RU2104685C1 - Method of removing ovarian cysts by conservative way - Google Patents

Abstract

FIELD: gynecology. SUBSTANCE: method consists in affecting sites used in Chzhen-Tszu therapy and vaginal vault by way of applying leeches in amount 6 to 50 in one time, number of daily treatment seances being from 31 to 150. EFFECT: avoided surgical intervention. 4 cl

Description

 The invention relates to healthcare, medicine, specifically to gynecology.

 A known method of removing ovarian cysts in an operative way (Shukurova SB, abstract of Candidate's dissertation., M., 1970; Linnik A.B.Problem of endocrinology and hormone therapy, 1965, 2, pp. 46-49; Mitrokhina M .V., In the book: Modern approaches to the diagnosis and treatment of ovarian tumors, L., 1981; Nechaeva ND, Treatment of ovarian tumors, L., 1972).

These methods are widely used in modern medical practice. However, these methods have a number of significant disadvantages:
1. Surgery;
2. The contents of the cyst in the abdominal cavity;
3. Injuries to the bladder, ureters, intestines, leading to peritonitis, followed by inflammation of the uterus and appendages.

4. The development of life-threatening complications (bleeding);
5. Post-castration syndrome and other complications.

 The use of hormonal drugs and radiation is known only in the treatment of experimentally induced cysts in a model of laboratory animals - rats (Ird E. A. Follicular ovarian cysts and dishormonal tumors. - L .: Medicine, 1966).

 Closest to the claimed method is a method for the rapid removal of cysts. To this end, surgical treatment of cysts is performed.

 Technique of operation. The patient is laid on the table in a supine position. Epidural anesthesia. Depending on the size of the cyst, the choice often falls on median laparatomy. The pelvic organs are revised, the uterus is fixed, the cyst is removed from the wound, avoiding the rupture of its walls. The cyst is cut off, the cyst stump is sutured, the abdominal organs are re-examined, the toilet of the abdominal cavity. The abdominal wall is sutured in layers tightly. Aseptic dressing.

 The described operation technique is classical, which is quite rare in practice. The disadvantage of this method are all of the above complications.

 The aim of the invention is the removal of ovarian cysts conservatively. This goal is achieved by the fact that in the proposed method, hirudotherapy is carried out as follows.

1. The number of sessions is from 31 to 150 continuously, daily;
2. The number of leeches in a hirudotherapy session is from 6 to 50 individuals;
3. Leeches are placed on the arches of the vagina and on the points of Hoy-Yin V C1; Jun Tzu V C3; guan-yuan V C4; cu-gu V C2; shen-qiu V C8;
4. At the point of qu-gu V C2; Jun-jiu V C3; guan-yuan V C4 leeches put in their natural habitat;
5. Stimulation of leeches is carried out with a solution of wine vinegar in a concentration of 2-4 g / l at 20-25 ^o With an ionized solution of lidase (32-64 PIECES per 1.0 l of water) at the same temperature. Ionization is carried out by passing through an solution of alternating current with a frequency of 25 Hz, a current value of 500 mA for 20 minutes For a better understanding of the invention we give specific examples of removal of ovarian cysts of the proposed method.

 Example 1. K.P.V., born in 1962 Diagnosis: ovarian cyst on the right, polycystosis of both ovaries, endometrial hyperplasia, primary infertility, multiple fibroadenomatosis of both mammary glands, adhesive process in the small pelvis. Complaints: persistent pain in the lower abdomen since 1984, infertility.

 Anamnesis of the disease: in July 1984 he was diagnosed with an ovarian cyst on the left, was treated inpatiently in the hospital "In" memory of October 25th, in February 1985 he received repeated conservative treatment, and in March 1985 he was again treated in maternity hospital N 8 St. St. Petersburg, where the patient underwent hysterosalcography and a cyst on the left leg was determined. In May 1985, surgery - removal of the cyst on the left and resection of the right ovary. One week after the operation, an increase in the ovary on the right was detected. In May 1986, diagnostic laparoscopy was performed - ovarian cyst on the right. In July 1986, about Oration - hatching of an ovarian cyst on the right. In 1986-87, she underwent several hydrotubation courses on an outpatient basis and in a hospital. In 1987, the Otto Institute of Obstetrics and Gynecology in St. Petersburg was diagnosed with adhesions, Adnexitis ridge, primary infertility From 1987 to 1991, she received several courses of anti-inflammatory treatment on an outpatient basis and was also treated in a homeopathic clinic.In December 1990, she was diagnosed with multiple fibroadenomatosis of the mammary glands. In February 1991, the diagnosis was made: recurrent ovarian cyst on the left, endometrial hyperplasia. Ultrasound from 03.03.91: ovarian cyst on the right. Referred to an oncogynecologist. Ultrasound from 12.20.91: the uterus is 5.1 x 3.6 x 5.2 cm, the endometrium is 1.4 cm, the right ovary cannot be determined, the cyst with clear contours of 5.5 x 5.0 cm is on the left.

