Functional state of the vaginal mucosa in bacterial vaginosis and its correction

2017 ◽  
pp. 77-82
Author(s):  
V.O. Beyuk ◽  
◽  
O.A. Shcherba ◽  
L.D. Lastovetska ◽  
◽  
...  

Bacterial vaginosis is the most common cause of the treatment of women of reproductive age to the gynecologist. It accounts for up to 50% of cases of pathological discharge from the genital organs. In 50-75% of cases, bacterial vaginosis is asymptomatic. The examination of the patient occupies one of the key positions in the effective treatment of the patient. Nitrosamines, which are metabolites of obligate anaerobic bacteria and coenzymes of carcinogenesis, and may be one of the cause for the genesis of cervical cancer. The objective: assess the condition of the mucous membrane of the vagina and cervix in bacterial vaginosis, the effectiveness of its treatment in women of reproductive age. Materials and methods. Оf investigation 64 women of reproductive age with bacterial vaginosis were examined and treated, of which 34 patients (group I of the study) conducted our therapy which received the Tyloron and the local combined preparation of dexpanthenol and chlorhexidine bigluconate, followed by the introduction of lactobacilli in standard doses. 30 patients (group II of the study) received standard treatment. The control group consisted of 27 healthy women. Results. Results of treatment of bacterial vaginosis in women of reproductive age are presented. In 94.1% and a group of cases, we achieved a clinically significant effect, compared with group II (76.7%) of 10 days of treatment. Three months after the end of treatment, 97.1% of the patients in the main group recovered (group II – 86.6%). Conclusions. The use of the complex therapy of bacterial vaginosis proposed by us showed a high rate of recovery, and a low rate of recurrence in women of reproductive age. Key words: bacterial vaginosis, diagnosis, treatment, tyrolon, dexpanthenol, chlorhexidine.

2017 ◽  
pp. 44-50
Author(s):  
V.A. Benyuk ◽  
◽  
A.A. Shcherba ◽  

The frequency of bacterial vaginosis (BV) ranges from 12 to 64% among diseases of the female body and in many respects depends on the contingent of the women being examined. Nitrosamines,the metabolic products of obligatory anaerobic bacteria, are coenzymes of carcinogenesis and can be one of the causes of the development of cervical cancer. The objective: is to evaluate the efficacy of bacterial vaginosis in women of reproductive age. Patients and methods. Of study 64 women of reproductive age with BV were examined and treated, which 34 patients (group I study) conducted our therapy with tinidazole and the local preparation Lactagel. 30 patients (group II) received standard treatment. The control group consisted of 27 healthy women. Results. The article presents the results of treatment of BV in women of reproductive age. In 94.1% of cases we’ve achieved a clinically significant effect in compared to Group II (76.7%) after 10 days of treatment. Three months after the end of treatment, recovery occurred in 97.1% of the patients in the main group (Group II – 86.6%). Conclusions. The application of the complex bacterial vaginosis treatment offered by us showed a high recovery rate and a low rate of relapse in women of reproductive age. Key words: bacterial vaginosis, diagnosis, treatment, Lactagel.


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.


2021 ◽  
pp. 12-17
Author(s):  
Svitlana Pandei ◽  
Dmytro Ledin ◽  
Oleksandra Lubkovska

The aim. Reducing the recurrence of vulvovaginal candidiasis (VVC) in combination with bacterial vaginosis (BV) in women of reproductive age by studying the pathogenesis and improving the algorithm of treatment and prevention measures. Materials and methods. During the study, 150 women of reproductive age who had the same clinical manifestations of VVC and BV were selected and divided into 3 groups of 50 women: Group I was treated with an antimicrobial combination drug (miconazole with topical metronidazole), group II – the same drug in combination with probiotic (lactobacilli) in candles, group III – according to the algorithm improved by the authors. In addition, a control group was formed, which included healthy women of reproductive age.  To establish the pathogenesis of VVC in combination with BV in the studied women, the concentration of cytokines and adhesion molecules in the blood before and after treatment was determined and compared with the control group. The clinical effect of different treatments was assessed at 3, 7, 10, 14 days, and the presence of relapses – 1, 3, 6 months after treatment. Results. The occurrence of a combination of VVC and BV in women of reproductive age is accompanied by a significant increase in the level of intercellular adhesion molecules (ICAM-1) and vascular cell adhesion molecules (VCAM-1) along with a statistically significant increase in proinflammatory cytokines (interleukin-6) (IL-6), interleukin-8 (IL-8)) and tumor necrosis factor (TNF) - TNF-α. As a result of the application of the algorithm improved by the authors, higher clinical efficiency and the ability to avoid recurrence of VVC in combination with BV in women of reproductive age were obtained. Conclusions. The authors' substantiated improvement of the algorithm of VVC treatment in combination with BV in women of reproductive age makes it possible to reduce the frequency of their recurrence and restore the biocenosis of the vagina to normal. In the case of this pathology there is an increase in the level of pro-inflammatory cytokines (IL-6, IL-8), TNF-α and ICAM-1 and VCAM-1.


