New approaches in complex therapy of inflammatory diseases of the pelvic organs in women of reproductive age

2017 ◽  
pp. 41-44
Author(s):  
O.V. Grischenko ◽  
◽  
T.A. Kozub ◽  

The objective: to study the efficacy of complex treatment of inflammatory diseases of the pelvic organs (vaginitis), occurring in conjunction with urinary tract infection (cystitis), with a combined medication of plant origin Tutukon produced by Miguel and Garriga, S. A. ("Grand medical Group AG", Spain/Switzerland) in women of reproductive age. Patients and methods. Were examined 60 women of reproductive age with the presence of vaginitis and associated cystitis. All the patients were divided into two clinical groups. In group I (control; n=30) treatment was carried out according to the standard scheme with the use of antimicrobial drugs, antispasmodics, local antiseptics for the sanitation of the vagina. In group II (study group; n=30) treatment was carried out according to the standard scheme with the inclusion of the drug Tutukon. All the patients were examined at 3-rd, 7-th, 10-th day of treatment and 30 days after discontinuation of therapy. Results. During the research was given the analysis of the dynamics of clinical and laboratory parameters in women of both groups before and after treatment. In patients of study group, the standard therapy which included Tutukon, the treatment was more effective than in patients of control group: a rapid onset of clinical effect, reducing the duration of the disease, a complete clinical response in 90% of cases versus 63%, alkalization of urine - pH 6.5±0.10, the absence of recurrence within 30 days after the end of therapy. Conclusion. Tutukon medicine is recommended for complex treatment of vaginitis, occurring in combination with cystitis in women of reproductive age. Key words: vaginitis, cystitis, dysuria, urine pH, Tutukon.

2018 ◽  
pp. 118-122
Author(s):  
N.V. Drohomyretska ◽  

Violation of hemomicrocirculatory processes is in the basis of the development of diseases of various organs and systems. The study of hemomicrocirculation at all levels allows us to understand the complexity and universality of these processes, as well as opens up new perspectives in the pathogenetic approach to the treatment and prevention of the diseases. The homogeneity of the reaction of all parts of the hemomicrocirculatory bed in various diseases has been proved on the basis of clinico-morphological comparisons. Study of some areas allows us to judge the state of hemomicrocirculation as an integral system. The objective: to study and compare the changes of the hemomicrocirculatory bed (HMCB) of the conjunctiva of the eyeball and adventitia of varicose veins of the small pelvis (VVSP) in women with chronic inflammatory processes of the internal genital organs (CIPIGO). Materials and methods. There were examined 54 women with chronic inflammatory processes of internal genital organs against the background of varicose veins of the small pelvis (group I); 30 – practically healthy women (control group). The age of women was between 18 and 45 years old. Bulbar microscopy was performed using the SHL-2B slit lamp. The results of microscopy were evaluated according to the system of V.S.Volkov et al. To evaluate the restructuring of the HMCB of adventitia of VVSP, the operating material of 12 women of reproductive age was used. Mainly, these were pieces of the ovarian vein. The study of HMCB in the vein wall was performed by the non-injecting method of silver impregnation according to V.V. Kupriyanov. To standardize the results, the state of the HMCB of venous wall adventitia was studied in norm in 5 women of reproductive age, who died as a result of various injuries. Results. Clinical-morphological parallels between changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis were revealed after the performed research. The arteriols’ architectonics was almost unchanged. Venules were dilated, twisted, somewhere varicose-enlarged, filled with formed elements. The structure of capillaries was polymorphic. The capillary net was localized and concentrated or shaped in the form of a thick planar net, the capillaries were expanded. In the micropreparations of the adventitia, there were arterio-venular anastomosis. The nuclei of the endothelial cells were shortened. In some preparations, the diameter of the arterioles corresponded to the diameter of the collection venules. Conclusions. 1. Our studies confirm both clinically and pathomorphologically that one of the links of the pathogenesis of CIPIGO, which occur against the background of VVSP, is a violation of HMCB. 2. Firstly, changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis in women with CIPIGO show that they are systemic. 3. The results obtained by us prove the necessity of the use of medicines that improve hemomicrocirculation in the treatment of CIPIGO against the background of VVSP. Key words: hemomicrocirculatory bed, bulbar conjunctiva, adventitia, varicose veins of the small pelvis, chronic inflammatory diseases of the small pelvic organs.


