Optimization of the Treatment and Rehabilitation Methods of Patients with Infertility caused by Inflammatory Uterus Diseases

The problem of treatment of patients suffering from infertility of tubal-peritoneal genesis does not lose its importance. Despite the wide arsenal of medicines and significant progress in the application of endoscopic techniques of adhesion and restoration of patency of the fallopian tubes, which can be restored at 70-90%, and pregnancy only occurs in 25-30% of operated women. Such results are caused by formation in the postoperative period of adhesions in the small pelvis and reocclusion of the fallopian tubes. The purpose of experimental research was to study the degree of influence of diathermic (300-400 Hz) and radiowave (3.5 MHz) energies and methods of preventing the development of the adhesion process in rat Wistar females using an anti-spark barrier derivative of carbomethylcellulose and comparison with the generally accepted prophylaxis. The purpose of the clinical study was to develop a complex of treatment and rehabilitation of the generative function in women with tubal-peritoneal infertility (TPI) using radiowaves energy in laparoscopic treatment, intraoperative prevention of adhesion with the use of antispasmodic gel of derivative carbomethylcellulose and a complex of physiotherapy in the postoperative period. Materials and methods: an experimental study was conducted on 50 Wistar female rats. A clinical study was performed on 96 women with TPI of inflammatory genesis, who carried out laparoscopic treatment and rehabilitation in the postoperative period. The results of the experimental study revealed that damage to tissue in the application of radiowaves energy on the tissues of uterine horns in female rats of the Wistar line occurs from the zone of influence only to 0.1 cm without causing necrosis or loss of functionally active epithelium, even with a maximum power of 40 W, and when the use of anti-spark gel reduces the volume and density of adhesions both on the macro and on the microscopic level. The results of the proposed clinical study allowed to reduce the average blood loss during the operation, the duration of the postoperative bed days, the need for the appointment of analgesic and antibacterial drugs. Conclusions: the proposed method of treatment and rehabilitation of women with TPB has allowed increasing the restoration percentage of uterine tubes patency, the onset of uterine pregnancy, reducing the risk of an ectopic pregnancy and reocclusion of the fallopian tubes.