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Women did not base their choice of abortion method only on rational information from professionals but also on emotions and especially fears. Support techniques for a more informed choice are needed. Recent high-quality studies in this area are lacking.

Summary This article outlines some of the ways in which women are particularly vulnerable to risk in relation to their sexuality, and suggests how primary health care programme could begin to address the impact of sexuality on health in a holistic and gender specific way. The article discusses the cultural and economic determinants of sexual expression and explores how these influence people's options for practising safer sex. Personal values around sexuality have a particularly profound influence on programme design and implementation. The first steps in any programme would be an exploration of how sexuality relates to health in different groups, followed by training which enables staff to address this area comfortably without imposing their own values. A genuinely participatory programme would acknowledge sexual diversity and respond to a range of needs. It would aim to empower people to make their own informed decisions, explore their values and practise skills. Often a development approach will be needed which involves activities outside the normal remit of the health sector. Integrating sexuality into PHC in this could have far‐reaching consequences. At the very least, it would highlight the way in which existing power relations between men and women, generations and people with different sexual orientations have severely detrimental effects on the health of the whole community. Resumé La sexualité — l'aspect négligé de la santé des femmes Les auteurs passent en revue certains des éléments qui rendent les femmes particulièrement vulnérables au risque et qui ont trait à leur sexualité, et suggèrent différentes approches holistiques et spécifiques aux femmes que peuvent adopter les programmes de soins de santé primaires dans un premier temps. Les déterminants culturels et économiques de l'expression sexuelle sont examinés ainsi que leur influence sur le choix des individus d'avoir des rapports protégés. Les valeurs personnelles sur la sexualité ont une profonde influence sur l'élaboration et la mise en oeuvre des programmes. La première démarche dans tout programme devrait être d'explorer la relation entre sexualité et santé, dans les différents groupes, approche qui serait suivie d'une formation pour permettre aux personnels d'aborder ce domaine débarrassé de tout préjugé et sans imposer leurs propres valeurs. Un programme vraiment participatif ne manquerait pas de reconnaitre la diversité sur le plan sexuel et de répondre à toute une gamme de besoins. Ce programme chercherait à offrir aux individus les moyens de décider en toute connaissance de cause, d'explorer leurs propres valeurs, et de faire valoir leurs compétences. Il sera souvent demandé de mettre en oeuvre des activités qui dépassent le cadre usuel de la santé. Intégrer la sexualité dans les soins de santé peut avoir des conséquences de longue portée. Tout au moins cette démarche soulignerait la manière dont les rapports de force entre hommes et femmes, entre générations et individus d'orientations sexuelles diverses ont des effets néfastes sur la s...

Aim Previous studies have shown favourable short‐term results after Bascom's pit‐pick procedure for simple pilonidal sinus disease. A minimum 5‐year follow‐up is considered the gold standard but only a few long‐term studies have previously been reported. Here, we aimed to estimate the long‐term risk of treatment failure, incomplete wound healing or recurrence, postoperative complications and patient reported outcome measures such as chronic pain and satisfaction with cosmetic appearance. Methods Medical records of patients registered in a local database after undergoing Bascom's pit‐pick procedure were reviewed and follow‐up data updated. The patients received an online survey including questions about demographics, lifestyle, complications, reintervention, pain, satisfaction with cosmetic appearance and supplemented with telephone interviews if no response was received. Results A total of 158 patients underwent Bascom's pit‐pick procedure during the period August 2007 to March 2014. Median follow‐up was 7.98 (0.66, 10.96) years. Twelve patients (8%) had reintervention due to incomplete wound healing. A total of 32 patients experienced a recurrence. In competing risk analyses, the 10‐year cumulative recurrence rate was 27% (95% CI: 19%–35%) of patients with complete wound healing. Treatment success was 68%. Recurrence was associated with active smoking, HR of 5.30 (95% CI: 1.42–19.86; p = 0.01), and number of primary pits ≥3, HR of 5.11 (95% CI: 1.49–17.47; p = 0.01). More than 90% had no postoperative complications or chronic pain, and more than 70% reported a high satisfaction with the cosmetic appearance. Conclusion Bascom's pit‐pick seems to be adequate treatment for most patients with a simple pilonidal sinus.