IntroductionTo evaluate the rates of complications of pelvic organ prolapse repair and to determine their risk factors.Material and methodsThe study included 677 patients operated for pelvic organ prolapse with trocar guided Prolift mesh. Patients were followed up within 1 and 3 months. A phone interview was conducted and patients with complaints were invited and evaluated in office settings.ResultsMean age was 60 years. For the phone interview, 86.5% of patients were available. Overall complication rates were 22.5% (152/677). Fifteen patients (2.2%) developed bleeding over 500 cc; pelvic hematomas – 5.5%; perineal hematomas – 2.5%; urethral injuries – 0.3%; bladder injury in 1.6%; rectal damage in 0.7% and ureteral trauma in 0.2%.Mesh related complications included: erosions in 4.8%; vaginal synechiae – 0.3%; protrusion of mesh into the bladder – 0.15%; vesicovaginal fistula with mesh protrusion – 0.3%; mesh shrinkage – 1%; dyspareunia and pain in 2.4% cases. Pelvic abscess was found in 0.6% including one case of lethal necrotizing fasciitis. The risk factors of complications were assessed via logistic regression analysis.ConclusionsYounger age, less prominent prolapse, hematomas and concomitant hysterectomies are associated with higher risk of complications.

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Эндометриоз является самым распространен-ным доброкачественным хроническим гинекологи-ческим заболеванием. Известно, что эндометриоз поражает около 10% женщин репродуктивного воз-раста и до 50% женщин, страдающих бесплодием [1]. Влияние эндометриоза на репродуктивную функ-цию женщин остается противоречивым с нескольки-ми предложенными механизмами, оказывающими негативное влияние на репродукцию [2]. Описаны две наиболее точные гипотезы, объясняющие эндо-e-mail: gyn_endoscopy@mail.ru метриозассоциированное бесплодие. Это прогресси-рующее интраперитонеальное воспаление и, как следствие, нарушение анатомических соотношений с формированием массивных спаек в малом тазу [3]. Другая гипотеза -снижение качества ооцитов, на-рушение маточно-трубного транспорта [4,5]. Основ-ной подход к лечению эндометриозассоциирован-ного бесплодия складывается из хирургического эта-па, гормонального лечения и экстракорпорального оплодотворения (ЭКО) или их комбинации [6]. Objective -to evaluate the feasibility of dienogest using after surgical excision of endometriotic focuses by counting the total number of coming pregnancies among the women with endometriosis-associated infertility. Material and methods. This retrospective study included 48 women with surgically confirmed endometriosis. Patients were divided into subgroups: the first group included 18 women with superficialis endometriosis, the second group consited of 23 women with endometriotic cysts, the third group had 7 women with deep infiltrating endometriosis. all patients were given dienogest 2 mg per day postoperatively within 6 months. Results. 31 (64,6%) patients became pregnant and 20 (41,7%) women achieved pregnancies by natural conception, in 5 (10,4%) cases pregnancy was obtained after IvF Conclusions. The combined approach (laparoscopy + dienogest) forendometrios-associated infertility treatment is effective among the patients with different stages of endometriosis (from superficial to infiltrative). Thus, 64.6% of women included in the study became pregnant after the treatment and 40% of women were delivered during the study period.

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