Optimization of treatment of endometrial hyperplastic processes in the late reproductive period by hysteroscopic сold loop technique

Abstract

The aim of the study was to evaluate the effectiveness of various methods of hyperplastic endometrium removing in late reproductive age women.

Materials and methods. In the prospective cohort study 321 women 35–44 year aged with hyperplastic endometrium processes were selected by the continuous sample method. Depending on the method of treatment of this pathology, the patients were divided into two groups: the Ith group included 143 women whom, after hysteroscopic confirmation of the diagnosis, the hyperplastic endometrium was removed using the “cold loop” technique with the further complex scheme of treatment which included therapy by synthetic gestagens, sedative therapy and use of drugs of melatonin (in the presence of disorders of a dream and hypomelatoninemia). The II group included 178 women, whom after hysteroscopic confirmation of the diagnosis, curettage of a cavity of the uterus was performed, the subsequent hormonal therapy by synthetic gestagena was used according to the Clinical protocol “Endometrial Hyperplasia” (the order of the MOH of Ukraine No. 676 from 31.12.2004). The women of both groups did not differ significantly by age, menstrual cycle peculiarities, gynecological, reproductive, somatic anamnesis and complaints.

Results and conclusions. Analisis of the long-term results of endometrial pathology treatment showed that among I-th group women recurrence of hyperplastic endometrium processes was observed several times less often (p <0.05). The author came to the conclusion that the removal of hyperplastic endometrium by the “cold loop” technique allows to significantly reduce the hyperplastic endometrium processes recurrence and newly detected intrauterine pathology level in comparison with endometrial curretage.