В связи с увеличением общего количества хирур-гических вмешательств в акушерстве и гинекологии, широким распространением повторных лапароско-пических операций (диагностические, малоинва-зивные вмешательства на яичниках и маточных тру-бах, повторные лапароскопические вмешательства по поводу эндометриоза, лапароскопические миом-эктомии и др.) в последнее время наблюдается тен-денция к увеличению числа пациенток со спайками в малом тазу и полости матки. В гинекологии тазо-вые перитонеальные спайки после операций диагно-стируют у 15-80% пациенток. Самым частым ме-стом локализации спаек являются яичники и маточ-ные трубы: одно-или двусторонняя окклюзия ма-точных труб вследствие спаечного процесса форми-руется у 15% пациенток после обычной аппендэкто-мии, окклюзия маточных труб вследствие спаечного процесса развивается у 60-80% пациенток после оперативных вмешательств на яичниках, по поводу трубной беременности, особенно выполненных по экстренным показаниям [1,2].Резидуальными осложнениями спаечного про-цесса малого таза являются: абдоминальный/тазо- Прогноз в отношении репродуктивной функции и качества дальнейшей жизни при гинекологических операциях во многом определяется возможным спаечным процессом. Адекватная интраоперационная антиадгезивная профилактика в гинекологии с использованием комплексного геля, содержащего в своем составе гиалуроновую кислоту и карбоксиметилцеллюлозу, способствует снижению риска образования спаек в малом тазу и их резидуальных осложнений. Forecast with respect to of reproductive function and quality of further life after gynecological operations is mainly determined by possible postoperative adhesions. Adequate intra-operating antiadhesivе prevention with the use of a complex gel which contains hyaluronic acid and carboxymethylcellulose contributes to reduction the risk of the pelvic adhesions and adhesion-related complications.
Introduction. About 10–20% of patients among women of reproductive age suffer from signs and symptoms of androgen excess in hyperandrogenism. Its skin symptoms may include hirsutism, acne, seborrhea and alopecia.Aim. To assess the effect of cyproterone acetate on skin symptoms of hyperandrogenism and improvement in the patients’ quality of life after treatment.Materials and methods. The study included 120 patients with skin symptoms of hyperandrogenism. The patients ranged in age from 18 to 35 years. The inclusion criteria were the main complaints of the patients as follows: acne, hirsutism and alopecia. The patients underwent a comprehensive clinical and laboratory examination. The drug of choice for the treatment of androgendependent dermatopathies was cyproterone acetate at a dose of 50–100 mg daily.Results and discussion. All patients were divided into three groups: 44 (37%) patients with hirsutism, 55 (53%) with acne, 12 (10%) with alopecia. Moreover, 32 (27%) patients had a mix of symptoms at the same time. Such patients were assigned to one of the groups depending on the predominant complaint. All patients were prescribed cyproterone acetate at a dose of 50-100 mg once daily, depending on the severity of symptoms from day 1 to day 10 of the menstrual cycle, and 54 (52%) patients were prescribed cyproterone acetate 20 mg and ethinyl estradiol 35 mg from day 1 to day 21 of the menstrual cycle. The study showed stabilization of the psychoemotional state, relief of anxiety, depressive disorders, enhancement of self-esteem and sociability, and improvement of the quality of life in its various manifestations in the majority of patients after the treatment.Сonclusion. When assessed using the dermatology life quality index questionnaires, all patients reported the stabilization of the psychoemotional state and the improvement in the quality of life after the treatment. The anxiety and depressive disorders decreased in 109 (91%) patients, which favourably influenced various areas of quality of life, enhanced self-esteem and sociability with a positive effect on personal relationships.
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