CHANGES IN SEX LIFE AFTER CHILDBIRTH

Background: Childbirth is major event in the life of closer and extended family. The aim of this study is to explore sex desire after childbirth and challenges for usual rhythm of intercourse. Subjects and methods: We studied 113 women who filled up questionnaire at the follow up examination. Inclusion criteria were: all women were secundigravidae and time between pregnancies was more than a year. Women anonymously filled out a survey with question on the time before first intercourse after delivery, frequency of sexual intercourse after delivery, sexual desire after delivery, sexual desire of partner after delivery, reasons for postponing sexual intercourse after delivery and frequency of intercourse in the first year after delivery. Results: Most women had same number of intercourse after delivery like before pregnancy (Hi-square test: Ȥ2(2)=22.04, p<0.0001). Significant proportion of women find their partners sexual desire to be the same like in the pre-pregnancy period (H i- square test: Ȥ2(2)=64.64, p<0.0001). Most women had intercourse once a week (several times a month) during first year after delivery (Hi-square test: Ȥ2(3)=91.93, p<0.001). Fatigue, sleep deprivation, bad mood and lack of time are the most common reasons for intercourse postponement. Most women find life conditions to be very good. They do not find that they neglect their children and partners find them attractive. Conclusion: Sex life after delivery is still taboo in most countries. Women should have the information that sex life after delivery will turn to normal after a certain time

Klinička vrijednost transvaginalne ultrasonografije u usporedbi s histeroskopijom i histopatološkom analizom kod dijagnoze endometralnih abnormalnosti

The aim of our retrospective study was to compare the performance of transvaginal sonography in relation to histologic diagnosis of samples obtained by hysteroscopy through analysis of data collected over 16 years. Data on suspected formation of endometrial polyp or submucosal fibroid found on ultrasound examination were extracted. The study included a total of 3679 women examined during the 2000-2015 period. All women underwent ultrasound examination preoperatively for better planning the type and scope of operation to be performed. The study included only women with samples for histopathologic analysis collected during the operation. Ultrasound diagnosis of polyps compared with histology showed 89.6% sensitivity and 39.1% specificity. For submucosal myomas, sensitivity was 69.2% and specificity 91.3%. In conclusion, ultrasound is not reliable method for definitive diagnosis but it is an excellent orientation method.Cilj ovog retrospektivnog istraživanja je bila usporedba pouzdanosti transvaginalnog ultrazvuka u odnosu na histološki nalaz dobiven histeroskopijom kroz analizu podataka skupljenih tijekom 16 godina. Podatci o suspektnim endometralnim polipima i submukoznim miomima primijećenim na ultrazvučnom pregledu su izdvojeni. U istraživanje je uključeno 3679 žena pregledanih u razdoblju od 2000. do 2015. godine. Svim ženama je učinjen prijeoperacijski ultrazvučni pregled radi planiranja tipa i opsega zahvata. U istraživanje su uključene samo žene kojima je uzet histološki uzorak tijekom operacije. Ultrazvučno utvrđeni polipi u usporedbi s histološkim nalazom pokazali su osjetljivost od 89,6% i specifičnost od 39,1%. Za submukozne miome utvrđena je osjetljivost od 69,2% i specifičnost od 91,3%. Može se zaključiti kako je ultrazvuk nepouzdana metoda pri donošenju konačne dijagnoze, ali odlična orijentacijska metoda

Cytologic Follow-up in Patients with CIN Treated by LLETZ, Cold Knife Conization and Semm’s Cold Coagulation

Management of cervical premalignant lesions starts with abnormal Pap smear. Regular screening of asymptomatic women (the Pap smear) allows us to diagnose and treat preinvasive lesions before they progress to cervical cancer. There is a wide variety of ablative and destructive methods used in treatment of cervical premalignant lesions. In this study we have compared follow-up cytology results in patient groups treated by LLETZ (Large Loop Excision of the Transformation Zone), Cold Knife Conization (CKC) and Semm’s cold coagulation (Electrocoagulation, ECG) according to CIN on target biopsy specimen, and definite therapeutic approach according to patient age, parity and lesion grading. The aim was to evaluate therapeutic success in all three patient groups on the basis of control cytology findings. Normal cytology findings after treatment were recorded in 43 women in LLETZ group (88%), 22 women in CKC group (73%) and in 22 women from the Semm’s cold coagulation group (73%). The importance of the use of diagnostic and therapeutic guidelines and regular follow up is emphasized, bearing in mind primarily the young female population with severe preinvasive lesions of uterine cervix. Treating cervical preinvasive lesions offers an excellent opportunity to prevent the occurrence of cervical cancer in the large majority of women with abnormal cervical smears

SECULAR CHANGES IN EDUCATION, URBAN-RURAL LIVING, MENARCHE AND ABORTION RATES IN PERINATAL POPULATION

Over a 25-year period we examined the anthropological characteristics of mothers and their partners, such as the place of living: urban vs. rural, the degree of education, parity, the time of menarche, and the frequency of intentional abortions. We examined 2 414 mothers and their partners in four periods of time extending from 1985 to 2009 in order to establish changes in the said anthropological characteristics over a period of 25 years. The degree of education of mothers and their partners is on the rise. In the period from 1985 to 1994, the percentage of mothers from the country was on the rise. Women with less education have on average more children, and those with better education the least children. Women from rural areas have on average more children than women from urban areas. The time of menarche dropped by 9 months over the period of 25 years. Girls from urban areas have their first menstrual cycle earlier. Women with higher professional qualifications had their first period earlier. The number of intentional abortions over the 25-year period dropped

