• Complex therapy adenomyosis commbined with hyperplastic processes of the endometrium in women reproductive age 

Complex therapy adenomyosis commbined with hyperplastic processes of the endometrium in women reproductive age 

HEALTH OF WOMAN. 2016.4(110):131–134; doi 10.15574/HW.2016.110.131 
 

Complex therapy adenomyosis commbined with hyperplastic processes of the endometrium in women reproductive age 
 

Benyuk V. A., Altibaeva D. M., Goncharenko V. N., Kurochka V. V.

A.A. Bogomolets National Medical University, Kiev

Kyiv maternity hospital № 5


The purpose of the study: is to develop and implement a comprehensive phased treatment of adenomyosis in combination with endometrial hyperplasia in women of reproductive age with the use of immunostimulatory drugs.


The materials and methods. We assessed the influence of hormone therapy 135 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: group І – 45 women using a progestogen (6 months); II – 45 women who took agonist of gonadotropin-relesing hormone (a-GnRH) (6 months) III – 45 women who received complex therapy involving a-GnRH during the first 6 months and immunomodulator intramuscularly every other day № 20, with subsequent use of tablets of 0,15 g of 1 times a week (course – 6 months), then in the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25 days. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy.


Results.The influence of hormonal therapy gestogen and a-GnRH on clinical course and homeostasis indexes in women with adenomyosis, combined with endometrial hyperplasia in dynamics. New pathogenesis units in benign uterus pathology by means of immune system dysfunction that was defined in decreased levels of cytotoxic index of NK-cells were revealed. Complex hormonal therapy in reproductive-aged women with combined benign uterus pathology was developed and estimation of influence on oncomarker indexes, immune status, steroid hormones and hematological indexes in observation dynamics was conducted.


Conclusions. Developed a comprehensive phased hormone therapy for women of reproductive age with adenomyosis in combination with endometrial hyperplasia normalizes the tumor markers; immune and humoral status. This treatment of the surveyed women improves haematological, immunological and echographically indicators in the follow-up period compared with the monotherapy progestogen and GnRH; significantly enhances the parameters of physical functioning, General health and vitality, improves the performance of both physical and psychological components of health, thereby improving quality of life.


Key words: complex therapy, adenomyosis, endometrial hyperplasia, gestagene, a-agonist of gonadotropin-relesing hormone.


REFERENCES

1. Benyuk V, Golota V, Dyndar E, Usevich I. 2006. The Role of GNRH agonists in treatment of endometriosis. «science.-pract. Conf. «Problems achievements and prospects of development of biomedical Sciences». Proceedings of the Crimean medical University 142:237.

2. Grischenko V, Shcherbina NA, Potapov LV, Lipko AP. 2002. Use of differentiated therapy in the treatment of patients with common forms of genital endometriosis 2(26):8–9.

3. Kucherenko SN. 2002. Differentiated therapy of adenomyosis with consideration of the peculiarities of hormonal disorders and the clinical-morphological and functional criteria of process. Women's Health 3(11):30–36.

4. Tatarchuk TF, Burlaka OV, Korinna KO. 2005. Medical therapy of endometrial processes. Drugs and life: 100–101.

5. Andreotti RF, Flescher AS. 2005. The sonographic diagnosis of adenomyosis. Ultrasound Q. 21(3):167–170. http://dx.doi.org/10.1097/01.ruq.0000174751.34633.9a

6. Afonso JS. 2005. Adenomiosis: pathohysiology, diagnosis and treatment (review). Vu Hysteroscopy at Fri. 12(2):1–52.

7. Frackiewicz EJ, Zarotsky V. 2003. Diagnosis and treatment of endometriosis. Expert Opin Rharmasother. 4(1):67–82.