scholarly journals Predictors of genitourinary syndrome in women of elderly reproductive age after hysterectomy

2021 ◽  
pp. 10-13
Author(s):  
Olha Proshchenko ◽  
Iryna Ventskivska ◽  
Natalia Kamuz ◽  
Svitlana Markitanyuk
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Pelvic Floor ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Rehabilitation Program ◽  
Reproductive Age ◽  
Life Assessment ◽  
Floor Failure ◽  
Genitourinary Syndrome

The article presents an analytical assessment of risk factors for distant postoperative urogenital disorders in women of older reproductive age after radical surgical treatment for uterine fibroids. The aim of the study was to optimize the diagnostic algorithm of genitourinary syndrome in women of older reproductive age after hysterectomy for uterine fibroids. Materials and methods – 80 women aged 40 to 50 years were examined: 40 patients after vaginal and laparoscopically assisted vaginal hysterectomy, 40 patients with abdominal hysterectomy, control – 30 relatively healthy women with asymptomatic fibroids. The examination was performed at the stage of preoperative observation and for 3 years after surgery. Research methods: data on the assessment of pelvic floor and urogenital dysfunction using a standardized POP-Q system, physical examination, the ICS classification was used to assess the severity of urinary incontinence; quality of life assessment using the MOS SF-36 questionnaire; standard methods of variation statistics. Research results and their discussion. The most important risk factors for genitourinary syndrome have been identified. These included obstetric and gynecological history (birth of large fetuses, episiotomies, birth trauma, high birth parity, ovarian surgery, the use of gonadotropin-releasing hormone agonists), chronic diseases accompanied by increased intramuscularly; the presence of stigmas of undifferentiated connective tissue dysplasia; clinical manifestations of pelvic floor failure and functional disorders of the urethral sphincter. Conclusions. In the case of surgical treatment of uterine fibroids, it is advisable to take into account not only the presence of vaginal prolapse and initial dysuric manifestations, but also their predictors in the preoperative stage of the examination, as this may affect the choice of method and access in the case of surgical treatment of uterine fibroids. rehabilitation program and will obtain the expected effect of surgical recovery.

scholarly journals Urogenital disorders in women of reproductive age after radical surgeries about uterine myoma – optimization of diagnostic algorithm

2020 ◽  
Vol 5 ◽  
pp. 29-32
Author(s):  
O. M. Proshchenko
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Pelvic Floor ◽  
Surgical Techniques ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Social Significance ◽  
Women Of Reproductive Age ◽  
Floor Failure

The article presents an assessment and analysis of the most important medical and social risk factors for long-term postoperative urogenital disorders in women of reproductive age after radical surgical treatment for uterine fibroids. Radical operations for uterine fibroids cause an increase in the proportion of urogenital disorders, the clinical manifestations of which have a negative impact on the physical, psycho-emotional form and social significance of women in society. A survey of 80 women aged 40 to 50 years, the main group included 40 patients who underwent vaginal hysterectomy, the comparison group consisted of 40 patients with hysterectomy performed by abdominal access. Data on the assessment of pelvic floor condition and urogenital dysfunction using a standardized POP-Q system, both at the stage of preoperative observation and for 3 and 5 years after surgery. Сonducted surveys, filling diaries of pain, urination, physical examination and bimanual examination, determination of the pH of the vaginal contents, colposcopy, evaluated the index of the vaginal condition, the state of the microbiota of the mucous membranes, a comprehensive urodynamic examination, cystometry, ultrasound examination of the pelvic organs and assessment of ovarian structure.The most important risk factors are identified, which would allow to form groups of patients that require individualized approaches in the choice of surgical techniques and rehabilitation program. These included obstetric and gynecological history (birth of large fetuses, episiotomies, birth injuries, high birth parity); ovarian surgery, the use of gonadotropin-releasing hormone agonists. chronic diseases of the respiratory system and gastrointestinal tract, accompanied by increased intra-abdominal pressure; the presence of stigmas of undifferentiated connective tissue dysplasia; clinical manifestations of pelvic floor failure and functional disorders of the urethral sphincter. When choosing a method and access in case of surgical treatment for uterine fibroids, it is advisable to take into account the presence of pelvic prolapse and initial dysuric manifestations in women, the functional state of the sphincter apparatus and urethral hypermobility, obstetric and gynecological pathology and previous surgery on the organs of the uterus. the patient, her awareness of possible complications, the surgeon’s experience and his choice of surgical techniques.

