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Aim. To analyze the dynamics of the incidence and prevalence of uterine fibroids (UF) in the population of women in the Sverdlovsk region (SR) and the municipality of Yekaterinburg. Materials and methods. A study was conducted on the incidence and prevalence of UF in rural and urban women aged 18 years and over in 2016–2022. The data from Table No. 3000 of the Federal Statistical Observation Form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical organization” were analyzed. When calculating the indicators, the average annual number of women aged 18 years and over in 2016–2022 was used, the values were expressed in 0/0000. Results. It was found that the incidence of UF in SR was 149.11 0/0000, in the city – 130.89 0/0000 in 2016. There was an increase in the incidence of UF in the SR and the city by 1.93 and 1.96 times in 2019, respectively, compared with 2016 (p0.001). The average growth rate (AGR) of incidence in the SR and the city was 24.6 and 25.2% respectively, and had a pronounced growth dynamics in 2016–2019. The prevalence of UF in SR was 735.8 0/0000, in the city – 650.74 0/0000 in 2016. Subsequently, the dynamics of the increase in prevalence, similar to the incidence, was observed. The prevalence rate in the region was 15.5%, in the city – 11.6% in 2016–2019. There was a decrease in the incidence of UF in SR (p=0.014) and the city (p0.001) in 2020–2022. The AFR had a negative value: -3.4 and -7.9%. The prevalence of UF corresponded to a moderate trend, taking into account the positive values of AFR: 1.3% in SR and 2.3% in the city. Conclusion. The prevalence of UF in SR and the city of Yekaterinburg in the pre-pandemic period (2017–2019) was characterized by a marked increase compared to the initial 2016 year. During the pandemic, there was a slight dynamics in the city and stagnation of the indicator in the SR due to a pronounced decrease in incidence.

Background. Most common clinical manifestations of endometriosis (N80) include pelvic pain and infertility, while adenomyosis is associated with abnormal uterine bleeding. At present, approach to the treatment of endometriosis has been revised towards shifting surgery to the second-line therapy; medications are considered as the first-line therapy: gonadotropin releasing hormone agonists, progestogens, aromatase inhibitors. Aim. Comparison of clinical and anamnestic characteristics and therapeutic procedures in women who were treated on an outpatient basis and those who were hospitalized and underwent surgical intervention. Materials and methods. Clinical-anamnestic and morphological characteristics were studied in two groups of women: 1st group (n=27) received drug therapy, 2nd group (n=28) underwent surgical intervention. Results and discussion. In the 1st group, 25.9% of patients received microdosed combined oral contraceptives which contain dienogest as a progestogen component, 44.4% of patients received monotherapy with dienogest, and 22.2% of patients received dydrogesterone in a prolonged mode. In the 2nd group, 39 foci of endometriosis, isolated and in a combination of various loci, were revealed during surgery, of which 30.8% were ovarian cysts, 10.2% were foci on the sacro-uterine ligaments, 23.1% were on the pelvis peritoneum. Surgical approach was determined by the urgency of intervention, an expect localization of endometriosis foci, a comorbidity of endometriosis with another pathology of the internal genitalia, 82.1% of surgery were performed by laparoscopic approach. Conclusions. The choice of treatment method depends on the severity of symptoms, the severity of endometriosis, the woman age and her reproductive intentions. When choosing a surgical treatment, one should be guided not only by the need for the most radical removal of endometriosis foci, but also should consider a surgical approach to minimize discomfort and provide a good quality of life after surgery. A three-stage model for the management of patients with endometriosis is proposed, which includes an assessment of treatment effectiveness and the need to develop a rehabilitation program.