Basaloid squamous cell carcinoma of the uterine cervix coexisting with undifferentiated sarcoma.

Basaloid squamous cell carcinoma is uncommon tumor and has received little recognition, there are only a few cases in the medical literature. Correct diagnosis is important due to the high malignancy of this cancer and poor prognosis. We present a rare and interesting case of a basaloid squamous cell carcinoma of the uterine cervix in a 71-year-old female with prolapse of the uterus with co-existing atypical undifferentiated sarcoma.

Leydig cell ovarian tumor - clinical case description and literature review.

Leydig cell ovarian tumors constitute not only a medical problem for clinicians but also a social problem - which is why women with symptoms of hirsutism relatively quickly contact physicians for medical consultation. Leydig cell ovarian tumor is a rare sex cord-gonadal stromal tumor which constitutes less than 0.5% of ovarian tumors. These cancers appear at all ages but the majority of the cases concern women in the perimenopause. In the majority of cases (70-85%), the growth is accompanied by androgen secretion, together with virilization and hirsutism. The presence of hormonally active ovarian cancers should be suspected in cases of rapidly growing symptoms of masculinization, especially when the level of free testosterone in the blood exceeds the upper limit for the given age more than three times. In diagnosing postmenopausal hyperandrogenism, it is necessary to take into account hormonally active ovarian tumors, as well as adrenal cancers. It is important to exclude other causes of hyperandrogenism, e.g. endocrinopathies (acromegaly or hypothyroidism), or iatrogenic and idiopathic factors. In order to make the diagnosis and implement the proper treatment method faster, an interdisciplinary team of physicians specializing in endocrinology, gynecology and oncology is crucial. This paper contains a study of two cases concerning Leydig cell ovarian tumors in women of postmenopausal age with symptoms of masculinization and hirsutism.

Interplay between miRNAs and Genes Associated with Cell Proliferation in Endometrial Cancer.

Endometrial cancer develops as a result of abnormal cell growth associated with uncontrolled cell proliferation, excessive activation of signaling pathways and miRNA activity. The aim of this study was to determine the expression profile of genes associated with cell proliferation and to assess which miRNAs can participate in the regulation of their expression. The study enrolled 40 patients with endometrial cancer and 10 patients without neoplastic changes. The expression profile of genes associated with cell proliferation and the expression profile of miRNAs were assessed using microarrays. RT-qPCR was performed to validate mRNA microarray results. The mirTAR tool was used to identify miRNAs that regulate the activity of genes associated with cell proliferation. Decreased expression of IGF1 and MYLK, as well as SOD2 overexpression, were observed in endometrial cancer using both mRNA microarrays and RT-qPCR. Microarray analysis showed low levels of NES and PRKCA, but this was only partially validated using RT-qPCR. Reduced activity of MYLK may be caused by increased miR-200c, miR-155 and miR-200b expression. Cell proliferation is disturbed in endometrial cancer, which may be associated with an overexpression of miR-200a, miR-200c, and miR-155, making it a potential diagnostic marker.

The role of complement components C1q, MBL and C1 inhibitor in pathogenesis of endometriosis.

PURPOSE: The purpose of the work was to evaluate possible associations between the complement components C1q, mannose-binding lectin (MBL) and C1 inhibitor (C1INH) with pathogenesis of endometriosis. METHODS: Concentrations of C1q, MBL and C1INH were measured by ELISA in peritoneal fluid (PF) in 80 women with or without endometriosis. RESULTS: Significantly higher PF levels of C1q, MBL and C1INH in women with endometriosis compared to control group were observed (p < 0.0001). A higher concentration of the studied parameter was found in PF of women at the early stage of the disease, as compared to women with advanced endometriosis (p < 0.0001). CONCLUSIONS: Our research suggests that in the peritoneal cavity in women with endometriosis there are abnormal regulations of both the classical and lectin pathways of the complement system. This can suggest impairments in purification of peritoneal cavity from ectopic endometrial cells and augmented local inflammation in endometriosis patients.

Dietary supplementation usage by pregnant women in Silesia - population based study.

