[Complications of mesh-vaginopexy: results of a multicenter trial].

A retrospective multicenter trial with participation of 7 large clinics of Moscow and Moscow Region has been performed to characterize complications after correction of genital prolapse with application of the PROLIFT system. The trial enrolled women with uterine and vaginal prolapse of stage II-IV by POP-Q classification. The women also had anatomic and functional defects of the adjacent organs. From January 2005 to March 2008 all the patients have undergone vaginal extraperitoneal colpopexy using Prolift system. The results of the trial showed that extraperitoneal colpopexy with application of the Prolift system should not be considered as a low-invasive intervention and therefore it is not valid to use this technique as a routine method of genital prolapse treatment as in 29.5% cases the operation is accompanied with complications of different severity.

[Pregnancy in women with heart defects: outlook on the problem].

Modern approach to management of pregnancy and delivery in women with heart defects is presented in this paper. The 3-level system of observation of this contingent of patients is based on stratification of risk of development of cardiological complications which allows to form an algorithm of physicians actions, and to optimize tactics of ambulatory and hospital stages of treatment. Stratification of risk is supplemented with quantitative echocardiographic parameters which reflect hemodynamic overload of the myocardium and facilitate work of a practical physician. Special consideration is given to pregnant women subjected to palliative cardiac surgery. If contractile function is preserved these women have good prognosis relative to prolongation of pregnancy and unassisted delivery.

[Delivery in pregnant women with previously operated on uterus]. / Opyt rodorazresheniia beremennykh s operirovannoi matkoi.

The delivery in 66 pregnant women previously operated on the uterus is analyzed. 40% of women with cicatrices on the uterus after cesarean section gave birth to children via the natural route. In order to improve the safety of spontaneous labor, echographic examination of the lower segment of the uterus in labor was carried out in these women, as well as ultrasonic cervicometry and monitoring of the detachment and delivery of the placenta.

[Reconstructive plastic operations in ptosis and prolapse of the genitalia. The choice of the technic and the prevention of complications]. / Rekonstruktivnye plasticheskie operatsii pri opushcheniiakh i vypadeniiakh polovykh organov. Vybor tekhniki i profilaktika oslozhnenii.

The principal causes of recurring prolapses are inadequate choice of surgical technique and unqualified performance of the operation proper, as well as the absence of expert evaluation of the performance capacity of this patient population. The authors suggest pathogenetically, anatomically, and functionally validated methods of reconstructive surgery permitting restoration of the position and function of the genitals and the adjacent organs and helping preserve the generative function of fertile women. Approaches to prevention of recurrences are outlined.

[Pregnancy and labor in women in the region of the accident at the Chernobyl Atomic Electric Power Station]. / Beremennost' i rody u zhenshchin v regione avarii na Chernobyl'skoi AES.

The authors analyze the tentative results of a multiprofile study, including a review of labor histories, examinations of pregnant women and parturients, measurements of fetoplacental hormones, study of the immunity status and microbiocenosis of the mothers and newborns, living in the first (up to 15 Ci/km2) and second (15 to 40 Ci/km2) zones of radioactive contamination. The detected shifts of a compensatory nature were found mostly in women living in the first zone. The disorders found in the women living in the second zone evidenced a decrease of the defense potential of the body, this necessitating nonspecific and correcting therapy during pregnancy, in labor and the postpartum period.

[Modification of the Aldrich operation--a method of choice in the surgical treatment of patients with stress-induced urinary incontinence]. / Modifikatsiia operatsii Oldridzha--metod vybora pri khirurgicheskom lechenii bol'nykh s nederzhaniem mochi pri napriazhenii.

The paper presents a rationale for and advantages of a modified Aldrich procedure in surgical treatment of patients with stress incontinence. This technique was supplemented by colpoperineoplasty in 24 patients. Long-term efficacy was assessed at 3 months to 4 years. No recurrence or complications were seen. Determinants of surgical success in these women were an appropriate patient selection with regard to urodynamic findings, meticulous performance at intraoperative stages and good rehabilitative care.

[Current aspects of surgical treatment of prolapse of internal female genital organs]. / Sovremennye aspekty khirurgicheskogo lecheniia opushcheniia i vypadeniia vnutrennikh polovykh organov zhenshchiny.

A study in 128 women with variable degrees of prolapse of the internal genitalia has identified significant functional abnormalities of both the genital and pelvic organs. Combined biphasic surgical treatment was performed simultaneously or at an interval of 3-6 months. The operation consisted in fixation of the uterus (its stump or the vaginal dome) using an aponeurotic flap and colpoperineolevatoroplasty. Long-term results were evaluated at 0.5 to 7 years. Complete anatomic and functional rehabilitation was achieved in 95.4% and a significant improvement in 3.8% of the patients.

[Suppurative inflammatory fistulas]. / Gnoino-vospalitel'nye svishchi.

The current incidence of purulent inflammatory fistulas is 31.1%. An analysis of 36 patients with these fistulas has identified stages of their formation. Anaerobic flora and a primary cause of pelvic and adnexal abscess formation were major determinants of fistula formation.

[Diagnosis and treatment of ureteral stricture in gynecologic pathology]. / Diagnostika i lechenie striktury mochetochnika pri ginekologicheskoi patologii.

The paper presents 10-year experience with surgical treatment of ureteral stricture in retrocervical endometriosis and suppurative adnexal diseases. The most efficient methods of diagnostic location and grading of ureteral stricture were found out. Therapeutic approaches to strictures coexisting with retrocervical endometriosis and suppurative adnexal lesions are discussed with reference to degrees of constriction and the status of the ureteral walls. The results of treatment are presented.

[Laser exposure of the blood as a method of preventing inflammatory complications following cesarean section]. / Lazernoe vozdeistvie na krov' kak metod profilaktiki vospalitel'nykh oslozhnenii posle kesareva secheniia.

Blood laser action (red spectrum, a wavelength of 628 nm, pulsed periodic quasi-continuous duty), a noninvasive tool, was demonstrated to stimulate the immune forces of the body, which showed a 2-fold or more decrease in the incidence of inflammatory complications after cesarean operation.

[Various problems and prospects of improving the outcome of cesarean section]. / Nekotorye problemy i perspektivy uluchsheniia iskhodov operatsii kesareva secheniia.

A review of the outcomes of 819 cesarean sections and the causes of intranatal and early neonatal loss of full-term newborns has demonstrated that postcesarean perinatal mortality and morbidity remains fairly high. Perinatal losses are largely seen in cases of late gestosis and placental disorders, i.e. where cesarean section is performed urgently for maternal reasons. Possibilities for improving perinatal parameters are in the optimization of indications for surgical delivery and timely as well as technically correct performance of the operation and high-quality anesthesiologic support at a specialized facility, well-equipped for urgent maternal and neonatal treatment and intensive care.