Introduction: In over of 99% cases of cervical cancer its appearing is preceded by persistent cervical epithelium infection caused by high-risk oncogenic types of human papillomavirus (HPV). The aim of the study was to examine the distribution of high-risk oncogenic HPV types compared to patohistological diagnoses of cervical diseases in women. Materials and methods: The study included 56 women with suspected premalignant and malignant cervical lesions, due to suspected colposcopic and cytological findings (Papanicolaou test). The HPV typing by "in situ" hybridization method on high-risk HPV types 16, 18, 31 and 33 was performed in all patients from cervical smear as well as cervical biopsy. Histological findings of cervical biopsy was a "gold standard" in the analysis of materials. Results: Histologically detected premalignant or malignant changes of the cervix were found at 34 (60.7%) of all 56 examined women: 17 of them had LSIL, 13 of them had HSIL, while 4 had squamous cell carcinoma. A positive HPV test had a 47 (84%) of them with a prove of the presence of one or more types of HPV. The most common type of virus was HPV 16 and it was detected in 27 (48.2%) women, followed by HPV 31 that was detected in 26 (46.4%) women, HPV 18 in 18 (32.1%) of women and HPV 33 in 4 (7.1%) women. The infection caused by oncogenic type HPV16 was significantly more frequent in patients with HSIL and cervical cancer (p<0,001), while the infection caused by oncogenic type HPV 31 was significantly more frequent in patients with LSIL and cervicitis (p=0,003). The distribution of HPV 18 and HPV 33 types was not statistically significantly different in patients with different histological findings (HPV 18, p = 0.41; HPV 33, p = 1.0). Conclusion: Based on our results we can conclude that there is a good correlation of HPV infection with pre-malignant cervical lesions and cervical cancer. The incidence of HPV type 16 infection increased with severity of cervical lesions and it is usually detected high-risk oncogenic type virus in women with severe cervical lesions type like HSIL and cancer are. HPV 31 is the most common high-risk type of HPV of mild type lesions, like LSIL and cervicitis are. We believe that women infected by high-risk oncogenic HPV types, although without histologically diagnose of cervical lesion, should be more frequent controle by colposcopy and cytology (Papanicolaou) test, because of possible disease progression to a more advanced level.

Vulva can easily be examined, therefore it could be expected that any changes that may emerge at it would be easy
to notice and treat quickly and efficiently. Despite that, the incidence of pre-malignant and malignant changes is increasing.
Many risk factors connected to the emerging of these changes have been discovered, but many explanations have become
available only when the theory of the participation of HPVin oncogenesis has been set. The goal of the study is to identify all
the pathological changes at vulva - benignant, pre-malignant and malignant, according to the age of the patients, and
therefore, both biopsy and operational material collected from 1331 patients treated at GAK “Narodni Front” Belgrade, has been used. There have been 46 diagnoses of benignant changes, of which 20 (43,48%) had been diagnosed as condylomata acuminata, a change including a HPV infection. Most of these changes have occurred at patients aged 31-40. In 17 cases of pre-malignant changes, VIN I has occurred in 2 cases (11,76%), and VIN II and VIN III as more serious pre-malignant lesions were noticed in 8 samples. In 7 cases (41,18%), VIN III was discovered to be moving into a starting invasion phase. It can be concluded that VIN is most often at patients aged over 60. Malignant vulva tumors occurred in 14 cases, 13 of those where diagnosed as invading planocellular carcinoma, and one of them was metastatic. Vulva carcinomas seem to occur most often at patients aged over 60.

Probiotics help to provde optimum balance in the intestines probiotics species competitive blocks toxics substances and growth of unwanted species in their struggle for space and food. Lactogyn is the first oral probiotics wich protects vaginal flora. The most researced probiotic is the Lactobacillus rhamnosssus. The goal of this study is to exam influence of probiotics to cytological smear test including: reliability for easier detection of atypical cells; false positive and false negative test; faster cytodiagnostic; incidence of invasive diagnostic procedures and incidence of intraepithelial and invasive changes of the lower genital tract. This study involved two groups of patient: the first one included 50 patients who has been taken specific probiotic therapy after taking cytological cervical smear test. The second one included 50 patients who has taken specific probiotic therapy before taking cytological cervical smear test. In the second group we discovered: statistically lover number od invasive diagnostic and therapeutic methods and statistically higher number of patients without invasive methods. It was statistical higher incidence of cytological smears with inflammations and ASCUS (atypical squamous cells undetermined significance) in the second group of patients. Lactogyn treatment with other medicament therapy provides: faster and better cytological diagnostic, decreases the number of cytological tests and invasive diagnostics methods per women, decreases the number of false positive and false negative tests and the percent of unsatisfactory tests and borderline satisfactory tests

