Prevention of peritoneal adhesions as a stage of early rehabilitation of reproductive function after myomectomy

Tkachenko L.V., Sviridova N.I., Verovskaya T.A., Khokhlova R.R.

1 Volgograd State Medical University, Ministry of Health of Russia, Volgograd 2 Volgograd Regional Clinical Perinatal Center Two, Volgograd
Objective. To evaluate the effectiveness of the early stage of reproductive function rehabilitation in patients after myomectomy.
Subjects and methods. Comprehensive clinical and laboratory examinations were performed in 84 patients aged 18 to 45 years with uterine fibroids admitted for elective surgery. The anti-adhesive absorbable gel Antiadhesin (5 g) was applied to the site of a postoperative scar at the final stage of surgery.
Results. Pregnancy was found to occur in 60 (71.4%) of the 84 patients: spontaneously in 48 (57.1%) females, after an IVF and embryo transfer program in 14.3% of cases with a successful outcome in 39 (46.4%).
Conclusion. The findings make it possible to consider the early stage of rehabilitation of female reproductive function scientifically well-grounded after myomectomy, by using an innovative agent to prevent adhesion formation (the absorbable gel Antiadhesin).

Keywords

peritoneal adhesions
prevention
myomectomy

References

  1. Адамян Л.В., Cеров В.Н., Сухих Г.Т., Филиппов О.С. Клинические рекомендации. Акушерство и гинекология. Проблемы репродукции. 2017; 23 (3, Cпецвыпуск): 466-568. [Adamyan L.V., Serov V.N., Sukhikh G.T., Filippov O.S. Clinical guidelines. Obstetrics and gynecology. Reproduction problems. 2017; 3 (23) (Suppl): 466-568 (in Russian)].
  2. Беженарь В.Ф., Комличенко Э.В., Шевелева Т.С., Кондратьев А.А. Терапия миомы матки: от хирургии к медикаментозной стратегии. StatusPraesents. Гинекология, акушерство, бесплодный брак. 2016; 4: 147-56. [Bezhenar’ V.F., Komlichenko E.V., Sheveleva T.S., Kondratiev A.A. Therapy of uterine fibroids: from surgery to drug strategy. StatusPraesents. Gynekologiya, akusherstvo, besplodnyj brak. 2016; 4 (33): 147-156 (in Russian)].
  3. Давыдов А.И., Лебедев В.А., Пашков В.М., Коваленко М.В., Панкратов В.В. Принципы терапии и профилактики рецидивов миомы матки у больных репродуктивного периода: реальность и перспективы. Вопросы гинекологии, акушерства и перинатологии. 2013; 12(1): 35-42. [Davydov A.I., Lebedev V.A., Pashkov V.M. Principles of treatment and prevention of recurrence of uterine fibroids in patients of the reproductive period: reality and prospects. Voprosy gynekologyi, akusherstva i perinatologyi. 2013; 12; 1: 35–42 (in Russian)].
  4. Сидорова И.С., Унанян А.Л., Агеев М.Б., Ведерникова Н.В., Жолобова М.Н. Современное состояние вопроса о патогенезе, клинике, диагностике и лечении миомы матки у женщин репродуктивного возраста. Акушерство, гинекология и репродукция. 2012; 6(4): 22-8. [Sidorova I.S., Unanyan A.L., Ageev M.B., Vedernikova N.V., Zholobova M.N. The current status of the issue of pathogenesis, clinic, diagnosis and treatment of uterine fibroids in women of reproductive age. Akusherstvo, gynekologiya i reproduktsya. 2012; 6; 4: 22–28 (in Russian)].
  5. Crosio A., Valdatta L., Cherubino M., Izzo M., Pellegatta I., Pascal D.et al. A simple and reliable method to perform biomechanical evaluation of postoperative nerve adhesions. Neurosci. Methods. 2014; 233: 73-7.
  6. Cardozo E.R., Clark A.D., Banks N.K., Henne M.B., Stegmann B.G., Segars J.H. The estimated annual cost of uterine leiomyoma in the United States. Am. J. Obstet. Gynecol. 2012; 206(3): 211. e1-9.
  7. Тихомиров А.Л., Манухин И.Б., Казенашев В.В., Манухина Е.И., Юдина Т.А. Профилактика спаечного процесса и его осложнений в оперативной гинекологии. Российский вестник акушера-гинеколога. 2016; 16(5): 100-5.[Tichomirov A.L., Manuchin I.B., Kazenashev V.V., Manuchina E.I., Yudina T.A.Prevention of adhesions and its complications in operative gynecology. Rossiyskyi vestnik akushera-ginekologa. 2016; 16; 5: 100-105 (in Russian)].
  8. Адамян Л.В., Козаченко А.В., Кондратович Л.М. Спаечный процесс в брюшной полости: история изучения, классификация, патогенез (обзор литературы). Проблемы репродукции. 2013; 19(6): 7-13. [Adamyan L.V., Kozachenko A.V., Kondratovich L.M. Adhesive process in the abdominal cavity: a history of study, classification, pathogenesis (literature review). Problemy reproductsyi. 2013; 6: 7-13 (in Russian)].
  9. Беженарь В.Ф., Цыпурдеева А.А., Байлюк Е.Н. Спаечная болезнь органов малого таза у гинекологических больных: от патогенеза к практике. Онкогинекология. 2014; 4: 68-74. [Bezhenar’ V.F., Tsypurdeeva A.A., Baylyuk E.N. Adhesion desease of pelvic cavity in gynaecological patients: from pathogenesis to practice. Onkoginecologiya. 2014; 4: 68-74 (in Russian)].
  10. Попов А.А., Мананников Т.Н., Колесник Н.А., Ромазанов М.Р., Федоров А.А., Барто Р.А., Земсков Ю.В. Применение противоспаечных препаратов в программе хирургического лечения трубно-перитонеального бесплодия. Журнал акушерства и женских болезней. 2012; 61(4): 97-103. [Popov A.A., Manannikova T.N., Kolesnik N.A., Ramazanov M.R., Fedorov A.A., Barto R.A., Zemskov U.V. Antiadhesion bariers application in infertile patients with pelvic adhesions. Zurnal akusherstva I zhenskikh boleznei. 2012; 61: 4: 97-103 (In Russian)].
  11. Arung W., Meurisse M., Detry O. Pathophysiology and prevention of postoperative peritoneal adhesions. World J. Gastroenterol. 2011; 17(41): 4545-53.
  12. Imudia A.N., Kumar S., Saed G.M., Diamond M.P. Pathogenesis of intra-abdominal and pelvic adhesion development. Semin. Reprod. Med. 2008; 24(4): 289-97.
  13. Полетаев А.Б. Физиологическая иммунология (естественные аутоантитела и проблемы наномедицины). М.: Миклош; 2015. 219c. [Poletaev A.B. Physiological immunology (natural autoantibodies and nanomedicine problems). М.: Мiklosh, 2015. 219p (in Russian)].
  14. Попов А.А., Мананников Т.Н., Колесник Н.А., Ромазанов М.Р., Федоров А.А., Барто Р.А., Земсков Ю.В. Применение противоспаечных препаратов в программе хирургического лечения трубно-перитонеального бесплодия. Журнал акушерства и женских болезней. 2012; 61(4): 97-103. [Popov A.A., Manannikova T.N., Kolesnik N.A., Ramazanov M.R., Fedorov A.A., Barto R.A., Zemskov U.V. Antiadhesion bariers application in infertile patients with pelvic adhesions. Zurnal akusherstva I zhenskikh boleznei. 2012; 61: 4: 97-103 (In Russian)].
  15. Тарабанова О.В., Крутова В.А., Коваленко Я.А., Мельконьянц Т.Г., Баширов Э.В., Ордокова А.А., Титова А.Н. Опыт органосохраняющих операций у пациенток с миомой матки. Доктор. Ру. 2017; 13 (142)-14 (143): 68-74. [Tarabanova O.V., Krutova V.A., Kovalenko Ya.A.,
  16. Melkoniyants T.G., Bashirov E.V., Ordokova A.A. Titova A.N. Conservative Surgery for Uterine Leiomyoma. Doctor.Ru. 2017; 13 (142)-14(143): 68-74. (In Russian)].

