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Endometriosis is defined by endometrial glands and stroma outside of the endometrial cavity Three types of endometriosis have been described: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis. Endometriosis afflicts 6-15% of women population. It occurs mainly in the group of women in reproductive age, but also in the group of minors and approximately 3% of women after menopause. Within the group of women suffering from infertility the frequency of endometriosis increased to 35-50% of cases. Endometriosis is associated with pain symptoms which can bear the character of pain occurring periodically and altering into constant pain, dysmenorrhea, dyspareunia, dysuria and dyschezia. The correlation between the stage of endometriosis and intensity of pain symptoms not always has to be proportionate. Laparoscopy can be perceived as a standard procedure in endometriosis diagnostics as it allows simultaneous treatment. Profound interview as well as visual diagnostics (USG, MRI) should precede laparoscopy Treatment of endometriosis can be divided into pharmacological and surgical treatment, which can be invasive or non-invasive. The type of treatment depends on patient's age and her procreation plans, occurring ailments and endometriosis type. Important role is played by adjuvant treatment such as appropriate diet and lifestyle. Treatment of advanced endometriosis should be conducted in reference centres that are appointed with adequate equipment and have the possibility of interdisciplinary treatment. Presented standards can digest and outline the order of proceedings both in diagnostics and endometriosis treatment. The research group believes that the above compilation will facilitate undertaking appropriate decision in diagnosis and treatment of the disease, which will subsequently contribute to therapeutic success.

To present a rare case of spontaneous ectopic pregnancy in a non-communicating heterotopic fallopian tube associated with unicornuate uterus without a rudimentary horn. Case report.Tertiary referral obstetrics and gynecology center.A 36-year-old woman in her fourth pregnancy (para 1, abortus 2) presented at 5th gestational week with severe abdominal pain and circulatory instability.Heterotopic fallopian tube removal by laparotomy. Investigation of the origin of the spontaneous heterotopic fallopian tube pregnancy and exploration of the gross structural development of the urinary system. Spontaneous ectopic pregnancy in a non-communicating heterotopic fallopian tube coexisting with corpus luteum in the contralateral ovary supports the hypothesis of transperitoneal migration of gametes or embryos.

Pregnant women, just like the rest of the population, are at risk of the novel A/H1N1 infection. However, since they belong to a more susceptible group of patients, the risk of a severe course of the disease is significantly higher when compared to their non-pregnant counterparts. This risk is especially great when the infection is accompanied by chronic conditions such as asthma or diabetes mellitus, resulting in an increased morbidity and mortality of both the mother and the fetus.The aim of the study was to present the first four cases of A/H1N1 infection in advanced pregnancy in Podkarpacie Province of Poland that were noted in the course of six weeks in November and December 2009.Maternal age ranged between 27 to 34 years, gestational age was between 29 to 38 weeks. One patient had been at first admitted to Infectious Disease Clinic, and later on transferred to the Intensive Care Unit due to respiratory distress syndrome. The remaining three patients were hospitalized in the obstetrical unit, two of them due to respiratory tract infection and one due to amniotic fluid leakage without any respiratory failure symptoms. Three patients required artificial ventilation. One patient delivered vaginally, and the remaining three had caesarean section, one of them had an emergency c-section in agonia. The fatal outcome in this patient was the result of improper diagnosis due to a false negative stripe-test result. In case of the other three patients, properly diagnosed with Real Time RT-PCR test, an immediate antiviral therapy was introduced. Two neonates died: one delivered by the woman in agonia, and one due to intrauterine hypoxia and prematurityDiagnostic and therapeutic difficulties in A/H1N1 infections in pregnant women may have their source in that fact that an unreliable stripe test alone is used (without confirmation of the infection with Real Time RT-PCR), risk factors are not taken into the account and antiviral therapy is delayed or postponed. Early antiviral therapy and delivery in case of respiratory distress syndrome improve the prognosis for both the mother and the child.

Perinatal infections are one of the fundamental causes of early puerperal complications in mothers and neonates. The aim of the study was to determine the incidence of Streptococcus group B (GBS) colonization in parturient women and the rate of pathogen transmission to the newborn.The study group consisted of 100 consecutive parturient women and their newborns. Smear samples for GBS identification were taken from the parturient vagina and from the newborns' nasal cavity. In patients with positive smears, both the mother and the child, a more in-depth analysis was performed, including investigation of the mode of delivery and premature rupture of membranes incidence.GBS colonization was found in 19 parturient women and in 4 newborns in the first 24 hours of their lives. In case of 4 women who gave birth to 4 colonized newborns, two cases of premature rupture of membranes, two vaginal and two caesarean deliveries and one case of symptomatic infection in the mother were found. No symptoms of infection appeared among the four colonized newborns.1. prevalence of GBS colonization appeared in one in five parturient women, 2. in GBS positive women, the risk of transmission to newborns is about 21%, 3. caesarean section and intact membranes do not prevent the transmission of GBS to a newborn.

The aim of the study was to evaluate the value of intraoperative assessment of depth of myometrial invasion in patients with FIGO stage I of the endometrial carcinoma.A total number of 112 patients with FIGO stage I of the endometrial carcinoma undergoing surgery were enrolled in the study. All patients had undergone intraoperative assessment of the depth of myometrial invasion performed by a surgeon. The depth was determined as more or less than 50% of myometrial thickness according to FIGO classification. Gross visual estimation of the depth of myometrial invasion at the time of the operation was compared with the final histopathological report. Sensitivity, specificity and positive and negative predictive values of the method were determined by means of statistical analyses.The depth of the myometrial invasion was accurately determined by the surgeon in 82.1% of cases. Sensitivity and specificity were 68% and 82.1%, respectively. The accurate prediction rate of the myometrial invasion in the group of patients with well differentiated (G1) endometrial carcinoma was higher (88.4%) than in group with moderately and low differentiated tumour (78.3%).The accuracy of macroscopic evaluation of myometrial invasion is high and reaches up to 82.1%. The accurate determination rate increases if the differentiation of tumour is higher.

