OBJECTIVE

To develop a differentiated approach to the treatment of patients with benign intrauterine diseases in the postmenopausal period on the basis of comparative evaluation of different organ-preserving methods of intrauterine surgery.

MATERIAL AND METHODS

288 postmenopausal patients with benign intrauterine diseases were examined. Patients were divided into 4 groups depending on the used method of pathological focus removal from the uterine cavity: The 1st group consisted of 82 patients who underwent mechanical removal of the pathological focus; the 2nd group consisted of 58 patients who underwent electromechanical removal of the pathological focus; the 3rd group consisted of 46 patients who underwent local electrosurgical resection of the endometrium; the 4th group consisted of 102 patients who underwent total electrosurgical resection of the endometrium.

CONCLUSION

All the methods of intrauterine surgery used by us can be differentially applied for the treatment of patients with benign intrauterine pathology depending on its nature and concomitant intrauterine and extragenital diseases, clinic equipment and surgeon’s experience. Electromechanical morcellation should be considered as the method of choice for removal of large endometrial polyps. In postmenopausal patients with benign intrauterine diseases, especially recurrent ones, and severe extragenital pathology, which is a contraindication to hysterectomy, total electrosurgical resection of endometrium may be the method of treatment of choice.

RESULTS

The efficiency of mechanical removal of pathological focus was 96.3%, electromechanical — 96.5%, local electrosurgical resection of endometrium — 97.4%, total electrosurgical resection of endometrium — 99.0%.