Multidisciplinary approach in the treatment of hyperplastic diseases of the uterus

Introduction. Uterine fibroids are ranked second and endometriosis is ranked third in the gynaecological pathology pattern. Uterine fibroids and endometriosis are among the most common diseases of the female genitalia and occur in every 4–5 gynaecological patients. Aim. To improve a multidisciplinary approach to the choice of surgical organ-preserving treatment strategies in hyperplastic diseases of the uterus using occlusion techniques. Materials and methods. A cohort prospective comparative study examined a multidisciplinary approach to the choice of surgical organ-preserving treatment strategies in uterine hyperplastic hysteropathies using occlusion techniques. Results. The study showed that uterine artery embolization is indicated if FIGO 2–5 fibroids’ size is > 4 cm in patients who are not planning pregnancy. The laparoscopic myomectomy with temporary uterine artery occlusion is provided if FIGO 2–6 fibroids’ size is from 6.0 to 8.0 cm, the laparoscopic myomectomy with temporary balloon occlusion of the internal iliac arteries is the procedure of choice if fibroids’ size is from 8.0 to 12.0 cm and they are located in the cervical-isthmus region and in areas of vascular bundles, and vaginal myomectomy with temporary balloon occlusion of the common iliac arteries is performed if FIGO 8 fibroids’ size is > 4 cm and they are located in the cervix. If adenomyosis nodes’ size is from 4.0 to 6.0 cm, they are removed using laparoscopic access with temporary occlusion of the uterine arteries; if adenomyosis nodes’ size is ≥ 6.0 cm, they are removed using laparoscopic access with temporary balloon occlusion of the internal iliac arteries. Conclusion. The multidisciplinary approach in the treatment of hyperplastic diseases of the uterus is regarded as optimal.