Vol 52, No 3 (2003)

There can be no doubt about expediency of reconstructive operations on the uterus in young patients. These operations make it possible to preserve reproductive and menstrual function. However, such operations are accompanied by formation of extensive wound surfaces, considerable muscular tissue defects and characterized by high traumatism, quite often impossibility to ensure effective hemostasis and massive blood loss during operation. In this connection a number of complications during early postoperative period is higher than after hysterectomy. Taking into account the above, it is actual to use the surgical techniques which allow to reduce traumatism of operation and ensure effective hemostasis. In present review different methods used for ensuring hemostasis and reducing operative blood loss during reconstructive operations on the uterus are considered.

We elaborated Operation technique for myo­mectomy by inferior median minilaparotomy with an adequate access of 5 centimeteres and laparoscopic asssistance. We performed 180 operations and experienced that this access is low traumatic but allows surgent's digital contact with utems, traditional Instru­ments usage and hand sewing on enucleated nodus bed.

The authors present analysis of outcomes 768 operations for ectopic pregnancy by laparoscopy. They are offered the new method blood reinfusion during laparoscopy and the original algorithm of diagnosis an ectopic pregnancy. Laparoscopy is the main method of treatment for ectopic pregnancy.

The present work contains the analysis of the follow-upgenitals prolapse surgery carried out with the 56 patients in the Kaliningrad regional centre of endo video surgery within the 1998 - 2002. In process of the analysis we have made a comparative assessment of long-term effectiveness of a number of the operations practiced in our centre. We have shown the evolution frequency pattern of such postoperative complications as dysuria and pain syndrome due to the fixed structures tention, as well as prolapse relapse pattern depending on the applied correction technology. We have also shown lack of their dependance on the degree of prolapse evidence. In addition the author has outlined his point of view on the ways of decreasing the amount of relapses in the follow-upgenitals prolapse.

Diagnostic laparoscopy solves all the problems arising from the doubts in diagnosing acute appendicitis and pelvioperitonitis of gynecological genesis. It must be widely used in the cases where clinical and laboratory data do not allow to reliably diagnose acute appendicitis or its absence, this method also allow to specify the nature of the patient's disease.

Here, data are presented about 150 laparoscopic surgical operations in women with spreaded forms of purativeinflammatory diseases of womb appendices. Laparoscopy is optimal diagnostic and medical intervention in case of gynecological pelvioperitonites. Patients with purative-inflammatory diseases of womb appendixes, inclusions of close organs and wide peritonitis need in the surgical aid trough laparotomic access.

The indices of local immunity were studied by the immunohistochemical method in the endometrium from 151 women with morphological manifestations of chronic endometritis. To confirm the inflammatory process and clarify its nature, the parameters of systemic immunity were studied. According to changes in the parameters of local immunity, three groups of patients were identified. Determination of the parameters of systemic immunity made it possible to confirm chronic endometritis in all women and to identify a group with an autoimmune nature of inflammation.

The article is devoted to the biographical sketches of one of the most distinguished pathologists in gynecology — K.P. Ulezko-Stroganova. The most contribution was done in the questions of myometrial tumours, adenomyosis and endometriosis.

For investigation of the influence of surgical intervention on life quality of gynecological patients 72 women were inspected, whose clinical picture had as a leading syndrome the chronic pelvis pain (CPP), and 32 women with womb myoma, who did not complain against a pain in the pelvis. Life quality was evaluated before surgical intervention and in 10-12 months after it.

It was detected that due to the big expression of psyching disorders of neurotic level in women with CPPtheir starting level of quality life was considerably lower than in patients with womb myoma.

Inspection results manifested that operative treatment led tc improving life quality evaluating in 10-12 months after surgical intervention in women with womb myoma, but did not lead tc changes in majority of patients with CPP.

In this article we present considerable date about simultaneous operations in case of combination both surgical and gynecological pathology. The character of operative interactions is also discussed. There we show the results that characterize the application of laparoscopy and hysteroresectoscopy in case of treatment of differently located uterus myoma.

In this review, it is presented the importance for metabolic processes of decreasing estradiol concentration in connection with prolapsus of ovary function in women. Here, influence of different modes of substitute hormonal therapy, of different progestagenic components included in preparations is discussed.

From 3 to 5 September 2003, the XII International Conference of the Russian Association for Human Reproduction «Reproductive technologies today and tomorrow» took place in St. Petersburg. It was attended by about 400 doctors from all over Russia, from Ukraine, Belarus, Kazakhstan, Georgia, Uzbekistan, Latvia, Sweden, Slovenia, Austria and Scotland.