2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


2020 ◽  
Vol 73 (5) ◽  
pp. 868-872
Author(s):  
Iryna M. Nikitina ◽  
Volodymyr I. Boiko ◽  
Svitlana A. Smiian ◽  
Tetiana V. Babar ◽  
Natalia V. Kalashnyk ◽  
...  

The aim: The aim of the study was to improve the results of treatment of patients with endometriosis by using a combination method of therapy. Materials and methods: For two years, 136 women of reproductive age who underwent laparoscopic surgeries for ovarian endometriosis were monitored: Group I (n = 24) did not receive any hormonal treatment in the perioperative period; Group II (n = 32) – received gonadotropin-releasing hormone agonists within 3 months after surgery; Group III (n = 80) prior to laparoscopic removal of the ovarian cyst used gonadotropin-releasing hormone agonists – Triptorelin 3.75 mg intramuscularly for 2 months, as well as three months after surgery. The control group consisted of 30 healthy women of reproductive age with regular menstrual periods. All patients underwent transvaginal ultrasound, counting the number of antral follicles before and after treatment. Serum hormone levels (FSH, prolactin, thyrotropic hormone, anti-Mullerian hormone, inhibin B) were determined by enzyme-linked immunosorbent assay on Cobas e-411 analyzer (Roche Diagnostics, Switzerland) on day 2-3 of the menstrual cycle and on day 2–3 of the first menstrual period after the end of treatment. Laparoscopic removal of the cyst was performed with exfoliation of the cyst, hemostasis on the wound surface of the bed of the cyst was performed with a bipolar electrocoagulator. Bipolar coagulation and resection of the ovarian tissue with no potential was used during surgical treatment of the ovaries, which made it possible to preserve the intact portion of the ovary as much as possible. Results: Analysis of ovarian reserve indices, namely number of antral foliculs, number of antral follicles, AMG, and inhibin B levels in all examined patients with ovarian endometriomas were significantly lower than those of the control group before the start of treatment: in the ovarian endometrial group group 1.26 times (p <0.01), inhibin B – 1.5 times (p <0.01), the number of antral follicles – 1.2 times (p <0.01), due to the development dystrophic changes of the follicular apparatus due to prolonged compression, hypoxia, fibrosis in the ovaries. Patients who planned pregnancy were advised to have an active sexual life before menstruation was restored. In 23 (46.9%) of 49 patients who had reproductive plans, pregnancy occurred without first menstruation after a course of gonadotropin-releasing hormone agonists, 12 (24.5%) women became pregnant during the first three menstrual cycles. Extracorporeal fertilization was recommended for women who did not have pregnancy within 6 months of surgery. For two years in women who did not plan pregnancy, recurrence of endometriosis was not observed. Conclusions: The combination of laparoscopic treatment with gonadotropin-releasing hormone agonists in patients with endometriosis with infertility allowed to restore reproductive function in 71.4% of women, which indicates the effectiveness of the treatment method used. In addition, it helps to achieve lasting remission and addresses the socio-social problems of women’s health and maternity.


2016 ◽  
pp. 123-128
Author(s):  
V.A. Benyuk ◽  
◽  
A.I. Kurchenko ◽  
О.A. Shcherba ◽  
Bu Weiwei ◽  
...  

