Features of medical­and­social factors during a conduct organ­preserving operations for the women of reproductive age

Abstract

DOI: 10.52705/2788-6190-2025-3-13
УДК 618.17/.5-006-018-089-039:614.2

Purpose. To investigate medical-and-social factors during a conduct organ-preserving operations for the women of reproductive age.
Materials and methods. As a result of clinical-and-statistical research of primary medical document of gynaecological permanent establishment of copies information from 520 medical histories of gynaecological patients, which was executed functionally-sparing operations. A structure and dynamics of gynaecological diseases was analysed, the specific weight of organ-preserving operations was determined with the different types of accesses and volume of surgical treatment. From this group of gynaecological patients a basic group (224 women) and group of comparison (108 women), which parted on 2 sub-groups (after radical operations and after conservative therapy), was selected (with the observance of rules of statistical and clinical selection), comparable on age, by the stage and severity of disease. Plugging criteria in a basic group were women with specific gynaecological diseases (prolapsus of front and back wall of vagina II, III degree, from the elongation of cervix, cystocele and rectocele; by the uterine fibroids of different form and sizes (to 16–17 weeks pregnancy); of high quality formations of appendages of uterus and by the ovarian apoplexy for the women of reproductive period).
Results. By us the presented analysis of structure of hospitalized on operative treatment, analysis of dynamics clinical-and-functional the states and efficiency functionally sparing gynaecological operations. In the structure of the women hospitalized for surgical treatment, greater specific gravity was made by patients with of high quality formations of appendages of uterus (36,6%), with the prolapsus of front and back wall of vagina II, III degree (30,4%), with the uterine fibroids of different form and sizes (20,9%) and with the ovarian apoplexy (12,1%). Results clinical and clinical-and-statistical it is testified an analysis, that in 33,0% women with pelvic organ prolapse II-III of degree reconstructive-rehabilitation operations are executed by vaginal access; Manchester operation (76,3%); anterior and posterior colporrhaphy, cystopexy, urethral fixation, pelvic floor muscle recovery (23,7%). With uterine fibroids a conservative myomectomy (21,0%) is executed women, Pfannenshtiel incision (97,8%). Organ-preserving operations for women with of high quality formations of appendages are executed mainly by a laparoscopic method (97,3%), including: cystectomy (46,7%); ovarian resection (26,6%); adnexectomy (12,4%); cystectomy from one side and ovarian resection on the other side (11,4%). Functionally sparing operations on the uterine appendages were 66,6% from all conducted operations.
Conclusion. A comparative analysis is conducted clinical-and-functional the states for women on the different stages of supervision testifies that more than half of gynaecological patients (53,4%) grumbled about the presence of pain syndrome at the bottom of stomach of different intensity. Found out the protracted terms of display of pains to hospitalization (during a month to hospitalization of pain marked 61,3% women, and 15,3% marked during anymore half-year). In 6 months after an operation periodic pains which heave up, at the bottom of stomach 24,7% women marked only, and in a remote period – there are 18,6% women. Almost in the halves of patients (45,2%) violation of menstrual cycle is marked in anamnesis, and 31,9% women of violation of menstrual cycle disturbed more than 6 months. Findings must be used for the conduct of diagnostic and treatment-and-prophylactic measures.