Endometriosis: clinical picture, diagnosis and treatment. Treatment and diagnosis of uterine endometriosis: reasons to contact the Center for Gynecology, Reproductive and Aesthetic Medicine

Causes of the disease

In European medicine there is no definitive opinion regarding the causes of endometriosis. Its hormonal nature is explainable; the implantation theory cannot be ruled out (some fragments of menstrual blood with endometrial particles enter the peritoneum and tubes, where they grow). Predisposing factors are: genetic, impaired development and structure of the fallopian tubes, metabolic diseases, changes in the concentration of sex hormones, decreased immunity, chronic inflammatory diseases and infections of the pelvic organs, cervical injury during childbirth or abortion.

In Chinese medicine, almost all diseases associated with the female reproductive system are associated with disturbances in the energy of the kidneys, liver, and heart, as the main regulators of the body's blood supply system. A change in their work due to an imbalance of hormones and metabolic processes, external cooling provokes stagnation of blood and energy in the uterine area, endometrial hypertrophy and the formation of endometrioid foci. It is the specialists of Chinese medicine who are more often able to restore a woman’s health without the use of surgical intervention, which in some cases of the traditional medical approach in our country is inevitably prescribed to the patient.

Symptoms of endometriosis

Before talking about the manifestations of the disease, I would like to give a little explanation about the variety of forms of endometiosis. The classification is based on the localization of the focus:

Genital endometriosis:

• internal - adenomyosis (in the canal and cervix)
• outer

Extragenital:

• peritoneal (ovaries, tubes, pelvic peritoneum)
• extraperitoneal (vagina, cervix)

Signs of the disease include the appearance of pain in the lower abdomen on the eve of menstruation, as well as during sexual intercourse; pain can often spread to the lumbar region and accompany urination and defecation. An important symptom: painful and heavy menstruation, the appearance of bleeding in the interval between menstruation. However, quite often endometriosis is first discovered during a gynecological examination, to which the patient comes for a completely different reason. And this indicates the tendency of the disease to have a hidden course. The most serious problem is the impairment of a woman’s ability to conceive, which occurs as a result of the appearance of adhesions and obstruction of the fallopian tubes during the development of endometriotic lesions. The sooner the disease is detected and treated, the higher the chances of restoring reproductive function.

Cervical endometriosis

In the case when a focus of endometrioid tissue penetrates the mucous membrane of the cervix, growing there, it is reasonable to talk about such a diagnosis as cervical endometriosis. It is quite easy to identify, since the cervix is ​​easily visible during a routine gynecological examination in the speculum. Complaints characteristic of this localization of the pathological process include pain and the appearance of dark brown spotting on the cervix after sex or medical procedures.

Treatment of endometriosis at the TAO clinic

The most important advantage of treating endometriosis in a Chinese medicine clinic can be considered the non-invasiveness of the methods (that is, the therapeutic effect is achieved without surgery, incisions or removal of organs) and their highest effectiveness, proven by the centuries-old practice of Chinese doctors. At the TAO clinic, the patient is prescribed herbal medicines to restore kidney energy, suppress the growth of endometrioid lesions, and often completely resolve them. In addition, experienced doctors perform procedures aimed at harmonizing energy along the main meridians: acupuncture, massage, warming with wormwood cigars. The body is preparing for recovery. And a woman, coming to the clinic, receives not only relief from endometriosis, but also the restoration of other disorders in the body identified during the consultation.

Treatment of uterine endometriosis

As a special case, treatment of uterine endometriosis using Chinese medicine methods guarantees the preservation of the anatomy and function of the organ. This is important given the fact that in the world there is a tendency towards “rejuvenation” of the disease, which means that more and more young women, often who have not yet realized their reproductive function, are falling ill. That is why when choosing a doctor it is necessary to rely on his knowledge and experience.

Endometriosis is a pathological process of spread of the endometrium (the inner layer of the uterine wall) beyond its normal location. The endometrium can spread to all organs and tissues, for example, to grow into the wall of the uterus, fallopian tubes, intestines, ovaries, bladder, eyes. Most often, endometriosis is localized on the pelvic organs.

The endometrium lines the inner surface of the uterus and during menstruation its functional layer peels off, which is accompanied by menstrual bleeding. However, with endometriosis, blood and endometrium can travel through the fallopian tubes into the abdominal cavity, where the endometrium attaches to organs and begins to function as in the uterine cavity.