OBJECTIVES: Despite wide access to gynecological and obstetric advice, informational campaigns, and information online and in magazines aimed at pregnant women, there is a worryingly high percentage of women who still do not use recommended dietary supplementation. The aim of this study was to assess the frequency of micronutrient supplementation by pregnant women and to specify the determinants that impact decisions concerning supplementation. MATERIAL AND METHODS: A cross-sectional survey was conducted between June 2016 and May 2017 among a group of pregnant women visiting gynecological and obstetric clinics in the Silesia region, who have completed an authorized questionnaire developed for the purpose of this study. The questionnaire addressed the women's dietary habits, micronutrient supplementation use, as well as their socio-economic status. Completed questionnaires were obtained from 505 pregnant women. RESULTS: Microminerals and vitamins supplementation during pregnancy was declared by 410 (81.2%) women. The most often used supplement was folic acid (62%). More than one-third of pregnant women (38.4%) declared vitamin D intake. Among the recommended supplements, the least commonly used (30.3%) were polyunsaturated fatty acids (PUFA). Factors contributing to supplementation use during pregnancy are past history of miscarriage and socioeconomic factors, such as: place of residence, financial situation and level of education. Inhabitants of larger cities, women with better self-perceived financial situations, higher education levels and those presenting past history of miscarriage took the supplements significantly more often. CONCLUSIONS: Lower levels of education, low-income financial status and living in rural localities are among the factors correlating with worse adherence to supplementation guidelines.

Cesarean scar pregnancy - case report and review.

Implantation of the embryo in the cesarean section scar is a rare form of ectopic pregnancy. Such condition poses significant threat to a woman's health and live, therefore, requires accurate diagnosis and rapid implementation of treatment. The following article presents the case of a patient with a pregnancy located in the scar after cesarean section treated in the Department of Gynecology and Obstetrics, Medical University of Silesia in Katowice, Faculty of Medicine in Katowice.

Changes in expression of cartilaginous genes during chondrogenesis of Wharton's jelly mesenchymal stem cells on three-dimensional biodegradable poly(L-lactide-co-glycolide) scaffolds.

BACKGROUND: In cartilage tissue regeneration, it is important to develop biodegradable scaffolds that provide a structural and logistic template for three-dimensional cultures of chondrocytes. In this study, we evaluated changes in expression of cartilaginous genes during in vitro chondrogenic differentiation of WJ-MSCs on PLGA scaffolds. METHODS: The biocompatibility of the PLGA material was investigated using WJ-MSCs by direct and indirect contact methods according to the ISO 10993-5 standard. PLGA scaffolds were fabricated by the solvent casting/salt-leaching technique. We analyzed expression of chondrogenic genes of WJ-MSCs after a 21-day culture. RESULTS: The results showed the biocompatibility of PLGA and confirmed the usefulness of PLGA as material for fabrication of 3D scaffolds that can be applied for WJ-MSC culture. The in vitro penetration and colonization of the scaffolds by WJ-MSCs were assessed by confocal microscopy. The increase in cell number demonstrated that scaffolds made of PLGA copolymers enabled WJ-MSC proliferation. The obtained data showed that as a result of chondrogenesis of WJ-MSCs on the PLGA scaffold the expression of the key markers collagen type II and aggrecan was increased. CONCLUSIONS: The observed changes in transcriptional activity of cartilaginous genes suggest that the PLGA scaffolds may be applied for WJ-MSC differentiation. This primary study suggests that chondrogenic capacity of WJ-MSCs cultured on the PLGA scaffolds can be useful for cell therapy of cartilage.

Clinical expression of Holt-Oram syndrome on the basis of own clinical experience considering prenatal diagnosis.

OBJECTIVES: Holt-Oram syndrome manifests with defects of upper limbs, pectoral girdle and cardiovascular system. The aim of this paper was to present complex clinical picture of the syndrome and its variable expression on the example of the family diagnosed genetically on the neonatal ward, after proband's prenatal examination. MARETIAL AND METHODS: Nine family members were tested for TBX5 gene mutation. RESULTS: Four of family members were diagnosed with Holt-Oram syndrome and five had correct genetic test results. The diagnosis allowed to identify a genetic risk family and enabled to provide them with genetic counselling. CONCLUSIONS: Diagnosis of Holt-Oram syndrome is possible as early as in prenatal period and it can be verified by genetic tests.

