Lukanova M, Miteva I, Gorgioski S, Popov I
Akush Ginekol (Sofiia). 2008;47(4):28-34.
To determine the trend in application of the basic therapeutical procedures in the most common gynaecological diseases combined or not with chronic pelvic pain /CPP/.
In the prospective study conducted in the Gynaecological Clinic at the Department of Obstetrics and Gynaecology, MU-Pleven in the period 01.03.2004-01.07.2007, 1356 women with leiomyomatosis /L/, endometriosis /E/, adenomyosis /A/, pelvic congestion syndrome /PCS/, Allen-Masters syndrome /AMS/, pelvic inflammatory disease /PID/ and adhaesion syndrome /AS/, were included in it. They were grouped according to their age, type of disease, presence of CPP, type of therapeutical procedure and histological verification of the condition. For the purpose of the study the following methods were used: documentary method, R-AFS classification of E, inquiry method-by a questionnaire /form/, based on instruments for pain assessment, accepted worldwide.
The highest frequency was determined for L, E and A, and AS. In the majority of the total number of consecutively admitted patients with those diseases an operative intervention was done, and almost one-sixth of women underwent conservative treatment. The same trend was observed in patients with chronic pain symptomatic, regarding their operative and conservative management. Histological verification of the condition was closely related with etiological reason and diagnostic approach.
A balance between conservative and operative treatment should be set in the basis of therapeutical management, consistent with modern diagnostic procedures. Determination of the trend in treatment of women with CPP will lead to falling off of indiscriminate application of operative methods prior to exact diagnostic specification and setting of multidisciplinary approach. That will serve as a background for the future conduct to that group of patients.
确定最常见妇科疾病（无论是否合并慢性盆腔疼痛/CPP/）基本治疗程序的应用趋势。
在2004年3月1日至2007年7月1日期间于普列文医科大学妇产科妇科诊所进行的前瞻性研究中，纳入了1356例患有平滑肌瘤病/L/、子宫内膜异位症/E/、子宫腺肌病/A/、盆腔淤血综合征/PCS/、艾伦 - 马斯特斯综合征/AMS/、盆腔炎性疾病/PID/和粘连综合征/AS/的女性。根据年龄、疾病类型、CPP的存在情况、治疗程序类型和病情的组织学验证对她们进行分组。为了该研究使用了以下方法：文献法、子宫内膜异位症的R - AFS分类、询问法——通过基于全球公认的疼痛评估工具的问卷（表格）。
确定L、E、A和AS的发病率最高。在这些疾病连续收治的大多数患者中进行了手术干预，近六分之一的女性接受了保守治疗。在有慢性疼痛症状的患者中，其手术和保守治疗也观察到了相同的趋势。病情的组织学验证与病因及诊断方法密切相关。
在治疗管理中应在保守治疗和手术治疗之间取得平衡，这与现代诊断程序相一致。确定CPP女性的治疗趋势将减少在精确诊断明确和多学科方法确定之前盲目应用手术方法的情况。这将为未来对该组患者的治疗提供依据。