The reasons why endometriosis begins to develop are still not fully understood. But the most well-known reasons are the following:

Menses- endometriosis usually occurs in young women of reproductive age, most often between the ages of 30 and 50 years. Endometriosis begins to develop during menstruation. At this moment, blood with the endometrium enters the abdominal cavity, after which the endometrium attaches to the organs and tissues in the abdominal cavity;

Endometrial metaplasia(transformation of one tissue into another). There is also an opinion that, when entering the abdominal cavity from the uterus, the endometrium can turn into another tissue. Although there is still no consensus regarding this theory, in addition, it is not clear how this tissue degeneration occurs.

Hormonal imbalances- Almost all patients with endometriosis begin to experience hormonal changes. Namely, the ratio of steroid hormones changes (follicle-stimulating hormone and luteinizing hormone increase. And at the same time, the level of the hormone progesterone begins to decrease, prolactin increases and the androgenic function of the adrenal cortex is disrupted;

Genetics- in some cases, endometriosis has a “familial” nature, that is, all women in one family suffer from this disease. Scientists have already been able to identify these genetic markers that are responsible for predisposition to endometriosis.

Decreased immunity- if the immune system is normal, then endometrial cells will not be able to survive outside the uterine cavity. It is the immune system, including the body’s protective functions, that destroys endometrial cells that have entered the uterus and prevents them from implanting and developing.

Endometriosis can be caused by some factors that provoke its appearance:

• lack of iron in the body;
• abortions performed;
• bad ecology;
• obesity;
• surgeries on the pelvic organs (cauterization of cervical erosion, cesarean section);
• wearing an intrauterine device;
• inflammatory diseases of the female genital organs;
• liver dysfunction, etc.

At-risk groups:

• age from 30 to 40 years;
• women who did not have children;
• with prolonged menstruation - more than 7 days or a cycle shorter than 28 days;
• early onset of menstruation - up to 12 years;
• if the immediate family (mother or sister) is suffering; endometriosis.

Most women experience improvement during menopause or pregnancy. Symptoms of endometriosis may simply disappear. About a third of women with low-grade endometriosis note that their symptoms went away on their own, without medical intervention.

Forms of endometriosis

There are several forms of endometriosis, which differ in the location of the endometrium:

• genital
• extragenital
• mixed form of endometriosis: a combination of genital and extragenital forms of endometriosis

The most common form of endometriosis is genital.

Symptoms

The manifestation of endometriosis depends on its form and degree, as well as on concomitant diseases. The main symptoms of endometriosis are severe pain in the lower abdomen of a bursting nature, bloating before the onset and on the first day of menstruation, pain during sexual intercourse. In some cases, there may be no symptoms, especially at the initial stage.

But still, there are characteristic clinical manifestations of this disease:

• pain in the lower abdomen and lumbar region of varying intensity
• increased pain during menstruation, sexual intercourse
• pain radiating to the rectum
• menstrual irregularities (appearance of spotting brown discharge 1-3 days and within 1-7 days after menstruation
• increase in the abundance of menstruation and its duration
• the appearance of intermenstrual bleeding
• infertility
• symptoms of intoxication (nausea, vomiting, weakness, fever, chills, increased leukocytes and ESR in the blood)

Diagnostics

To make an accurate diagnosis, it is necessary to undergo an examination, which will include the following diagnostic methods:

• Ultrasound of the pelvic organs
• Hysterosalpingography (using contrast agent)
• Hysteroscopy
• Laparoscopy
• Blood test for CA-125 (a marker of endometriosis)

The required set of studies is determined by the gynecologist. Often, a chair examination and ultrasound are sufficient to diagnose endometriosis; in other cases, only laparoscopy can help.

Treatment of endometriosis

Treatment of endometriosis It can be conservative, operative and combined (both).

Conservative treatment of endometriosis

Conservative treatment is based on long-term hormonal therapy. Typically, the following are prescribed to treat this disease:

• COCs - single-phase combined oral contraceptives (Zhanine, Logest, Diane-35, Regulon), continuously for 6-9 months.
• norsteroid derivatives - LNG (levonorgestrel). Very often they use the hormonal intrauterine device "Mirena", which is installed for 5 years.
• Prolonged MPA (Depo-Provera), the drug is administered intramuscularly once every 2-3 months, the total course of treatment is 6-9 months.
• Androgen derivatives: (Danazol, Gestrinone), for 3-6 months.
• GnRH agonists - gonadotropin-releasing hormone agonists (Zoladex, Buserelin) for a course of up to 6 months.

