Human papillomavirus infection (HPV) and pregnancy.

Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, which may result in the development in benign lesions or malignant tumors. The prevalence of HPV infection is twice as high in pregnancy as in non-pregnant women. Additionally, there is a risk of vertical transmission of HPV from mother to fetus during pregnancy or childbirth. Various studies have reported an increased risk of adverse pregnancy outcomes in HPV-positive women, including miscarriage, preterm birth, premature rupture of membranes, preeclampsia, fetal growth restriction, and fetal death. HPV vaccination is not currently recommended during pregnancy. On the other hand, there is no evidence linking HPV vaccination during pregnancy with adverse pregnancy outcomes and termination of pregnancy is not justified in this case.

[Prediction of bowel damage in patients with gastroschisis]. / Predikce poskození streva u pacientu s gastroschízou.

INTRODUCTION: Gastroschisis is the most common malformation among abdominal wall defects with the incidence of 1:45000 live birth neonates. Postoperative care for these patients is very difficult due to the risk of abdominal compartment syndrome. The identification of markers that correlate with bowel damage in gastroschisis may prevent this serious postoperative complication. METHODS: Review of the literature. CONCLUSION: Prenatal ultrasound prediction of bowel damage followed by an appropriate surgical strategy is a possibility of optimizing care and outcomes in gastroschisis patients. The dynamics of I-FABP is a promising biomarker for the elimination of abdominal compartment syndrome during postoperative care.Key words: gastroschisis preformed silo intraabdominal dilatation I-FABP.

[Application of the concetrations ratio of soluble receptor tyrosine kinase type 1, and placental growth factor for short-term prediction and diagnosis of preeclampsia]. / Vyuzití pomeru koncentrací solubilního receptoru tyrozinkinázového typu 1 a placentárního rustového faktoru pro krátkodobou predikci a diagnostiku preeklampsie.

OBJECTIVE: Bring a comprehensive overview of the available information about applications of the concetration ratio of soluble receptor tyrosine kinase type 1 (sFlt-1), and placental growth factor for short-term prediction and diagnosis of preeclampsia. DESIGN: Overview study. SETTINGS: Department of Midwifery, Faculty of Health Sciences, Olomouc; Department of Clinical Biochemistry, University Hospital Olomouc; Department of Obstetrics and Gynecology, University Hospital Olomouc; Department of Obstetrics and Gynecology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital. METHODS: Analysis of literary sources and databases Ovid, Medline (2001-2016). CONCLUSION: Preeclampsia is a multisystem disease with not fully understood etiology. This disease occurs in 2-5% of pregnant women. Preeclampsia is one of the main causes of global maternal and perinatal morbidity and mortality. It manifests itself as a newborn hypertension and proteinuria after 20 weeks of pregnancy in previously normotensive women. The only effective treatment is the delivery of the child. Diagnosis of preeclampsia comprises measuring blood pressure and proteinuria. These indicators have low diagnostic sensitivity and specificity. In preeclampsia, there is a decrease of serum levels of placental growth factor (PlGF). Soluble receptor tyrosine kinase type 1 (sFlt-1) is an antagonist of PlGF. Increased levels of sFlt-1 in proportion to the reduced level of PlGF are associated with an increased risk of preeclampsia. The sFlt-1/PlGF ratio can be a better predictive marker in the diagnosis of pre-eclampsia after 20 weeks of gestation.

[Rupture of focal nodular hyperplasia in the 37th week of pregnanacy - case report]. / Ruptura jater u pacientky s fokální nodulární hyperplazií ve 37. týdnu tehotenství - kazuistika.

OBJECTIVE: We describe a case of spontaneous hepatic rupture associated with undiagnosed focal nodular hyperplasia of a patient in the third trimester of pregnancy. Additionally, we provide a brief review of literature. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague. RESULTS: We report the case of a 29 year old patient with otherwise physiological pregnancy, who was hospitalized with pain in left hypochondrium. The patient experienced painful respiration, increasing in intensity in supine position. The possibility of lung embolism was considered and ruled out. Based on a suspected haemoperitoneum, caesarean section was performed. During the inspection of peritoneal cavity a ruptured tumor on the liver was identified. Histological examination showed focal nodular hyperplasia. CONCLUSION: Focal nodular hyperplasia is a benign liver lesion. Complications involving rupture or bleeding are very rare. 17 cases of hepatic rupture associated with focal nodular hyperplasia were described in published reports with only one case related to pregnancy. Our case emphasizes the importance of a close cooperation between a gynaecologist, radiologist and surgeon.

