В статье представлены результаты исследований 58 пациенток, средний возраст 29±1,7 года с хронической тазовой болью и лапароскопически подтвержденным диагнозом «наружный генитальный эндометриоз». На основании результатов исследования метаболитов эстрогенов было выделено 2 группы обследованных пациенток. 1-я группа – 26 (44,8%) пациенток с преобладанием канцерогенных фракций эстрогенов в моче 2-ОНЕ1/16-ОНЕ1 менее 2 (в среднем 0,8±0,2), 2-я группа – 54 (55,2%) пациентки с нормальным метаболизмом эстрогенов (в среднем 2,3±0,3). На фоне супрессивной терапии диеногестом 2 мг после хирургического лечения через 12 мес отмечено достоверное (р<0,05) снижение тазовой боли по ВАШ.
This article presents the results of studies 58 patients, mean age 29±1,7 years with chronic pelvic pain and laparoscopically confirmed diagnosis of external genital endometriosis. Based on the research results of estrogen metabolites has been allocated two groups studied patients. Group I – 26 patients (44,8%) with a predominance of carcinogenic fractions of estrogen in the urine of 2-ONE1/16-ONE1 least 2 (average 0,8±0,2), II group – 54 patients (55,2%) with normal estrоgen metabolism (average 2,3±0,3). Against the background of suppressive therapy with dienogest 2 mg after surgery in 12 months was significant (p<0,05) reduction in pelvic pain VAS.
1. Adamson GD, Hummelshoj L. Creating solutions in endometriosis: global callsboration through the World Endometriosis Reserch Foundation. J Endometriosis 2010; 2: 3–6.
2. SOGC Clinical Practice Guidelin (II-3) 244, 2010.
3. Ашрафян Л.А., Киселев В.И., Муйжнек Е.Л. Патогенетическая профилактика рака репродуктивных органов. М.: Молодая гвардия, 2009.
4. Neil P. Johnson. Lone Hummelshoj Consensus on current management of endometriosis for the World Endometriosis Society Montpellier Consortium. Hum Reprod first published online July 12, 2013 doi:10.1093/humrep/det282
5. Nnoaham KE, Hummelshoj L, Webster P et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 2011; 96 (2): 366–73.
6. Moniek M. ter Kuile, Philomeen TM Weijenborg, Spinhoven P. Sexual Functioning in Women with Chronic Pelvic Pain: The Role of Anxiety and Depression J Sex Med 2010; 7: 1901–10.
7. Sepulcri R de P, do Amaral VF. Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol 2009; 142 (1): 53–6. Epub 2008 Nov 17.
8. Смулевич А.Б. Депрессии при соматических и психических заболеваниях. М., 2003.
9. Wheeler JM. Epidemiology and prevalence of endometriosis. Infertil Reprod Med Clin North Am 1992; 3: 545–9.
10. Адамян Л.В., Кулаков В.И., Андреева Е.Н. Эндометриозы. М.: Медицина. 2006; 416.
11. Kennedy SH, Mardon HJ, Barlow DH. Familial endometriosis. J Ass Reprod Genet 1995; 72: 32–4.
12. Pascual M. Role of color Doppler ultrasonography in the diagnosis of endometriotic cyst. J Ultrasound Med 2000; 19: 695–9.
13. Манухин И.Б., Тумилович Л.Г., Геворкян М.А. Клинические лекции по гинекологической эндокринологии. М.: ГЭОТАР-Медиа, 2013.
14. El-Sahwi K, El-Faham M, Ei-Sahwi S. Laparoscopic management of ovarian endometriomas: incision peeling versus coagulation. Proceedings of XIX World Congress on Fertility & Sterility. Durban, South Africa, 2007; FC1502: 78; Koninckx PR, Barlow D.
15. Shimizu Y et al. Steroids 2011; 76 (1–2): 60–7.
16. Redwine DB, Wright JT. Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil Steril 2001; 76: 358–65.
17. Leyland N et al. J Obstet Gynaecol Can 2010; 32: S1–S32; Deutsche Gesellschaft fuer Gynaekologie and Geburtshilfe e.V. Diagnostik und Therapie der Endometriose (S1). 2010; Fertility and SterilityR Vol. 97, No. 2, February 2012 0015-0282.
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1. Adamson GD, Hummelshoj L. Creating solutions in endometriosis: global callsboration through the World Endometriosis Reserch Foundation. J Endometriosis 2010; 2: 3–6.
2. SOGC Clinical Practice Guidelin (II-3) 244, 2010.
3. Ашрафян Л.А., Киселев В.И., Муйжнек Е.Л. Патогенетическая профилактика рака репродуктивных органов. М.: Молодая гвардия, 2009.
4. Neil P. Johnson. Lone Hummelshoj Consensus on current management of endometriosis for the World Endometriosis Society Montpellier Consortium. Hum Reprod first published online July 12, 2013 doi:10.1093/humrep/det282
5. Nnoaham KE, Hummelshoj L, Webster P et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 2011; 96 (2): 366–73.
6. Moniek M. ter Kuile, Philomeen TM Weijenborg, Spinhoven P. Sexual Functioning in Women with Chronic Pelvic Pain: The Role of Anxiety and Depression J Sex Med 2010; 7: 1901–10.
7. Sepulcri R de P, do Amaral VF. Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol 2009; 142 (1): 53–6. Epub 2008 Nov 17.
8. Смулевич А.Б. Депрессии при соматических и психических заболеваниях. М., 2003.
9. Wheeler JM. Epidemiology and prevalence of endometriosis. Infertil Reprod Med Clin North Am 1992; 3: 545–9.
10. Адамян Л.В., Кулаков В.И., Андреева Е.Н. Эндометриозы. М.: Медицина. 2006; 416.
11. Kennedy SH, Mardon HJ, Barlow DH. Familial endometriosis. J Ass Reprod Genet 1995; 72: 32–4.
12. Pascual M. Role of color Doppler ultrasonography in the diagnosis of endometriotic cyst. J Ultrasound Med 2000; 19: 695–9.
13. Манухин И.Б., Тумилович Л.Г., Геворкян М.А. Клинические лекции по гинекологической эндокринологии. М.: ГЭОТАР-Медиа, 2013.
14. El-Sahwi K, El-Faham M, Ei-Sahwi S. Laparoscopic management of ovarian endometriomas: incision peeling versus coagulation. Proceedings of XIX World Congress on Fertility & Sterility. Durban, South Africa, 2007; FC1502: 78; Koninckx PR, Barlow D.
15. Shimizu Y et al. Steroids 2011; 76 (1–2): 60–7.
16. Redwine DB, Wright JT. Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil Steril 2001; 76: 358–65.
17. Leyland N et al. J Obstet Gynaecol Can 2010; 32: S1–S32; Deutsche Gesellschaft fuer Gynaekologie and Geburtshilfe e.V. Diagnostik und Therapie der Endometriose (S1). 2010; Fertility and SterilityR Vol. 97, No. 2, February 2012 0015-0282.