 Anamnesis of life: mental illness, tuberculosis, denied. Heredity is not burdened.

 Gynecological history: menstruation from 14 years old, regular, for 3-4 days, lives sexually from the age of 21. After the onset of sexual activity, menstruation has become rare and painful. In the anamnesis - Trichomonas colpitis. After 0.5 years from the onset of sexual activity, the above pathology began on the part of the female genital organs.

 Vaginal examination from 12.23.91

 The neck is conical in shape. Purulent discharge. The uterus is rejected posteriorly, painful, of normal size. The areas of the appendages are sharply painful, infiltrates on both sides, motionless. The back arch is painful.

For help turned 23.12.91 to the authors of the invention. The patient received treatment according to the following scheme:
- number of sessions - 110, daily;
- the number of leeches in a hirudotherapy session ranged from 6 to 40; - leeches were placed on the vaginal vaults and on the hoy-yin points V C1; cu-gu V C2; shen-qiu V C8; V C3 Junzi; V C4 guanyuan;
- to the point: V C2 Qu-gu, V C3 Jun-Chiu, V C4 Guanyuan leeches put "in their" natural habitat;
- leeches were stimulated with a solution of wine vinegar at a concentration of 2-4 g / l at 20-25 ^° C or with an ionized solution of lidase (32-64 units per 1 liter of water) at the same temperature.

In the process of treatment, body temperature rose to 40 ^o With the first 1.5 months of treatment, and lasted a total of 25 days. The treatment was accompanied by significant pain in the lower abdomen, in the lower back with irradiation to the front of the thighs. Sharp pains in the indicated areas as pelvic peritonitis were noted during the first two months of treatment, and they lasted a total of 17 days. Since March 1992, in addition to purulent discharge from the vagina, odorless liquid periodically began to pour out, cloudy or pinkish in an amount of 20 to 70 ml. Since that time I felt lightness in my stomach. Ultrasound from 04/17/92: the uterus is not enlarged, the size of the left ovary is 3.9 x 3.0 cm, the size of the right ovary is 2.7 x 2.3 cm, the structure is not broken, the endometrium is 0.7 cm.

 Since March 1992, menstruation has become painless, regular. Since April 1992, pain in the lower abdomen, lumbar region ceased. The patient did not live sex during treatment. The treatment is completed. Ultrasound from 10.29.92 (control): the uterus is not enlarged, the endometrium is not expanded, the contours are even, the left appendages are 1.4 x 2.0 cm, the right ones are 1.9 x 2.3 cm, echogenicity is usual.

 10.24.92 the patient was examined by a surgeon, pathology in the mammary glands was not found, when examined by an oncologist on 10.26.92, the diagnosis is the same.

 At present (January 1993), the patient's condition is satisfactory, there are no complaints, there are no pathologies from the female genital organs.

 Example 2. L.N.A., born in 1965

 Diagnosis: chronic adnexitis, ovarian cyst on the right, primary infertility. Complaints: periodic pains in the lower abdomen.

 Anamnesis of the disease: suffers from chronic inflammation of the appendages since 1988. Was treated in a hospital and on an outpatient basis. Ultrasound from 07/17/90: the size of the uterus is vertical 3.0 cm; transverse 5.0 cm; anteroposterior 2.7 cm. The right ovary is 3.7 x 2.6 cm, the left ovary is 4.0 x 2.3 cm.

 Regarding chronic adnexitis, primary infertility is registered in a antenatal clinic. A gynecologist is periodically examined.

 03/26/92, an ultrasound scan revealed an ovarian cyst on the right about 8.0 cm.

