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Background. Multiple studies emphasize the consequences of vaginal delivery on the pelvic floor, but the pregnancy itself represents a risk factor for the appearance of static pelvic disorders. Methods. Review of specialty literature by studying the articles published in PubMed and Cochrane databases between 1980 and 2010. Results. The prevalence of urinary incontinence (UI) is correlated with parity and the way that vaginal delivery is assisted. Although delivery is an independent risk factor for the occurrence of UI, pregnancy plays an important role in its pathophysiology. UI during pregnancy is considered a prediction factor for the subsequent appearance of UI. Damage to the pelvic nerves and muscles during childbirth increases the risk of postpartum urinary retention, the effect of epidural analgesia being controversial. Hormonal influences during pregnancy cause the relaxation of utero-vaginal support systems resulting in the emergence of uterine prolapse, its level increasing in the third trimester. Postpartum fecal incontinence presents as risk factors the external and/or internal anal sphincter lacerations, which have a maximum incidence at first vaginal delivery and the pudendal neuropathy respectively, which is strongly associated with multiparity. Discussion. Among the prophylactic factors for the appearance of postpartum perineal disorders we mention avoiding the use of instrumental delivery by forceps application, the correct diagnosis of fetal pelvic disproportion and limiting the duration of the second active phase of labor. Conclusions. The majority of pelvic floor disorders occur as a result of the first vaginal delivery. Although cesarean section represents a prophylactic factor for static pelvic disorders, it does not have a protective role when performed in the second stage of labor. [ABSTRACT FROM AUTHOR]

Peritoneal tuberculosis is a very rare location of tuberculosis even in high endemic countries such as Romania. It is a delayed diagnosis disease due to insidious clinical course, nonspecific nature of the clinical examination, of the imaging investigations results and of the cytogenetic or biochemical appearance of ascites fluid. We present the case of a 27-year-old young immunocompetent patient, with small abdominal lymphadenopathy and unknown cause ascites, originally labeled as carcinomatous lymphangitis. Tuberculous etiology confirmation by biopsy and/or BK bacteriological is the gold standard for diagnosis. The therapeutic regimen includes four anti-TB drugs for a period of minimum 6 months and corticosteroid association in the first months of treatment. Disease progression under therapy is favorable. [ABSTRACT FROM AUTHOR]

The mechanisms of urinary continence are still controversial and poorly understood. We present in this paper the main concept concerning the physiology of urinary continence. According to the more recent data, we sustain the “Integral Theory of Urinary Continence” of Scandinavians Petros and Ulmsten as the most comprehensive physiology of continence. Based on evidence of the spectacular worldwide spreading of some surgical techniques as “IVS” or “TVT” as the golden standard for all types of urinary incontinence, we are convinced that this fact represents a hope for future. [ABSTRACT FROM AUTHOR]

Genital prolapse and its associated pathological manifestations represent a significant health problem among elderly female population. Posterior vaginal fornix syndrome belongs to the category of mistreated or ignored pathologies, and it has a significant negative impact on the patients' quality of life. Posterior vaginal fornix syndrome symbolizes a complex pathophysiological manifestations classically defined by the triad: micturition imperiosity, nocturia and chronic pelvic pain. Clinical and paraclinical examination allows a proper identification of the perineal defect which leads to the symptomatolgy appereance. Modern treatment of posterior vaginal fornix syndrome is the reconstructive surgery of the perineum that restores the perineal anatomy. Reconstructive surgical techniques final objectives are an improvement in urinary and feces continence, disappearance of the chronic pelvic pain and an improved sexual life of the patients. [ABSTRACT FROM AUTHOR]

Introduction. Mature teratoma represents one of the most frequent ovarian tumors. Yet, its malignization represents a rarity, the most frequent histological type being the squamous-cell carcinoma. Coexistence with Brenner tumor is very rare. Case report. We present the case of a 59-yearold patient, diagnosed 6 years ago with Brenner tumor coexisting with malignant teratoma. The treatment was total hysterectomy and bilateral annexectomy, lymphadenectomy and omentectomyand adjuvant chemotherapy. Six years postoperatively, the patient presents minimum vaginal bleeding and polakyuria, a pelvic tumor being found, invading the urinary bladder. We practiced infralevator anterior pelvectomy with Briker type urinary derivation and adjuvant radiotherapy. Discussions. Even if the squamous carcinoma represents the most frequent type of malignization of the ovarian malignant teratoma and Brenner tumor, it is not histologically different from other vaginal squamous primary carcinomas. The symptomatology is unspecific, the tumor markers being usually positive. Anatomopathological and immunohistochemical they are similar, p63 positive pleading for epithelial origin. Yet, the free timeframe of the disease in spite of all the paraclinical investigations and periodical oncological consultations negative may plead for a new neoplasia. Conclusions. The correctly directed treatment of an ovarian malign teratoma has led to a good survival of the patient, in spite of the lack of international therapeutic protocols! The accurate treatment of the relapse will determine the prognosis of the the patient, but the main factor is the Brenner tumor's aggressiveness. [ABSTRACT FROM AUTHOR]

Crying represents the initiation of human vocal communication, as it is the most important mean of transmitting infant's needs and wants. This article provides the necessary information for designing the collecting system of newborn's crying and associating it with their physical condition. The study involves the development of a database with information about the full needs of newborns and infants expressed throughout crying. It includes newborn babies with a gestational age at birth more than 34 weeks, and chronological age (or corrected age for premature babies) smaller than 3 months. After analyzing the specialty literature we identified 6 types of crying in healthy newborns, associated with different needs, and the pathological crying. The 6 physiological crying types are caused by hunger, pain, postprandial or belching, fatigue or sleep, minor discomfort and abdominal colics. For each type of crying to be identified we will highlight: the stimuli (if applicable) applied to the subject to produce the type of crying, the moments of time in which the likelihood of appearance is highest or any dependencies between the types of crying. Crying will be acquired in the maternity and at domicile of subjects and data acquisition will be performed by specialized personnel (in the nursery) or parents (at home). For each subject will be stored in the database information to characterize the newborn, regarding in particular the parameters of the birth. Depending on the characteristics at birth (gestational age, weight, health status, Apgar score), newborns can be grouped into three categories: healthy term newborn, at risk newborn, sick newborn. Besides acquisition of the needs associated with crying, other information will be retained for each record of crying: the need that labels the cry (of the 7 types listed), the subject's age (0-3 months), the time of the acquisition of crying, the recording location (maternity or home), the date of registration, the time from the last meal, the type of diet (milk or formula, if relevant), the time from the last sleep (depending on the sleeping and waking pattern). The main purpose of the video recording application is to allow the association between infant crying and its condition. We chose filming not only sound in order to facilitate the labeling of offline data by health care professionals and to create the foundations for the development of algorithms recognition that use images as complementary information. The study of recognizing newborn and infant's language by finding correlations between their crying and their physiological or pathological needs is an ongoing project, which will bring a real help to both parents and medical personnel involved in treating and attending babies. [ABSTRACT FROM AUTHOR]

