur around 4.6 years after menarche. The chief symptoms are palpable pelvic mass and dysmenorrhea. The treatment of endometriosis in adolescence does not differ principally from that in adult women. In the treatment of endometriosis and for the prevention of recurrence, it is recommended to give 3-6 months of oral contraceptives.

[Application of human papillomavirus dectection in women with abnormal cervical cytology].

OBJECTIVE: To detect the human papillomavirus (HPV) infectious condition in women with abnormal cytology and evaluate its values in the screening of high grade cervical intraepithelial lesion. METHOD: 101 patients who underwent thinprep cell test(TCT) with abnormal cervical cytology were selected to undergo HPV test, all subjects also received tissue biopsy at the same time. RESULTS: (1) Among the 101 patients,the incidence rates of high risk HPV infection of those with ASCUS, LSIL, HSIL and squamous cell carcinoma were 84.2%, 88.6%, 100.0% and 2/2 respectively. (2) Among the patients with abnormal cytology,the number of patients with pathologically confirmed results of CIN I and CIN II or worse were 20 and 81, the incidence rates of high risk HPV infection of those with CIN I and CIN II or worse were 60.0% and 97.5% respectively. (3) In the ASCUS group, the incidence rates of CIN II or worse with high risk HPV infection were 87.5% and the incidence rates of CIN II or worse without high risk HPV infection were 16.7%. (4) The prevalence of high risk HPV types from highest to lowest order were follow: HPV16 (39.6%), 58 (17.8%), 52 (16.8%), 18 (9.9%), 33 (9.9%). CONCLUSIONS: The infection rate of high risk HPV was positively correlated with the levels of cervical lesions. HPV test is a good triage approach for the patients with ASCUS. HPV16, 58, 52, 18, 33 are the most common in the patients of cervical lesions.