Redko N. Justification of methods of preventing endometrial dysfunction in women after different types of organ saving surgical treatment of uterine leiomyoma.

The work is dedicated to the prevention of endometrial dysfunction in women with uterine leiomyomas after various types of organ saving surgical treatment. Studying the features of endometrium functional status after different types of organ saving surgery we received the following information. The endometrium status after KM without penetration into the uterus more often matches the standard criteria. Changes after hysteroscopic endometrial resection site and after the CM with penetration into the uterus during the surgery procedure are characterized by the development of endometrial hypoplasia, endometrial synechiae, reduced expression of estrogen and progesterone receptors, moderate increase expression of inflammatory markers. Immunohistochemical study performed in endometrium in women after EMA, especially in case of expulsion of myoma node into the uterus, showed positive expression of CD 138, which indicates the presence of chronic endometritis in the group. It was also found high levels of expression of inflammatory markers (CD 68, CD 45, CD 16 and CD 56) in patients after EMA. It was developed the algorithm and a mathematical model of forecasting occurrence of endometrial dysfunction, and offered pathogenetically reasonable preventive complex of treatment depending on the type of surgery, which reduces the risk of endometrial dysfunction in patients of this category.