scholarly journals Specific Aspects of Life Quality Estimation and Ways of Rehabilitation in Women Who Underwent Uterine Surgery

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
H. M. Havrylyuk ◽  
O. M. Makarchuk

Recently, it has been noticed a great number of uterine fibroids in women with unrealized reproductive function; moreover, the number of combined forms of hyperplastic processes of the reproductive system in 20-25% of women under 30 years of age and 60% of women over 40 years of age is constantly growing creating a favourable background for cancer. It is also known that women with hyperplastic processes suffer from psycho-emotional disorders both before surgeries and after surgical recovery; many of them are diagnosed with adjustment disorder. As many researches note, the main psychotherapeutic aspects include passive view of life, increased anxiety, tendency to dependent behaviour, rejection of own body, protective behaviour and problems with self-assessment. It should also be noted that a comprehensive study of clinical and laboratory data and subjective criteria of life quality is essential in assessment of the feasibility of hysterectomy in women of reproductive age, even if they do not plan to bear children in the future. The objective of the research was to estimate life quality as well as to improve the system of dispensary observation and rehabilitation of women who underwent uterine surgery.Materials and methods. There was performed a comprehensive examination and surgical treatment of 60 women of reproductive age with uterine fibroid who underwent hysterectomy with preservation of appendages. We used modern high quality endocrinological and instrumental techniques. The assessment of the received data was made immediately after surgery, 6 and 2 months, 3 and 5 years after surgery. Quality of life was studied on the basis of a comprehensive assessment using the modified scale of the Nottingham Health Profile and the study of such important indicators as energy, sleep, emotional reactions, social isolation, physical activity, pain. All statistical analysis was performed using a standard package “Statistica for Windows – 6.0”.Results and discussion. On the basis of anamnestic data of patients we revealed health deterioration with high rates of liver and gastrointestinal tract disorders, metabolic disturbances (obesity, hypertensive disorders, fibrocystic breast disease), metabolic-endocrine changes and surgery. Reproductive health in women with uterine fibroid was characterized by long establishment of regular menstrual cycle, its breach in the period of puberty, inflammatory diseases of the genital organs, benign ovarian tumours and their surgical removal, inadequate reproductive behaviour with absent or delayed implementation of reproductive function and induced abortion. 12 months and especially 5 years after surgery there was noticed a progressive deterioration of the ovarian function, which was reflected as the reduction in their volume due to the reduction in the number and size of follicles, deterioration of blood supply to the ovaries, decreased blood flow in the internal iliac artery basin. It should also be noted the progressive hypestrogenism; in addition, there was a clear correlation with the age of the woman, who underwent surgical operation. Changes in life quality of patients with hyperplastic processes of the uterus were manifested in the postoperative period as follows: a decrease in physical activity (43.33% of cases), increased sexual dysfunction (36.66%), inhibition of mental state, conflict-orientated social behaviour, weakening of role functions and subjective deterioration of health and life quality (51.66% of cases).Conclusions. Thus, surgery on uterine fibroids with total or subtotal hysterectomy contributes to interference in a complex neuroendocrine interaction between hypothalamus, pituitary, ovaries, adrenal cortex, thyroid gland and affects the blood supply, innervation, and lymph efflux in the pelvic floor; therefore, postoperative syndromes are polyglandular and polysystemic. Long-term effects after surgery are accompanied by progressive hypestrogenism, decrease in the ovarian function (the reduction in their volume observed during ultrasound examination), reduction in the number and size of follicles, deterioration of blood supply to the ovaries, low blood supply to the internal iliac artery basin.