[Expression of melatonin receptors genes and genes associated with regulation of their activity in endometrial cancer]. / Ekspresja genów receptorów melatoninowych i genów zwiazanych z regulacja ich aktywnosci w gruczolakoraku endometrium.

OBJECTIVES: The aim of the study was to evaluate transcription activity of melatonin receptors and genes associated with regulation of their activity in endometrial adenocarcinoma to identify probable diagnostic and prognostic molecular markers. MATERIAL AND METHODS: The material included endometrial adenocarcinoma tissue samples of histopathological grades G1, G2, G3, and normal endometrium. The molecular analysis was performed on 37 patient samples. Total RNA was extracted and used for the microarray HG-U133A analysis. Among 22 283 ID mRNA, only entities of genes associated with regulation of melatonin receptors activity were selected. qRT-PCR was employed for validation, what allowed to compare melatonin receptor genes activation in endometrial cancer tissues to the normal endometrium. RESULTS: The results of the microarray experiments showed that only 18 ID mRNA were differential in endometrial cancer samples as compared to the control at p-value<0.05 and FC(log2)>1.5. These genes were identified as differentially expressed in grade G2-ASMTL, GNA 11, PER2, PTGDS and in grade G3-GNA12, GNA 11. Silencing of RGS4 encoding RGP4, which regulates signal transmission by G protein, was observed in all cancer groups, independently of the histopathological grade. CONCLUSIONS: The profile expression of genes associated with regulation of melatonin receptors activity was different and dependent on the histopathological grade of endometrial cancer and can be an additional diagnostic and prognostic marker Statistically significant was the down-regulation of melatonin biosynthesis genes (ASMTL) and melatonin signal transmitters (GNA 11, GNA 12, RTGS).

[Expression profile of genes associated with the histaminergic system estimated by oligonucleotide microarray analysis HG-U133A in women with endometrial adenocarcinoma]. / Profil ekspresji genów zwiazanych z ukladem histaminergicznym wyznaczony technika mikromacierzy oligonukleotydowych HG-U133A u kobiet z gruczolakorakiem endometrium.

INTRODUCTION: Influence of histamine on tumor development remains obscure. The exact mechanism of this action is not known. Different data indicate high concentrations of histamine in tumor tissues, such as malignant melanoma, breast cancer, colon carcinoma, lymphomas and leukemia. To the best of our knowledge, the literature offers no reports about the role of histamine and of differences between expression patterns of histamine-related genes in endometrial cancer AIM: The aim of the study was a comparative analysis of the gene expression profile involved with histaminergic system in endometrioid endometrial cancer in relation to histologically normal endometrium, and identification of differentiation genes whose transcriptional activity significantly differs in pathomorphological grades G1,G2, G3 of endometrial cancer as compared to the control group. MATERIAL AND METHODS: Total RNA was extracted from 24 endometrial probes using TRIzol reagent (Invitrogen). The expression profile of 119 transcripts associated with histaminergic system was assessed using oligonucleotide microarrays of HG-U 133A (Affymetrix). After normalization of the results with RMA Express software, differentiation genes were mined by the use of one-way analysis ANOVA and U Mann-Whitney test carried out in Gene Spring 11.5 software. RESULTS: Among 119 transcripts, 14 expressed more than 1.5-fold change and were significant at p<0.05 in endometrioid endometrial cancer in relation to the normal endometrium. Further analysis led to the identification of differentially expressed genes in grades G1, G2 and G3 of endometrial adenocarcinoma as compared to the control group, which were specific for each of the studied groups in grade G1 (CPA3), in grade G2 (HNMT LYN, DPT ITPKB, RASA4, APR RAB1 1FIP1, YWHAZ, VAMP8, RAB25) and in grade G3 (HRH3). CONCLUSIONS: Our results confirmed the role of the histaminergic system in the pathogenesis of endometrial adenocarcinoma. The observed differences in the expression of those genes, depending on the grade of adenocarcinoma, may indicate an important role of the isolated differentiation genes in endometrial tumorigenesis.

