SOME PECULIARITIES OF HISTORY AND CLIINICAL DATA OF PATIENTS WITH TUBOPERITONEAL INFERTILITY AND RESULTS OF THE MORPHOLOGICAL RESEARCH OF ADHESIONS IN THIS CATEGORY OF PATIENTS
DOI:
https://doi.org/10.11603/24116-4944.2019.1.10203Keywords:
adhesions, tuboperitoneal infertility, histological examinationAbstract
The aim of the study – to learn the history, clinical manifestations and histological structure of adhesions in patients with tuboperitoneal infertility.
Materials and Methods. There were examined 66 women with tuboperitoneal infertility and 30 healthy women. The anamnesis was collected, clinical manifestations, and additional examinations were performed. Adhesions of the pelvic organs were evaluated by J. Hulka et al. The inclusion criterion in the study was the presence of 2 and 3 degrees adhesions. All patients underwent an ultrasound scan of the pelvic organs to assess the presence of signs of adhesions. During laparoscopy adhesions were sampled; serial histological sections were stained with hematoxylin and eosin, with picrofuchsin according to van Gison and fukselin according to Hart.
Results and Discussion. The study showed that patients with tuboperitoneal infertility, unlike the control group, had surgery on the abdominal cavity and pelvic organs much more often (and repeated operations were carried out in every third case), as well as inflammatory diseases of the reproductive organs. The authors showed that most of the surveyed women had pregnancies in history, but differences in structure were recorded: the majority of women in the control group gave birth, whereas among the patients with infertility ectopic pregnancies and abortions prevailed. All examined women had adhesions, which was confirmed during laparoscopy. The study showed that ultrasound is not an informative method to confirm this pathology. A histological study of adhesions revealed the presence of differences in their structure depending on the etiological factor (surgery or inflammation), as well as signs of inflammation in women without surgical interventions in history, despite the absence of its clinical manifestations.
Conclusion. The authors of the study concluded that it is necessary to take into account the presence or absence of a chronic inflammatory process when developing approaches for the secondary prevention of the formation of adhesions in women with tuboperitoneal infertility at the stage of postoperative rehabilitation and infertility treatment.
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