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Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives. Assessment of key endometriosis diagnostic ultrasound techniques, highlighting technique, advantages and limitations of each method. Method. We reviewed the literature for different methods of ultrasound diagnosis of endometriosis and selected representative articles. In each study, final diagnosis of endometriosis was established on laparoscopy and/or histopathological examination. Results. We included 16 studies that investigated the use of ultrasonographyin the endometriosis diagnosis. Of these, 13 were prospective studies, a prospective studybased on personal cases, a presentation of a ultrasound technique (sonorectovaginography) and a review study that researched the accuracy of rectosigmoid deep infiltrative endometriosis diagnosis by transvaginal ultrasound (TVS). Data was analyzed by comparing statistical indicators for every sonographic investigation: prevalence, sensitivity, specificity, positive and negative predictive value. Conclusion. TVS stands as the first choice investigation for non-invasive diagnosis of endometriosis. TVS has an increased accuracy in detecting lesions of the ovaries, bladder and rectosigmoid. TVS with water contrastin the rectum (RWC- TVS) and sonovaginography prove to be more useful in detecting recto-vaginal lesions and are recommended to be used in cases where TVS can not exclude rectum infiltration. Transrectal ultrasound indications are limited to cases with a significant discrepancy between the results of clinical examination and TVS and is considered to be the best technique for evaluating the craniocaudal extension of rectal endometriosis. Gel sonovaginography and sonorectovaginography are effective diagnostic methods of endometriosis of the recto-sigmoid and posterior compartment. [ABSTRACT FROM AUTHOR]

The aim of this paper is to present the importance of ultransonography in diagnosing antenatal intracranial hemorrhage. The obstetrician and the fetal ultrasound specialist must be aware of the predisposing factors, pathogenic mechanisms and suggestive imaging in diagnosing intracranial fetal hemorrhage given the fact that neonatal neurologic sequelae are associated and have potential forensic implications. Intracranial hemorrhage can occur spontaneously antenatal or determined by a number of maternal or fetal factors. Early ultrasound signs of intracranial hemorrhage are represented by the occurrence of localized hyperechogenic areas situated intraventricular, periventricular, intraparenchymal or intracerebelar. Acute hemorrhage phenomena can be associated with signs of fetal distress or changes in the fetal heart rate. Because most newborns with intracranial hemorrhage are initially asymptomatic at birth, prenatal ultrasound diagnosis of hemorrhagic lesions is very important in order to draw attention on close monitoring with transfontanellar ultrasonography and/or magnetic resonance imaging (MRI) immediately after birth. [ABSTRACT FROM AUTHOR]

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hypogastric artery ligation is a method to control bleeding during obstetrical or gynecological surgery that should be included in the portfolio of each gynecologic surgeon. In literature there are conflicting data regarding the effectiveness of this maneuver. The explanation for the failure of this technique can be explained by the system of anastomoses between uterine and vaginal arteries. In the past, it was thought that hypogastric artery ligation is equivalent traffic disruption in the territory served. If the procedure is performed correctly, short and long term morbidity is low. Aim: This paper aims to present the anatomical landmarks and collateral circulation in the female pelvis in order to determine the effectiveness of bilateral hypogastric artery ligation. Methods: We analyzed the articles published in professional journals to observe the efficiency of hypogastric artery ligation and its impact on fertility. Results: The study of uterine blood supply and collateral circulation has stagnated for many years. There are three arterial pedicles which provide vasculature to the lower portion of the uterus: uterine artery, the artery cervical and vaginal arteries. Because of the anastomosis network present at this level the distal portion of the hypogastric artery is never emptied of blood flow. Conclusions: The anastomosis system between uterine and vaginal arteries explains maneuver failure, hemodynamic disorders and complications that can occur after bilateral ligation hypogastric artery. Collateral circulation becomes operational in 45-60 minutes after ligation. The data described in the literature presents a success rate which varies between 48 and 85%. It is a technique that allows preservation of fertility but there are a small number of case studies showing the evolution of the pregnancies obtained after ligation bilateral hypogastric artery. [ABSTRACT FROM AUTHOR]

Autonomic innervation of the pelvis involves sensory and motor fibers originating from the lateral horn of the spine, C12-L4 (sympathetic) or S3 to S5 (parasympathetic) and is represented by the sympathetic sacral trunk, the pelvic splanchnic nerves and the hypogastric plexus. Sacral sympathetic trunk continues the lumbar one from the upper strait of the pelvis, being in contact anterior with the rectum, posterior with the sacrum and lateral with the sacral holes. Each of the right and left trunks contain four nodes, connected by internodal fibers, that merge and form anterior to the coccyx the imparganglion. Sacral sympathetic trunk gives postnodal efferent fibers to the sacral plexus that innervate the inferior limbs and to the inferior hypogastric plexus. Superior hypogastric plexus (presacral nerve) contains sympathetic fibers from the aortic plexus anastomosed with lumbar splanchnic nerves (right and left) inferior to the bifurcation of the aorta at the level of L5. It has a short downward trajectory through the pelvis and anterior to the promontory it divides into right and left hypogastric nerves, which may have a plexiform aspect. They have a descending pathway to the anterior and lateral, reaching the lateral sides of the rectal ampulla, where they branche. Pelvic splanchnic nerves (erector) containpreganglionic parasympathetic fibers originating from the spinal segments S2-S4 and fibers from the sacral paravertebral chain. Inferior hypogastric plexus is formed by anastomosis of the hypogastric nerves with the splanhnic pelvic nerves, containing sympathetic and parasympathetic fibers. They have the aspect of a network of nerve fibers, mixed with irregular nodal masses, which can combine forming several bulky nodes. Their efferencesform periarterial plexuses (hemorrhoidal, vesical, uterine, vaginal) distributed along the internal iliac artery to all the pelvic and perineal viscera. [ABSTRACT FROM AUTHOR]