Long-term impact of surgical repair for stress urinary incontinence on female sexual functions, distress and behaviours.

AIMS AND OBJECTIVES: To evaluate sexual functions, distress and behaviours in women who underwent surgical repair of stress urinary incontinence (SUI) in long-term follow-up. BACKGROUND: Contemporary management of SUI includes conservative therapy and surgical repair - the choice of treatment modality depends on the severity of symptoms. If conservative treatment fails, surgical correction is necessary. The outcomes of the surgery for SUI and their influence on sexual functions are satisfactory in short-term follow-up. DESIGN: A total of 50 women diagnosed with SUI according to International Continence Society standards were included in the study. The patients were qualified for surgical procedures such as: transobturator suburethral tape (TOT) (n = 35), Perigee (n = 6) or MiniArc (n = 9). METHODS: Sexual functions and behaviours were evaluated prior to the operation and 1-3 years postoperatively in all patient using Female Sexual Function Index (FSFI) and non-validated questions. RESULTS: The mean time after the operation was 1·96 ± 0·83 years. Postoperatively, all women reported significant reduction of urinary incontinence symptoms. According to DSM-IV criteria, female sexual dysfunctions were diagnosed in 12% of females after the urogenital operation. However, sexual complaints (FSFI scores equal or <26·55 points) without distress were reported by 62% of the patients. The comparison of sexual complaints declared prior to and after the operation showed significant differences in the prevalence of decreased desire, decreased arousal and decreased orgasm frequency. In addition, we documented significant improvement of sexual attractiveness and sexual life evaluation after the SUI operation. CONCLUSIONS: Surgical repair for SUI improves female sexual functions and reduces sexual distress, as observed in a long-term follow-up. RELEVANCE TO CLINICAL PRACTICE: Sexual functions, distress and behaviours in women who underwent surgical repair of SUI; the impact of SUI female quality of life as well as on sexual functions.

Survivin expression at the mRNA level in tumors and the protein concentration in the serum and peritoneal fluid in patients with serous ovarian tumors.

OBJECTIVES: Ovarian cancer is one of the gynecological cancers that have the worst prognosis. The expression of the proteins from the IAP family (inhibitor of apoptosis protein), including survivin, is observed in many types of cancer. The aim of the study was to evaluate survivin at the mRNA level in tumors and the protein concentration in the serum and peritoneal fluid of patients with serous ovarian cancer in order to assess the relationship between the concentration of survivin and the histological subtypes of cancer. MATERIAL AND METHODS: The study group consisted of 55 women, including patients with serous ovarian cancer (n = 30, nine low-grade serous carcinoma LGSC, 21 high-grade serous carcinoma HGSC), serous cysts (n = 10) and the control group (n = 15). The concentration of protein in the peritoneal fluid and serum was assessed using ELISA tests. The expression of survivin gene BIRC5 in the tumors was assessed using the RT-qPCR method. RESULTS: The data that was obtained indicated that the concentration of survivin was higher in the serum of the women with serous ovarian cancer compared those that had benign tumors (p < 0.05) and the control group (p < 0.001). The survivin concentration was also higher in both the serum and peritoneal fluid in the HGSC group compared to the LGSC group (p < 0.001). The mRNA level was highest in the HGSC group, and there was a statistically significant difference compared to those in the benign tumor group and HGSC group ( p < 0.05). CONCLUSIONS: The observed changes prove that the expression level increases significantly in HGSC in both the protein and mRNA levels. Based on these findings, it can be assumed that assessing this parameter could be a useful additional indicator of the progression and differentiation of this type of cancer. However, this requires further research in a larger group of patients and possibly in other types of ovarian cancer.

Expression pattern of circadian rhythm-related genes and its potential relationship with miRNAs activity in endometrial cancer.

