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Guideline [The statement of Polish Gynecological Society experts on oral use of contraceptive 75 microg desogestrel minipill in different clinical cases--state of art in 2008] 2009
Debski R, Kotarski J, Paszkowski T, Pawelczyk L, Skrzypulec V, Tomaszewski J, Anonymous00190. · No affiliation provided · Ginekol Pol. · Pubmed #19323063 No free full text.
Abstract: Recent epidemiologic studies indicate that use of combined oral contraception is associated with a increase in the incidence of cardiovascular disease (venous thromboembolism, pulmonary embolism, myocardial infarction and stroke). The risk of cardiovascular disease is strongly related to estrogen dose, progestogen type and other factors for example thrombogenic mutations and cigarette smoking among female over age 35. The progestogen only contraception is safe alternative to combined hormonal contraception. Progestogen only pill (POP) has different levels of action (local and/or central) which may vary from one drug to another. As for the cardiovascular disease risk, progestogens are not considered to be risk factors. Desogestrel containing POP is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; medical, metabolic or cardiovascular contraindications to estroprogestogen contraception. Lastly, POP should be used as a prime contraception in some particular situations (breast feeding, endometriosis, adenomyosis, cigarette smoking, contraception for older women). These recommendations present the actual system of care in that population of women in Poland.
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Article [Laparoscopic resection of rectovaginal endometriosis: a case report] 2000
Rechberger T, Tomaszewski J, Jakowicki J. · Kliniki Ginekologii Operacyjnej II Katedry Połoznictwa i Chorób Kobiecych Akademii Medycznej w Lublinie. · Ginekol Pol. · Pubmed #11082990 No free full text.
Abstract: Two patients aged 35 i 40 years after extensive clinical evaluation were operated by means of combined approach--laparoscopy and vaginal resection of endometriotic tumors. First laparoscopy was performed in order to dissect rectovaginal septum and separate rectum from the vagina in order to facilitate complete vaginal resection of endometriotic lesions. The integrity of rectum was checked by means of bubble test and after the control of the haemostasis endoscope was removed. The post operative period was uneventful and the patients were discharged from the hospital on the 5th and 8th day of surgery. The combined laparoscopic and vaginal approach in order to dissect endometriotic rectovaginal tumor is in our opinion the treatment of choice for this peculiar localization of ectopic endometrium.
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