The effect on the body of physical factors is very diverse. Along with a specific effect, each factor also has a more or less pronounced non-specific effect. The influence of physical agents is conventionally divided into general and local. Due to the general predominantly neurohumoral effect, physiotherapeutic procedures can have a positive therapeutic effect not only with a direct effect on the focus of the pathological process, but also with extrafocal.
The energy of the physical factor has an effect primarily on the nervous elements of the body, which are most sensitive to external influences. At the same time, following the response of the nervous system, expressed by the mobilization of numerous physicochemical and biochemical processes with a change in the protein structures of the cell, the formation of mediators and biologically active substances, humoral regulation mechanisms are also included. In physiotherapy, there is a pattern similar to that observed when taking medications: weaker doses more often stimulate functions, including defense mechanisms, very intense effects have the opposite, negative effect.
In gynecology, the most widely used physical factors in the treatment of inflammatory diseases of the female genital organs. With the help of physiotherapy it is possible to achieve an analgesic, anti-inflammatory effect, restoration of normal metabolism, normalization of ovarian-menstrual and secretory functions, stimulation of immunobiological processes.
Physiotherapy is contraindicated in malignant and benign neoplasms, blood diseases, active forms of pulmonary tuberculosis, hypertensive PB - stage III, decompensation of the cardiovascular system, pronounced atherosclerosis, acute inflammation involving the pelvic peritoneum, with the presence of non-emptying ulcers.
Phototherapy can be used at the end of the acute period and in the sub-acute stage of inflammatory diseases of the female genital organs, located in the pelvic cavity, during infiltrative-inflammatory processes in the region of the external genital organs. It is prescribed in the subacute phase in the form of irradiation with a semi-thin light and a Solux lamp. Good results are obtained by ultraviolet irradiation (UVR), short ultraviolet irradiation (FUV) in inflammatory processes in the external genital area. In case of damage to the internal genital organs, it is better to use ultraviolet radiation in weak erythemal doses (1–2 biodoses) of segmental zones (“pants” according to E. A. Scherbak) - 5–6 sessions.
Sollux and light semi-bath have a thermal effect, somewhat increase hyperemia, help to improve the metabolism and conditions for the manifestation of cellular immunity in the focus of inflammation. In the chronic stage, they can provide a resorptional effect. Ultraviolet rays contribute to subside inflammatory changes, improve the performance of nonspecific not only cellular, but also humoral immunity. Histamine-like substances formed in the skin under the influence of the ultraviolet part of the spectrum have a powerful, favorable stimulating effect on the hypothalamic-pituitary-adrenal system, which is very important for mobilizing the body's defenses. Ultraviolet radiation has anti-inflammatory, desensitizing, analgesic and bactericidal action. In addition to irradiating the skin in the abdomen and lumbar region according to the Zakharyin – Ged zone with ultraviolet rays, the mucous membrane of the vagina and cervix can also be affected using quartz lamps with a special tube. Ultraviolet radiation is contraindicated (in addition to general contraindications) for kidney diseases (chronic nephritis, pyelitis), thyroid gland, acute eczema, pulmonary tuberculosis in the active phase, kidney tuberculosis, bleeding tendency.
A large place in the physiotherapy gynecological and, in particular, inflammatory diseases is electrotherapy . The introduction of direct current (electrophoresis, ion-galvanization) of medicinal substances acting on the nerve receptors of the skin, entering the blood, reaching the affected tissues and organs is effective. Thus administered antibiotics (penicillin, streptomycin, tetracycline, neomycin, etc.), Antibacterial drugs (PASK tuberculosis), analgesics (procaine, analgin, anesthetics mixture Parfenova), magnesium ions (magnesium sulfate), calcium (calcium chloride), iodine (potassium iodide).
The advantage of electrophoresis is that the injected substances penetrate directly into the tissue, can form a depot, long being preserved here. In addition, under the influence of a low-frequency galvanic current, the permeability of cell membranes changes, metabolism improves, and an anti-inflammatory effect is manifested. Calcium ions reduce vascular permeability, tissue hydration, tone up smooth muscles, have antiallergic and hemostatic effect. However, they should not be used in cicatricial-adhesive processes in the small pelvis, since calcium contributes to the compaction of adhesions. For their resorption iodine is shown, which, along with calcium, is impractical.
On the other hand, for pain associated with spasms, ganglioblocker electrophoresis can be used. Women with thrombophlebitis and phlebothrombosis show heparin electrophoresis.
Using electrophoresis, microelements are introduced into the body. It is known, for example, that with fibromyoma in the muscles of the uterus and in the blood, the amount of copper is increased, the zinc content is reduced, whereas in healthy women there is more copper in the ovaries than in the tissue of the uterus.
Zinc in cases of fibroids in the ovarian tissue is almost undetectable. In cases of inflammation, the luteal phase of the ovarian cycle is often incomplete with sufficient estrogen saturation. Iodine electrophoresis is contraindicated in girls during puberty, in women with ovarian hypofunction, with underdevelopment of the genital organs, with a tuberculous process in the genitals.
Given the close functional relationship between the female sexual apparatus and the nasal mucosa, it is influenced by physical factors, drugs are administered using a galvanic current (endonasal electrophoresis).
With symptoms of hypoplasia, amenorrhea, and hypomenstrual syndrome, endonasal electrophoresis of thiamine, novocaine, and zinc can be successfully administered.
Good effect is obtained with the introduction of vitamins in the neck area using electrophoresis. The galvanization of the cervical and facial area provides for not only the therapeutic effect of medicinal substances, but also a physical effect, including on the hypothalamic-pituitary area with the expectation of normalizing the regulatory function of the nerve centers located here. Electrophoresis of bromine and novocaine on the cervico-facial zone is effective in the case of hypothalamic amenorrhea, the introduction of bromine and magnesium has a positive effect in post-attritional syndrome.
Galvanic current (as well as diathermy) with the introduction of medicinal substances, such as calcium, sometimes affect the mammary glands (autoamminization). This reflex increases uterine contractions, changes the endocrine function of the mammary glands and ovaries. Developing uterine contractions provide a therapeutic effect for dysfunctional and some other types of uterine bleeding.
Similarly, it is possible to influence the mammary glands by the currents of high frequency d'Arsonval. Darsonvalization is also used for the purpose of trophic influence in vulvar kraurosis and persistent colpitis.