OBJECTIVES: The circadian clock is an autonomous oscillator that controls key aspects of cell physiology, including metabolism, transcriptional state, and cell signaling. Disturbances of circadian rhythms lead to disruption of cell and tissue homeostasis, which promotes carcinogenesis. The aim of the study was to determine the expression of circadian rhythm-related genes in endometrial cancer and to select miRNAs involved in the regulation of their expression. MATERIAL AND METHODS: 50 endometrial tissue samples were collected from patients who underwent hysterectomy: 40 diagnosed with endometrial cancer and 10 without cancer. Expression profile of circadian rhythm-related genes was evaluated using microarrays and validated with RT-qPCR. MicroRNA expression was assessed using microarrays. Then mirTAR tool was used to identify miRNAs involved in the expression regulation of circadian rhythm-related genes. RESULTS: CLOCK expression is disrupted in endometrial cancer, which may be due to miR-15b, miR-331-3p and miR-200a overexpression. Elevated NPAS2 and CSNK1D levels may be associated with miR-432 silencing. In addition, high miR-874 and miR-200a expression may be potentially responsible for the reduction of PER3 level. CONCLUSIONS: Change of CLOCK, CSNK1D, NPAS2 and PER3 expression may suggest that circadian rhythms are disrupted in endometrial cancer. A possible mechanism of the observed changes may be related to miRNAs activity.

Coffee consumption during pregnancy - what the gynecologist should know? Review of the literature and clinical studies.

Coffee is one of the most consumed beverages in the world. The impact of coffee consumption on human health has been the subject of many clinical studies and meta-analyses. Taking into account the results of these studies, it can be concluded that coffee has a number of health benefits in terms of the population, including the reduction of the risk of death from any cause. From a clinical point of view, the safety of coffee consumption in a specific subpopulation of pregnant women is important. A large percentage of women continue to consume this drink during pregnancy, while a significant proportion of them exceed the permissible daily dose of caffeine (≤ 200 mg). During pregnancy, the metabolism of caffeine slows down significantly, which prolongs its action and penetrates into the body of the fetus. These biochemical observations have become the driving force behind numerous clinical studies assessing the impact of coffee consumption during pregnancy on its course, complications and the health of the newborn. This review article summarizes the current knowledge of these important issues.

Analysis of CXCL8 and its receptors CXCR1/CXCR2 at the mRNA level in neoplastic tissue, as well as in serum and peritoneal fluid in patients with ovarian cance.

Understanding the relationship between the coexistence of inflammatory and neoplastic processes in ovarian cancer, particularly those involving chemokines and their receptors, may help to elucidate the involvement of the studied parameters in tumor pathogenesis and could lead to improved clinical applications. Therefore, the present study aimed to analyze the levels of C­X­C motif chemokine ligand 8 (CXCL8), and its receptors C­X­C chemokine receptor (CXCR)1 and CXCR2, in the serum and peritoneal fluid of women with ovarian cancer, and to evaluate the association between the expression of these parameters in tumor tissue and patient characteristics, particularly the degree of histological differentiation. The study group included women with ovarian cancer diagnosed with serous cystadenocarcinoma International Federation of Gynecology and Obstetrics stage IIIc and a control group, which consisted of women who were diagnosed with a benign lesion (serous cystadenoma). The transcript levels of CXCL8, CXCR1 and CXCR2 were evaluated using reverse transcription­quantitative PCR (RT­qPCR). The quantitative analysis was carried out using the LightCycler® 480 System and GoTaq® 1­Step RT­qPCR System, according to the manufacturers' instructions. The concentration of CXCL8 in serum and peritoneal fluid was determined using a Human Interleukin­8 ELISA kit, and the concentrations of CXCR1 and CXCR2 were determined using the CLOUD­CLONE ELISA kit. Local and systemic disturbances in immune and inflammatory responses involving the CXCL8 chemokine and its receptors indicated the involvement of these studied parameters in the pathogenesis of ovarian cancer. Immunoregulation of the CXCL8­CXCR1 system may influence the course of the inflammatory process accompanying ovarian cancer development, which may result in the identification of novel clinical applications; however, further studies are required.

Grading of endometrial cancer using 1H HR-MAS NMR-based metabolomics.