2016 ◽  
pp. 94-97
Author(s):  
O. Makarchuk ◽  
◽  
G. Gavrilyuk ◽  

One of the most common benign hyperproliferative diseases of the female reproductive organs are uterine leiomyoma, the frequency of which, according to various literature in women of reproductive age is between 20% and 40%, and is the main indication for surgery, including removal of the organ. Long-term effects of surgical interventions for uterine fibroids have been the subject of numerous debates. In modern literature is not much research on the assessment of the quality of life both in organ treatment of uterine fibroids, and after surgical recovery. Quality of life have undoubtedly significant prognostic value and can be used in selecting the optimal treatment of uterine fibroids, as well as the development of individual approach to postoperative rehabilitation of patients. The objective: was the study of quality of life and the search for possible ways to improve in women after surgical healing uterine fibroids. Materials and methods. A survey of 80 women of reproductive age (study group), which was conducted without hysterectomy applications. Clinical and laboratory examination conducted in the dynamics of the postoperative period and at 6, 12 months and 3 years after surgical recovery. Assessment of comparative analysis require further formation of two groups comparing 20 patients with myoectomy and 20 women with no uterus amputation supravaginal applications. The control group consisted of 20 healthy patients. Assessment of quality of life survey conducted by using common clinical trials and monitoring at the individual questionnaire MOS 36- Item Short-Form Health Survey- MOS SF-36. Statistical analysis of the survey results was carried out using the software package Microsoft Office Excel and Statistica 6.0 for Windows. Results. In women, the main indicators of psycho-emotional and vegetative manifestations were most pronounced immediately after surgery and remained stable in three years with no significant deviations in the comparison group. Among the most frequently observed fatigue (76.25%), sleep disorders (88.75%), irritability and mood changes (76.25%) and emotional lability, anxiety and depressive symptoms. Of The results of evaluation of quality of life should be noted that first disturbed functioning role of women because of poor physical and emotional state, as evidenced by the significant differences obtained on the scale of General Health (GH) (overall health). Three years after the rapid improvement in women’s core group established stable condition posthisterektomy pronounced effect on quality of life. Thus, in total 33.75% of the principal groups characterized as low quality of life, compared with 5.0% of patients in the control group and 10,0% of women with myoectomy. Conclusions. The highest level of dissatisfaction with life studied patients presenting in health – 28.75% (23) cases, slightly less professional – 22.5% (18), emotional – 17.5% (17) and as in the sexual sphere – 13.75% (11) cases. That associated complications related symptoms posthisterektomy syndrome, increases the level of stress and hysterectomy as the body creates prerequisites for psychosomatic disorders. This action provides additional risk factors for the development of psychosocial distress in this group of patients. Key words: uterine fibroids, hysterectomy, posthisterektomy syndrome, psychosomatic disorders, quality of life.


10.12737/3314 ◽  
2014 ◽  
Vol 21 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Камаев ◽  
I. Kamaev ◽  
Русановская ◽  
G. Rusanovskaya ◽  
Шпрыков ◽  
...  

The authors assessed the quality of life of 263 women of reproductive age. The main group consisted of 139 women aged o18-44 as the patients with active pulmonary tuberculosis disease treated in 2011-2012, and the other group of comparison consisted of 124 healthy women of the same age. To assess the life quality the authors used Russian version of the SF-36 which included questions of medico- social nature. It was proved that all the life quality parameters of the women suffering from tuberculosis disease were reduced in comparison with the control group of the healthy women. The only exception was the pain syndrome for which the statistical significance wasn’t reached at all and the physical functioning was assessed at the lowest level. The life quality problem was identified almost in half of the women that proved by the obtained data. Analysis of quality of life of the women established that 25-34 years respondents had the highest reducing of the rates. The analyzed group of patients differed from the low level of the socio- economic independence relatively favorable structure of clinical tuberculosis forms but with a high frequency of tubercle bacilli discharging and detection of lung tissue destructing. Generally, women with pulmonary tuberculosis had numerous risk factors for disease and co-morbidities aggravating the main process. The unfavorable health and social hygienic characteristics of the analyzed group of patients contribute to late making a diagnosis and spreading the infection among the population, including the women of reproductive age. Therefore health care professionals need to make efforts to promote healthy lifestyle and prevention of tuberculosis with this contingent that will allow to prevent new cases of disease and to reduce morbidity. The aim of any disease treatment, including tuberculosis should be considered as acts to improve the life quality of patients in case of positive clinical dynamics. Therefore it is important to guide medical practice for the patients’ psychosomatic status correcting in the early stages of disease that will be able to solve health problems more successfully. Thereby, the authors think it is necessary to organize services; to open offices where patients could get psychosocial correction and rehabilitation, to train the specialists.


1993 ◽  
Vol 2 (3) ◽  
pp. 181-197 ◽  
Author(s):  
Christine P West

Uterine fibroids are estimated to affect up to 25% of women of reproductive age and are a common cause of morbidity, being associated with menstrual dysfunction, iron deficiency anaemia, pregnancy wastage and subfertility. Their pathogenesis remains unknown but their association with ovarian function and oestrogen production is undisputed and supported by their occurrence only after puberty and the shrinkage observed after the menopause. This oestrogen dependency has recently been exploited therapeutically through investigation of the use of agents that induce a hypo-oestrogenic state, the gonadotrophin-releasing hormone (GnRH) or luteinizing hormone-releasing hormone (LHRH) analogues.