2021 ◽  
pp. 83-88
Author(s):  
N.F. Zakharenko ◽  
I.P. Manoliak

Research objective: to increase the effectiveness of bacterial vaginosis (BV) treatment in women of reproductive age.Materials and methods. The study involved 64 women of reproductive age with BV. After a course of local antibiotic therapy participants were divided into 2 groups: patients of group I were not prescribed local remedies to restore the vaginal microflora, patients of group II were prescribed vaginal prebiotic suppositories Folial № 10. No additional drugs were used in subgroups IA and IIA, while oral probiotic Maxibalance was prescribed in subgroups IB and IIB. The effectiveness of BV treatment was evaluated at the first, third and sixth months of the observation period according to the results of clinical examination and vaginal pH evaluation by litmus strips.Results. The course of BV in subgroup IA was characterized by prevailing number of relapses and their early appearance. 1 case of BV recurrence was found among patients of subgroup IA at the 1st month of follow-up, 6 and 8 BV episodes were found at 3 and 6 months of follow-up respectively. Sequential treatment with antibiotics and oral probiotics (subgroup IIB) was associated with the onset of 3 BV relapses on 4–5 months from baseline. Local prebiotic (subgroup IIA) after the vaginal sanation was associated with BV reoccurrence in only one patient at the end of the study. No relapses of BV were detected in subgroup IIB during the study.Conclusions. Permanent imbalance of vaginal normocenosis creates optimal conditions for chronic and recurrent diseases of dysbiosis nature, especially BV. Despite the sensitivity of the anaerobic flora to the recommended antibacterial medications, their use as monotherapy in BV treatment is often insufficient. The results of the study demonstrate a significant anti-relapse efficiency of consecutive treatment by antibacterial drugs and a complex of probiotic + prebiotic. This effect is probably based on the restoration of vaginal immunity and metabolism by stable colonization of the vaginal mucosa with live lactobacilli of eubiotic origin.


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.


2017 ◽  
pp. 89-95
Author(s):  
O.V. Golyanovsky ◽  
◽  
V.V. Mehedko ◽  
M.A. Budchenko ◽  
◽  
...  

The objective: to evaluate the effectiveness of treatment of women with various dysbiotic vaginal conditions with Limenda. Materials and methods. 58 women of reproductive age with BV and mixed nonspecific vaginitis participated in the study. The main group included 30 women, whose treatment was carried out with Limenda drug. The control group consisted of 28 women, whose treatment was performed according to the standard scheme using a combination of drugs. Results. Based on the results of control tests, complete elimination of pathogens occurred in 29 (96.67%) patients of the main group and in 26 (92.86%) patients of the control group. Five days after the treatment, all 30 (100%) women in the main group noted complete disappearance of symptoms on the control visit, and 2 (7.14%) of the control group complained of minor discomfort in the vagina, which required continued treatment. The conclusion. For the treatment of nonspecific vaginitis and bacterial vaginosis, especially chronic and often recurrent forms, it is better to use combined local remedies. The results of this study reliably testify to the high effectiveness of the combined drug Limenda compared with standard treatment regimens. Key words: vaginitis, bacterial vaginosis, vaginal biocenosis, conditional resistance, metronidazole, miconazole, Limenda.


2020 ◽  
pp. 66-70
Author(s):  
T.G. Romanenko ◽  
◽  
T.N. Ignatiuk ◽  
E.A. Molthanova ◽  
◽  
...  

