D.E. Nikiforova’s research while affiliated with Krasnoyarsk State Medical University and other places

This article systematizes the results of studies on the pathogenetic mechanisms of CPPS formation in patients with EGE. Pain is one of the severe clinical manifestations and complications of endometriosis. To ease the pain in patients with EGE is complex but urgent task. Long diagnostic search (mean period 5−8 years) leads to the formation of a persistent Autonomous pain syndrome associated with relapses of pain even after a com-prehensive treatment of patients (surgical and/or long-term hormonal). Patients with endometriosis suffer from mixed pain including neuropathic and nociceptive components which is proved by the example of expression in ectopic foci of specific biomarkers. Therefore, the question of early non-invasive diagnosis of endometriosis is very vital and can be solved by the development of a diagnostic panel consisting of biomarkers expressed by ectopic foci at the initial stage of the disease.

The article is devoted to the issues of surgical treatment and prevention of recurrence of intrauterine sinechia (IUS) and its severe condition Asherman syndrome. The topicality of the IUS is characterized by a high incidence of infertility, common miscarriage, amenorrhea and hypomenstrual syndrome. The article describes the principles for management of patients with IUS, the features of surgical treatment and the prevention of recurrence of the disease. The authors present their own clinical data summarizing the experience in treating 64 women with IUS. All patients underwent a hysteroscopic adhesiolysis. In the postoperative period, 48 women (group 1) received an adhesion barrier based on hyaluronic acid and carboxymethylcellulose – Antiadhesin injected into the cavity of the uterus. 16 women (control group 2) did not receive Antiadgesin. The study showed that significantly fewer relapses and a significant increase in commenced pregnancy were detected among patients in group 1. As can be seen from the above, not only the careful and complete dissection of the adhesions, but also the active postoperative rehabilitation period, which includes the prevention of relapsing adhesiogenesis using intrauterine injections of adhesion barriers, is crucial for the comprehensive treatment of patients with IUS.

Relevance. Asherman’s syndrome is one of the most difficult problems in gynecologic practice, because in addition to complex clinical picture, which includes secondary amenorrhea and infertility is a significant difficulty in diagnosis and treatment. The purpose was to improve the results of treatment of Аsherman’s syndrome after conducting hysteroresectoscope adhesiolysis using anti adhesive barrier “Antiadgezin”. Materials and methods. The study included 36 patients with peritoneal process in the uterus of varying severity. Group I consisted of 20 women who are in the postoperative period in the uterine cavity was entered “Antiadgezin”, group II - 16 women with similar pathology without introducing anti adgesive barriers. Results. All women 3 months after adhesiolysis was performed a control hysteroscopy. The presence of adhesions was diagnosed in 2 (10%) patients in the first group, while adhesions were isolated delicate and easily destroyed by the sheath of a hysteroscope. In group II adhesions had recurrences in 5 (31,3%) patients (p = 0,038), and one patient was visualized “tunnel” - uterus, which is extremely unfavorable course of disease. Conclusion. Treatment of Asherman’s syndrome, as extreme degree of intrauterine adhesions, requires a comprehensive approach, which is based on prevention of recurrence of the formation of adhesions after surgical interventions. Research on application anti adgesivebarriers will continue, as intrauterine their use on the example of antiadgezin showed good results.