ATYPICAL CLINICAL MANIFESTATIONS OF COMPLICATIONSIN THE SUBMUCOSAL LOCALIZATION OF THE UTERINE FIBROIDNODE

The purpose of this study is to study the features of atypical clinical manifestations of complications in the submucosal localization of uterine fibroids. When analyzing this medical history, it was revealed that the patient, according to her medical history, had been suffering from cystitis and chronic pyelonephritis for the past 5 years. She often received treatment for these diseases. The cause of this pathology was a myomatous node in the projection of the posterior wall of the bladder, visually with signs of necrosis. A characteristic pattern was found intraoperatively – intimate fusion of the posterior wall of the bladder, plicavesico –uterinae with the uterus. In the uterus, this cause caused the appearance of pyometra. The inflammatory process in the myomatous node, uterus, has spread to the tissues of the bladder. The intraoperative finding was precisely this submucous node in the isthmus of the uterus. Its removal led to a defect in the uterus and the bladder wall soldered to the uterus. The question arises – could this complication have been avoided? Theoretically, yes, but subject to certain conditions. According to the data of the pelvic ultrasound protocol, the patient showed signs of an endometrial polyp. It was only intraoperatively that the surgeon discovered the submucous node and indicated its topography. However, it was possible to expand the cervical canal only up to No. 8 of the Geghar expander, which technically did not allow performing a hysteroresectoscopy. To perform hysteroresectoscopy, it was necessary to expand the cervical canal to No. 12 of the Gegar dilator. The submucous node was removed by unscrewing. The complication was promptly diagnosed (intraoperatively, on the operating table in a small operating room). All subsequent research methods confirmed the correctness of the diagnosis and made it possible to perform timely surgical intervention to eliminate iatrogenic injury to the bladder wall.