Результаты хирургического лечения проляпса в области заднего сегмента тазового дна у пациенток с раком молочной железы на фоне эндокринной терапии

Abstract

The cause of pelvic organ ptosis in women is damage or weakening of the connective tissue and muscle structures of the pelvic floor, which normally serve as a supporting framework for pelvic organs and are estrogen-dependent. Most women with receptor-positive breast cancer are prescribed adjuvant endocrine therapy after surgery to suppress estrogen levels. The authors investigated the results of surgery of posterior pelvic floor segment prolapse in this category of patients (n = 50). The study was conducted in a comparative aspect with a group of patients who do not suffer from breast cancer (n = 50). For anatomical correction of prolapse, posterior colporaphy, anterior levatoroplasty or sphincterolevatoroplasty, resection of rectal mucosa prolapse using the STARR method, sacrocolporectopexy, depending on the pathology of certain structures of the pelvic floor, were performed. The evaluation of the treatment results was carried out after 3 years using clinical, radiological (defecography) and physiological methods (anorectal functional tests) studies. The authors showed that the symptoms of obstructive defecation and anal incontinence were less amenable to correction in patients with endocrine therapy. The authors concluded that it is necessary to prevent pelvic organ prolapse and the advantages of surgical correction of the initial forms of prolapse in this group of patients.