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A lot of methods have been used to evaluate the lower uterine segment after cesarean section: hysterography of the uterine scar, pelvic examination, amniography, x-ray pelvimetry and ultrasonography. The present study consisted of 275 secondiparous with the gestational age between 36 and 38 weeks. All recruited patient were evaluated by transvaginal ultrasound in order to characterize the lower uterine segment (LUS). LUS thickness was measured as the distance between the two calipers placed at the urinary bladder - myometrium interface and at the myometrium - chorioamniotic membrane interface. The appearance of the LUS where classified into three categories, where class I and II are considered non-dehiscent and class III was considered dehiscent. Therefore, the intraoperative assessment results included 19.6% patients in class III (dehiscent LUS, uterine content visible) and 80.4% patients in class I and II (non-dehiscent LUS). In the intraoperative non-dehiscent group 25.8% patients were included in class I (normal, well-developed LUS) and 54.6% were included in class II (thin LUS, uterine content not visible). The results showed that at a LUS thickness less than 2 mm carries a higher risk for dehiscence (incomplete uterine rupture) than those with a thickness more than 2 mm. [ABSTRACT FROM AUTHOR]

Every year, over 1800 women die in Romania as a result of cervical cancer and up to 3,400 are newly diagnosed with this pathology. The incidence is 2.5 times higher than the European average, and the mortality rate is over four times higher, placing us in the first place in terms of incidence and mortality associated with cervical cancer. Thus, there is a need to improve both the primary prevention of HPV vaccination and the screening with anemphasis on the screening strategy with primary testing of persistent HPV infection. According to multiple recent studies, due to the noninvasive nature and the potential for self-administration, including at home, HPV DNA testing tends to be a screening method appreciated by patients, in contrast to those that postpone the visit to the gynecologist due to psychological considerations. [ABSTRACT FROM AUTHOR]

Introduction. Bacterial vaginosis is an important affliction. The mechanism may be an increase in mucin degradation enzyme in vaginal fluid in patients with bacterial vaginosis which promotes virulence by disrupting mucosal protective barriers, resulting in increased HPV infection through viral adhesion, invasion and HPV genome integration. Materials and method. The analysis of the relationship between the vaginal environment and HPV to regulate vaginal microecological balance, block HPV infection and intervention in the prognosis of cervical lesions. Conclusions. Bacterial vaginosis (mycoses, mycoplasmas, Chlamydia) and reduced lactobacilli are associated with an increased risk of HPV infection and with the development of CIN. This study shows that vaginal microecological imbalance and weakened local cervical immune function are reasons for the development of cervical lesions. The association of bacterial vaginosis with HPV can be seen. The prevalence of HPV is high in patients with bacterial vaginosis. [ABSTRACT FROM AUTHOR]

Introduction. The uterine malformations are caused by deficitary development of the müllerian ducts during the embryological life. With a prevalence of 1-6% in the general population, they result in an abnormal uterine cavity, which has a negative impact on fertility. The most frequent uterine malformations are represented by the septated arcuate and bicornuated uterus and result from an incomplete absorption of the müllerian ducts. Often, the differentiation between these pathologies through imagistic techniques can be troublesome. The new ASRM classification comes with remarks in this regard. The aim of the treatment is the restoration of the uterine cavity, since the reconstruction of the normal uterine anatomy is key to a better reproductive function. Materials and method. This poster describes a clinical case of uterine malformation in a 33-year-old patient with infertility, showing the diagnostic and therapeutic protocol, as well as the impact over fertility. Results. Using 3D US and ASRM criteria, the correct diagnosis of septate uterus could be placed. Hysteroscopic resection of the septum and the restoration of the uterine cavity allowed the implantation of an embryo via IVF. Conclusions. The treatment gold standard of uterine malformations is represented by hysteroscopy, which has a low risk of postoperative complications and leads to an improvement of the reproductive function. Applying the ASRM criteria, a correct diagnosis can be made with ease, allowing for the most effective treatment protocol to be followed. [ABSTRACT FROM AUTHOR]

Endometriosis is a relatively common pathology that frequently affects the general population, found in approximatively 10% of women of reproductive age. Although most often multiple endometriosis foci are found, the ovaries are the most prevalent location, approximately 20-40% of the patients suffering from ovarian endometriosis cysts. Women of reproductive age are at risk of developing premature ovarian failure, determined by the affliction itself, which causes chronic inflammation of the ovarian cortex and increased oxidative stress and folliculogenesis disarray (“burnout theory”), as well as the repetitive, most often bilateral, therapeutic surgical interventions. These repeated and chronic aggressions lead to a denaturation of the ovarian cortex, a lower AFC (antral follicular count) and, subsequently, to a lower AMH (anti-müllerian hormone). Premature menopause is characterized by the cease of ovarian function before the age of 40, impacting the cardiovascular, nervous and osseous systems. In women of young reproductive age with endometriosis who have not yet completed family planning, the potential risk for low ovarian reserve, POI (premature ovarian insufficiency) and future infertility must be carefully assessed. These patients frequently need assisted reproduction techniques in order to obtain pregnancy. In vitro fertilization (IVF) has better outcomes if the patient had the opportunity to store oocytes (egg cells) or ovarian tissue before surgery. In patients with early menopause, although the reproductive function cannot be recovered, hormone replacement therapy (HRT) is recommended in order to lower the systemic affections. In patients suffering from endometriosis, this therapy may be considered, but we need to take into consideration the risk of disease reactivation. [ABSTRACT FROM AUTHOR]

