First of all, it must be said that at the Central Clinical Hospital all specialists, including a gynecologist, receive consultations. HE works as usual and receives women on issues of detection, prevention and treatment gynecological diseases.
What are the categories of gynecologists?
It must be said that gynecology covers a huge spectrum women's diseases, and studies the female body comprehensively. Therefore, for full-fledged work in this area, specialists from various fields are required:
1. Gynecologist immunologist.
2. Homeopathic gynecologist.
3. Gynecologist endocrinologist.
4. Gynecologist and obstetrician.
5. Mammologist.
6. Pediatric gynecologist.
7. Gynecologist, obstetrician, surgeon.
All these specialists deal with issues women's health in the field:
1. Genitourinary system.
2. Reproductive system.
3. Reproductive system.
4. Endocrine system.
5. Mammary gland.
6. Surgery.
It is also worth noting that adult woman should regularly visit a gynecologist and undergo a gynecological examination. Additionally, if she experiences gynecological symptoms, of the following nature, then she should consult a doctor immediately:
1. Strong or nagging pain lower abdomen.
2. Vaginal discharge.
3. Bloody or brown discharge in the middle of the menstrual cycle.
4. Menstrual irregularities.
5. Itching and burning in the genitals.
6. Discomfort or pain during sexual intercourse.
When should a woman see a gynecologist?
There are several periods in a woman’s life when she may need help and advice from a gynecologist. This is the beginning of sexual activity, at which point the woman can already undergo a full examination by a gynecologist. He will conduct a visual examination and also prescribe an ultrasound examination of the internal organs of the pelvis. This is necessary in order to identify disturbances in their work, as well as to identify congenital pathologies and structural changes.
In addition, a woman should consult a gynecologist at the stage of pregnancy planning. This approach is extremely justified, since it makes it possible to enter into pregnancy completely healthy and with cured gynecological diseases. This will guarantee a good pregnancy and birth. healthy child. Moreover, an experienced gynecologist will conduct a detailed consultation and tell the woman about all the features of this condition and prepare her for childbirth.
Next, consultation and examination by a gynecologist during menopause is necessary. A woman should definitely consult a doctor and he will explain to her how this period proceeds and prescribe tests. During climatic periods, it is very important to monitor hormone levels to avoid unpleasant symptoms such as hot flashes and surges. blood pressure.
What does a gynecologist do?
Gynecological care means that specialists identify, prevent and treat all types of diseases:
- inflammatory processes in the internal organs of the pelvis,
- acute inflammation of the external genitalia,
- treatment of complex gynecological diseases,
- identification congenital pathologies gynecological nature,
- viral diseases genital area.
In addition, gynecologists carry out a number of surgical measures:
- abortion,
- laparoscopic operations, including diagnostic ones,
- hysterological operations,
- endoscopic operations,
- introduction of intrauterine contraception.
In order to identify these disorders, the gynecologist prescribes a series of tests and examinations for the woman, which will enable him to correctly diagnose the gynecological disease:
1. Ultrasonography.
2. Basic tests:
- for HIV infection,
- PCR diagnostics,
- on bacterial flora,
- for hepatitis.
3. Laparoscopic diagnosis.
4. Hysterological diagnosis.
5. Endoscopic diagnostics.
6. Biopsy.
There are several periods in a woman’s life when she may need help and advice from a gynecologist. This is the beginning of sexual activity, at which point the woman can already undergo a full examination by a gynecologist.
Gynecologist– deals with the diagnosis, treatment and prevention of diseases of the female reproductive system.
Consultation with a gynecologist is necessary not only for those women who have discovered symptoms of the disease. As a preventative measure, it is recommended to visit a gynecologist at least once a year.
Symptoms that require consultation with a gynecologist- Lower abdominal pain;
- Discharge from the genitals;
- Bloody issues in the middle of the menstrual cycle;
- Menstrual irregularities;
- Itching and burning of the genitals;
- Discomfort during sexual intercourse.
- Pregnancy planning;
- Menopause;
- Beginning of sexual activity.