Patohistološki nalazi kod žena podvrgnutih histeroskopskoj resekciji endometralnih polipa i mioma maternice

The aim of our study was to determine the prevalence of endometrial premalignant and malignant lesions in women undergoing hysteroscopy and to identify anthropologic factors related to the presence of malignancy. Data on 3470 women with submucosal myomas or endometrial polyps suspected on ultrasound were retrospectively analyzed. Hysteroscopy was performed in all these women in order to make a more precise diagnosis. Histologic analysis of endometrial samples obtained during hysteroscopy was used to confirm the diagnosis. Statistical analysis was performed using the SPSS 20.0.0 software. The mean age of study women was 49.1±13.3 years. The number of procedures performed due to the referral diagnosis of endometrial or submucosal myoma significantly increased over the 16-year study period. A significantly higher number of women had a benign histopathologic diagnosis. Histologic analysis revealed malignancy in 67 women. The youngest woman and oldest woman with malignant findings was aged 32 and 75, respectively. A significantly higher number of women with atypical hyperplasia and malignancy were in menopause. A comparable number of women with different histologic findings lived in urban and rural areas. There were a significantly larger proportion of widows among women with the histologic diagnosis of atypical hyperplasia or malignancy. The prevalence rate of malignancy in women having undergone hysteroscopy for polyps and myoma found by ultrasound was 1.93%. Postmenopausal status and older age were associated with an increased risk of malignancies, but premalignant changes and malignancies were also found in young and premenopausal women. Therefore, diagnostic hysteroscopy can be recommended in women of all age groups.Cilj ove studije bio je odrediti učestalost endometralnih premalignih i malignih lezija nakon histeroskopije te identificirati antropološke čimbenike povezane s malignitetom. Retrospektivno su analizirani podaci za 3470 žena s ultrazvučnom sumnjom na submukozni miom ili endometralni polip. Svim ženama je učinjena histeroskopija kako bi se dobila precizna dijagnoza. Uzorci iz endometrija dobiveni histeroskopijom poslani su na histološku analizu. Statistička analiza učinjena je primjenom programa SPSS 20.0.0. Prosječna dob žena u studiji bila je 49,1±13,3 godine. Broj zahvata zbog uputne dijagnoze endometralnog ili submukoznog mioma značajno je porastao u šesnaestogodišnjem razdoblju trajanja studije. Značajno veći broj žena imao je benignu histopatološku dijagnozu. Histološka analiza pokazala je malignitet u 67 žena. Najmlađa i najstarija žena s malignitetom imale su 32 i 75 godina. Značajno veći broj žena s atipičnom hiperplazijom i malignitetom bio je u menopauzi. Usporediv broj žena s različitim histološkim nalazima živio je u urbanim i ruralnim sredinama. Bio je značajnije viši udio udovica s dijagnozom atipične hiperplazije ili maligne bolesti. Učestalost malignosti kod žena kojima je učinjena histeroskopija zbog ultrazvučnog nalaza mioma ili polipa bila je 1,93%. Menopauza i starija dob bile su povezane s povišenim rizikom za zloćudne bolesti, ali premaligne i maligne promjene nađene su i kod mladih i premenopauzalnih žena. Stoga se dijagnostička histeroskopija preporuča u svim dobnim skupinama

Rupturirana tubarna trudnoća, dermoidna i endometriotična cista te tuboovarijski apsces na istim adneksima

A 32-year-old pregnant woman presented to the hospital with abdominal pain and minimal vaginal bleeding. Transvaginal ultrasound revealed visible fluid in pelvic region with suspected tubal rupture, and subsequently laparoscopy was performed. During laparoscopy, additional gynecologic pathologies were noticed. Histopathologic finding showed dermoid and endometriotic cyst, as well as tubo-ovarian abscess in the same adnexa. This case report highlights the necessity of considering multiple diagnoses in the same organic system, which may be encountered by surgeon and histopathologist.Tridesetdvogodišnja trudnica primljena je u bolnicu zbog bolova u abdomenu uz minimalno vaginalno krvarenje. Transvaginalnim ultrazvukom ustanovljena je slobodna tekućina u zdjelici te je učinjena laparoskopija kojom je otkrivena višestruka ginekološka patologija. Histopatološki nalaz je uz rupturiranu tubarnu trudnoću ukazao na istodobno postojanje dermoidne, kao i endometriotične ciste te apscesa jajovoda i jajnika. Ovaj prikaz slučaja ukazuje na mogućnost postojanja višestruke patologije na istom organskom sustavu, što bi operater i patolog trebali imati na umu u procjeni opsega operacijskog zahvata

Detection of Ovarian Cancer by Determination of Ca 125 in Different Patohistologycal Types of Tumor According to Age

During the eighteen-year period in »Sestre milosrdnice« University Hospital Center, Zagreb, 271 women with ovarian tumor was studied. 229 women with ovarian cancer and 42 with borderline tumor. The pathohistological types of tumors were different. The age of the patients ranged from 20–83 years. In all patients the value of biochemical marker CA125 was determined. The aim of this study was to determine the usefulness of CA125 measurement in different age groups and in different patohistologycal forms of tumor. CA125 has proven to be positive in 89.1% of women with ovarian cancer and in 62% with neoplasm of low malignant potential. The higher values of CA125 were detected in younger women with lowmalignant tumor potential. Serous and metastatic tumor types were also associated with higher values of CA125