Zhelezov D. The prognostic, diagnostic and treating aspects of hyperplastic processes of endometrum

It was observed results of comlex investigations and treatment 110 patients in reproductive and premenopausal age with abnormal uterine bleedings cause by reccurrent hyperplastic processes of endo and myometrium and 30 healthy women. In cases with mostly positive expression of ER and PR in endometrium we used levonorgestrelreleasing intrauterine system. In patients with low or irregular ER and PR expression or increasing erxpression of proliferation marker Ki67 and high level of cytogenetic abnormalities we proposed total hysteroscopic electrosurgical endometrial resection. Positive therapeutic effects in the form of amenorrhea after 6 months occurred in patients of group 1 in 29 (63.0%) cases, hypomenorrea – in 15 (32.6%) patients in group 2, respectively amenorrhea developed in 45 women (70.3 %), hypomenorrea – in 17 cases (26, 5%), accompanied by reduced blood flow in the basal and arcuate arteries of the uterus according sonodopplerometry, intrauterine synechia formation. Therapeutic effect persisted for 13 years of observation. Psychoemotional status of patients examined after treatment showed reducetion of anxiety, manifestations disadaptation alexytymia and personality traits. Praise the treatment and patient quality of life tended to increase in 1 group (84,8 + 2,2)% and (76,6 + 2,9)%, which can explain the preservation of menstrual function, decrease pelvic pain syndrome and effective contraception. We have obtained the data of high effectiveness and safety of both methods of treatment abnormal uterine bleeding in women with reccurent benign hyperplastic porocesses of endo and myometrium by using strong differential criteria of treatment modalities