Grek L. Chronic pelvic pain syndrome: etiopathogenesis, diagnosis, treatment and rehabilitation

The dissertation is devoted to the study of the features of the pathophysiological role of regulatory and proinflammatory cytokines, morphogenesis of eutopic endometrium, hormonal ratios, psycho - personality characteristics of women with chronic pelvic pain syndrome. The results indicate that the imbalance of the cytokines toward the proinflammatory component affects both the nociceptive and central nervous systems of patients with chronic pelvic pain who have higher levels of pain by VAS and anxiety-depressive disorders. In women with genital endometriosis, adenomyosis, in combination with uterine leiomyoma and endometrial hyperplasia, the proliferative and inflammatory activity of the glandular and stromal components of eutopic endometrium and the presence of nerve fibers as mechanisms of chronic pelvic pain have been determined. Such features testify to the formation of central sensitization during the development of CPP. The proposed therapeutic tactics, taking into account pathogenetic conditions, allowed to reduce the recurrence of CPP by 3.4 times, surgical treatment by 4 times, compared with women who received traditional treatment. Reduction of reactive anxiety and depressive disorders to the norm was identified in 86.18% of patients, which indicated the clinical effectiveness of the proposed treatment modality, which may be recommended for clinical practice.