Recently, diadynamic currents have become quite widely used in gynecology. They have a deep penetrating irritant effect. When this irritation is applied to the skin in accordance with the pathological focus in the segmental zone, a new dominant is believed to appear, a vicious circle in the focus chain is broken - irritation - pain sensation in the central nervous system - focus. As a result of negative induction, the pathological focus of excitation is extinguished, the pathological dominant and the parabiotic focus are eliminated.
Diadynamic currents have a pronounced analgesic effect, normalize blood and lymph circulation, tissue metabolism, accelerate the resorption of pathological exudate, reduce the compression of sensitive nerve endings by reducing perineural edema.
Diadynamic currents are shown in the subacute stage of the inflammatory process, when the pain syndrome prevails against the background of neurodystrophic phenomena. The combination of diadynamic currents with electrophoresis (diadynamophoresis) of novocaine or magnesium, calcium, zinc, amidopirin gives very good results. The therapeutic effect depends on a combination of different types of impulse currents. The more acute the inflammatory process, the shorter the procedure should be, weaker stimuli.
Diadynamic points for thrombophlebitis and phlebothrombosis are contraindicated.
Ultra high frequency currents
In the subacute period in the stage of attenuation of the inflammatory process, ultra high frequency currents (UHF) are prescribed. They cause an oligothermal effect, favorably affect tissue metabolism, resistance of biocolloids and blood morphology. These currents uniformly and deeply warm the fabric.
Procedures are contraindicated in tuberculosis, thyrotoxicosis, thrombophlebitis, and suppurative inflammatory processes in the pelvic organs.
Ultra high frequency (UHF) currents are also used, they are generated by the “Luch-2” and “Luch-58” devices. At the same time, electromagnetic oscillations of the centimeter and decimeter ranges are used. These currents penetrate into the tissue by 3-5 cm, are absorbed and partially reflected by them. And here the principle of inductothermy lies at the heart of the action - the conversion of electrical energy into heat in the tissues due to the induction of eddy currents and the manifestation of a specific oscillatory action (dielectric loss). Microwave therapy is effective in the treatment of inflammatory processes without scar-adhesive changes.
In gynecological diseases, short-wave diathermy (DHQ) is also used. Due to the application of a high-frequency alternating electromagnetic field in the tissues, eddy currents are produced that cause endogenous heat generation, and the extrathermal (extrathermal) effect on the body is not excluded. The advantage of the method compared to diathermy is a more homogeneous heating of the tissues. At the same time, anti-inflammatory, antispastic, analgesic (due to the removal of edema) action is implemented, the phagocytic activity of leukocytes increases, and the sensitivity of the uterus to hormones increases.
The method gives good results in cases of hypoplasia of the female genital organs.
Inductothermy, like a number of other methods of electrotherapy, provides an even greater therapeutic effect when combined with electrophoresis of various medicinal substances. The heat load during the application of electrophoresis of absorbable drugs should be gradually increased.
Inductothermia is not recommended for women with purulent inflammatory processes due to deep hyperemia, with the danger of disturbing the wall of a purulent cavity and the spread of pathogenic microbes in the body.
One of the effective methods of electrotherapy is diathermy. It also belongs to the factors of heat exposure and is used in the chronic, sometimes more carefully, in the subacute phase of inflammatory diseases of the female genital organs. Usually they begin with one of the variants of external application of electrodes, and then internal, usually vaginal, electrodes are also used. Diathermy has a beneficial effect in the underdevelopment of the genital apparatus in girls and women.
Various variants of direct electrical stimulations are also used, causing corresponding reflex reactions. So, for example, the use of pulsating pulsed exponential currents (the AFM-3 device) during abdominal-sacral imposition of electrodes has a beneficial effect on the uterus, and possibly the ovaries in order to accelerate puberty with symptoms of hypoplasia of the genital apparatus. Good results can be obtained with dysfunctional uterine bleeding by stimulating the receptors of the cervical canal using the apparatus of SN Davydov.
There is evidence that, under the influence of this effect, the hypothalamic-pituitary system is reflexively activated, its regulatory function is normalized, and oxytocin is released into the bloodstream, which promotes uterine contractions. To influence these regulatory centers, indirect electrostimulation of the hypothalamic-pituitary system is also used with pulsed low-frequency current (in the temporal region, bitemporal).
For the purpose of a general effect on the organism, for example, with the phenomena of climacteric neurosis, the electric electros are successfully used, and lately, electrolanalgesia has been used with even better results.
Increasingly, ultrasound therapy has been used in gynecology in recent years. Energy in the form of ultrasonic vibrations is absorbed by tissue elements and causes mechanical, physical and physico-chemical changes in them. Under the influence of vibrational vibrations, micro-massage of tissues takes place. Due to the movement of particles, heat is generated. In addition, ultrasound acts as a physical catalyst that accelerates interstitial metabolism, increases the permeability of cell membranes, changes the ionic medium in the direction of decreasing acidosis, accelerates diffusion processes, and increases the intensity of oxidative processes. Depending on the dosage, ultrasound can stimulate the glucocorticoid function of the adrenal cortex, activate phagocytic reactions that are important for ensuring immunity.
In small doses, ultrasonic vibrations stimulate ovarian function. Under the influence of ultrasound, the analgesic effect is manifested due to its effect on the peripheral nerve endings, fibrous-scar changes in the tissues become fragmented, which is especially important in the chronic stage of inflammation.
With the help of ultrasonic vibrations, medicinal substances can be introduced into the tissues. This method is called phonophoresis. Use phonophoresis of hydrocortisone, streptomycin, analgin, anestezina and other drugs.
Ultrasound therapy is recommended to be combined with thermal procedures (sollux, infraruzh). Infrared rays, penetrating into the tissue to a depth of 5 cm, have a pronounced analgesic effect, cause persistent hyperemia and contribute to better penetration of drugs. We observed a number of cases of exacerbation of inflammation with the appointment of ultrasound too early, so we use it in the persistently subacute phase, when the acute process has already subsided.
Physiotherapy procedures are often combined with the use of resort factors (in resorts and in non-resort conditions). The most commonly used in polyclinics and hospitals are curative general, semi-sitting baths (hydrosulphuric, radon, salt-coniferous, etc.), circular douche as a general stimulating effect on underdevelopment of the genital apparatus, menopause, in the subacute, chronic stage of inflammation of the internal genitalia. In local inflammatory processes in the vagina prescribed hydrogen sulfide irrigation.