The aim of the study: assessment of influence of complex treatment of chronic recurrent chlamydial cervical infection with probiotics of various forms of the use on the immune status and the vaginal microbiocenosis in women of reproductive age. Materials and methods. The study surveyed 87 women of age from 18 to 35 years, from which 67 patients of recurrent chlamydial cervicitis, which (according to the protocol) were eligible for inclusion. The control group included 20 gynecologicaly healthy women. All surveyed women were representative by age and data of the obstetric-gynecologic and somatic anamnesis. In accordance with the objectives of the study, all patients with chlamydia infection (CHI) before the appointment of therapy were randomized into two groups matched for age, symptoms and duration of the inflammatory process. The I (main) group included 35 patients who underwent complex therapy. Part of therapy included drugs Sumamed 250 mg (1 capsule) 1 time a day for 5-7 days according to the scheme: 1st day – 1 g (4 capsules) with the 2nd -3rd day – 500 mg per day (2 capsules) and 4th – 7th day – 250 mg per day (1 capsule). Topically applied combination of reparative, anti-inflammatory and antimicrobial drug Depantol in the form of suppositories – appointed standard one vaginal suppository twice a day for 10 days. Later was appointed eubiotic Lacto® 2 capsules 3 times a day during 3 weeks. The II group included 32 patients (comparison group) who underwent treatment involving Sumamed and Depantol, but with the subsequent appointment of local eubiotiks (1 vaginal suppository at night) – 10 days. Results. The results of the survey of women of reproductive age with chronic recurrent chlamydial cervicitis during colposcopic study found a high frequency of cervical pathologies, namely, inflammatory changes – 100%, ectopia prismatic epithelium – 32.8%, the true erosion – 19.4%, that in 5.9% cases was combined with leukoplakia, and dysplasia – 16.4%, which correlated with cytological examination (ASCUS – 68.6%, LSIL – 25.5%, HSIL and 2.9%). Most women with CHI noted deep violations of microbiocenosis of the vagina with a predominance of opportunistic pathogenic bacteria: Peptostreptococcus – in 43.3%, Corynebacterium – in 56.7%, epidermal staph in 65.7% and gardnerellas – in 74.6%, candida – in 46.3% of cases. Patients with CHI were stated a lack of interferon Genesis – reduction of IFN-a 1.4-fold and IFN-g – 1.8 times. Conclusion. The complex therapy of chronic recurrent chlamydial cervicitis in women of reproductive age was conducted by the developed algorithm with the inclusion of oral probiotic Lacto® contributed to the increase of parameters of nonspecific resistance of the organism in 88% of cases, which was reflected in the reduction of titers of specific IgM 1.4-fold, IgG – 1.8 times, raising the level of lysozyme in cervical mucus – 1.5 times and sIgA – 1.2 times, the restoration of cytokine profile and normalization of microbiocenosis of the vagina in 76.4% of women. Key words: probiotics, immunity, cytokines, T-lymphocytes, microbiocenosis, Saccharomyces, Bifidobacterium, antibiotic-associated diarrhea, chlamydial infection, efficiency.


2014 ◽  
Vol 63 (5) ◽  
pp. 46-50 ◽  
Author(s):  
Valentina Fiodorovna Dolgushina ◽  
Nadezhda Aanatolyevna Troshina ◽  
TatianaVladimirovna Vladimirovna Nadvikova

The aim of our research was to identify clinical, morphological features of chronic endometritis among women of reproductive age with a hysteromyoma. 150 patients of reproductive age were surveyed. After which women were divided into three groups. The first group consisted of women at whom the hysteromyoma was combined with a chronic endometritis. The second group - chronic endometritis without hysteromyoma. The third group consisted of apparently healthy women who have addressed to the doctor with questions of contraception and pregnancy planning. It is established that the clinical and morphological picture of a chronic endometritis doesn’t depend on existence at such women of a hysteromyoma. At the women surveyed in both the first and second group almost equally often found inflammatory diseases of the pelvic organs, the bottom department of the genitals, hyperplastic process of endometrium, abnormal uterine bleeding. Special difference in activity of inflammatory process in an endometriya depending on the availability at these women hysteromyoma is not revealed. The combination of chronic endometritis with hysteromyoma is more common for women of late reproductive age, in the anamnesis whicht had childbirth, induced abortion.


