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
Kreisel, K., Torrone, E., Bernstein, K., et al. “Prevalence of Pelvic Inflammatory Disease in Sexually Experienced Women of Reproductive Age – United States, 2013–2014.” MMWR Morb Mortal Wkly Rep 66.3 (2017): 80–3.
Haggerty, C.L., et al. “Identification of novel microbes associated with pelvic inflammatory disease and infertility.” Sex Transm Infect 92.6 (2016): 441–6.
Miller, J.M., et al. “A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya.” Clin Infect Dis 67.6 (2018): 813–6.
Vander Borght, M., Wyns, C. “Fertility and infertility: Definition and epidemiology.” Clin Biochem 62 (2018): 2–10.
European Guideline for the Management of Pelvic Inflammatory Disease, v. 5. Available from: [https://www.coursehero.com/file/17921754/PID-Treatment-Guidelines-Europe2012v5/].
Ashrafian, S., Uyar, D. “Impact of BMI on Pelvic Inflammatory Disease [32Q].” Obstet Gynecol 131 (2018): 192S–193S.
Tatarchuk, T.F., Kosei, N.V., Zanko, O.V., Yusko, T.I. “Endometrial polyps: optimization of anti-inflammatory therapy.” Reproductive endocrinology 6.44 (2019): 8–14. DOI: 10.18370/2309-4117.2018.44.8-14
Mayorov, M.V., Zhuchenko, S.I., Zhuperkova, E.A., Chernyak, O.L. “Inflammatory diseases of the pelvic organs: the role of combination therapy.” Medical aspects of women's health 2.107 (2017): 58–64.
Dubossarskaya, Z.M., Dubossarskaya, Y.A., Grek, L.P., Ushakova, T.B. “A modern look at the problem of inflammatory diseases of the pelvic organs in women.” Women’s Health 6.122 (2017): 57–62.
Moreno, I., Franasiak, J.M. “Endometrial microbiota – new player in town.” Fertil Steril 108.1 (2017): 32–9.
Islamova, G.O. “On the issue of treatment of menstrual cycle disorders in women of reproductive age.” Women’s Health 5.91 (2014): 1–3.
Rasmussen, C.B., Kjaer, S.K., Albieri, V., et al. “Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case Control Studies.” Am J Epidemiol 185.1 (2017): 820.
Cicinelli, E., Matteo, M., Tinelli, R., et al. “Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy.” Human Reproduction 30.2 (2015): 323–30.
Inhorn, M.C., Patrizio, P. “Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century.” Hum Reprod Update 21.4 (2015): 411–26.
Akopians, A.L., Pisarska, M.D., Wang, E.T. “The role of inflammatory pathways in implantation failure: chronic endometritis and hydrosalpinges.” Seminars in reproductive medicine 33.04 (2015): 298–304.
Ross, J., Guaschino, S., Cusini, M., Jensen, J. “2017 European guideline for the management of pelvic inflammatory disease.” Int J STD AIDS 29.2 (2018): 108–14.
Savaris, R.F., Fuhrich, D.G., Duarte, R.V., et al. “Antibiotic therapy for pelvic inflammatory disease: an abridged version of a Cochrane systematic review and meta-analysis of randomised controlled trials.” Sex Transm Infect 95.1 (2019): 21–7.
Volodarsky-Perel, A., Buckett, W., Tulandi, T. “Treatment of hydrosalpinx in relation to IVF outcome: a systematic review and meta-analysis.” Reproductive biomedicine online 39.3 (2019): 413–32.
Wu, S., Zhang, Q., Li, Y. “Effect comparison of salpingectomy versus proximal tubal occlusion on ovarian reserve: A meta-analysis.” Medicine 99.30 (2020).
Safonova, I.N., Abdullaev, R.Y., Paraschuk, Y.S., et al. “Echographic picture of hydrosalpinx as a predictor of the effectiveness of treatment of distal occlusion of the fallopian tubes.” Medical aspects of women's health 9.73 (2013): 51–6.
Saavedra-Saavedra, J. “The Effectiveness of Hydrosalpinx Treatments in Patients that Need Assisted Reproductive Techniques.” Revista colombiana de obstetricia y ginecología 60.2 (2009): 171–8.
Gharib, W.F. “Ovarian Doppler changes following tubal salpingectomy for hydrosalpinx.” The Egyptian Journal of Fertility of Sterility 23.2 (2019): 42–6.
Noventa, M., Gizzo, S., Saccardi, C., et al. “Salpingectomy before assisted reproductive technologies: a systematic literature review.” J Ovarian Res 9 (2016): 74.
D’Arpe, S., Franceschetti, S., Caccetta, J., et al. “Management of hydrosalpinx before IVF: a literature review.” Journal of Obstetrics and Gynaecology 35.6 (2015): 547–50.
Chaika, A.V., Nosenko, E.N., Suslikova, L.V. “Distreptase in the prevention of adhesions in patients with tubo-peritoneal infertility.” Women’s Health 6.52 (2010): 166–70.
Sadłocha, M., Paszkowski, T., Skrzypulec-Plinta, V. “Badanie skuteczności i tolerancji leczenia preparatem Distreptaza® w przypadkach przewlekłego zespołu bólowego miednicy mniejszej.” Forum Położnictwa i Ginekologii 42 (2018).
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