Mud and ozokerite treatment
The treatment with mud and ozokerite has a very strong effect on the body. They are used in non-resort conditions in the form of applications on the skin of the abdomen, in the form of "pants", vaginal tampons. Assign no less than 8 weeks after the end of the acute period of the inflammatory process, with postoperative inflammatory complications, infertility of inflammatory genesis, hypoplasia of the female genital organs.
The following treatment sequence is usually used:
- In the free from hydrotubation day - inductothermy, ultrasound, ozocerite "pants".
- Ozocerite "panties" that alternate with electrophoresis of antibiotics.
- The combination of ozocerite applications with hydrogen sulfide irrigation, ultrasound.
The general course of physiotherapy treatment should not exceed 1 month, after which, if the effect has not yet been achieved, a break should be taken, the duration of which depends on the patient's condition (3–6 months).
The exacerbation of the disease (focal reaction) observed in some cases, which is not accompanied by a persistent increase in ESR, leukocytosis, is not a reason for the abolition of the prescribed procedures.
Мы приводим схему применения перечисленных методов лечения при различных заболеваниях с учетом фазы развития патологического процесса.
Лечебная физкультура является одним из эффективных средств лечения гинекологических заболеваний. Moreover, it has the most successful action in combination with other therapeutic measures.
Being a biological stimulant of favorable reactions, physiotherapy improves the results of complex treatment, prevents the development of complications, reduces the period of disability, accelerates the functional recovery of the patients.
Physical therapy is considered as a non-specific type of therapy, and exercise is a non-specific irritant. It has been established that neuroendocrine-humoral regulation of functions determines the general reaction of the body when performing physical exercises, which is characteristic of the method of general active therapy.
A feature of physical therapy is that it is among the methods of functional therapy, since exercise, stimulating the activity of all the main systems of the body, leads to the development of functional adaptation of patients to various stimuli.
Physical therapy is a method of pathogenetic therapy, which often affects the cause, course and outcome of the disease. It changes the overall reactivity of the body and its local manifestations. It is necessary to take into account the preventive effect of physical therapy.
Physical therapy should be combined with a rational strictly dosed mode of motor activity of patients, not only in inpatient, but also outpatient treatment.
The basis of the positive effect of physical therapy on the body is the neuroendocrine mechanism. The nerve link of this mechanism provides for the improvement of existing and the formation of new conditioned reflex connections between the cerebral cortex, subcortical structures, internal organs and working muscles. In addition, the systematic use of physical exercises improves cortical neurodynamics. Optimized processes of excitation and inhibition, increasing their strength, mobility and balance. Under the influence of physical exercises, a new powerful dominant is created in the central nervous system, which suppresses the centers of stagnant inhibition of a negative nature.
Improvement in performing physical exercises is associated with the formation of a code (model and energy supply of the desired motor action) in the central nervous system.
An important role in the development of adaptive reactions is played by the pituitary – adrenal cortex system. It is one of the links in the mechanism of the therapeutic effect of systematically performed physical exercises on the patient’s body, and stimulates the function of the adrenal cortex.
Rational muscular activity contributes to the restoration of positive neuroendocrine influences on the activity of the autonomic nervous system, and positive emotions from performing physical exercises improve the autonomic shifts in the body involved in physical exercise.
The functional state of the internal organs depends on the flow of impulses coming from the central nervous system, the direct and inverse connections between the central nervous system and the working organs. Blood supply, trophism and functional activity of organs and systems, in turn, depend on the state of the motor analyzer. The lack of excitation of proprioceptors reduces the activity of the central nervous system, leads to disruption of trophic processes, as well as the activity of the vegetative and endocrine systems.
It is noted that physical therapy provides for the restoration of the functional activity of the organism that is disturbed by the pathological process, increasing the activity of the organism and its adaptive mechanisms.
There are conditioned-reflex connections between the cerebral cortex and the uterine receptors. In the blood vessels of the uterus is established the presence of chemoreceptors, irritation which causes changes in blood pressure and respiration. The uterus also has thermoreceptors. From the standpoint of modern physiology, the uterus should be considered as an organ with a large and complex receptor field, the irritation of which is transmitted by numerous impulses to the cerebral cortex.
The neuroendocrine mechanism of the positive effect of exercise is manifested in the mobilization of the endocrine system in response to appropriate afferent signaling. Neuroendocrine regulation determines a complex of mediator and hormonal influences, controls function and metabolism. Neuroendocrine mechanisms control the degree of load, the resistance of the vascular bed, hemopoiesis, and the need of tissues for oxygen when performing exercises in remedial gymnastics, which compensates for the deficit of proprioceptor stimulation, which is especially important in inpatient treatment.
Thus, physical therapy as a favorable stimulator of the organism's reactivity is an important component in the complex treatment of patients, including those with gynecological diseases.
The main means of physical therapy are exercise. Physical therapy in the gynecological clinic is indicated for various diseases of the female genital organs (chronic inflammatory processes, incorrect position of the uterus, failure of the pelvic floor) and in the postoperative period after laparotomy and vaginal operations.
Common contraindications to the use of physical therapy in the gynecological clinic are acute inflammatory processes that occur with fever and signs of growth in the blood picture, vascular disorders like phlebitis, thrombophlebitis in pelvic and lower limb vessels, septic conditions, uterine and postoperative bleeding, acute pain aggravated after movement, other manifestations of a complicated postoperative period.
The general methodological principles of using physical therapy in a gynecologic clinic should be considered the correct choice of painless and unloading initial positions, systematic exercise, the right combination of movements with respiratory phases, strict control of exercise dosage, consideration of the effectiveness of classes and familiarization of patients with the results of treatment, emotional saturation. classes, hygienic conditions of their conduct.
In appointing physical therapy, the nature of the existing and possible functional disorders should be considered. (based on the pathogenesis of the disease), determine its specific objectives, indicate the basic principles for performing the recommended physical exercises, ensure the selection of a special set of exercises with a description of the initial position, number of repetitions and guidelines for the correct implementation of each exercise by patients.
In chronic inflammatory diseases of the female genital area, a number of morphological and functional disorders can occur, leading to impaired menstrual function and infertility. In this disease, complaints are general and local in nature: pain in the sacrum and lower abdomen. With tension and movement, this pain may increase. Cicatricial adhesions impede physiological functions, resulting in displacement of the bladder and uterus, symptoms occurring due to the displacement of organs: pain during defecation, constipation, signs of general intoxication of the body, general exhaustion, reduced working capacity.
Therefore, inflammation should be considered as a general process for patients: they must prescribe a complex treatment taking into account the general and local effects on the body.
