P29.02: Doppler sonography peculiarities of uterus tissual blood flow of patients with adenomyosis treated with steroid hormonal therapy

To research the peculiarities of uterus tissual blood flow during steroid therapy of adenomyosis. 66 patients with adenomyosis, diagnosed according to clinical symptoms, transvaginal ultrasonography with color Doppler imaging (CDI) and loop biopsy of myometrium, were treated with combination of 30 mkg of ethinylestradiol and 2 mg of dienogest for 3 months daily and then for 9 months under contraception regimen, the menstrual blood volume, dysmenorrhea, the quantity of blood flow loci in myometrium were meanwhile observed. The patients were divided in two groups according to treatment results: effective—60, ineffective—6. In the first 6 months of treatment, the menstrual blood volume was reduced significantly (P < 0.01) in both groups, and dysmenorrhea was obviously relieved. According to the data of CDI the quantity of color loci in middle and internal layers of myometrium per unit area during the treatment in the first group was reduced by the 3 month (P < 0.01) and didn't change during the treatment and for 3 months after cessation of therapy. In the second group recurrences of haemorrhage and/or dysmenorrhea served as indications for surgical treatment in 2 cases 8–10 months since the beginning of treatment, in 4 cases in 3 months after the cessation. In this group the reduction of myometrium vascularisation level wasn't registered in 5 cases in the whole course of observation. The difference in quantity of blood flow loci in 3 and 6 months after the beginning of the treatment between groups was significant (P < 0.05). Continuously high level of myometrium vascularisation according CDI data can serve as a predictor of ineffectiveness of steroid therapy of patients with adenomyosis.