Objective. To study the condition of the pelvic organs in women of reproductive age with uterine leiomyoma UL, depending on the type of treatment based on ultrasonographic monitoring.Materials and methods. 299 women of reproductive age were examined. Patients were divided into 3 groups: 1 group consisted of 159 women with uterine leiomyoma (UL) who underwent surgical treatment, 2 group – 120 women with UL who underwent conservative treatment, 3 control group consisted of 20 healthy women of reproductive age. In order to obtain the most complete information about the size of the uterus, the structure and topography of myomas, the features of their vascularization, patients underwent ultrasound before and 3 months after treatment.Results. Ultrasound examination of the average parameters of the uterine body in the main groups showed an excess of these indicators relative to the control group (3.2 times in group 1 and 1.3 times in group 2). Uterine volume was greater in women of group 1 compared with women of groups 2 and 3 (p <0.05). In most cases, in 139 (49.0%) women of the main groups, the localization of fibroids was intramural with central growth, without changing the configuration of the uterus from the outside and was not deformed cavity. Whereas, intramural nodes with centripetal growth deformed the uterine cavity in 39 (14.0%) cases, and centrifugal - in 100 (36.0%) subjects - its contour. Mixed and central types of angioarchitectonics were characteristic of women with the largest uterine sizes. In dynamic ultrasound examination in women after conservative myomectomy who did not receive hormone therapy, the level of myometrial perfusion was higher than in those who received gonadotropin-releasing hormones before and after treatment, which may be more prognostically favorable for UL recurrence. Women in group 2 after receiving conservative treatment had a positive tendency to reduce the volume of the uterus and fibroids.Conclusions. Ultrasound diagnostics can be considered a highly informative, non-invasive method that helps to identify the presence, location, structure, size of the myoma, the presence of concomitant pathology of the pelvic organs, as well as in addition to Doppler color flow mapping and pulsed Doppler blood allows us to detect the presence of tumor blood circulation. Echographic and Doppler evaluation of uterine leiomyoma with peculiarities of vascularization in the diagnostic algorithm helps to differentiate the choice of the method of treatment (conservative or surgical).
The objective: of the study was to study the microbial vaginal tract in women with infertility, who had undergone surgical treatment on the uterine appendages. Materials and methods. An examination of vaginal discharge on flora and STIs was conducted in 120 women of reproductive age with infertility and benign ovarian formations, ectopic pregnancy, which was organ-retained surgical intervention on the appendages of the uterus. Of these, 76 (1 group) patients were surgically treated in a planned manner, 44 (in 2 groups) – in urgent cases. Results. Inflammatory diseases of the genital area were more common in women with infertility, who had surgical treatment in an urgent manner than in women of group 1 (p<0.05), especially inflammatory diseases of the cervix – almost twice as likely as in group 1. The vaginal microbial examination of women with infertility who were hospitalized for surgical treatment in an urgent manner indicates a significant imbalance between the parameters of contamination of the genital tract by conditionally pathogenic and normal microflora. This, above all, was manifested by the high frequency of determination in women of the 2nd group of representatives of optional aerobes and anaerobes (p<0.05). The concentration of facultative-aerobic and anaerobic microorganisms was in patients of the 2nd group, mostly of high degree of microbial dissemination, and in women of the 1 group, medium and low. STIs were found mainly in association with anaerobic and aerobic microorganisms in patients who were operated in an urgent manner. Conclusion. It is necessary to correct the vaginal biotope in women with infertility before surgical treatment – to promptly influence pathogenic microorganisms with antimicrobial agents and restore physiological vaginal microbial vagina. Key words: women, infertility, vaginal microbial, appendages of the uterus, surgical treatment.
The objective: the study of the psychoemotional state in women with infertility, who underwent surgical treatment on the uterine appendages in the planned and urgent order. Materials and methods. 120 women of reproductive age with a tubal peritoneal factor of infertility and benign ovarian formations, an ectopic pregnancy, who underwent organ-preserving surgical intervention on the uterine appendages (the main group) were examined. Planned surgical treatment was performed in 76 (63.7%) of the examined main group (group 1); In urgent order, 44 (36.7%) patients of the main group (the second group) underwent surgical treatment. Depending on the access, laparoscopy (LP) with the use of monopolar or bipolar electrosurgery was performed in 54 women of the 1st group and in 24 patients of the 2nd group, and laparotomy (LT) in 22 patients of the 1st group and in 20 patients - 2 nd group. The control group included 20 patients with reproductive function without infertility (3rd group). Twenty women of reproductive age with infertility without surgery entered the comparison group (group 4). Results The article examines the effect of surgical treatment on the uterine appendages in 120 women with infertility on the psychoemotional state depending on the planned nature of the surgical intervention. Women who underwent surgical treatment in urgent order found that pronounced depression and neurotic manifestations are closely related to sleep disturbances, decreased mood, crying, irritability. Conclusion. A month after surgery, depression, anxiety, nervousness decreased, which indicates positive changes in the mental state of patients and an improvement in the state of internal comfort as a result of the recovery of somatic well-being, increased optimism and self-confidence, which is the result of cosmetic effect and organ-preserving surgical treatment. Key words: infertility, operations on the appendages of the uterus, psychoemotional state
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