When surgically treating SUI with a TOT, incision at the mid-urethra using the 1/2 rule is recommended as it leads to better outcomes for most patients, particularly those with normal urethral mobility.

The reduced cure rate for ISD patients was due to the subgroup with a hypomobile urethra. A prospective study is needed to confirm that slightly shorter tape-urethra distances and a relative tape position more toward the mid-urethra will lead to better outcomes for this patient group.

No abstract

Diagnosis and treatment of ectopic cesarean scar pregnancy has become a challenge for contemporary obstetrics. With an increase in the number of pregnancies concluded with a cesarean section and with the development of transvaginal ultrasonography, the frequency of cesarean scar pregnancy diagnoses has increased as well. The aim of the study is to evaluate various diagnostic methods (ultrasonography in particular) and analyze effective treatment methods for cesarean scar pregnancy. An ultrasound scan, Doppler examination and magnetic resonance imaging are all useful in early detection of asymptomatic cesarean scar pregnancy, thus enabling effective treatment and preservation of fertility. Dilatation and curettage is not recommended as it carries significant risk of bleeding and very high risk of hysterectomy and fertility loss. Systemic methotrexate treatment should not be applied on the routine basis due to its low efficacy, high risk of fertility loss and adverse effects. Local methotrexate therapy (under ultrasound or hysteroscopy guidance) should be considered a perfect management method as it offers fertility preservation in asymptomatic pregnant patients without concomitant hemodynamic disorders. Synchronous usage of several treatment methods is an effective way to manage cesarean scar pregnancy. The combination of local methotrexate with simultaneous aspiration of gestational tissues under ultrasound or hysteroscopy guidance seems optimal. Subsequently, the remaining gestational tissues can be removed hysteroscopically in combination with vascular coagulation at the implantation site. In more advanced cases, local methotrexate treatment should be considered followed by laparoscopic or laparotomic wedge resection with subsequent surgical correction of the cesarean section scar.

Long urethral funneling (> 50% of urethral length) seems to be a characteristic sign for SUI in women. The presence of urethral funneling shorter than 50% of urethral length (short urethral funneling) is not a SUI symptom - it is probably a sign of asymptomatic funneling of bladder neck.

There is an almost perfect inter-examiner agreement of the S-POP system for the overall stage and each point within the system.

Objectives: The aim of the study was the evaluation of repeatability and reproducibility of chosen urethral neck mobility measurements obtained during introital pelvic floor sonography performed with a 2D transvaginal probe. Material and methods:In order to assess the repeatability and reproducibility, independent measurements on the ultrasound image were taken by two specialists on 92 female patients at rest and at strain (Valsalva maneuver). 2D ultrasound examination was performed introitally with a transvaginal probe (PFS-TV). The location of the urethral internal orifice was defined with coordinates of two points. Point CI marks the urethral anterior edge visualized on ultrasound as closer to the pubic symphysis. Point CII marks the posterior edge visualized more peripherally from pubic symphysis.Results: Repeatability and reproducibility measurements of point CI location and mobility were good and very good (0.6710-0.9961), while of point CII -were medium, good and very good (0.5738-0.9944). Point CI was clearly visible in all cases. It was not possible to accurately mark point CII in 4.3-17.4% of cases. Conclusions:The possibility to visualize point CI in every single case with very good and good repeatability and reproducibility of measurements of this point's location and mobility allows the usage of CI point as a universal reference point for evaluation of bladder neck mobility and position during PFS-TV in the clinical practice and for research purposes.

The social aspect of overactive bladder syndrome (OAB) and the lack of objective diagnostic methods for this syndrome have spurred research into its potential biomarkers which can constitute useful diagnostic tools, while also allowing the evaluation of the intensity of clinical symptoms and the efficacy of implemented pharmacotherapy in OAB patients. Due to the complex etiopathogenesis of this syndrome, the researchers are seeking biomarkers connected with inflammation or nerve growth. The aim of this review was to analyse the latest literature data regarding potential biomarkers in OAB. The most promising opportunities are connected with the diagnostic use of the nerve growth factor (NGF), the brain derived neurotrophic factor (BDNF), C-reactive protein (CRP), prostaglandins and cytokines. Despite the most promising results to date having been obtained with regards to neurotrophic factors, it seems that, at the moment, none of these meets the criteria for becoming an isolated OAB marker. It is also suggested that the combined use of several biomarkers will facilitate obtaining the appropriate level of specificity and selectivity to allow their use in clinical practice.