2021 ◽  
Vol 38 (1) ◽  
pp. 64-71
Author(s):  
L. M. Rzakulieva ◽  
A. E. Hajizade

Objective. The aim was to study the characteristics of reproductive function in women of fertile age with infertility and hyperfunction of the thyroid gland. Materials and methods. The object of the study was 148 women of fertile age. To compare the indicators obtained by special methods, the control group included the indicators of laboratory and instrumental examination of 30 non-pregnant women of reproductive age. Reproductive function was evaluated in 118 women with hyperthyroidism: 58 retrospectively (group I) and 60 prospectively (group II); the control group consisted of 30 healthy women of reproductive age. Hormonal studies were performed by radioimmune and enzyme immunoassay methods using the automatic analyzer "Cobb" ("Hoffmann La Roche", Switzerland), as well as DPS test systems the analyzer Immulite (USA). Ultrasound of the thyroid gland was performed by a linear sensor with a frequency of 7.5 MHz. The volume of the thyroid gland was calculated according to the Bruno formula. Results. For women of fertile age with hyperthyroidism, a decrease in ovarian reserve is characteristic that is manifested by a significant increase in FSH level (14.1 3.1 IU / L, p 0.05), and a decrease in inhibin B level (35.9 12,7 pg / ml, p 0.05). In 47.7 % of women of fertile age with hyperthyroidism, there is a decrease in ovarian volume and a significant reduction in the average number of antral follicles of normal size (4.34 1.56, p 0.05). Conclusions. Based on the results obtained, it can be assumed that in diffuse toxic goiter there are not only functional disorders (metabolism of hormones of the reproductive system), but also deep organic changes in the structure of the ovaries that leads to a rapid suppression of their functions. In cases of thyroid diseases, the clinical manifestation of these changes is premature and early menopause.


2019 ◽  
Vol 147 (5-6) ◽  
pp. 321-326
Author(s):  
Radmila Sparic ◽  
Dimitrios Papoutsis ◽  
Svetlana Spremovic-Radjenovic ◽  
Sasa Kadija ◽  
Zoran Bukumiric ◽  
...  

Introduction/Objective. Very little is known about the factors influencing women?s attitude towards colposcopy follow-up after cervical treatment. The aim of the study was to investigate the long-term attitude to follow-up colposcopy in women of reproductive age after cervical excision and to evaluate if their attitude was related to their anxiety and depression levels. Methods. Women treated with cervical excision were interviewed after a follow-up colposcopy visit. Their socio-demographic and clinical characteristics were recorded. All women filled in the Beck?s anxiety and depression inventory. Results. A total of 160 women were divided into the study group of 42 (26.3%) women who felt discomfort during follow-up colposcopy and the control group of 118 (73.7%) women who did not report such feelings. The mean age of the total sample was 35.3 ? 5.4 years with median time after treatment being five years (range: 2?18). Women in the study group had a significantly lower BMI values, had higher rates of nulliparity and nulligravidity, were more often single or living alone, and had significantly changed their attitude towards condom use after treatment. Beck?s anxiety and depression scores were significantly higher in the study group. Multivariate analysis showed that independent predictors of discomfort during follow-up colposcopy were anxiety levels (OR: 1.06; 95% CI: 1?1.12), living alone or without a partner (OR: 2.65; 95% CI: 1.08?6.55), and the change in their practice of condom use after treatment (OR: 2.69; 95% CI: 1.02?7.07). Conclusion. Almost one third of women after excisional treatment reported discomfort during their follow-up colposcopy. These women exhibited higher levels of anxiety.


2019 ◽  
Vol 9 (3-4) ◽  
pp. 612-616
Author(s):  
N. A. Burova ◽  
P. A. Soltys ◽  
N. A. Zharkin ◽  
M. S. Selikhova ◽  
N. I. Sviridova ◽  
...  

