Aim of the study Lateral episiotomy is a widely used procedure, although it is rarely mentioned in the literature and its effects on the pelvic floor are largely unexplored. The purpose of this study is to evaluate the impact of lateral episiotomy on the incidence of urinary incontinence (UI) after vaginal delivery in primiparas. Material and methods The study design is a prospective cohort study. The primiparas were divided into two groups. The first group consisted of women who gave birth with lateral episiotomy, while the second group included women who gave birth with an intact perineum or with perineal tears of first and second degree. Assessments of UI were performed at 5 and 8 months after childbirth using the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) questionnaire followed by the stress test. Results The results revealed no significant differences (p > 0.05) in emergence of stress urinary incontinence (SUI) between the groups at the two time points. There were no statistically significant differences in overall rate of UI, urge urinary incontinence (UUI), or mixed urinary incontinence according to the ICIQ-SF questionnaire. The overall incontinence rate on the first examination was 24% in the episiotomy group and 36% in the perineal laceration group, although the difference was not statistically significant (p = 0.064). On the second examination, rates were similar and without a statistically significant difference. Conclusions Lateral episiotomy has a neutral effect on the onset of UI in primiparous women in the first year after delivery.

Background: In pediatric and adolescent gynecology, ovarian-sparing surgery (OSS) is an approach for preserving the ovaries affected by tumors and torsion during surgical treatment. Materials and Methods: We analyzed participants from a tertiary Gynecology and Obstetrics University Hospital. Participants were patients <19 years of age with adnexal tumors managed surgically with removal of pathologically confirmed ovarian tissue in the period from 2008 to 2017. Results: The average age of 38 patients who underwent surgery for adnexal tumors and were included in the study was 16.78 ± 2.15 years, from 12 to 19 years, with significantly younger patients in the salpingo-oophorectomy/oophorectomy and laparotomy group (P = .036 and P = .001). The laparoscopic approach was performed in 28 (73.68%) patients and laparotomy in 10 (26.31%) patients (P < .0001). Cystectomy was performed in 29 (76.31%), oophorectomy in 1 (2.63%), and salpingo-oophorectomy in 8 (21.05%) patients. A significantly higher number of patients underwent OSS with laparoscopy in scheduled surgical procedure and emergency surgery groups (P = .021 and P = .028). Benign ovarian tumors were found in 31 (81.57%), borderline in 3 (7.89%), and malignant in 4 (10.52%) patients. Conclusion: Our study has shown a high trend in OSS using the endoscopic approach in management of adnexal tumors despite the fact that the management was done by general gynecologists.

Tvrtko Tupek, Analena Gregori c, Dino Pavokovi c, Anis Cerovac and Dubravko Habek Department of Obstetrics and Gynecology, Clinical Hospital ,,Sveti Duh“, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Obstetrics and Gynecology, General hospital Virovitica, Virovitica, Croatia; Department of Obstetrics and Gynecology, General hospital Te sanj, Te sanj, Bosnia and Herzegovina; Department for Anatomy, University of Tuzla School of Medicine, Tuzla, Bosnia and Herzegovina; Department of Obstetrics and Gynecology, Croatian Catholic University, University of Zagreb, Zagreb, Croatia

Clinic for Gynaecology and Obstetrics, University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina School of Medicine, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina Department of Gynaecology and Obstetrics, General Hospital Tešanj, 74260 Tešanj, Bosnia and Herzegovina Gynecology Centre "Dr Mahira Jahic" Tuzla, 75000 Tuzla, Bosnia and Herzegovina University Department of Gynecology and Obstetrics, Clinical Hospital, "Sveti Duh", 10000 Zagreb, Croatia School of Medicine, Croatian Catholic University Zagreb, 10000 Zagreb, Croatia

Increasing the incidence of caesarean section is not in line with professional and deontological guidelines. Elective cesarean section prevents primordial prevention of chronic cardiovascular, gastrointestinal, imunological, endocrinologicalmorbidity by peripartal programming. Elective non-medical indicated caesarean section is not a procedure that respects deontological, clinical etics, scientific and professional principles. It is like an unacceptable surgery outside the scope of medical ethics. Clientelism in high-risk clinical obstetric medicine is not a professional and deontologically correct category: a physician shouldnotbeaprovider on request of healthypregnant women with the potential to have a medically incorrect procedure and complications associated with it and to put a healthy pregnant/maternity and child status in the patient's status. Thefinancial, social, political and cultural components must not outweigh good clinical practice and themoral principles ofmedicine.

Balneo-gynaecological treatment methods include external bath hydrotherapy, sedentary baths and topical dressings/cataplasm, and internal (intravaginal or intrarectal use of peloids and mineral water). Hyperosmolar thermal spas have been very popular in the treatment of infertility due to the improvement of symptoms of chronic pelvic pain, endometriosis, chronic vascular and inflammatory pelvic diseases. Acute pelvic inflammatory syndrome is a contraindication for balneo-hydrotherapy while hyperthermal hydrotherapy is contraindicated in endometriosis and neurovegetative dystonia due to the stimulation of hyperemia, which worsens the clinical picture. Balneo-hydrotherapy is not recommended in metrorrhagia and malignancies. Balneogynaecological treatment certainly has its own primary but also complementary role in the treatment of chronic gynaecological diseases and is increasingly recommended today.

Background: Amniocentesis (AC) is the most commonly used invasive prenatal test. The aim of this study was to determine which were the most common indications for AC, chromosomal abnormalities in relation to the age of the mother and complications as a result of AC. Methods: This is a retrospective thirteen-year cohort study including pregnant women who underwent AC in the period from 2008 to 2020. Patients were divided into two groups: below and above 35 years of age of mother at the time of AC. Results: During study period 2213 AC were performed, out of which 759 (34.29%) were in mother below, and 1454 (65.70%) above 35 years of age (p < 0.00001). The most common indication for AC in group above 35 years of age was advanced maternal age (93.9%), in group below 35 years of age was familial chromosomal diseases (29.91%). In all indications there is a statistically significant difference between the two age groups of pregnant women, all these indications are more prevalent in the group of pregnant women younger than 35 years (p < 0.00001). The most common chromosomal abnormalities in both groups was Down syndrome from numerical aberrations, and from structural inversion of chromosome 9. Short term complications were spontaneous abortion in 26 (1.17%), missed abortion in 4 (0.18%) and premature rupture of membranes in 4 (0.18%) cases. Conclusion: Advanced maternal age, demonstrated the strongest association with the uptake of AC, trisomy 21 was the most prevalent abnormal finding. Complications of AC are not significant compared to the general population of pregnant women.

Background: Leiomyomas comprise 0.5%–1% of all benign ovarian tumors and occur between adolescence and postmenopause; ∼ 80% have been reported in premenopausal women. These tumors are very rare, an...