3D laparoscopy as a tertiary cytoreductive (TCR) surgery in infiltrating ureter recurrent epithelial ovarian cancer - case report and a mini-review of the literature.

The paper describes a case of a 61-year-old woman with recurrent epithelial ovarian cancer infiltrating the ureter treated with 3D laparoscopy as a tertiary cytoreductive surgery (TCR). In addition, a mini-review of the literature concerning TCR is presented.

Functional Assessment of Synoptic Pathology Reporting for Ovarian Cancer.

BACKGROUND: Ovarian cancer has one of the highest death/incidence rates and is commonly diagnosed at an advanced stage. In the recent WHO classification, new histotypes were classified which respond differently to chemotherapy. The e-standardized synoptic cancer pathology reports offer the clinicians essential and reliable information. The aim of our project was to develop an e-template for the standardized synoptic pathology reporting of ovarian carcinoma [based on the checklist of the College of American Pathologists (CAP) and the recent WHO/FIGO classification] to introduce a uniform and improved quality of cancer pathology reports. A functional and qualitative evaluation of the synoptic reporting was performed. METHODS: An indispensable module for e-synoptic reporting was developed and integrated into the Hospital Information System (HIS). The electronic pathology system used a standardized structure with drop-down lists of defined elements to ensure completeness and consistency of reporting practices with the required guidelines. All ovarian cancer pathology reports (partial and final) with the corresponding glass slides selected from a 1-year current workflow were revised for the standard structured reports, and 42 tumors [13 borderline tumors and 29 carcinomas (mainly serous)] were included in the study. RESULTS: Analysis of the reports for completeness against the CAP checklist standard showed a lack of pTNM staging in 80% of the partial or final unstructured reports; ICD-O coding was missing in 83%. Much less frequently missed or unstated data were: ovarian capsule infiltration, angioinvasion and implant evaluation. The e-records of ovarian tumors were supplemented with digital macro- and micro-images and whole-slide images. CONCLUSIONS: The e-module developed for synoptic ovarian cancer pathology reporting was easily incorporated into HIS.CGM CliniNet and facilitated comprehensive reporting; it also provided open access to the database for concerned recipients. The e-synoptic pathology reports appeared more accurate, clear and conclusive than traditional narrative reports. Standardizing structured reporting and electronic tools allows open access and downstream utilization of pathology data for clinicians and tumor registries.

Hysteroscopic Patterns in Women on Treatment With Ulipristal Acetate 5 mg/day: A Preliminary Study.

STUDY OBJECTIVE: To describe the hysteroscopic findings in women on treatment with ulipristal acetate (UPA) and to define the most common hysteroscopic patterns related to the treatment and compare them with the histologic findings. DESIGN: Preliminary study. SETTING: OB-GYN and Gynecology Oncology Clinic, Military Medical Institute, Ministry of Defense, Warsaw, Poland, and Obstetrics and Gynecology Department, University of Bari, Italy. PATIENTS: Seventy-four premenopausal patients complaining of abnormal uterine bleeding due to uterine myomas and on treatment with UPA 5 mg/day for at least 30 days. INTERVENTIONS: Women received transvaginal sonography (TVS) and then office hysteroscopy and visually guided endometrial biopsies. Video hysteroscopies were recorded in digital format. Pictures were evaluated by 2 authors off-line and compared with histologic results. MEASUREMENTS AND MAIN RESULTS: Hysteroscopic aspects and classification of progesterone receptor modulator-associated endometrial changes were measured. The most common hysteroscopic finding was the combination of a flat subtle epithelium with small glandular openings; large isolated or confluent cysts in the stroma, giving the surface a floating aspect at fluid distention; and well-evident subendometrial vascular network with a "chicken-wire" vascular pattern (44.6%). This finding accounted for 82% of cases with endometrial thickness > 10 mm at TVS. Histology confirmed a combination of epithelial secretory (vacuoles) and hypotrophic effects (small and dilated glands), whereas at stromal level the combination of cysts, dense stroma, and vascular wall thickening was found. At 3 months follow-up echographic, hysteroscopic, and histologic endometrial patterns were normal in all patients. CONCLUSIONS: In most women on UPA and with thickened endometrium at TVS, the hysteroscopy showed benign and characteristics aspects related to the ambivalent effects of UPA on progesterone receptor. These alterations took place just after 1 month of treatment but disappeared within 3 months of stopping treatment.

Ulipristal acetate before high complexity endoscopic (hysteroscopic, laparoscopic) myomectomy - a mini-review.

