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Background Photodynamic therapy has been gaining popularity, particularly among young women. Therefore it is crucial to evaluate PDT for safety and its impact on fertility and delivery of healthy newborns. Objective The study analyzed the PDT treatment of 10 young women, who suffered from diseases of the vulva and cervix. The aim of the analysis was evaluating what impact PDT treatment had on their pregnancies and delivery. Methods 10 patients (22–32 years of age, 25.5 years of age on average) were treated with PDT in 2007-2014. 2 patients suffered from squamous cell hyperplasia, 2 patients from vulvar lichen sclerosus, 1 – genital warts, 1 - VIN I (current terminology: LSIL/Flat condyloma), 2 – CIN III (HSIL), 2 - CIN I (LSIL). The patients underwent photodynamic therapy (PDT). In the course of PDT the 5% 5- aminolevulinic acid was used in gel form three hours before irradiation. The affected areas were irradiated with a halogen lamp PhotoDyn 501 (590–760 nm) during a 10-min radiation treatment. The treatment was repeated weekly for 10 weeks. Results The median observation time period between the end of therapy and delivery was 3.92 years (2–7 years). None of the patients suffered from infertility. All patients gave birth to healthy, full-term infants. In case of one pregnancy cervical cerclage was needed. Two patients were treated for hypothyroidism caused by the Hashimoto disease. One patient had gestational diabetes. Two patients had already given birth to 2 children. Five patients gave birth by caesarean section. Conclusion Topical PDT selectively used for treating the diseases of the female reproductive organs was applied in our group of patients and proved to be a safe method. It had no apparent negative impact on female fertility and allowed these women to give birth to healthy children.

Background The association between lichen sclerosus (LS) and human papilloma virus (HPV) infections remains unclear. The co-occurrence of both pathologies may impact treatment and prognosis. This study aimed to assess the results of photodynamic therapy (PDT) for vulvar LS and the effect of incidence of HPV infection on the results of treatment and duration of remission. Methods A total of 73 patients with LS were included in the study. In each patient, 14 types of HPV were detected. PDT was performed using the PhotoDyn 501, which emits light at 630 nm wavelength and power density of 204 mW/cm². Focal lesions were exposed for 10 min once weekly for a total of 10 weeks. The complete treatment cycle was repeated after 3 months, whenever required. The biopsy was repeated after completion of treatment. Results The number of treatment cycles for HPV-positive and HPV-negative patients were not statistically different (cases after one or two PDT cycles). An exception was a group of patients with LS requiring three PDT cycles. Analysis of remission period considering HPV results (positive vs. negative) did not reveal a significant statistical difference. Mean remission period among HPV-negative patients was longer in comparison to remission time for those with positive HPV results (14 ± 9 vs. 11 ± 9 months). Conclusions PDT may be a promising, effective, and safe method for the treatment of LS regardless of HPV infection.

Introduction Cervical cancer is one of the most frequent malignant neoplasms in females. Such neoplasms can be almost completely eliminated by means of adequate primary and secondary prophylaxis. The most developed countries focus their attention on the improvement of prophylaxis systems, test quality, and efficacy improvement, as well as on the expansion of the primary prophylaxis. In Poland, the discussions focus on the improvement of the malfunctioning population programme. Objective Drawing on recent research findings, the article presents current Polish and global recommendations with regard to screening tests for cervical cancer. The results of the Population Programme of Prophylaxis and Early Detection of Cervical Cancer are discussed in the context of current trends of healthy behaviour among women inhabiting rural areas. Description of the state of knowledge In the future, it will be relevant to increase the number of human papillary virus (HPV) tests as part of the prophylaxis programme, especially among the high risk patient group. In particular, there is a necessity to increase the number of vaccinations among young women, especially before the beginning of their sexual activity, as well as to establish new strategies of secondary prophylaxis in this group. At present, women who had been vaccinated should undergo routine screening. In Poland, the report based on SIMP registry (IT System of Prophylaxis Monitoring), shows that only 27% of the 3.3 million of invited women participated in the cytology tests. The data analysis shows that women living in rural areas more often respond and participate in the tests, compared to women living in the cities (39.3% vs. 16.8%).

Background Vulvar lichen sclerosus is a chronic and incurable disease that causes various unpleasant symptoms and serious consequences. Objective The purpose of the study was to assess the effectiveness of photodynamic therapy in the treatment of vulvar lichen sclerosus. Methods Participants in the study included 102 female patients aged 19–85 suffer from vulvar lichen sclerosus. The patients underwent photodynamic therapy (PDT). In the course of PDT the 5% 5- aminolevulinic acid was used in gel form. The affected areas were irradiated with a halogenic lamp PhotoDyn 501 (590–760 nm) during a 10-min radiation treatment. The treatment was repeated weekly for 10 weeks. Result PDT has brought about a good therapeutic effect (complete or partial clinical remission), with 87.25% improvement rate in patients suffering from lichen sclerosus. The greatest vulvoscopic response was observed in the reduction of subepithelial ecchymoses and teleangiectasia (78.95%), and the reduction of erosions and fissures (70.97%). A partial remission of lichenification with hyperkeratosis was observed in 51.61% of cases. The least response was observed in the atrophic lesions reduction (improvement in 37.36% of cases). Conclusion Our patients suffering from vulvar lichen sclerosus demonstrated positive responses to photodynamic therapy and the treatment was well tolerated. Photodynamic therapy used to treat lichen sclerosus yields excellent cosmetic results.

The paper presents the frequency of conducting relaparotomies and discusses indications for reoperations after primary gynecologic surgeries due to oncological...