Received 30.11.2018

Accepted 07.12.2018

About the Authors

Tkachenko, Lyudmila V., MD, professor, head of the Department of Obstetrics and Gynecology, Faculty of Advanced Medical Studies, Volgograd State Medical University, Ministry of Health of Russia. 400131, Russia, Volgograd, pl. Fallen fighters str. 1. Tel: +79050631072. E-mail: tkachenko.fuv@mail.ru
Sviridova, Natalia I., PhD, associate professor of the Department of Obstetrics and Gynecology, Faculty of Advanced Training of Doctors, Volgograd State Medical University, Ministry of Health of Russia. 400131, Russia, Volgograd, pl. Fallen fighters, str. 1. Tel: +79064090343. E-mail: n.i.sviridova@yandex.ru
Verovskaya, Tatyana A., chief medical officer of the Volgograd Regional Clinical Perinatal Center 2, chief obstetrician-gynecologist of the Healthcare Committee of the Volgograd Region. 400008, Russia, Volgograd, Marshal Vasilevsky str. 70. Tel: +79023144483. E-mail: vokpc2@vomiac.ru
Khokhlova, Regina R., graduate student of the Department of Obstetrics and Gynecology at the Faculty of Advanced Training of Doctors of Volgograd State Medical University, Ministry of Health of Russia. 400131, Russia, Volgograd, pl. Fallen fighters str. 1. Doctor obstetrician-gynecologist GBUZ Volgograd Regional Clinical Perinatal Center №2. 400008, Russia, Volgograd, Marshal Vasilevsky str. 70. Tel: +79033714323. E-mail: regina621@yandex.ru

For citations: Tkachenko L.V., Sviridova N.I., Verovskaya T.A., Khokhlova R.R. Prevention of peritoneal adhesions as a stage of early rehabilitation of reproductive function after myomectomy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (1): 118-24. (in Russian)
http://dx.doi.org/10.18565/aig.2019.1.118-124

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.