Along with hormonal therapy, anti-inflammatory drugs, antispasmodics, sedatives, enzyme preparations, and vitamin therapy are often prescribed.

Surgical treatment of endometriosis

In cases where hormonal therapy is not effective and in certain forms of this disease, strictly surgical treatment is indicated:

• in the presence of an endometrioid ovarian cyst and complications leading to pelvioperitonitis;
• with retrocervical endometriosis;
• with a combination of adenomyosis, fibroids and uterine bleeding;
• if conservative therapy is ineffective;
• in case of oncological alertness - probable ovarian tumor;
• in case of dysfunction of neighboring organs.

For the surgical treatment of endometriosis, laparoscopy is most often used; in rare cases, laparotomy (dissection of the abdominal wall) is performed.

During laparoscopy, electrocoagulation or cauterization/laser removal of endometriosis is performed. But, as a rule, surgical treatment of endometriosis is always combined with conservative treatment. Typically, a course of hormonal therapy is prescribed for 3-6 months, after which laparoscopy is performed. Treatment is also possible in the reverse order - first surgery, and then a course of hormones.

After successful treatment of endometriosis, it is possible to restore a woman’s reproductive function, and pain during menstruation goes away.

In the subsequent period, constant monitoring by a gynecologist is necessary - once every 3 months.

• Precision and efficiency An integrated approach using advanced methods of radiation and endoscopic diagnostics. Accurate determination of indications for surgical treatment based on approved international standards is a guarantee of the quality and effectiveness of subsequent treatment.
• Restoration of reproductive function Reliable algorithms for complex drug therapy with advanced methods of minimally invasive surgery. Removal of endometrioid ovarian cyst while preserving ovarian function. Elimination of foci of endometriosis and adhesions that prevent pregnancy.
• Leading specialists Doctors of Medical Sciences. Authors of recognized methods of treating endometriosis. Thousands of grateful patients, preserved health, newfound happiness of motherhood. Your health and our reputation are in their kind and skillful hands.

Endometriosis. Causes and development of the main forms of the disease

Etiology of the disease. Endometriosis is one of the most common diseases of the female reproductive system, which is associated with the formation of ectopic foci of endometrial tissue outside the uterine cavity. During menstrual bleeding and intrauterine interventions, the cells that make up the lining of the uterus (endometrium) enter the abdominal cavity through the fallopian tubes through the bloodstream. In the presence of certain conditions - a hormonal background favorable for the development of cells and the absence of a reaction from the immune system, the cells take root on the surface of neighboring organs. As they multiply, they form foci of endometriosis, which behave during menstruation like the endometrium lining the uterine cavity. Some of the cells forming the lesion exfoliate, and pinpoint bleeding occurs within the lesion itself, leading to its growth and further spread of endometriosis. In rare cases, lesions can even be found in the lungs.

Pelvic endometriosis and infertility. In most cases, endometriosis affects organs adjacent to the uterus. As they develop, foci of endometriosis cause an inflammatory reaction around them with the formation of an adhesive process in the pelvic area, which leads to impaired reproductive function and pain.

Endometrioid cyst. With the development of endometriosis, an endometrioid cyst is formed inside the ovary, which can reach significant sizes, damage normal ovarian tissue, disrupt its function and affect the ovarian reserve, reducing a woman’s reproductive potential.

Adenomyosis. Lesions of endometriosis also penetrate into the thickness of the uterine wall (myometrium) - a condition called "adenomyosis", forming clumps that look like uterine tumors (fibroids) on ultrasound. Adenomyosis causes heavy and painful bleeding during menstruation.

Symptoms of the disease

Endometriosis can occur at the very beginning of the reproductive period with the onset of the menstrual cycle. This disease is completely dependent on the hormonal activity of the ovaries and therefore goes away on its own upon the onset of menopause, along with the decline of ovarian function. Quite often, endometriosis is asymptomatic and is accidentally discovered during routine examinations, ultrasound examinations or during abdominal surgery. If symptoms are present, treatment is carried out depending on the severity and extent of the process, the location of the lesions, the age of the patient and the need to preserve or restore reproductive function.

