RETROSPECTIVE ANALYSIS OF ANAMNESIS OF WOMEN WITH PERITONEAL COMMISSURES

Abstract

The problem of peritoneal commissures is of general medical importance; obstetrician-gynecologists and surgeons constantly face it in their practice. Commissures between the abdominal organs mainly occur as a result of surgical interventions and inflammatory processes of the pelvic organs. They lead to such complications as tuboperitoneal infertility, chronic pelvic pain syndrome, dysfunction of visceral organs.

The aim of the study – to identify risk factors for the formation of peritoneal adhesions in reproductive age women.

Materials and Methods. A retrospective analysis of histories and 187 women who were operated by laparoscopic access and diagnosis of adhesive disease was carried out as the main or concomitant. Data on somatic, reproductive and gynecological history, age and social status were assessed. The comparison group consisted of data from 65 women in whom abdominal adhesions during surgery were not detected.

Results and Discussion. Analysis of the somatic history of women with and without adhesions in the abdominal cavity showed that women with adhesions had 3.2 (14.97 compared with 4.62 %, p<0.05) times more often one or another type of allergy, and 3.5 times more (10.70 and 3.07 %) – autoimmune diseases. Surgical interventions in the past were recorded in both groups, although their number was almost 6 times higher in case of adhesive disease presence (53.48 % compared to 9.23 %, p<0.05). In women with adhesions in the abdominal cavity, the percentage of operations on the pelvic organs was 2.5 times higher (85.00 % compared to 33.33 %, p<0.05), and only in this category of patients was performed abdominal drainage during surgery (22.4 %, p<0.05). The study of gynecological morbidity in the examined women showed that patients with abdominal adhesions had 3.6 times more often inflammatory diseases of the pelvic organs (61.50 % compared to 16.92 %, p<0.05), and every third had more than one episode of this pathology in history (33.68 %, p<0.05). In addition, every fifth woman with adhesions in the abdominal cavity had endometriosis (17.11 % compared with 3.08 %, p<0.05). A significant proportion of patients in the main group have had 2 or more abortions in the past.

Conclusions. According to the study results, risk factors for the formation of peritoneal adhesions in reproductive age women include allergic diseases; surgery on the abdominal organs, especially repeated and pelvic organs; drainage of the abdominal cavity after surgery; inflammatory diseases of the pelvic organs, and their recurrences; repeated surgical abortions.