2020 ◽  
Vol 11 (3) ◽  
pp. 15-19
Author(s):  
N. I. Volkova ◽  
Yu. S. Degtyareva

Obesity is a common problem among women of reproductive age. Overweight is known to negatively affect a woman’s fertility. So, women of reproductive age who are obese may experience menstrual irregularities, endometrial pathology and, ultimately, infertility. The pathogenetic mechanisms of reproductive dysfunction in obesity remain actively studied issues. It was established that leptin synthesized by adipose tissue inhibits granulosis, cell steroidogenesis and interferes with the ovulation process, which can directly affect reproductive function. Insulin resistance and compensatory hyperinsulinemia, which accompany obesity in women, can contribute to menstrual irregularities, ovulation and, ultimately, fertility. Obesity is also characterized by a state of «relative functional hyperandrogenism», which can affect ovarian function, contributing to the development of infertility. Moreover, obesity is characterized by a state of hyposomatotropinism, which can affect fertility, through changes in ovarian and endometrial function. Weight loss is most likely able to restore fertility in most cases, but there are no practical guidelines that would help the clinician choose the best method to reduce body weight from increased physical activity, dietary restrictions, drug therapy and bariatric surgery.


2021 ◽  
Vol 50 (3) ◽  
pp. 100-102
Author(s):  
V. I. Konovalov ◽  
M. A. Zvychayny

The aim of the study was to investigate the effect of endometriosis and somewide-spread contemporary methods of its conservative hormonal and operative treatment on the life quality of women of reproductive age. 546 women, aged 20-40, were examined: 371 patients with initially diagnosed endometriosis, 64 after conservative hormonal therapy, 111 after efficient surgical interventions and 30 healthy women (a control group). The following conclusion has been made: endometriosis arising at the reproductive age greatly deteriorates the life quality of women as compared to the healthy ones but none of the studied methods of its conservative hormonal therapy and efficient surgical treatment enables its rehabilitation.


2021 ◽  
Vol 2 (2) ◽  
pp. 102-109
Author(s):  
Made Indira Dianti Sanjiwani ◽  
I Made Widianantara

Uterine fibroids or leiomyomas are benign neoplasms that occur in the uterus and still become a health problem among women of reproductive age. Predominantly, uterine fibroids are found at productive age but some cases are found after menopause. Based on previous studies, there were 145 cases of uterine fibroids in 2014 and 69.7% were found in women over 40 years. Patients with uterine fibroids show a decreased quality of life with symptoms such as heavy uterine bleeding, pelvic pain, and loss of pregnancy. The pathogenesis of uterine fibroids is still unknown, but genetic factors, cytokines, growth factors, and steroid hormones are weak and play an important role in the development of uterine fibroids. Several studies have shown the effect of resveratrol that can be obtained from grape skins. Resveratrol can reduce extracellular matrix deposition and uterine fibroid cell proliferation. Looking at the induced events then resveratrol is effective in preventing the progression of uterine fibroids.


2020 ◽  
pp. 59-63
Author(s):  
I. Ventskivska ◽  
◽  
О. Proshchenko ◽  
Ya. Vitovsky ◽  
S. Markitanyuk ◽  
...  

Hysterectomy, performed in reproductive age, undoubtedly causes a decrease in all parameters of quality of life and contributes to the development of imbalance of hormonal homeostasis, psycho-emotional, vegetative-neurotic symptoms, increasing sexual and urogenital dysfunction, impeding psycho-social adaptation in the family,the professional and intellectual spheres of a woman’s life. This aspect is often overlooked by surgeons when evaluating the effectiveness of treatment, although it has a significant impact on recovery from surgery. The article presents data on experimental psychological research, evaluation of the severity of urogenital dysfunction using a standardized POP-Q system, characteristics of quality of life parameters both at the stage of preoperative observation and within 1, 3 and 5 years after surgery in 80 women of reproductive age with uterine fibroids who have undergone vaginal hysterectomy. The comparison group included 60 patients with hysterectomy performed by abdominal access. According to the results of this study, in women of reproductive age after radical surgery for fibroids, it was determined that the leading violations of quality of life after hysterectomy are general somatic symptoms, psycho-emotional disorders, genitourinary and sexual disorders. Radical operations for uterine fibroids cause an increase in the proportion of urogenital disorders, among which the most important are urinary incontinence and prolapse, the clinical manifestations of which have a negative impact on, including the psychosocial sphere, while reducing quality of life. Today there is no consensus on the degree of impact of radical surgery for uterine fibroids on the versatility of metabolic and hormonal homeostasis, the formation of psychovegetative symptom complex, and as a consequence, the impact on quality of life, which necessitates a validated method of quality of life optimization of the rehabilitation program with personalized consideration of the leading factors of status comorbidity when planning surgical treatment. Keywords: uterine fibroids, hysterectomy, quality of life parameters.


