Optimization of treatment tactic in women of reproductive age with dysplastic lesions of cervical epithelium and adenomyosis

Optimization of treatment tactic in women of reproductive age with dysplastic lesions of cervical epithelium and adenomyosis DOI: https://doi.org/10.18370/2309-4117.2016.29.54-59Keywords: cervix dysplasia, adenomyosis, radiowave surgery, progestins, conservative treatment, multifocal targeted therapyAbstract The study to analyze the results of treatment of reproductive age women with dysplastic lesions of the cervical epithelium and adenomyosis was performed. Study includes 70 women of reproductive age with dysplastic lesions of cervical epithelial and infection caused by high risk strains of human papillomavirus: the main group consisted of 40 women with adenomyosis and chronic inflammation of genitals, the comparison group included 30 patients with chronic inflammatory diseases of genitals. According to the results of cytological examination of patients with dysplastic lesions of cervical epithelium and adenomyosis in 27.5% of women were detected squamous epithelial cells of uncertain origin; in 42.5% of cases are diagnosed low grade squamous intraepitelial lesion; in 30.0% – high grade squamous intraepitelial lesion. Cervical intraepithelial neoplasia grade I was histologically verified in 60.0% of women with dysplastic lesions of the squamous epithelium of the cervix and adenomyosis; cervical intraepithelial neoplasia grade II confirmed in 22.9% of cases; cervical intraepithelial neoplasia grade III was diagnosed in 17.1% of patients. In 82.5% of women with dysplastic lesions of cervical epithelium and adenomyosis identified pathological changes of the endometrium (simple and complex endometrial hyperplasia, endometrial polyps). Treatment of dysplastic lesions of cervix epithelium in patients with adenomyosis include integrated anti-inflammatory therapy, radiowave surgery, vaginal suppositories Revitaksa, a synthetic progestin Orgametril®, herbal preparation Epigalin® and was effective in 77.5% of cases. Clinically it is manifested a decrease in the frequency of pain, dysuria manifestations, dyspareunia, restoration of physiological menstrual and menstrual blood loss, lack of spotting before and after menstruation, normalization of cytological, colposcopic and ultrasonographic data. Complex therapeutic measures in patients with dysplastic lesions of the squamous epithelium of cervix and adenomyosis allow to accelerate the timing of postoperative epithelialization of the wound surface and to reduce the incidence of complications and recurrences. 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