Introduction. Symptomatic pelvic organ prolapse has a relatively high prevalence and women have a 13-20% lifetime risk of having a surgical procedure to repair vaginal support defects. Despite the anterior vaginal compartment being the most common site of pelvic organ prolapse, the loss of apical support is typically associated with defects that usually occur at the insertions of cardinal-uterosacral ligament complexes, pubocervical fascia, and rectovaginal fascia to the pericervical ring. In addition to the midline defects in the posterior vaginal wall, detachments of the rectovaginal fascia along the arcus tendineus fasciae rectovaginalis and breaks at the pericervical ring insertion are responsible for the lateral and transverse defects, respectively. All of these defects can form rectoceles. Minimally invasive pelvic surgery to correct apical prolapses and posterior defects primarily includes laparoscopic or robotic assisted hystero-/sacrocolpopexy for defects that are more than grad III (grade III and IV) and the native tissue alternative of uterosacral ligament culdoplasty and suspension for defects that are less than grad III (grade II or III). Materials and method. In this paper, we present several cases of pelvic organ prolapse through which we highlight the techniques and advantages of the minimally invasivepelvic reconstructive surgery. Results. The gold standard procedure for apical prolapse that are grade III or IV remains the sacral colpopexy that suspends the vaginal vault by reinforcing the anterior and posterior vaginal fibromuscularis with mesh secured to the anterior longitudinal sacral ligament. The laparoscopic or robotic repair techniques of a uterine or vaginal vault prolapse or a rectocele that are grade II or III must address the reconstruction of the pericervical ring and its attachments to the cardinal-uterosacral ligament complexes, pubocervical fascia, and rectovaginal fascia by approaching the uterosacral ligaments together and reattaching to these ligaments. Conclusions. Sacrocolpopexy is the gold standard repair for apical prolapse that are grad III or IV for those who desire to maintain their sexual function, and minimally-invasive approaches offer similar efficacy with fewer risks than open techniques. Laparoscopic or robotic uterosacral ligament culdoplasty and suspension with reinforcing of the pericervical ring is a safe and effective native tissue option for grade II or III defects. [ABSTRACT FROM AUTHOR]

Introduction. The use of minimally invasive surgery with robotic assistance has grown exponentially since its approval. Applications include benign afflictions and staging and management of gynecologic malignancies. The rapid adoption of robotic technology comes from the enhanced visualization, wristed instrumentation, and improved ergonomics inherent to such systems, enabling more surgeons to perform minimally invasive procedures previously restricted to surgeons with advanced laparoscopic skills. Such technology may also enable those with laparoscopic experience to perform more complex cases that would otherwise require open techniques. Compared with traditional laparoscopy, robotic platforms are promoted as resulting in less blood loss, less postoperative pain, shorter hospital stay, and higher lymph node retrieval, although perhaps at the expense of cost. Compared to robotic surgery, laparoscopic surgery has certain limitations, such as two-dimensional imaging, restricted range of motion of the instruments, and poor ergonomic positioning of the surgeon. Materials and method. In this paper, we present our personal experience of 1171 surgical interventions regarding laparotomy versus laparoscopy versus robotic surgery. Results. Although the available literature suggests that robotic and laparoscopic techniques seem to be no different for many outcomes, there is compelling evidence that robotics has advantages over open techniques. Of the three outcomes that we believed had the most critical effect on patient care (operative time, length of hospital stay, and days to return to normal activity), there was a consistent trend toward reduced length of stay for robotic surgery compared to laparotomy. A total of 1171 interventions have been performed either by laparotomy, vaginal, laparoscopic or robotic. Out of these, 491 (41.92%) were performed laparoscopically and 83 were performed robotically (7.08%). Regarding the indications of the interventions, 414 (84%) laparoscopical interventions were performed for benign afflictions and 77 (16%) for malignancies. From the 83 robotic surgeries, 56 (75.9%) were performed for benign diseases and 20 (24.1%) were performed for malignancies. The cases of complex comorbidities, such as severe adhesions, obesity or deep infiltrating endometriosis, are well suited for robot-assisted surgery. More extensive interventions in deep infiltrating endometriosis with partial resection of the bowel or bladder can also be performed with lower complication rates by this minimally invasive approach. The use of robotic surgery for malignant gynecological diseases is increasing in proportion to centralization and the availability of the robot. The use of the robot may be meaningful even in fertility-conserving operations like trachelectomy. Conclusions. Overall, there seems to be an advantage to robotic techniques over traditional open surgery in the management of gynecological afflictions. Therefore, the specific method of minimally invasive surgery, whether laparotomy, conventional laparoscopy or robotic surgery, should be tailored to patient selection, surgeon ability and equipment availability. [ABSTRACT FROM AUTHOR]

Cystic hygroma represents a fluid accumulation in different structures, often cephalic, on the left side, with an incidence of 1/6000-1/16,000. Karyotype anomalies are found in 20-75% of cases, most frequently Turner, Down, Klinefelter, Edwards and Patau syndromes. Subchromosomal abnormalities include Noonan syndrome, Fryns syndrome, multiple pterygium syndrome and achondroplasia, and also maternal alcohol consumption. We report a series of cases diagnosed in the first trimester with cystic hygroma and their genetic determinacy. The first patient was diagnosed at 11.6 weeks of gestation with a large cystic lesion sheltering the entire fetus, with omphalocele, AVSD and arthrogryposis. The patient decided the termination of pregnancy and the karyotype confirmed the Down syndrome. The second patient, having a term birth by caesarean section followed by five first-trimester miscarriages, presented at 8.5 weeks of gestation, with an ultrasound image of large cystic hygroma causing double contour suggestive for fetal hydrops and no fetal heartbeat. The abortion product karyotype revealed Turner syndrome. Couple karyotyping and genetic counseling were recommended, showing a 46,XX/47,XXX mosaicism in the mother, respectively an addition in the 9th pair of chromosomes in the father – 46,XY,add(9)(p12), for which arrayCGH was recommended in order to detect a possible chromosomal balanced translocation, which was ruled out. The third patient, with history of two early pregnancy miscarriages and two failed IVF procedures, presented with a spontaneous 11.6-week pregnancy showing cystic hygroma, medium size omphalocele, micrognathia and hypoplastic nasal bone. The parents decided the termination of pregnancy and the karyotype revealed trisomy 18. The fourth patient was diagnosed in the first trimester with a large left laterocervical cystic mass, consistent with lymphangioma. The follow-up showed normal development and amniocentesis revealed a normal karyotype. An appropriate weight neonate was born at 38 weeks by caesarean section, with a good postnatal transition, expecting removal surgery of the cervical lymphatic cyst sized 12 cm. We suggest a significant association between cystic hygroma and karyotype anomalies, stronger in patients with obstetrical failure history, validated by invasive genetic testing. [ABSTRACT FROM AUTHOR]

