PATHOGENETIC FEATURES OF ADENOMYOSIS DEVELOPMENT IN WOMEN OF REPRODUCTIVE AGE IN THE POST-COVID PERIOD

Purpose. To study the prevalence and forms of adenomyosis for women of reproductive age after COVID-19, to study pathomorphological changes in the uterine tissues of women of reproductive age with adenomyosis after COVID-19. Materials and methods. We examined 114 patients of reproductive age who underwent hysterectomy for various pathologies. Of these, 40 patients (35%) in 2019 before the COVID-19 pandemic, and during the pandemic in 2021 - 36 patients (31.6%), in 2022 - 38 (33.4%) patients. Results. The study found that the total number of histologically confirmed adenomyosis in patients of reproductive age increased from 55% in 2019 (before the COVID-19 pandemic) to 66.6% and 71% in 2021 and 2022, respectively; the number of diffuse adenomyosis increased significantly from 12.5% in 2019 (before the COVID-19 pandemic) to 41.6% and 47.4% in 2021 and 2022, respectively; the percentage of diffuse adenomyosis in relation to other forms of adenomyosis increased from 22.7% in 2019 (before the COVID-19 pandemic) to 62.5% and 66.6% in 2021 and 2022, respectively. Given the increase in the prevalence of adenomyosis in the post-COVID period compared to the period before the COVID-19 pandemic, we studied pathomorphological changes in the basal layer of the endometrium and the inner layer of the myometrium that correlated with the clinical features of the disease in the patients who participated in the study. The study included cases with histologically confirmed adenomyosis Pathologically detected changes in the endometrium and inner layer of the myometrium in adenomyosis after COVID-19, namely the line of separation between the endometrium and myometrium is unclear, vessels in the form of clusters, thickwalled, narrowed lumen, edema between fibers, edema between fibers and around vessels, thickening of the vessel wall and narrowing of the lumen, pronounced revascularization, the presence of myxomatous edema, foci of hemosiderosis in the interstitial tissue, thrombosis of vessels of different caliber with hemorrhages, and microcirculatory disorders. Conclusion. The results obtained indicate that after COVID-19 disease, the total number of histologically detected adenomyosis in women of reproductive age increased, and the number of diffuse adenomyosis increased. Characteristic changes occurred in the uterine tissue at the border of the endometrium and myometrium, which are morphologically confirmed.