 Ultrasound from 03/26/92: uterus 5.8 x 3.8 x 3.9 cm. Endometrium 1.3 cm. Left appendages are not visualized. An anterior echogenic formation with smooth contours is visualized anteriorly and to the right of the uterus. The internal structure is heterogeneous, with multiple dense partitions and fluid inclusions. Education dimensions: 7.7 x 7.2 cm. Conclusion: cyst of the right ovary. The patient is directed to surgery.

 Anamnesis of life: mental illness, tuberculosis denies. Heredity is not burdened.

 Gynecological history: monthly from 13 years old, regular, after 21 days, 4-5 days. He has been living sexually since 22 years. Suffers from chronic adnexitis since 24 years. Since that time, Trichomonas has been found in the smear.

 Vaginal examination: the vagina is free, the neck is conical in shape. The mucous discharge is moderate. The uterus is slightly reduced in size, painless. On the left, the area of the appendages is painful, on the right in the area of the appendages, the formation of a rounded shape about 8 cm is palpable, painful, mobile.

For help to the authors of the invention, the patient turned 8.09.92. The patient received treatment according to the following scheme:
- the number of sessions 31, daily;
- the number of leeches in the session from 6 to 22;
- leeches were placed on the vaginal vaults and on the hoy-yin points V C1; cu-gu V C2; Jun Tzu V C3.

From September 14, 1992, the temperature began to rise to 37.5 ^° C. From September 16, 1992, the patient's condition worsened sharply: the temperature remained the same, weakness, dizziness appeared. Clinical blood test: HB - 75.0 g / l, ROE - 49 mm / h. The treatment is ongoing. Clinical blood test from 09/21/92: HB - 102 g / l, ESR - 25 mm / h. The patient's condition has improved significantly, from the same time there is a discharge of fluid from the vagina pink or colorless from 20 to 50 ml. 6.10.92 the release of fluid stopped.

 Ultrasound from 10.10.92: the uterus is usually 4.8x2.5x2.2 cm, the contour of the uterus is even, the structure is homogeneous. The median structure is 8 mm. The right ovary is 3.0x2.2 cm, the left ovary is 3.0x2.0 cm. In the structure of the ovaries around the periphery are single small cystic shadows with a diameter of up to 4-5 mm.

 Conclusion: smallcystic ovarian change.

 The last menstruation began on 09/11/92, the next were supposed to start on 2/10/92, but did not come. Indirect signs of pregnancy appeared: nausea, swelling of the mammary glands.

 After an ultrasound scan dated 10.10.92, the diagnosis of an ovarian cyst on the right was made by a gynecologist at the women's consultation at the patient’s place of residence.

 Example 3. R.S.V., born in 1961

 Diagnosis: chronic adnexitis, follicular ovarian cyst on the left. Complaints: pain in the lower abdomen and in the lumbar region.

 Anamnesis of the disease: suffers from chronic adnexitis for 1.5 years, was treated in a hospital and outpatient in Germany in a hospital. In March 1992, a miscarriage occurred within a period of 6 weeks, and the uterine cavity was scraped. Since May 1992 lives in St. Petersburg. On 20.06.92 an ultrasound scan was performed, where an ovarian cyst was found on the left, the patient was referred for surgical treatment.

 Ultrasound from 06/20/92 (N 678): the uterus in the center, dimensions - 4.2x4.0x5.3 cm, the endometrium in the form of a thin linear echo signal with a thin hypoechoic zone around. On the left is the ovary with a follicular cyst (smooth-walled formation with a thin capsule with a diameter of 4.2 cm, the liquid is clear). To the right is an ovary with a diameter of 2.2 cm with a hyperzone, a cystic change in the ovary is not excluded.

 Anamnesis of life: in childhood, whooping cough, chicken pox. Mental illness, tuberculosis denies. Heredity is not burdened, but her husband has pulmonary tuberculosis of 18 years, at this time removed from the dispensary.

 Gynecological history: monthly from 15 years old, regular, after 30 days for 3-4 days. He has been living sexually since 17 years.

 Vaginal examination: the vagina is free, the neck is cylindrical in shape, erosion is the size of a two-copeck coin. The discharge is mucopurulent, odorless. The uterus is mobile, painless, deflected anteriorly. In the field of appendages, infiltration. Closer to the corners of the uterus, soreness, more to the left. The vaults are free.

