Vasocorrigating effect of general magnetotherapy and electromyostimulation with biofeedback in combination with fractional microablative co2 laser therapy in patients with posterior vaginal wall prolapse after surgery

Abstract

Background. The high recurrence rate after surgical treatment of pelvic organ prolapse makes it necessary to improve therapeutic methods.

Objective: to develop and scientifically substantiate the use of a rehabilitation complex, including general magnetotherapy, electromyostimulation with biofeedback in combination with fractional microablative therapy with a CO₂ laser, in patients of different age groups with rectocele after surgery.

Methods. The article presents the treatment data for 100 women of childbearing, peri- and menopausal age with rectocele II–III degree, which were divided into 2 groups comparable in terms of clinical and functional characteristics (main and control), within each group they were divided by 2 subgroups: subgroup A included women of childbearing age, subgroup B included women of peri- and menopausal age. The patients of the main group in the early postoperative period after plastic surgery for rectocella (from 1 day) underwent a course of general magnetotherapy and in the late postoperative period (one month after the operation) they performed a set of measures consisting of a course of electromyostimulation with biological connection of the pelvic floor muscles and a special complex physiotherapy exercises and 2 intravaginal procedures of fractional microablative CO₂ laser therapy with an interval of 4–5 weeks. Patients in the control group after surgical treatment of rectocele in the late postoperative period received symptomatic therapy, including painkillers and antispasmodics, which served as a backdrop for patients of the main group.

Results. As a result of the studies, it was found that regardless of the age and severity of uterine blood flow disorders in the uterine arteries in patients with rectocele, the most pronounced dynamics was observed in patients of the main group, which, in our opinion, is associated primarily with the vasoactive effects of general magnetotherapy, manifested in the removal of spasm from arteries and arterioles, improving the contractility of the veins and increasing venous outflow, which in combination with electrical stimulation, exercises to strengthen the muscles of the pelvis bottom and fractional microablative therapy allowed to obtain such a pronounced vasocorrigating effect.

Conclusions. Due to the pathogenetic effect of the developed complex (electrical stimulation, exercises to strengthen the pelvic floor muscles and fractional microablative therapy) on one of the main mechanisms of the development of the disease, a pronounced vasocorrecting effect was obtained.

Keywords

pelvic organ prolapse / rectocele / childbearing / peri- and menopausal age / surgical intervention / non-drug technologies / general magnetotherapy / electromyostimulation / biological feedback / fractional microablative therapy with a CO2 laser / blood flow / uterine arteries / vasocorrection effect

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