- Inflammatory diseases (vaginitis, colpitis, cervicitis, endometritis and others);
- Sexually transmitted diseases (STDs);
- Menstrual irregularities (amenorrhea, dysmenorrhea, PMS, menorrhagia);
- Menopausal syndrome;
Initial consultation
At the initial appointment, the gynecologist will listen to your complaints and conduct a thorough examination. If your disease requires urgent treatment, already at the first consultation the gynecologist will prescribe medications that will reduce symptoms and make you feel better.
To clarify the diagnosis, additional examinations may be prescribed -
- fence biological material to the flora,
- on diagnosis of infections,
- colposcopy,
- Ultrasound – transvaginal or transabdominal.
- Blood tests that may be prescribed include: hormone analysis, enzyme immunoassay.
Repeated consultation with a gynecologist
At a repeated consultation with a gynecologist, changes in well-being and examination results are taken into account. If the diagnosis is not completed and doubts remain about the accuracy of the diagnosis (for example, difficult cases infertility), a decision may be made to conduct additional examinations– hysterosalpingography, hysteroscopy, laparoscopy.
In some cases, at this appointment the doctor decides to adjust the treatment to get rid of the pathology as effectively as possible.
Don't underestimate the importance readmission: even if you have passed unpleasant symptoms, you definitely need to see a specialist - after all, only he can remove the appointments and inform you that you are healthy!
Diagnosis of gynecological diseases
The following studies can be used to diagnose gynecological diseases:
At the Central Clinical Hospital of the Russian Academy of Sciences you will receive a consultation from a qualified experienced gynecologist and will be able to go through all necessary research at a time convenient for you on one base.
The CDC of the Central Clinical Hospital of the Russian Academy of Sciences (metro Leninsky Prospekt) and the Treatment and Diagnostic Center (metro Yasenevo) are equipped with everything necessary for accurate and quick diagnostics diseases - own laboratory, ultrasound diagnostics, X-ray diagnostics, magnetic resonance imaging (MRI), multislice computed tomography (MSCT), endoscopic diagnostics, experienced consultant doctors of all specialties.
It is also possible to perform minor surgical interventions in the operating room Day hospital(without daily hospitalization). The advantage is that you do not need to stay in hospital around the clock - you are discharged a few hours after the operation.
Gynecologists of the CDC of the Central Clinical Hospital of the Russian Academy of Sciences in the conditions of the Day Hospital carry out:
- coagulation and conization of the cervix
- removal of condylomas, papillomas
- biopsy of the external genitalia
- cervical biopsy
- separate diagnostic curettage
- Bartholin gland cyst removal
If at the appointment the gynecologist identifies indications for inpatient treatment, he may offer you hospitalization in the hospital of the Central Clinical Hospital of the Russian Academy of Sciences.
Gynecologists of the Diagnostic and Treatment Center carry out:
The antenatal clinic based at the Central Clinical Hospital of the Russian Academy of Sciences is a reliable medical institution whose doctors you can trust with your health. If you notice signs of pathology, are planning a pregnancy, or are simply looking for the best gynecologist in Moscow - we recommend signing up for paid consultation and professional examination by our doctors. Clarify any details regarding gynecologists’ work schedules and prices medical services at the clinic, you can find out how to prepare for tests or get other information by calling the hospital. If you have decided for the first time to make an appointment with a gynecologist at the medical center of the Central Clinical Hospital of the Russian Academy of Sciences, immediately indicate your wishes - should it be a female specialist, do you need an obstetrician-gynecologist or a gynecologist-endocrinologist, etc. Registration is also carried out online on the website of the Central Clinical Hospital clinic.
EndocrinologistConsultation with a gynecologist and endocrinologist is indicated if it is necessary to diagnose and treat diseases caused by hormonal imbalance female body.excessive or insufficient production of certain hormones. We remind you that an endocrinologist is responsible for working with problems such as endometriosis, juvenile bleeding, severe premenstrual syndrome, menopausal symptoms, infertility by hormonal reasons etc.
OncologistAn appointment with a gynecologist-oncologist should not be delayed if you suspect the development of a neoplasm in the pelvic organs. Good specialists CDBs effectively use complex therapy for cervical cancer, ovarian cancer and uterine cancer, including when it comes to the disease at serious stages.