For help to the inventors turned 27.06.92. The patient received treatment according to the following scheme:
- the number of sessions 120, daily;
- the number of leeches in the session from 6 to 50;
- leeches were placed on the posterior vaginal fornix and on the points: shen-tsiu V С8; hoy-yin V C1;
- stimulation of leeches was carried out by an ionized solution of lidase (32-64 units per 1 liter of water) at 20-25 ^o C.

From the first day of treatment I began to feel strong pulling pains in the lower abdomen. From July 16, 1992, the temperature began to rise to 37.6 ^o C, and for a month kept at subfebrile level. 08.21.92 leakage of fluid from the vagina began. Liquid from colorless to pink in an amount of from 20 to 50 ml, fluid leakage continued intermittently until 09/20/92.

 Ultrasound from 7.09.92 (N 2496): the uterus is medium in size, the contours are even and clear, the structure is without features, the endometrium is weakly expressed. Ovaries on the right and left without clear contours, in structure without features. In the projection of both appendages between the tubular corners of the uterus by the ovaries, formations up to 1-1.5 cm in size, of irregular shape (hydrosalpinx ?, small cystic changes in the ovaries ?, endometrioid heterotopias?) Are determined. Behind the posterior wall of the uterus in the isthmic section, a hypoechoic formation of 1.2 x 0.8 cm is determined (posterior cervical endometriosis?). The treatment continued.

 Ultrasound from 6.10.92: the uterus is of a homogeneous structure, the contour is even 4.6 x 3.7 x 4.1 cm, the left ovary is 3.2 x 2.3 cm, cystically changed, the right ovary is 2.9 x 1.6 cm, the structure is normal.

 The diagnosis of "ovarian cyst" was made by a gynecologist at the women's consultation at the place of residence.

 Ultrasound from 5.12.92 (control): the uterus is usually located, not enlarged, the structure is homogeneous. The right ovary is 2.3x2.4 cm, hypoechoic, the left ovary is enlarged 3.3x2.5 cm, small cystic.

 Example 4.L.K.R., born in 1959

 Diagnosis: ovarian cysts on both sides, chronic adnexitis, adhesions in the pelvis, primary infertility. Complaints: pain, heaviness in the lower abdomen and lower back, pain in the inguinal regions, bloating, increased gas, frequent urge to stool, complaints of postoperative fistula in the navel with purulent discharge.

 Anamnesis of the disease: suffers from chronic adnexitis since 1989. On March 6, 2011, an operation was performed for chronic salpingoophoritis of the left-sided sactosalpinx. Parovarial cyst on the left. Operation: tubectomy on the left. Histology: lymphoid infiltrates in the tube wall. Papillary serous cystoma. She underwent several courses of anti-inflammatory treatment on an outpatient basis. It was treated from 04/20. on 05/19/90 in the clinic of the Sanitary-Hygienic Medical Institute about postoperative pelvic infiltrate.

 Ultrasound from 05/04/91: the uterus with smooth contours, the usual sizes of 6.5x3.0x4.8 cm, the endometrium is developed. The right ovary is enlarged (4.1 × 3.1 cm), cystically altered. To the left of the uterus is a formation containing liquid, of a rounded elongated shape, multi-chamber, thin-walled, measuring 7.2 x 3.8 x 4.8 cm (a cyst without an endophytic component). Confirmation of this diagnosis is an ultrasound scan from 8.05.91.

 Ultrasound from 09/18/91: the uterus-body is 4.7x4.5x5.1 cm, deflected posteriorly, bent, the ovary on the right 3.4x3.3x3.1 cm, enlarged, filled with fluid; enlarged on the left 3.5x3.4x3.6 cm, filled with liquid. The glandular tissue of both ovaries is displaced in the form of a crescent to the periphery.

 Conclusion: cyst of the left ovary.

 Before contacting the authors of the invention about this disease in 1991, the patient was not treated anywhere.

 In April 1992, she turned to a local therapist for chest pain, cough, fever. Radiograph N 27 of 04/20/92, N 35 of 05/20/92: a draining inflammatory infiltration is determined on the right in the root projection in the sixth segment, otherwise without pathology.

 I received medication from a local therapist about a change in the lungs. In August 1992, similar complaints reappeared (as in April), she turned to the local GP. The x-ray from 08/19/92 is similar to the two previous ones (N 27 and N 35).

