[Data from our recent trials with tension-free vaginal tape (TVT) procedure for surgical treatment of genuine urinary stress incontinence]. / Wstepne wyniki zastosowania techniki TVT (tension-free vaginal tape) w leczeniu wysilkowego nietrzymania moczu.

UNLABELLED: There exist many surgical procedure for the treatment of urinary incontinence. Most of them require relatively extensive surgery and several days hospitalization. The advantage of tension-free vaginal tape procedure is a possibility to be performed on an ambulatory basis and under local anesthesia. OBJECTIVES: The aim of the study was to evaluate the results and morbidity of TVT procedure in genuine urinary stress incontinence. MATERIAL AND METHODS: The study group consists of 26 women, aged 39-69, suffering from genuine stress incontinence class I to III according to Stamey classification. The operation was carried out under epidural anesthesia. The procedure was performed as described by Ulmsten at al. The period of follow-up ranged from 3 to 20 month. RESULTS: The mean time of procedure was 26 minutes (range 18-43). The stay in hospital in 23 patient (88.46%) did not exceed 2 days. Three patients experienced urinary retention lasting four days requiring catheterization. No patients had bladder perforations or severe blood loss. No evidence of defect healing or rejection of the tape was found. Twenty four patients (92.31%) of patients were completely cured, 2 patients (7.69%) had considerably improved urinary continence. CONCLUSIONS: Our early study indicate that TVT procedure is effective and safe method of the surgical treatment of urinary stress incontinence in women.

[Integrated colposcopy and phase contrast microscopy for diagnosis of squamous intraepithelial lesions and invasive cervical neoplasms]. / Skojarzone badanie kolposkopowe i mikroskopia kontrastowo-fazowa w diagnostyce sródnablonkowych zmian przednowotworowych i raka inwazyjnego szyjki macicy.

Colposcopy or cytology examinations alone allows to obtain diagnostic concordance with histopathological examination between 74-89% and 68-86%, respectively in SIL and cervical cancer detection. Both methods used simultaneously allow increase concordance with histopathology up to 95-100%. Cytological examination may be used simultaneously with colposcopy when Ph microscopy is used. The aim was to estimate benefits of conjunction of colposcopy and Ph cytology in SIL and cervical cancer detection in daily gynecological practice. Integrated colposcopy and cytology examinations were performed in 200 patients. Cervico-vaginal smears were obtained from the patient before Acetic-Acid Test and Lugol-Solution-Test were performed. Wet smears (Ph) were made. Results of integrated colposcopy and cytology were verified by histopathological examination. Diagnostic specificity, sensitivity, and Youden's value were estimated for Ph cytology, H-E cytology, and colposcopy alone and for integrated colposcopy and Ph cytology. Simultaneous colposcopy and Ph cytology reveal specificity 97.1% sensitivity 94.6% and Youden's value 91.8% thus provide fast, reliable and comprehensive information for accurate diagnosis in daily gynecological practice.

[The value of micro-colpo-hysterectomy in the diagnosis and therapeutic evaluation of squamous intraepithelial lesions]. / Wartosc mikrokolpohisteroskopii w diagnostyce i kwalifikacji terapeutycznej zmian sródnablonkowych szyjki macicy.

Simultaneous application of cytology, colposcopy and colposcopically directed punch biopsy is acknowledged diagnostic procedure in squamous intraepithelial lesions (SIL) and cervical cancer, but not in every case it allows for precise estimation and localisation of the lesion. The aim of the study was evaluation of the value of microcolpohysteroscopy (MCH) in diagnostics and therapeutical qualification of SIL. The study group comprised 86 women cytologically suspected for SIL. Sensitivity, specificity, positive and negative predictive values of MCH in detection of SIL were calculated. The estimation of the value of MCH in therapeutical qualification was based on therapy effects of SIL performed according microcolpohysteroscopy evaluation of the cervix. In cases of low-grade SIL the sensitivity of MCH reached 0.73, the specificity 0.5, positive predictive value was 0.85 and negative predictive value was 0.33. For high-grade SIL and cervical cancer the values were 0.98, 0.33, 0.95 and 0.5 respectively. Totally, for all lesions of SIL type and cervical cancer sensitivity of MCH reached 0.94, specificity 0.75, positive predictive value was 0.99, and negative predictive value was 0.38. The high value of microcolpohysteroscopy in evaluation of the cervix made possible to optimize the treatment mode and adequately employ of minimal invasive therapeutic methods.