Reproductologist
It is necessary to undergo an examination and get advice from a reproductive specialist if within 12 months a married couple cannot conceive a child or there is a miscarriage. A reproductive technology specialist will conduct an examination, verify the diagnosis, and select effective treatment.
The gynecological department at the Central Clinical Hospital of the Russian Academy of Sciences is widely known in Moscow the highest level treatment, qualified personnel, including doctors of the highest category and individual approach to every patient who turns to us for help. In the conditions of the gynecology center of our clinic, you can use diagnostic and treatment paid services, planned or emergency, which are affordable.
The gynecological department of the hospital has a capacity of 30 beds.
The department has 1 and 2-bed wards, as well as 1-bed superior wards.
Every year more than a thousand patients are treated in our department.
Diagnosis and treatment wide range gynecological diseases are carried out in accordance with international standards, using modern diagnostic and treatment methods. Our hospital provides 24-hour emergency care and, if necessary, prepares and examines patients for planned surgical treatment.
Gynecological diseases treated at the clinic of the Central Clinical Hospital of the Russian Academy of Sciences
- Adenomyosis
- Atypical endometrial hyperplasia
- Genital prolapse (prolapse of the uterus and vaginal walls)
- Ovarian dysfunction during the reproductive and premenopausal periods
- Ovarian cysts
- External genital endometriosis
- Incipient miscarriage
- Urinary incontinence
- Non-developing pregnancy
- Acute pelvioperitonitis
- Acute, chronic salpingoophoritis
Treatment methods
Therapeutic treatment of gynecological diseases in our hospital carried out using medication and physiotherapy - ozone therapy, magnetic therapy, ultrasound.
The department performs the following types of operations:
- Diagnostic hysteroscopy, surgical hysteroscopy and separate diagnostic curettage (for endometrial pathology: hyperplasia, endometrial polyps and cervical canal). When saved menstrual cycle the intervention is carried out on days 5-7 of the menstrual cycle.
- Hysteroresectoscopy, polypectomy, myomectomy for submucosal uterine fibroid nodes, endometrial ablation, dissection of the intrauterine septum and synechiae.
- Radio wave surgery of the cervix using the Surgitron device, including conization of the cervix (ectopia of the cervix due to infection with the human papillomavirus, leukoplakia, dysplasia). High cervical amputation with severe cervical dysplasia.
- For prolapse (prolapse, prolapse) of the genitals, hysterectomy through vaginal access, colpoperineorrhaphy, levatoroplasty, and Manchester surgery are performed. Correction of stress urinary incontinence using free synthetic loop urethropexy.
- Removal of a large gland cyst of the vaginal vestibule.
- Laparotomy, hysterectomy, myomectomy for myomatous nodes and giant ovarian tumors.
- Operations on the appendages using laparoscopic access: external endometriosis, endometrioid ovarian cysts, benign tumors ovaries, ectopic pregnancy, inflammatory diseases appendages (including tubo-ovarian formations), tubo-peritoneal infertility, PCOS.
- Supravaginal amputation of the uterus, hysterectomy using laparoscopic access, myomectomy for subserous nodes using laparoscopic access.
The best gynecologists in Moscow
Doctors of the highest category see patients from the capital and regions. A deep understanding of the characteristics of the female body and many years of practical experience allow the patients of the department antenatal clinic count on accurate diagnosis and individual plan treatment of diseases of any complexity.
Outpatient appointment
Doctors obstetrics and gynecology clinics RAS provides consultations to patients on an outpatient basis. It is possible to receive recommendations on any gynecological pathology, including problems of hormonal contraception, hormonal treatment various diseases, treatment of menopausal syndrome.
Hospital
On the basis of the gynecological departments of the City Clinical Hospital No. 31, a clinic of the Department of Obstetrics and Gynecology of the Russian National Research Medical University has been established.
Gynecology of City Clinical Hospital No. 31 is rightfully considered one of the best in Moscow. All types of conservative and surgical treatment of any gynecological diseases are used. Hysteroscopic and laparoscopic diagnosis is possible, and surgical treatment using these methods allows you to speed up as much as possible recovery period and is the most gentle for patients.
