Comparative aspects of different methods surgical treatment of the combined pathology of uterus

Abstract

DOI: 10.52705/2788-6190-2024-01-09
UDC 618.14-006+618.14-007.415]-089

The objective: to learn the comparative aspects of different methods of surgical treatment of the
combined pathology of uterus.
Materials and methods. 362 women are plugged in research, that has signs of adenomyosis
and uterine fibroids. To the operation the followings symptoms served certificates: subjective
complaints of patient about a pain syndrome, irregular bloody protracted excretions (bleeding)
from sexual ways, abdominal discomfort, related to disfunction of nearby with an uterus organs.
At laboratory control to the basic certificates the presence of protracted chronic anemization
served to operative interference, to the uncomplying pharmacological correction. In an obligatory
order to all patients ultrasonic research of organs of small pelvis was conducted with the coloured
Doppler lodging of uterine vessels.
Results. It is discovered that increase of volume of organ which retires, the risk of damage of
urinoexcretory ways increases time of operation laparoscopic access (р<0,05). The use of vaginal
access is increased by the risk of forming of dispaurenia for patients with the large organ size
which retires, and at the increase of time of operation (р<0,05) which can be constrained from
traumatisation tissue at the oncotomy of large size and greater blood loss at lengthening of time
of operation.
Consequently, there are grounds to draw conclusion about the necessity of bringing of limitations
of the use of littleinvasion accesses at the large size of tumour of uterus. At the sizes of tumour
more than 14 weeks, in behalf of patient it is expedient to use transabdominal access in order to
avoid heavy intraoperative complications, bleeding and negative symptoms in a late postoperative
period, related to forming of proof pain syndrome and forming of dispaurenia.
Conclusions. The results of the conducted researches testify to the necessity of the use of
the differentiated going near the use of different methods of surgical treatment (abdominal,
laparoscopic and vaginal) for patients with combination of uterine fibroids and endometriosis.
Rational use of modern methods of operative treatment taking into account age of patients, sizes
of tumour, presence of concomitant extragenital pathology and others like that will allow to reduce
frequency of early and late postoperative complications, and also instrumental in more rapid
renewal of patients.