MEDICAL-SOCIAL PECULIARITIES OF CHRONIC INFLAMMATORY PROCESSES OF THE INTERNAL GENITAL ORGANS IN WOMEN AGAINST THE BACKGROUND OF VARICOSITY OF PELVIS MINOR
Aim of the research. Study the peculiarities of chronic inflammatory processes of the internal genital organs in women against the background of varicose veins of the pelvis minor.
Materials and methods. In the comparative aspect, the main points of the clinical characteristics of 30 women of the control and 120 patients of the main groups (with chronic inflammatory processes of the internal genital organs against the background of varicose veins of the pelvis, isolated chronic inflammatory processes of the internal genital organs) are represented in the work.
Results. Performed researches have shown that the vast majority of women in the group 1 were engaged in manual labor, of which 32 were workers ((47,1±6,1) %), 13 – were housewives ((19,1±4,8) %). The proportion of unemployed among patients of the group 2 was 1.2-fold higher than of the group 1, prolonged static load in a standing or sitting position was observed in 38 ((55,9±6,0) %) and in 7 ((10,5±3,7) %) cases, respectively; excessive physical activity, especially related to the lifting of loads – in 12 (23,1±4,6) %) and in 6 (11,05±4,4) %) cases, respectively; and this definitely made the negative impact on the venous hemodynamics. Statistical calculations showed that the risk of VPM (varicosity of pelvis minor) in female workers was significantly higher compared to the control group (OR 3,56; 95 % CI 1,29-9,80; p=0,02) and group 2 (OR 2,67; 95 % CI 1,21-5,86; p=0,02).
Analysis of the peculiarities of genital function has shown that the early sexual activity (up to 18 years) was started by 19 ((27,9±5,4) %) women of the group 1, by 22 women ((42,3±6,9) %) – of the group 2, that was 1,8-fold more than in patients of the control group (7; (23,3±4,7) %). The women of the group 1 were found to have a significantly higher risk of sexual dysfunction compared to the group 2: dyspareunia (OR 2,39; 95 % CI 1,14-5,04; p=0,03) and anorgasmia (OR 2,60; 95 % CI 1,12-6,06; p=0,04).
Regarding the use of contraceptives, it was found that almost half of the patients of the first group resorted to interrupted sexual intercourse, which adversely affects the venous hemodynamics of the pelvis and significantly increases the risk of VPM against the background of CIPIGO (chronic inflammatory processes of the internal genital organs) (OR 2,41; 95 % CI 1,11-5,24; p=0,04).
Studying the reproductive history of patients, it was determined that women in the group 1 have had 3,4-fold higher birth parity compared to the group 2 (p<0,05), which can also be considered a leading risk factor for VPM. In addition, in the research groups there was a significant proportion of miscarriages (4,7-fold more in the group 1; p<0,05) and stillbirths, which may be a consequence of the past acute inflammatory diseases of specific etiology.
Conclusions. Anamnestic data (static lifestyle and physical activity, miscarriages, high parity of childbirth), as well as peculiarities of the clinical course of chronic inflammatory processes of the internal genital organs in women against the background of varicose veins of the pelvis minor (severe chronic pelvic pain, swelling and aching fornices, dyspareunia, sexual dysfunction) should be the leading factors in the selection of patients for the use of an advanced diagnostic algorithm (ultrasound examination of the lesser pelvic veins in combination with color Doppler examination).
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