Impact of childbirth on women's sexuality in the first year after the delivery.

AIM: The aim was to compare the quality of sexual life before pregnancy and after delivery and to find out whether and how selected factors affect women's sexuality during this period. METHODS: The study group consisted of 433 women who completed the survey containing basic demographic questions and two Female Sexual Function Index (FSFI) questionnaires: a retrospective one, regarding time before pregnancy and the current period. The inclusion criteria: time between 10 weeks and 1 year after delivery, vaginal intercourses before pregnancy and the resumption of vaginal intercourses after delivery. RESULTS: We observed the negative impact of labor on the total FSFI score, regardless of the time that had passed since birth and the delivery mode. The decrease by at least 10% of the initial FSFI score was noticed in 44.3% of the participants. FSD (Female Sexual Dysfunction) occurred statistically more commonly after delivery than before pregnancy (45.3% vs 17.1%; P < 0.001). The following factors had an impact on the risk of post-partum FSD: pre-pregnancy FSD (adjusted odds ratio [aOR] = 4.17 [95% confidence interval [CI] 2.38-7.31]) and nulliparity (aOR = 1.67 [95% CI 1.09-2.53]). CONCLUSION: Childbirth has an undeniable impact on women's sexuality. The prevention and treatment of sexual dysfunctions is very important, especially in this crucial period of life.

Tumor, host and surgery related factors predisposing to cranial nerve deficits after surgical treatment of parapharyngeal space tumors.

PROPOSE: Identification of relevant features acquired on preoperative evaluation of parapharyngeal space (PPS) tumors or related to the performed surgical approach that are predictive of the most important complication of surgical treatment of these tumors, cranial nerve palsy. METHODS: This was a retrospective analysis of 68 patients with PPS tumors treated with surgical resection in a tertiary referral center from 2009 to 2019. The preoperative clinical symptoms, age, sex, tumor size, location, histopathological type, surgical approach, radical resection, intraoperative bleeding and the occurrence of complications were collected, evaluated and compared. RESULTS: Cross-table and chi-square test results revealed that cranial nerve deficits were more common in neurogenic tumors than in other types, including malignant tumors (χ2 = 6.118, p = 0.013); the cervical approach was selected more often for neurogenic tumors (χ2 = 14.134, p < 0.001); neurogenic tumors were more frequently removed intracapsularly (χ2 = 6.424, p = 0.011); and neurogenic tumors were more likely to be located in the poststyloid area (χ2 = 17.464, p < 0.001). The two-sample t test revealed a significant correlation between age and the prevalence of cranial nerve complications (t = 2.242, p = 0.031). The mean age in the group of patients with cranial nerve palsy was 45.89 years, and that of the group without complications was 54.69 years. The results of logistic regression confirmed that the risk of nerve deficits was almost 8 times higher for neurogenic tumors (OR = 7.778, p = 0.01). None of the other analyzed variables related to tumor or surgery was significantly correlated with an increased risk of cranial nerve dysfunction. CONCLUSION: Surgical resection of tumors other than neurogenic tumors of the PPS reveals no significant risk for permanent neural dysfunction. Tumor size also had no significant effect on the risk of postoperative nerve palsy.

Spinal Cord Ischemia Because of Microvascular Thrombosis in a Patient with Necrotizing Pancreatitis. Case Report and Literature Review.

BACKGROUND Central nervous system ischemia in acute pancreatitis is rare with only a handful of cases reported in the literature. We report a case of spinal cord ischemia due to microvascular thrombosis complicating acute on chronic pancreatitis. CASE REPORT A 37-year-old male was transferred to a university hospital intensive care unit with a diagnosis of acute onset chronic pancreatitis, paraplegia, and multi-organ failure. Laboratory studies showed elevated serum amylase activity and leukocytosis. The patient deteriorated quickly and anemia with thrombocytopenia and coagulation abnormalities developed. Computed tomography showed large pancreatic pseudocyst and ischemic lesions in abdominal organs. Symptoms of paraplegia preceded by the bilateral paresis were noted 7 days from the onset of his disease and magnetic resonance imaging showed ischemia involving the central part of the medullary cone resulting from microvascular thrombosis. The patient underwent endoscopic retrograde cholangiopancreatography and repeated surgery with a number of complications but 2 months later was discharged to rehabilitation center due to persistent neurologic deficit. CONCLUSIONS Patients with severe pancreatitis and multiorgan failure requiring intensive care should undergo routine neurological examination to identify and treat deficits early.

Surgical treatment results of parapharyngeal space tumors: a report of 22 cases.

INTRODUCTION: Parapharyngeal space (PPS) is the anatomical area lateral to the upper pharynx and clinically important due to PPS tumors. They account for less than 1% of head and neck neoplasms. Both benign and malignant neoplasms may arise there and typical for this localization is diversity of histological origin. Complete surgical excision is still the basis of treatment. AIM OF THE STUDY: Evaluation of the results of surgical treatment of PPS tumors in the Department of Otolaryngology at the Medical University over the period 2015-2017. MATERIAL AND METHODS: A retrospective analysis of medical records including complaints, physical examination, results of imaging studies, surgical approach, postoperative complication and histopathological results in 22 patients with a diagnosis of a PPS tumors. RESULTS: The most frequent complaints reported by the patients were: discomfort in the throat, dysphagia, hearing disorders and a palpable tumor on the neck. Asymptomatic course of the disease was demonstrated in 4 cases. All patients were treated surgically: 2 with transoral approach, 9 with transparotid-transcervical approach, 11 with transcervical approach. In most cases the tumor was removed radically. In 2 patients intracapsular tumor resection was performed. Based on histopathological examination the benign lesions dominated (18/22). In 4 cases malignant neoplasms were diagnosed: carcinoma ex pleomorphic adenoma, adenoid cystic carcinoma and two cases of squamous cell carcinoma. The most common origin of PPS tumors was deep lobe of parotid gland and for this group 11 patients had diagnosis of pleomorphic adenoma. Other diagnosis included: paraganglioma, neurofibroma, hemangioma, lymphangioma and rhabdomyoma. Postoperative complications occurred in 9 patients and presented as hoarseness and dysphagia due to paresis of the lower group of cranial nerves (IX, X, XII). Significant intraoperative bleeding during surgery occurred in 2 cases and ligation of the external carotid artery was necessary. CONCLUSION: Due to the anatomical topography of PPS and its content with the essential vessels and the lower group of cranial nerves, the surgical treatment of pathology of this area is still a challenge for head and neck surgeons. The decrease of voice quality and impaired speech and swallowing should always be considered as complications post the surgical resection in PPS.