 X-ray from 12/23/92, No. 163 (performed after hirudotherapy): the infiltration in the sixth segment on the right resolved completely, there was an increase in vascular pattern at the root, otherwise without pathology.

 Anamnesis of life: a patient in childhood has pulmonary tuberculosis, has been treated for 7 years, after treatment has been deregistered, she has been to children's sanatoriums in Sochi and Anapa many times. After that, she was registered for chronic pneumonia up to the present time.

 In 1980 - appendectomy. Since 1981, chronic gastritis, heredity is not burdened.

 Gynecological history: monthly from 13 years old, regular, after 28 days for 4 days. He has been sexually active since he was 25 years old.

 Vaginal examination of July 8, 1992: the vagina is free, erosion on the neck with a two-copeck coin, discharge purulent, moderate, odorless. The uterus is mobile, painful, increased to 6-7 weeks, of a dense consistency, tuberous. Painful cords, very dense, up to 3-4 cm, extend from the corners of the uterus. The arches are painful, in the lateral arches are dense tuberous seals, inactive.

For help to the authors of the invention, the patient turned 8.07.92. The patient received treatment according to the following scheme:
- the number of sessions 150, daily;
- the number of leeches in the session from 6 to 50;
- leeches were placed on the posterior vaginal fornix and on the hoy-yin points V C1; cu-gu V C2; guan-yuan V C4; Shen-Qiu V C8.

From 17.07.92 a chill appeared, the temperature rose to 38 ^o C and continued periodically for the next 2 months. From the same day, pain in the lower back and lower abdomen intensified, which lasted until the end of September 1992. Often, pain in the lower abdomen was accompanied by symptoms of pelvic peritonitis. On July 18, 1992, a fistula opened in the umbilical region; before the fistula opened, a dense infiltrate of 5.0x4.0x2.5 cm in size was palpated in the umbilical region. By the end of treatment, the infiltrate disappeared, the fistula closed. From 5.08.92, the patient began to leak fluid from the vagina. The liquid is colorless to pink in an amount of 30 to 80 ml. The leakage of liquid continued intermittently until 10/20/92.

 Ultrasound from 10.30.92: the uterus in retroflexio version with clear, even, contours, sizes 5.0 x 3.3 x 4.5 cm. Endometrium, day 19 of the cycle, the structure is homogeneous. Left ovary: 3.0 x 2.2 cm contours are even, the structure is homogeneous. Right ovary: 3.9x3.0 cm (enlarged), the contours are even, in the ovary there are multiple anechogenic masses in the diameter of 0.4-0.6 cm.

 Conclusion: cystic change in the right ovary.

 The patient continues treatment for polycystic right ovary.

 Example 5. Sh.V.V., born in 1963

 Diagnosis: chronic adnexitis, adhesions in the pelvis, secondary infertility, ovarian cyst on the right. Complaints: pain during menstruation, a feeling of heaviness in the lower abdomen.

 Anamnesis of the disease: at the age of 18, she underwent a criminal abortion, after which there were pains in the lower abdomen, after 2 years with these pains she got to the gynecological department of the Kuibyshev hospital, where an operation was performed on the formation on the right, the right ovary was resected. There he was diagnosed with Stein-Leventhal syndrome. Until February 1992, she continued to be treated on an outpatient basis for adnexitis.

 Ultrasound from 01/17/92: the uterus is in the correct position, slightly deflected to the left, dimensions are 6.7x4.3x5.8 cm, the neck is 3.3 cm long, the endometrium is developed to 9.7 cm, proliferative, uniformly uniform. Myometrium without visible changes. The left ovary is closely adjacent to the uterus of 3.7 x 2.4 x 3.7 cm with a cystic inclusion in diameter of 1.3 cm (corpus luteum?), Stroma of normal density, the capsule is not expressed. The right ovary is right behind the uterus, the dough is adjacent to the uterus 5.5x4.0x4.2 cm, with several cystic inclusions, the largest in diameter is 2.3 cm, contours are even with homogeneous semi-liquid contents (regressing cystic corpus luteum?). Stroma normal density, the capsule is not expressed. Parametries are not compacted. Diagnosis: ovarian cyst on the right.

