The structure of somatic dysfunctions in women with a nodular form of uterine myoma

Introduction. Uterine myoma (leiomyoma) occupies one of the first placesin the structure of gynecological diseases.This disease negatively affects both the state of health and the reproductive function of women. Now the problem of the effective methods for the treatment of leiomyoma (including non-medicinal methods, one of which is the osteopathic correction of somatic dysfunctions) is still acutedespite some progress in understanding the mechanisms of this disease pathogenesis. However, the structure of these functional disorders has not been practically studied.

The goal of research — to investigate the structure of somatic dysfunctions (SD) in women with uterine myoma before and after osteopathic correction and its relationship with the severity of subjective indicators.

Materials and methods. A simple longitudinal randomized study was conducted in 2018–2019 on the basis of a women’s consultation in Kirov, it included 30 women aged 35 to 44 years being under the medical supervision of an obstetrician-gynecologist, with a diagnosis of intramural uterine myoma, nodular form. All women with intramural nodular leiomyoma were divided into 2 groups of 15 people, comparable in age, presence of comorbidities and duration of the disease, using a simple randomization method (a random number generator was used). The main group received osteopathic treatment, and for patients of the control group it was carried out dynamic monitoring. According to the scheme, all patients underwent a clinical gynecological examination, a clinical osteopathic examination, and the dynamics of the severity of subjective manifestations (complaints) was evaluated.The collected data was processed by nonparametric statistics.

Results. In the course of osteopathic diagnostics in women with uterine fibroids the following SD were identified: the somatic dysfunctions of the pelvic region dominated among the regional SD, and the most common among the local SD were the somatic dysfunctions of the segment С₀–С_I and the thoracic diaphragm. As the result of osteopathic correction of diagnosed SD in patients with leiomyoma, the decrease of the total number of SD (p<0,05) and the change of their structure has occurred (before treatment the SD at the regional level prevailed, after treatment there was a reduction in their number, and the increasing of the number of SD local level due to the carried out correction of most existing regional violations); and the severity of subjective symptom (algodismenorrhea) has decreased (p<0,05).

Conclusion. In women with uterine myoma (leiomyoma), SD can manifest at different levels. Osteopathic correction of SD in women with uterine myomasignificantly reduces the severity of subjective manifestations (algodismenorrhea), which allows us to continue the research in studying of the impact of the SD osteopathic correction in the complex treatment of women with intramural nodular form of uterine myoma. 

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