Hak I. Diagnosis and treatment of recurrent flat-epithelial endocervix dysplasia in women with a tubal peritoneal infertility factor.

This dissertation is devoted to the reduction of recurrent flat epithelial endocervical dysplasia incidence after physiological surgical treatment of exocervical dysplasia in women who have a tubal peritoneal infertility by developing and implementing modern methods of diagnosis and treatment.The frequency of recurrent flat-epithelial dysplasia of endocervix (36.1%) was first established after treatment of exocervical dysplasia by physiological surgical methods in women with tubal peritoneal infertility.Risk factors for this pathology was clarified. It is proved, that the leading etiopathogenetic factor of recurrent flat-epithelial dysplasia of endocervix in women with tubal peritoneal infertility is HPV, predominantly type 16 and similar to 39, 45 (53.9%) predominantly (87.8%) with moderate to high levels of viral load, especially when combined with another urogenital infection (60.0%), which correlates with the degree of dysplasia. For the first time, the use of the Broder's index has been proposed and its degrees are determined, which describe tactics of conducting such women, which is confirmed by almost 100% coincidence with the increase of IB> 25 with coexpression of markers of proliferation (p16 and K i-67). Comprehensive treatment of recurrent flat-epithelial dysplasia of endocervix in women, with tubal peritoneal infertility factor was proposed, which includes 2 stages - conservative etiopathogenetic treatment (antibacterial and antiviral therapy with ?-2?- interferons, restoration of normal vaginal microbiocenosis) and combined operative treatment with intraoperative cytology.