RELEVANCE
The search for alternative methods of treatment for patients with HSIL who are planning to become pregnant in the future is an urgent task. Articles on the use of photodynamic therapy in the treatment of CIN regularly appear in literary sources. The results of treatment indicate the high efficiency of PDT in the complex treatment of preinvasive diseases of the cervix, both with intravenous and local administration of a photosensitizer.
OBJECTIVE
To present and analyze a clinical case of successful treatment of CIN II by photodynamic therapy as an alternative to surgical treatment in a woman with a burdened obstetric and gynecological history.
CLINICAL CASE
A patient with CIN II at the age of 27 years turned to Family Clinic LLC for pre-pregnancy preparation with miscarriage and a history of ICN. After the consultation, it was decided to treat CIN II by photodynamic therapy with an intravenous photosensitizer. Results. According to the results of the examination, the patient was diagnosed with incomplete septum in the uterine cavity (by ultrasound), hyperprolactinemia syndrome, cytological examination from the cervix showed CIN III, adenocarcinoma in situ questionable. No HPV type from the highly oncogenic panel was also detected. During colposcopy, an abnormal picture of the 1st degree was found in the form of a thin acetobelous epithelium along the posterior lip. The patient underwent photodynamic therapy with an intravenous photosensitizer. After 3 months, a thorough examination and histological control were performed, and a revision of the previous histological samples was performed. Based on the results, a conclusion was made about the therapeutic pathomorphosis and the absence of any signs of CIN in histological preparations after treatment.
CONCLUSION
The method of photodynamic therapy with an intravenous photosensitizer allows for organ-preserving treatment of the cervix, every millimeter of which is so important when entering a subsequent pregnancy. Increasing the awareness of doctors about the method and its widespread use in the Russian Federation will allow it to be used as an alternative to surgical tactics, which means — to prevent isthmic-cervical insufficiency and miscarriage in general, high efficiency in CIN I-II and increase the reproductive potential of the nation.