scholarly journals Key Etiopathogenetic Features of Formation of Uterine Myoma

2019 ◽  
Vol 5 (4) ◽  
pp. 113-118
Author(s):  
S. Abramova ◽  
V. Selkin ◽  
D. Iseev ◽  
A. Usov ◽  
D. Grachev
Keyword(s):  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Benign Neoplasm ◽  
Clonal Expansion ◽  
Reproductive Organs ◽  
Reproductive Age ◽  
Steady Growth ◽  
Key Issues ◽  
Hormone Sensitive ◽  
Social Importance

The steady growth of proliferative diseases from year to year is becoming more and more medical and social importance, which is associated with their clinical manifestations and recurrent course, adversely affect the quality of life and the ability to work of women. Uterine fibroids are the most common benign neoplasm in women of reproductive age. This article discusses the key issues of the etiopathogenesis of uterine fibroids. Uterine fibroids are a monoclonal hormone-sensitive neoplasm and are the most common tumour of the reproductive organs of women. The pathogenesis and developmental mechanisms of uterine fibroids today are complex and not fully understood. Perhaps the underlying theory is the ‘clonal expansion of uterine fibroids’, it is the clonal expansion that initiates the processes of neoangiogenesis, activated by tumor growth. Although to this day there remain many controversial and unresolved issues.

Frequency, Complications and Outcomes of Myomectomy in Reproductive Age Women: Retrospective Analysis and Expert Opinion

2017 ◽  
Vol 9 (2) ◽  
pp. 116-119 ◽  
Author(s):  
Alexander A. Popov ◽  
Anton A. Fedorov ◽  
Ekaterina A. Loginova
Keyword(s):  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Medical Center ◽  
Uterine Fibroids ◽  
High Technology ◽  
Reproductive Age ◽  
Newly Diagnosed ◽  
Female Population ◽  
Reproductive Age Women ◽  
Uterine Scar

The incidence of uterine fibroid in the general female population is estimated at 20%-25%. In 2008, a study involving 145 gynecologists from a few large Russian cities demonstrated that the majority of the respondents had to handle from 10 to 30 (mean 20) women with fibroid every month. Only 28.8% of the patients had newly diagnosed uterine fibroids. Surgical treatment was recommended to 29.8% of the women. A few variants of myoma treatment are distinguished. Fortunately, over 40% of these tumors are asymptomatic. We performed a retrospective analysis of 218 patients submitted to myomectomy in our medical center between 2011 and 2013. In 149 cases (68%) myomectomy was conducted as a step of preparation for pregnancy. The pregnancy rate was 51.6%. A single (1.3%) complication in the form of uterine scar rupture was documented in week 34 of pregnancy. In our opinion, myomectomy is a high-technology operation that must be performed strictly based on the principle of “best” surgery for the “best” patient.

scholarly journals Effects of menarche, parity, primiparous age, and reproductive diseases on uterine fibroids of rural women in China

2020 ◽  
Author(s):  
Bing-Jie Wu ◽  
Chun-Yan Shao ◽  
Yun Zhu ◽  
Kai Huang ◽  
Wu Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Women ◽  
Uterine Fibroids ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Age At Menarche ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Effective Prevention ◽  
Potential Risk Factors