Since 2004, the hospital has firmly established a modern organ-saving method of treating uterine fibroids and adenomyosis - uterine artery embolization.
detailed information
Head of Department No. 1 - Doctor of Medical Sciences, Professor E.N. Kauhova.
Older nurse departments - Yu.N. Tarasova.
Head of Department No. 2 - Ph.D. O.I. Mishieva.
Senior nurse - N.G. Kosolapova.
In two gynecological departments of the hospital, all types of conservative and surgical treatment are successfully used, including for the following diseases:
- uterine bleeding of the reproductive, perimenopausal periods, menopausal periods;
- cervical diseases;
- physiology and pathology of the postmenopausal period;
- intrauterine pathology (uterine fibroids, adenomyosis, endometrial polyps, endometriosis, synechiae, foreign bodies);
- ovarian formations in patients of different age periods
- inflammatory diseases of the internal genital organs.
Main types of surgical treatment:
- diagnostic laparoscopy;
- abdominal sectioning and laparoscopic operations including amputation and hysterectomy;
- abdominal sectioning and laparoscopic operations on the appendages;
- vaginal extirpations;
- plastic vaginal surgeries, including for uterine prolapse and prolapse of the vaginal walls;
- laparoscopic surgeries for the treatment of infertility;
- laparoscopic organ-saving operations for tubal pregnancy; restoration of pipe patency;
- hysteroscopic treatment of intrauterine pathology;
- electrosurgical, laser and thermal ablation of the endometrium, embolization of the uterine arteries.
The motto of the team of gynecological departments is
warm and attentive attitude towards patients.
Dozens of people come to the clinic letters of thanks. The implementation of high-tech methods is carried out by the doctors of City Clinical Hospital No. 31 in close professional contact with the staff of the department.
general information
- Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty of the Russian National Research Medical University - Doctor of Medical Sciences, Academician of the Russian Academy of Sciences, member of the presidium of the board Russian society obstetricians and gynecologists, chairman of the presidium of the Moscow Society of Obstetricians and Gynecologists, member of the New European Surgical Academy (NESA), member of the International Federation of Obstetricians and Gynecologists (FIGO) - Kurtser Mark Arkadievich— student of the founder and honorary head of the department — Savelyeva Galina Mikhailovna, Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Honored Scientist, Vice President Russian Association obstetricians-gynecologists, head of the department of obstetrics and gynecology of the pediatric faculty from 1971 to 2017.
Currently, the clinic’s achievements are associated with performing a wide range of laparoscopic therapeutic and diagnostic interventions on the pelvic organs. Over the past 20 years, one of the department’s employees, Doctor of Medical Sciences, Professor Sergei Vyacheslavovich Shtyrov a school of endoscopic gynecology was created on the basis of 31 hospitals.Professor Valentina Grigorievna Breusenko- founder of the hysteroscopic method in City Clinical Hospital No. 31. On modern stage, with the introduction of hysteroresection, laser ablation and thermal ablation of the endometrium, the arsenal of hysteroscopic operations performed has been significantly expanded. Since 2004, the hospital has firmly established a modern organ-saving method of treating uterine fibroids and adenomyosis - uterine artery embolization. Over the past 5 years, cooperation with the department has allowed practicing doctors to defend 4 doctoral and 38 candidate dissertations. Currently, a grant has been received to carry out scientific research on the topic “ Early diagnosis ovarian cancer." To the employees of the department: Academician of the Russian Academy of Medical Sciences G.M. Savelyeva, professors V.G. Breusenko, S.V. In 2003, Shtyrov was awarded the Russian Government Prize for the development and implementation of endoscopic methods of diagnosis and treatment in gynecology.
- Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty of the Russian National Research Medical University - Doctor of Medical Sciences, Academician of the Russian Academy of Sciences, member of the presidium of the board Russian society obstetricians and gynecologists, chairman of the presidium of the Moscow Society of Obstetricians and Gynecologists, member of the New European Surgical Academy (NESA), member of the International Federation of Obstetricians and Gynecologists (FIGO) - Kurtser Mark Arkadievich— student of the founder and honorary head of the department — Savelyeva Galina Mikhailovna, Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Honored Scientist, Vice President Russian Association obstetricians-gynecologists, head of the department of obstetrics and gynecology of the pediatric faculty from 1971 to 2017.
general information
Uterine artery embolization (UAE) is one of the modern areas of surgical treatment of uterine diseases, which consists of puncture of the artery on the thigh, catheterization of the uterine vessels and the introduction of particles of a special embolization drug.