Introduction/objective. The isthmocele represents a discontinuity of the anterior uterine wall that appears as a result of a deficient healing at the level of hysterorraphy after caesarean section, which involved both gynecological and obstetric complications. Depending on the thickness of the overlying myometrium, there may be a large defect, affecting more than 50% of it, or a small defect with an interest of less than 50% or a thickness of more than 3 mm of the myometrium. This classification is important in the therapeutic decision to establish a hysteroscopic or laparoscopic treatment. Methodology. The present paper aims to present the case of a 27-year-old patient who presents to the clinic for secondary infertility, dysmenorrhea, intermenstrual spotting and severe dyspareunia. Ultrasound examination reveals a wide niche after caesarean section. Results. The patient undergoes laparoscopic correction of the isthmocele. The follow-up at six weeks postoperatively showed a significant improvement of symptoms and a normal ultrasound examination, with the disappearance of the niche. Discussion and conclusions. Although a still incompletely understood entity, the diagnosis of isthmocele is constantly increasing, which is why the treatment should be chosen depending on the presence of symptoms, the size of the defect, the secondary infertility and the desire to conceive. [ABSTRACT FROM AUTHOR]

Introduction. The increasing incidence of abnormal insertion of placenta justifies the need to highlight which are the frequent factors involved in this pathology and to improve the methods able to sustain a prenatal diagnosis of abnormal placenta spectrum disorders, so useful to avoid a catastrophic postpartum hemorrhage. Material and method. The study was conceived by analysis of articles and clinical guidelines published online concerning the placenta accreta spectrum disorders (PAS) in the last five years. The study allows to clarify the terms that define PAS, the factors that frequently generate this pathology, and the ultrasonographic criteria able to support PAS diagnosis. Results. The most proper terminology remains the one launched by Luke (1966), because it includes all three significant criteria, such as the depth of the myometrial invasion of the villi, the lateral extension of the placenta accreta, and the variable degrees of myometrial invasion in the same placenta. Among the factors most frequently involved, there are repeated caesarean sections, uterine curettages and manual extraction of the placenta. The features of ultrasonographic criteria were the loss of hypoechogenic space, placental abnormal lacunae, loss or disruption of bladder wall continuity, thinning of the thickness of the myometrium, bulging of the placenta, focal placental exophytic, color Doppler changes such as uterovesical hypervascularization, subplacental hypervascularization, “bridging vessels” and Doppler intramiometrial vessels with high velocimetry oriented to the placental lacuna. The three-dimensional (3D) power Doppler sonography shows placental hypervascularization, vessels with a twisted path and different caliber. MRI is recommended to validate if a posterior placenta is accreta too. Conclusions. Women with risk factors for PAS should be screened by US at 11-14 weeks of pregnancy. The US criteria for antenatal diagnosis of SAP must be checked in the second trimester of pregnancy to avoid a catastrophic postpartum hemorrhage associated with disseminated intravascular coagulation syndrome. [ABSTRACT FROM AUTHOR]

HIV infection represent a worldwide health issue, with 38 million known patients and around 1.7 million new cases every year. Vertical transmission from mother to child represents 2% of the new cases. Also, studies of HIV pregnancies have shown a higher rate of complications such as prematurity and intrauterine growth restriction. This paper presents a study on 78 HIV pregnancies managed in the “Prof. Dr. Panait Sîrbu” Clinical Hospital of Obstetrics and Gynecology, Bucharest, between 2018 and 2020. The main conclusion of the study is that the rate of prematurity was 11.53% (9 out of 78), lower than what the literature previously reported (24%), mainly due to a very strict management of ART and pregnancy monitoring. [ABSTRACT FROM AUTHOR]

Introduction. Vulvar cancer is the fourth most common gynecological malignancy. According to predisposing factors, vulvar cancer can be categorized into two types: the first type is found in younger women and is correlated with HPV infection. The second type is independent of HPV and occurs in elderly women. Squamous cell carcinoma accounts for 90% of the vulvar cancer. Early-stage disease is defined as stage I or II. Locally advanced disease is defined as stage III or IVA. Stage IVB disease refers to women with distant metastases. Materials and method. We present a systematic review in which we included articles concerning the treatment of advanced vulvar cancer. We will also present several cases of advanced vulvar cancer in order to demonstrate the right management of such cases. Results. The treatment of vulvar cancer involves a combination of surgery, radiotherapy and, rarely, chemotherapy. If the disease is locally advanced and the lesion is ≥1 cm from the median line, a radical vulvectomy and ipsilateral dissection of the inguino-femoral lymph nodes are performed. If the lesion is in median line, a radical vulvectomy and bilateral dissection of the inguino-femoral lymph nodes are performed. If the lymph nodes are positive, it can be opted for external beam radiotherapy of the primary tumor, lymph node and pelvis. If the nodes are negative, external beam radiotherapy of the primary tumor is performed. In all cases, adjuvant treatment follows. In patients with large tumors (above 4 cm) and macroscopic nodal metastases or extended localized disease to adjacent organs, the treatment course consists of chemoradiation with external beam radiotherapy to the tumor, groin and pelvis, as well as chemotherapy and surgery with perineal reconstruction. Conclusions. The basic treatment for vulvar cancer is surgery, but the radical nature of the procedure and adjuvant chemoradiation depends on the affectation of the lymph nodes in the inguino-femoral region and on the size of the tumor. The treatment can be long lasting and have a major impact on the quality of life. Perineal reconstruction can be accomplished using vulvoplaty, musculocutaneos flap, gracilis muscle flap, local flaps (transposition flaps) and biological graft flaps, with good results. [ABSTRACT FROM AUTHOR]