Abstract Objectives: Given the increasing prevalence of hysteromyoma among the Chinese rural women of childbearing age, it is imperative that more attention should be given to researching risk factors that predispose women to this condition so that early preventive measures may be taken. Our study investigates potential risk factors for uterine fibroids such as participants' demographic characteristics (age, ethnicity, education), physiological characteristics (age at menarche, primiparous age), and the occurrence of several different female reproductive diseases (vaginitis, pelvic inflammatory disease).Methods: 2,200 rural women of reproductive age were screened from a cross-sectional study carried out in the Anhui province. Data was collected by questionnaire surveys, gynecological and laboratory examinations and were subjected to univariate and multivariate analysis to evaluate the risk factors for uterine fibroids.Results: Of the 2,200 women, 440 had uterine fibroids. In general, women with endometriosis, ovarian cysts and early menarche were more likely to suffer from hysteromyoma. Factors including higher parity, late age of first childbirth, and a regular menstrual cycle were protective against uterine fibroids.Conclusions: Our findings indicate that parameters such as earlier age of menarche, early primiparous age，lower parity and a variety of female reproductive diseases could increase the risk of uterine fibroids. These findings may be used to guide the formulation of effective prevention and intervention protocols to improve the reproductive health of rural women.

scholarly journals Causes and clinical picture of very early preterm birth

2021 ◽  
Vol 6 ◽  
pp. 44-49
Author(s):  
O.V. Mosendz
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Uterine Fibroids ◽  
Perinatal Outcomes ◽  
Reproductive Age ◽  
Surgical Interventions ◽  
Urogenital Infections ◽  
Fetoplacental Complex ◽  
Inflammatory Processes ◽  
Early Preterm Birth

The objective: the determination of the risk factors, causes and clinical features of very early preterm birth.Materials and methods. The data of anamnesis, the course of pregnancy, childbirth and perinatal outcomes in 166 women of reproductive age with very early preterm birth at 22–27 weeks of gestation were analyzed. The fact of childbirth at these terms of pregnancy is the main criterion of inclusion. The patients were divided into two groups depending on the criteria of live birth: 1 group — 79 women, whose labor was regarded as late miscarriage (retrospective study); 2 group — 87 women with very early preterm (prospective study). Exclusion criteria: congenital malformations of the fetus. Results. The main risk factors for the development of very early preterm labor are urogenital infections (83.7 % and 78.9 % in 1 and 2 groups, respectively). A combination of pathogens was found in almost half of the subjects (43 % in 1 group, 44 % in 2 group). The patients in both groups had a complicated general and obstetric anamnesis, in particular, a significant frequency of inflammatory processes of the genital organs (50.0 % – in 1 group and 59.2 % – in 2 group), surgical interventions (50.0 % and 59.2 %, respectively), as well as hormonal disorders and related diseases (ovarian dysfunction – 27.8 % and 27.6 %, uterine fibroids – 16.4 % and 17. 2%, ovarian cysts – 11.4 % in both groups). 35.4 % of patients in 1 group and 28.7 % of patients in 2 group had a history of chronic foci of infections, pathology of the urinary system – 30.3 % and 28.7 %, respectively, of the digestive tract – 24 % and 22.98 %, hypertension – 32.9 % and 31 %. The main complications of gestation in pregnant women in both groups in the II trimester were the threat of abortion (43 % and 30 %, respectively) and dysfunction of the fetoplacental complex (22.7 % and 21.8 %). This caused fetal growth retardation in both groups – 66 % and 63 % of newborns, respectively.Conclusions. Analysis of the general and obstetric history, the presence of infectious factor in combination with extragenital pathology confirm the polyetiology of the causes that leads to very early preterm birth. Considering the main risk factors of preterm birth, a complete examination for urogenital infections in women before and during pregnancy, followed by treatment and restoration of normal vaginal biocenosis, as well as the study of fetoplacental system function from early pregnancy is neseccary.Preventive measures and timely treatment of fetoplacental disorders should prolong pregnancy for the terms in which there is the best way to improve perinatal outcomes.

scholarly journals Predictors and symptomatic burden of uterine fibroids among women in South-Eastern India: a cross-sectional survey analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 524
Author(s):  
Dharitri Swain ◽  
Chanchal Yadav ◽  
Jyoti Kumari ◽  
Monika Rani ◽  
Priyanka Daunrai Rongmei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Age Group ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
Reproductive Age Group