Dynamics of serum proinflammatory cytokines such as interleukins (IL)-1, -2 and -6, tumor necrosis factor alpha (TNFα) was examined in patients of reproductive age suffering from acute inflammatory diseases of the pelvic organs. Our study was carried out with female patients at hospital admission prior to therapy applied with conventional methods of treatment and improved treatment by using vaginal low-frequency laser in a constant continuous magnetic field. The data obtained were compared with serum cytokine level from 20 healthy female volunteers of reproductive age consulted on better contraception methods. It was found that cytokine profile of in patients with acute inflammatory processes in pelvic organs was characterized by a high level of proinflammatory cytokines. It was shown that patients receiving conventional treatment contained decreased level of serum IL-1, IL-2, IL-6 and TNFα displaying slight dynamics, which did not reach it in control group. This may contribute to ongoing inflammatory process, despite the positive clinical dynamics. In turn, imbalance of immune responses leads to a persistently impaired fertility in women and need to perform subsequent comprehensive rehabilitation measures. Moreover, patients applied with intravaginal low-frequency laser radiation in a constant magnetic field were found to contain serum TNFα < 100 pg/ml observed in 59.7% of cases, IL-6 level was lower than 20 pg/ml (prevalent in control group) found in 54.2% of cases. Serum IL-2 level was decreased by 3.5-fold compared to baseline, whereas for IL-1β it was higher than 100 pg/ml in as few as 23.6% patients. Such temporal pattern of inflammatory markers with rapid significant decrease of serum proinflammatory cytokines in patients with preformed pathogenic factors can reduce probability of connective tissue formation and activate their own repair as well as regenerative events. The results obtained allow to wider use combined physical interventional factors for therapy of patients with acute inflammatory diseases of the pelvic organs.


Author(s):  
N.Ye. Horban ◽  
N.P. Dzys ◽  
O. V. Lynchak ◽  
T.M. Pokanevych

One of the main conditions for the birth of a healthy baby is the gynecological health of the mother. For this reason, the purpose of the work was to assess the state of gynecological health of women in the Kyiv region. In this work, we used the data of departmental statistical reporting of the Ministry of Health of Ukraine about the number of cases of gynecological pathology from 2010-2017. The number of women of the corresponding age was determined according to the State Statistics Service of Ukraine. The relative risk of pathology (taking into account the 95 % confidence interval) from 2010-2013, 2014-2017 in the Kyiv region was evaluated in comparison with the general indicators in Ukraine as well as from 2014-2017 compared to 2010-2013 in the Kyiv region and general data in Ukraine. Separately for the Kyiv region, the frequency of gynecological pathology was determined among women of reproductive age (707 women), who visited Municipal Institution of Kyiv Regional Council “Kyiv Regional Centre for the Mother and Child Health Defense” from 2014 to 2017. The average age of women was 31.66±0.37. In most cases, the residents of the Kyiv region were diagnosed with chronic inflammatory diseases of the pelvic organs (salpingitis, 21.6 ‰). The relative risks of the occurrence of such diseases were determined in the region, compared with Ukraine, and over time. Those, who had menstrual disorders, hyperproliferative processes of the endometrium were more often recorded (10.8% versus 3.1%, p<0.01), and those with inflammatory processes of the pelvic organs more often had cervical dysplasia (19.8 % versus 4.7 %, p<0.001), chronic diseases of the genitourinary system (7.1 % versus 3.2 %, p<0.05) and digestive organs (17.3 % versus 9.6 %, p<0.01), which indicates a possible pathogenetic role of the inflammatory factor in the development of gynecological pathology. The relative risk of gynecological diseases among the women in the Kyiv region showed that the greatest attention is needed to improving the diagnostics of infertility and endometriosis, as well as the prevention and treatment of salpingitis and uterine cancer. Women with menstrual disorder during their visit to a gynecologist should be checked for the presence of hyperproliferative pathology and, in case a woman is diagnosed with other chronic diseases, they should be offered treatment of these areas of inflammation, which can further positively affect their reproductive health.


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