The use of a combined method of treatment in the combination of the endometrial hyperplasiа with adenomyosis
Objective. To optimize treatment for endometrial hyperplastic processes (EHP) concurrent with adenomyosis. Subjects and methods. Sixty-five patients with recurrent EHP concurrent with grade 1 adenomyosis were examined and treated using up-to-date diagnostic and therapeutic techniques. Results. The outcome measure is radical removal of pathologically altered tissues, the absence of recurrences, and the presence of hypo- or amenorrhea. At 6 months after surgery, amenorrhea was found in 49 (75.4%) patients; hypomenorrhea was noted in 16 (24.6%). Patients with amenorrhea were diagnosed with grade 1 adenomyosis with endometrial penetration of <1-2 mm. In patients with hypomenstrual syndrome, grade 1 adenomyosis was more pronounced and the depth of endometrial penetration reached 3-4 mm, as evidenced by biopsy. Conclusion. The concurrence of recurrent EHP and grade 1 adenomyosis requires vaporization or resection technology during drug therapy, which will be able to improve the efficiency of the treatment performed. Hysteroscopic endometrial destruction with short-duration surgery and anesthesia, reduced hospital length of stay, a shorter rehabilitation period, and a rapid recovery of working capacity, which is used in combination with gonadotropin-releasing hormone agonists, is an effective treatment for concomitant uterine disease.Ulankina O.G., Sarkisov S.E.
Keywords
recurrent hyperplasia
adenomyosis
hysteroscopy with biopsy
hysteroscopic endometrial ablation
gonadotropin-releasing hormone agonists
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Received 16.02.2018
Accepted 02.03.2018
About the Authors
Olga Gennadevna Ulankina, researcher innovational Department of minimally invasive technologies in gynecology, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: olgaulankina@yandex.ruSergey Eduardovich Sarkisov, PhD, professor Innovational Department of minimally invasive technologies in gynecology, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: 7341497@mail.ru
For citations: Ulankina O.G., Sarkisov S.E. The use of a combined method of treatment in the combination of the endometrial hyperplasiа with adenomyosis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (4): 119-24. (in Russian)
https://dx.doi.org/10.18565/aig.2018.4.119-124
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