Comparative aspects of surgical treatment of combination of uterine fibroids from adenomyosis and their relapses

Abstract

DOI: 10.52705/2788-6190-2023-04-12
УДК 618.14-006+618.14-007.415]-089

The objective: to learn the comparative aspects of different methods of surgical treatment of
combination of uterine fibroids from adenomyosis and their relapses.
Materials and methods. 362 women are plugged in research, that has signs of adenomyosis
and uterine fibroids. To the operation next symptoms – subjective complaints of patient served
certificates on 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. As a result of research of postoperative complications it is possible to draw conclusion
for the patients of basic group, that in most cases at the use of transabdominal access there are
not reliable differences between the middle indexes of the compared parameters in groups for
patients with complications and without complications. A difference found out in one case: increase
of volume of organ, which retires, for certain increases complication in a postoperative period from
the side of operating wound at transabdominal access. All complications at conducted laparotomy
are related to greater traumatic, by limitation of mobility of patient in an early postoperative period,
conditioned by the expressed pain syndrome.
In the basic group of patients with arising up complications with the use of laparoscopic and vaginal
accesses, middle sizes of organ, time of operation, eyelids was exceeded by the middle sizes
of those indexes for patients without complications, but at statistical treatment of these differences
discovered it was not in most sub-groups of comparison.
It is discovered for certain, that increase of volume of organ which retires, the risk of damage of
urinoexcretory ways increases time of operation laparoscopic access. The use of vaginal access
is increased by the risk of forming of dyspareunia for patients with the large of organ which retires,
and at the increase of time of operation which can be constrained from tissue trauma at the large
tumor and greater blood loss at lengthening of time of operation.
Conclusion. 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.