[Induction of labor]. / Indukce porodu.

UNLABELLED: Data published in this guideline are based on previous guideline issued by Society of Perinatal Medicine of Czech Gynecological and Obstetrical Society (CGPS) [55], international guidelines and data from peer-reviewed journals. The fundamental document for this guideline is guideline issued by The Society of Obstetricians and Gynaecologists of Canada (SOGS) Induction of labor, No. 296, 2013 (reviewed 2015) [61]. The literature review is added to the aforementioned document and some of its recommendations are further discussed in this guideline. DESIGN: Review of literature.

[Prevention of preeclampsia - review]. / Prevence preeklampsie - prehledový clánek.

Preeclampsia is a serious condition that affects about five percent of pregnant women. The disorder itself or related complications are responsible for a significant percentage of maternal and fetal morbidity, even in developed countries. Although our understanding of etiology is still limited, the possibility of detecting and evaluating certain angiogenic factors by the end of the first trimester gives food for thought about prospects for preeclampsia prevention. Secondary prevention is currently based mostly on the effort to pharmacologically affect the spiral artery transformation and development of the abnormal placental microcirculation which lead to clinical symptoms of preeclampsia. The preventive treatment options are narrow. Greatest effect was noted with acetylsalicylic acid medication in the at-risk population. The dose of 75-150 mg per day is considered optimal. The treatment should start before the 16th gestational week; later initiation of therapy is associated with considerably smaller effect. The incidence of the early-onset preeclampsia (<34th gestational week) can be reduced up to 50% while preventive treatment affects the late-onset preeclampsia only minimally. Calcium supplementation is effective only in women with low calcium intake. Question for the future as well as subject of several studies is a clinical significance of low molecular weight heparin and sildenafil.

A pilot study on peak systolic velocity monitoring of fetal anemia after administration of chemotherapy during pregnancy.

OBJECTIVES: To monitor fetal anemia during administration of chemotherapy to the fetus's mother. STUDY DESIGN: Between 2007 and 2012 six patients with malignancy diagnosed during pregnancy were included in our prospective study. For evaluation of fetal anemia, peak systolic velocimetry (PSV) of the middle cerebral artery is considered the best method. The patients were repeatedly examined one day before and on the third day after the administration of chemotherapy. At least three measurements were performed and the highest value was used as appropriate. Multiples of the median (MoM) were calculated using the website http://www.perinatology.com/calculators/MCA.htm. When the MoM reached 1.29, moderate anemia was diagnosed. RESULTS: The women's average age was 30 years. The average gestational age at diagnosis was 20.7 weeks of pregnancy. Borderline fetal anemia was detected in only in one patient. After delivery newborns were examined by standard pediatric evaluation and blood count was provided. There was no evidence of any newborn anemia. CONCLUSIONS: Chemotherapy administered during pregnancy is becoming more frequent due to increasing knowledge and data on such cases. Close monitoring of the fetus should be performed in specialized centers. For detection of chemotherapy-induced anemia, PSV measurement should be employed.

[Pregnancy and delivery in a patient with pure 46,XY karyotype. Summary of actual knowledge about XY women]. / Tehotenství a porod u pacientky s cistým karyotypem 46,XY Souhrn dosavadních poznatku o XY zenách.

TYPE OF STUDY: Summary review and a case report. SETTINGS: GEST IVF, Centre of Reproductive Medicine, Prague. INTRODUCTION: In scientific literature there two syndrome have been described in the presence of pure 46,XY karyotype when an individual is phenotypically and psychosexually identified as a woman. Androgen insensitivity syndrome (AIS) and pure gonadal dysgenesis XY (GD XY, Swyer syndrome). Thanks to the presence of a uterus in Swyer syndrome we can treat this type of sterility with donated oocytes. METHOD: The paper describes both syndromes from prenatal, genetical, endocrinological, oncological, reproductive and perinatological points of view. A case study concerning a patient with pure gonadal dysgenesis XY, who successfully became pregnant through a donated oocytes programme, is also described. The pregnancy progressed physiologically, and a healthy boy, 3820g/52cm, was delivered in term by ceasarean section. DISCUSSION: In world scientific literature at least fifteen successful pregnancies with pure gonadal dysgenesis XY have been described. In spite of the expectation of diminished uterine capacity, children are born to term with a normal delivery weight. CONCLUSION: This article should be considered as a summary of all actual knowledge about these patients. This article should be available and usefull for clinicians who come across XY females. The case study provides evidence that even an individual with male genetic gender can be pregnant and deliver a healthy child.

