Endometriosis is common among women of reproductive age. Due to its nonspecific clinical picture, a correct diagnosis of endometriosis is especially important in developing an effective treatment plan. Ultrasound and magnetic resonance imaging with correct interpretation, and combined with differential diagnosis, is essential for determining the location and spread of endometriosis, which helps optimize the surgical treatment.

The article focuses on the identification of causal relationships between dysmenorrhea, endometrioid and tumor processes. Studies have shown that dysmenorrhea, apart from a decline in the quality of life, can be the cause of development of a number of serious health disturbances, including endometriosis, adenomyosis and even tumoral diseases. Non-steroidal anti-inflammatory drugs are not only the effective means of therapy for dysmenorrhea patients, but also a pathogenetically reasonable approach to prevent the outbreak of the disease.

This article describes the present views on ultrasound diagnosis of infertility. The generalized data on modern techniques. Pressing questions of the most common causes of infertility.

This article describes the present views on ultrasound diagnosis of cervical changes. The generalized data on the size and measurement procedures. Pressing questions of the most common changes in the cervix.

Polycystic ovarian syndrome (PCOS) is a rather common disease which represents one of the most topical issues of gynecological endocrinology. This review article presents modern data on etiology and pathogenesis of PCOS and provides substantiation for frequent combination of hyperandrogenia and insulin resistance during PCOS. Also, considerations are given to the characteristic clinical manifestations of PCOS and modern approaches to its diagnosis and treatment. The latter includes drugs which affect the neuromediator systems (sibutramine, orlistat), drugs of the insulin sensitizing group (metformin, progestagens or low dose, single phase, third generation oral contraceptives (COC) combined with progestagens), synthetic anti estrogens (clostilbegit) and other medications. The outlook and methods of surgical intervention, as well as treatment tactics during infertility at the backdrop of PCOS, are addressed.

Detailed clinical and morphological study was undertaken on 101 young patients (age 20-30) diagnosed with Uterine fibrosis (the average patient age was 24,7±1,5 years). From the medical history, integrated clinical and morphological study, immunological analysis it was proved to exist two seldom forms of myomatous nodes at a young age: simplefibroid and invasive fibroid, that prevails. The growth originates in a vessel wall from the progenerating muscle cells with relatively high Ki-67 expression, high expression of growth factors and formation of new micro vessels (СD-34). These muscle cells have a very low apoptosis activity that determines the fast proliferation of cells (invasive fibroid).

On the basis of immunohistochemical studies the role of chronic endometritis in the potentiation of the proliferative activity of the endometrium was demonstrated; defined and denoted were the values of the chronic inflammatory process in the endometrium, as an independent factor determining the prognosis of the disease.

This article describes the present views on ultrasound diagnosis of cervical changes. The generalized data on the size and measurement procedures. Pressing questions of the most common changes in the cervix.

This article describes the present views on ultrasound diagnosis of infertility. The generalized data on modern techniques. Pressing questions of the most common causes of infertility.

Detailed clinical and morphological study was undertaken on 101 young patients (age 20-30) diagnosed with Uterine fibrosis (the average patient age was 24,7±1,5 years). From the medical history, integrated clinical and morphological study, immunological analysis it was proved to exist two seldom forms of myomatous nodes at a young age: simple fibroid and invasive fibroid, that prevails. The growth originates in a vessel wall from the progenerating muscle cells with relatively high Ki-67 expression, high expression of growth factors and formation of new micro vessels (СD-34). These muscle cells have a very low apoptosis activity that determines the fast proliferation of cells (invasive fibroid).

Эндометриоидное поражение яичников является наиболее часто встречающейся формой наружного генитального эндометриоза. Важность рассматриваемой проблемы определяется также частым возникновением у женщин с эндометриозом яичника нарушений генеративной функции, а также возможностью развития рецидива и метастазирования. Рецидивирование или персистенция эндометриоза после лечения является одной из наиболее дискутируемых проблем в современной гинекологии, обусловленной непредсказуемостью течения заболевания.Целью нашего исследования явилось выявление особенностей клиники и послеоперационной терапии у больных с эндометриоидными кистами яичников.

В течение ряда десятилетий для лечения аденомиоза использовались разнообразные группы гормональных препаратов. Основным механизмом действия большинства гормональных препаратов является торможение выделения гонадотропных гормонов гипофиза, подавление функции яичников, благодаря чему достигается состояние гипоэстрогении и происходит уменьшение размеров матки, а также обратное развитие очагов аденомиоза.При сочетании аденомиоза с миомой матки не рекомендуется применение с лечебной и контрацептивной целью эстроген-гестагенных препаратов в виду возможного эффекта стимуляции роста миомы.Для терапии аденомиоза оральными контрацептивами целесообразно назначать только монофазные эстроген-гестагенные препараты. Механизм лечебного воздействия эстроген-гестагенных препаратов обусловлен ингибированием синтеза гонадотропин-рилизинг-фактора, следствием чего является подавление циклической секреции фолликулостимулирующего и лютеинизирующего гормонов.Использование этих препаратов приводит к регрессии пролиферативных изменений в первой фазе и к неполноценной секреторной трансформации во второй фазе менструального цикла.

Transabdominal ultrasonic scanning was used to examine 48 patients with endometrial carcinoma; 39 of them were later operated on, and 5 of these examined in various periods after surgery. No image of the median uterine echo in women with clinical symptoms of cancer of the body of the uterus or thinning of the median structure may evidence in favor of poorly-differentiated adenocarcinoma. The authors emphasize the usefulness of echography in the diagnosis of the depth of the tumor invasion into the myometrium, detection of the recurrences, and pay special attention to imaging the uterine myoma and other associated diseases of the genitals in these patients.

As many as 56 patients with uterine myoma underwent conservative myomectomy. In 40 patients (group I), it was performed by laparotomy and in 16 (group II) ++trans-cervically under the control of hysteroscopy. The group I patients' age amounted on the average to 33.2 +/- 0.6 years, in group II, it was 46.3 +/- 0.8 years. Before operation the size of the uterus ranged from 6 to 32 weeks of pregnancy. Uterine incisions were made with regard to the site of myomatous nodes and the architectonics of the myometrium and vessels. To additionally strengthen++ sutures on the uterus, use was made of containing which provided for more favourable conditions for the formation of the scar on the uterus. Every second patient of the reproductive age manifested menstrual function improvement and 4 women conceived. The data obtained point out that the carrying out of conservative myomectomy is desirable in different age groups. The choice of the surgical technique is dependent on the primary site of myomatous nodes, their dimensions, the patient's age and concomitant extragenital pathology.