Study of vaginal microbiota in postmenopausal women with surgical correction of genital prolapse

The study of the vaginal microflora of women with genital prolapse (GP), who are ref erred to surgical treatment, is of particular importance. Infectious and inflammatory complications after the surgical correction of GP significantly increase the recovery time, the length of the patient’s hospital stay and the cost of treatment. It is important to be able to change the qualitative composition of microflora, thereby exerting a beneficial effect on the course of the postoperative period, affecting the outcome of surgical treatment. Evaluation of the vaginal microbiota by real-time polymerase chain reaction in postmenopausal women with surgical correction of genital prolapse against the background of using low-dose local therapy regimens with a drug containing estriol, progesterone and Lactobacillus culture

Molecular genetic determinants of stress urinary incontinence in women: Prospective comparative study

Aim. To identify the molecular genetic determinants of stress urinary incontinence (UI) in women. Materials and methods. A comparative study involving 120 women was conducted. Group 1 (main group) included 80 women with UI. Group 2 (comparison group) included 40 women without UI. Statistic data processing was performed using the Excel software package, SPP Statistics 22.0, Statistica for Windows 10 (TIBCO Software Inc., Palo Alto, CA, USA). The mean and standard deviation were reported for quantitative variables with a normal distribution. The statistical hypotheses on the absence of intergroup differences for quantitative variables with normal distribution were verified using Student's test. The absolute and relative values (in percent) were reported for qualitative variables. The chi-square test was used to verify the statistical hypotheses. Results. Molecular genetic predictors of UI in women are the carriage of polymorphisms of the estrogen receptor gene ESR1:-351_G and the type I collagen gene COL1A1:1546_T. These polymorphisms can be considered as genotypes of "risk" since their carriage is associated with an increased risk of UI. Conclusion. Genetically determined disorders of the estrogen receptor function and type I collagen synthesis can be one of the essential mechanisms of stress incontinence occurrence. Studying molecular genetic determinants of stress incontinence can provide a deeper understanding of its pathogenetic mechanisms and develop a personalized approach to surgical correction

Efficiency of FUZ-MRI ablation in the pre-operational preparation for laparoscopic myomectomy in reproductive age women

The problem of high-quality preoperative preparation for laparoscopic myomectomy in patients with symptomatic uterine myoma is far from final solution. At the present stage, a non-invasive drug-free method of preparation for laparoscopic myomectomy using FUZ-MRI ablation of uterine fibroids in patients of reproductive age is being studied. The Objective of the study is to study the effectiveness of the use of MRI-FUS ablation of uterine fibroids as a preoperative preparation for laparoscopic myomectomy. Materials and methods: The study included 22 women with uterine myoma of reproductive age, who have indications for surgical treatment in the volume of laparoscopic myomectomy. The main group of the study consisted of 5 women who underwent preoperative preparation using FUZ-MRI ablation of the dominant uterus myoma node before conducting myomectomy. The comparison group consisted of 17 patients who underwent myomectomy without prior preparation. The size of the uterine imoma was assessed by MRI and ultrasound, the time of surgical intervention, the time of uterine fibroid suturing, the volume of intraoperative blood loss and the frequency of complications. Results: The study demonstrated a decrease in the volume of the dominant node and the time of surgical intervention in patients of the main observation group. The volume of intraoperative blood loss had a correlation dependence on the time elapsed from the preoperative preparation by MRI-FUS ablation prior to the surgical intervention. The exponent of the dependence of the volume of blood loss on the time elapsed since the MRI-FUZ ablation demonstrates the maximum blood loss after 3 months or more after preparation, while the optimal period of intervention is one month after the operation. Conclusion: The method of MRI-FUS ablation of uterine fibroids can be effectively used in patients of reproductive age with large symptomatic uterine myomas as preparation for laparoscopic myomectomy in the presence of contraindications to other types of drug preparation.Проблема качественной предоперационной подготовки к лапароскопической миомэктомии у пациенток с симптомной миомой матки далека от своего окончательного решения. На современном этапе изучается неинвазивный безмедикаментозный способ подготовки к лапароскопической миомэктомии с применением ФУЗ-МРТ аблации миомы матки у пациенток репродуктивного возраста. Цель исследования - изучение эффективности применения МРТ-ФУЗ аблации миомы матки в качестве предоперационной подготовки к лапароскопической миомэктомии. Материалы и методы: В исследование включены 22 женщины с миомой матки репродуктивного возраста, имеющие показания для хирургического лечения в объеме лапароскопической миомэктомии. Основную группу исследования составили 5 женщин, которым перед проведением миомэкомии была выполнена предоперационная подготовка с применением ФУЗ-МРТ аблации доминантного узла миомы матки. Группу сравнения составили 17 пациенток, подвергшиеся миомэктомии без предварительной подготовки. Оценивались динамика размеров миомы матки по данным МРТ и УЗИ, время оперативного вмешательства, время ушивания ложа миомы матки, объем интраоперационной кровопотери и частота осложнений. Результаты: В результате исследования продемонстрировано снижение объема доминантного узла и времени оперативного вмешательства у пациенток основной группы наблюдения. Объем интраоперационной кровопотери имел корреляционную зависимость от времени, прошедшего от предоперационной подготовки методом МРТ-ФУЗ аблации до момента оперативного вмешательства. Экспонента зависимости объема кровопотери от времени, прошедшего с момента МРТ-ФУЗ аблации демонстрирует максимальную кровопотерю спустя 3 месяца и более после подготовки, тогда как оптимальным сроком вмешательства является один месяц после операции. Заключение: Метод МРТ-ФУЗ аблации миомы матки может быть эффективно использован у пациенток репродуктивного возраста с крупными симптомными миомами матки в качестве подготовки к лапароскопической миомэктомии при наличии противопоказаний к другим видам медикаментозной подготовки

Discussion issues of incompetent uterine scar in the era of the caesarian section epidemic

The article presents a review of the scientific literature containing data on the problems of an insolvent uterine scar after a cesarean section, complications and prognosis of the occurrence of pregnancy in the operated uterus. The review covers the topics of etiology and pathogenesis of incompetent scar, attention is paid to methods of diagnosis and surgical treatment at the planning stage of pregnancy. The analysis shows the need to study this problem, to conduct research aimed at optimizing the pregravid preparation of patients at risk.В статье представлен обзор научной литературы, содержащий данные о проблемах несостоятельного рубца на матке после операции кесарева сечения, об осложнениях и прогнозах наступившей беременности в оперированной матке. В обзоре рассмотрены темы этиологии и патогенеза несостоятельного рубца, уделено внимание методам диагностики и хирургического лечения на этапе планирования беременности. Проведённый анализ свидетельствует о необходимости изучения данной проблемы, проведения исследований, направленных на оптимизацию прегравидарной подготовки пациенток группы риска

Study of vaginal microbiota in postmenopausal women with surgical correction of genital prolapse

The study of the vaginal microflora of women with genital prolapse (GP), who are ref erred to surgical treatment, is of particular importance. Infectious and inflammatory complications after the surgical correction of GP significantly increase the recovery time, the length of the patient’s hospital stay and the cost of treatment. It is important to be able to change the qualitative composition of microflora, thereby exerting a beneficial effect on the course of the postoperative period, affecting the outcome of surgical treatment. Evaluation of the vaginal microbiota by real-time polymerase chain reaction in postmenopausal women with surgical correction of genital prolapse against the background of using low-dose local therapy regimens with a drug containing estriol, progesterone and Lactobacillus culture