The genital infection as the trigger of development of a myoma of the uterus
Abstract number: 1135_224
Tikhomirov A., Sarsaniya S.
The estimation of efficiency anti-inflammatory therapies in complex treatment of a myoma of an uterus.
There were surveyed 320 patients with a myoma of an uterus. The clinical, bacteriological, immunohistochemical, pathohistological, PCR-researches myometrium, endometrium, a serous cover of a uterus, myomatous units were carried out. The studying of anamnestic material by method 'the case-control.
The inflammatory diseases of genitals were preceded and accompanied in half of the patients of leiomyoma. In 60% various combinations of pelvic inflammatory disease. The method 'the casecontrol has revealed a high risk of development of a myoma of an uterus (the relative risk of occurrence by a parameter of the attitude of chances is 1.75) in patients with inflammatory diseases of genitals. The bacteriological research of 80 myomatous units, has revealed the associated microbic flora in them, in comparison with non changed fabrics of a uterus. Identification of flora by carrying out 400 PCR testifies to presence Chlamydia trachomatis (mainly in submucous) and Ureaplasma urealyticum (in intermuscular-subserous) myomatous units, even at their absence before operation in underlying departments of sexual ways. Pathohistological research of non struck with a myoma uteruses, removed concerning endometritis in a combination with purulent tubo-ovarian formations in three women of 2425 years old, has shown formation of the reclaiming rudiments consisting from proliferated, concentrically located smoothly-muscular cells (SMC) around the inflammatory infiltrates in myometrium-leiomyomatoz. Immunohistochemical researches with PCNA have established its accumulation in nucleus SMC in inflammatory mononuclear infiltrates zones in myometrium at endometritis, that is considered by us as the trigger of a myoma of an uterus.
In our opinion, uterin fibroid embolization (UFE) is a prime method of a choice in treatment of a myoma of a uterus. In some cases there is a risk of secondary infection in degradation of unit or allocated myomatous detritus, that can demand hysterectomy. Taking into account all set forth above, before carrying out UFE, in our practice, we used: Fromilid 500 mg twice a day during 10 days + Tiberal 500 mg twice a day during 10 days. Using the given circuit, in complex treatment of a myoma of an uterus, has allowed to increase efficiency of conservative treatment in twice.
|Session name:||XXIst ISTH Congress|
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