OBJECTIVE
The purpose of this study was to describe the distribution of pelvic organ support in a gynecologic clinic population to define the clinical disease state of pelvic organ prolapse and to analyze its epidemiologic condition.


STUDY DESIGN
This was a multicenter observational study. Subjects who were seen at outpatient gynecology clinics who required an annual gynecologic examination underwent a pelvic organ prolapse quantification examination and completed a prolapse symptom questionnaire. Receiver operator characteristic curves were used to define pelvic organ prolapse with the use of symptoms and pelvic organ prolapse quantification examination measures. Standard age-adjusted univariate and multivariate logistic regression analysis were used to evaluate various relationships.


RESULTS
The population consisted of 1004 women who were aged 18 to 83 years. The prevalence of pelvic organ prolapse quantification stages was 24% (stage 0), 38% (stage 1), 35% (stage 2), and 2% (stage 3). The definition of pelvic organ prolapse that was determined by the receiver operator characteristic curve was the leading edge of their vaginal wall that was -0.5 cm above the hymenal remnants. Multivariate analysis revealed age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus as risk factors for pelvic organ prolapse, as defined in this population.


CONCLUSION
The results from this population suggest that there is a bell-shaped distribution of pelvic organ support in a gynecologic clinic population. Advancing age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus have the strongest correlations with prolapse.

Iconographies supplémentaires de l'article : Pelvic Organ Support Study (POSST): The distribution, clinical definition, and epidemiologic condition of pelvic organ support defects

Beside cytotoxic drugs, other drugs can impact men's fertility through various mechanisms. Via the modification of the hypothalamic-pituitary-gonadal axis hormones or by non-hormonal mechanisms, drugs may directly and indirectly induce sexual dysfunction and spermatogenesis impairment and alteration of epididymal maturation. This systematic literature review summarizes existing data about the negative impact and associations of pharmacological treatments on male fertility (excluding cytotoxic drugs), with a view to making these data more readily available for medical staff. In most cases, these effects on spermatogenesis/sperm maturation/sexual function are reversible after the discontinuation of the drug. When a reprotoxic treatment cannot be stopped and/or when the impact on semen parameters/sperm DNA is potentially irreversible (Sulfasalazine Azathioprine, Mycophenolate mofetil and Methotrexate), the cryopreservation of spermatozoa before treatment must be proposed. Deleterious impacts on fertility of drugs with very good or good level of evidence (Testosterone, Sulfasalazine, Anabolic steroids, Cyproterone acetate, Opioids, Tramadol, GhRH analogues and Sartan) are developed.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/andr.12366

The impact of drugs on male fertility: a review

Uterine preservation vs hysterectomy in pelvic organ prolapse surgery: a systematic review with meta-analysis and clinical practice guidelines

Background Climate change will affect most populations in the next decades and put the health of billions of people at risk Health care facilities represent a significant source of pollution around the world and contribute to environmental changes To address this topic, we performed a review of the available literature on tactics to reduce operating room (OR) waste and the potential of these strategies to impact the environment Data Sources A literature search was performed querying PubMed, Web of Science, and Science Direct No comparative data were found; most were opinion papers, white papers, and case studies For this reason, we proceeded with a narrative review, which provides an overview of the evidence on this topic and identifies areas for future research Results This systematic review summarizes the available literature on the 5 “Rs” of waste management: reduction, reusing, recycling, rethinking, and renewable energies Conclusions Surgery has a unique opportunity to transition to more environmentally-friendly operating room strategies, which may help decrease waste and lessen the impact of climate change

Greening the operating room.

Women's sexual fudction improved when partners are administered vardenafil for erectile dysfunction : a prospective, randomized double-blind, placebo-controledtrial

Assessing the costs of disposable and reusable supplies wasted during surgeries

The prevalence of pelvic organ prolapse (POP) varies between 2.9 and 11.4% in questionnaire-based studies and from 31.8 to 97.7% according to the ICS Pelvic Organ Prolapse Classification (POPQ) anatomical classifications. The cumulative incidence of surgery for POP is as high as 70% in women more than 70-year-old. Aging is significantly associated with the prevalence and severity of POP. Pelvic disorders are a health economic challenge for the future due to the longer life expectancy of women and to an increasing demand for a better quality of life. Identification of risk factors will be critical in order to develop strategies to prevent the disease and limitate the need for surgical intervention.

État des lieux de l’épidémiologie des prolapsus génitaux

Recommendations to general practice doctors for first line management of erectile dysfunction

Recommandations aux médecins généralistes pour la prise en charge de première intention de la dysfonction erectile.

Recommandations aux médecins généralistes pour la prise en charge de première intention de la dysfonction érectile (réactualisation 2010)

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