Main symptoms of endometriosis

• Nagging pain in the lower abdomen, intensifying on the eve of menstruation and radiating to the lumbar region, sacrum, perineum;
• Spotting before or after menstruation;
• Pain during menstruation;
• Heavy and prolonged bleeding during menstruation;
• Pain during sexual intercourse;
• Reproductive dysfunction - infertility;
• Pain when emptying the bowels and bladder;
• In rare cases, with atypical localization of lesions and serious organ damage, blood appears in the urine and stool. If the lungs are affected, there is blood in the sputum (hemoptysis).

It should be understood that the presence of the above symptoms, even if they are all present together, does not mean that they are necessarily caused by endometriosis. To establish a diagnosis, you need to see a doctor and undergo the necessary examination!

Diagnosis of endometriosis

An integrated approach using advanced methods of radiation and endoscopic diagnostics guarantees an accurate determination of further treatment tactics based on approved international standards.

In their work, specialists at the Yauza Clinical Hospital use their own proprietary methods, which are recognized by the international medical community and allow not only to accurately diagnose pathological changes, but also to predict the development of endometriosis in the future.

The examination includes:

• Taking an anamnesis and gynecological examination is the first and most important examination for making the correct diagnosis, choosing additional research methods and determining further treatment tactics.
• Ultrasound examination (ultrasound) is today the “gold standard” for non-invasive diagnosis of endometriosis. Allows you to detect foci of endometriosis in the ovaries - endometrioid cyst and in the uterus - adenomyosis. Determine the signs of adhesions in the pelvic area.
• MRI - magnetic resonance imaging - helps in the differential diagnosis of adenomyosis and uterine fibroids. It can establish damage to the pelvic organs - the bladder and intestines and detect the spread of endometriosis outside the pelvis.
• Endoscopic diagnostic methods - laparoscopy. The most reliable way to detect endometriotic lesions in the abdominal cavity with the possibility of their elimination during the procedure.

Treatment of endometriosis

In the treatment of endometriosis, an integrated approach is important, taking into account the clinical manifestations of the disease. When endometriosis is detected, pain is not always present, reproductive function is impaired and intensive treatment is required. Experienced doctors of the Yauza Clinical Hospital, themselves the authors of world-recognized methods for diagnosing and treating endometriosis, determine for each individual patient, depending on the characteristics of the clinical picture, the need for appropriate drug therapy and indications for combining conservative treatment with surgical correction of the disease.

Conservative therapy

The basis of conservative (medicinal) treatment is a combination of hormonal and symptomatic therapy. Drug therapy is designed to relieve pain, stop the growth of endometriosis lesions and normalize the menstrual cycle. The main groups of drugs for drug therapy include:

• oral combined hormonal contraceptives;
• progesterone preparations and its synthetic analogues - gestagens and progestins;
• hormone-containing intrauterine devices.
• blockers of estrogen receptors and enzyme systems responsible for the production of sex hormones.
• antagonists of hormones that regulate ovarian function.

Surgical treatment of endometriosis

If drug therapy is not effective, or the patient already has an actively progressive disease with severe symptoms and dysfunction of the affected organs, the doctor decides on the need for surgical intervention to remove foci of endometriosis.

In this case, the method of choice is gentle minimally invasive surgery - laparoscopic operations, with the help of which maximum preservation of the integrity of healthy tissues and restoration of normal organ function can be achieved.

Extensive experience in surgical treatment of endometriosis allows specialists at the Yauza Clinical Hospital, even with severe adhesions, to carefully remove all lesions, including endometrioid formations in the ovary, and stop the development of the disease. Organ-preserving laparoscopic interventions do not require long-term hospitalization, recovery processes occur very quickly and, what is especially important for women, no noticeable scars remain on the body. .

Prevention of the development of the disease and its complications in endometriosis

• thorough examination of girls and young women in the presence of painful menstruation;
• observation and monitoring of the condition of patients after intrauterine interventions;
• properly selected drug therapy for the initial signs of endometriosis.

Take care of your health - make an appointment with a gynecologist at the Yauza Clinical Hospital by filling out the form or calling the phone number listed on the website.

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The article was checked by an obstetrician-gynecologist Glukhova N.K., is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, consultation with a doctor is necessary.

Unique methods of treating endometriosis

Symptoms of endometriosis

There is probably no other disease of the female genital organs that would be characterized by such a variety of symptoms. Often, there are no manifestations of endometriosis at all, and it is discovered completely by accident during a routine examination by a gynecologist. The most common symptoms of endometriosis are:

• heavy and painful menstruation;
• spotting bloody discharge that begins 1-3 days before menstruation;
• nagging pain in the lower abdomen between periods or severe PMS syndrome;
• infertility;
• pain during sexual intercourse;
• menstrual irregularities.

