Diagnosis and treatment of benign intrauterine pathologies in postmenopausal patients

Authors / Institutions

Mark A. Kurtser / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Valentina G. Breusenko / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Georgiy N. Golukhov / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Yu.А.Golova / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Irina А. Еsipova / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Anstasiya V. Ovchinnikova / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

D.M.Lyafisheva / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

The objective. To assess the effectiveness of electrosurgical resection of the endometrium in postmenopausal patients with benign intrauterine pathologies, using up to date diagnostic methods.
Patients and methods. We examined 148 postmenopausal patients, who underwent local or total bipolar transcervical resection of the endometrium (TCRE) depending on the character of endometrial process and a concomitant intrauterine pathology. For diagnostic purposes, all patients underwent two-dimensional and three-dimensional ultrasound examination before electrosurgical resection and 3, 6, 12, 24, 36 months after.
Results. The effectiveness of bipolar electrosurgical resection in patients with endometrial polyps was 86.8%. A full effect after total TCRE was noted in 93.1%, partial – in 5.9%, absence of effect was noted in 1 patient with glandular endometrial hyperplasia, which necessitated total hysterectomy.
Conclusion. Total TCRE might be used for treatment of benign intrauterine processes in the postmenopausal period, if there are contraindications for hormonal therapy and the risk of mortality due to surgery. Patients after total TCRE should be observed in the settings of a specialised clinic with dynamic ultrasound examinations by qualified specialists only for early diagnosis of a possible relapse of the hyperplastic endometrium.

Key words: endometrial hyperplasia, cystic glandular endometrial atrophy, postmenopause, endometrial polyps, electrosurgical resection.
For citation: Kurtser M.A., Breusenko V.G., Golukhov G.N., Golova Yu.А., Esipova I.А., Ovchinnikova A.V., Lyafisheva D.M. Diagnosis and treatment of benign intrauterine pathologies in postmenopausal patients. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(3): 71–79. (In Russian).
DOI: 10.20953/1726-1678-2019-3-71-79