COMPLEX ASSESSMENT OF REPRODUCTIVE HEALTH IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS AFTER SURGERY
Keywords:
external genital endometriosis, endometrioid disease, reproductive health.
Abstract
Aim. Complex assessment of reproductive health in patients with external genital endometriosis after surgery. Materials and Methods. The study involved 55 women of childbearing age who received treatment in the department of gynecology of Bauman City Clinical Hospital № 29 and 30 women observed in Central Clinical Hospital № 6. In 2014–2016 the patients underwent laparoscopic surgery for external genital endometriosis. External genital endometriosis of different extent and severity (according to R-AFS) was diagnosed and confirmed using laparoscopic and morphologic assessment methods. 70 patients underwent endometrioma nucleation, and 15 patients with retrocervical endometriosis were subjected to excision of endometrioma with mobilization of the anterior wall of the colon as well as coagulation of endometrioid heterotopias of various sites; all patients were subjected to adhesiolysis. Results. 48 (64%) patients had III–IV stage endometriosis. In 20% endometriosis was diagnosed during surgery. Anthropometric indicators were mostly associated with asthenic type. Emotional and behavioral disorders were observed in 25 (33.3%) patients with tendency to hysterical personality disorder; the rest had mood swing and liability to depression. In less than 60% of patients the severity of endometriosis was significantly related to pelvis pain intensity. The majority of patients were women of asthenic type and with expressed pain syndrome, and hysterical personality disorder according to Beck scale. Conclusion. Individual assessment of pain, anthropometric and personal traits in patients together with complex assessment of morphologic and anatomic changes in reproductive organs make it possible to see a real pattern of disease and condition in women with external genital endometriosis, which helps in choice of surgery volume and appropriate medical treatment.References
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2. Radzinskiy V.E. (Ed.) Ginekologiya. Rukovodstvo po prakticheskim zanyatiyam [Gynecology. On Practical Training Manual]. 3nd ed. Moscow, 2013. 552 p.
3. Damirov M.M., Oleynikova O.N., Mayorov O.V. Vzglyad praktikuyushchego vracha: monografiya [Look Practitioner. Monograph]. Moscow, BINOM Publ., 2013. 152 p.
4. Dubossarskaya Z.M. [Differential Tactic of Treatment of Benign Diseases of the Genital Organs, Accompanied by Chronic Pelvic Pain Syndrome]. Women's Health, 2012, no. 6 (72), pp. 132–136. (in Russ.)
5. Zhigunova A.K. [New Horizons Gynecological Surgery] Ukrainskiy meditsinskiy zhurnal [Ukrainian Medical Journal], 2013, no. 6, pp. 1–4. Available at: http://www.umj.com.ua/article/69568/novye-gorizonty-ginekologicheskoj-xirurgii.
6. Gasparov A.S., Burlev V.A., Dorfman M.F., Dubinskaya E.D., Barabanova O.E., Shnayderman M.S. [The Use of Argon Plasma Coagulation in Surgical Treatment of External Genital Endometriosis]. Vestnik RUDN. Ser. Meditsina. Akusherstvo i ginekologiya [Bulletin of Peoples' Friendship University, a Series of Medicine. Obstetrics and gynecology], 2012, no. 5, pp. 253–258. (in Russ.)
7. Fedotova L.V., Andreev A.N., Konovalov V.I. [Assessment of Quality of Life in Patients with Hyperplastic Diseases of Genitals Under the Influence of Therapy]. V Mezhdunarodnaya nauchnoprakticheskaya konferentsiya “Farmatsiya i obshchestvennoe zdorov'e” [V International Scientific-Practical Conference Pharmacy and Public Health], 2012, pp. 398–400. (in Russ.)
8. Kharchenko Yu.A. [Adequate Assessment of Pain – the Key to Successful Treatment]. Universum: meditsiny i farmakologii: Elektron. [Universum. Medicine and Pharmacology. Elektron], 2014, pp. 5–10. (in Russ.)
9. Chernyshova I.V., Tarasova I.V., Sandakova E.A. [Alarmingly-Depressivnye Accentuation in the Evaluation of the Quality of Life of Patients with Endometriosis]. Lechenie i profilaktika [Treatment and Prevention], 2013, no. 2 (6), pp. 54–58. Available at: http://www.lechprof.ru/catalog/article/original_research/anxietydepressive_accentuation_in_assessing_the_quality_of_life_of_patients_with_genital_endometrios/?sphrase_id=3332.
10. Endometriosis. Diagnosis, Treatment and Rehabilitation. Federal Guidelines for the Management of Patients. Moscow, 2013, pp. 1–65. Available at: http://www.ncagip.ru/upload/obrazovanie/16.pdf
11. Brawn J., Morotti M., Zondervan K.T. Central Changes Associated with Chronic Pelvic Pain and Endometriosis. Hum. Reprod. Update, 2014, vol. 20, iss. 5, pp. 737–747. DOI: 10.1093/humupd/dmu025
12. Damirov M.M., Oleinikova O.N., Mayorov O.V. Endometriosis: a View of the Practitioner: Monograph. BINOM Publ., 2013. 152 p.
