Uterine fibroids and adenomyosis
Indications:
- a woman's desire to preserve the uterus;
- miscarriage due to the presence of myomatous nodes or adenomyosis;
- severe clinical symptoms with a woman's unwillingness to remove an organ.
Contraindications:
- weight more than 110 kg; the distance from the skin to the middle of the node exceeding the focal length (determined on the device, on the marking), as a rule, this distance is more than 20 cm;
- lack of clear node visualization; adhesion of intestinal loops to the node during the adhesive process; the presence of any nature formation in the ovaries and fallopian tubes;
- suspected pathological changes in the endometrium; the presence of a IUD; the presence of a note on a thin stalk; acute inflammatory diseases of any etiology.
Preoperative examination:
- Ultrasound (with a filled bladder and transvaginal);
- Contrast-enhanced MRI;
- standard gynecological examination with cytological smear analysis and flora analysis;
- if there is a suspicion of endometrial pathology on ultrasound, preliminary D&C is necessary, HIFU can be performed not earlier than 3 weeks after D&C;
- standard examination for neuroleptanalgesia or deep sedation (clinical blood test, clinical urine test, ECG, blood biochemistry, chest X-ray, blood serology, blood type and Rh factor).
Preparation:
- "water diet" for 3 days: there are pureed soups, broths, copious drinking, puree, pureed porridge;
- the goal is to flood the loops of the small intestine with liquid contents and expel air from the intestine;
- all products that cause bloating of the intestine are prohibited;
- three days of Espumisan 3-5 capsules 3 times a day, preferably liquid Espumisan 1 tablespoon 3 times a day; all products that cause bloating of the intestine are prohibited;
- the day before the procedure, Sumamed is prescribed 500 mg once a day, Metronidazole 500 mg three times a day;
- taking medications continues for another three days after the procedure;
- on the eve of the operation - shaving of the pubes and lower abdomen (important: do not scarify the skin!);
- immediately before the operation, catheterization of the bladder is performed with a three-way Foley catheter.