Uterine myomas (fibromas, leiomyomas) are the most common tumours in women, and their clinical signs and symptoms are presented by 25-40% of patients with these benign tumours. According to current guidelines, the armamentarium for myoma management consists of: medical therapy (GnRH, SPRMs), non-surgical alternatives including uterine artery embolisation (UAE), vaginal temporary occlusion of uterine arteries using clamp-like device or MRgFUS technique, and surgical treatment (including minimally invasive techniques). In cases of submucous myomas STEPW classification correlates very well with the risk of incomplete hysteroscopic myomectomies. According to limited literature data, ulipristal acetate as a pre-treatment seems to be very prudent in high complexity hysteroscopic myomectomy (STEPW II, score 5-6). In patients with large uterine myomas (FIGO type 3, 4, 5) undergoing laparoscopic myomectomy, three-month pre-treatment with ulipristal acetate before laparoscopy is feasible and can be recommended because of shorter time of surgery, lower intraoperative blood loss, lower haemoglobin drop, and low postoperative blood transfusion rate.

Retrospective comparison between the Prolift and Elevate anterior vaginal mesh procedures: 18-month clinical outcome.

INTRODUCTION AND HYPOTHESIS: There are few direct comparisons between the first-generation trocar-guided and the second-generation single-incision mesh systems in the treatment of anterior pelvic organ prolapse (POP). Hence, the purpose of this retrospective review was to compare 18-month operative success in female patients who had undergone POP surgery with the anterior Prolift (n = 52) or the anterior Elevate mesh (n = 62). METHODS: Subjective (bulge symptoms) and objective measures (absence of anterior or apical descent beyond the hymen, POP-Q anterior stage 0 or I, no retreatment for POP) were used as the measures of surgical efficacy. Postoperative pelvic floor pain, dyspareunia, de novo overactive bladder (OAB), de novo stress urinary incontinence (SUI), and mesh exposure were addressed as complications of POP surgery. RESULTS: The two groups did not differ with regard to the subjective and objective measures of the operative efficacy. There were no between-group differences in the proportion of women reporting postoperative pelvic floor pain, dyspareunia, de novo SUI, and de novo OAB symptoms (all p values >0.05). The proportion of patients with postoperative vaginal exposure was significantly higher in the Prolift group (7.7 %) than in the Elevate group (0.0 %; p = 0.02). CONCLUSIONS: In conclusion, our results suggest that the use of the Elevate system in patients with anterior compartment prolapse results in fewer mesh erosions, but similar efficacy, compared with the Prolift mesh.

Survivin expression as a prognostic factor in patients with epithelial ovarian cancer or primary peritoneal cancer treated with neoadjuvant chemotherapy.

BACKGROUND: The aim of this study was to evaluate association of expression of survivin and p53 with the effects of neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer (AOC). METHODS: We retrospectively evaluated 60 consecutive patients with AOC (International Federation of Gynecology and Obstetrics stage IIIC-IV) treated with NAC. The expression of p53 and survivin was assessed immunohistochemically. The median of expression total score survivin equals 2 was adopted to dichotomize the group. The positive and negative expression of p53 was used to dichotomize the group. RESULTS: The expression of survivin in tumor tissue taken before and after NAC was a significant difference in the percentage of stained nuclei (P = 0.0002), the intensity of staining (P = 0.0003), and total score (P = 0.0001). There was a significant difference in p53 expression in tumor tissue before and after NAC in the percentage of stained nuclei (P = 0.0424). Survivin expression, in contrast to p53 expression, was a prognostic factor in patients with AOC treated with NAC (P = 0.0484). The expression of survivin and p53 was not a predictive factor. Independent adverse predictor factors were as follows: lack of optimal interval debulking surgery and the lack of an objective response (the respective hazard ratio was 3.93 [95% confidence interval, 2.07-7.46; P < 0.0001] and 2.36 [95% confidence interval,1.25-4.47; P = 0.0080]). The suboptimal range of interval debulking surgery, resistance to platinum, and the lack of paclitaxel in the NAC were adverse prognostic factors (the respective hazard ratio was 2.61 [95% confidence interval, 1.17-5.83], 2.72 [95% confidence interval, 1.07-6.89], and 2.56 [95% confidence interval, 1.06-6.18]; P < 0.05]). CONCLUSIONS: High expression of survivin could be a prognostic factor in patients treated with NAC for AOC.

A case of a large solitary fibrous tumour of the uterine cervix.