The tissue metabolomic characteristics associated with endometrial cancer (EC) at different grades were studied using high resolution (400 MHz) magic angle spinning (HR-MAS) proton spectroscopy. The metabolic profiles were obtained from 64 patients (14 with grade 1 (G1), 33 with grade 2 (G2) and 17 with grade 3 (G3) tumors) and compared with the profile acquired from 10 patients with the benign disorders. OPLS-DA revealed increased valine, isoleucine, leucine, hypotaurine, serine, lysine, ethanolamine, choline and decreased creatine, creatinine, glutathione, ascorbate, glutamate, phosphoethanolamine and scyllo-inositol in all EC grades in reference to the non-transformed tissue. The increased levels of taurine was additionally detected in the G1 and G2 tumors in comparison to the control tissue, while the elevated glycine, N-acetyl compound and lactate-in the G1 and G3 tumors. The metabolic features typical for the G1 tumors are the increased dimethyl sulfone, phosphocholine, and decreased glycerophosphocholine and glutamine levels, while the decreased myo-inositol level is characteristic for the G2 and G3 tumors. The elevated 3-hydroxybutyrate, alanine and betaine levels were observed in the G3 tumors. The differences between the grade G1 and G3 malignances were mainly related to the perturbations of phosphoethanolamine and phosphocholine biosynthesis, inositol, betaine, serine and glycine metabolism. The statistical significance of the OPLS-DA modeling was also verified by an univariate analysis. HR-MAS NMR based metabolomics provides an useful insight into the metabolic reprogramming in endometrial cancer.

The Assessment of IL-21 and IL-22 at the mRNA Level in Tumor Tissue and Protein Concentration in Serum and Peritoneal Fluid in Patients with Ovarian Cancer.

The aim of the analysis was for the first time to assess the expression of genes encoding IL-21 and IL-22 at the mRNA level in ovarian tumor specimens and the concentration of these parameters in serum and peritoneal fluid in patients with ovarian serous cancer. The levels of IL-21 and IL-22 transcripts were evaluated with the use of the real-time RT-qPCR. Enzyme-linked immunosorbent assay (ELISA) was used to determine the concentration of proteins. Quantitative analysis of IL-21 gene mRNA in the tumor tissue showed the highest activity in the G1 degree of histopathological differentiation and was higher in G1 compared to the control group. The concentration of IL-21 and IL-22 in the serum and in the peritoneal fluid of women with ovarian cancer varied depending on the degree of histopathological differentiation of the cancer and showed statistical variability compared to controls. The conducted studies have shown that the local and systemic changes in the immune system involving IL-21 and IL-22 indicate the participation of these parameters in the pathogenesis of ovarian cancer, and modulation in the IL-21/IL-22 system may prove useful in the development of new diagnostic and therapeutic strategies used in patients, which require further research.

Expression Profile of EMT-related Genes and miRNAs Involved in Signal Transduction via the Wnt Pathway and Cadherins in Endometrial Cancer.

BACKGROUND: Epithelial-Mesenchymal Transition (EMT) is a molecular reprogramming that leads to an increased ability to migrate, which can promote invasion and metastasis. EMT can be initiated in response to the activity of signaling pathways such as Wnt as well as miRNAs. OBJECTIVE: The aim of the study was to determine the expression profile of EMT-related genes involved in signal transduction via the Wnt pathway and cadherins and to assess which miRNAs can participate in the regulation of their expression. METHODS: The study material consisted of 50 endometrial samples: 40 with diagnosed endometrial cancer and 10 without neoplastic changes. The expression profile of EMT-related genes was assessed with microarrays and validated by RT-qPCR. MicroRNA expression profiling was performed using microarrays. It was also determined which miRNAs may participate in the expression regulation of EMT-related genes. RESULTS: CDH1 overexpression was observed in all three endometrial cancer grades using both mRNA microarrays and RT-qPCR. The microarray experiment showed a decrease in CDH2 level regardless of the endometrial cancer grade, however, it was only partially validated with RT-qPCR. Low levels of WNT2, WNT4, WNT5A have also been observed. Decreased expression of WNT2 and WNT5A may be caused by miR-331-3p and miR-200b-5p, respectively. CONCLUSION: The Wnt signaling is disrupted in endometrial cancer, which may be due to miR-331- 3p and miR-200b-5p activity. In addition, a change in WNT5A level in endometrial cancer compared to control may indicate that it acts as a suppressor gene and that its low expression is associated with tumor progression.

