Application of modern non-medicine technologies to improve the state of the mucous vagina in patients of different age groups after plastic surgery for the rectocele

Cover Page

Cite item

Full Text

Abstract

Background. The specific weight of genital prolapse among gynecological nosologies in Russia in the departments of operative gynecology ranges from 28 to 38.9% and in the structure of planned indications for surgical treatment ranks third after benign tumors and endometriosis.

Aim. Development and implementation of new comprehensive rehabilitation programs for women with II−III degree rectocele after surgical treatment.

Methods. The article presents the treatment data for 100 women of different age groups with II−III degree rectocele who, in the early postoperative period after plastic surgery for rectocell, used to improve the condition of the vaginal mucosa with general magnetotherapy, electromyostimulation with biological connection of the pelvic floor muscles, a special complex of physiotherapy exercises and intravaginal procedures of fractional microablative carbon dioxide laser therapy. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics; within each group, depending on age, they were divided into

2 subgroups: women of childbearing age were included in subgroup A, and peri- and menopausal women were included in subgroup B. To assess the condition of the vaginal mucosa and maturity of the vaginal epithelium after surgery in patients included in the study, a pH-metry of the vaginal discharge was performed and the Vaginal Health Index was determined.

Results. As a result of the studies, it was found that a more pronounced therapeutic effect was obtained with the use of the complex, which includes a course of general magnetotherapy from the first day after surgery, as well as a month after surgery, a course of electromyostimulation with biological connection of the pelvic floor muscles and a special complex of physiotherapy exercises and 2 intravaginal procedures of fractional microablative carbon dioxide laser therapy.

Conclusion. The obtained results indicate a pronounced therapeutic effect of the complex, which includes a course of General magnetotherapy from the first day after surgery, a course of electromyostimulation with biological connection of pelvic floor muscles and a special complex of physical therapy, as well as 2 intravaginal procedures of fractionation microablative therapy with a carbon dioxide laser 1 month after surgery..

About the authors

E. N. Zhumanova

Central State Medical Academy of the Office of the President of the Russian Federation; Moscow State University of Medicine and Dentistry a.n. A.I. Evdokimov

Author for correspondence.
Email: ekaterinazhumanova@yandex.ru
ORCID iD: 0000-0003-3016-4172

MD, PhD

Russian Federation, Marshala Timoshenko str.,19, Moscow, Russia, 121359; 20/1, Delegatskaya street, Moscow, 127473