Symptomatic or growing uterine fibroids
- Size up to 20 weeks of pregnancy in the absence of significant pathology of the cervix, endometrium and ovaries.
- In patients interested in pregnancy, with a confirmed role of uterine fibroids in the pathogenesis of infertility or with high risk miscarriage, if it is impossible to perform a safe myomectomy.
- As preparation for myomectomy or hysteroresectoscopy.
Intense uterine bleeding of various etiologies, when other treatment methods are impossible or are associated with a real threat to the patient’s life.
When determining indications for UAE for fibroids important has the motivation of patients: the patient’s persistent desire to preserve the uterus, avoid surgery, interest in pregnancy.
Uterine artery embolization (UAE) is performed in:
general information
Robotic surgery is a new high tech look minimally invasive surgery, which consists of surgical intervention through small incisions on the patient’s skin and the ability to operate remotely. This ensures minimal trauma, faster recovery, reduces the patient's length of stay in the hospital, and minimizes the likelihood of further complications.
Benefits of Robotic Surgery
The da Vinci Si robot does not perform operations on its own, contrary to popular belief. But thanks remote control and high-quality visualization, it allows the operating surgeon to make clearer movements and eliminates hand tremors. That is, the robot follows all the movements of the surgeon, and it is not able to move or program itself.
These factors create ideal conditions for the surgeon and facilitate complex laparoscopic operations. As a result of the maximum precision of even very complex instrument movements, thanks to excellent image quality and the ability to perform surgery in small and difficult-to-reach areas, the length of hospital stay for patients is reduced, they feel less pain, lose less blood, have a better aesthetic result, undergo faster rehabilitation and return to work sooner. Everyday life.
Robotic surgeries in gynecology, City Clinical Hospital No. 31
In the 70-80s, the widespread introduction of laparoscopy in clinical practice, which was associated with the advent of fiber optics and special instruments. As a result, not only the quality of diagnosis has improved, but also some interventions on organs have become possible abdominal cavity. By the way, in our country, the experience of using laparoscopy in gynecology was summarized in 1977 in the monograph by G.M. Savelyeva - Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, professor and our doctor, under whose leadership the first operation was performed in our hospital after its opening in 1970.
On this moment Almost all gynecological operations performed using laparoscopy and a robot. Robotic surgery in gynecology is one of the fastest growing fields and is used in the treatment of all benign and malignant gynecological diseases. Our gynecologists perform operations on women with the problem of genital prolapse (prolapse), including pelvic floor support (promontofixation using a mesh implant), removal of myomatous nodes (myomectomy) with preservation of the uterus, panhysterectomy with lymph node dissection. Thus, operations previously performed laparoscopically can now be reliably performed robotically.
Surgery for uterine fibroids and ovarian tumors
Today, endoscopic operations are routinely performed regardless of the size of the uterus. Depending on the location of the myomatous nodes and their number, removal can be done with small incisions and without resorting to open surgery. In this case, uterine fibroids, regardless of their size, are removed from the abdomen in small sections using a marcellator.
Radical hysterectomy (removal of the uterus) is a classic and effective method treatment oncological diseases uterus and appendages initial stage. Robot-assisted surgery makes it minimally invasive, with less blood loss and hospitalization time.
Experience in performing robotic operations in City Clinical Hospital No. 31
At the moment, in City Clinical Hospital No. 31, robotic operations of varying complexity using the da Vinci robotic system are carried out on a regular basis.
Today, gynecological robotic surgeries include removal of ovarian tumors, myomectomies, promontofixations, total and partial hysterectomies, treatment of endometriosis, as well as treatment of endometrial and ovarian cancers.
general information
Laparoscopy is endoscopic method emergency and planned surgery. It allows you to inspect internal organs abdomen through a small hole in the abdominal wall. The inspection is carried out using an optical tube. After 2-3 other punctures, the necessary manipulations with the organs are performed. Laparoscopy is practically bloodless and low-traumatic.
