title: [The use of restorative medicine technologies for the rehabilitation of the patients presenting with endometriosis of external genitalia].
abstract: This paper reports the results of analysis of the psycho-emotional status and pain syndrome in the women presenting with endometriosis of external genitalia treated with a combination of hormonal preparations and balneotherapy. A total of 216 infertile patients were involved in the study. The duration of the infertility period varied from 1.5 to 19 years. All the patients underwent surgical intervention. The influence of rehabilitative therapy on the quantitative vital indices (psycho-emotional adaptation to the social environment and pain intensity) was estimated before and after the treatment. The patients were divided into 3 groups. Those of group 1 received an oral contraceptive (30 mcg of ethinylestradiol plus 2 mg dienogest) as a continuous three-cycle course (63 tablets) followed by its discontinuation for the 7 day menstrual period and the final three-cycle course (total duration of therapy 6 months). The patients of group 2 were treated with injections of agonists of gonadotropin releasing hormone (GnRH) at a dose of 3.75 mg once every 4 weeks (total duration 6 months). In group 3, the injections of GnRH agonists (3.75 mg once every 4 weeks, total duration 6 months) were combined with a course of balneotherapy using radon. All the three rehabilitative modalities produced a well-apparent positive effect. Chronic pelvic pain before treatment was reported by 90,3% of the patients. After the treatment, the number of such women in groups 1, 2, and 3 decreased to 20,8%, 12,5%, and 30,6% respectively Dyspareunia in the pre-treatment period was diagnosed in 66,7% of the patients. After treatment, this pathology persisted only in 23,6%, 18,1%, and 31,9% of the patients in groups 1, 2, and 3 respectively. Psycho-emotional disorders before treatment were documented in 90,3% of the patients compared with 27,8%, 25%, and 30,6% after therapy. It is concluded that all the three therapeutic modalities markedly improved health conditions of the patients presenting with endometriosis of external genitalia, but the combination of GnRH agonists with radon therapy produced the most pronounced clinical effect.
authors.forename: L V
authors.initials: LV
authors.lastname: Makarenko
authors.forename: V A
authors.initials: VA
authors.lastname: Krutova
authors.forename: K V
authors.initials: KV
authors.lastname: Gordon
mesh_terms: D000328:Adult; D001452:Balneology / Q000379:methods*; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D004715:Endometriosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D013997:Time Factors
chemical_list: D003278:Contraceptives, Oral, Hormonal; D007987:Gonadotropin-Releasing Hormone; D004997:Ethinyl Estradiol