Currently, the extent of pelvic and aortic lymphadenectomy is currently described by numerous and ambiguous terms. The aim of this study is to present a classification of pelvic and aortic lymphadenectomy in cervical cancer patients. On the base of the data from the literature, pelvic and aortic lymphadenectomies have been assigned to three different classes, depending on surgical technique, the extent of the lymphadenectomy and the specificity of the removed lymph node groups. Class I equals removal of selected lymph nodes; Class II: removal of lymph nodes situated ventrally and laterally to large extraperitoneal vessels and the obturator nerve and of lymph nodes situated ventrally and laterally to the aorta and vena cava; Class III: total removal of lymphatic tissue around the iliac vessels and from the obturator fossa dorsally to the obturator nerve and from the presacral region and lymphatic tissue around the aorta and vena cava. The presented classification allows for a unequivocal assessment of pelvic and aortic lymphadenectomy.

The aim of the study was to review the literature concerning nerve sparing radical hysterectomy (NSRH). The data about anatomical and physiological background of this operation, its history, technique and perspectives has been presented. In conclusion it has been estimated that the technique is new and its oncological efficiency is not yet fully established; it requires special anatomical knowledge and new instruments.

Cervical cancer is the only gynecological tumor staged clinically. The aim of this study was comparison of clinical staging to surgical specimen evaluation in cervical cancer patients.Clinical staging of cervical cancer was compared to histopathological outcome in prospective study.One hundred patients with cervical cancer treated with radical hysterectomy combined with pelvic lymphadenectomy were included in the study.Discrepancies between clinical and surgico-pathological staging occurred in 62% of cases. The tendency towards overdiagnosis was found to be increasing with local advancement of neoplasm.Accuracy of preliminary cervical cancer staging needs further improvement.

Infections caused by Chlamydia trachomatis (ChT) are the most prevalent sexually transmitted bacterial infections worldwide. ChT is a cause of cervicitis, endometritis, salpingitis, tubal infertility and ectopic pregnancy. Perinatal infections with ChT have been associated with premature rupture of membranes, stillbirth, preterm delivery, and in newborns with conjunctivitis and pneumonia. There are controversial data referring to the association between colonisation by ChT and the risk of spontaneous abortion. Only few studies investigated the prevalence of ChT antigens in aborted tissues.To determine the prevalence of ChT in patients with spontaneous pregnancy loss using Polymerase Chain Reaction (PCR).We completed prospective analysis of 50 patients after spontaneous abortions. The prevalence of ChT infections was assessed by PCR performed in samples taken during curettage following miscarriage.ChT was present in 16 (32%) of samples. Other pathogens of the lower genital tract were found in cultures from 11 patients.The prevalence of ChT infections in early abortions in this study was found to be surprisingly high. It implies the importance of screening of women planning pregnancy and pregnant women for this disease.

The study presents modified detachable Deschamps ligature carrier (MDDLC), which applied in sacrospinous ligament fixation (SSLF) procedure allows for suture placement through the sacrospinous ligament in a limited pararectal space.Prototype of new surgical instrument has been applied in paravaginal procedures suspending vaginal vault to the sacrospinous ligament among other reconstructive procedures performed on nine patients with genital prolapse.No complications have been noticed with the use of new device.MDDLC, designed and accomplished by authors, is simple in its construction and easy in application.

A rare case of uterine's mixed mesodermal malignant tumor in young woman was described. Clinical symptoms, risk groups, treatment, and prognosis were presented. It was noticed that every year younger women are attacked by this kind of tumor.

A rare case of Guillain-Barre syndrome in the course of an acute CMV infection during twin pregnancy was reported. A clinical picture, diagnostic procedure and therapeutic management of CMV infection and its complications were presented. The reported case indicates that CMV infections should be taken into account in differential diagnosis in pregnant women with unclear neurological symptoms.

The aim of the study was to evaluate the outcomes of meshes' use in gynecological vaginal operations.A prospective analysis of early postoperative results and complications.All patients were operated on in Gynecological Department of District Hospital in Rzeszow. The investigated group consisted of 37 women suffering from pelvic organ prolapse. The degree of prolapse was evaluated with modified Baden Walker scale before procedure and three months after operation. Operations with use of synthetic materials (anterior and posterior colporraphy) were performed parallel with other gynecological procedures. The results of operations were compared to control group matched according to the age and parity. The control group consisted of patients operated on because of genital organs disorders excluding genital prolapse.The reduction of genital prolapse degree was found in all patients. In 3/4 of them it was degree 0 in Baden-Walker modified scale.The synthetic materials may be used in gynecological vaginal surgery together with conventional procedures. The advantages of operations with meshes' use are high efficacy and small number of complications.

There has been a case presented of multifoci preinvasive cancer in a twenty three years old female. In the case an operation has been performed involving a superficial excision of the changing vulvar skin. On the basis of meta-analysis we compared the efficiency of the performed surgical method and other destructive techniques used in the intraepithelial vulvar neoplasm treatment.