S. M. Kornienko

IMPROVING THE EFFICIENCY OF HYSTEROSCOPIC TREATMENT OF ENDOMETRIAL HYPERPLASTIC PROCESSES IN PREMENOPAUSE

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About the author:	S. M. Kornienko
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The endometrial hyperplastic processes (EHP) shared from 15% to 50% in the structure of gynecological diseases. EHP is the main form of hyperproliferative processes in the uterine mucosa in pre-menopausal period. The first stage of this pathology treatment is the dissection of the abnormal endometrium with further morphological examination. Electrosurgical hysteroresectoscopy represent the most modern method of operative treatment in EHP patients. The effectiveness of this procedure is 60-98%. The purpose of this study was to increase the EHP treatment effectiveness in the pre-menopausal period. 122 women with EHP (age 45-54) were involved in this randomized controlled trial. The participants were randomized into two groups: the group I included 44 patients with ablation of the endometrium and subsequent therapy with gonadotropin-releasing hormone agonist (GnRH) for 3 months; and the group II 78 women with endometrial ablation without concomitant drug therapy. The studied groups were comparable in terms of obstetric-gynecological, reproductive and somatic anamnesis, the complaint spectrum, and the basic and accompanying diagnoses. A follow-up analysis after treatment revealed EHP recurrences in 5 (11.4%) women of group I and 28 (35.9%) of group II, p <0.003; among them the recurrences of endometrial polyps – in 4 (9.1%) and 19 (24.4%), p <0.04; recurrences of endometrial hyperplasia in 1 (2.3%) and 11 (14.1%), p <0.03, respectively. The therapy with GnRH agonists after endometrial ablation in premenopausal women allows to increase the therapy efficiency 3 times (from 35.9% to 11.4%) and should be recommended as an obligatory component of therapy, especially among patients with recurrent disease.
Tags	endometrial hyperplastic processes, pre-menopause, endometrial ablation
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Publication of the article	«World of Medicine and Biology» №2(60), 2017 year, 066-070 pages, index UDK 618.14-007.61-072.1-036.8-053.84