The differentiated approaches to surgical tactic at the combined uterine pathology

Abstract

DOI: 10.52705/2788-6190-2025-01.1-13
УДК 618.14-06-089

Research purpose. To develop the differentiated approaches near the choice of surgical tactic for patients with the combined uterine pathology on the basis of comparing of different types of operative access to application of highly technological operations.
Material and methods. By us the generalized and analysed experience of operative treatment 150 patients which have a certificate to surgical interference at presence of the combined uterine pathology. All patients parted on three groups of inspection on the presence of the different combined signs: group 1 are patients with a uterine fibroids and adenomiosis (50 patients); group 2 are patients with a uterine fibroids in combination with incontinence of urine at tension 2 or 3 to the type (50 patients); group 3 are patients with a uterine fibroids and pelvic organ prolapse (50 patients).
Results. For every operating access there are the certain certificates, related to the sizes of tumour, anamnesis, age of patient, possibilities of the use of different anaesthetic manuals. One of determinatives there is experience and qualification of surgeon. Not correct is approach – to execute a littleinvasion operation «at any cost», that entails the increase of amount of complications, decline of quality of life of patient in a late postoperative period, when, as a rule, an operating doctor does not see the results of the labour. However, executed by us an analysis was rotined by a good effect at the use of endoscopic and vaginal accesses for women with the combined uterine pathology at the correct selection of patients for this type of interference.
Conclusion. The sizes of tumour of less than 14 weeks appeared the determining criteria of choice of laparoscopic acces., absence of the expressed adhesive process and absolute contra-indications is for laparoscopy. Hysterectomy it is expedient to execute vaginal access at the sizes of tumour of to 12 weeks. At combination of uterine fibroids with pelvic organ prolapse and incontinence of urine at tension the choice of surgical access for hysterectomy is determined by advantages of littleinvasion interferences which allow other things being equal to get a satisfactory anatomic and functional result.