The article presents the clinical features of the complicated course of tumor-like formations of the uterine adnexa in girls, adolescents and young women. The characteristic symptoms of adnexal torsion are described. Topographic and anatomic features leading to torsion of ovarian cysts and uterine appendages, features of the surgical treatment of patients with complicated adnexal torsion are presented. The aim was to study the frequency of occurrence of ovarian tumor-like formations and their complicated course in girls, adolescents and young women, improve early diagnosis and develop optimal methods of conserving surgical treatment of this pathology. Material and methods. The study included 90 girls, adolescents and young women. Patients were divided into three groups. 1 group included 30 young women; the 2nd group consisted of 35 adolescents 13-17 years; 3 group consisted of 25 girls from 2 to 12 years. Diagnostic complex included clinical, special gynecological, comprehensive laboratory, ultrasound (including doppler ultrasound) research, computer and magnetic resonance imaging (if indicated). Results and discussion. The final diagnosis of “Ovarian cyst” was verified in 46 of 90 patients (51,1 %): group 1 – 26 of 30 (86,6 %), in 2 – 18 of 35 (51,4 %), in 3 - 2 of 25 (8 %). It is established that the torsion of the uterine adnexa was detected in 44 of 90 patients: in 1 group – 13,3% of cases (4 of 30 young women), in 2 group – 48,5 % (17 of 35 adolescents), in 3 group – 92 % (23 of 25 girls). 76 surgeries were performed by laparoscopy with preservation of the ovarian reserve, 12 patients were treated conservatively with final diagnosis “Ovulatory syndrome” and “Retention cyst of the ovary”. Conclusions. Ovarian cyst as the cause of abdominal pain is significantly more often diagnosed in young reproductive age than in patients of prepubertal and pubertal age. In girls and adolescent girls with symptoms of acute abdomen the torsion of intact uterine adnexa was significantly more common than in adult patients, due to anatomical features of the internal reproductive organs and more a mobile lifestyle inherent in this age group. Optimal treatment of functional ovarian cyst is complex conservative therapy, surgical treatment of ovarian cysts at a young age is conducted under strict indications, treatment of choice is laparoscopy.
We studied the effect of birth weight on ultrasound parameters of the uterus and ovaries in adolescent girls with gynecological pathology. 65 adolescent girls aged from 10 to 18 years old, who were treated at the surgical department № 4 of the Regional Child Clinical Department, were examined. Study groups were formed according to data relating to gestational weight in terms of low or overweight. The differences in ultrasound scanning of the pelvic organs between the studied groups were revealed. So, with the syndrome of intrauterine growth retardation of the fetus, a lag in ultrasound indicators develops in the postnatal period, and with macrosomia, on the contrary, a tendency to an increase in the size of the uterus and ovaries is revealed. The revealed changes can serve as prognostic criteria in diagnosing the risk of developing disorders of puberty during ultrasound scanning of the internal genital organs of adolescent girls, depending on the body weight at birth. Keywords: epilepsy, affective disorders, rehabilitation, psychoeducation.
Objectives: to determine the features of the uterine cavity in women with extragenital disorders and abnormal uterine bleedings (AUB) using modern diagnostic methods.Materials and methods. The study involved 100 women with AUB and concomitant extragenital disorders, who constituted the main group. The control group consisted of 50 somatically healthy women. Women underwent ultrasound with Doppler mapping, and MRI if indicated to assess the condition of the pelvic organs. Due to the presence of AUB the patients of the main group underwent hysteroscopy and/or separate diagnostic curettage with further morphological assessment of the material obtained.Results. Ultrasound showed that the uterine size in women of the control group corresponded to physiological norms, and the thickness and structure corresponded to the M-echo phase of the menstrual cycle. The main group was additionally divided into subgroups depending on the detected pathological changes in the uterine cavity: endometrial polyp (glandular polyp, adenofibromatous polyp), submucous leiomatous node, endometrial polyp and submucous leiomatous node, endometrial hyperplasia, endometrial hyperplasia in combination with submucous leiomatous node. During the Doppler study the blood flow in the uterine, basal and spiral arteries was analyzed depending on the echographic assessment of the state of the uterine cavity in the main group in comparison with the data of the control group. The patients of the main group were found to have a significant increase in the level of the pulsation index in all the studied vessels in comparison with the corresponding values in the control group (Kruskal–Wallis test, Mann–Whitney test, p < 0.001).Conclusions. The most common disorder of the uterine cavity in women with extragenital diseases and AUB, detected by ultrasound scanning, were polyps of the uterine cavity and endometrial hyperplasia. A feature of blood flow in pathological processes in the uterine cavity was an increase in the pulsation index in the uterine, basal and spiral arteries in women of the main group compared to the control group.
In modern conditions, health problems (somatic, reproductive, mental) of adolescent girls occupy a special place in the health care system, as a reserve in reducing maternal and infant mortality, maintaining the fertility of the expectant mother. The aim. To study the frequency and character of extragenital diseases of adolescent girls with gynecological pathology, born with low and excessive body weight. Materials and methods. The project design is a population-based prospective cohort study. To achieve the goal and the implementation of the tasks, a prospective examination of girls and adolescent girls born with deficiency or excess body weight was carried out. The sample size was 77 people. Additionally, statistical processing was carried out using the Excell software. Results. Thus, the study of somatic health indicates its deterioration in the groups of girls born with polar values of body weight. In groups 1 and 3, infectious diseases were identified, which can serve as a starting point in the development of reproductive system disorders. In girls of group 1, mumps prevailed (20.0%), which could cause damage to the follicular apparatus, while in group 3, girls were more likely to have influenza (25.8%), the virus of which has a damaging effect not only on the structure of the ovaries, but also on endometrium. Conclusions. Comparative analysis of the structure of somatic morbidity made it possible to identify the most significant pathology characteristic of each of the groups. Girls born with a large body weight have an increased risk of endocrine pathology. In girls born with low body weight, somatic diseases associated with manifestations of diseases of the musculoskeletal system prevail. This dictates the need to single out girls born with polar values of body weight in the risk group for the development of somatic pathology and requires complex therapeutic and prophylactic measures.
Incidence of dysmenorrhea in female adolescents was shown to be 28.4 % of all gynecological disorders (41 %). The study involved treatment of 88 girls aged 14-18 by complex of non-hormonal and physiotherapy. The effectiveness of complex non-hormonal therapy for gynecological patients was 76.6-83.3 %. No side effects and complications were observed. For most of patients the positive effect of treatment was preserved for 2-3 months.
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