Apart from great frequency of epithelian, especially preinvasive changes, some very rear diseases common for other lower parts of genital tract (cervix and vulva), are vaginal epithelian changes and especially vaginal intraepithelial neoplasia (VAIN). That's the reason why we don't usually think about this disease, which can have very serious consequences, especially in late discovering of changes in the stadium of invasive malign disease.The aim of this work was to diagnose all pathological changes on vagina: benign, premalign and malign, according to the age of female patients. Biopsy and operative material taken from 1331 female patients treated in Ginecology and Obstetrics Clinic “Narodni front” in Belgrade, were used in this study. The most diagnosed benign changes was condylomata acuminate (42%). Out of 20 cases of premalign changes, VAIN I was diagnosed in 5 cases (25%) as a slight degree of premalign changes, while VAIN II and VAIN III were diagnosed in 5 cases as a severe degree of premalign lesions. Out of 11 cases, there were 3 cases (27.27%) of invasive planocellar vagina carcinoma with histological degree G1N1. 8 cases (72.72%) were with histological degree G2N2, while there were not a single case with histological degree G3N3. Planocellar vagina carcinoma is the most common in the age of 41-50.

Endometrial carcinoma is still one of the most common malignant tumor of the female genital system in the most industrialized countries. Endometrial cancer is due to 3,9% of all female malignant tumors. The occurence of endometrial cancer varies with age. In 75% of all cases endometral carcinoma tipically occurs in postmenopausal women, with the highest incidence between 50 and 59 year. The high frequence of endometrial carcinoma in younger age is also found in women with ovarian estrogen-secreting tumors. About 10% of all endometrial carcinomas also in association with a genetic predisposition, but the most cases of endometrial carcinomas are sporadic. The most important prognostic factors for endometral carcinomas are: clinical stage, age, histopathological type and grade, as wel as hormonal receptors. Younger nulliparous women with early detected well-diferentiated endometrial carcinoma are usually treated by high doses of progesterone. Older women with endometrial carcinoma are usually treated by hysterectomy. Administration of postoperative radiation and chemiotherapy depends on clinical stage.

We tested the performance of telecolposcopy in the diagnosis of various squamous intraepithelial lesions. There were three groups of physicians: Group 1 consisted of 15 gynaecologists who were not trained in colposcopy; Group 2 consisted of six experienced colposcopists (specialists); Group 3 was a supervising team constisting of three experts (colposcopists with more than 15 years of colposcopy experience). The first group took colpophotographs during gynaecological examinations and used a Web browser to compare them with examples from a database of colposcopy findings. Group 2 made their own diagnoses independently. Then the supervising team examined the findings from all 250 patients and made diagnoses that could be considered the ''gold standard''. The findings were identical for Groups 1 and 2 in 219 cases, i.e. an inter- observer agreement of 88%; Cohen's kappa was 0.81. The findings were identical for Groups 1 and 3 in 208 cases, i.e. an inter- observer agreement of 83%; Cohen's kappa was 0.74. The findings were identical for Groups 2 and 3 in 239 cases, i.e. an inter- observer agreement of 96%; Cohen's kappa was 0.93. There was high inter- observer agreement between all participants. However, there were also significant differences in some cases. In the cases of suspected invasive carcinoma, 2 the results showed a significant difference (x =4.8, p < 0,005) because gynaecologists from Group 1 were not sure of their diagnosis and they wanted to obtain a second opinion by referring the decision to a higher level.

Today it is noticeable that the incidence and mortality from cervical carcionoma increases, especially the growth of
frequency of those changes at younger women. The total number of diagnosis of invasive carcinoma at the processed biopsy and operative matrials was 186. The majority of results were the histological grade G1 N1 54,83% in the group of 41-50 years old patients, and the less significant was number of histological grade G2 N2 at the age 51-60 and G3 N3 at patients over 60 years old. In 72 cases the radical surgical treatment was done after previously made HP diagnosis of planocellular carcinoma on the biopsy material, and it was done in the cases that were operable in stage Ib (FIGO). The most of operated women were with histological grade G1 N1, so we followed in what degree the size of tumor, beside the histological grade G1 N1, so we followed in what degree the size of tumor, beside the histological grade, have an effect on the possibility of presence of the metastasis in regional lymphatic nodes. We came to the conclusion that with the growth of macroscopically size of tumor, the frequency of appearance of lymphatic nodes increases. Those parameters could not the small number of operated cases. When the disease is discovered in these histological grades. It is not operable, and then we perform radiotherapy as a method of treatment.

Condylomata gigantea is an expansive, destructive lesion that affects most frequently anal and perianal region, and
rarely vulvar and vaginal region. We will describe a clinical case of a 28 years old female patient with a diagnosis of Condylomata gigantea in anal and perianal region with propagation on vulva, vagina and clitoris. After we detected a wide base of condylomas in anal and perianal region, we performed a deep, multiple biopsy for discover of eventual malignancy.
Histologically, malignancy was not confirmed, but it was discovered a presence of HPV types 6 and 11. The patient was initially treated with a wide surgical excision, and then the rest of condylomas were removed using CO laser which had an 2
haemostatic function in the same time. Three months later, there was no recurrence.