BACKGROUND: Solitary fibrous tumour of the uterine cervix is an extremely rare phenomenon. We present a case of the largest cervical tumour of this type in this anatomical location reported so far. CASE PRESENTATION: A 45-year old white female presented with abdominal pain, abnormal uterine bleedings and a 15 cm mass of the uterine cervix/left parametrium. Histological examination with immunohistochemistry of the tumour biopsy revealed diagnosis of solitary fibrous tumour. The patient underwent radical abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. No recurrence has been observed for 8 months of follow-up. CONCLUSIONS: Solitary fibrous tumour can be occasionally found in patients with large cervical/parametrial masses. Immunohistochemistry was helpful in diagnosis and surgery was feasible and effective in treatment of our case of a large solitary fibrous tumour of the cervix.

[Carcinoma of the cervical stump--multicenter study]. / Wystepowanie raka szyjki macicy po histerektomii nadszyjkowej--badanie wieloosrodkowe.

OBJECTIVES: Cervix-sparing hysterectomy due to benign conditions remains controversial, especially when the presumed risk of cervical cancer in the retained cervical stump is concerned. On the other hand, supracervical hysterectomy is associated with shorter operative time, decreased blood loss and decreased intraoperative complications. Moreover, beneficial effects of retaining the cervix on the pelvic statics and female psychosexual functioning have been suggested, although not yet proven. THE AIM: The aim of the study was to determine the frequency and types of cervical cancers in the retained cervical stump after supracervical hysterectomy performed due to benign diseases of the uterine corpus in four academic settings. MATERIAL AND METHODS: Retrospective review of medical records of 903 women who underwent treatment due to cervical carcinoma in four departments participating in the study: Centre 1- 2nd Department of Gynecology, Medical University Lublin (years: 2001- 2011); Centre 2- Department of Gynecology and Gynecologic Oncology, Military Institute of Medicine, Warsaw (years: 2002-2012); Centre 3- Katedra i Kliniki Poloznictwa, Chorób Kobiecych i Ginekologii Onkologicznej II Wydzialu Lekarskiego WUM, Warsaw (years: 2008-2013) and Centre 4- Department of Gynecologic Oncology, Poznan University of Medical Sciences, (years: 2000-2012). The occurrence rate of cervical stump carcinoma was reported in relation to patient age, time elapsed between supracervical hysterectomy and diagnosis stump cancer and histological type of cancer. RESULTS: Only 3 cases of cervical stump carcinoma (0.33%) were identified among the 903 investigated women. In all these cases, cervical stump cancers were diagnosed several years after supracervical hysterectomy. In one case the only treatment was radiotherapy in one case only trachelectomy was performed, whereas in one case surgery followed by radiotherapy was used. CONCLUSIONS: It should be remembered that subtotal hysterectomy carries a risk, albeit relatively low, of developing stump cancer. Therefore, patients should be informed that after such operation further cervical cancer screening is mandatory. Moreover subtotal hysterectomy should not be offered in populations at risk of developing cancer of the uterine cervix.

CD4⁺ CD25⁺ FOXP3⁺ regulatory T cells in peripheral blood and peritoneal fluid of patients with endometriosis.

STUDY QUESTION: Is endometriosis associated with changes in CD4⁺ CD25⁺ FOXP3⁺ regulatory T cells (Treg cells)? SUMMARY ANSWER: Endometriosis is associated with disturbed compartmentalization of CD25(high) FOXP3⁺ Treg cells. WHAT IS KNOWN ALREADY: Endometriosis is associated with an abrogated immune response and displays some features of an autoimmune disorder. Treg cells play a part in the development of autoimmune reactions; however, their role in pathogenesis of endometriosis is still poorly recognized. STUDY DESIGN, SIZE AND DURATION: Case-control study comparing 17 women with laparoscopically and histopathologically confirmed ovarian endometriosis with 15 control women without visible endometriosis foci, pelvic inflammation or related pathology who were subjected to laparoscopic surgery between 2010 and 2011. PARTICIPANTS/MATERIALS, SETTING AND METHODS: Peripheral blood and peritoneal fluid were collected during laparoscopy and T cell subpopulations were analysed by flow cytometry using specific monoclonal antibodies recognizing CD4⁺, CD25⁺ and FOXP3⁺ markers. MAIN RESULTS: The percentage of CD25(high) FOXP3⁺ Treg cells was significantly decreased in the peripheral blood of women with ovarian endometriosis compared with control women. On the other hand, the proportion of these cells was significantly increased in the peritoneal fluid of women with endometriosis. LIMITATIONS, REASONS FOR CAUTION: The present study is limited to patients with ovarian endometrioma and further investigations are needed, including patients with lower grade of endometriosis. WIDER IMPLICATIONS OF THE FINDINGS: The present results suggest that Treg cells may play a part in immunopathogenesis of endometriosis being responsible for abrogated local cellular immune responses and facilitation and development of autoimmune reactions. Treg cells may be thus a potential target in the treatment of endometriosis. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by 1M15/N/2011 and NK1W grants from the I Faculty of Medicine, Warsaw Medical University. None of the authors has any competing interests to declare.

