Objective: Pregnancy and postpartum are stages in a woman's life associated to important psychological and physiological changes that can affect her sexual behaviour. In addition, some sociodemographic and obstetric factors can also alter the sexual response. The aim of this study is to evaluate the modifications in sexual behaviour before, during and after pregnancy in a group of Spanish pregnant women and the factors that may be associated. Materials and methods: A prospective study was performed on 111 healthy pregnant women who completed a questionnaire about their sexual habits (including coital and orgasm frequency, satisfaction and pain during intercourse) prior to gestation, at 20, 30 and 38 weeks, and at three and six months postpartum. Data regarding sociodemographic variables (maternal age, marital status and parental educational level) and obstetric variables (parity) were also included. Results: The frequency of sexual activity declined progressively during pregnancy compared with pre-pregnancy levels, with a partial recovery six months after childbirth (p < 0.001). Orgasm frequency (p < 0.006), satisfaction (p < 0.001) and dyspareunia (p < 0.016) also changed, but these declined especially in the last weeks before delivery. Overall, women 30 years or younger, nulliparous, unmarried and women with primary education showed better results in the variables of sexuality while father's education level had little effect. Conclusion: A deep understanding of the changes in sexuality during pregnancy and postpartum is needed to provide couples with information about the normal aspects of their sexuality and to detect sexual dysfunction in these periods. Modificaciones en el comportamiento sexual durante el embarazo y los factores relacionados con el postparto RESUMENObjetivo: El embarazo y el postparto son etapas en la vida de la mujer asociadas con importantes cambios psicológicos y fisiológicos que pueden afectar su comportamiento sexual. Además, algunos factores sociodemográficas y obstétricos también pueden alterar la respuesta sexual. El objetivo de este estudio es evaluar las modificaciones en el comportamiento sexual From:

with post-cholecystectomy BDI and treated with small diameter hepaticojejunostomy (HJ) Roux-en-Y. Method: Between January 1992 and December 2014, All patients who underwent HJ Roux-en-Y for treatment of post-cholecystectomy BDI were retrospectively studied. Group A (HJ with a diameter 10mm or less) and group B (HJ with a diameter more than 10mm). Long-term follow up was done for detection of the rate of anastomotic stricture. Results: A total number of 320 patients were included in the study with 22 patients (6.9%) were missed during long-term follow up. Group A included 64 (20.5%) patients while group B included 256 (79.5%) patients. There was a significant difference in the level of injury between 2 groups (P = 0.028). The long-term follow up was performed after a median 75 months, range (2e246) for 298 patients. The overall long-term complications were higher within group A (15/62-24.2%) than group B (32/236-13.6%), (P = 0.041). The incidence of anastomotic stricture within group A was higher than group B (P = 0.043). Conclusion:The incidence of anastomotic stricture is higher in small diameter hepaticojejunostomy. Technical skills are important to ensure wide patent mucosa-tomucosa hepaticojejnostomy to avoid development of anastomotic stricture.

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