The objective: to study the effectiveness and safety of modern antiandrogen therapy in patients with polycystic ovary syndrome (PCOS). Materials and methods. Materials and methods. The first (main) study group included 39 patients with PCOS who received combination nonsteroidal antiandrogen therapy: antiandrogen drug containing flutamide (125 mg 3 times a day) and phyto drug Ovarimedin 1 capsule 2 times a day after meals for 6 months . The II (control) group included 37 patients who received a combination drug containing 35 μg of ethinylestradiol and 2 mg of cyproterone acetate for 6 months. Results. After the course of treatment, biphasic MC was preserved in 25 (64.1%) patients of group I, and in 14 (37.8%) of group II. In group I, before the treatment of stage III hirsutism was in 23 patients (58.9%), after treatment – in 6 patients (15.3%); II stage in 10 patients (25.6%) before treatment, after treatment – in 18 patients (46.1%); I stage was found in 6 patients before treatment (15.5%) and in 15 patients (38.6%) after treatment. In group II patients, stage ІІІ hirsutism was detected in 21 patients (56.7%) before treatment, and in 7 patients (18.9%) after treatment; II stage in 9 patients (24.3%) before treatment, after treatment – in 13 patients (35.1%); I stage was found in 7 patients before treatment (19.0%) and in 17 patients (45.9%) after treatment. Conclusions. Antiandrogenic nonsteroidal therapy with multicomponent herbal drug (Ovaremidine) and nonsteroidal antiandrogens may be recommended for the treatment of women with functional hyperandrogenism accompanied by hirsut syndrome, menstrual irregularities and / or infertility. Our study confirmed that the use of this therapy contributes to the effective treatment of hirsutism, the restoration of menstrual disorders and fertility in women. Differential algorithm for the treatment of hyperandrogenism of various etiologies, which can be recommended in the clinical practice of obstetricians and gynecologists. Keywords: hyperandrogenism, polycystic ovary syndrome (PCOS), menstrual cycle, infertility, hirsutism, phytotherapy.


2020 ◽  
Vol 14 (5) ◽  
pp. 551-567
Author(s):  
A. Yu. Vlasina ◽  
A. G. Solopova ◽  
E. A. Son ◽  
A. E. Ivanov ◽  
I. M. Zhalyalova

Aim: to study the severity of surgical menopause (postovariectomy syndrome), anxiety, depression and sexual function in patients with borderline ovarian tumors (BOTs) after radical treatment, depending on management in the rehabilitation period.Materials and Methods. There were examined 62 women of reproductive age (42.0 ± 4.1 years) after radical treatment of BOTs: Group I - 29 patients were observed during rehabilitation period according to the standards and the National Clinical Guidelines and underwent a 12-month Comprehensive Personalized Rehabilitation Program; Group II - 33 non-participating rehabilitation program patients. The Modified Menopausal Index (MMI) and all related constituent subscales, the level of anxiety and depression according to the HADS (Hospital Anxiety and Depression Scale), as well as sexual function according to the FSFI (Female Sexual Function Index) scale were assessed prior to surgery as well as 1, 6, and 12 months afterwards.Results. All study participants noted significantly aggravated symptoms related to surgical menopause as early as 1 month after treatment: the total MMI increased from 10.9 ± 2.2 score (lacked manifestations of surgical menopause) up to 37.0 ± 6.3 score (moderate manifestations) in Group I and from 10.5 ± 2.0 score (lacked manifestations of surgical menopause) up to 35.8 ± 4.3 score (moderate manifestations) in Group II. By the 12 months, MMI decreased down to 22.2 ± 4.6 score (mild manifestations) in Group I and remained almost unchanged in Group II - 36.9 ± 8.0 (moderate manifestations). In 93.1 % and 81.8 % women from Group I and Group II, respectively, 1 month after antitumor therapy, disorders of the psycho-emotional sphere were observed. In Group I, after 12 months parameters returned to preoperative baseline magnitude, whereas in Group II 87.9 % of patients noted their significant altered values. A twofold decrease in anxiety values according to the HADS was observed in Group I after 12 months of rehabilitation therapy, whereas in Group II, it was also decreased, but to a lower degree. While assessing level of depression, it was found to gradually increase in Group II within the first year after the operation, whereas in Group I it was steadily decreased. Within 1 month after radical treatment of BOTs, a significant decrease in sexual function and the FSFI index was observed in all women of reproductive age (from 23.7 ± 5.5 to 4.0 ± 1.2 score in Group I and from 23.4 ± 5.3 up to 4.0 ± 1.3 score in Group II). After 12 months of comprehensive rehabilitation, sexual function was almost completely recovered in Group I (22.5 ± 5.4 score), whereas in Group II sexual dysfunction was markedly evident (14.9 ± 6.4 score).Conclusion. Comprehensive personalized rehabilitation can reduce the negative symptoms of surgical menopause, normalize the psycho-emotional state, increase sexual function, and hence, improve the quality of life of patients with BOTs of reproductive age after radical treatment.


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.


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.


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