The features of adhesions’ prevention and treatment in patients with chronic inflammatory pelvic diseases

Abstract

Pelvic inflammatory diseases (PID) are on the second place in the structure of gynecological incidence. It has been proven, that PID develops in case of disturbed immune balance and often complicated by pelvic adhesions. Aim - to study in a comparative aspect the features of expression and distribution of proinflammatory cytokines (IL-1, IL-2, IL-6 and TNF-a) in the tissue of intact pelvic peritoneum and adhesions in women of reproductive age with PID, and evaluate the effectiveness of the proposed method of prevention of pelvic adhesions at women of reproductive age. Materials and methods. One hundred patients of reproductive age suffering from tubal and peritoneal form of infertility, who had a history of chronic PID and pelvic adhesions and thirty healthy women in the control group, were included at this study. Results. The presence of macrophages and proinflammatory cytokines IL-1, IL-2, IL-6 and TNF-a in adhesions of the abdominal cavity in patients with PID is the evidence of their internal inflammatory activity. According to the received data, the number of patients without pelvic adhesions was 4.3 times higher in the main group compared to the control group. Сonclusion. The proposed scheme of pelvic adhesions prevention, taking into account the pathogenic role of inflammatory disorders in the adhesiogenesis, allows to reduce the adhesion after the surgical treatment in 4.3 times and the density of the reformed adhesions in 8 times.