The women of young age have features of treatment of submucosal uterine fibroids

Abstract

DOI: 10.52705/2788-6190-2024-03.2-06
УДК 618.14-006.36-02-008.6:612.621.31:618.17-08

The objective: The women of reproductive age have an increase of efficiency of diagnostics and treatment of submucosal uterine fibroids on the basis of study of clinical-and-echographic, endocrinology and immunohistochemical features, and also development and introduction of the improved algorithm of diagnostic and treatment-and-prophylactic and rehabilitation measures with the use of modern endoscopic technologies and directed medicinal correction.
Materials and methods. A complex inspection is conducted 60 women which a conservative myomectomy was conducted. In the complex of the conducted methods researches were included: behind-the-scenes clinic inspection; clinical-and-laboratory methods of diagnostics; echography of organs of small pelvis; hysteroscopy; separate diagnostic scraping the mucous membrane of the cervical canal and cavity of uterus with subsequent morphological research; immunohistochemical methods of study of biomolecular markers. For the estimation of remote consequences were analysed clinical-and-laboratory indexes in 60
women after a conservative myomectomy, which were up-diffused on two groups: a to 1 group entered 30 patients in which operative treatment was conducted on the method improved by us, and also which hormonal preparations were appointed taking into account immunohistochemical of information; 2 groups were made by 30 women, operated on the generally accepted method
and recipient treatment only on the basis of morphological research of myoma and endometrium.
Results. The results of immunohistochemical researches of remote myomatous nodes testify that in their tissue receptor dependence on estrogen absents in 56,7%; weak – in 26,7%; moderate – in 10,0% and strong – in 6,7% supervisions. In the structure of expression of receptors on progesterone the moderate (36,7%) prevail and strong (36,7%) in comparing to weak (20,0%) and its absence (6,7%). The use of the algorithm of rehabilitation measures improved by us allows to reduce frequency of pain syndrome on 36,7%; violations of menstrual function on 33,3%; prophylaxis of relapses of disease (during the generally accepted rehabilitation – 8,3%), and also on 18,0% to promote efficiency of proceeding in a reproductive function as an offensive of pregnancy. Conclusions.The conducted analysis of the nearest and remote results of submucosal myomectomy rotined that a myomectomy was the expedient and effective surgical method of treatment. The use of less invasion endoscopic accesses on the algorithm improved by us is instrumental in more «smooth» motion of postoperative period, abbreviates the terms of stay of patients in permanent establishment, that in combination with an endocrinotherapy, appointed taking into account immunohistochemistry endo- and myometrium, instrumental in normalization of menstrual function and creates favourable terms for realization of reproductive function of woman.