Introduction. The standard treatment for earlystage cervical cancer is represented by radical hysterectomy with pelvic lymphadenectomy. Laparotomy has been the main choice of approach for a long period of time and, although effective, it is highly invasive and associated with increased morbidity, longer hospital stay and postoperative complications. Since the early 1990’s, radical hysterectomy with pelvic lymphadenectomy has been successfully performed laparoscopically. The use of minimally invasive techniques has led to better postoperative outcomes, lower intraoperative blood loss and shorter hospital stay. Although there is recent debate concerning the significant inferiority of the minimally invasive approach followed by the LACC (laparoscopic approach to cervical cancer) study in 2018, there are recent studies that question its findings and that sustain that there is still an important place for minimally invasive surgery in early cervical cancer. Materials and method. We present a systematic review in which we included articles regarding minimally invasive surgery in cervical cancer and the future perspective of this approach. Results. There are several meta-analyses that compared minimally invasive surgery with open surgery for early cervical cancer. Regarding intraoperative blood loss, hospital stay and postoperative complications, there are four meta-analyses which conclude that laparoscopic approach is superior to the abdominal one. The careful selection of patients can lead to excellent oncologic outcomes. The results from the studies incriminating minimally invasive surgery showed no significant differences in disease-free survival rate and overall survival rate for low-risk cervical cancer (tumors below 2 cm, no lymphovascular space invasion, depth of invasion below 10 mm and negative pelvic lymph nodes). So, at least for these patients, minimally invasive surgery is naturally a better solution. Fertility sparing surgery includes mainly patients with low-risk cervical cancer, a category for which minimally invasive surgery should be primarily used for. Conclusions. While there are still aspects that undoubtedly need to be improved concerning a standardized technique, minimally invasive surgery still has an important role in the treatment of early-stage cervical cancer. [ABSTRACT FROM AUTHOR]

Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide, with half of them acquiring the infection either perinatally or in the early childhood, especially in endemic areas. The management of HBV during pregnancy remains a challenge and involves various aspects of maternal and fetal care. The aim of this review is to present the current knowledge regarding pregnancy and HBV infection, as well as recent efforts to reduce the rate of mother-to-child transmission (MTCT). Although in most cases, acute or chronic HBV infection in pregnancy is similar to that in the general adult population, testing for HVB is recommended in every pregnancy, regardless of the previous testing or vaccination, due to the higher incidence of low birth weight, prematurity as well as gestational diabetes mellitus and antepartum hemorrhage reported in pregnancies with chronic maternal HBV infection. The identification of HVB-positive pregnant women remains the most effective way to prevent HVB transmission to newborns, combined with passive and active prophylaxis at birth. Breastfeeding is not contraindicated for HVB patients, but it is not recommended for women to take antiviral drugs due to the potential teratogenic effect on the fetus. Finally, there remains no clear evidence that elective caesarean section reduces the risk of mother-tochild transmission compared to vaginal delivery. [ABSTRACT FROM AUTHOR]

Introduction. With nearly 570,000 new cases per year and 310,000 deaths per year, cervical cancer is the second most frequent cancer in women and the third leading cause of cancer-related deaths in females. Good oncologic outcomes after surgery have been reported for early-stage cervical cancer with a disease-free survival of 90.6% at three years and 96.5% at 4.5 years, respectively, and an overall survival of 96% and 99%, respectively. For this subset of patients, lymph node status is a major prognostic factor since five-year disease-free survival falls from 88% to 57% in case of lymph node metastasis. Materials and method. We present a systematic review in which we included articles regarding the sentinel lymph node mapping and the future perspective of this procedure. Results. According to the international guidelines for the treatment of early-stage cervical cancer, the gold standard treatment includes pelvic-lymph-node dissection (PLND) in order to adapt the treatment to a potential lymphatic metastasis. A lymph-node metastasis is present in 27% of early cervical cancers, leading to a high rate of overtreatment with unnecessary pelvic lymphadenectomy in three out of four patients. Moreover, this lymphatic surgery is known to induce significant morbidity and can lead to a decreased quality of life. The sentinel node detection rate is high in women with early-stage cervical cancer (96.3%, with 82% bilateral detection). Sentinel node mapping has a sensitivity of 96.3% and a negative predictive value of 98.7% in women with tumor size above 20 mm. This high sensitivity, with a low risk of complications after it, concludes that sentinel lymph node biopsy is a very promising technique but demands full adherence to the sentinel lymph node algorithm and experience with this method. Conclusions. The current trend in cervical cancer management is focused on less aggressive strategy without jeopardizing oncologic outcomes. The sentinel lymph node biopsy is a sturdy alternative to systematic full pelvic lymphadenectomy for lymph node staging in early-stage cervical cancer. According to the abundant literature, there is a trend in the acceptance of sentinel lymph node biopsy in current clinical practice and, in time, maybe will became the gold standard of node staging in early-stage cervical cancer. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis is an estrogen-dependent chronic inflammatory disease defined as the presence of endometrium-like tissue outside the uterus. Due to the steroid-dependent nature of the disease, it was considered that endometriosis lesions regress and most frequently disappear after the menopause, but more recent information showed that women with a history of endometriosis may experience the worsening of symptoms and the reactivation of residual disease. Materials and method. We present our clinic experience and a systematic review concerning endometriosis in menopause, manifestation, management and treatment. Results. The prevalence of postmenopausal endometriosis is estimated to be about 2-5% of all patients diagnosed with endometriosis. As it is well known, no existing theory can explain the development of all endometriosis lesions. It is believed that, in early menopause, endometriosis is due to an estrogen responsive tissue – for example, increased ovarian estrogen secretion during the first years of menopause or conversion of precursor steroids to estrogens in peripheral tissue. During the late menopause, endometriosis can be explained by genetic and/or epigenetic incident causing estrogen-independent progression, increased sensitivity to estrogens or increased local production of estrogens. Menopausal hormone therapy is believed to stimulate the growth of endometriosis. However, endometriosis has also been reported in postmenopausal women who do not use hormone therapy, which underlines the complex pathogenesis of this disease. Knowing the increased potential risk of underlying malignancy in this population, hormone therapy approaches are more limited and it is suggested that the first-line treatment for endometriosis in postmenopausal patients should be surgical. Conclusions. Although it is a rare disease, peri- and post-menopausal endometriosis should be taken into account due to the risk of disease recurrence and malignant transformation. Understanding the genetic or epigenetic incidents involved, the hereditary incidents and the environmental factors will be important for prevention, diagnosis and therapy. Postmenopausal endometriosis seems to expose the patient to a higher risk of malignant transformation. Due to the lack of high-quality studies, the therapeutic conduct in patients with a history of endometriosis during menopause is not clear. The surgical excision should be taken into consideration due to the risk of disease recurrence and malignant transformation. Multicenter randomized trials or large observational studies are needed to inform clinicians and patients alike. [ABSTRACT FROM AUTHOR]