The following contraindications to the use of physiotherapy exercises for inflammatory diseases of the female genital organs are identified: an acute stage of the disease, accompanied by fever, signs of increasing inflammation, symptoms of pelvic peritoneal irritation or bleeding.
The tasks of physical therapy in this pathology: to improve blood circulation in the pelvic organs, accelerate the resorption of inflammation, prevent the development and possible elimination of already developed complications in the form of adhesions in the pelvic area, stimulate the bowels, improve the respiratory system, moderately tone the musculoskeletal the apparatus of the abdominal and pelvic floor, help to increase the overall and emotional tone of the body.
The methodical principles of conducting classes consist in the correct choice of starting positions during the conduct of classes. The initial position should provide for the unloading of the body from the pressure along the vertical axis.
The most convenient starting positions are as follows: sitting on the floor, lying on the back, on the side, on the stomach, knee-hand and knee-elbow position. It should also take into account the correctness of the combination of movements with breathing.
Thoracic and diaphragmatic breathing, exercises for the distal and proximal parts of the extremities, for the hip and knee joints, for the lumbosacral spine, treatment with the position (knee-elbow, knee-hand, lying on the abdomen) in cases where it is necessary to fix the uterus are recommended. in the correct position.
Exercises should be performed under the control of pain, avoiding exacerbation of pain after training in gymnastics.
From the wrong positions of the uterus, retrodeviations are distinguished with preservation of anteflection (retroposition) and retroversion - inclination of the uterus posteriorly without a pronounced angle between the cervix and the body of the uterus.
Physical exercises are prescribed for both the mobile and fixed uterus, but physiotherapy exercises with the mobile uterus are more effective.
The main objectives of physiotherapy exercises with incorrect uterine positions are to provide more complete circulatory conditions in the pelvis, strengthen the abdominal muscles and pelvic floor, as well as the ligamentous apparatus, increase uterine mobility and transfer it to a normal position. Exercise should, in addition, help to improve the activity of the gastrointestinal tract and the general strengthening of the body.
Defined methodological principles for the use of physiotherapy exercises with incorrect uterine positions. With poor tone of the ligament apparatus, the uterus easily changes its position. With the tension of the abdominal muscles and the subsequent increase in intra-abdominal pressure, the uterus is shifted back, especially in cases where there is already a posterior displacement. Push back the uterus and the filled bladder, as well as the rectum. All this should be taken into account by specialists in physiotherapy.
Special starting positions and physical exercises correct the position of the uterus. The main starting positions are the knee-elbow, knee-wrist, plantar-ulnar, plantar-wrist and lying on his stomach.
The pressure on the uterus on the part of the abdominal organs is reduced due to the movement of intestinal loops, in addition, a highly raised pelvis helps the uterus to return to its normal position.
If the uterus is not in the correct position, caused by the relaxation of the uterus suspending device, and if the supporting apparatus is inferior, exercises that strengthen the abdominal muscles, pelvic floor and back muscles are recommended.
In the postoperative period, physiotherapy exercises are most productive in cases where preoperative preparation has been performed. It provides for the development of those exercises that will be applied in the postoperative period. Preoperative preparation for physical exercises creates a favorable emotional background and a positive attitude, prepares patients for the correct - voluntary (consciously regulated) relaxation of the sphincters of the bladder and rectum, reduces the possibility of postoperative urine retention and a tendency to constipation in the prone position.
After surgery, functional impairment due to the presence of pain. They manifest reflex-painful schizhenie, as a result of which the volume of respiratory movements is limited, breathing becomes shallow, frequent. In addition, in the presence of pronounced pain syndrome, the muscle tone is weakened, out of caution, patients try to limit even minimal movements, which further reduces the overall tone and contributes to the development of hypodynamics.
In the regime of absolute rest in the postoperative period, complications are possible in the form of postoperative pneumonia, bronchitis, intestinal atony, and congestion in the pelvic organs and lower extremities.
In addition to these disorders, reflex-pained schazhenie and hypodynamia in the absence of irritants contributes to slowing down the regenerative processes, poor healing of the postoperative wound. As a result of muscle weakness and reduction of regenerative processes, the formation of postoperative hernias is possible, especially after laparotomy.
The tasks of physical therapy in the postoperative period are as follows: normalization of the respiratory rhythm, the effect on the acceleration of regenerative processes, the prevention of the above postoperative complications, the increase in the general and emotional tone of the body.
Contraindications to the use of physical therapy in the postoperative period are temperatures above 37.5 ° C, thrombophlebitis, acute inflammation in the uterus, appendages and adjacent tissue, bleeding, acute pain, especially if it increases after movement.
In the postoperative period, strictly dosed exercises are used for the abdominal muscles and pelvic floor, for the distal, and then the proximal parts of the limbs (mainly the lower ones), fortifying and breathing exercises of the abdominal, thoracic and mixed type.
It must be remembered that during vaginal surgeries, exercises with leg abduction are limited to the side, special exercises with muscle tension, lifting the anus are used, with folded and crossed legs, and exercises with maximum extension in the ankle joints with straightened knee joints and strained toes (plantar bending of the feet).
Light exercise can be applied starting from the 2nd day after the operation in the absence of general contraindications, and breathing exercises - even on the 1st day after the operation. From the following physical exercises you should choose the most lightweight, painless, easily tolerated. The total duration of therapeutic gymnastics in the first days after acute inflammatory events and when mastering a new method of therapeutic gymnastics is 5-7 minutes, and then at the discretion of the attending physician and methodologist of physical therapy, depending on the patient's condition.
The duration of physiotherapy should be gradually increased, bringing it to 30 minutes.
Contraindications to physiotherapy
- High fever - above 38 degrees and fever.
- Purulent processes of different localization.
- Acute form of any disease.
- Oncological diseases and, especially, blood diseases.
- Tendency to bleeding or taking blood-thinning drugs (warfarin, heparin)
- Acute cardiac diseases - arterial hypertension, angina, the presence of a pacemaker.
- Tuberculosis of any localization.
- Mental diseases in the acute stage.
- Skin lesions in the area of impact, especially for thermal and electrical procedures.
These are general contraindications for all physiotherapy in all branches of medicine. Separately, we make a list of contraindications to this treatment in gynecology:
The advantages and disadvantages of physiotherapy
Of course, any treatment has its advantages and disadvantages.
Let's start with the pros:
- Simplicity. Physical therapy departments exist in almost every hospital or clinic, many have home physiotherapy equipment.
- High efficiency, especially with proper and timely appointment of complex procedures.
