Improving of recovery therapy in women with surgically treated polycystic ovary syndrome
ARTICLE PDF (Українська)

Keywords

polycystic ovary syndrome, morpho-functional status of ovaries, lipid peroxidation, antihypoxants, antioxidants

How to Cite

Lytvak, O. O., Khabrat, B. V., Khabrat, A. B., & Lysenko, B. M. (2018). Improving of recovery therapy in women with surgically treated polycystic ovary syndrome. Clinical and Preventive Medicine, (2-3), 22-32. https://doi.org/10.31612/2616-4868.2-5.2018.03

Abstract

Morpho-functional and ultrastructural characteristics of polycystic ovaries indicate their metabolic and structural changes. Functional ovarian failure causes the development of circulatory and tissue hypoxia in them. The consequence of these processes is the increased formation of reactive oxygen compounds that initiate enzymatic and non-enzymatic lipid oxidation, which leads to damage to the membrane structures of the ovary and causes an increase in the number of products with vasoconstrictor action, exacerbating the hypoxic state.

The purpose of the work is to optimize regenerative therapy in women with polycystic ovary syndrome (PCOS) after surgical treatment.

Material and methods. 112 women with PCOS were screened for surgical treatment due to lack of effect or partial effect of prior hormonal therapy. For the duration of the disease, women were divided into three groups: 1st group - 57 women with a duration of illness up to 2 years; Group 2 - 35 patients with the disease period from 2 to 5 years; Group 3 - 20 women with a disease duration of more than 5 years. The control group consisted of 20 practically healthy women of reproductive age. For the examination of women, used general clinical and laboratory methods, bimanual gynecological examination, cytological and colposcopic diagnosis, radiography of the skull.

Results. On the background of a hypoxic condition in the vast majority of cases, women with PCOS increased the diameter of the ovaries by 1.5-2.5 times, as well as their volume, follicular index, surface area and ovary circle index. The ovarian sheath in most of the subjects was defined as a hyperherogenic formation of different thicknesses - from 0.2 cm to 0.7 cm. A significant proportion of women with PCOS revealed changes in the ratio of cortical substance and ovarian cerebellum. For a duration of more than 5 years, this process has been slower, and its manifestations have been less. The scheme of regenerative therapy with the inclusion of the drug quercetin, which produces antihypoxic and antioxidant action, is developed. Definite morphologic-functional characteristics testify that PCOS in ovaries develops metabolic and structural diseases, which correlate with terms of disease. It has been proved that one of the mechanisms that determines patient’s functional ovaries’ insufficiency is circulatory and tissue oxygen starvation (hypoxia). The result of the process is increasing formation of responsive oxygen combinations, which initiate enzyme and non-enzyme lipid oxidation. It has been established that excessive lipid peroxide oxidation excretion (POE) leads to destruction of diaphragm structure functionally active cell elements and results to the development of atresia. The lipid enzyme link activation promotes to increase products with vasoconstructor action (Tromboxan B2 and Leucotrien C4) that intensify hypoxic condition, which increase functional activity of fibroblasts and extend collagen formation, cortex substance fibrosis and arteries hardening. The ultrasound criteria of marked pathological process in ovaries under PCOS that have prognostic meaning while choose the amount of surgical intervention were clearly defined. The regenerative therapy diagrams of women with PCOS after surgical treatment including Kvertsityn preparation with anti-hypoxia and anti-oxygen effect were worked out. The efficiency of the suggested patho-genetic advanced therapy during post-operative period of PCOS women was proved.

Conclusions. In the initial stages of the disease (up to 2 years), changes in the ovaries can be considered as compensatory and adaptive processes, and with the increase in the duration of the disease there comes a stage of irreversible disorders, when the effect of surgical treatment is low. The efficiency of application of the developed regimen therapy scheme with the inclusion of quercetin in the postoperative period in women with PCOS has been proved.

https://doi.org/10.31612/2616-4868.2-5.2018.03
ARTICLE PDF (Українська)

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