High-grade squamous intraepithelial lesion (HSIL) includes the entities formerly called intraepithelial cervical neoplasia (CIN 2, CIN3), moderate and severe dysplasia, and in situ carcinoma. Although not all high-grade lesions will progress to cancer, HSIL is considered a preneoplasic lesion. The aim of our study was to compare colposcopy changes associated with the diagnosis of HSIL (high-grade squamous cervical lesion) cytologically and histologically confirmed and the role of the interprofessional team in the prompt evaluation and management of these lesions. We evaluated cytological/ histological diagnoses of HSIL and colposcopic diagnostic elements. The cytological and histological diagnoses were reported according to the Bethesda system. Out of the total of 1180 PAPS collected in 2020, a number of 27 presented HSIL results, these being the ones evaluated in the present paper. [ABSTRACT FROM AUTHOR]

Cervical carcinomas can be prevented by detecting and treating precancerous lesions early. Although the cytological screening has decreased the incidence worldwide, the results obtained must be integrated in a clinical context in order to avoid false-positive diagnoses. Persistent infection with high-grade HPV is the leading cause of preneoplastic and neoplastic lesions. Although the Babeş-Papanicolaou cytological examination, performed both conventionally and liquid-based, is the most efficient method in terms of quality/price ratio, and the histopathological examination is often considered the gold standard, in some cases there are inconsistencies between the two. In our study, we aimed to retrospectively evaluate Babeș-Papanicolaou smears and post-biopsy results in order to determine the incidence of false-positive and false-negative cases. [ABSTRACT FROM AUTHOR]

Objectives. In vitro fertilization (IVF) includes a complex set of procedures used to improve fertility, prevent genetic problems, and help conceive a child. In most cases, this procedure results in more than one embryo. The couples have a major problem after IVF regarding the remained cryopreserved embryos and what should happen with it. Materials and method. We performed a research on the international studies about the fate of frozen embryos after obtaining the number of pregnancies desired by the patient. Results. There are some principles of bioethics that are very important for both patients and medicine: respect for autonomy, non-maleficence, beneficence and justice. There are specific laws that must be respected, laws stipulated by the Societies of Human Reproduction and Embryology, the Declaration of Human Rights and various civil and criminal codes available, which differ in each country and state worldwide, and also the beliefs of the Christian religion. The couples can opt for donation or adoption meaning they can transfer the embryos to another couple. Another option is the destruction of the surplus embryos. Conclusions. This article provides a complete picture of patients, as well as doctors in general, in terms of justice, religion and bioethics on surplus frozen embryos remaining after obtaining the desired number of children. [ABSTRACT FROM AUTHOR]

Objective. Hematopoietic autologous stem cells are undifferentiated cells with the potential to multiply and differentiate into different types of mature cells, which are obtained by harvesting bone marrow from the iliac crest, for example, from the same patient, in the same intervention as the treatment. The goal is to rejuvenate the ovaries in patients with premature ovarian failure and endometrial regeneration in pathologies such as Asherman syndrome. This treatment can give women the chance to have a pregnancy without donated oocytes, improves the quality of life of women suffering from premature menopause and restores fertility. Materials and method. We performed an analysis of studies in the literature on the results of treatment with hematopoietic autologous stem cells in improving fertility. Results. Studies that have evaluated patients who want a pregnancy but have been advised to use donated oocytes (due to a poor ovarian response to controlled ovarian hyperstimulation for in vitro fertilization or due to low ovarian reserve and low oocyte quality) show promising results. Laparoscopic injection of stem cells proved superior to transvaginal injection. The use of autologous bone marrow stem cells has proven superior to the use of adipose tissue stem cells and is a minimally invasive technique with low associated risks. After the procedure, studies show follicular growth, improved vascularity, increased follicular and stromal cell proliferation and also reduced apoptosis and cell atresia. In refractory cases of Asherman’s syndrome or endometrial atrophy for various reasons, studies reveal that the instillation of hematopoietic autologous stem cells has had favorable results in endometrial regeneration and the reappearance of menstruation and fertility. Studies also include obtaining spontaneous pregnancies after stem cell treatment in patients with a history of IVF failure. Conclusions. Stem cell therapy may provide solutions for dozens of women suffering from ovarian failure, poor oocyte quality, premature menopause, infertility or endometrial pathology such as Asherman syndrome. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis of the abdominal wall is a condition defined by the presence of endometrial tissue in the subcutaneous adipose tissue and in the muscles of the abdominal wall. The diagnosis can be difficult due to the fact that the symptoms are not specific. The patients present with catamenial abdominal pain and palpable abdominal tumor. Endometriosis of the abdominal wall usually affects women of fertile age and most commonly occurs on the post-caesarean scar. The diagnosis can be made by ultrasound or magnetic resonance imaging, correlated with medical history and clinical examination. The treatment of choice is surgical resection of the endometrioma. Methodology. During 2019 and 2020, 146 patients diagnosed with endometriosis were treated in our clinic. Eleven of these cases were diagnosed and treated for abdominal wall endometrioma. Results. 16.06% of the patients diagnosed with endometriosis were diagnosed with abdominal wall endometrioma. Of the 11 cases of parietal endometriomas, 45% also associated deep endometriosis lesions of the pelvic peritoneum, unilateral or bilateral endometriotic cysts, deep endometriosis nodules in the parameters or uterosacral ligament or intestinal nodules. The average age of patients was 35 years old. The results of the histopathological examination confirmed in all cases the diagnosis of parietal endometriosis. In two of the 11 patients with abdominal wall endometrioma, polypropylene mesh was used to close the aponeurotic defect. Conclusions. Endometriosis of the abdominal wall is usually manifested by palpable tumor formation accompanied by cyclic abdominal pain. Ultrasound together with a correct clinical examination and the patient’s history can guide the diagnosis. MRI is nonspecific but it can help diagnose node extension and the deep pelvic endometriosis lesions. In our experience, abdominal wall endometriomas occur quite frequently, with or without deep endometriosis. The number of cases diagnosed with parietal endometriosis is increasing, in line with the increase in the number of caesarean sections. [ABSTRACT FROM AUTHOR]

