PERSONIFICATION OF VISUAL DIAGNOSTIC METHODS IN WOMEN WITH SUBMUCOSAL UTERINE FIBROIDS: A RETROSPECTIVE CLINICAL ANALYSIS.

OBJECTIVE: The aim: To determine the parameters of perioperative application of radiographic methods for visual diagnosis in women with submucous uterine fibroids. PATIENTS AND METHODS: Materials and methods: We conducted a retrospective analysis of the data from 200 medical records of women with submucous uterine fibroids (SUF). RESULTS: Results: Preoperatively, nodes were diagnosed by ultrasound as follows: solitary nodes - SM0 type - 65 (46%) near the fundus; SMІ - 41 (29%) on the anterior or posterior wall; SMІІ - 35 (25%) on the lateral walls of the uterus and in the cornual areas of the fallopian tubes; multiple in combinations: О3-4 / SMІ - 16 (27.0%) and О3-6 / SMІІ - 14 (24.0%); with localization: О3-4 / SM0 - mainly in the fundus - 49%, О3-4 / SMІ and О3-4 / SMІІ on the posterior and lateral - 25.0%, 28.0%; О5-6 / SM0 - posterior and fundus - 38.0%, 49.0%; О5-6 / SMІ and О5-6 / SMІІ - posterior and lateral - 45.0% and 37.5%. The maximum average diameter was 20-30 mm, with a quantity of ≤ 3 per individual. When comparing ultrasound and MRI data, discrepancies in the number and localization of nodes were observed in cases of isolated SMІ / SMІІ (on the lateral walls and in the cornual areas of the uterus) at 29.0%; as well as in cases involving combinations of nodes of types О 3-4 / SMІ at 39.0% and О 3-4 / SMІІ at 23.0% (p<0.05). During hysteroscopy, in the group without intraoperative sonography, there were 30% more conversions from hysteroscopic to laparoscopic myomectomy, and 25% more combinations of hysteroscopic myomectomy with laparoscopic monitoring. CONCLUSION: Conclusions: Hysteroscopic myomectomy with intraoperative sonography is an effective method of treatment for isolated and multiple fibroids of types SMІ/ SMІІ and О3-4/SMІ as well as О3-4/SMІІ.

CLINICAL PROFILES AND CHARACTERISTICS OF MENSTRUAL DYSFUNCTION IN WOMEN AFTER SUFFERING FROM COVID-19 OR VACCINATION.

OBJECTIVE: The aim: To investigate changes in the characteristics of menstrual function in women after suffering from Covid-19 or vaccination against SARS-CoV-2. PATIENTS AND METHODS: Materials and methods: After the retrospective analysis of 378 medical records patients were divided into: Group 1 (177 women) with menstrual function disorders (MFD) after COVID-19, Group 2 (121 women) with MFD after SARS-CoV-2 vaccination, Group C (80 women) without MFD after COVID-19 or vaccination (controls). The study focused on the clinical and hormonal menstrual cycle characteristics and factors influencing MFD. RESULTS: Results: Dyshormonal thyroid disorders were observed in 63.0% of Group 1 and 45.7% of Group 2 patients; hyperprolactinemia - in 31.0% and 39.4%, hyper¬estrogenia - in 50% and 21%, and hyperandrogenism - in 39% and 20%. MFD was associated with hyperandrogenism with concurrent hyperprolactinemia, in the context of thyroid dysfunction; and with changes of gonadotropin production, along with normal and elevated estrogen concentrations and worsening of mental health that suggest disruption of central regulatory and feedback mechanisms in the pituitary-thyroid-ovarian system under the stressors influence. CONCLUSION: Conclusions: There are changes in the menstrual cycle associated with disruption of the hypothalamus-pituitary-ovary system and thyroid function in women after suffering from Covid-19 or vaccination. To reestablish reproductive homeostasis, employing a personalized diagnostic strategy is recommended, encompassing the evaluation of thyroid gland status, hormonal profiling, and the consideration of psychosocial facets.