Aim. To study the effect of gabapentin on females in laparoscopic surgery in gynecology.Methods. The study included 2 groups of patients aged 25 to 75 years admitted for scheduled laparoscopic hysterectomy. A total number of patients was 161. Distribution between the groups was carried out based on the use of pre-emptive analgesia with gabapentin before surgery at a dose of 600 mg orally.Results. In both groups absence of predisposition to neuropathic pain in females scheduled for hysterectomy due to benign diseases was revealed. Significant difference between the groups in pain intensity after 24 hours after the surgery and development of adverse opioid-caused events such as light sedation, nausea and vomiting due to inhibitory effect of gabapentin on trigger areas of the brain were revealed. There is also marked difference in the need for opioid analgesics at stages of surgical treatment.Conclusion. Use of gabapentin prior to surgery decreased the level of reactive anxiety and stress response to surgery by 44.8%, which reduced the need for opioid analgesics in intra- and postoperative periods; in the group of females who received gabapentin, postoperative nausea and vomiting were less prominant by 33%.

Asherman syndrome is a controversial topic in gynecology without a clear consensus for treatment. This pathology is characterized by adhesions in the uterine cavity. The main cause of this disorder is injuries to the gravid uterus especially in abortion, during postnatal period or after missed miscarriage. Menstrual disorders and infertility are characteristic clinical features of Asherman syndrome. Pregnancy may be complicated with premature labor, placenta previa and placenta accreta. Introduction of hysteroscopy has changed diagnosis and management of intrauterine synechiae and it is therefore considered the most valuable tool nowadays. Preferred treatment method is hysteroscopic lysis of adhesions combined with estrogens. A clinical case of asymptomatic Asherman syndrome in a 29 year old female is presented in the article. Bipolar hysteroscopic resection of synechiae in combination with curettage was proved to be an effective and safe method of treatment.

The hysteroscopy diagnostic is considered as the method of definitive diagnostic of the endometrium cancer before the operation. The hysteroscopy is worth while in cases of difficulties with the diagnostic of the diseases. It is reasonable to introduce the hysteroscopy diagnostic in the algorithm of examination of the endometrium cancer diseases.

Objective. The aim of this study was the optimization of vaginal hysterectomy (VH) using laparoscopic technology (LAVH) in order to improve the results in the treatment of benign and malignant deseases of uterine.