Problematic issues of treatment of ovarian endometriomas in women of reproductive age

Abstract

Introduction. The wide spread of endometriosis disease, difficulties in diagnosing and choosing the tactics of its treatment cause the existing problems of management of endometriosis. Absence of the onset of the period of stable remission, high frequency of recurrence of the disease make it possible to consider this problem actual in the group of patients of reproductive age, and especially among women with previously realized reproductive potential, since pregnancy is considered to be the important principle of treatment of endometriosis. The aim of the study was to study the effectiveness of various treatment regimens for endometriomas in patients with previously realized reproductive potential. Materials and M ethods. 44 women aged from 17 to 49 years were examined: the first group consisted of 25 healthy nonpregnant women, the second group included 19 women, with endometriomas receiving the traditional (subgroup 2a) and complex (subgroup 2b) treatment. Results. It was revealed that in patients receiving traditional therapy, in the end of the course of treatment, the initial activation of the humoral unit of the immune system was observed, which indicated the need for immunocorrection. In patients receiving complex therapy, normalization of the body's immune homeostasis, stabilization of the processes of apoptosis and proliferation, the main links in the etiopathogenesis of endometriosis were noted, which indicated an improvement in the effectiveness of the treatment. The control ultrasound in the dynamics in 1 and 3 months in patients who continued to receive complex therapy, revealed a decrease in the size of pathological formation and a pronounced antiproliferative effect on the hyperplastically altered endometrium, diagnosed before the start of treatment in 21.05% of patients. After 3 months of treatment, there was no need for an endometrial biopsy in this group of patients. Conclusions. With the use of a comprehensive approach to the treatment of endometriomas normalization of the body's immunodeficiency parameters, regression of the endometriomas and the absence of hyperplastic endometrial processes are noted, which allows to recommend this scheme for further use.