Discrepancies in staging and perioperative classification of pelvic endometriosis according to #Enzian 2021.

AIM: The aim of this study is to compare the extent of ovarian endometriosis diagnosed at preoperative staging with subsequent perioperative findings. Definition of discrepancies observed according to the #Enzian 2021 classification. MATERIAL AND METHODS: The cohort includes 62 patients of reproductive age with preoperative findings of ovarian endometrioma. Patients were divided according to the #Enzian 2021 classification into subgroups (O1, O2 + O3) with unilateral and bilateral findings. The percentage concordance of preoperative and perioperative findings was evaluated. RESULTS: In the evaluation of ovarian involvement, the preoperative ultrasound diagnosis shows almost 100% agreement with the findings on the ovaries during surgery. Periadnexal adhesions were predicted preoperatively in only half of the cases. The difference in laterality was confirmed with T3 involvement in the O2 + O3 subgroup. In the bilateral involvement, the finding of the presence of grade 3 adhesions was doubled. An association of ovarian form of endometriosis (O2-O3) with deep infiltrating endometriosis of the small pelvis was observed in 50% of the cohort. CONCLUSION: The ovarian form of endometriosis is associated with the occurrence of other endometriosis lesions in the small pelvis. In this study, it was confirmed that preoperative staging underestimates the extent of endometriosis in the small pelvis. In the surgical management of ovarian endometriosis, extensive adhesive process should be expected.

Dissecting leiomyoma of the uterus with unusual clinical and pathological features.

OBJECTIVE: Case description of dissecting uterine leiomyoma with extrauterine extension and infiltration of right parametrium, ureter and bladder wall. DESIGN: Case report. SETTING: Department of Pathology, Znojmo Hospital. METHODS: A 64-year-old woman with chronic pelvalgia and loss of renal function of the right kidney due to urinary tract obstruction is presented. Ultrasound examination, magnetic resonance imaging and computer tomography scan revealed a pelvic tumour affecting the right edge of the uterine wall, the right parametrium, distal part of the right ureter, the right and partially the cranial bladder wall. Due to this finding, hysterectomy, unilateral parametrectomy, partial resection of the bladder wall and resection of the distal part of the ureter was performed. Histology revealed morphologically bland spindle-cell smooth-muscle tumour corresponding to conventional uterine leiomyoma. Tumour necrosis, cellular atypia, vascular invasion or hydropic degeneration were not observed. A final diagnosis of dissecting leiomyoma of the uterus was made. CONCLUSION: The diagnosis of dissecting leiomyoma should be considered in all malignant tumours affecting the uterine corpus.

Primary synovial sarcoma of the ovary and Fallopian tube - case report and review of the literature.

OBJECTIVE: Case description of advanced biphasic synovial sarcoma in the tubo-ovarian area. DESIGN: Case report. SETTING: Department of Pathology, Znojmo Hospital. METHODS: Own observation, review of the literature. CONCLUSION: The diagnosis of synovial sarcoma must be considered in all spindle cell and undifferentiated tumours in various anatomical sites including female reproductive organs.

[Personal experience with colpoureteral suspension using the Burch method]. / Nase zkusenosti s kolpouretrosuspenzí sec. Burch.

The objective of the work was to evaluate one approach of evaluation of the effect achieved by the mentioned corrective operation, i.e. the subjective evaluation by the patients themselves. In order to ensure comparability of evaluation at different time intervals, the authors used a questionnaire with 13 questions focused on continence and changes of micturition as well as on sexual aspects and changes in the social sphere. Sixty-nine patients were at least one year after operation. Evaluation 6 weeks after operation was implemented in 105 patients. The subjective sensation of complete recovery and satisfaction with treatment in 93.33% after six weeks and 94.20% after one year with minimal complaints regarding micturition indicates that the operation sec. Burch is a very good corrective operation, resolving stress incontinence of urine in women.