2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Donna M. Williams ◽  
Kathryn Evans Kreider

The prevalence of type 2 diabetes in women of reproductive age ranges from 3% to 7%. Due to the common nature of this condition, it is imperative for nurse practitioners who care for women to understand evidence-based methods of diabetes management. The aim of this article is to describe current screening and diagnostic criteria for type 2 diabetes, discuss current evidence-based management and patient education necessary to prevent long-term complications, and provide the tools for a healthy reproductive plan in women with type 2 diabetes from puberty until menopause. Diabetes management extends well beyond glucose control, and nurse practitioners should be attuned to all factors that can impact cardiovascular risk and quality of life.


2021 ◽  
Vol 68 (1) ◽  
pp. 40-47
Author(s):  
Catalina Diana Stanica ◽  
◽  
Adrian , Neacsu ◽  
Romina Marina Sima ◽  
Raluca Gabriela Ioan ◽  
...  

Endometriosis is a benign, chronic, estrogen-dependent condition, present in 10% of women of reproductive age. The condition is associated with chronic pelvic pain and infertility that influence their quality of life, as well as married life and has important socio-economic consequences. Despite its high morbidity, its etiopathogenesis is incompletely known. A large number of studies suggest that the ability of endometrial implants to grow in ectopic locations may be correlated with the altered immune response towards the endometriotic tissue. There are enough data to show that immune system mediators, such as cytokines and chemokines, are playing key roles in the onset and olso on progression of endometriosis. There are studies that prove the association between endometriosis and autoimmune diseases. The present paper aims to investigate the implications of the immune response in the etiopathogenesis of endometriosis. The study of cellular or humoral immunity deficits, the presence of autoantibodies associated with this condition, can facilitate the understanding of the mechanisms that lead to the appearance and spread of endometriosis. We hope that this information will ultimately provide the basis for the development of new effective approaches in endometriosis management.


Author(s):  
Mikhail S. Shelygin ◽  
Nadezhda S. Guziy ◽  
Viktoria S. Kaplitskaya

The combined dyshormonal pathology of the uterus and mammary glands represents a great danger to the health of a woman, as well as impairs the quality of life, reduces the reproductive capacity of a woman and leads to premature loss of reproductive function. Steroid hormones play a large role in the regulation of proliferative changes in the uterus and mammary glands. Regulation of target organs, uterus and mammary glands, due to the presence of common mechanisms associated with the presence of the receptor apparatus in the tissues of these organs to sex hormones. The general links of pathogenesis and the high frequency of combined pathology of the uterus and mammary glands are of interest to study not only isolated forms of proliferation, but also the development of a unified systematic approach to the study of this pathology. In recent times, there are opposing views on the role of hormonal dysfunction as a factor in proliferative processes. The management tactics of patients with pathological changes in the mammary gland in various gynecological diseases is an assessment of endocrine status, normalization of hormonal and metabolic disorders, especially when progesterone and cortisol are excreted, testosterone levels are increased, and hyperprolactinemia is affected. Special attention should be paid to patients with menstrual disorders, reproductive health disorders. We believe that the problem of the hyperproliferative processes of the uterus and mammary glands should not be considered only from the perspective of gynecological or mammological practice. This pathology is polymorphic and should have broad interdisciplinary connections with such disciplines as oncology, endocrinology, gastroenterology, psychiatry, therapy, pathomorphology, histology, obstetrics and gynecology. Only by studying all possible links of etiopathogenesis, by combining interdisciplinary communication, it is possible to effectively fight for the quality of patients with a combined pathology of the uterus and mammary glands. Family planning, prevention of unplanned pregnancy, timely implementation of maternity, prevention of miscarriage, the use of modern contraceptives, support for breastfeeding is also of high importance for the prevention of disorders and the preservation, extension of reproductive capabilities, and the prevention of combined dyshormonal pathology of the uterus and breast.


Sign in / Sign up

Export Citation Format

Share Document