[Influence of complex rehabilitation programs on the uterine blood flow in patients of different age after plastic surgery for rectocele]. / Vliyanie reabilitatsionnykh kompleksnykh programm na pokazateli matochnogo krovotoka po dannym 3D-ekhodopplerografii u patsientok raznykh vozrastnykh grupp posle plasticheskoi operatsii po povodu rektotsele.

OBJECTIVE: To develop the optimized complex programs, including general magnetotherapy, fractional microablative therapy with a CO2 laser, electromyostimulation with biofeedback of the pelvic floor muscles, and a special exercise therapy complex in late rehabilitation programs for women of different age after reconstructive plastic surgery for rectocele. MATERIAL AND METHODS: There were 200 women of childbearing, peri- and menopausal age with rectocele grade II-III and 20 healthy women of comparable age. All patients were divided into 4 groups by 50 womes: main group, two comparison groups and control group. Surgical treatment of rectocele was followed by long-term postoperative rehabilitation including symptomatic therapy, general magnetotherapy, and electromyostimulation with biofeedback of the pelvic floor muscles, intra-vaginal fractional microablative therapy with a CO2 laser and special complex of therapeutic physical education. RESULTS: General magnetotherapy in early (1 day) postoperative period and complex rehabilitation in long-term postoperative period (within a month after surgery) including 2 procedures of intra-vaginal microablative fractional therapy with carbon dioxide laser, electromyostimulation with biological connection of the pelvic floor muscles and special complex of therapeutic physical education ensured more significant improvement of uterine blood flow regardless age and baseline disorders in the uterine arteries in patients with rectocele. In our opinion, this is primarily due to vasoactive effects of general magnetotherapy, recovery of circulation via relief of spasm in the arteries and arterioles, improved vein contractility and venous outflow. These processes combined with electrical stimulation and therapeutic exercises of pelvic floor muscle followed by their reinforcement, as well as fractional microablative therapy ensured significant vascular effect.

[Myostimulating effect of comprehensive application of general magnetotherapy, fractional CO2 laser, electro-myostimulation and special complex of exercise in patients with rectoceleal after open-peconstructure]. / Miostimuliruyushchii effekt kompleksnogo primeneniya obshchei magnitoterapii, fraktsionnogo CO2-lazera, elektromiostimulyatsii i spetsial'nogo kompleksa LFK u patsientok s rektotsele posle rekonstruktivno-plasticheskikh operatsii.

The article presents data on the treatment of 200 women of childbearing, peri - and menopausal age with rectocele of II-III degree, which were divided into 4 groups comparable in clinical and functional characteristics: 1-50 patients who, after surgical treatment of rectocele, underwent a complex consisting of a course of General magnetic therapy, 2 intra-vascular procedures of fractional microablative CO2 laser therapy, electromyostimulation with the pelvic floor muscles and a special complex of therapeutic physical education; comparison 1, which included 50 patients who underwent the above-mentioned complex of rehabilitation measures without General magnetotherapy; comparison of 2-50 patients after surgical treatment of rectocele, who in the late postoperative period (one month after the operation) underwent a set of rehabilitation measures, including a course of electromyostimulation with the biological connection of the pelvic floor muscles, consisting of 10 daily procedures and a special complex of physical therapy and a control group - 50 patients after surgical treatment of rectocele, who in the late postoperative period were treated with symptomatic therapy, including painkillers and antispasmodics, which served as a background for all other groups. As a result of the research, it was found that the developed rehabilitation complexes have a pronounced myostimulating effect, and can be recommended for wide use in rehabilitation programs for postoperative management of patients with rectocele.

[Influence of various rehabilitation complexes on sexual function in fertile females and women of perimenopausal and menopausal age after surgery for rectocele]. / Otsenka vliyaniya razlichnykh reabilitatsionnykh kompleksov na seksual'nuyu funktsiyu u patsientok detorodnogo i perimenopauzal'nogo i menopauzal'nogo vozrasta posle operatsii po povodu rektotsele.

OBJECTIVE: To study the effect of general magnetotherapy, muscle stimulation with biofeedback of pelvic floor muscles, and a special complex of physiotherapy exercises with and without fractional microablative CO2-laser therapy on sexual status in females after plastic surgery for rectocele. MATERIAL AND METHODS: There were 200 fertile females and women of perimenopausal and menopausal age with rectocele grade II-III. Various rehabilitation programs were used in delayed postoperative period in order to improve sexual function. Rehabilitation included various combinations general magnetotherapy, electrical muscle stimulation with biofeedback of pelvic floor muscles, intravaginal fractional microablative CO2-laser therapy and a special complex of exercise therapy. RESULTS AND CONCLUSION: Postoperative rehabilitation including general magnetotherapy, fractional microablative CO2-laser therapy, muscle stimulation with biofeedback of pelvic floor muscles and a special exercise therapy significantly improves sexual function in patients with rectocele. This is true for fertile females and women of perimenopausal and menopausal age. Significant data on PISQ-12 questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire) and Female Sexual Function Index of (FSFI) confirmed these results.

[Effect of conservative treatment in the management of low-degree urogenital prolapse]. / Apport du traitement conservateur dans la prise en charge du prolapsus urogénital de bas grade. Le devenir après deux ans.

OBJECTIVE: The objective of our study was to determine the respective effects of conservative treatment (pelvic muscle exercises plus advice on healthy living) and the absence of treatment in the management of urogenital prolapse. MATERIALS AND METHODS: Forty-seven women (mean+/-S.D. age: 53.42+/-11.01 years) consulting for genital prolapse (grade I or II cystocele) were randomized into two groups: a conservative treatment group (CTG) and a nontreated group (NTG). The patients' outcomes were rated according to several parameters; a clinical examination, the "Measurement of Urinary Handicap" (MUH) scale, urodynamic tests, the Ditrovie quality of life scale and patient satisfaction on a visual analogue scale (VAS). RESULTS: The immediate post-treatment results showed that pelvic heaviness persisted in only five patients (18.51%) in the CTG compared with fourteen (70%) in the NTG (p<0.001). Furthermore, a significant improvement in the MUH scale score was noted in the CTG compared with the NTG. The Ditrovie score also improved. The maximum urethral closure pressure (MUCP) ranged from 54.4+/-13.23 to 57.81+/-12.8 cm H(2)O in the CTG versus 54.05+/-12.18 to 52.95+/-12.18 cm H(2)O in the NTG. Uroflowmetry revealed a significant improvement in the maximum flow rate. These benefits were maintained two years after cessation of the conservative treatment in 20 of the CTG patients. CONCLUSION: Conservative treatment can be effective in the treatment of low-degree urogenital prolapse and enables the improvement of clinical symptoms and urodynamic parameters. The benefits were maintained two years after treatment cessation.