EnglishУкраїнська
  • Main
  • Useful links
  • Information for Contributors
  • About
  • Editorial board

  • Article
    S. M. Kornienko

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


    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
    Bibliography
    • Bahvalova AA. Risk regeneratsii slizistoy obolochki tela matki posle ablatsii endometriya u bolnyih s retsidiviruyuschimi giperplasticheskimi protsessami v endometrii. Vestn. Ros. assots. Akusherov-ginekologov. 2000. 1: 95-9.
    • ovk IB, Gorban NE, Borisyuk OYu. Giperplaziya endometriya (Klinicheskaya lektsiya). Zdorove zhenschinyi. 2016. 5, 111: 10-8.
    • Korniienko SM. Histeroskopiia v diahnostytsi ta likuvanni vnutryshnomatkovoi patolohii u zhinok piznoho reproduktyvnoho ta premenopauzalnoho viku. Pediatriia, akusherstvo ta hinekolohiia. 2011. 73, 4:219-22.
    • Tatarchuk TF, Kalugina LV, TutchenkoTN. Giperplasticheskie protsessyi endometriya: Chto novogo?. Reproduktivna endokrinologIya. 2015. 5, 25: 7-13.
    • Ulankina OG. Klinicheskoe znachenie sostoyaniya interstitsialnogo otdela matochnoy trubyi dlya gisterorezektoskopicheskoy ablyatsii endometriya. Ginekologiya. 2002. 4, 3. http://old.consilium-medicum.com/media/gynecology/02_03/100.shtml.
    • Fischer F, Klapdor R, Gruessner S et al. Radiofrequency endometrial ablation for the treatment of heavy menstrual bleeding among women at high surgical risk. Int J Gynaecol Obstet. 2015.131, 2: 123-8.
    • Giuntoli RL, Gerardi MA, Yemelyanova AV. et al. Stage I noninvasive and minimally invasive uterine serous carcinoma: comprehensive staging associated with improved survival. Int. J. Gynecol. Cancer. 2012. 22, 2: 273–9.
    • Glazerman LR. Endometrial ablation as a treatment for heavy menstrual bleeding. Surg Technol Int. 2013. 23: 137-41.
    • Korniyenko S. The peculiarities of the history and condition of the endometrium of premenopausal women. Zdorovie zhenschiny. 2016. 10: 91-3.
    • Moulder JK, Yunker A. Endometrial ablation: considerations and complications. Opin Obstet Gynecol. 2016.  28, 4:261-6. doi: 10.1097/GCO.0000000000000282. PMID: 27253237.
    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