Obstetrics, Gynaecology

Anal incontinence represents a distressing and functionally limiting condition, particularly among young women. Its prevalence estimates vary across the literature, and the condition encompasses involuntary leakage of flatus and faeces. According to the Oxford classification, faecal incontinence is divided into congenital and acquired forms.

Obstetric anal sphincter injuries (OASI) Grade III or higher are associated with a tear in the continuity of the anal sphincter. Accurate classification and timely diagnosis are essential for the appropriate management of these injuries. If not properly identified or adequately treated, such injuries may result in complications including gas and faecal incontinence, anorectal dysfunction, or dyspareunia. These conditions can significantly affect a woman’s quality of life and may lead to socio-economic stigmatisation, particularly among young women. Precise sphincter repair and comprehensive postpartum care play a pivotal role in a woman’s recovery and long-term well-being following OASI. This presentation focuses on the classification and diagnosis of OASI, with particular emphasis on the surgical management of obstetric trauma. The individual steps of the procedure are demonstrated on a human cadaver model, and both early and late aspects of postpartum care are addressed.

The insertion of a tension-free vaginal tape (TVT) under the urethra has become the golden standard in the treatment of stress urinary incontinence in women. Stress urinary incontinence represents serious medical and social problem. Surgical treatment of urethra hypermobility or hypotonia has become the optimal treatment option. Mini-invasive vaginal surgical approach is the most effective. This video shows vaginal urethropexis with tension free vaginal tape inserted to obturatory fossa by "inside-out" technique.

The first child after in vitro fertilisation in the Czech Republic was born just at our Department as early as in 1982.