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History: 6 months before admission a 21-year-old woman had developed anogenital condylomata acuminata (CA). Since early childhood she had been treated for primary hypoparathyroidism (PHPT) and recurrent mucocutaneous candidiasis. 5 years before admission corneal clouding had caused visual impairment. Recently, mainly truncal vitiligo with occipital poliosis had developed., Investigations: PHPT was confirmed (parathormone level 7.7 mg/l). In addition, liver transaminases were raised (GOT 105.8 U/l, GPT 145.6 U/l, gamma-GT 56.8 U/l), pointing to noninfectious hepatitis. An ACTH stress test could not exclude manifest adrenocortical insufficiency, and thyroid function was also normal. The Merieux Multitest indicated an anergy., Diagnosis, Treatment and Course: The constellation of test results suggested autoimmune polyglandular syndrome type I. The condylomata were treated by electrocautery and the intestinal candidiasis with amphotericin B suspension. Calcitriol capsules, 0.5 microgram, and calcium gluconate or lactate, 500 and 300 mg respectively, 3 times daily each, were given for the PHPT., Conclusion: This case demonstrates a complex syndrome which can be recognized early by simple clinical tests. Early diagnosis prevents possible life-threatening complications.

We report on two cases of vaginal bleeding after hysterectomy. These patients suffered from cyclical therapy resistant vaginal bleeding and complaint in the lower abdomen. The final diagnosis and therapy of a vaginal cuff endometriosis made it possible to eliminate the persistent clinical symptoms. These cases show the need for a discussion on the necessity of a special operative procedure in case of endometriosis genitalis interna and externa.

We report on a case of recidival rupture of an enterocele with vaginal rupture and incarceration of small bowel. This event was probably caused by an extreme insufficiency of the patient's connective tissue. In literature four similar cases have been reported.

Vaginal adenosis is a rare kind of disease without specific symptoms and does not represent a very serious disorder from the beginning. Concerning the etiology teratogenetic dependencies are known which still are interpreted in different ways in the recent literature. The increased number of cases, including those with clear-cell-carcinoma of the vagina, in juveniles after exposition to DES during the early embryonal development shows in particular (Central index for the stilbestrol-adenosis-carcinoma-syndrome in the USA, since 1971) a wrong pathway in the organogenesis of cervix and vagina. This occurs at the interference zone between the epithelium of the Müllerian ducts and the epithelium of the sinus urogenitalis of the female fetus and in so far constitutes the origin of vaginal adenosis. The basics of the possibility of the development of such irregular differentiation and heterotopic dissemination are proven again by the case report of a vaginal adenosis showing the highly differentiated endocervical type. Not every case of vaginal adenosis does signify a precancerous lesion. The separation of the most frequently endocervical manifestation observed from endometrial and intermediate forms might be difficult. A positive distinction is prognostically essential, however, since clear-cell-carcinomas of the vagina are known in occurence with the endometrial type of vaginal adenosis only. Scanning electron microscopy as a method to follow tissue organization reveals the way of differentiation between the various types via ultrastructural analysis for vaginal adenosis is an example for failures of developmental organization. The same analysis is feasible in cytological smears also. The therapeutic requirements of vaginal adenosis depend on the tissular differentiation and the given local extent of the adenomatous lesions.

Over a period of 33 years during which nearly 13,600 hysterectomies were carried out, there was one case of prolapse of the small bowel through the ruptured vaginal vault stump, which occurred spontaneously 7 months after vaginal hysterectomy and colporrhaphy. At operation the small bowel was returned into position and an ovarian cyst was removed by the vaginal route. The patient made an uneventful recovery.

Oestro-Gynaedron or Kolpi-Gynaedron vaginal gel were applied by the authors to 53 patients for treatment of oestrogen deficit of differentiated aetiology. The patients were between 17 and 73 years old. The therapy resulted soon in mitigation of subjective complaints, that is perception of burning, stinging, and dryness. The majority of patients was entirely free of complaints, following treatment. The cytological condition of atrophic colpitis was visibly improved. The authors are in agreement with numerous data in the literature according to which colpitis vetularum complaints can be completely eliminated by application of Oestro-Gynaedron or Kolpi-Gynaedron, with the colpocytological pattern being improved. Oestro-Gynaedron and Kolpi-Gynaedron were found to be properly applicable. Both medicaments have added greatly to the therapeutic potential by which to get to grips with fluor vaginitis.