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 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 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 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.

Assessment of quality of life after hysterectomy with uterine myoma

2020 ◽  
pp. 59-63
Author(s):  
I. Ventskivska ◽  
◽  
О. Proshchenko ◽  
Ya. Vitovsky ◽  
S. Markitanyuk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radical Surgery ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Sexual Disorders ◽  
Women Of Reproductive Age ◽  
Urogenital Dysfunction ◽  
The Impact

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.

scholarly journals Identifying risk factors of anemia among women of reproductive age in Rwanda - a cross-sectional study using secondary data from the Rwanda Demographic and Health Survey 2014/2015

2019 ◽  
Author(s):  
Dieudonne Hakizimana ◽  
Marie Paul Nisingizwe ◽  
Jenae Logan ◽  
Rex Wong
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Pregnant Woman ◽  
Intrauterine Device ◽  
Cross Sectional Study ◽  
Hemoglobin Level ◽  
Reproductive Age ◽  
Sectional Study ◽  
Women Of Reproductive Age ◽  
Cross Sectional

Abstract Background Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing countries, including Rwanda, where it increased in prevalence between the 2015 and 2010 Rwanda Demographic and Health Survey (RDHS) reports. A thorough understanding of its risk factors is necessary to design better interventions. However, to the best of our knowledge, no study has been conducted in Rwanda on a nationally representative sample to assess factors associated with anemia among WRA. Accordingly, this study was conducted to address such gap. Methods A quantitative, cross-sectional study was conducted using data from the RDHS 2014-2015 report. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having a hemoglobin level equal to or below 10.9 g/dl for a pregnant woman, and hemoglobin level equal to or below 11.9 g/dl for a non-pregnant woman. Pearson’s chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis, respectively. Results The prevalence of anemia among WRA was 19.2% (95% CI: 18.0 - 20.5). Four factors were found to be associated with lower odds of anemia, including being obese (OR: 0.61, 95% CI: 0.40 - 0.91), being in the rich category (OR: 0.74, 95% CI: 0.63 - 0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74 - 0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50 - 0.73). Five factors were associated with higher odds of anemia, including being underweight (OR: 1.39, 95% CI: 1.09 - 1.78), using an intrauterine device (OR: 1.98, 95% CI: 1.05 - 3.75), being separated or widowed (OR: 1.35, 95% CI: 1.09 - 1.67), and living in the Southern province (OR: 1.45, 95% CI: 1.11 - 1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06 - 1.88). Conclusion Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations in anemia risk, seek to improve women’s economic statuses, and strengthen iron supplementation especially for Intrauterine device users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.

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