In addition, if endometriosis has spread to the peritoneum and intestines, abdominal pain, bloating, colic, and nausea may occur, which coincide with the start of menstruation.

Diagnosis of endometriosis

Only a gynecologist can diagnose endometriosis. Even if a suspicion of this disease arises from a doctor of another specialty, to whom the patient turned with complaints, the final diagnosis is made only by a female doctor.

If, after listening to the complaints, the gynecologist has an assumption that the patient has endometriosis, then the first thing he does is conduct a classic examination of the woman in the gynecological chair. This allows you to examine the external and internal genital organs, their condition, size, shape, and correlate them with normal values.

A detailed questioning of the woman about the nature of the pain, the presence of discharge, and the characteristics of the menstrual cycle is of great help in diagnosis.

The diagnosis of endometriosis must be confirmed by one or more instrumental methods:

• minihysteroscopy;
• MRI, CT scan of the pelvis;
• minilaparoscopy.

Diagnostic methods

3 reasons to apply
at the “Center for Gynecology, Reproductive and Aesthetic Medicine”

Treatment of endometriosis

Like any serious disease, endometriosis requires treatment. The earlier the disease is detected, the more successful the course of therapy is and the greater the chances of a complete recovery.

Our medical center uses both conservative methods, that is, aimed at treating endometriosis with the help of a course of drugs, and surgical methods that allow us to achieve good results even in the most severe and advanced cases.

A strictly individual treatment plan is drawn up for each patient.

Treatment tactics for endometriosis should take into account:

• patient's age;
• presence of children;
• fertility;
• combination with inflammatory processes;
• spread of pathology;
• severity of the course;
• the need to preserve reproductive function.

In young women, preference is given to conservative treatment. This allows you to preserve and restore reproductive function. The main component of this method is hormone therapy. Advanced treatment regimens and the use of only modern drugs with a low level of side effects allow you to achieve good results without putting a strain on the body.

Surgeries to remove endometriosis can be performed with preservation of the reproductive organ or with its removal. Removal of the uterus or ovary affected by endometriosis is used when therapeutic treatment is ineffective and in severe stages of the disease. Most often, removal is performed in women over 40 years of age.

Types of treatment

• 01.

  Treatment of endometriosis with laser drilling

  Treatment of endometriosis with laser drilling is carried out with a special laser, the effect of which on the walls of the uterus is controlled using laparoscopy. Special channels are created in the uterine wall that block the spread of endometriosis, preventing the development of the disease. This treatment not only preserves the uterus, but also restores reproductive function. The holmium laser appeared at the end of the twentieth century. Its testing in practical surgery has shown high efficiency. It is able to cut through hard and soft tissues, leaving virtually no scars after healing.

• 02.

  UAE for the treatment of nodular endometriosis

  Uterine artery embolization (UAE) is used for the nodular form of the disease. In this method of treating endometriosis, an embolic drug is injected into the uterine arteries that feed the node. In other words, they are blocked. The entire treatment process is controlled by x-rays. This deprives the adenomyotic nodes of nutrition, causing them to shrink and disappear. Treatment of endometriosis takes about 60 minutes under local anesthesia. A hospital stay will be required for 24 hours.

• 03.

  Removal of endometriosis lesions using laparoscopic method

  The purpose of laparoscopic surgery is to remove foci of endometriosis. For this purpose, laser energy is used: a special device is inserted into a small incision in the abdominal wall, which literally evaporates foci of endometriosis.

  When working with neighboring organs, urologists are involved, who, together with surgeons, free the bladder and intestines from endometriosis.

  Advantages of the method:

  • low invasiveness - incision length up to 1 cm;
  • absence of severe postoperative pain;
  • There are practically no postoperative scars;
  • semi-bed rest is several hours;
  • rapid recovery of the body;
  • minor blood loss.

Complications of endometriosis

If left untreated, endometriosis can cause a number of complications.

• The main complication is infertility. It occurs in 25-40% of patients with endometriosis.
• Significant regular blood loss leads to the development of posthemorrhagic anemia. This disease often provokes heavy bleeding during menstruation.
• Adhesive processes develop in the pelvis and abdominal cavity. Cysts form on the ovaries.
• Significant neurological complications of endometriosis occur. This occurs due to compression of the nerve trunks by the tumors, which causes severe pain.
• If left untreated, endometrioid tissue can eventually degenerate into a malignant formation.

