Aim. The aim of our work was the development and testing method of hysterectomy, which would greatly facilitate radical hysterectomy in patients who are overweight. Materials and methods. In the main group of supervision were included 76 women who had 0 and stage 1 prolapse by POP-Q classification and were operated under minimally invasive surgery of RPCPCM in the period from 2019 to 2020because of uterine fibroids by the method developed by us.The control group consisted of 50 women whom was performed intrafascial hysterectomy by the method of Oldridge. To study the vaginal profile marked by two indicators: the length of the vagina and the range of displacement of the proximal point of the vagina (apex), which were determined before surgery and 24 months after surgery at intervals of one year. Determining the length of the vagina was performed in the supine position, immediately determine the most proximal point of the vagina. Results and discussion Conclusions. Methods of intrafascial hysterectomy using high-frequency diathermy are effective in preventing prolapse stump and shortening of the vagina. Shortening of the vagina in patients in the control group may have been caused by the degenerative processes due to serious injury of support structures and vessels of proximal vagina with the emergence in this context of inflammatory processes in the stump. Shortening of the vagina in patients operated on the proposed method was observed. Trends shortening of the vagina or prolapse at follow-up were found.

Objective: to review a new potential diagnostic criteria for predictors and premorbid conditions of female genital cancer, including endometrial cancer and breast cancer. Materials and methods. Bibliographic, information-analytical methods were used in the work. Sources of information were data from the scientific literature on the topic of the study, modern gadleins, a review of randomized controlled trials. Results. The results of epidemiological studies suggest that the increased risk of cancer of the female reproductive system is the presence of obesity and type 2 diabetes. Potential mechanisms of their association are hyperinsulinemia, hyperglycemia, chronic inflammation, and insulin resistance. Because insulin is a major regulator of cell metabolism and is a tissue growth factor, hyperinsulinemia increases the risk of cancer. Hyperinsulinemia is associated with increased secretion of androgens by the ovaries and decreased levels of the protein that binds sex hormones, leading to higher concentrations of biologically active estrogens, which are also known to be risk factors for female genital cancer. In recent years, PFAA profiles have been found to be significantly altered in cancer and type 2 diabetes. Because cancer cells require certain amino acids to synthesize DNA, tumor growth factors, build new blood vessels, and duplicate all of their protein content, changes in PFAA profiles can be used as biomarkers of disease and different types of cancer at different stages. Conclusions. With the growing incidence of cancer, the issue of early diagnosis and detection of cancer in the pre-clinical stages remains relevant. Protein metabolism in cancer remains unclear and requires further research using a larger sample size. In addition, the biological mechanisms by which amino acids may contribute to the risk and progression of cancer or other premorbid conditions need to be elucidated. Determining the exact mechanism underlying changes in PFAA profiles has great potential for cancer diagnosis and treatment.

The aim. To analyze the methods of visual diagnosis used in reproductive age women with uterine fibroids. Materials and Methods. Retrospective analisys, information–analytical methods were used in the work. Sources of information were data from the scientific literature on the topic of the study, modern gadleins, a review of randomized controlled trials. Results. Depending on the types of visual diagnostics used in the preoperative examination were formed groups: I group (n=120) – patients were examined only by the sonographic method; II group (n=80) – patients were examined by MRI and ultrasound. Comparative analysis of the MRI and sonographic studies results determined the number of myomatous nodes inpatients of the II group (n=80 (100%): by ultrasound – solitary nodes in 52 (65%), multiple in 28 (35%), and by MRI – a solitary nodule in 37 women (according to FIGO classification – type SM0 – 16 women, SMI in 8 patients, SMII in 8 patients, O3–6 typein 5 women), two nodules in 27 people and three myomatous nodules in 16 women (among multiple myomas n=43 (100%) according to the FIGO classification, , were diagnosed: SM0/О3–4 type– 20 (47%), SM1/О3–4 type –13 (30%), SM2/ O3–4 type –10 (23%), and according to MP type: MP1 – 16 (37%), MP2 –11 (26%), MP3 –16 (37%), and among solitary nodes n=37 (100% ): MP1 – 27 (71%), MP2 –10 (29%). The frequency of cases of inconsistency the clinical situation with ultrasound data interms of the number and localization of myomatous nodes in multinodular UF, especially in SM0–2/О3–4 type combinations, was 39, 0%, and when was using MRI – 8.0% (p<0.05). The structure of organ–preserving surgical intervention in the scope of myomectomy is presented as follows: hysteroscopy – 118 (59%), a combination of laparoscopy and hysteroscopy – 50 (25%), in 28 (14%) a combination of laparoscopy and hysteroscopy was converted to laparoscopic–vaginal access and 2.0% were converted to laparoscopic laparotomy. In the 1st group (n=120(100%)) where only preoperative ultrasound was used, a higher specific weight of conversions from hysteroscopy to laparoscopy – 36 cases (30%), from a combination of laparoscopy and hysteroscopy to laparoscopic–vaginalaccess – 24 (20%) and from laparoscopy laparotomy – 12 (10%). Conclusions. Ultrasound in the perioperative period is unable to fully determine clear navigation for the operation, especially for multinodular UF and hard–to–reach UF localization for hysteroscopic myomectomy. This clinical problem can be solved by using MRI in the perioperative diagnostic and intraoperative sonography.