MEDICAL-SOCIAL AUDIT OF REPRODUCTIVE AGE WOMEN WITH OVARIAN ENDOMETRIOMAS

Abstract

Background. Ovarian endometriomas account for 35% of all benign ovarian cysts and are identified in 17-44% of women with endometriosis. External genital endometriosis is diagnosed in 10-15% of women in the general population, 25-60% of patients with infertility, 80% of those with pelvic pain syndrome, and in cases of dysmenorrhea, it ranges from 40 to 60%. Priority issues include early diagnosis, management tactics, and preservation of ovarian reserve in women with ovarian endometriomas. However, risk factors contributing to the formation and progression of the disease are nonspecific, and the clinical presentation does not always correspond to the severity of the condition. Aim. To determine the clinical and anamnestic features of women of reproductive age with ovarian endometriomas. Materials and methods. A clinical and anamnestic examination was conducted on 120 reproductive-aged patients with ovarian endometriomas (main group) and 30 women without gynecological pathology (control group). The average age of the examined individuals was 29.5±1.3 years. The examination protocol included the assessment of objective and subjective data recorded in a specially designed questionnaire containing 300 questions. Statistical data analysis was performed using the computer program "Statisticа 13.3.721." Results. The main complaints of examined women with ovarian endometriomas include a dragging pain in the lower abdomen (82.5%), menstrual cycle disturbances (95.8%), dyspareunia (26.7%), impairment of adjacent organ functions (10.8%), periovulatory pain (12.5%), primary (30.8%), and secondary (19.2%) infertility. Early menarche was found in 48.3% of women, and late menarche in 15.8%. Dysmenorrhea was observed in 86.7%, hypermenorrhea in 73.3%, and acyclic bloody discharges in 12.5%. From the gynecological history, there is a 3.8 times higher frequency of inflammatory diseases of the appendages, a 4.1 times higher frequency of breast diseases, a 2.4 times higher frequency of abnormal uterine bleeding, a 2.3 times higher frequency of "functional" ovarian cysts and ovarian apoplexy. Endometriomas in 13.3% of patients were combined with adenomyosis, in 14.2% with uterine fibroids, and in 10.8% with intrauterine pathology. Conclusion. The analysis of clinical and anamnestic data of women with ovarian endometriomas revealed the main complaints at the time of admission to the hospital, previous and concomitant extragenital pathology, identified the family history, status of menstrual and reproductive function, and gynecological diseases.