[Extended analysis of urethral profilometry in women with urinary stress incontinence--preliminary report]. / Rozszerzona analiza profilu cewkowego u kobiet z wysilkowym nietrzymaniem moczu o nowe parametry--doniesienie wstepne.

UNLABELLED: Stress urinary incontinence (SUI) is the most common kind of urinary incontinence in women. Treatment efficiency depends on the type of stress urinary incontinence. OBJECTIVES: The purpose of the following study was to compare certain urethral profilometry parameters, including additional ones, in women with stress urinary incontinence (type 0) and women categorized as a 'transitional group' who were likely to have the mechanism of the intrinsic sphincter deficiency in pathogenesis of SUI. MATERIAL AND METHODS: Examinations included 100 patients with diagnosed SUI based on medical history clinical evaluation, pad test and urodynamic evaluation. Studied population was divided into three groups depending on the presence of leakage and VLPP value in the urodynamic test. The first group consisted of 19 patients with no leakage during urodynamic test (with SUI type 0), the second group (2) comprised 30 patients with VLPP 60-89 cmH2O and the third group included 36 patients with VLPP > or =90 cmH2O. 15 patients with leakage appearing at VLPP <60 cmH2O were excluded from the study The final analysis was carried out in a group of 85 patients. The analysed urethral profilometry parameters included: (MUCP, cmH2O), (Total Profile Area, cmH2O mm), (Profile Length to Peak, mm), (Proximal Area to Peak cmH2O mm), (Distal Area after Peak, cmH2O mm) RESULTS: Most of the analyzed urethral profilometry parameters, excluding Profile Length to Peak, in the group of patients with VLPP 60-89 cmH20 have revealed significantly lower values of MUCP than in the group with no leakage. No significant differences of the analyzed parameters between group 1 and group 3 and between group 2 and group 3 have been revealed although their values were slightly elevated in the group of patients with critical VLPP. CONCLUSION: Lower values of fields under the urethral profilometry curve can suggest a greater urethral closing mechanism deficiency and the coexistence of the external sphincter insufficiency This parameter can be very useful in the group of patients with moderate leakage point.

[Expert panel recommendations on therapeutic and diagnostic management of urinary incontinence and overactive bladder in women]. / Wytyczne Zespolu Ekspertów odnosnie postepowania diagnostyczno-terapeutycznego u kobiet z nietrzymaniem moczu i pqcherzem nadreaktywnym.

The expert panel recommendations are issued in order to increase the number of patients with urinary incontinence and overactive bladder receiving appropriate care. The expert panel recommends that urologists, gynecologists and other physicians interested in the field of incontinence should Incontinence question should be actively asked during each physician visit and if the answer is positive it should be followed by detailed questionnaire aiming at disclosing at which occasion patient is loosing urine. The next step should be urogynecological examination and cough stress test. The panel recommends urine dipstick in all women and post void residual urine measurement only in women with voiding difficulties. Other tests, such as ultrasound, cystoscopy urodynamics are not recommended during initial diagnostic procedure. The indications for referral are significant pelvic organ prolapse, haematuria, pain during micturition, recurrent incontinence and infections, suspicion of fistula. The initial management of stress urinary incontinence should include lifestyle interventions, and physiotherapy Use of pessaries is acceptable in women who are not fit or do not want surgical therapy Local estrogen therapy should only be used in women with urogenital atrophy Duloxetin is an option in the pharmacological therapy of stress incontinence, but it doesn't cure the disease. The ineffectiveness of initial procedure should be indication to surgery Alphaadrenomimetic drugs are not recommended in the therapy of urinary incontinence. The initial management of overactive bladder and urgency incontinence should include lifestyle interventions, however fluid restrictions (if fluid load is less than 3000 ml) are not recommended. The cornerstone of overactive bladder and urgency incontinence therapy remains the treatment with anticholinergic drugs. Drugs are only effective when used accordingly to the registered doses. The new generation anticholinergics are recommended over the old ones, especially in frail elderly patients and in patients with concomitant diseases, due to their better safety profile. The evaluation of anticholinergics efficacy should be performed after 2-3 months, then after 6 months.