At the origins of laparoscopic gynecology in Russia is Academician of the Russian Academy of Medical Sciences, Professor, Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty of the Russian State Medical University Galina Mikhailovna Savelyeva. Every laparoscopy specialist rightfully calls her your Teacher.
Range surgical interventions performed by laparoscopic access is wide: gynecological operations, cholecystectomy and hernioplasty, gastrectomy, pancreaticoduodenectomy and operations on the colon and rectum.
general information
Ectopia of the cervix (also Ectopia of the cervical epithelium, Pseudo-erosion of the cervix, Cervical erosion, Endocervicosis) is the location of the columnar epithelium lining the canal of the cervix on its vaginal surface, which outwardly looks like a red spot around the external opening of the canal. Ectopia occurs in approximately half of women of reproductive age and almost never occurs in women over 40 years of age.
general information
Hysteroscopy is an examination of the walls of the uterine cavity using a hysteroscope, followed by (if necessary) diagnostic and surgical procedures. Hysteroscopy allows you to identify and eliminate intrauterine pathologies, remove foreign bodies, take tissue biopsies, and remove endometrial polyps.
Indications for the diagnostic procedure are:
- Anomalies of uterine development.
- Bleeding in postmenopause.
- Infertility.
Indications for the surgical procedure are:
- Submucosal uterine fibroids.
- Intrauterine septum.
- Intrauterine synechiae.
- Endometrial polyp.
- Endometrial hyperplasia.
Contraindications are:
- Recent or existing inflammatory process of the genital organs at the time of the study.
- Progressive pregnancy.
- Abundant uterine bleeding.
- Cervical stenosis.
- Common cervical cancer.
- Common infectious diseases in the acute stage (influenza, pneumonia, pyelonephritis, thrombophlebitis).
- Severe condition of the patient with the disease of cardio-vascular system, liver, kidneys.
Indications for carrying out diagnostic procedure are:
- Submucosal uterine fibroids.
- Intrauterine septum.
- Intrauterine synechiae.
- Endometrial polyp.
- Endometrial hyperplasia.
- Removing remnants of the intrauterine contraceptive device.
Indications for use surgical procedure:
- Suspicion of internal endometriosis of the uterine body, submucosal fibroids, synechia (adhesions) in the uterine cavity, remnants of the fertilized egg, cervical and endometrial cancer, endometrial pathology, perforation of the uterine walls during abortion or diagnostic curettage.
- Suspicion of uterine malformations.
- Menstrual irregularities in women of childbearing age.
- Anomalies of uterine development.
- Bleeding in postmenopause.
- Infertility.
- Control examination of the uterine cavity after surgery on the uterus, in case of miscarriage, after hormonal treatment.
Gynecological department Clinical hospital No. 1 has 22 beds. The department has 1 and 2-bed wards, as well as 1-bed superior wards.
Every year more than a thousand patients are treated in our department. Our hospital provides 24-hour emergency care, and, if necessary, prepares and examines for planned treatment. The department performs the following types of operations:
Diagnostic hysteroscopy and separate diagnostic curettage (for endometrial pathology: hyperplasia, endometrial and cervical canal polyps).
Endometrial hyperplasia and endometrial polyps are observed in 5-25% of gynecological patients of all age groups. They predominate during premenopause. Clinically, endometrial pathology is manifested by menstrual cycle disorders, acyclic bloody discharge from the genital tract. There are certain ultrasound signs of endometrial pathology. To make a diagnosis and develop correct tactics Treatment requires the first step - separate diagnostic curettage of the uterine mucosa under the control of hysteroscopy with histological examination of the obtained material.
If the menstrual cycle is preserved, the intervention is carried out in phase 1 of the cycle.
Hysteroresectoscopy, polypectomy, myomectomy for submucosal uterine fibroid nodes, endometrial ablation, dissection of the intrauterine septum and synechiae.
