ARGONOPLASMIC COAGULATION IN THE TREATMENT OF EXTERNAL GENITAL ENDOMETRIOSIS IN WOMEN

Aim: to evaluate the effectiveness of the argonoplasmic coagulation method in the treatment of external genital endometriosis (GE) in women. Materials and methods. An open, prospective, controlled, clinical and experimental study was conducted. 50 women with genital endometriosis aged 20 to 50 years and older were examined (the average age was 35±15 years). The following forms of GE were identified: peritoneal endometriosis - in 21 (42%) patients; extraperitoneal endometriosis - in 15 (30%); uterine body endometriosis - in 9 (18%); retrocervical endometriosis - in 5 (10%) patients. Clinical, laboratory (blood test, urinalysis, biochemical studies, hemostasiogram, bacteriological and microscopic studies of the cervical canal and vagina, cytological studies); instrumental and special research methods were used. By the method of enzyme immunoassay (ELISA), studies were conducted for the presence of infections: toxoplasmosis, herpes and cytomegalovirus, chlamydia, mycoplasma, ureaplasma infections, rubella. Results. For the treatment of external genital endometriosis, a combined treatment regimen was applied: argonoplasmic coagulation of endometrioid heteropathies using the FOTEK EA 141M apparatus, followed by the prescription of a course of hormone therapy including dienogest (visanna), which contributed to improving the general condition and quality of life, relieving clinical symptoms, reducing the frequency of relapses, improving the hormonal status of the women. With a mild form of external genital endometriosis, argonoplasmic coagulation of endometrioid heteropathies was carried out in the "spray" mode at a power of 37-42 W, at a depth of 0.1-1 mm with a time interval of exposure of 2-4 seconds. In the moderate-severe form of external genital endometriosis, argonoplasmic coagulation of endometrioid foci located at a depth of 1-2 mm was carried out in the "spray" mode at a given power of 42-50W, with a time interval of exposure to an argon torch of 3-5 seconds. In severe external genital endometriosis, argonoplasmic coagulation was performed in the "filgur" mode at a given power of 57-64 watts with a time interval of exposure of 4-7 seconds, at a distance of no more than 2.5-3.0 mm. Conclusions. The use of APC using the FOTEK EA 141M device ensures the effectiveness of treatment that enables to avoid the formation of rough scars, adverse reactions and / or complications, shortening of the time interval, absence of pain syndrome, microbial contamination, risk of massive bleeding. The use of dienogest group is effective in preventing relapses after surgical treatment of severe forms of genital endometriosis.