DIAGNOSIS AND EVALUATION OF CRITERIA FOR CONDUCTING SURGICAL TREATMENT IN WOMEN WITH CYSTOCELE AND STRESS URINARY INCONTINENCE

Purpose of the study. Clarification of absolute and relative criteria for the surgical treatment of pelvic pelvic prolapse (PMT) and stress urinary incontinence (SNA). Materials and methods. A survey was conducted on 85 patients in whom OST and SNA were detected. The women were divided into groups according to the stage of POMT and SNM: 2nd group – 32 patients with PIDs of stages I and II and SNM 2a, 2b types of lung and moderate severity; Group 3 (main) - 53 patients with MIDI III and IV stages and MSM type 3 moderate and severe severity. This group of patients subsequently undergone operative treatment according to the patent for utility model No. 109201. The main group (3rd group) included: 3a group – 28 women from the OMT III and IV stages and SNM 3rd type of medium and severe severity without delay in urination; 3b group – 25 women with STI III and IV stages and SNM of type 3 of moderate and severe degree of severity with delay of urination (chronic or acute). 15 women were examined without complaints, who entered the control group (1st group). Results. According to the results of the study, it was recorded that, regardless of the stage of the PMS and SNM, even their minimal manifestations significantly reduced the quality of life of patients (by 64%) due to the impact on the physical, but to a greater extent, on the psychological components of health. Conclusion. The absolute criterion for operative treatment is a set of prolapse of the pelvic organs (PMTCT), urinary incontinence, vesicularization of the bladder type 2a and above, an increase in the posterior urethro-vascular angle of more than 114 °. Treatment of stress urinary incontinence on the background of OST should necessarily include fixation of the uterine ligation apparatus and surgery on the Berch in connection with significant deformation of the bladder neck. Keywords: pelvic organ prolapse, urinary incontinence, methods of diagnostics.

Experience in surgical correction of genital prolapse caused by abdominoperineal operations for colon cancer in anamnesis

In recent studies, it has been established that extralevator abdominoperineal extirpation (ELAPE) of the rectum can improve the oncological results of treatment of distal rectal cancer compared to standard abdominoperineal extirpation. As a result of extralevator dissection, a large defect of the perineum is formed, which requires plastic closure. While performing ELAPE, the structures that form the pelvic diaphragm are affected. This increases the risk of pelvic organ prolapse in women and significantly affects the quality of life of these patients, which requires subsequent surgical treatment. Despite the fact that pelvic organ prolapse develops as a consequence of previous surgical treatment by an oncologist, they do not consider it as a complication in the long-term postoperative period. Such patients are not referred to the operating gynecologist. Currently, this problem is poorly understood and there are no standardized approaches to the surgical treatment of pelvic prolapse in this category of patients.