- Painlessness Many patients are worried about whether it is painful or not to do physiotherapy. We hasten to reassure: it does not hurt at all, and sometimes even pleasantly.
- A large enough list of contraindications.
- Physiotherapy is not the main method of treatment, it can only be used as an adjuvant therapy.
- It is necessary to carry out procedures regularly and methodically. For this, you often have to travel to a medical facility and spend a lot of time there.
UHF and EHF-therapy
These are types of therapy with electromagnetic fields of various frequencies.
- The main effect of UHF is a warming effect, widely used in the treatment of inflammatory diseases: adnexitis, salpingitis, especially in chronic course. Heat relieves pain and improves blood flow to the affected area.
- The main effect of EHF is the stimulation of cells of the immune system. When exposed to EHF, the processes of healing and tissue repair are enhanced, and the local immunity of the female genital sphere is activated.
Pulse Current Treatment
In gynecology, cervical electrostimulation is most commonly used. Суть методики заключается в том, что шейке присоединяют специальные электроды, через которые с определенной периодичностью подаются электрические импульсы.
Это вызывает активацию обратной связи регуляции работы половых органов – гипоталамуса и гипофиза. Такая методика применяется при:
- Нарушениях цикла,
- Infertility with weak ovarian function,
- Early menopause
- Uterine hypoplasia,
- Preparation and stimulation of labor
- Weakness of labor.
The main effect of physiotherapy ultrasound is micromassage. The wave causes microvibrations in the tissues, which improve:
- Blood flow and microcirculation.
- Reduces swelling of tissues and stimulates the outflow of fluid from the source of inflammation.
- It has anti-inflammatory and analgesic effect.
- The most beneficial effect of ultrasound is antispak action. It is very important for the prevention of adhesions after acute inflammatory processes or operations. The ideal is a combination of ultrasound and electrophoresis with lidzoy in the postoperative period - as prevention of adhesive processes.
Ultrasound physiotherapy in gynecology is performed very simply - special sensors are applied and driven by them on the lower abdomen or the mammary gland for about 10 minutes for 5-10 days. There are special vaginal attachments for ultrasound machines.
An apparatus for magnetic therapy is in every clinic, and many have “magnets” at home - in the form of small home appliances.
The magnetic field has the following effects:
- Improve microcirculation.
- Increases smooth muscle tone - thereby contributing to the contraction of the uterus. This effect is used in the postpartum period, as well as to stop heavy menstruation.
- It has a pronounced analgesic effect - especially in case of painful menstruation and endometriosis.
The procedure of magnetic therapy is similar to that with ultrasound - a special sensor is driven through the lower abdomen for 10-15 minutes daily. Usually the course of procedures takes 7-10 days.
Laser radiation is widely used in medicine. Its effects are highly dependent on wavelength and power. High-power radiation is used as a scalpel analog or tissue evaporator during microsurgery. The physiotherapy laser also has a powerful immune stimulating and stimulating growth and cell renewal action.
In recent years, a procedure called supravascular laser irradiation of blood (NLOC) has gained much popularity. This technique consists in the irradiation of large vessels with a laser - the procedure has a pronounced immunomodulatory effect for combating chronic inflammatory processes.
Various water activities are not only pleasant, but also very useful procedures:
- Shower charcot
- Circular shower
- Different types of baths - conifer-pearl, mineral, turpentine.
These common water treatments soothe the nervous system, normalize sleep, activate blood circulation processes, and help fight edema. These effects are very important in pregnant women and women in menopause.
Local water treatments are various vaginal showers and baths. For them, medicinal mineral waters and various solutions of medicines are used. Such local procedures are effective for various vaginitis and cervical diseases.
Therapeutic mud has long been used to treat female diseases. In tsarist Russia and the Soviet Union, mud baths were created specifically for the treatment of female ailments - Kislovodsk, Saki and others. The mud contains a large amount of nutrients, minerals and bioactivators that penetrate into the fabric when using the mud.
In gynecology, mud tampons and lotions on the cervix, vulva in their inflammatory diseases are widely used. You can also use mud applications externally - on the skin in the projection of the ovaries and uterus. This is especially effective in combination with other methods of physiotherapy - thermal procedures, electrophoresis and ultrasound.
These methods are actively used for the treatment of various diseases, since the pulse effect in a certain predetermined rhythm corresponds to the physiological rhythms of functioning organs and systems. For the treatment of infertility is used:
- interferential therapy
- amplipulse therapy.
It is also possible to use direct current. Women diagnosed with infertility prescribed drug electrophoresis, galvanization. However, with such a problem it is recommended to use impulse currents. Because the movement of interstitial, intracellular ions occurs faster.
Impulse current action:
- helps to reduce vascular spasms and smooth muscles,
- nutrition of the tissues improves due to the restoration of blood circulation in the pelvic organs,
- pain relief.
The effectiveness of treatment is higher if the fight against infertility is started without delay. Recommendations of the gynecologist or fertility specialist should be carried out strictly, it is impossible to skip procedures. The course of therapy ranges from 5 to 10 procedures, further treatment is prescribed after repeated tests.
Considerable experience in treating diseases of the pelvic organs of an inflammatory nature in women complicated by infertility has Matsesta spa specialists. The question of the inability to conceive naturally remains open. Gynecologists and fertility specialists recommend using the hydrogen sulphide water from the Matsesta field.
Vaginal irrigation has proven to be effective in the treatment of pathological conditions, they help to restore the functioning of the reproductive system. Act:
- change in the activity of a number of enzymes,
- metabolic restoration,
- positive effect on the functioning of the endocrine glands.
Vaginal irrigation stimulates the effect on the functional state of the hypothalamus-pituitary-ovaries system. They have bactericidal properties. Simultaneously with the hydrogen sulfide waters, radon, iodine-bromine and sulphide waters are used. They are used in one day at the beginning of the procedure.
EHF-treatment of TBP
TPB is hard-peritoneal infertility. EHF-therapy - the use of millimeter-wave waves for therapeutic purposes. This method is capable of:
- improve tissue trophism
- restore mucous membranes at the cellular level,
- stimulate immune processes in the body.
The course of therapy begins one month after the operation. Conducted from 5-7 days of the menstrual cycle. Women with infertility will need to undergo about 30 sessions.
Infertility is not a sentence. The use of all methods of therapy simultaneously increases the chances of a married couple to the possibility of conceiving a baby. Mud therapy is one such way.
Method of the procedure:
- Dirt is heated in a thermostat to the optimum temperature.