Resectoscopy and endometrial ablation are used for recurrent endometrial polyps, allowing targeted elimination of the polyp stalk, while affecting its growth zone, for recurrent endometrial hyperplasia, infertility (malformations of the uterus (septum), synechiae in the uterine cavity, submucosal (submucosal) myomatous nodes, that prevent conception or pregnancy). Resectoscopy allows you to eliminate the cause of pain and menometrorrhagia leading to anemia - submucosal (submucosal) myomatous nodes without opening and removing the uterus. The technique of hysteroresectoscopy for submucosal myoma consists of gradual fragmentation of the node with a resectoscope loop. If necessary, preparation for hysteroresectoscopy is carried out hormonal drugs(gonadoliberin agonists, oral contraceptives, gestagens) to reduce the thickness of the uterine mucosa - endometrium.
Radio wave surgery of the cervix using the Surgitron device, including conization of the cervix (ectopia of the cervix due to infection with the human papillomavirus, leukoplakia, dysplasia). High cervical amputation for severe cervical dysplasia and cervical cancer.
The International Agency for Research on Cancer has declared human papillomavirus (HPV) types 16 and 18 to be carcinogenic, and types 31, 33 and 35 to be possible carcinogens. Cervical dysplasia (cervical intraepithelial neoplasia CIN) is a precancerous disease of the cervix. Occurs against the background of HPV infection. The frequency of transition of CIN to cervical cancer reaches 40-60%. To carry out the prevention and timely treatment of cervical cancer, screening examinations are used: annual gynecological examinations from 18 years of age or from the first year after first sexual contact. Necessarily: cytological examination cervical smears ( Pap test). If there are three negative Pap tests, cytological screening is then carried out once every 2-3 years until the age of 50, and once every 5 years until the age of 65. It is advisable screening test on HPV of oncogenic risk. If changes are detected during screening, radio wave biopsy, conization (with CIN grades 2 and 3) of the cervix with curettage of the cervical canal. The final diagnosis is established after receiving the results of histological examination. The use of the Surgitron radio wave scalpel allows you to completely remove the altered area of the cervix and obtain high-quality material for histological study. In addition, after using radio wave method treatment, scarless healing of the cervix is noted, which is important for subsequent planning of pregnancy and childbirth.
The operation is performed in the first phase of the cycle (from 5 to 10 days from the start of menstruation). Specific prevention HPV infection - vaccination.
Uterine artery embolization (UAE) for uterine fibroids.
Uterine fibroids (MM) are limited benign tumors consisting of smooth muscle and fibrous connective tissue elements of the myometrium. The tumor can be single, but more often multiple nodes are detected (sometimes up to 10 or more).
MM is a common disease and the most common tumor of the internal genital organs of women. The disease is detected in 15-35% of women over 30 years of age. During reproductive age, MM occurs in 13-27% of cases. It is detected in 4-11% of all women, in 20% of women over 30 years of age and in 40% of women over 50 years of age. In postmenopause, as a rule, the tumor reverses. IN Lately MM often occurs at the age of 20-25 years. IN last years entered clinical practice relatively new method treatment of uterine fibroids - endovascular uterine artery embolization (UAE). When the blood supply to myomatous nodes is cut off, degenerative processes occur in them, which leads to an irreversible reduction in the size of the nodes. Spontaneous expulsion (birth) of submucosal nodes is observed in the first 2-6 months after UAE.
To determine possible contraindications to UAE, at the first stage an ultrasound examination is performed to determine the speed of blood flow in the fibroid nodes, hysteroscopy, and RDV. UAE is recommended to be performed in phase 2 of the cycle on days 22-25, since during this period the blood flow in the uterine arteries is most pronounced.
