Vladimir Kalis

Evaluation of the incision angle of mediolateral episiotomy at 60 degrees

To study the angle of mediolateral episiotomy at the time of cut, after primary repair, and 6 months postpartum; and the incidence and severity of perineal pain and anal incontinence 6 months after delivery.

The incision angle of mediolateral episiotomy before delivery and after repair

To assess the relevance of the suture angle when evaluating mediolateral episiotomy, and the safety of the accepted lower limit of 40° for the incision angle.

Clinical evaluation of peripartum outcomes of mediolateral versus lateral episiotomy

To evaluate the incidence and extent of vaginal and perineal trauma among primiparous women after mediolateral and lateral episiotomy.

Anal dilation during labor

To determine the incidence and range of anal dilation during the final phase of the second stage of labor and shortly after delivery; determine whether parity affects anal dilation; and obtain anthropometric data for future projects.

Stereophotogrammetry of the perineum during vaginal delivery.

To analyze deformation of the perineum during normal vaginal delivery in order to identify clinical steps that might be beneficial when executing manual perineal protection.

Borderline papillary serous tumor of the fimbriated end of the fallopian tube with peritoneal implants

Diagnosis of Borderline papillary serous tumor of the fallopian tube was comprehensively established by Zheng in 1996 supported mostly by a histological similarity to its ovarian counterpart. It is a very rare entity with eight cases published so far and the ninth case described here as a 41‐year‐old woman presented with non‐specific lower abdominal pain, dyspareunia and dysuria. Left adnexal mass was identified and she was operated on. It turned out the tumor was attached exclusively to the left tube, with no connection to any of the surrounding structures and with histology of borderline serous tumor with non‐invasive implants in the left and right ovary and visceral peritoneum. Reviewing available data on genetics of these tumors there was diploid status in one examined tumor, and in our case no mutations of KRAS, BRAF and p53 genes were found. Histomorphology remains the mainstay of diagnosis and staging operation is the mainstay of patient management. Prognosis is uncertain with a 6‐year survival documented in one case.

Timing of episiotomy and outcome of a non-instrumental vaginal delivery

The aim of this study was to compare to compare immediate delivery outcome as well as healing, pain, anal incontinence and sexuality in a short‐term and a long‐term follow up after episiotomy performed before or at crowning in nulliparous women.

Anal incontinence severity assessment tools used worldwide

To conduct an international survey of anal incontinence assessment tools and the need to evaluate frequency of occurrence of fecal urgency.

Mediolateral versus lateral episiotomy and their effect on postpartum coital activity and dyspareunia rate 3 and 6 months postpartum

OBJECTIVES Comparison of the effects of two episiotomy types on sexual activity, dyspareunia and overall satisfaction after childbirth. STUDY DESIGN A prospective follow-up study of a randomized comparative trial evaluating peripartum outcome of a vaginal delivery after mediolateral (MLE) or lateral (LE) episiotomy. MAIN OUTCOME MEASURES The participants completed questionnaires regarding sexual activity, dyspareunia, perineal pain, aesthetic appearance and overall satisfaction 3 (3M) and 6 months (6M) postpartum. RESULTS A total of 648 women were available for the analyses (306 MLE, 342 LE). The groups showed no difference regarding resumption and regularity of sex, timing of resumption, frequency and intensity of dyspareunia, perineal pain, aesthetic appearance or overall satisfaction 3M or 6M postpartum. 98.0% of women after MLE and 97.7% after LE resumed sexual intercourse within 6M after delivery (p = 0.74). In the same period 15.6% of women after MLE and 16.1% after LE suffered from considerable dyspareunia (p = 0.86). CONCLUSIONS Quality of sexual life and perception of perineal pain after MLE is equivalent to LE.

Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy

To evaluate short‐term perineal pain among primiparous women after mediolateral episiotomy (MLE) and lateral episiotomy (LE).