- With the help of a dispensing tip, the agent is inserted into the vagina.
- At the same time, local applications are placed on the lower abdomen.
The duration of one procedure is 10-30 minutes. The course of treatment consists of 12-18 sessions. The treatment regimen may be different. For infertility of unknown origin, the procedure is carried out daily.
Such physiotherapy for infertility helps to cure chronic inflammation of the uterus, restore hormones, restores menstrual functions, and facilitates the course of adhesions in the pelvis.
In addition to previous physiotherapeutic methods of treatment, abdominal-vaginal vibratory massage is used. The effect of this method of therapy:
- increased tissue metabolism,
- improves blood flow and lymph flow,
- normalizes the contractile activity of the fallopian tubes,
- prevents the formation of adhesive processes.
The method of therapy involves the mechanical shaking of the pelvic organs. Abdominal-vaginal vibratory massage is conducted by courses. For a good result, sessions are held daily. Women spend 10-12 procedures.
Physiotherapy in many cases can replace surgery. Procedures do not help immediately. No wonder they are appointed courses, procedures can not be skipped. Physiotherapy in gynecology with infertility, reviews of which are mostly positive, prepares the reproductive organs for pregnancy. These methods are good when the pregnancy ended in miscarriage, or the couple cannot conceive a child for a long time.
In some pathological processes, physiotherapy is the only treatment. The method of physiotherapeutic effect is selected individually. In this case, the doctor is repelled from both the diagnosis and the characteristics of the human body.
Physical therapy is characterized by the use of magnetic fields, ultrasound, laser and currents.
Often, physiotherapy copes where even effective medicines are powerless. Despite the seeming simplicity, this therapeutic method can arrest the development of even serious pathological processes that are difficult to treat.
How is the method used
Physiotherapy in obstetrics and gynecology is used both during gestation and after the resolution of the burden.
In the first case, this practice eliminates the symptoms of early toxicosis, it significantly reduces the risk of miscarriage. After resolution of the burden, physiotherapy is prescribed for women who are diagnosed with inflammatory processes in the uterine mucosa. Against this background, the stitches heal much faster.
One of the most effective methods of exposure is magnetic therapy. Often it is assigned to women with pathologies of internal and external genital organs. In many cases, the passage of physiotherapy is recommended to young ladies suffering from infertility.
What are the indications
Physiotherapy is recommended for such conditions:
- cycle violations
- irregular ovulation or lack of it,
- chronic inflammatory processes in the uterus,
- chronic inflammatory processes in the uterine appendages,
- pipe obstruction
- strong painful sensations
- progressive mastopathy,
- uterine hypoplasia,
- the course of urological pathological processes.
In addition, the passage of physiotherapy is necessary for adhesions and after surgery on the genitals.
What are the contraindications
Physiotherapy, unfortunately, is not always possible. This method of treatment is not recommended for women suffering from liver failure. Another contraindication is renal failure. Physiotherapy is not prescribed for circulatory disorders and genital tuberculosis. Another serious contraindication is the presence of pustules in the genitals.
It is strictly not recommended to undergo physiotherapy for benign and cancerous tumors!
But this or that contraindication is not always a barrier to physiotherapy. The final decision belongs to the doctor.
Features of the hardware method
By the hardware method should include procedures involving the use of various devices and instruments. The following types of exposure are practiced:
- a magnetic field,
- ozone therapy
- vacuum massage
- ultrasound exposure.
Magnetic impulses help to get rid of pain, have anti-inflammatory effect. Using electrophoresis improves blood flow to the pelvic organs. This helps to relieve vascular spasms, and muscle spasms also disappear.
Through ultrasound therapy significantly improves the functioning of the ovaries. Adhesions soften, hormone production is normalized. Pain syndrome is stopped, blood circulation becomes much better.
To relieve inflammation, women are often given treatment with infrared rays. In addition, this method of exposure contributes to the relief of pain, improves the work of the fallopian tubes, uterus and ovaries.
Features of natural factors
The effective natural factors of physiotherapy should include water procedures and therapeutic mud. Often dirt is used simultaneously with hardware techniques. The most common of these is electrophoresis.
Many young ladies are prescribed wraps and mud baths. Sometimes it is assumed the use of tampons with healing mud.
Medicated water is used for douching. If allowed by the chemical composition, it can be taken orally.
The mechanical properties of the healing fluid are often used during hydromassage manipulations. Heating baths and showers, as well as contrasting water procedures are based on the application of the thermal properties of the liquid. This helps to enhance the functioning of the internal organs.
Features gynecological massage
If the doctor diagnoses an extensive adhesions process, the woman is prescribed gynecological massage procedures. The remaining indications for this method of treatment include uterine pathology and obstruction of pipes. Manipulations are performed exclusively by a qualified gynecologist. The number of sessions is determined by the characteristics of the pathological process.
Gynecological massage is often combined with exercises physical therapy, designed for independent performance of the young lady. Usually exercise therapy is prescribed by a doctor after surgery. Thus prevented the development of adhesions. In addition, it helps to improve blood circulation in the pelvis.
The main advantages of the method
The main advantage of physiotherapy is the democratic cost of procedures. Many manipulations are actively carried out in state polyclinics, and a woman with a doctor’s referral can undergo treatment for free. You will have to pay only for the ampoules injected into the body, ointments and other active ingredients.
The second advantage is the lack of side effects. Some effect is observed after exposure to a magnetic floor, but in most cases it is a positive effect.
The third advantage is the reduction in the duration of treatment of many pathologies. The therapeutic effect of any drug will be increased with complex use along with physiotherapy. This helps in the future to significantly reduce the dosage of the medication. Physiotherapy does not allow the transition of the acute form of a pathological process to a chronic one, but in the acute phase many types of procedures are contraindicated.
Expectant mothers on the note
During pregnancy, the passage of physiotherapy should be strictly regulated by a doctor. This type of treatment is prescribed in rare cases. Physiotherapy should be beneficial for the health of both the expectant mother and the child.
Sometimes this method of treatment is prescribed for early toxicosis. Physiotherapy impulses follow to the brain, and thus conditions are created for the relief of an unfavorable symptom. Usually in these cases, electrophoresis procedures are prescribed.
To reduce the risk of early delivery and miscarriage, the doctor makes a decision about reducing uterine tone. This is also achieved through physiotherapy.
What are the disadvantages
Physical therapy has almost no downsides. The main disadvantage of many is the need to regularly visit the physiotherapy room. If such therapy is prescribed to the patient after surgery, no problems arise - the woman has the opportunity to attend the procedure in the hospital.
