Aim: to improve outcomes of the surgical management of cervix disorders by using a hemostatic agent with antimicrobial activity. Patients and Methods: the study included 47 women, 25–45 years of age, with CIN II/III to whom cervical radiofrequency ablation was performed. The main group comprised 26 (55.3%) patients. During the ablation procedure, a 1% aqueous solution of incomplete polyacrylic acid silver salt with integrated nanoparticles was used as an additional treatment for this group of patients. The control group consisted of 21 (44.7%) patients for whom the standard ablation technique was used. The assessed criteria included the clinical course and laboratory test results before and three months after the surgical treatment, as well as the bleeding rates. Results: in the main group of patients, the mean leucocyte number in the smear after the treatment was 9.2±1.2 per field of vision, in the control group — 18.5±2.9; pH of the vaginal discharge — 4.2±0.2 (from 3.8 to 4.5) and 4.7±0.2 (from 4.2 to 5.8), respectively. Intraoperative bleeding from the surgical wound which required additional manipulations was reported in 2 (7.7%) patients of the main group and 2 (9.5%) patients of the control group. Ten days after the surgery, one patient (3.8%) from the main group had complaints on heavy bloody vaginal discharge. Three (14,3%) patients from the control group had the same complaint 11–13 days after the surgery (3.7 relative risk, 95% confidence interval (CI) 1,0–18,2) which required the use of tranexamic acid as tablets for oral administration. Three months after the surgery the clue cells were found in one (3.8%) patient of the main group and in 7 (33.3%) patients of the control group (8.7 relative risk, 95% CI 1.2–16.5), and the fungal mycelia — only in 8 (38.1%) patients of the control group. Conclusion: the use of a 1% aqueous solution of incomplete polyacrylic acid silver salt with integrated nanoparticles during the cervical ablation resulted in a statistically significant reduction of the bleeding risk and improved the vaginal microflora profile in postoperative period. KEYWORDS: cervical dysplasia, cervical excision, cervical conization, bacterial vaginosis, hemostatic agent, bleeding. FOR CITATION: Il’ina I.Yu., Dobrokhotova Yu.E. Optimizing surgical management of uterine cervix disorders. Russian Journal of Woman and Child Health. 2022;5(3):188–193 (in Russ.). DOI: 10.32364/2618-8430-2022-5-3-188-193.

Aim: to develop a postoperative rehabilitation program for women with pelvic organ prolapse (POP). Patients and Methods: sixty postmenopausal women aged 55–75 with POP were randomized into two equal groups. All women underwent surgical intervention, which included anterior and posterior colporrhaphy and colpoperineo-levator-plasty. Group 1 women underwent five courses of radiofrequency therapy with a 14-day interval 30 days after surgery. Radiofrequency exposure was addressed by dynamic quadripolar radiofrequency (DQRF). Group 2 women were followed up without any additional rehabilitation measures. Ultrasound (US) examination using compression elastography was performed in all women To assess tissue elasticity. Neovascularization of vaginal walls was evaluated by superb microvascular imaging (SMI). The vascular intensity of the selected area of the vaginal wall was measured by automatic calculation of the vascularization index. US was performed twice, e.g., before and after surgery and rehabilitation (in group 1) or three months after surgery (in group 2). Results: in women who underwent DQRF therapy, an increase in the elasticity of vaginal walls was reported that indirectly demonstrates the increase in type 1 collagen and improvement of tissue vascularization. After surgery and radiofrequency therapy, the vascularization index increased by 1.6 times in group 1 and 1.2 times in group 2 compared to baseline. No postoperative complications were reported. Conclusion: this rehabilitation program is recommended for women who underwent surgical intervention for POP, given the efficacy and safety of radiofrequency therapy in the postoperative period. KEYWORDS: pelvic organ prolapse, rehabilitation period, dynamic quadripolar radiofrequency, dynamic quadripolar radiofrequency therapy, tissue elasticity, neovascularization, elastography, superb microvascular imaging. FOR CITATION: Dobrokhotova Yu.E., Komagorov V.I., Il’ina I.Yu. et al. Efficacy of dynamic quadripolar radiofrequency assessed by advanced ultrasound technologies. Russian Journal of Woman and Child Health. 2021;4(4):311–316 (in Russ.). DOI: 10.32364/2618- 8430-2021-4-4-311-316.