[Lower urinary trauma complicating gyneacologic and obstetrical surgery]. / Les lésions urologiques provoquées par des interventions chirurgicales gynécologiques et obstétricales.

INTRODUCTION: The trauma of the lower urinary tract in gynecologic and obstetrics surgery is rare. AIM: Discover the circonstances of their happening, their symptoms, and their methods of diagnostic and their treatment. METHODS: Authors report 24 cases observed over a 12 years period. RESULTS: These lesions consisted on 20 bladder lesions and 4 ureteric lesions. The frequency of these urological complications was 0.21% among the 12000 surgical operations performed between 1992 and 2003. The most causal operation was caesarean and abdominal hysterectomy. Urinary trauma was more frequent in patients with history of abdominal surgery. Post operative course was uneventful in most cases. CONCLUSION: Trauma of the lower urinary tract in gynecologic and obstetrics surgery is rare but their ignorance may seriously affect the functional urinary prognostics.

[Cesarean deliveries in the maternity of military hospital of Tunis. Indication and prognosis: about 5008 cases]. / Les césariennes à la maternité de l'hôpital militaire de Tunis indication et pronostic: à propos de 5008 cas.

BACKGROUND: The rates of cesareans increased in many countries, these last years. AIM: we propose to evaluate the indications, and the maternal and foetal prognosis. METHODS: it's a retrospective study of 5008 cesareans during 10 years period, collected in the maternity of the military hospital of Tunis. RESULTS: Cesarean section rate is 21.59%. The cicatricial uterus constitutes the dominant indication (34%). In the event of noncicatricial uterus, the fetal suffering (24.7%), the failure of the trial of labour (14.2%), and the breech presentation (12.7%) are the principal indications. The hemorrhage constitutes the major complication into peroperational (2%). The post-operative complications are noted in 15.5%. Maternal mortality is 0.13%; perinatal mortality is 1.06%; perinatal morbidity is 9.68%. CONCLUSION: The increase of cesarean rate improves fetal and neonatal prognosis however it was associated to an increase of maternal.

[Premature ovarian insufficiency. Analysis of 30 cases]. / Insuffisances ovariennes prematurees. Etude analytique de 30 cas.

Premature menopause is a relatively rare disease but it has delicate consequences dominated by infertility problems. Most often, etiologic investigation is disappointing. Helped in some cases by the association to some auto-immune diseases or a previous treatment with chemotherapy or an irradiation may be useful to understand the origin of the premature ovarian failure. We analyse in this paper 30 cases of premature menopause to try to precise its etiologic factors, its diagnosis tools, the fertility prognostic and the therapeutic possibilities

[Management of adnexal torsion]. / Prise en charge des torsions d'annexe.

Adnexal torsion is a current emergency in gynecology because it may compromises young women fertility. We have conducted a retrospective study about 26 adnexal torsion cases managed in B service of C.M.N.T during 4 years (1997-2001). Objective of our study is to improve patient fertility prognosis; we propose a diagnosis and therapeutic attitude which respect the time between diagnosis and treatment. Laparoscopy authorizes diagnosis, treatment and prognosis of this situation. It must usually be done in young woman who declare acute pelvic pain.