Organ-preserving operations are on the organs of the small pelvis for proceeding in a reproductive health
Authors: Kolesnik Ganna , Adamchuk Nazariy 
Published: January 2024

The objective: increase of efficiency of treatment of infertility and prophylaxis of perinatal pathology for women with violation of reproductive function as a result of dysfunction of ovaries on a background different genital morbidity on the basis of improvement and introduction of the algorithm of diagnostic, treatment-and-prophylactic and rehabilitation measures with the use of modern endoscopic and reproductive technologies.

Materials and methods. The research was conducted in two stages. In the first stage, the functional state of the reproductive system was studied in 316 patients with female infertility (1st group), which carried organ-preserving operations on the organs of the small pelvis. These patients were up-diffused into 4 sub-groups taking into account the variant of present pathology. In this second stage, the evaluation of clinical motion of pregnancy and births is conducted in 129 (40,8%)from 316 patients, operated on the first stage, which was also up-diffused on 4 sub-groups. The complex of the conducted research included clinical, endoscopic, echographic, doppler, endocrinology, morphological, and statistical.

Results. The patients of reproductive age have organ-preserving surgical interferences on the organs of the small pelvis, regardless of nosology, during a 6 miss cause a considerable diminishing of the volume of the uterus and both ovaries and also brings to the increase of vascular resistanceviolation over the collateral network on the periphery of ovaries with diminishing of the volume of peripheral fabric in 1,5 times. During comparison of different variants of operative interferences the state of follicle pool(anymore after laparoscopic operative interference by comparison to laparotomy – on 33,7%; after the use of bipolar electrosurgery by comparison to monoarctic – on 25,3%). The efficiency of the conducted operative interference with the subsequent rehabilitation of reproductive function is 33,0%, here frequency of the use of assisted reproductive technologies arrives at 53,6%. For different pathology it got the followings results: for women with the pathology of ovaries pregnancy came in 31,4%, and a level of the use of assisted reproductive technologies was 56,3%; at the pathology of the uterus – 32,3% and 48,4%; at pipe peritoneal to the factor – 35,4% and 55,9%; at the presence of adhesive process on a background the united pathology – 29,3% and 81,8%.

Conclusion. Women, operated on concerning different genital pathology in the volume of organ-preserving operations, are included in the group of high risk in relation to the efficiency of proceeding in a reproductive function, and in future and considerable frequency of perinatal pathology. It is necessary to develop stage-by-stage going near the conduct of such women, beginning from the quality of operative interference and concluding tactic of conduct of pregnancy and births. Just the same approach will allow for reducing the frequency of reproductive and perinatal pathology for the women of a group of high risk.