[Pregnancy and multiple sclerosis -outcomes analysis 2003-2011]. / Tehotenství a roztrousená skleróza - analýza výsledku z let 2003-2011.

OBJECTIVE: The analysis of perinatal results in pregnant women with multiple sclerosis (MS) and the assessment of the influence of pregnancy on this chronic disease in the population of pregnant women in our hospital in the years 2003-2011. DESIGN: Retrospective analysis. SETTING: Department of Obstetrics and Gynecology and Department of Neurology, 2nd Faculty of Medicine, Charles University and the Motol Hospital, Prague. METHODS: Sixty-six women with the diagnosis of MS were included in our study in the years 2003-2011. All these women delivered at our clinic and were neurologically followed until the end of six months post partum. We evaluated the influence of pregnancy on the activity of the disease during the pregnancy and 6 months after delivery, the impact on the disability progression, the influence of the mode of delivery, the analgesia used, and breastfeeding, on the relapse rate post partum. We also assessed the impact of multiple sclerosis on the course of the pregnancy, where we looked for pregnancy complications in patients with multiple sclerosis, differences in the management of labor, and the results of newborns of mothers with this disease. We performed a statistical analysis. RESULTS: Relapse during pregnancy occurred in 4 of the 66 women (6.1%, relapse rate - RR 0.1);17 women experienced a post partum relapse in the first six months after delivery (25.7%, RR 0.5). From our sample of 44 women breastfed (66.7%), 10 had relapse (10/44, 22.7%) in comparison with the 7 women out of a total of 22 who did not breastfed (7/22, 31.8%). No statistical significance was established, OR = 0.6 (0.2-2.0), p = 0.5518. Epidural analgesia (EDA) was used by 16 women (24.2%). Post partum relapse experienced 3 women that used EDA (3/16, 18.8%) and 14 women that did not use EDA (14/50, 28 %). OR = 0.6 (0.1-2.4), p = 0.5325. Neither breastfeeding, nor epidural analgesia correlated with presence of a post partum relapse. Pregnancy did not influence disability progression, EDSS (Disability status scale, Kurtzke`s scale) before pregnancy and after delivery was stable (EDSS 1.5 or EDSS 1.6). Vaginal delivery had 77% women, post partum relapse had 15 of them (15/50, 30%), 12 women (18.1%) had a caesarean section, relapse occure at 2 of them (2/16, 12.5%), three births (4.5%) were completed by vaginal extraction operations. Five women (7.6%) delivered before 37th week of pregnancy. Birth weight under 2500 g was found in 9 women (13.6%). The incidence of serious pregnancy complications was not increased, intrauterine growth retardation (IUGR) was confirmed in 4 births (6%). CONCLUSION: There is no need to worry about pregnancy in patients with multiple sclerosis. Therapy provides long-term remission of the disease, and during pregnancy itself due to hormonal changes it is stabilized and the relapse rate decreases. In the post partum period relapse rate increases, however, the pregnancy did not influence disability progression. The mode of delivery in women with this disease is not different from the general population. Neither breastfeeding, nor epidural analgesia correlated with presence of a post partum relapses. The number of complications in pregnancy is not increased and the overall perinatal outcomes are comparable with the general population.

[Monochorionic biamniotic twins with a common yolk sac in the first trimester ultrasound scan - is there a higher risk of a congenital defect?]. / Monochoriální biamniální gemini se spolecným zloutkovým váckem pri UZ vysetrení v I. trimestru -je zde zvýsené riziko vrozené vývojové vady?

TYPE OF STUDY: Case report. SETTING: GEST IVF, Centre of Reproductive Medicine, Prague. METHODS: The case report describes pregnancy after IVF + ET. The first trimester ultrasound scan showed monochorionic biamniotic twins with one common yolk sac (YS) only, which is possible in biamniotic twins, but very rare. Identical congenital defects such as anal, coccygeal atresia, and others, were diagnosed prenatally and postnatally in both twins. CONCLUSION: Yolk sac number in monochorionic twins can play an important role in embryogenesi. Any possible relation with certain congenital defects has not yet been described. It is necessary to describe more cases.

