Frozen pelvis
Tskhay V.B., Polstyanoy A.M., Iptishev A.M., Khudyakov A., Friedrich M., von Westernhagen M.
Frozen pelvis is an informal medical term used in medical practice to describe a condition where the pelvic organs are extensively bound together by adhesions, resulting in significant disruption of their function and anatomy. Surgical treatment of this condition is challenging, even for experienced surgeons, because of the complexity of the adhesion process and resulting anatomical changes. The most common cause of frozen pelvis in gynecology is deep infiltrating endometriosis, which involves a complex interaction between inflammatory processes, tissue damage, impaired healing mechanisms, and neovascularization. The primary goal of surgical intervention is to remove adhesions, restore the pelvic anatomy, and alleviate symptoms. Successful treatment typically requires a multidisciplinary approach involving gynecologists, colorectal surgeons, urologists, and reproductive physicians to ensure optimal patient management and outcomes.
After reviewing the available literature, we found that there is a lack of domestic scientific publications on this pathology. Therefore, we conducted an analysis of the current scientific literature to provide up-to-date information on the pathogenesis, diagnosis, and management strategies of frozen pelvis. Additionally, we present two case studies from our own practice to illustrate the surgical treatment options for patients with a frozen pelvis.
Conclusion: Our analysis of the literature and clinical observations highlights the complexity of diagnosing and surgically treating frozen pelvis in gynecological practice. An interdisciplinary approach, individualized treatment strategies, preventive measures, and long-term monitoring are crucial for optimizing treatment outcomes and improving patient quality of life. Gynecologists who encounter this challenging condition should continually expand their knowledge and skills, exchange experience, and collaborate with other specialists to enhance diagnostics and patient management.
Authors' contributions: Tskhay V.B., Friedrich M. – conception and design of the study; Polstyanoy A.M., Iptishev A.M., Khudyakov A., von Westernhagen M. – material collection, drafting of the manuscript, review of the relevant literature; Tskhay V.B. – editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Patient Consent for Publication: All patients provided informed consent for the publication of their data and associated images.
For citation: Tskhay V.B., Polstyanoy A.M., Iptishev A.M., Khudyakov A.,
Friedrich M., von Westernhagen M. Frozen pelvis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (9): 190-197 (in Russian)
https://dx.doi.org/10.18565/aig.2024.87
Keywords
frozen pelvis
adhesions
surgical gynecology
deep infiltrative endometriosis
stage IV endometriosis
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Received 09.04.2024
Accepted 15.07.2024
About the Authors
Vitaly B. Tskhay, Dr. Med. Sci., Professor, Head of the Department of Perinatology, Obstetrics and Gynecology of the Medical Faculty, Prof. V.F. Voino-Yasenetsky Krasnoyarsk SMU, Ministry of Health of Russia, 660022, Russia, Krasnoyarsk, P. Zheleznyak str., 1; Scientific Director for Obstetrics and Gynecology, FSRCC FMBA of Russia, +7(923)287-21-34, tchai@yandex.ruAleksey M. Polstyanoy, PhD (Med.), Head of the Gynecological Department, FSRCC FMBA of Russia, 660037, Russia, Krasnoyarsk, Kolomenskaya str., 26, +7(902)917-79-97, al-polstyanoy@yandex.ru
Alexander M. Iptishev, Resident of the Department of Perinatology, Obstetrics and Gynecology of the Medical Faculty, V.F. Voino-Yasenetsky Krasnoyarsk SMU, Ministry of Health of Russia, 660022, Russia, Krasnoyarsk, P. Zheleznyak str., 1, +7(923)369-88-24, alexandriptishev@gmail.com
Alexander Khudyakov, Obstetrician-Gynecologist, Private clinic «GTK- Krefeld», 47800, Germany, Krefeld, Violstraße 92, +10(49)17623243098, khudyakov@gtk-krefeld.de
Michael Friedrich, Dr. Med. Sci., Professor, Chief Physician of the Perinatal Center, Gynecological Oncological Center, Center of Operative Gynecology, Helios Medical Center, 47805, Krefeld Germany, Lutherplatz 40, +10(49)2151322201, michael.friedrich@helios-kliniken.de
Michael von Westernhagen, Obstetrician-Gynecologist, Private clinic «GTK- Krefeld», 47800, Germany, Krefeld, Violstraße 92, westernhagen@gtk-krefeld.de
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