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REHABILITATION OF WOMEN WHO HAVE UNDERGONE TUBECTOMY
Fayzullayevna Munira Alisher qizi
Samarkand State Medical University Department of Obstetrics and Gynecology No. 3
Tugizova D. I.
PhD.
Scientific supervisor.
Department of Obstetrics and Gynecology No. 3
Samarkand State Medical University
https://doi.org/10.5281/zenodo.14671522
Objective
: The features of restoration of the anatomy and function of the fallopian tubes
in the early postoperative period after laparoscopic reconstructive plastic surgery were identified
and studied in detail. The work for the first time improved the algorithm for perioperative treatment
of patients with tubal infertility. Severe degrees of pelvic adhesions prevail in 81.7% of patients
with tubal infertility, so grade 2 was detected in 49.5%, grade 3 in 27.3% of women, and grade 4
in 4.9%. For the first time, a comprehensive rehabilitation method was proposed and tested in the
early postoperative period, which allowed restoring reproductive function in 60.8% of patients. It
was found that 98% of patients with tubal infertility were carriers of sexually transmitted
infections, which served as the basis for perioperative antibiotic therapy to reduce the incidence of
exacerbation of inflammatory processes and adhesions in the postoperative period. In 51%, tubal
infertility is aggravated by additional factors: in 19.2% of women, tubal infertility is combined
with sclerocystic ovaries, in 7.7% with peritoneal endometriosis, in 3.8% with ovarian retention
cysts, and in 1.9% with uterine fibroids.
Materials and methods of research:
Laparotomy method: the doctor makes an incision
along the midline of the abdomen or a transverse incision above the pubis. Tubectomy is
distinguished by the incision made. The first incision is used in cases where it is urgent to stop
bleeding. This method is also used in the presence of adhesions and malignant neoplasms in the
pelvic area. During planned operations, a second laparotomy incision is made. After this method,
the operation is faster and a cosmetic suture can be applied. Currently, in most cases, this type of
operation is performed laparoscopically. Due to the fact that special instruments are installed on
the anterior abdominal wall, this operation is less traumatic.
Research results:
The high percentage of infection detected in patients with tubo-
peritoneal infertility (96%) necessitates the mandatory introduction of antibacterial therapy in the
preoperative period. For the first time, a quantum therapy scheme has been developed for patients
with tubal infertility in the early postoperative period. The introduction of polyquantum therapy in
early postoperative rehabilitation allowed to reduce adhesions by 32.6%. Carrying out the
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recommended early complex for the rehabilitation of patients with tubo-peritoneal infertility
allowed to restore the patency and function of the fallopian tubes in 92.2% of patients and the
onset of pregnancy in 60.8%. With traditional rehabilitation in patients after reconstructive plastic
surgery with tubal infertility, the effectiveness of restored patency of the fallopian tubes decreases
from 75% to 52% due to postoperative complications. It was found that 98% of patients with tubal
infertility were carriers of sexually transmitted infections, which served as the basis for
perioperative antibiotic therapy to reduce the severity of inflammatory processes and the frequency
of adhesions in the postoperative period. In 51%, tubal infertility is aggravated by additional
factors: in 19.2% of women, tubal infertility is combined with sclerocystic ovaries, in 7.7% with
peritoneal endometriosis, in 3.8% with ovarian retention cysts, and in 1.9% with uterine fibroids.
In patients with tubal infertility, severe degrees of pelvic adhesions prevail in 81.7%, so grade 2
was detected in 49.5%, grade 3 in 27.3% of women, and grade 4 in 4.9%. Consider it justified to
perform dynamic laparoscopy after reconstructive plastic surgery on the fallopian tubes in patients
with grades 2 and 3 of the spread of the adhesive process, which increases the effectiveness of
treatment by 35.8%. The developed complex for early postoperative rehabilitation of patients with
tubo-peritoneal infertility allowed to restore the patency of the fallopian tubes in 92.2% of patients
and the onset of pregnancy in 60.8% of women.
Conclusion
. If the fallopian tube is completely removed, it cannot be restored during
subsequent surgical interventions. This is because the mucous membrane of this organ contains
many villi that perform translational movements, helping the fertilized egg to enter the uterine
cavity. So far, there is no way to artificially replace this organ.
If partial removal of the fallopian tube is performed, it should be noted that various types
of plastic surgery are used in such uterine appendages. However, according to statistics, such
surgical interventions are ineffective, and doctors are increasingly refusing to perform them. Since
assisted reproductive technologies have shown excellent results during the IVF protocol in the
absence of tubes. Tubal reversal surgery offers a ray of hope for women who want to get pregnant
after a tubectomy. Although it has its own challenges and considerations, successful reversal can
lead to a happy pregnancy and birth. By understanding the procedure, success rates, and
alternatives, you can make an informed decision that meets your personal and family goals. As
with any medical procedure, it is important to consult with a qualified doctor to assess your specific
situation and determine the best course of action for you and your family. With the right
preparation and care, a tubectomy reversal can open the door to new beginnings.
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