Introduction. In the field of human assisted reproduction, patients with low ovarian reserve are one of the main challenges for the infertility specialists. This is due to the low number of oocytes obtained after controlled ovarian stimulation cycles. Materials and method. As many studies reveal, the number of oocytes is directly proportional to the rate of blastocysts and the rate of pregnancy. This paper is a review of the literature, with the role of highlighting the news in the field. Results. What can we do for these patients to maximize their chances of pregnancy? Dualstim, luteal phase stimulation, ovarian PRP and growth hormone therapy are just some of the latest options that poor responders seem to benefit from. Conclusions. As we well know, there are no effective methods to increase the ovarian reserve, so the poor responders are always in the center of scientific research, out of a desire to improve the pregnancy rate and the live birth rate. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis is a common gynecological condition among women of childbearing age, associated with chronic pelvic pain, dysmenorrhea, infertility and impaired quality of life. Although the internationally accepted gold standard is the diagnostic laparoscopy, the preoperative noninvasive diagnosis methods – clinical examination, transvaginal ultrasound and magnetic resonance imaging (MRI) – are an important step in the correct preoperative diagnosis of endometriosis. The aim of this paper is to determine the ideal method of preoperative noninvasive diagnosis depending on the symptoms and location of endometriosis lesions, whether clinical examination and transvaginal ultrasound are sufficient or when MRI examination is necessary. Methodology. We performed, on a group of 96 patients diagnosed with endometriosis, imaging examination by transvaginal ultrasound and MRI before the surgical treatment of the lesions, with the collection of biological samples for histopathological examination. The results obtained after the intervention were observed, comparing the lesions identified preoperatively with those excised during surgery. Results. MRI provides accurate information for the staging of deep endometriosis, especially when the case does not allow a transvaginal ultrasound examination – it is limited by chronic pelvic pain, virgo intacta or obese patient. MRI is used when the clinical examination and ultrasound do not identify lesions in symptomatic patients (parametric lesions, uterosacral ligaments). The association of MRI increases the sensitivity of transvaginal ultrasound in the diagnosis of endometriosis in these cases (70.3% compared to 11.3%). Large endometriosis lesions that can be easily identified on clinical examination and ultrasound do not require MRI (rectal nodules d≥2 cm, endometriomas d≥4 cm). For intestinal endometriosis, MRI and ultrasound have similar efficiency (83.78% and 87.75%). Discussion and conclusions. Although it is not a routine investigation in all patients suspected of having endometriosis, MRI is effective in identifying the lesions. It is necessary for the gynecologist to request an MRI investigation when the transvaginal ultrasound is insufficient or cannot be performed. The methods depend on the experience of the gynecologist and radiologist in making a preoperative assessment of the lesions, so that the surgical treatment is performed in the most complete way possible. [ABSTRACT FROM AUTHOR]

Neuroendocrine tumors of the genital tract are infrequent and most of them are located in the cervix or ovary. We present the case of a 54-year-old woman with endometrial carcinoma admixed with neuroendocrine tumor. Extensive histological assessments completed with additional immunohistochemical tests are necessary for the diagnosis of this rare entity. [ABSTRACT FROM AUTHOR]

Objectives. Platelet-rich plasma (PRP) is gaining more and more popularity as a minimally invasive option for a series of disease, therefore it is important to be informed about the potential use and indications of this therapy. Platelets stimulate the natural healing process of tissue, having 5- to10-fold higher concentration of growth factors than the whole blood, and in the same time no side effects. Methodology. This is a literature review highlighting the results of the use of PRP in different gynecological pathologies. Results. Platelets promote healing and attract stem cells to the site of the injury, thus they stimulate the natural healing process. PRP can be successfully used for faster re-epithelialization in the treatment of cervical ectopy or vulvar dystrophy (lichen sclerosus, kraurosis vulvae), for obtaining lower rates of wound infection, necrosis and wound dehiscence, and shorter recovery time in breast and vulvar reconstructive surgery and in fistulae treatment. In addition to these, it has been shown that PRP addition with absorbable and nonabsorbable vaginal meshes used in pelvic floor reconstructive procedures is associated with a better functional outcome. Nevertheless, PRP plays an important role in reproductive medicine, when used in premature ovarian failure for “ovarian rejuvenation”, in ovarian torsion for a better reperfusion, in intrauterine infusion for a better endometrial growth and receptivity. In vitro, it is demonstrated to seal amion tears and enhance membrane healing, preventing the premature rupture of membranes. Last but not least, PRP is used in aesthetic gynecology, including female sexual dysfunction (O-Shot, G-Shot therapy, vaginal rejuvenation). Conclusions. PRP is a simple but effective therapeutic modality to treat numerous noninvasive or minimally invasively gyneologic conditions, it has no side effects, and it is worth to be studied on a large scale and clinically used. [ABSTRACT FROM AUTHOR]