Metastases and Recurrence Risk Factors in Endometrial Cancer-The Role of Selected Molecular Changes, Hormonal Factors, Diagnostic Methods and Surgery Procedures.

The presence of metastatic endometrial cancer (EC) is a key problem in treatment failure associated with reduced overall survival rates. The most common metastatic location is the pelvic lymph nodes, and the least common is the brain. The presence of metastasis depends on many factors, including the molecular profile of cancer (according to the TCGA-Genome Atlas), the activity of certain hormones (estrogen, prolactin), and pro-inflammatory adipocytokines. Additionally, an altered expression of microRNAs affecting the regulation of numerous genes is also related to the spread of cancer. This paper also discusses the value of imaging methods in detecting metastases; the primary role is attributed to the standard transvaginal USG with the tumor-free distance (uTFD) option. The influence of diagnostic and therapeutic methods on EC spread is also described. Hysteroscopy, according to the analysis discussed above, may increase the risk of metastases through a fluid medium, mainly performed in advanced stages of EC. According to another analysis, laparoscopic hysterectomy performed with particular attention to avoiding risky procedures (trocar flushing, tissue traumatization, preserving a margin of normal tissue) was not found to increase the risk of EC dissemination.

The Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guideline for the diagnostic assessment of stress urinary incontinence in women.

OBJECTIVES: The aim of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) was to develop an updated Guideline for the diagnostic assessment of stress urinary incontinence (SUI) in women. MATERIAL AND METHODS: Earlier PSGO guidelines and the literature about the diagnostic assessment of SUI, including current international guidelines, were reviewed. RESULTS: As in the earlier guidelines, the diagnostic process was subdivided into the initial and the specialized diagnostics. Patients who required specialized diagnostic testing were identified. Functional diagnostic tests, performed by physiotherapists, were included. Attention was paid to new diagnostic possibilities. CONCLUSIONS: Initial diagnostic assessment is sufficient to devise the optimal treatment plan in a number of patients. It also allows to identify which patients will require specialized diagnostics, whose scope is individually tailored to the patient needs and depends on symptom complexity, surgical history, treatment plan, experience of the physician, availability of the equipment, and cost-effectiveness ratio.

Etanercept immunotherapy in women with a history of recurrent reproductive failure.

OBJECTIVE: The aim of the study was to evaluate the effect of etanercept immunotherapy on peripheral natural killer (NK) cell activity in women with a history of recurrent miscarriage (RM) or failed in vitro fertilization (IVF). MATERIALS AND METHODS: Thirty nonpregnant women with reproductive failure and increased peripheral NK-cell number and/or activity before conception were studied. Women with reproductive failure received 4 doses (25 mg) of etanercept twice weekly before conception. Peripheral NK-cell activity before and after etanercept therapy in RM women was measured using flow cytometry In addition, the peripheral blood NK-cell surface antigens- CD16- and CD56 and peripheral blood regulatory T cell (T reg) antigens- CD4- and CD25 were studied using flow cytometry before treatment and 2 weeks after the last etanercept dose. RESULTS: NK-cell activity was significantly decreased after etanercept therapy in the study women (P < .05). This effect was significantly higher in women with subsequent pregnancy success (P < .05), but not in those with pregnancy failure (P > .05). There were no significant differences in T reg level before and after etanercept therapy (P > 0.05). CONCLUSION: Etanercept therapy might be effective treatment for women with increased NK-cell activity. Regulation of immune system activity may underlie the possible effect of such therapy.

Endometrial Cancer Management in Young Women.

