Dunaevskaya V. New approaches to the diagnosis and treatment of uterine leiomyoma.

The dissertation presents a new solution to the actual problem of modern gynecology - improving the efficiency of organ treatment of uterine leiomyoma in women of reproductive age. On the basis of clinical and anamnestic data, functional ultrasonic tumor morphology with two-and three-dimensional ultrasound and elastography, the state of blood flow in the vessels of the uterus and the nodes of the LM, histomorphological and immunohistochemical markers of angiogenesis research, developed a new methodological approach to the prediction of the clinical course and the choice of method of surgical treatment of LM, which contributed to a decrease intraoperative blood loss and postoperative complications, in an effective recovery of reproductive function in 61.1 % of operated women. To prevent intraoperative blood loss during transcervical resection of submucosal fibroids in the use of scientifically based synthetic analogue of vasopressin - terlipressin. It was found that the mechanism of its pharmacological action is associated with inhibition of tumor tissue expression of endothelial nitric oxide synthase (eNOS), which is a key enzyme in the synthesis of a powerful messenger vasodilation - nitric oxide and the lack of which is accompanied by temporary uterine bleeding during surgery.