Профілактика рецидивів лейоміоми матки та ендометріозу за їхньої коморбідності в жінок репродуктивного віку після хірургічного лікування

Objective of the study: to evaluate the effectiveness of a medication containing a gonadotropin-releasing hormone antagonist, estradiol, and norethisterone (Rieko) in the postoperative period after surgical treatment of women of reproductive age with comorbidity of uterine leiomyoma and endometriosis in order to prevent recurrence of the disease. Materials and methods. The study included 49 women aged 26 to 45 years with a combination of uterine leiomyoma and endometriosis. 21 patients received the medication Rieko in the postoperative period starting from the first day of the menstrual cycle for the prevention of recurrence during three menstrual cycles (the main group). 28 patients in the postoperative period did not receive treatment with hormonal medications (comparison group). All patients underwent surgical laparoscopy or laparotomy via the Pfannenstiel approach under endotracheal anesthesia. Conservative myomectomy, removal of ovarian endometriomas, and/or vaporization or excision of endometrioid heterotopias on the pelvic organs were performed during laparoscopy or laparotomy. Results. Examination of patients after treatment showed that severe and moderate pain was observed only in 4.8% of women in the main group, which was almost three times less than in the comparison group and almost 19 times less than before surgical treatment. Dysmenorrhea was reported three times less frequently by patients in the main group. Abnormal uterine bleeding and significant blood loss ceased in the main group, in the comparison group they were observed in 17.9% of women (p < 0.05). Assessment of the psychoemotional state of the participants three months after treatment indicated an increase in the overall level of indicators in 95.2% of patients who received hormonal therapy. Conclusions. Timely administration of the medication Rieko in the postoperative period in women of reproductive age with comorbidity of uterine leiomyoma and endometriosis improves the psychoemotional state, reduces clinical manifestations of the disease, and prevents recurrence.