[A set of patients with breast cancer associated with pregnancy]. / Soubor pacientek s karcinomem prsu v souvislosti s tehotenstvím.

OBJECTIVE: The aim of our study is to follow patients diagnosed with breast cancer associated with pregnancy. DESIGN: Prospective follow-up study. SETTING: Department of Obstetrics and Gynecology of the 2nd Medical Faculty of the Charles University and Faculty Hospital Motol, Prague. METHODS: Between the year 2002 and 2006 12 women were reffered to our department, seven with the diagnosis of breast cancer during pregnancy, three within one year after the delivery, two pregnant after the therapy for breast cancer. A managment was sellected individually with respect to the age of pregnancy, the stage of the disease and to the decision of the women. The average age of the diagnosis, managment, way of delivery, fetal and maternal outcome were recorded. RESULTS: The average age was 31.7 years. Two patients underwent a termination of the pregnancy, other delivered a healthy newborn. Two of our patients are dead, three have a metastatic disease, one was lost for follow-up, the rest are further followed. CONCLUSIONS: Breast cancer diagnosed during pregnancy is a special and rare situation, which needs to be managed individually as there is a lack of information about such patients. These patients should be concentrated in specialized centers.

[Effectivity and complications rate of surgical treatment of stress urinary incontinence with tension-free vaginal tape--Uretex]. / Efektivita a komplikace chirurgické lécby stresové mocové inkontinence pomocí volne ulozene pásky pod uretrou--Uretex.

OBJECTIVE: To evaluate the safety and efficacy of the Uretex tension-free vaginal tape procedure in the treatment of female stress urinary incontinence. DESIGN: Retrospective multicenter clinical trial. SETTING: Obstetrics and Gynecology Department, The Charles University 2nd Medical School and Teaching Hospital Motol, Prague. METHODS: A group of 145 patients with stress urinary incontinence who underwent Uretex tension-free vaginal tape procedure was studied. Procedures were performed from vaginal retropubic route. Patients were operated on in one urological and five gynecological departments in Czech Republic. Preoperative evaluation consisted of complete urogynecological examination, age, parity, body mass index, history of previous pelvic surgery and hormonal status. The cure rate and complications were determined in short-term postoperative follow-up. RESULTS: The mean age was 56 (25-80) years, the median parity was 2.25 (1-4), 113 (78%) patients were slightly overweight (BMI 25-30 kg/m2) and others had normal weight (BMI 20-25 kg/m2). The cure rate after surgery was 903% (131 women). Complications occured in 22 (15.2%) cases. In two (1.4%) patients perforation of the urinary bladder wall occurred. In two (1.4%) women nonperforated injury of bladder wall was postoperatively diagnosed. Retropubic haematoma occurred in another two patients (1.4%). 16 (11%) patients had mild early postoperative complications (eight times short-term urinary retention, six lower urinary tract infections, two urgent symptomatology). Erosion of vaginal wall did not occur postoperatively. All complications were resolved and the patients were free of negative postoperative symptoms 6 month after the procedure. CONCLUSION: This study shows that Uretex tension-free vaginal tape procedure is an effective and safe minimally invasive surgical procedure in the treatment of stress urinary incontinence.

Non-invasive fetal RHD and RHCE genotyping from maternal plasma in alloimmunized pregnancies.

BACKGROUND: In this prospective study, we assessed the feasibility of fetal RH genotyping by analysis of DNA extracted from maternal plasma samples of alloimmunized pregnant women using real-time PCR and primers and probes targeted toward RHD (exon 7 and exon 10) and RHCE (intron 2 and exon 5) genes. METHODS: We analysed 23 alloimmunized pregnant women (16 anti-D, 5 anti-D + C, 2 anti-E) at risk of haemolytic disease of the newborn (HDN) within 11th and 37th week of pregnancy and correlated the results with serological analysis of cord blood. RESULTS AND CONCLUSION: Detection of the presence of the RHD gene, the C and/or E alleles of the RHCE gene in maternal plasma samples is highly accurate and enables implementation in a clinical diagnostic algorithm for following pregnancies at risk for HDN. The absence of RHD gene, the C and/or E alleles of RHCE gene in the current pregnancy excludes the risk of HDN caused by anti-D, anti-C and/or anti-E alloantibodies and the performance of invasive fetal-blood sampling.

[Lower urinary tract infections in urogynaecology]. / Infekce dolních mocových cest v urogynekologii.