Endometrial cancer (EC) rarely develops in young women. Most cases are associated with known risk factors: BMI > 30, history of Polycystic Ovary Syndrome (PCOs), and race differentiation. The molecular EC classification based on The Cancer Genome Atlas Research Network divides these heterogeneous cancers into four types: Polymerase Epsilon Mutation (POLE), Microsatellite Instability (MSI), Copy Number Low (CNL), and Copy Number High (CNH). This division was introduced to allow for early assessment of neoplastic changes and clinical management, including targeted therapies. The basic technique for imaging endometrium changes is transvaginal sonography. Hysteroscopy is the standard for obtaining endometrial material for histological evaluation. The MRI result permits assessment of the extent of EC cancer infiltration. In young women who want to preserve fertility, apart from surgery, conservative management is often implemented after strict selection based on clinical and pathological data. This pharmacological treatment involves the administration of progestogens MPA (medroxyprogesterone acetate) and MA (megestrol acetate). The use of metformin may increase the effectiveness of such treatment. An alternative option is to apply progestogens locally­via the levonorgestrel-releasing intrauterine device. In addition to pharmacological treatment, hysteroscopic resection may be used­part of the uterine muscle adjacent to the pathologically changed endometrium may also undergo resection. An alternative is the administration of estrogen receptor modulators (e.g., SERMs) or aromatase inhibitors, or GnRH agonists.

Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guidelines on the management of recurrent pelvic organ prolapse.

OBJECTIVES: The aim of the publication was to present the Guideline of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the management of recurrent pelvic organ prolapse, based on the available literature, expert knowledge and opinion, as well as everyday practice. MATERIAL AND METHODS: In 2005, 2006 and 2010, the panel of PSGO experts published guidelines for the diagnosis and treatment of patients with lower urinary tract symptoms (LUTS). This publication presents an update of those recommendations and concerns recurrent POP treatment. MAIN CONCLUSION: The analysis of data revealed that sacrocolpopexy with the use of commercial sets or polypropylene hernia mesh is the method of choice for the surgical repair of recurrent vaginal vault prolapse. However, a significantly higher risk of surgical and postoperative complications after sacrocolpopexy, as compared to vaginal surgeries, should be considered when making treatment decisions. In other types of recurrent POP, the choice of surgery method should be tailored to the individual needs of each patient and may depend on the medical center.

The Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guidelines for the diagnostic assessment of pelvic organ prolapse.

OBJECTIVES: The aim of the team appointed by the Board of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) was to develop this interdisciplinary Guideline for the diagnostic assessment of pelvic organ prolapse (POP) in women, based on the available literature, expert knowledge and opinion, as well as everyday practice. MATERIAL AND METHODS: A review of the literature, including current international guidelines and earlier PSGO recommendations (2010-2020) about POP, was conducted. RESULTS: The steps of the diagnostic assessment for patients with POP, subdivided into initial and specialized diagnostics, have been presented. Indications for specialized diagnostic assessment have also been listed. In case of surgical treatment, the patient may be referred solely based on the initial diagnostics or after certain elements of the specialized diagnostics have been completed. CONCLUSIONS: Due to inconclusive data, the scope of the diagnostic process for POP is individualized for each patient and depends on patient-reported symptoms, initial diagnostic findings, surgical history, management plan, availability of the equipment, and cost.

Urogynecology Section of the Polish Society of Gynecologists and Obstetricians guidelines on the management of stress urinary incontinence in women.

OBJECTIVES: The aim was to present an interdisciplinary Guideline of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the management of stress urinary incontinence (SUI). MATERIAL AND METHODS: A review of the literature, including current international guidelines and earlier recommendations of the PSGO Urogynecology Section, about the treatment of SUI was conducted. RESULTS: Management of SUI is presented. Four lines of therapy were identified: line 1 - the so-called 'conservative treatment', which should always be attempted, regardless of SUI symptom severity; line 2 - surgical intervention; lines 3 and 4 - reoperations after unsuccessful surgeries from line 2. The literature reports which provided supporting evidence for this Guideline, including the practical aspects, were discussed. CONCLUSIONS: A systematic review of the guidelines and an analysis of SUI management were conducted. The need for an individualized approach was emphasized.

The Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guideline on the use of urodynamic testing in gynecological practice.

