Репозиторий Университета

© 2018, Dynasty Publishing House. All rights reserved. The objective is to study the results of treatment of female patients with endometrial hyperplasia considering the 2014 WHO Classification and to make adjustments in tactics of conducting it, based on the individual approach. Patients and methods. Eighty-two (82) female patients at the age from 19 to 47 years (37.5 ± 2.6 years) were examined. Most of them (54/65,8%) were in the reproductive period. Methods of diagnosis: a) 2D and 3D transvaginal ultrasound scan with the use of color Doppler; b) video histeroscopia; C) histologic study of endometrial scratching or macropreparations, removed during the surgery. Results. It has been found in the analysis of the 2014 WHO Classification and Protocol RCOG & BSGE that when EH diagnosed for the first time in women of reproductive age after 3 months of taking NET, it is advisable to use estrogen-progestin products (COCP) for another 3 months with prolongation if necessary for further protection from unwanted pregnancy. The morphological picture of AEH should be carefully estimated, taking into account that in its simplest form total ablation of the endometrium is valid. Conclusion. No algorithm is able to cover all possible clinical situations and to adhere to individual approach in the choice of patient treatment tactics with endometrial hyperplasia.

© Bionika Media Ltd. Objective. To investigate whether early endometrial cancer can be treated and whether fertility can be preserved in young women, by using a hormonal combination: levonorgestrel intrauterine hormonal system (LNG-IUS; Mirena 52 mg of LH) and gonadotropin-releasing hormone agonists (Zoladex 3.6 mg). Subjects and methods. The investigation covered 79 patients. The case histories of 37 patients with atypical hyperplasia and 42 with stage IA (T1aNxMo) endometrial cancer were analyzed. The patients’ mean age was 33 years. The investigation was conducted at the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation. Results. Primary treatment was completed in 67 (84.8%) patients and in 12 (15.2%) during hormonal treatment. After completion of special treatment, 8 (11.9%) of the 67 women had 10 pregnancies that resulted in childbirth and spontaneous miscarriage in 8 and 2 cases, respectively. Recurrences and incurable disease were stated in 3 (4.2%) and 9 (12.8%) cases, respectively. Repeated hormone therapy cycles were not performed because the patients had refused organ-sparing treatment. All the 12 (17.1%) patients were successfully operated on. Conclusion. The proposed treatment regimen is a highly effective medical treatment in patients with precancer and early endometrial cancer. Independent hormone therapy is undoubtedly the best alternative to hysterectomy today in this group of patients who want to preserve reproductive function.