Urinary tract infections belong among the most common infectious diseases in adult women. Sporadic infection is usually not a diagnostic and therapeutic problem. Recurrent lower urinary tract infections significantly decrease the quality of life of the affected women. Colonisation of the vagina, vulva and the perineum by the uropathogens is the main risk factor of any urinary infection, but only concomitant action of some other factor (e.g. immunosuppression, urethral stenosis, urolithiasis, urethral diverticulum, diabetes and urinary incontinence) can induce the recurrent infection. Correct primary treatment and proper used preventive method is highly advantageous not only from the individual but also from the global point of view (high diagnostic and therapeutic expenses, increase of resistance and imminent success decrease of the modern treatment). Continuous low dose antimicrobial treatment is the most common prophylactic modality. Postcoital antimicrobial prophylaxis and immunomodulative therapy are the other used modalities. Local vaginal estrogen therapy is recommended in postmenopausal women. Estrogens improve the symptoms of the urogenital atrophy and decrease the vaginal pH, which is very important in prevention of the pathological bacterial colonisation of the vagina. Decision about the individual therapy and prophylaxis must be preceded by the evaluation of the risk factors with positives and negatives of the used drug.

[Contemporary potential of the mini-invasive surgical treatment of the female stress urinary incontinence]. / Soucasné moznosti miniinvazivní chirurgické lécby zenské stresové mocové inkontinence.

In 1994 DeLancey published the hammock hypothesis. According to this theory the increase of the urethral closure pressure depends on the urethral compression by the suburethral supportive tissue and the intraabdominal position of the proximal urethra and the bladder neck are not the main factors ensuring the continence. In connection with this new theory Ulmsten published (in 1996) results of the stress incontinence treatment with the tension-free polypropylene vaginal tape (TVT). This operation represents a revolution in the antiincontinent surgery. The success rate of this procedure is about 90% and it is the same in obese and in non obese women. Concomitant TVT and transvaginal procedures for prolapse do not decrease the effectiveness and do not increase the perioperative and postoperative morbidity. The procedure is connected with some peroperative (bladder perforation, retropubic haematoma), early postoperative (urinary retention) and late postoperative complications (urge incontinence, vaginal protrusion of the tape). In 2003 newly developed tape procedure--TOT (transobturator tape) was an evolutionary step in the improvement of tape procedures. The evaluation of the efficacy and complications rate of this modification is premature up to this time but hitherto positive results predetermine this surgical modality to successful expand.

[Diagnostic algorithms in female urinary incontinence]. / Diagnostické algoritmy u zenské mocové inkontinence.

Urinary incontinence is frequent problem with significantly negative impact on the quality of life. The correct plan of examination leads to the proposal of the appropriate treatment. The history, correct judgment of symptoms of incontinence and detailed gynaecological examination are important at the beginning of the diagnostic process. Negative urine cultivation is necessary condition for the invasive investigation of the urinary tract. Special questionnaires, micturition diary and clinical tests belong to the physical examination. The pad-weight test is based on the measurement of weight gain of absorbent pads during a test period under standardised conditions. Q-tip test (cotton swab test) measures the degree of mobility of urethra and bladder neck. Most of the clinical tests can be replaced by the ultrasound examination (introital or perineal approach), which helps to appreciate the vigour of urethra, bladder neck and vagina during the resting period and at stress. Urodynamic examination records pressure changes during the bladder filling, pressure gradients in urethra and the velocity of the urinary flow. It should be carried out when antiincontinence surgery is planned or when conservative therapy failed. Urodynamic examination helps to distinguish between stress and urge type of incontinence. Urethrocystoscopy is indicated for the diagnosis of the recurrent urinary infections, urge incontinence when structural pathologies of the urinary bladder are suspected, iatrogenic incontinence or postoperative complications.

[Epidemiological aspects of the female urinary incontinence]. / Epidemiologické aspekty zenské mocové inkontinence.

Urinary incontinence is defined as an involuntary loss of urine, which makes social and hygienic problem. It is a symptom with different causes. According to the typical clinical manifestation it is classified as stress, urge, reflex and paradox urinary incontinence. Loss of small amount of urine related to the increase of intraabdominal pressure (during coughing, sneezing or running) is characteristic for stress urinary incontinence. Sudden and uncontrollable voiding with loss of greater amount of urine is typical for urge incontinence. Reflex incontinence means that urinary bladder is emptying without voiding. Paradox incontinence is caused by an acquired smooth muscle weakness of the bladder and it manifests with incomplete emptying and with growing residual urine. Prevalence of urinary incontinence increases with age. Significant increase of female urinary incontinence symptoms is found in fifth and sixth decade. Urinary incontinence in young women is more a dynamic than a permanent symptom but the postmenopausal incontinence obviously does not disappear spontaneously. Urge and mixed incontinence are less frequent than stress symptomatology (between 10 and 15%). According to the prevalence studies only 1,5 to 6% of incontinent women are looking for a medical help. Because the urge symptoms are more limiting, the patients with urge incontinence are searching treatment possibilities more often than those with stress incontinence.

