Сучасний погляд на етіологію, діагностику, лікування та профілактику спайкового процесу органів малого таза у жінок репродуктивного віку

Abstract

The article presents a review of the literature in recent years on the problem of peritoneal pelvic adhesions in women of reproductive age. The main issues of etiology and pathogenesis of peritoneal pelvic adhesions as one of the leading causes of reproductive dysfunction, chronic pelvic pain and surgical complications in patients of reproductive age are highlighted. It has been shown that the main etiological preconditions for formation of adhesions and the development of adhesive intestinal obstruction are a peritoneal injury, intraabdominal bleeding, presence of infection, influence of various aggressive substances, local antibiotic therapy, and regional tissue ischemia. Peritoneal commissures have high health and social significance due to a wide range of surgical procedures causing peritoneal trauma and to a high frequency of adhesive process. Pelvic adhesion is a dynamic differentiated cell vascularized structure. Development of an active inflammatory process, which involving cells and proinflammatory mediators may be into a stage of tissue remodeling, collagen formation, that is the initial symptoms of adhesions. A vicious circle and a cascade of mutually supporting changes leads to adhesive disease and patients’ disability. Whatever reasons of adhesions are, ones are a major cause of pelvic pain, infertility and ovarian failure. Though the researches of the pathophysiological mechanisms of growth of adhesions are going on the attempts to determine effective methods to prevent adhesions do not rule to expected results. Keywords: peritoneal adhesions, adhesive disease, etiology, pathogenesis, prevention, treatment, reproductive age.