Silin H. Diagnostics and treatment of ovarian varices among women of childbearing age.

The thesis presents a solution of the scientific task: how to improve the efficacy of diagnostic tools and treatment of women of childbearing age with ovarian varices and chronic pelvic pain. The solution is based on clear diagnostic criteria identifying, creation of diagnostic and treatment algorithm, creation of individual approach to the treatment of ovarian varices according to a clinical form of the diseases. As a result of our research risk factors and pathogenic factors of the disease were specified, features of clinical course of ovarian varices were studied in details, influence of the disease on menstrual and reproductive function of women was estimated, hormonal profile of the women with ovarian varices was comprehensively explored, the anatomic and functional characteristics of the pelvic organs and pelvic venous system were specified by using ultrasound examination, ovarian venography and laparoscopy. On the basis of the research the sonogram types were classified for diagnostics of ovarian varices. Sensitivity, specificity and positive prognostic value of ultrasound and Doppler examination for diagnosis of ovarian varices were calculated. Having identified the chains of pathogenesis and clinical forms of the disease, a conservative and an operative treatment of ovarian varices were offered. Taking into consideration the clinical data and features of ovarian veins that were specified by instrumental examinations the differential approach to a choice of method for treatment of ovarian varices was created. The criteria of a choice depend on a type of vein, a degree of ovarian varices and presence of retrograde flow in the vein. The diagnostic and treatment algorithm offered in our research is proven to be effective.