Background: Uterine fibroid is the most common pelvic tumor in women of reproductive age and are asymptomatic in at least 50% of affected women. Various risk factors are associated with development of uterine fibroids during this reproductive age. The present study established various associated risk factors increases the prevalence of uterine fibroid among reproductive age group and clinical symptoms burden of diagnosed case.Methods: A cross sectional study design was used to collect samples for a period of six months in an OPD basis. Purposive sampling technique was used to select the 362 sample of reproductive age group (15-45 years) women in a tertiary care hospital, Southeastern India. Women diagnosed with uterine fibroid by ultrasonography were included as cases. Symptomatic features and associated risk factors of UF were collected through structure interview schedule.Results: Point prevalence of uterine fibroid among women in reproductive age group during the period of six months was 20%. Majority of them were in the age group of 30-39 years. Demographic factor such as overweight and obesity and consume dairy products daily has increased the prevalence of UF, whereas use of oral contraceptive pills and normal BMI had inverse relationship with UF risk. Most of the cases reported of having menstrual disturbances like heavy bleeding, passes blood clots during menstruation, prolonged period, urinary symptoms and pressure symptoms were considered independent predicting factors for the occurrence of uterine fibroid.Conclusions: Uterine fibroid is more prevalent among women of reproductive age causing various bleeding and renal symptoms that can have negative impact on quality of women’s life.

The role of vitamin D deficiency in the risk for uterine fibroids relapse after laparoscopic conservative myomectomy in women of reproductive age

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 20-24
Author(s):  
Yanina A Lebedeva ◽  
Inna I Kovalenko ◽  
Oleg L Molchanov ◽  
Dmitrii V Baibuz ◽  
Natalia V Kulikova
Keyword(s):  
Vitamin D ◽  
Surgical Treatment ◽  
Vitamin D Deficiency ◽  
Negative Impact ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Risk Of Recurrence ◽  
Vitamin D Levels

Relevance. Due to the high prevalence of uterine fibroids in women of reproductive age and the negative impact on reproductive health, one of the priority tasks of specialists is to search not only for new therapeutic methods, but also for ways to prevent this disease. Aim. To determine the role of vitamin D deficiency in the risk of uterine fibroids recurrence after surgical treatment in women of reproductive age. Materials and methods. A comparative analysis of the recurrence rate of uterine fibroids in patients of reproductive age after surgical treatment. The study involved 49 women of reproductive age 20-39 years (average age 31.5±4.3 years) with unrealized reproductive plans. All underwent surgical treatment in the scope of laparoscopic conservative myomectomy for uterine fibroids with different symptoms. All patients were given vitamin D levels. Results. In 93.5% of cases, the risk of recurrence of uterine fibroids increases at vitamin D levels below 34.5 ng/ml, when reaching 38.6 ng/ml and above, the risk of reformation of nodes is minimal. Conclusions. When the vitamin D level exceeds 38.6 ng/ml, it is possible to minimize the risk of recurrence of uterine fibroids in women of reproductive age, thereby avoiding repeated surgical interventions and associated complications.

Evaluation of the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 19-23
Author(s):  
Yanina A Lebedeva ◽  
Inna I Kovalenko ◽  
Oleg L Molchanov ◽  
Dmitrii V Baibuz ◽  
Natalia V Kulikova
Keyword(s):  
Reproductive Potential ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Results Of Treatment ◽  
High Prevalence ◽  
Group 2 ◽  
Group 1

Relevance. Due to the high prevalence of uterine fibroids in young women and the possible effect on reproductive potential, the development, implementation and application of the most benign treatment methods are a priority. Aim. To evaluate the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age. Materials and methods. A comparative analysis of the results of treatment of patients of reproductive age with uterine myoma has been carried out. Group 1 (n=38) included patients who underwent conservative myomectomy and/or hysteroresectoscopy without subsequent anti-relapse drug therapy. The average age is 31.5 years (4.6). Group 2 (n=43) included patients after conservative myomectomy who received mifepristone as anti-relapse therapy after surgery. The average age is 31.9 years (4.5). Results. Mifepristone therapy, as an adjuvant treatment after conservative myomectomy, can significantly reduce the risk of recurrence, stabilize the size of the uterus, reduce the severity of clinical manifestations in the form of pain syndrome and heavy menstruation associated with relapse, thereby improving the reproductive health of women. Conclusions. The use of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age is a very effective method for treating uterine fibroids and can be considered as a therapy of choice in such patients.

