Les débuts de l’obstétrique et de la gynécologie à Québec

The history of medicine in Canada started around 1639 with Robert Giffard, Michel Sarrazin, Jean Madry, and François Gaultier, “surgeons-barbers” who transmitted their art through apprenticeship from the early seventeenth century up to the mid-eighteenth century. The first school of medicine was established in Quebec City on January 18, 1819, and was recognized by Parliament in 1845. In 1837, formal teaching in obstetrics and gynaecology was provided at Hôpital de la Marine by Joseph Painchaud.The Faculty of Medicine of Laval University took over the School of Medicine in 1854 with 120 hours of formal teaching in obstetrics in two hospitals: Hôpital de la Marine and Hôpital de la Miséricorde. Progressively, obstetrics and gynaecology teaching was carried out at several hospitals adding Hôtel-Dieu de Québec and, eventually, Hôpitals Saint-Sacrement, Enfant-Jésus, and Saint-François d’Assise. The Department of Obstetrics and Gynaecology was formally recognized within the Faculty of Medicine in 1955.     

Synéchies utérines postopératoires : quels moyens de prévention ?

Operative hysteroscopic surgery can lead to intra-uterine adhesions reducing procreation chances. Prevention of this kind of adhesions is necessary. Several pre-, per-, and post-operative means have been proposed against these adhesions. However data concerning their functional interest are lacking.     

Réunion de concertation pluridisciplinaire de l’endométriose pelvienne profonde : intérêts et modalités de fonctionnement

Deep endometriosis is a frequent disease that affects reproductive age women. This disease is characterized by the presence of functional endometrium-like tissue outside the uterus. The common sites of extragenital endometriosis are the bowel and the urinary tract. This disease is also associated with infertility. Furthermore, this disease can cause physical and psychological damage. Therefore, it is really important to develop a multidisciplinary approach in the aim to offer the appropriate treatment. The multidisciplinary team approach for endometriosis is developing to improve the understanding of endometriosis and a multidiciplinary committee for endometriosis was developed in our center. During this meeting, gynecologic, digestive surgeons, urologist, radiologist, procreative medical assistance physicians analyse the case. The role of surgery, before, after or as an alternative to in vitro fertilization (IVF) must be defined. The role of the medical treatment before or after the surgery, before the IVF shall be discussed in order to propose the optimal treatment. In fact, radical surgery is no more recommanded and minimaly invasive conservative surgery is encouraged in order to preserve the fertility. The multidisciplinary appraoach permits an appropriate optimal and personalised management of this multifocal disease. The multidisciplinary team approach helps in the developpement of evidence-based guidelines for the diagnosis and management of endometriosis.