Prevention of endometriosis

Prevention for endometriosis comes down to a routine gynecological examination. Most often, the disease is detected when patients complain of problems with conception.

A thorough examination to prevent endometriosis should be carried out:

• after operations.

Prevention of endometriosis involves timely treatment of inflammatory diseases. At the same time, chronic inflammation of the reproductive system should not be overlooked.

• avoid overwork;
• do not be nervous;
• do not use tampons as a permanent hygiene product during menstruation;
• avoid the use of intrauterine contraceptives;
• normalize the daily routine;
• sleep at least 8-9 hours at night;
• do not bear weight, especially during menstruation;
• abstain from sexual intercourse during menstruation;
• engage in gentle physical training;
• no smoking.

Tampons are quite convenient in terms of hygiene, but they can contribute to the development of endometriosis due to the fact that they do not allow blood to freely exit the body through the vagina. Blood with the endometrium can flow back into the uterus, and from it to other organs.

Prevention in the presence of symptoms of endometriosis - immediate contact with a specialist.

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Zhumanova Ekaterina Nikolaevna

Head of the Center for Gynecology, Reproductive and Aesthetic Medicine, Candidate of Medical Sciences, doctor of the highest category, Associate Professor of the Department of Regenerative Medicine and Biomedical Technologies of Moscow State Medical University named after A.I. Evdokimova, board member of the Association of Aesthetic Gynecologists ASEG.

• Graduated from the Moscow Medical Academy named after I.M. Sechenova, has a diploma with honors, completed clinical residency at the Clinic of Obstetrics and Gynecology named after. V.F. Snegirev MMA named after. THEM. Sechenov.
• Until 2009, she worked at the Clinic of Obstetrics and Gynecology as an assistant at the Department of Obstetrics and Gynecology No. 1 of the MMA named after. THEM. Sechenov.
• From 2009 to 2017 she worked at the Federal State Institution “Treatment and Rehabilitation Center” of the Ministry of Health of the Russian Federation
• Since 2017, he has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine of Medsi Group of Companies JSC.
• She defended her dissertation for the degree of Candidate of Medical Sciences on the topic: “Opportunistic bacterial infections and pregnancy”

Myshenkova Svetlana Aleksandrovna

Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category

• In 2001 she graduated from the Moscow State Medical and Dental University (MGMSU)
• In 2003, she completed a course of study in the specialty “obstetrics and gynecology” at the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences
• He has a certificate in endoscopic surgery, a certificate in ultrasound diagnostics of pathologies of pregnancy, fetus, newborn, in ultrasound diagnostics in gynecology, a certificate of a specialist in the field of laser medicine. He successfully applies all the knowledge acquired during theoretical classes in his daily practice.
• She has published more than 40 works on the treatment of uterine fibroids, including in the journals “Medical Bulletin” and “Problems of Reproduction”. He is a co-author of methodological recommendations for students and doctors.

Kolgaeva Dagmara Isaevna

Head of pelvic floor surgery. Member of the scientific committee of the association for aesthetic gynecology.

• Graduated from the First Moscow State Medical University named after. THEM. Sechenov, has a diploma with honors
• She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov
• Has certificates: obstetrician-gynecologist, specialist in laser medicine, specialist in intimate contouring
• The dissertation is devoted to the surgical treatment of genital prolapse complicated by enterocele
• The sphere of practical interests of Dagmara Isaevna Kolgaeva includes:
  conservative and surgical methods of treating prolapse of the walls of the vagina, uterus, urinary incontinence, including the use of high-tech modern laser equipment

Maksimov Artem Igorevich

Obstetrician-gynecologist of the highest category

• Graduated from Ryazan State Medical University named after academician I.P. Pavlova with a degree in general medicine
• Completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology Clinic named after. V.F. Snegirev MMA named after. THEM. Sechenov
• Proficient in a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access
• The scope of practical interests includes: laparoscopic minimally invasive surgical interventions, including single-puncture access; laparoscopic operations for uterine fibroids (myomectomy, hysterectomy), adenomyosis, widespread infiltrative endometriosis

Pritula Irina Alexandrovna

Obstetrician-gynecologist

• Graduated from the First Moscow State Medical University named after. THEM. Sechenov.
• She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• She is certified as an obstetrician-gynecologist.
• Possesses the skills of surgical treatment of gynecological diseases on an outpatient basis.
• He is a regular participant in scientific and practical conferences on obstetrics and gynecology.
• The scope of practical skills includes minimally invasive surgery (hysteroscopy, laser polypectomy, hysteroresectoscopy) - Diagnosis and treatment of intrauterine pathology, cervical pathology