K. V. Lyadov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: klyadov@mail.ru
ORCID iD: 0000-0001-6972-7740

MD, PhD, Professor

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

K. V. Kotenko

Moscow State University of Medicine and Dentistry a.n. A.I. Evdokimov

Email: Kotenko_kv@nrcki.ru
ORCID iD: 0000-0002-6147-5574

MD, PhD, Professor

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

References

  1. Abuladze TV, Shapataeva KV, Ivanishvili TK, et al. Operatsii pri kombinirovannom: vypadenii pryamoi kishki i matki, nedostatochnost' anal'nogo zhoma i rektotsele. In: Tezisy doklalov V Vserossiiskoi konferentsii s mezhdunarodnym uchastiem «Aktual'nye problemy koloproktologii». Rostov-on-Don; 2001. p. 4. (In Russ).
  2. Hitar'jan AG, Prokudin SV, Dul'erov KA. Improved diagnostic and surgical treatment of patients with rectocele. Meditsinskii vestnik Yuga Rossii. 2016;(1):77-83. (In Russ).
  3. Bezhenar VF, Bogatyreva EV, Tsypurdeeva AA, et al. Complications from pelvic organ prolapse correction using a Prolift prolene system: ways of prevention and quality of life. Akusherstvo i ginekologiia. 2012;(4-2):116-121. (In Russ).
  4. Ginekologiya. Natsional'noe rukovodstvo. Ed by Kulakov VI, Savel'eva GM, Manukhin IB. Moscow: GEOTAR-Media; 2009. (In Russ).
  5. Podolsky VV, Podolsky VV. Modern possibilities of recovery and healing genital lower division women. Zdorovʹe zhenshchiny. 2014;(8):102-104. (In Russ).
  6. Altomare DF, Rinaldi M, Veglia A, et al. Combined perineal and endorectal repair of rectocele by circular stapler: a novel surgical technique. Dis Colon Rectum. 2002;45(11):1549-1552. doi: 10.1007/s10350-004-6465-9.
  7. Apolikhina IA, Gorbunova EA. Clinical and morphological aspects of vulvovaginal atrophy. Meditsinskii sovet. 2014;(9):110-116.
  8. Groshilin VS, Shvetsov VK, Uzunyan LV. Preimushchestva ispol'zovaniya individual'nykh kriteriev vybora metoda lecheniya rektotsele. Koloproktologiya. 2016;(1S):23a.
  9. Zhukov BN, Isaev VR, Sukhobokov AA, Savinkov AI. Operativnoe lechenie poslerodovoi nedostatochnosti anal'nogo sfinktera. In: (Conference proceedigs) Aktual'nye voprosy koloproktologii. Materialy I s'ezda koloproktologov Rossii. Samara; 2003. p. 59-61; 118. (In Russ).
  10. Smirnov AB, Khvorov VV. Sravnitel'naya otsenka metodov khirurgicheskoi korrektsii rektotsele. Khirurgiyia. 2006;(10):22-26. (In Russ).
  11. Balan VE, Kovaleva LA. Combination treatment of urogenital atrophy and recurrent urinary tract infections in postmenopausal women. Effektivnaya farmakoterapiya. 2013;(18):48-53. (In Russ).
  12. Glazunova AV, Yureneva SV, Ezhova LS. Vulvovaginal atrophy: symptoms, impact on emotional well-being, quality, and sexual function. Akusherstvo i ginekologiia. 2015;(12):97-102. (In Russ).
  13. Dobrokhotova YuE, Ibragimova DM, Mandrykina ZhA, Serova LG. Mikrobiotsenoz genital'nogo trakta zhenshchin. Moscow: GEOTAR-Media; 2014. 80 p. (In Russ).
  14. Dobrokhotova YuE, Ilyina IYu, Venediktova MG, et al. Local nonhormonal therapy in patients with genitourinary menopausal syndrome. Rossiiskii vestnik akushera-ginekologa. 2018;18(3):88-94. (In Russ). doi: 10.17116/rosakush201818288-94.
  15. Tikhomirov AL, Kazenashev VV, Yudina TA. Contemporary nonhormonal correction of the menopausal disturbances. Meditsinskii sovet. 2016;(12):102-105. (In Russ). doi: 10.21518/2079-701X-2016-12-102-105.
  16. Yureneva SV, Ermakova EI, Glazunova AV. Genitourinary syndrome of menopause in peri- and postmenopausal patients: Diagnosis and therapy (short clinical guideline). Akusherstvo i ginekologiia. 2016;(5):138-144. (In Russ). doi: 10.18565/aig.2016.5.138-144.
  17. Erekson EA, Yip SO, Wedderburn TS, et al. The VSQ: a questionnaire to measure vulvovaginal symptoms in postmenopausal women. Menopause. 2013;20(9):973-979. doi: 10.1097/GME.0b013e318282600b.
  18. Rad'ko VYu. Sovremennye vozmozhnosti vosstanovleniya slizistoi obolochki vlagalishcha i ustranenie simptomov vaginal'nogo diskomforta pri lechenii nespetsificheskikh kol'pitov. Zhenskoe zdorov'e. 2016;(5):30-32. (In Russ).
  19. Ettinger B, Hait H, Reape KZ, Shu H. Measuring symptom relief in studies of vaginal and vulvar atrophy: the most bothersome symptom approach. Menopause. 2008;15(5):885-889. doi: 10.1097/gme.0b013e318182f84b.
  20. Sinha A, Ewies AA. Non-hormonal topical treatment of vulvovaginal atrophy: an up-to-date overview. Climacteric. 2013;16(3):305-312. doi: 10.3109/13697137.2012.756466.
  21. Berlin AL, Hussain M, Phelps R, Goldberg DJ. A prospective study of fractional scanned nonsequential cabon dioxide laser resurfacing: a clinical and histopathologic evaluation. Dermatol Surg. 2009;35(2):222-228. doi: 10.1111/j.1524-4725.2008.34413.x.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Dynamics of the pH-metry index of the vaginal discharge in patients of childbearing age (subgroup A) under the influence of the combined use of general magnetotherapy, electromyostimulation of the pelvic floor muscles with biofeedback and fractional photothermolysis with a CO2 laser

Download (39KB)
Indexing metadata
3. Fig. 2. Dynamics of the pH-metry index of the vaginal discharge in patients of peri- and menopausal age (subgroup B) under the influence of the combined use of general magnetotherapy, electromyostimulation of the pelvic floor muscles with biofeedback and fractional photothermolysis with a CO2 laser

Download (38KB)
Indexing metadata

Copyright (c) 2018 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies