Korniyenko S. Endometrial pathology in women of late reproductive and premenopausal age (diagnosis, prevention and treatment).

The dissertation shows new solution of scientific problem. The solution consists of theoretical synthesis of the results of the study of mechanisms and factors that contribute to the occurrence and recurrence of endometrial pathology in women of late reproductive and premenopausal age, reducing the quality of life of such women, and on this basis – pathogenetic substantiation and development of the system of curative and prophylactic measures, improvement of diagnostics, surgical and rehabilitation tactics. For the first time, based on complex studies, a new concept of relapse of the endometrium pathology of women of late reproductive and premenopausal age, connected with gynecological and reproductive anamnesis, a personality profile, a decrease in the quality of life, high comorbidity with somatic and other gynecological pathology. The system of curative and prophylactic measures for women in late reproductive and premenopausal age with endometrium pathology is substantiated and implemented and includes 3 stages: preoperative (anamnestic, clinical, instrumental and laboratory examinations, questionnaires, relapse prediction, preoperative preparation), surgical – hysteroresectoscopy (technique «cold» loops depending on nosology), postoperative therapy (antibacterial, hormonal, metabolic, ozonotherapy in case of chronic endometritis, biocenosis recovery, correction of hypomelatoninemia, sedation therapy, psychotherapy). This system can reduce the rate of relapse of the pathology of endometrium allows to reduce the frequency of recurrence of the pathology of the endometrium in 1.92 times (OR=3.24±0.18, 95 % CI: 2.29-4.60), the mean score of the vegetative dysfunction syndrome at 1.28 and the number of cases of insomnia in 1.74 (OR=0.41±0.18, 95 % CI: 0.29-0.59), to improve the quality of life by 18.3 %, and also in women of late reproductive age with infertility to increase the frequency of pregnancy 2.38 times (OR= 5,35±0.52, 95 % CI: 1.92-14.93).