Differentiated approach to the treatment of external genital endometriosis as prevention of recurrence

The objective: to evaluate the effectiveness of a differentiated approach in postoperative management patients with external genital endometriosis (EGE) determine regression clinical symptoms and reduce number recurrences. Materials methods. 207 different forms EGE after surgical treatment foci removal were examined. After determination prevalence pathological process (intraoperatively), subjects divided into three groups. A1 group (n=67) included women severe disease who had an optimized for management. A2 (n=75) moderate severity traditional approach. B was comparison (n=65) formed from traditionally treated.Clinical-anamnestic, laboratory, morphological, immunohistochemical methods, gynecological examination data, ultrasound pelvic organs used during EGE; magnetic resonance imaging (MRI) – if necessary. standard (laparoscopic method), visible endometrioid heterotopias medical 1st day next menstrual cycle surgery (progestins (dienogest 2 mg) 6 months or gonadotropin-releasing agonists presence comorbidity hyperplastic processes 3-6 combination add-back therapy). In absence reproductive plans combined oral contraceptives intrauterine levonorgestrel-releasing system used. Patients observed 1 month, year surgery, then once year. (laparoscopy laparotomy) heterotopias, use nonsteroid anti-inflammatory drugs period 5 days, dienogest mg by cases algomenorrhea other manifestations pain. pathogenetic therapy started on 2nd 3rd period. every 3 pain assessed Biberoglu Behrman (B’n’B) Numerical Rating Scale (NRS) scales. Recurrence diagnosed heterotopia according and/or MRI, as well appearance complaints (pain) their absence.Results. one first recurrence found 13.43 % group, 12 24.61 group. average value NRS scale 3.26 points 2.47 1.59 B’n’B - 1.94, 1.61, 1.40 points, respectively. Conclusions. applying (more radical prescription at hormonal drugs, more frequent observation surgery) compared lead decrease 1.94 Scale, rate 45.4%.