Young ladies undergoing outpatient treatment rarely manage to carve out a minute for physiotherapy. Most of these procedures involve rest, and usually it takes between fifteen and twenty minutes. Only after that the patient is allowed to get up and do the usual things. This feature also causes a lot of inconvenience to business women, whose schedule is set every minute.
It is not recommended to immediately leave the medical facility. This is especially true in the fall, winter, and early spring, when a raw wind “walks” along the streets.
The duration of the course of physiotherapy varies from ten to fifteen procedures. The number of sessions is determined by the nature of the disease. Many women feel relief after the first two or three procedures, but it is not recommended to stop treatment because there is a possibility that the disease will return and attack the body with a new force.
What are the methods of treatment of gynecological diseases
There are two main methods:
Before determining which method of treating a disease will be most effective in a particular case, first of all, the patient’s primary reception by a gynecologist is required. After listening to the purpose of the visit, answering questions of interest to the visitor, the doctor draws a superficial picture of the woman's state of health. The priority for the specialist gynecologist are questions about hereditary susceptibility to the characteristic types of diseases, the presence of allergic reactions and, of course, chronic diseases that occur.
The doctor listens to the patient's complaints and conducts an examination.
After that, the doctor proceeds to the examination of the patient. For this purpose, a gynecological chair, as well as a set of sterile gynecological instruments. Careful examination are the cervix and vaginal fornix. Data on their physiological condition should be in the outpatient map. As a result of the general information obtained at this stage, the primary diagnosis is made.
At the initial examination, the necessary smears are also taken for clinical analysis, the result of which clarifies or refutes the preliminary conclusion of a specialist. If necessary, additional examinations are conducted to establish the final diagnosis. Having received the diagnosis, a detailed treatment regimen is prepared, which includes complex procedures and medical preparations.
Conservative treatment of gynecological diseases
These are various forms of drug treatment of the inflammatory process in the female body, accompanied by diet, regimen and a sufficient amount of rest. Contraindications for all types of gynecological diseases is the complete elimination of physical activity from the life mode, as well as heavy burdens. Some antibiotics cause gastrointestinal upset. Most often in the form of constipation, so patients recommend a special diet with an increase in the amount of fiber in the diet. More precisely, vegetables and fruits should be the main type of food.
With conservative treatment, the patient undergoes therapeutic procedures recommended by the attending physician. Some of them have to perform at home, as most appointments are prescribed in the evening, before bedtime. One type of conservative treatment is syringing. It refers to therapeutic and prophylactic procedures, the principle of which consists in the introduction of special solutions into the vagina. They contain medicinal substances with a healing effect. Chronic inflammatory processes in the pelvic organs are shown douching as one of the necessary procedures.
Tampons for treatment and medical candles are also recommended to do in the evening before bedtime, as it is not only more effective, but also much more convenient. So Chinese tampons are widely recognized by doctors and patients. Their antibacterial, antiviral, anti-fungal and anti-inflammatory effects have a healing effect on many gynecological diseases.
Sterility in the use of Chinese tampons is guaranteed, therefore, in many cases, it was impossible to aggravate the inflammatory process by making tampons manually. In addition, the ease of use of special tampons eliminated the discomfort with the introduction.
Conservative treatment also includes a number of simple medical procedures that are carried out by specialists directly in the treatment room. Laser treatment, physiotherapy, monotherapy, light therapy, gynecological sanatoriums with the treatment of chronic diseases and postoperative patients, and many other conservative types are often carried out in conjunction with the surgical method.
The device almag in the treatment of gynecological diseases has analgesic, anti-inflammatory and resorptional effect. It is often used in physiotherapy as the most effective treatment method.
Under the action of its traveling pulses, the following processes are normalized:
Surgical treatment method
Surgical intervention is necessary when there is a threat to the life and health of the patient or when the neglected form of the disease is not amenable to any of the types of conservative treatment. There are several types of radical effects on the disease:
- abdominal surgery
- laparoscopy (intervention is performed through small holes),
- endoscopy (inspection using an endoscope).
Each of the types is characterized by properties, thanks to which experts will determine the most effective for each individual case. So, for example: modern gynecology more often uses laparoscopy and endoscopy as sparing methods of operable treatment. Indeed, in most cases there is no need to open the abdominal cavity of the patient, leaving ugly scars on the skin and significantly extending the time of postoperative rehabilitation. A few small punctures or the natural pathways of the body allow you to completely replace the traditional method of abdominal surgery in some cases.
As with the conservative and operative method of treatment, the process of healing is accelerated by therapeutic physical training (exercise therapy). It favorably affects the pathological process, prevents the development of complications, and also helps to get rid of postoperative pain.
Exercise therapy can be carried out in a hospital, clinics and even at home. The main condition is the control of the attending physician and the correct choice of therapeutic physical training techniques: mechanotherapy, occupational therapy or therapeutic massage.
Principles of physiotherapy in gynecology
There are several principles for the use of physiotherapeutic methods in gynecological practice:
- the diagnosis should be fully clarified and confirmed by surveys
- individual approach to the choice of physical effects in each individual clinical case,
- during physiotherapy treatment, it is important to consider not only the state of the affected organ, but also the daily rhythms, menstrual cycle, ovarian functional activity and other nuances,
- consistency in the procedures, if they are performed simultaneously with others or in combination,
- Mandatory control over the dynamics of changes in the process of, and at the end of physiotherapy.
Indications for the use of physiotherapy in gynecology
Since the main direction of the use of physiotherapeutic methods is medical, the indications will be various female diseases, for example:
- inflammatory processes in the tissues of the internal and external genital organs (endometritis, bartholinitis, vulvitis and others),
- menstrual disorders (dysmenorrhea, amenorrhea),
- atrophic processes (for example, associated with menopause, uterus prolapse),
- problems with conception (infertility) and carrying a child,
- the presence of adhesions,
- pain in the pelvic organs and many others.
Physiotherapy in gynecological practice is included in the complex of measures for rehabilitation after curettage (abortion or performed for diagnostic purposes), operations, including cesarean section, removal of the uterus. In some cases, physical methods are used for analgesic effect during childbirth, during preparation for IVF, if it is impossible to become pregnant, in patients with a history of miscarriages or other pathologies.
Only a doctor can choose one or another method of physiotherapy and draw up a treatment regimen.