scholarly journals Innovative approach to the rehabilitation of patients undergone surgical treatment of herniated invertebrate discs

2016 ◽  
Vol 19 (3) ◽  
pp. 125-128
Author(s):  
A. G Kulikov ◽  
Daria D. Voronina ◽  
I. V Luppova ◽  
S. G Abramovich
Keyword(s):  
Surgical Treatment ◽  
Blood Circulation ◽  
Clinical Manifestations ◽  
Rehabilitation Program ◽  
Aquatic Therapy ◽  
Spinal Degeneration ◽  
Comprehensive Rehabilitation ◽  
The Common ◽  
Magnetic Therapy ◽  
Treatment Procedures

One of the most remarkable manifestations of the spinal degeneration is the occurrence of herniation of the invertebrate disc and in more than in 80% of cases the disease is revealed in the lumbar spine. The surgical treatment is merely a phase in the treatment of a patient. The changes persisting in the postsurgical period necessitate the implementation of an early comprehensive rehabilitation program, including along with medication treatment, kinesitherapy, aquatic therapy and physical therapy. The aim of the study - the elevation of the efficacy of rehabilitation ofpatients after surgical treatment of herniated invertebrate discs in lumbar sacral spine by including into the complex of treatment procedures general magnetic therapy. There was performed an examination and observation of 52 patients divided into 2 groups matchedfor the gender, age and main clinical manifestations. All patients received basic therapy including medications, kinesitherapy, hydro kinesitherapy. Patients from the basic group additionally received the course of the general magnetic therapy. It has been found that procedures of the general magnetic therapy were revealed to favourably affect on the common symptoms of the disease, regeneration processes, as well as improves of the state local blood circulation in the area of surgical intervention.

scholarly journals Long-term effects of hysterectomy due to uterine fibroids in women of reproductive age

2021 ◽  
pp. 3-6
Author(s):  
Olha Proshchenko ◽  
Iryna Ventskivska ◽  
Natalia Kamuz
Keyword(s):  
Valsalva Maneuver ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Vaginal Prolapse ◽  
Reproductive Age ◽  
Long Term Results ◽  
Women Of Reproductive Age ◽  
Cough Test ◽  
Group I

The article presents an analytical assessment of long-term postoperative consequences in women of reproductive age after hysterectomy for uterine fibroids. The aim of the study to determine the structure of long-term results of hysterectomy for uterine fibroids in women of reproductive age using different approaches to the possibility of optimizing the diagnostic algorithm in the preoperative period in the future. Materials and methods – 160 women aged 40 to 50 years with symptomatic uterine fibroids, who underwent hysterectomy performed by vaginal, laparoscopically assisted vaginal, abdominal, were examined. Research methods are the following: physical examination of patients, assessment of pelvic floor (cough test, Valsalva maneuver, “Stop Test” with Kegel cones), diagnosis of urogenital dysfunction using a standardized POP-Q system; instrumental examination:, complete urodynamic testing, cystometry, (for assessment of the severity of urinary incontinence the classification of the International Continence Society (ICS) was used); assessment of the patient’s quality of life on the 10th day after surgery, 3, 6, 12 months and three years after surgery using the international standard questionnaire MOS SF-36; study of the local infectious status of the female body (bacteriological and bacterioscopic examination of discharge from vagina and urethra, determination of vaginal pH Results and their discussion. The structure of distant postoperative manifestations was determined (after 36 months of postoperative monitoring): clinical manifestations of intestinal function discomfort in the same degree in patients of three subgroups, 2.4 and 2.9 times less often in group I patients indicated chronic pelvic pain, in 1.7 times less often - for genitourinary disorders, vaginal prolapse in a third of cases, especially in women with abdominal HE and classic vaginal HE (30.0±5.0 % and 37.8±5.0 %, respectively, against 17.8±4.0 % – in the group with laparotomically assisted HE). Conclusions. Given the data on genitourinary disorders and vaginal prolapse in almost a third of observations after hysterectomy for uterine fibroids, it is advisable to consider additional examination of latent signs of genitourinary syndrome at the preoperative stage to optimize the choice of access, the volume of surgical treatment.

Sign in / Sign up

Export Citation Format

Share Document