The differential approach to surgical treatment of the combined pathology of uterus and ovaries on a background pelvic organ prolapse

Abstract

DOI: 10.52705/2788-6190-2024-04.1-09
УДК 618.14-06:61871-007.43]-089.168

The objective: Decline of frequency of relapse of pelvic organ prolapse for women after surgical treatment of the combined pathology of uterus on the basis of development and promoting of the differentiated approach near the choice of method of operation.
Materials and methods. At implementation of this research by us the conducted analysis of results of surgical treatment 90 patients which are operated concerning the of benign diseases of uterus and pelvic organ prolapse with the use of vaginal operative access. As a basic (base) operation to all patients was executed vaginal hysterectomy. Distinctive features had variants of vaginal operations for the patients of different clinical groups. Dividing of patients by clinical groups it is mine-out by us depending on testimonies for the delete of uterus, presence of concomitant pelvic organ prolapse (complicated or not by a stress
incontinence of urine) and age of patients. 1 group – 30 patients in which was executed vaginal hysterectomy in combination with culdoplasty for Makkollu and colpoperineolevatoroplasty. 2 groups are 30 patients in which was executed vaginal hysterectomy for Meyo. 3 groups are 30 patients in which was executed vaginal hysterectomy in combination with front coplporrhaphy,
colpoperineolevatoroplasty, fixing of dome of vagina to the sacrospinous ligament and urethrovesicvaginopexy (minimized sling).
To the complex of the conducted researches clinical, laboratory, instrumental and statistical methods were included.
Results. At surgical treatment of the combined pathology of uterus without and with pelvic organ prolapse it is necessary to give advantage to explorer anaesthesia (epidural anaesthesia or spinal anaesthesia), that allows to shorten duration of operation, decrease the volume of blood loss and risk of thromboembolic complications, accelerate and facilitate a postoperative rehabilitation for somatically weak patients and elderly patients and danced age. Efficiency of the differentiated approach at surgical treatment of the combined pathology of uterus with pelvic organ prolapse is 96,7 %, thus 83,3 % women are respect yourself completely cured.
Most high-frequency of relapse (6,7%) takes place for women without pelvic organ prolapse, what hysterectomy was executed only concerning the of benign diseases of uterus and ovaries with laparoscopic assistance.
Conclusions. The results of the conducted researches testify that the use of the differentiated approach to surgical treatment of the combined pathology of uterus and pelvic organ prolapse allows to promote efficiency, reduce frequency of relapse and improve quality of life of women.