Main physiotherapy in gynecology
On the basis of a preliminary study of the history and conducted diagnostic measures, the gynecologist prescribes one or another type of physical therapy. It often happens that a woman is shown several methods at once, which can be used together or in combination (alternately). Different methods of physiotherapy have been used in gynecological practice. Below is a brief description of the procedures that are prescribed most often, and have proven to be the most effective.
Electromagnetic Field Therapy
The action of electromagnetic fields of different frequencies is used in gynecology through the use of techniques such as UHF and EHF. It manifests itself in the warming up of tissues, as a result of which the blood flow in the pathological area increases, metabolism accelerates, pain disappears, regenerative and local immune processes are activated. These techniques are successfully used in the chronic form of certain inflammatory processes, for example, in adnexitis.
Laser beam treatment
The physiotherapeutic effect of the laser beam in gynecological diseases and disorders has a strong regenerating and immune stimulating effect. In addition, the laser helps to reduce itching, renewal of epithelial cells during atrophic processes associated with age-related changes, improve blood circulation in the external and internal genital organs of a woman.
Electric Pulse Therapy
Electropulse therapy (EIT) is used to normalize the functional activity of the organs of the reproductive system. Most often, impulse currents are directed to the cervical region, from where they are transmitted via neural connections to the appropriate departments of the central nervous system. The result is a reflex production of active compounds that restore and regulate the functioning of the reproductive system. Among the indications for use of this physiotherapeutic technique are:
- early onset of menopause
- menstrual disorders,
- insufficient activity of appendages,
- hypoplasia of the uterus,
- weak labor activity.
Electropulse therapy is used during childbirth to stimulate uterine contractions during the preparatory period.
Mud treatment is deservedly popular with women who have gynecological disorders. The therapeutic composition can be applied locally, on the lower abdomen, or applied to the whole body. In some cases, the introduction of mud tampons into the vagina is allowed, for example, in case of cervical diseases. Greater effect is achieved by combining pelotherapy with thermal procedures, ultrasound exposure, electrophoresis. This combination enhances the penetration of biologically active compounds to the site of pathology.
Physiotherapy for menstruation
One of the principles of the use of physiotherapeutic methods in gynecology is to take into account the peculiarities of the female menstrual cycle. What day is best to start treatment? The optimal period for starting a course of physiotherapy is 5-7 days from the first day of menstruation. In most cases, by this time women run out of bleeding. If the patient suffers from amenorrhea, then one should be guided by premenstrual sensations. If not, then the time to start therapy does not matter.
Why do you need to pay attention to the menstrual cycle during physiotherapy gynecological disorders? The fact is that as a result of clinical studies, the following was noted: if the beginning of a course of physical procedures occurs at the time of ovulation or directly on the days before menstruation, then the probability of a negative response from the body increases significantly. This may be manifested by the increase or the occurrence of pain of varying intensity. Moreover, the pain in this case does not indicate the development of the inflammatory process, but only is its imitation.
In the second half of the menstrual cycle, physiotherapy is not recommended, since during this period the likelihood of an existing pregnancy is high. Physiotherapy can interrupt it.
Of particular note is the holding of physiotherapy sessions on menstrual days. In this case, the specialist is required to carefully monitor the response of the woman’s body, which can manifest itself as increased bleeding. If this happens, the patient should report this fact to the physiotherapist. To reduce the amount of menstrual flow to normal will help reduce the energy impact, the cessation of physiotherapy is not required.
It is another matter if during physical exposure simultaneously with an increase in the volume of blood secreted there is a release of clots. Such a phenomenon can speak of existing pathologies that have not yet manifested themselves as characteristic symptoms. These are: fibroids, dystrophic processes in the endometrium and its growth, the presence of polyps and other diseases. In this case, the use of physiotherapy should be stopped.
Menstruation is not a contraindication to the use of physiotherapeutic methods, including transvaginal ones. However, in this case, before their conduct, you should consult with a gynecologist.
Physiotherapy during pregnancy
During pregnancy, the use of physical methods is indicated for the treatment of gynecological diseases, auxiliary measures in preparation for childbirth, in the postpartum period. Despite the fact that not all methods of physiotherapy can be used in carrying a child, many techniques are absolutely safe for mother and baby.
In addition, physiotherapy can often replace drug treatment, as the latter have side effects and can adversely affect the condition of the fetus. Transdermal administration of drugs makes it possible to avoid negative consequences and stop taking the medication.
Physiotherapy procedures in gynecology and obstetrics during pregnancy are indicated for toxicosis, an increased tone of the uterine muscle wall, for stimulating and facilitating childbirth, for some diseases requiring immediate treatment, and so on.
In the postpartum period, the use of physiotherapy promotes more rapid healing of sutures in the case of cesarean section, perineal ruptures. Some methods accelerate the contraction of the uterus, have an anti-inflammatory effect. Moreover, physiotherapeutic effect prevents the development of mastitis, which often accompanies the initial stage of breastfeeding.
Advantages and disadvantages of physiotherapy in gynecology
The benefits of using physiotherapy in gynecology and obstetric practice are as follows.
- No adverse reactions. With a properly chosen treatment regimen and taking into account the individual characteristics of the woman and contraindications, physiotherapy practically does not lead to negative reactions from the body (especially when compared with drugs) and does not cause harm.
- Affordable price. All basic physiotherapy can be done in the clinic at the place of residence. Paid treatment will be inexpensive, and if there is a referral from a doctor on hand, then you will not have to pay anything. Sometimes it may be necessary to purchase a drug. But in most cases, inexpensive means are used for physical procedures.
- Acceleration of recovery. Used as an additional treatment, physiotherapy enhances the therapeutic effect of drugs, while also allowing them to significantly reduce their number. Physical methods significantly reduce the recovery period, reducing the risk of complications.
- High degree of efficiency. Many patients are skeptical of physiotherapy, not observing significant "visible" effects, especially after the first sessions. However, numerous studies prove the opposite - procedures have a very high efficiency. For this you need to undergo a full course of treatment.
Physiotherapy procedures have virtually no flaws. We can only note the need for regular visits to medical facilities. Since almost all such centers and clinics provide services during the daytime, it is not easy for working patients to get to a session in time.
The use of physiotherapy in gynecology is considered an important direction in the treatment of diseases. Many of the gynecological disorders hardly respond to the effects of drugs, for example, adhesive processes in the tubes, chronic lower abdominal pain, chronic inflammatory processes, and others. Therefore, very often the appointment of physical treatments becomes the only means of getting rid of pathologies and their prevention.