Complicated chronic salpingo-oophoritis in young women. Possibilities of conservative therapy
Keywords:pelvic inflammatory disease, hydrosalpinx, young women, conservative treatment
Purpose of the study: to improve the scheme of conservative treatment of chronic salpingo-oophoritis complicated by hydrosalpinx in young women.
Materials and methods. The study included 65 patients with chronic salpingo-oophoritis complicated by hydrosalpinx. The mean age of patients was 28 ± 5.9 years. Women were randomized into 2 groups depending on the therapy scheme. Group I (33 women) in addition to the standard complex were prescribed Distreptaza® suppositories rectally for a period of 15 days. Group II (32 women) received a standard complex, which included an antibacterial drug and a symbiotic. The diagnostic complex carried out in the treatment dynamics included a general clinical, gynecological examination, microbiological studies. Ultrasound and determination of luteinizing hormone, follicle-stimulating hormone, prolactin, estradiol and progesterone in plasma were performed before therapy and 1 month after.
Results. Faster regression of pain in patients receiving treatment with Distreptaza® was accompanied by no sonographic signs of distal occlusion in fallopian tube in 48.48% patients; standard therapy was effective in 21.87% women. Microbiocenosis of the genital tract was restored in most patients of the examined groups after a month of treatment. There was a significant (p <0.05) 3-fold increase in progesterone levels in the second phase of the menstrual cycle after the end of antibacterial therapy in the first group. This is indicated the resumption of ovulatory cycles. This is makes it appropriate to use the selected drugs combination in young patients (up to 35 years) with unrealized reproductive plans.Conclusions. Treatment of chronic salpingo-oophoritis complicated by hydrosalpinx in young women should be comprehensive and include in the first stage empirical antibacterial, anti-inflammatory and antifungal therapy, symbiotics and polyenzyme drugs. Organ-preserving methods should be preferred among surgical methods№ 4
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