Доброкачественные опухоли и опухолеподобные поражения яичников: структура, методы диагностики, тактика оказания медицинской помощи

Abstract

Relevance of the study. Benign ovarian tumors (hereinafter referred to as BOT) and tumor-like lesions of the ovaries are an acute problem in gynecology, since they develop mainly in women of childbearing age (75-87%) and cause a decrease in reproductive potential. The aim of the study was to study the structure of the BOT and tumor-like lesions of the ovaries, to identify defects in the treatment. Research materials: in compliance with the legislation on the protection of personal data, with the preservation of medical secrecy, the medical records of 350 women who underwent inpatient treatment in 2017-2020 in the gynecological department of Maternity Hospital No. 3 in Tyumen were studied. Results of the study. Only 151 (43%) patients were admitted with complaints, the main complaint was nagging pain in the lower abdomen. The structure of the pathology: corpus luteum cyst – 95 (27%), follicular cyst – 63 (18%), benign endometrioma – 77 (22%). More rare cases: benign cystadenoma – 36 (10%), paraovarian cyst – 30 (9%), benign teratoma – 28 (8%), paratubar (inflammatory) cyst – 21 (6%). There were no statistically significant differences in the frequency of localization (right, left ovaries). The accuracy of ultrasound diagnostics was 99%. Conservative treatment was used in 89 (56%) patients with tumor-like ovarian formations (follicular cyst, corpus luteum cyst). The gynecological history of patients is characterized by a high frequency of inflammatory diseases of the pelvic organs, including chronic salpingo-oophoritis (22%), chronic metroendometritis (10%), inflammatory disease of the cervix (27%). The infertility rate was 7%. Normal CA-125 values were in 83%, increased in 17%. In the tactics of surgical treatment of various forms of BOT and tumor-like lesions of the ovaries, laparoscopy (73%) and Pfannenstiel laparotomy (25%) prevailed. Conclusion. The corpus luteum cyst and follicular cyst are the most frequent nosological form of pathological processes of the ovaries, they require careful diagnosis and, if necessary, the timely appointment of conservative treatment. Surgical treatment in the absence of indications for that or due to inappropriate therapy at the prehospital stage is considered as a defect in the provision of gynecological care.