Muravlev Alexey Ivanovich

Obstetrician-gynecologist, gynecological oncologist

• In 2013 he graduated from the First Moscow State Medical University named after. THEM. Sechenov.
• From 2013 to 2015, he completed clinical residency in the specialty “Obstetrics and Gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University named after. THEM. Sechenov.
• In 2016, he underwent professional retraining at the State Budgetary Institution of Healthcare of the Moscow Region MONIKI named after. M.F. Vladimirsky, specializing in Oncology.
• From 2015 to 2017, he worked at the Federal State Institution “Treatment and Rehabilitation Center” of the Ministry of Health of the Russian Federation.
• Since 2017, he has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine of Medsi Group of Companies JSC.

Mishukova Elena Igorevna

Obstetrician-gynecologist

• Doctor Mishukova Elena Igorevna graduated with honors from the Chita State Medical Academy with a degree in general medicine. She completed clinical internship and residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• Mishukova Elena Igorevna has a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingoophoritis, etc.
• Mishukova Elena Igorevna is an annual participant in Russian and international congresses and scientific and practical conferences on obstetrics and gynecology.

Rumyantseva Yana Sergeevna

Obstetrician-gynecologist of the first qualification category.

• Graduated from the Moscow Medical Academy named after. THEM. Sechenov with a degree in general medicine. She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University named after. THEM. Sechenov.
• The dissertation is devoted to the topic of organ-preserving treatment of adenomyosis using FUS ablation. He has a certificate as an obstetrician-gynecologist and a certificate in ultrasound diagnostics. Proficient in the full range of surgical interventions in gynecology: laparoscopic, open and vaginal approaches. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingoophoritis, etc.
• Author of a number of published works, co-author of a methodological guide for doctors on organ-preserving treatment of adenomyosis using FUS ablation. Participant of scientific and practical conferences on obstetrics and gynecology.

Gushchina Marina Yurievna

Gynecologist-endocrinologist, head of outpatient care. Obstetrician-gynecologist, reproductive specialist. Ultrasound diagnostics doctor.

• Gushchina Marina Yurievna graduated from Saratov State Medical University. V.I. Razumovsky, has a diploma with honors. She was awarded a diploma from the Saratov Regional Duma for excellent achievements in studies and scientific activities, recognized as the best graduate of Saratov State Medical University named after. V. I. Razumovsky.
• She completed a clinical internship in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• He is certified as an obstetrician-gynecologist; ultrasound diagnostics doctor, specialist in laser medicine, colposcopy, endocrinological gynecology. She has repeatedly completed advanced training courses in “Reproductive Medicine and Surgery” and “Ultrasonic Diagnostics in Obstetrics and Gynecology.”
• The dissertation work is devoted to new approaches to differential diagnosis and management tactics for patients with chronic cervicitis and early stages of HPV-associated diseases.
• Proficient in the full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, hysterosalpingography) and in a hospital setting (hysteroscopy, cervical biopsy, cervical conization, etc.)
• Gushchina Marina Yuryevna has more than 20 scientific published works, is a regular participant in scientific and practical conferences, congresses and conventions on obstetrics and gynecology.

Malysheva Yana Romanovna

Obstetrician-gynecologist, gynecologist for children and adolescents

• Graduated from the Russian National Research Medical University. N.I. Pirogov, has a diploma with honors. She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the Faculty of Medicine of the First Moscow State Medical University. THEM. Sechenov.
Graduated from the Moscow Medical Academy named after. THEM. Sechenov with a degree in general medicine
• She completed clinical residency in the specialty “Ultrasound Diagnostics” at the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky
• Has a Certificate from the FMF Fetal Medicine Foundation confirming compliance with international requirements for 1st trimester screening, 2018. (FMF)

Proficient in ultrasound examination techniques:

• Abdominal organs
• Kidney, retroperitoneum
• Bladder
• Thyroid gland
• Mammary glands
• Soft tissues and lymph nodes
• Pelvic organs in women
• Pelvic organs in men
• Vessels of the upper and lower extremities
• Vessels of the brachiocephalic trunk
• In the 1st, 2nd, 3rd trimester of pregnancy with Doppler ultrasound, including 3D and 4D ultrasound

Kruglova Victoria Petrovna

Obstetrician-gynecologist, gynecologist for children and adolescents.

