Intrauterine adhesions in later productive and premenopausalage
A total of 325 women of 35-55 years old with different forms of endometrial pathology were examined: endometrial polyp was detected in 192 (59.1%), endometrial hyperplasia - in 99 (30.5%), chronic endometritis - in 113 (34.8%), simple hyperplasia with atypia - in 7 (2.2%). Intrauterine adhesions were diagnosed in 20 (6.2%) patients. Chlamydia, ureaplasma and candida were detected significantly more often in women with adhesions. The results of anamnestic, clinical, hysteroscopic and histological examination showed that the patients with adhesions were characterized by increased frequency of infertility among comorbidities. Analysis of the SF-36 questionnaire showed that patients with adhesions rated their quality of life much better than women without adhesions. It was concluded that adhesions were the hysteroscopic finding in every fourth case. Suspicion for the presence of adhesions is a critical aspect of infertility on the background of the transferred urogenital infections and hysteroscopy should be considered as a diagnostic standard for these patients. More than a third of patients have relapse within 1.5 years after hysteroscopic treatment of adhesions.