[The role of physiotherapy in selected gynecological disorders]. / Znaczenie zabiegów z zakresu fizjoterapii w wybranych schorzeniach ginekologicznych.

Physical training is a method supporting pharmacological and surgical treatment by shortening the time of recovery and effectiveness of the entire treatment. Many kinds of such methods, despite their availability remain unpopular and unused. The aim of the following study was to present possibilities of aiding the processes of curing by means of new physical methods. Guidelines for the treatment of adnexitis and rehabilitation after operative treatment were presented.

El papel del fisioterapeuta pélvico / The role of the pelvic physical therapist

La fisioterapia pélvica se centra en la prevención y el tratamiento de todos los tipos de trastornos funcionales de las regiones abdominal, pélvica y lumbar como la incontinencia urinaria, que está considerada como un problema de salud de alta prevalencia en mujeres, hombres, niños y ancianos. La fisioterapia está considerada a menudo como el tratamiento de primera elección dado su carácter no invasivo y los resultados en términos de alivio de los síntomas, la posibilidad de combinar fisioterapia con otros tratamientos, el bajo riesgo de efectos secundarios y un coste entre moderado y bajo. Entre las limitaciones importantes que alcanzan el éxito están la motivación y la perseverancia tanto del paciente como del terapeuta y el tiempo que hay que emplear para llevar a cabo la fisioterapia. Los recursos del fisioterapeuta pélvico incluyen intervenciones como el diagnóstico fisioterapéutico, la educación e información de los pacientes, el entrenamiento de la musculatura del suelo pélvico (MSP), el entrenamiento de la vejiga (EV), el entrenamiento con conos vaginales, la estimulación eléctrica, la biorretroalimentación, etc. En la incontinencia de esfuerzo, para mejorar el mecanismo extrínseco de cierre de la uretra, la fisioterapia tiene como objetivo mejorar la fuerza y la coordinación de los músculos periuretrales y del suelo pélvico. El entrenamiento de la MSP resulta especialmente eficaz. En la hiperactividad del detrusor, el objetivo de la fisioterapia es reducir o eliminar las contracciones involuntarias del detrusor mediante la inhibición del reflejo. Aquí, la terapia mediante estimulación eléctrica parece ser una intervención eficaz. En la incontinencia urinaria mixta el proceso de diagnóstico y tratamiento fisioterapéutico se centra en los factores predominantes. La prostatectomía radical es la causa más importante de incontinencia en los varones. Un programa adecuado de entrenamiento de la MSP después de la prostatectomía radical disminuye la duración y la extensión de la incontinencia y mejora la calidad de vida. Conclusión: la fisioterapia es en muchos casos de incontinencia una opción de tratamiento eficaz

Pelvic physical therapy focuses on the prevention and the treatment of all kinds of functional disorders of the abdominal, pelvic and low back region, like urinary incontinence, that is considered as a high prevalent health problem in women, men, children and the elderly. Physical therapy is often considered as the first-choice treatment, due to its non-invasive character, the results in terms of symptom relief, the possibility of combining physical therapy with other treatments, the low risk of side effects and the moderate to low costs. Important restrictions for success might be motivation and perseverance of patient and therapist and the time needed for physical therapy. The armentum of the pelvic physical therapist contains interventions such as physiotherapeutic diagnostics, education and information of patients, pelvic floor muscle (PFM) training, bladder training (BlT), training with vaginal cones, electrical stimulation, biofeedback, etc. In stress incontinence, to improve the extrinsic closing mechanism of the urethra, physical therapy is aimed on strength improvement and coordination of the peri-urethral and pelvic floor muscles. Especially, PFM training is effective. For detrusor over activity physical therapy aims to reduce or eliminate involuntary detrusor contractions through reflex inhibition. Here, electrical therapy appears to be an effective intervention. In mixed urinary incontinence the physiotherapeutic diagnostic & therapeutic process focuses on the predominant factors. Radical prostatectomy is the most important cause of incontinence in men. An adequate program of PFM training, after radical prostatectomy, decreases the duration and the extent of incontinence and improves the quality of life. Conclusion: physical therapy is in many cases of incontinence an effective treatment option

[An experimental and clinical validation of a method for treating acute inflammatory diseases of the adnexa uteri by using the electrophoresis of a therapeutic mud preparation]. / Eksperimental'no-klinicheskoe obosnovanie metoda lecheniia ostrykh vospalitel'nykh zabolevanii pridatkov matki s ispol'zovaniem élektroforeza preparata lechebnoi griazi.

Experimental and clinical investigations have demonstrated that the addition of abdominal-sacral electrophoresis of esobel 1% solution to combined therapy of acute inflammation of the uterine appendages improves treatment results. Bioantioxidants bring about the antiinflammatory action of the mud preparation esobel while its high-polar lipids prevent structural-metabolic impairment of the appendages' tissue elements as shown by a pronounced antiexudative effects and weak secondary alteration.

[An experimental validation of the use of the ultraphonophoresis of the mud preparation Eplir in inflammation of the uterine adnexa]. / Eksperimental'noe obosnovanie primeneniia ul'trafonoforeza griazevogo preparata "Eplir" pri vospalenii pridatkov matki.

Eplir ultraphonophoresis started on day 5 of experimental inflammation of the uterine appendages in the presence of antibacterial therapy reduces the severity of exudative processes, hemodynamic disorders, leukocytic infiltration, follicular atresia, prevents growth of connective tissue stroma.

[The effect of the brine and mud extract from Lake Karachi on the morphofunctional status of the adnexa uteri in experimental inflammation]. / Vliianie rapy i ékstrakta griazi ozera Karachi na morfofunktsional'noe sostoianie pridatkov matki pri éksperimental'nom vospalenii.

