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CNAA / Theses / 2009 / June /

The correction of the reproductive function in patients with infertility developed after surgical operations on the pelvic organs

Author: Ostrofeţ Constantin
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Scientific adviser: Olga Cerneţchi
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Victor Ghicavîi
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific council:


The thesis was presented on the 23 June, 2009
Approved by NCAA on the 1 October, 2009


Adobe PDF document0.38 Mb / in romanian


T tubal-peritoneal infertility, laparoscopy, Regesan, adherences formation, postsurgical adherences, prolin, oxiprolin


The present work is dedicated to a major problem in modern gynecology – tubal peritoneal infertility in women with anterior surgical operations. The obtained results demonstrated that tubal peritoneal infertility in women with anterior laparotomies is determined by the presence of one (45,7%) or more (54,3%) surgical operations in their history, in combination with PID (59,8%), medical or spontaneous abortions (46,8%) that lead to 1st degree adherence process in 32,2% cases, 2nd degree - in 46,4% cases and 3rd degree - in 21,4% cases P (t) = 0,95 ).

In the present study we determined the particularities of the pathogenesis of adherence process formation after surgical operations and clinical particularities of infertility in women with laparotomies in there history. The role of homeostasis troubles in the etiopathogenesis of post surgical adherence process was estimated and stages of post surgical adherence formation were determined with their influence on the fertility.

For the first time two techniques for the diagnostically and surgical laparoscopies were elaborated in dependence of postsurgical scare localisation.

Inoffensive methods of surgical correction of tubal-peritoneal pathology were considered and improved. After the basically laparoscopic operation, at the level of tissue lysis, a medicine with regenerative and cytoprotective effects - Regesan - was applied. This medicine provides the prevention of new adherences formation and positively influences the restore of tubal function.

The established benefits of the medicine Regesan offers a new strategy for practical implementation for the rehabilitation after endoscopical correction of tubal-peritoneal infertility in patients after anterior surgery. This method induced an increase in fertility restore up to 50,5%.