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The recommendations represent the current procedure, which may be modified and changed where justified, after a thorough analysis of the given clinical situation, which may be the basis for their modification and updating in the future.

Objectives: The aim of the study was to estimate the prevalence rate of patients with urinary incontinence after pelvic surgery as well as the distribution of urinary incontinence types depending on the type of surgery., Material and Methods: 200 consecutive female patients, aged between 33 and 85 years old, administered to urodynamic diagnostic due to urinary incontinence, were included in the study. After collecting medical history and performing a urogynecological examination, a urodynamic study was done. We estimated the relation between urinary incontinence types, bladder activity and type of surgical procedure., Results: 35,5% of patients had undergone obstetric-gynecological operations (abdominal hysterectomy was most frequent, followed by vaginal reconstructive operations, Caesarean sections, adnexal operations and vaginal hysterectomy). We observed 56% of stress urinary incontinence (SUI), 35% of mixed urinary incontinence (MUI) and 9% of overactive bladder (OAB). Among patients with SUI, we found 55% women after abdominal hysterectomy, 5% after vaginal hysterectomy, 20% after adnexal operations, 15% after vaginal reconstructive operations and 5% after Caesarean section. In the group with MUI, 40% patients were after vaginal reconstructive operations, 32% after Caesarean sections, 20% after abdominal hysterectomy and 8% after adnexal operations. Among women with OAB we noticed 33% patients after vaginal reconstructive operations, 33% after abdominal hysterectomy, 17% after Cesarean sections and 17% after vaginal hysterectomy., Conclusions: The results of the study show that patients after obstetric-gynecological surgery procedures make up 30% of all urinary incontinence cases. Distribution of urinary incontinence types in the group of operated women is similar in the entire investigated group. Abdominal hysterectomy and reconstructive vaginal operations are clearly connected with urinary incontinence.

Objective: Obstetrical hysterectomy still remains life saving operation. The aim of study was to determinate the frequency, indications and complications after the operation in the hospital in Zielona Góra, Poland., Materials and Methods: A retrospective review based on hospital data of 36 patients undergoing obstetrical hysterectomy over the period of 11 years was undertaken., Results: The incidence of obstetrical hysterectomy during 1990-2001 et the Department of Obstetrics and Gynaecology in the district hospital in Zielona Góra was 1: 593 deliveries. Post partum hysterectomy occurred in 0.021% of normal deliveries and 1.03% of cesarean sections. The most common indications were placenta increta and placenta accreta /61.1%/, followed by uterine atony /13.8%/ and rupture of the uterus /11.1%. The most frequent complications were shock and lesion of the urinary bladder/both 5.6%/. The maternal mortality was 2.8%., Conclusions: 1. The most common indications for the obstetrical hysterectomy are: placenta's pathologies; uterine atony and rupture of the uterus. 2. Obstetrical hysterectomy is connected with high risk of complications and maternal mortality.

Objective: The objective of this publication was the analysis of 102 laparoscopic hysterectomy. The results were discussed in comparison with traditional laparotomy., Material and Methods: There was the analysis of 102 hysterectomy by the means of laparoscopy done in 2000-2002. Following parameters were evaluated: duration of the operation, blood loss, complication, the day of introducing enteral nutrition and duration of hospitalization., Results: It was observed, that laparoscopic operation took more time than laparotomy (average time: 96.4 min vs 62.37 min). Blood loss was similar in both procedures. Comparing the changes of hemoglobin concentration in serum before and after the procedures it was observed average change 1.75 g% for laparoscopy and 1.71 g% for laparotomy. Time introducing enteral nutrition and duration of hospitalization was shorter for laparoscopic procedures. 87.25% of patients was able to eat in next day after laparoscopic operation. Average amount of days of hospitalization after laparoscopic procedures was 3.75 days, after laparotomy 6.44 days. The infections were the most common postoperative complications. The infections were more common in laparotomy group., Conclusions: The new method causes: shortened time of hospitalization, quicker introducing of general diet, avoiding the large wound of abdominal segments, small amount of complications.