Rehabilitation of women of early reproductive age with a uterine fibroids after surgical treatment

Abstract

DOI: 10.52705/2788-6190-2023-04-9
УДК 618.14-006.36-055.23-053.7-036.65-089-084

The objective: decline of frequency of relapses after operative treatment of uterine fibroids for the
women of early reproductive age on the basis of development and introduction of the improved
algorithm of treatment-and-prophylactic and rehabilitation measures with the use of modern
endoscopic technologies and directed medicinal correction.
Materials and methods. In accordance with the put purpose our researches carried stage-bystage
character. On I the stage (retrospective) the clinical analysis of a 1891 case of operative
treatment of uterine fibroids is conducted. On the II stage (prospective) by us was conducted
complex clinical-and-laboratory and instrumental inspection 100 women with uterine fibroids
under age 30 (basic (1) group), which had a testimony to operative treatment. It was the basic
criteria of including. The basic criterion of exception was malignant new formations of uterus. The
group (2) of comparison was made by 50 women with a uterine fibroids in age from 40 to 50,
which also had a testimony to operative treatment. A control group was made 30 gynaecological
healthy women in age from 20 to 30 years.
Results. The women of early reproductive age have posthemorragic anaemia the basic clinical
displays of uterine fibroids (61,0%); hasty growth of sizes of uterus (51,0%); pain syndrome
(46,0%); violation of menstrual function (43,0%); infertility (18,0%) and miscarriage (10,0%).
To operative treatment of uterine fibroids the women of early reproductive age have large of
tumour additional testimonies (except for clinical symptoms) (middle index – 15,1±1,5 week;
a middle diameter of node is 9,2±0,8 sm); multiplicity of nodes (44,0%); violation of trophism
(43,0%); mainly interstitial (79,0%); subserous-interstitial (24,0%) and interstitial with centripetal
growth (22,0%) localization of myomatous nodes.
The use of the algorithm of rehabilitation measures improved by us allows to normalize a
menstrual function (diminishing of duration is on 30,4%; profusion on 27,8% and to the sickliness
on 29,4%); to decrease the amount of relapses (from 22,0% to 16,0%); sizes of myometrium –
from 573,4±52,8 см3 to 461,5±50,7 см3; to and also to normalize the level of steroid and sexual
of hormones.
Conclusion. With the purpose of decline of amount of relapses after operative treatment of uterine fibroids for the women of early reproductive age it is necessary to crush advantage to the combined oral contraceptives on a draught no less 6 months after operative treatment.
For control after efficiency of rehabilitation measures after operative treatment of uterine fibroids
for the women of early reproductive age it is necessary additionally to take into account the results
of the got immunohistochemical researches of tumour.