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INTRODUCTION: Infertility associated with submucosal myomas may be treated by hysteroscopic resection. Aim: this retrospective study is aimed to analyze 50 subfertile patients who underwent hysteroscopic myomectomy with particular regard to their post procedure pregnancy outcome. METHODS: the patient group (n=50) underwent the procedure between January 2012 and January 2017. The submucosal were G0 (n=37), G1 (n=12) and G2 (n=4). The mean size was 3.2 cm, while the mean duration of the procedure was 26 minutes and the mean follow-up was 18 months (9 months to 5 years). Eight cases had one or more associated infertility factors. RESULTS: eighteen patients (36%) conceived after procedure, at 12 months ±2.6 months after procedure. The pregnancy rate was better when myomas was the exclusive etiology of infertility (42.85%). The complication rate was 7%. CONCLUSION: hysteroscopic myomectomy is a safe procedure to enhance infertility essentially in case of unexplained infertility.

Le kyste hydatique est une zoonose causée par l´ingestion accidentelle de l´Echinococcus granulosus. Cette parasitose est un problème de santé en Tunisie où elle constitue une endémie. Les organes les plus touchés sont essentiellement les poumons et le foie. La localisation appendiculaire est exceptionnelle. La rareté de la localisation appendiculaire peut être à l´origine de confusion diagnostique avec les masses latéro-utérines. Nous rapportons dans cet article le cas d´un kyste hydatique appendiculaire chez une jeune femme de 36 ans pris à tort initialement comme un kyste ovarien compliqué. Il s´agit d´une femme âgée de 36 ans, sans antécédents pathologiques, qui a été hospitalisée dans un tableau de suspicion de torsion d´annexe. L´échographie pelvienne a montré une formation kystique latéro-utérine droite. En per-opératoire on découvre une formation kystique qui dépend de l´appendice. La patiente a eu une appendicectomie avec la résection de la masse. L´examen anatomo-pathologique était en faveur d´un kyste hydatique appendiculaire. Les suites opératoires étaient simples. La localisation appendiculaire, dans l´hydatitose, est certainement exceptionnelle. Cependant, ce diagnostic doit être évoqué devant toute lésion kystique abdomino-pelvienne, surtout dans les pays où l´hydatidose est une endémie.

The vaginal aplasia is a rare Mullerian duct malformation characterized by the absence of the vagina. The management of this malformation is based on surgery to restore a normal sexual life and eventually to hope having a normal fertility. In this case, we presented a spontaneous pregnancy in a 15 year-old girl who underwent a vaginoplasty with re-implantation of the uterus corpus in the neovagina.

Objectives: This document aims to identify the clinical, therapeutic, and prognostic features of this association and to provide the up-to-date management. Methods and materials: Our study design is retrospective based on 25 cases of pregnancy-associated breast cancer, carried out at the Maternity and Neonatology Center of Tunis over a period of 10 years, between January 2001 and December 2013. Results: The mean age of the patients was 35.84 years. Breast cancer was diagnosed during pregnancy in fourteen patients and after delivery in eleven patients. Pathohistological diagnosis was established by ultrasoundguided biopsy and surgical biopsy in fourteen and seven patients, respectively. The most common histological type was infiltrating ductal carcinoma (96% of cases). Pregnancy was completed in nine patients. The mean gestational age at which delivery occurred was 35.4 weeks. Twenty patients underwent surgical treatment by mastectomy and breast-conserving surgery (lumpectomy) associated with axillary lymph node dissection was performed in three cases. Chemotherapy was allowed during pregnancy, and was given to 23 patients. On the other hand, radiotherapy, antiestrogens (Tamoxifene) and targeted therapies (Herceptin) must be postponed after delivery because of their teratogenic effects. After a 5-year follow-up, two of eighteen patients died and six were lost to follow-up. Conclusion: The poor prognosis of the pregnancy-associated breast cancer is no longer attributed to pregnancy but rather to the young age of the patients and the delay in the diagnosis of cancer. Treatment should be started promptly during pregnancy.