[Photomedicine in gynecology]

In ancient years, knowledge about healing capacity of extracts from plants together with sunshine became evident in medicine. In our days second generation photosensitizers (they stand for plant extracts) and laser light (stands for sunshine) are ready for use in the clinic. Photomedicine recently became a selfstanding clinical area composed of photodynamic diagnosis (PDD) and photodynamic therapy (PDT) as its subdisciplines. Clinical application of photomedicine in gynaecology has been carefully prepared. By a number of experiments using in vitro and in vivo techniques a basis was developed to make possible clinical photomedical applications in gynaecology. In PDD 5-aminolevulinic acid, a stimulator for the production of cellular protoporphyrin IX, was used for the detection of tumour lesions of microscopical dimensions. Another approach in PDD called Frequency Domain Photon Migration technology makes it possible to quantify amounts of hem, water and oxygen in a given (tumour) tissue area. They are different from normal breast tissue. In PDT besides new technological components (diode lasers, light diffusers) there is specific need for new photosensitizers whose wavelength of activation is in the area of near infrared, allowing a better tissue penetration. Very recently, research results indicated that PDT does not create resistance against its own and suggest that this procedure can be used successfully even after radio- and/or chemotherapy. PDT of non-neoplastic but pathological cell proliferation such as endometriosis is very promising. One goal in gynaecology will be a reduction of the number of hysterectomies surgically performed by this minimally invasive approach.