• Victoria Petrovna Kruglova graduated from the Federal State Autonomous Educational Institution of Higher Education "Russian Peoples' Friendship University" (RUDN).
• She completed clinical residency in the specialty “Obstetrics and Gynecology” on the basis of the department of the Federal State Budgetary Educational Institution of Additional Professional Education “Institute for Advanced Training of the Federal Medical and Biological Agency.”
• He has certificates: obstetrician-gynecologist, specialist in the field of colposcopy, non-operative and operative gynecology of children and adolescents.

Baranovskaya Yulia Petrovna

Ultrasound diagnostics doctor, obstetrician-gynecologist, candidate of medical sciences

• Graduated from the Ivanovo State Medical Academy with a degree in general medicine.
• She completed an internship at the Ivanovo State Medical Academy, a clinical residency at the Ivanovo Research Institute named after. V.N. Gorodkova.
• In 2013, she defended her thesis on the topic “Clinical and immunological factors in the formation of placental insufficiency” and was awarded the academic degree “Candidate of Medical Sciences.”
• Author of 8 articles
• Has certificates: ultrasound diagnostics doctor, obstetrician-gynecologist.

Nosaeva Inna Vladimirovna

Obstetrician-gynecologist

• Graduated from Saratov State Medical University named after V.I. Razumovsky
• Completed an internship at the Tambov Regional Clinical Hospital, specializing in obstetrics and gynecology.
• He is certified as an obstetrician-gynecologist; ultrasound diagnostics doctor; specialist in the field of colposcopy and treatment of cervical pathology, endocrinological gynecology.
• Repeatedly took advanced training courses in the specialty “obstetrics and gynecology”, “Ultrasonic diagnostics in obstetrics and gynecology”, “Fundamentals of endoscopy in gynecology”
• Proficient in the full range of surgical interventions on the pelvic organs, performed by laparotomy, laparoscopic and vaginal approaches.

» Contacts

Where to treat endometriosis?

Swiss gynecology clinic in Moscow

Endometriosis.ru – website

Created by the world's leading surgeons in the traditions of Western European medicine. The clinic’s specialists collaborate with leading doctors from France, Switzerland and Germany.

The Swiss clinic in Moscow employs highly qualified professional doctors. Approximately one hundred types of operations are developed by the clinic’s specialists. Some types of surgical gynecological treatment in the country are performed only in this clinic. In addition, the clinic staff performed a number of operations for the first time in Russia.

The clinic guarantees high quality, strict adherence to medical technologies, compliance with Russian and European legislation in the field of patient health. Every year, about 1,500 unique surgical interventions are performed here at the highest level, the technique of which is selected individually for each patient.

The Swiss clinic in Moscow provides medical consultations, surgical and conservative treatment for various gynecological diseases.

• uterine fibroids and multiple myomatosis
• external endometriosis - damage to the abdominal and pelvic organs, peritoneum
• internal endometriosis of the uterine body (adenomyosis)
• office hysteroscopy, surgical hysteroscopy and hysteroresectoscopy.
• diseases of the cervix (leukoplakia, dysplasia, cysts, etc.)
• intrauterine pathology (polyps and endometrial hyperplasia, submucous fibroids, intrauterine septum, synechiae, etc.)
• ovarian diseases (cysts, polycystic disease, tumors)
• female infertility (adhesions, scleropolycystic disease, etc.)
• pathology of the fallopian tubes (adhesions, hydrosalpinx, ectopic pregnancy, etc.)
• oncological diseases in gynecology (cancer of the uterus and ovaries)
• prolapse and prolapse of the internal genital organs
• surgical treatment of stress urinary incontinence
• intimate plastic surgery

Swiss gynecology clinic in Moscow offers its patients all diagnostic capabilities such as video colposcopy, hysteroscopy, diagnostic mini-laparoscopy, ultrasonography, biopsy followed by cytological and histological examination, laboratory tests.

Thanks to the latest technologies, they provide effective comprehensive treatment of gynecological diseases, trying as much as possible to ensure minimal trauma and preservation of organs during operations. For example, when removing a cyst of the largest size, clinic doctors strive to preserve healthy ovarian tissue; when treating endometriosis, maximum work is done to preserve a woman’s reproductive function; and when removing fibroids, there is a struggle to preserve the uterus.