 Anamnesis of life: mental illness, tuberculosis denies. The mother has a breast tumor that died from colorectal cancer. Uncle bladder cancer, died of cancer. Since February 1991, the patient was diagnosed with fibroadenomatosis of the right breast.

 Gynecological history: monthly from 13 years old, regular, after 30 days for 2-3 days. He has been living sexually since he was 18 years old. Criminal abortion in the period of 5 months of pregnancy at the age of 18 years. At age 25, curettage of the uterine cavity due to heavy bleeding. In 1991 - curettage of the uterine cavity due to spontaneous miscarriage in the period of 7 weeks.

 Vaginal examination (5.09.92): the vagina is free, the neck is clean, normal consistency, the discharge is light, normal consistency, odorless. The uterus is mobile, painless, of normal size, on the right in the area of the appendages closer to the corner of the uterus, it is palpated by the formation of a little more than a walnut, painful, slightly mobile. On the left in the area of the appendages, infiltration, soreness, vaults are free.

For help to the authors of the invention, the patient turned 5.09.92. The patient received treatment according to the scheme:
- the number of sessions 95, daily;
- the number of leeches in the session from 8 to 25;
- leeches were placed on the posterior vaginal fornix and on the hoy-yin points V C1; Jun Tzu V C3; guan-yuan V C4; cu-gu V C2; Shen-Qiu V C8.

From 12.09.92, the temperature began to rise from 37 to 38 ^o C, lasted 8 days. Pain appeared in the lower abdomen, the pain lasted for 2.5 months, periodically for several days were very strong.

 In November 1992, there were indirect signs of pregnancy, a delay in menstruation for a week. Vaginal examination (of the author): the vagina is free, the neck is of a mild consistency, the uterus is slightly enlarged (3-4 weeks of pregnancy), the texture is mild. In front of the uterus and on the right, a formation the size of a male fist is palpated, slightly dense, painful. Left area of the appendages without features.

 5 days after the examination and continued treatment, leakage of pink liquid in the amount of approximately 50 ml per day began. 11/20/92 (2 days after the start of leakage), heavy spotting began, which suddenly ended 2 days later, indirect signs of pregnancy disappeared. Vaginal examination (of the author) 11.29.92: the vagina is free, the cervix is of normal consistency, the uterus is mobile, painless, of normal size, consistency. The areas of the appendages to the right and left without features. Education on the right is not palpable.

 Ultrasound from 10.12.92 (N 133): the uterus is 6.2 x 8.0 x 3.9 cm, the contours are not broken, the structure is homogeneous, the median echo is not expanded. The endometrium is not thickened (0.4 cm). The uterus is moderately shifted to the right. Appendages: the right - 3.9 x 3.3 cm, the left - 3.3 x 2.4 cm, the right - is pulled up to the uterus, the contour of the appendages is not broken. The echostructure is not changed. Conclusion: ultrasound signs of adhesions in the parametric tissue.

 Continues treatment for adhesions in parametria.

 The next periods were in December - the 22nd of 1992, normal.

 As follows from the listed examples, the treatment regimen used by the authors gives a complete cure. In total, about 100 people were cured of patients with ovarian cysts.

 It should be especially emphasized that during treatment, patients are recommended to drink plenty of fluids, a diet enriched with animal proteins, carbohydrates, vitamins and minerals.

 In some cases, it is necessary to take iron preparations.

Claims (4)

 1. A method of removing ovarian cysts, characterized in that the effect is carried out by setting leeches on the vaginal arches and on the points used in zhen-ji therapy, in the amount of 6 50 leeches per session, with the number of sessions per course from 31 to 150, carried out daily .  2. The method according to claim 1, characterized in that the leeches put on the points of zhen-jiu therapy US1 hui-yin, US2 qu-gu, USZ zhong-ji, US4 guan-yuan, US8 shen-quye.  3. The method according to claim 1 or 2, characterized in that at the points US2 qu-gu, USZ zhong-ji, US4 gaun-yuan leeches are placed in water identical to their aquatic environment. 4. The method according to claim 1, or 2, or 3, characterized in that the stimulation of leeches is carried out by an ionized solution of lidase with a concentration of 32 64 units per 1 liter of water at 20 25 ^o C or a solution of wine vinegar with a concentration of 2 4 g per 1 liter water at the same temperature.