PROBLEMATIC ISSUES OF REHABILITATION OF PATIENTS OF REPRODUCTIVE AGE AFTER SURGICAL TREATMENT OF UTERINE FIBROIDS

Abstract

Problems of rehabilitation of patients reproductive system occupy a special place in gynecological practice.Aim. To study the degree of influence on the ovaries of mechanical techniques for reducing intraoperative blood loss during myomectomy in patients of reproductive age.The study included 64 patients with uterine leiomyoma without underlying ovarian pathology, surgically treated within the scope of myomectomy, using mechanical techniques of temporary blood flow arrest in the uterine tissues: the main group consisted of individuals (n = 32) who underwent laparoscopic myomectomy with the imposition of temporary clips on the internal iliac arteries; the 2nd comparison group included women who underwent laparotomic myomectomy with a tourniquet on the uterine arteries in the isthmus area (n = 32). The control group consisted of 34 patients without ovarian and uterine pathology who consulted a gynecologist for a preventive examination.The obtained results of the examination of intraovarian blood flow in the ovaries of patients of the main study groups in comparison with the control group indicated the presence of ovarian insufficiency as a result of myomectomy with the use of mechanical means of temporary blood flow arrest in the uterine tissues. Ultrasound examination of the ovaries and blood flow in the ovarian arteries, both before and in the postoperative period, in women who underwent myomectomy with mechanical means of temporary blood flow arrest in the uterine tissues, allows for timely detection of signs of the development of the syndrome of exhausted ovaries.All patients of reproductive age who underwent myomectomy with mechanical means of temporary blood flow arrest in the uterine tissues should be considered as a group at increased risk of developing premature ovarian exhaustion syndrome.The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee. Informed consent was obtained from women for the study.The authors declare no conflict of interest.