[Abdominal hysterectomy--risk factor in development of urinary incontinence? Results of a questionnaire study]. / Abdominální hysterektomie--rizikový faktor vzniku mocové inkontinence? Výsledky dotazníkové studie.

OBJECTIVE: To evaluate the risk of urinary incontinence development after abdominal hysterectomy for benign gynecological disease. DESIGN: Retrospective questionnaire study. SETTING: Obstetrics and Gynecology Department, Charles University 2nd Medical Faculty and Teaching Hospital Motol, Prague. METHODS: Questionnaire study of women in which abdominal hysterectomy for benign gynecological disease was performed from January till December 2001 at our Department of Gynecology and Obstetrics. The questionnaire included questions about symptoms of stress, urge and mixed urinary incontinence. They were evaluated in connection with age, parity, hormonal status and body mass index. Student t-test was used for the statistical analysis. RESULTS: 114 (59.7%) from all sent-out questionnaires were obtained. In 15.8% cases (18 from 114) de novo urinary incontinence after surgery developed. 77.8% (14 from 18) from these patients suffered from genuine stress incontinence. The rest (4 from 18) of the women had symptoms of mixed incontinence. Study results draw attention to 13.1% women (15 from 114) in which preoperative stress incontinence persisted even after hysterectomy. Preoperative stress incontinence was cured in 6.1% (7 from 114) cases after hysterectomy. Age, parity, hormonal status and body mass index were not statistically different in all groups after surgery. CONCLUSIONS: The results of the study show relatively high risk of urinary incontinence development after abdominal hysterectomy in previously continent women. The results also show high persistence of the stress incontinence symptoms in women who did not inform about their incontinence even if they were asked about it. Higher quality of further health education of the women with drawing their attention to both the possibility of surgical treatment of urinary incontinence simultaneously with hysterectomy are the most important aspects how to make the current gynecological surgical therapy more effective.

[Prevalence of the female urinary incontinence. Results from a questionnaire study]. / Prevalence zenské mocové inkontinence. Výsledky dotazníkové studie.

OBJECTIVE: To evaluate the prevalence of urinary incontinence in patients of gynecological practise aged 31-60. DESIGN: Prospective questionnaire study. SETTING: Obstetric and Gynecologic Department, Charles University 2nd Medical Faculty and Teaching Hospital Motol, Prague. METHODS: Questionnaire study of 561 women aged 31-60 examined with gynecological problems (not for the symptoms of urinary incontinence) from November 2001 till October 2002 in standard gynecological practise. The questionnaire included history, evaluation of urinary continence, lasting of the symptoms, body mass index, obesity, age, parity. Stress, urgent and mixed incontinence and influence on the sexual life were also evaluated. Cochran Mantel-Haenszel test and chi2 test were used for the statistical analysis. RESULTS: The incontinence rate in the group of 533 evaluated patients (95% completed questionnaires from 561) of gynecological practise was 23.8%. 81.1% of incontinent patients in the study suffered from stress urinary incontinence. For an easy survey and analysis the patients were divided into three age groups (31-40, 41-50, 51-60). Prevalence of the urinary incontinence rised with age. Statistically significant lower prevalence of urinary incontinence was in the age group 31-40 (p<0.0005). Influence of parity on the prevalence of incontinence was statistically significant only in the age group 31-40 (p=0.002). Obesity had no statistical impact on prevalence of urinary incontinence (p=0.79). 5.5% of incontinent women suffered from negative effect of urinary incontinence on sexuality; the differencies among the age groups were not statistically significant. CONCLUSIONS: The results of the study show high prevalence of urinary incontinence in population of healthy women of gynecological practise. Low interest for the treatment is in contrast with high prevalence of this symptom. Higher quality of the enlightenment with attention to the prevention and therapy of urinary incontinence in population is the way how to improve quality of lives of the afflicted women.