13. Zhang X.M., Huang X.F., Xu H. Endometriosis: a Consequence of Varying Injuries to Pelvic Autonomic Nerves. Fertil. Steril., 2012, vol. 98, iss. 6, pp. 543–546. DOI: 10.1016/j.fertnstert.2012.10.002
14. Vercellini P., Vigano P., Somigliana E. Endometriosis: Pathogenesis and Treatment. Nat. Rev. Endocrinol., 2014, vol. 10, iss. 5, pp. 261–275.
15. Herington J. Immune Interactions in Endometriosis. Expert Rev. Clin. Immunol., 2012, vol. 7 (5), pp. 611–626. DOI: 10.1586/eci.11.53
16. Johnsonт N. Consensus on Current Management of Endometriosis. Hum. Reprod. 2013, vol. 28(6), pp. 1552–1568. DOI: 10.1093/humrep/det050
17. Abbott J., Hawe J., Hunter D. Laparoscopic Excision of Endometriosis a Randomized, Placebo-Controlled Trial. Fertil. Steril., 2014, vol. 82, pp. 878–884. DOI: 10.1016/j.fertnstert.2004.03.046
18. Laschke M.W. Vasculogenesis. A New Piece of the Endometriosis Puzzle. Hum. Reprod. Update, 2012, vol. 18, iss. 6, pp. 682–702. DOI: 10.1093/humupd/dms026
19. Neil P.J., Hummelshoj L. For the World. Consensus on Current Management of Endometriosis. Endometriosis Society Montpellier Consortium. Hum. Reprod., 2013, vol. 28, iss. 6, pp. 1552–1568.
20. Koninckx P., Corona R., Timmerman D., Verguts J. Peritoneal Full-Conditioning Reduces Postoperative Adhesions and Pain. A Randomised Controlled Trial in Deep Endometriosis Surgery. J Ovarian Res., 2013, vol. 11, 90 p.
21. Simoens S. The Burden of Endometriosis. Costs and Quality of Life of Women with Endometriosis and Treated in Referral Centres. Hum. Reprod., 2012, vol. 27, pp. 1292–1299. DOI: 10.1093/humrep/des073
22. Taran F.A., Stewart E.A., Brucker S. Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. Geburtshilfe Frauenheilkd., 2013, vol. 73, iss. 2, pp. 924–931. DOI: 10.1055/s-0033-1350840
23. Cardozo E.R., Clark A.D., Banks N.K. The Estimated Annual Cost of Uterine Leiomyoma in the United States. Am. J. Obstet. Gynecol., 2012, vol. 206, iss. 3, pp. 234–239.
24. Dijk L.J., Nelen W.L., D'Hooghe T.M. The European Society of Human Reproduction and Embryology Guideline for the Diagnosis and Treatment of Endometriosis. An Electronic Guideline Implementability Appraisal. Implement. Sci., 2011, vol. 19, iss. 6, p. 7.
25. Treatment of Pelvic Pain Associated with Endometriosis: a Committee Opinion. The Practice Committee of the American Society for Reproductive Medicine. – http://fertstertforum. com/asrmpraccompelvic-pain-endometriosis/ (Accessed 13 March 2014).
26. Trioloa O., Laganaa S., Sturlese E. Chronic Pelvic Pain in Endometriosis. J. Clin. Med. Res., 2013, vol. 5, iss. 3, pp. 153–163.
27. Verit F.F., Yucel O. Endometriosis, Leiomyoma and Adenomyosis: the Risk of Gynecologic Malignancy. Asian Pac. J. Cancer. Prev., 2013, vol. 14, iss. 10, pp. 5589–5597. DOI: 10.7314/APJCP.2013.14.10.5589
28. Wang Y., Qu Y., Song W. Genetic Variation in COX-2-1195 and the Risk of Endometriosis and Adenomyosis. Clin. Exp. Obstet. Gynecol., 2015, vol. 42, iss. 2, pp. 168–172.
29. Nnoaham K.E., Hummelshoj L., Kennedy S.H. World Endometriosis Research Foundation Women is Health Symptom Survey Consortium. Developing Symptom-Based Predictive Models of Endometriosis as a Clinical Screening Tool. Result From a Multicenter Study. Fertil. Steril., 2012, vol. 98, iss. 3, pp. 692–701. DOI: 10.1016/j.fertnstert.2012.04.022
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Published
2016-12-01
How to Cite
Zakirova, Y., Babaeva, E., Orazov, M., & Aryutin, D. (2016). COMPLEX ASSESSMENT OF REPRODUCTIVE HEALTH IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS AFTER SURGERY. Human. Sport. Medicine, 16(4), 32-42. https://doi.org/10.14529/hsm160404
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Clinical and Experimental Medicine
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