The intervention is performed by vascular surgeons in a cath lab with the participation of an anesthesiologist. A puncture is being performed femoral artery, through which a special catheter is passed into the left uterine artery. Performed selective angiography and a substance is injected that clogs the vessels of the fibroids - an embolisate. The most commonly used particles are polyvinyl alcohol particles with sizes of 355-710 microns. The catheter is then advanced into the right uterine artery, where the same process occurs. After embolization, blood flow in the vessels of the fibroid nodes stops, whereas in normal endometrium blood flow is maintained. In the first 2-3 days, infusion, antibacterial, anti-inflammatory, and analgesic therapy is prescribed. The development of post-embolization syndrome is often observed: fever, pain in the lower abdomen, which is a natural reaction of the body to ischemia of the tissue of myomatous nodes. Until the next morning - bed rest. The punctured limb should remain in a straightened position for 6 hours. Removed in the morning pressure bandage from the puncture site and urinary catheter, and the patient becomes more active. Follow-up examinations at 3, 6 and 12 months. Of particular note is the use of UAE in women who want to maintain or restore their ability to bear children. The probability of pregnancy after UAE is comparable to that after myomectomy. Moreover, in the group of patients in whom myomectomy is impossible or carries a high risk of conversion to hysterectomy, UAE represents the last chance to preserve fertility. UAE in our hospital costs an order of magnitude lower than in many medical centers Moscow.
For prolapse (prolapse, prolapse) of the genitals, hysterectomy through vaginal access, colpoperineorrhaphy, levatoroplasty, and Manchester surgery are performed. Modern methods of treating prolapse and prolapse of the genital organs, allowing to avoid relapses of prolapse: extraperitoneal colpopexy using a prolene mesh through vaginal access (Perigi and Apoggi system from AMS). Correction of stress urinary incontinence using urethropexy with a free synthetic loop using a transobturator approach (Monark, TVT-O).
Marsupialization, removal of a cyst of the large gland of the vaginal vestibule.
Laparotomy, hysterectomy, operations for uterine fibroids, ovarian tumors, stage 1 uterine cancer, tubo-ovarian formations of inflammatory etiology.
Operations on the appendages using laparoscopic access: external endometriosis, endometrioid ovarian cysts, benign ovarian tumors, ectopic pregnancy, inflammatory diseases of the appendages (including tubo-ovarian formations), tubo-peritoneal infertility, PCOS.
All ovarian masses (cysts, tumors) existing for more than 3 months are subject to surgical removal. Laparoscopic access is the gold standard for operations on the appendages. If necessary, an emergency histological examination is performed during surgery, which allows you to correctly determine the extent of the operation.
Supravaginal amputation of the uterus using laparoscopic access (for uterine sizes no more than 9-10 weeks of pregnancy), myomectomy for subserous nodes using laparoscopic access.
Now in our clinic we treat delicate issue- stress urinary incontinence.
The prevalence of urinary incontinence among women is 36%. When genital prolapse occurs, urinary incontinence occurs in 25-80% of patients. Shyness, as well as the attitude of women with urinary incontinence as a normal sign of aging, leads to the fact that women are poorly informed possible methods treatment.
The following types of urinary incontinence are distinguished:
Urge urinary incontinence (UI) is a complaint of involuntary leakage of urine that occurs immediately after a sudden strong urge to urinate.
stress UI (stress urinary incontinence) - involuntary leakage of urine during stress, coughing, laughing, jumping.
mixed NM - a combination of 1 and 2 types
other types of NM
Perhaps you yourself have noticed how urinary incontinence affects women’s professional, social and personal activities, leading to a deterioration in the quality of life, and sometimes to complete isolation. This is why it is vital to know that urinary incontinence can be treated.
In the gynecological department of Clinical Hospital No. 1 of the Presidential Administration of the Russian Federation, a modern method of treating stress urinary incontinence in women is used - TVT-O, or Free Synthetic Loop, which requires minimal surgical intervention.
There is virtually no postoperative pain, and the patient can return home 1-2 days after surgery. The result is achieved by supporting the middle part of the urethra in correct position. The operation is usually performed under intravenous anesthesia or spinal anesthesia. Using needles, a loop is inserted through a small incision on the front wall of the vagina and placed under the middle part of the urethra, providing reliable support for it, thereby eliminating the cause of urinary incontinence. The effect occurs immediately after the operation.
The department treats patients with chronic inflammatory processes, therapy aimed at prolonging pregnancy until 12 weeks of pregnancy. Physiotherapy is widely used; if necessary, ozone therapy and plasmapheresis are possible.
Before hospitalization for planned surgical treatment, it is advisable to consult with the head. department