Two-stage electrophoresis of preparations made of natural brine and extract of mud taken from the Lake Karachi tried in combined treatment of experimental inflammation of the uterine appendages prevents proliferative and sclerotic alterations in ovarian stroma, stimulates repair of the intramural nerves, corrects follicular atresia.

[The treatment results in inflammatory diseases of the adnexa uteri with different methods of using sinusoidal modulated currents]. / Rezul'taty lecheniia vospalitel'nykh zabolevanii pridatkov matki razlichnymi metodikami primeneniia SMT.

Electrophoresis of 2% solution of sodium salicylate was made by impulse currents (SMC) according to transcutaneous, intracavitary, intraorgan techniques in 90 gynecological patients with nonspecific acute and chronic affections of the uterine appendages. Echography proved high efficacy of the intracavitary and intraorgan treatment. Simple performance of SMC therapy in combination with sodium salicylate solution microclysters and efficacy which was not inferior to intracavitary drug electrophoresis makes the method practicable in gynecology and physiotherapy.

[The effect of a low-frequency magnetic field on the clinico-immunological indices of patients with chronic inflammatory diseases of the organs of the female genital system]. / Vliianie nizkochastotnogo magnitnogo polia na kliniko-immunologicheskie pokazateli bol'nykh s khronicheskimi vospalitel'nymi zabolevaniiami organov zhenskoi polovoi sistemy.

Low-frequency magnetic field generated by the vaginal inductor used in 120 females with chronic genital inflammation promoted a decrease in leukocytosis, elevation of total population of T-lymphocytes, inhibition of high proliferative activity in PHA test. However, marked immunocorrection was not reached.

[An intensive regimen of supersonic-frequency-current therapy in chronic inflammation of the adnexa uteri]. / Intensivnyi rezhim TNCh-terapii pri khronicheskom vospalenii pridatkov matki.

As shown by clinical, electrophysiological and hormonal examinations of 34 patients with chronic inflammation of the uterine appendages and control subjects, the disease treatment with intensive low-frequency current has no negative effects on cardiovascular and endocrine systems, improves function of the reproductive system. Intensive low-frequency currents are believed to be a useful modality in management of chronic genital inflammation.

[The comparative efficacy of the treatment at Sochi of women with inflammatory diseases of the lesser pelvis who live in different climatic and geographical regions of Russia]. / Sravnitel'naia éffektivnost' lecheniia v Sochi zhenshchin s vospalitel'nymi zabolevaniiami organov malogo taza, prozhivaiushchikh v razlichnykh klimatogeograficheskikh regionakh Rossii.

225 females of reproductive age were treated in Sochi for inflammatory diseases of the small pelvis. The patients underwent climate, balneological, laser treatments and received thymogen. Therapeutic results estimated clinically, by adaptive responses, protein metabolism, proteolysis and ceruloplasmin activity, concentrations of proteolysis inhibitors and middle-mass molecules were analyzed with respect to the patients' residence and the season of their stay in the sanatorium. The best results in warm seasons were achieved in women from south regions. In northerners and some residents of middle Russia there were adaptive failures. For them, cool seasons were more advantageous. The authors recommend cool Sochi weather for treatment of small pelvis diseases in women living in the north, south and middle Russia.

[The use of the Shirsal concentrate in treating chronic inflammatory diseases of the uterine adnexa]. / Ispol'zovanie kontsentrata "Shirsal" v lechenii khronicheskikh vospalitel'nykh zabolevanii pridatkov matki.

Shirsal concentrate, mineral water salt from Shira lake, of sulfate chloride magnesium and sodium composition is suggested for therapy of women suffering from chronic inflammations of pelvic organs. Eighty-three women were administered Shirsal solution electrophoresis combined with endovaginal vibration massage or microenemas of 0.5% solution of the same agent. The treatment had an evident anti-inflammatory, analgesic, and resolving effect.

[Rationale for using physiotherapeutic procedures adapted to the phases of menstrual cycle in women of reproductive age]. / O ratsional'nosti fizioterapevticheskikh vozdeistvii, adaptirovannykh k fazam menstrual'nogo tsikla u zhenshchin reproduktivnogo vozrasta.

The efficacy of the routine anti-inflammatory and resolving therapy and the rehabilitation method which is based on the principle of exposing the patients to physical factors with due regard to the specific features of menstrual cyclic processes in the female body was studied in 170 patients with chronic non-specific salpingo-oophoritis during their steady-state remission. The efficiency was checked up by using general clinical, instrumental, and laboratory tools and examining viscerocutaneous and vegetative reflexes. It was concluded that it was impossible to achieve a full restoration of specific functions in the patients without normalizing the cyclic changes in homeostasis, autonomically endocrine regulation which should be the major matter of a physician's therapeutic efforts.

Management of chronic pelvic inflammatory disease with shortwave diathermy. A case report.

Patients with pelvic inflammatory disease (PID) are not routinely referred for physical therapy until the condition is found to be resistant to antibiotic therapy. A 39-year-old black woman with an eight-year history of PID was treated with shortwave diathermy (SWD) using a modified "cross-fire" technique. A thermal dosage treatment lasting between 20 and 30 minutes (for each half of the cross-fire technique treatment) was administered. At the beginning of every treatment session, the patient rated her pain perception on a 10-point ratio scale. The patient received a total of nine treatments, after which she was completely pain free. The results of this case study suggest that SWD may be effective in the management of pelvic infections that are unresponsive to chemotherapy. Further studies using larger sample sizes and a control group, however, are needed before conclusive statements can be made on the relative efficacy of SWD in the management of chronic PID.