OBJECTIVES: The aim was to present an interdisciplinary Guideline of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the use of urodynamics (UDS) in the diagnostic process of patients with lower urinary tract symptoms (LUTS) based on the available literature, expert knowledge, and everyday practice. MATERIAL AND METHODS: A review of the literature concerning the use of UDS in women, including current international guidelines and earlier recommendations of the PSGO Urogynecology Section, was conducted. RESULTS: Urodynamic testing allows to make the urodynamic diagnosis which, nevertheless, remains to be the preliminary diagnosis. Medical history, physical examination, and detailed analysis of the previous test results (laboratory, imaging, endoscopic) need to be taken into consideration before making the final diagnosis. Urodynamic testing before surgical treatment of SUI is allowable, but the decision remains at the discretion of the physician. Urodynamic testing is not necessary before primary surgical treatment of uncomplicated SUI, but it has been demonstrated to optimize the therapeutic methods in complicated SUI. The significance of UDS in the diagnostic process of patients with overactive bladder symptoms, voiding dysfunction, and bladder outlet obstruction was discussed. CONCLUSIONS: Urodynamic testing is a vital element of the urogynecological diagnostic process. The scope of UDS should reflect the individual needs and symptoms of each patient and be based on the current guidelines, expert knowledge and experience of the physician, indications, and eligibility, as well as additional test results of the affected patients. Due to formal and legal requirements, PSGO, in this Guideline, wishes to emphasize the need for an individualized approach to both, test performance and result interpretation.

The Urogynecology Section of the Polish Society of Gynecologists and Obstetricians guidelines on the management of non-neurogenic overactive bladder syndrome in women.

OBJECTIVES: The aim of the publication was to present the interdisciplinary guidelines of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the treatment of overactive bladder (OAB) syndrome based on the available literature, expert knowledge, and everyday practice. MATERIAL AND METHODS: A review of the literature, including current recommendations for the treatment of overactive bladder syndrome, urinary incontinence, urgency and mixed urinary incontinence, as well as the earlier recommendations of the PSGO Urogynecology Section, was conducted. RESULTS: Management of the patients with OAB is presented. Four lines of therapy were identified: 1) educating the patient, behavioral therapy with pelvic floor muscle training, 2) pharmacotherapy, 3) botulinum toxin injection and tibial nerve stimulation; and sacral nerve stimulation even though so far it has been used only in selected populations, 4) surgical intervention. The literature reports which provided supporting evidence and presented various aspects of the therapy were discussed. OAB pharmacotherapy-related issues which are vital in everyday clinical practice were presented. CONCLUSIONS: A systematic review of the available guidelines and an analysis of OAB (including urgency urinary incontinence) management were conducted. The Polish Society of Gynecologists and Obstetricians issued the guidelines for the therapeutic management of OAB patients. The need for an individualized approach was emphasized.

Reliability and clinical validity of a Polish version of the CONTILIFE: a quality of life questionnaire for urinary incontinence.

INTRODUCTION AND HYPOTHESIS: The primary aim of the study was to translate and validate a Polish version of the CONTILIFE, a quality of life questionnaire. The clinical validity of the CONTILIFE was assessed against the number of urinary leaks, Valsalva leak point pressure (VLPP), and maximum urethral closure pressure (MUCP). METHODS: One hundred women with stress urinary incontinence completed a Polish version of the CONTILIFE twice with a 4-day interval. RESULTS: Internal consistency (Cronbach's alpha= 0.94) and test-retest reliability of the instrument (ICC = 0.96) were very good. A significant relationship was found between all the CONTILIFE dimension scores, the CONTILIFE global score, and the number of urinary leaks per week. A less significant relationship was found between VLPP, MUCP, and CONTILIFE dimension and global scores. CONCLUSIONS: A Polish version of the CONTILIFE can be a reliable measure of quality of life in stress urinary incontinence patients.

[Revised FIGO staging systems for gynecologic malignancies--2009 update]. / Zmiany klasyfikacji zaawansowania nowotworów narzadu plciowego u kobiet--stan na 2009 rok.

Neoplasm staging system was created to facilitate making diagnoses and planning treatment for cancer patients. Since medical research and practice in the field of oncology have shown explosive growth, the staging of some of the gynecologic cancers did not give a good spread of prognostic groupings. In the light of these breakthroughs, the following changes to the staging of gynecological cancers were proposed and approved by the FIGO Committee. In vulvar cancer Stage IA remained unchanged but Stage I and II have been combined. The number and morphology of the involved nodes have been taken into account, and the bilaterality of positive nodes has been discounted. In cervical cancer Stage 0 has been deleted and substages in Stage IIA have been included. In endometrial cancer Stage IA and IB have been combined so that now Stage IA involves the endometrium and/or less than one-half myometrial invasion and IB is equal to or greater than the outer one-half of the myometrium. Stage II no longer has a subset A and B. Involvement in the endocervical glandular portion of the cervix is now considered Stage I. Pelvic and para-aortic node involvement have been separated. The committee has also established a sarcoma staging system based on the criteria used in other soft tissue sarcomas.