Vaginal discharge syndrome. Problem with many unknowns

Authors

  • Т. Ф Татарчук SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine” State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine", Kyiv, Ukraine https://orcid.org/0000-0002-5498-4143
  • Л. В. Калугіна SI “O.M. Lukyanova Institute of Pediatrics NAMS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0003-2263-6627
  • Г. А. Петрова Sumy branch of V.I. Grishchenko Clinic for Reproductive Medicine, Sumy, Ukraine
  • В. В. Радченко FPE of Dnipropetrovsk Medical Academy, Dnipro, Ukraine
  • В. В. Шаверська Specialized Medical Center “Optima-farm”, Kyiv, Ukraine https://orcid.org/0000-0002-7330-8562
  • А. М. Сорокіна SPS “Consultative and Diagnostic Center” Desnyansky district of Kyiv, Ukraine https://orcid.org/0000-0001-9993-6359
  • О. В. Смирнова Clinic of St. Catherine MoH of Ukraine, Medical Center LLC "Cardica Assistance", Odesa, Ukraine https://orcid.org/0000-0001-9794-5753

DOI:

https://doi.org/10.18370/2309-4117.2020.53.94-100

Keywords:

vaginal discharge syndrome, bacterial vaginosis, mixed infection, treatment, metronidazole, miconazole

Abstract

The main reason for visiting an obstetrician-gynecologist is the vaginal discharge syndrome (VDS) of infectious etiology. The most common causes of infectious vaginitis wich are identifed by European researchers are bacterial vaginosis (BV), aerobic vaginitis, vulvovaginal candidiasis and mixed infections. Treatment of VDS is a serious problem not only because of the pathogens’s resistance and frequent recurrences, but especially due to the COVID-19 pandemic which can complicate further patient`s examination for determination of infectious agent and the choice of individual approach to etiotropic therapy.

Purpose of study: to investigate the structure of causes of pathological vaginal discharge in Ukrainian women, as well as assess the compliance and effectiveness of their treatment.

Methods: 472 doctors of women's consultation centres, gynecological hospitals and centers of reproductive medicine from 23 regions of Ukraine were enrolled in multi-center study of vulvovaginal infections management. During the study, which lasted from August to December 2019, were examined 45,295 patients aged 18 to 59 years who complained for pathological vaginal discharge.

Results: analysis of the structure of nosologies that caused VDS showed that the examined patients were most often diagnosed with BV (41.1%), colpitis of mixed etiology (26.59%) and vulvovaginal candidiasis (19.22%), trichomoniasis was confirmed in 8.44%. The interviewed gynecologists preferred topical therapy in 95,99% cases of BV and colpitis of mixed etiology. Topical combined medications were prescribed in 85,21% of cases, monoforms – in 14.79%. Among the combined vaginal dosage forms the combination of metronidazole 750 mg /miconazole 200 mg was preferred in 48.81% of cases with clinical efficacy 87.1% in patients with BV and 86,9% in women with mixed infection. Normalization of the vaginal biocenosis was observed in 93.50% of the examined patients. The study demonstrated the safety, good tolerability and compliance of patients to therapy with the combined medications metronidazole 750 mg / miconazole 200 mg in vaginal suppositories.

Conclusion: BV, colpitis of mixed etiology and vulvovaginal candidiasis are predominated in structure of main causes of VDS in Ukraine. In the treatment of VDS, priority is given to vaginal forms with the most compliant (89.8%) regimen: once a day for a short period (7 days). The obtained high bacteriological (93.50%) and clinical (86,9%) efficacy of therapy of BV and vaginal mixed infections with the combined drug metronidazole 750 mg / miconazole 200 mg allows to recommend it as the drug of choice.

Author Biographies

Т. Ф Татарчук, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine” State Scientific Institution “Center for Innovative Medical Technologies of the NAS of Ukraine", Kyiv

MD, professor, corresponding member of the NAMS of Ukraine, deputy director for research work, head of the Endocrine Gynecology Department

Head of the the Department of Reproductive Health

Л. В. Калугіна, SI “O.M. Lukyanova Institute of Pediatrics NAMS of Ukraine”, Kyiv

MD, leading researcher, Endocrine Gynecology Department

Obstetrics and Gynecology

Г. А. Петрова, Sumy branch of V.I. Grishchenko Clinic for Reproductive Medicine, Sumy

MD, obstetrician-gynecologist, head doctor

В. В. Радченко, FPE of Dnipropetrovsk Medical Academy, Dnipro

MD, assistant, Department of Obstetrics, Gynecology and Perinatology

В. В. Шаверська, Specialized Medical Center “Optima-farm”, Kyiv

Obstetrician gynecologist

А. М. Сорокіна, SPS “Consultative and Diagnostic Center” Desnyansky district of Kyiv

Obstetrician gynecologist, branch No. 2

О. В. Смирнова, Clinic of St. Catherine MoH of Ukraine, Medical Center LLC "Cardica Assistance", Odesa

Obstetrician gynecologist

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Published

2020-07-10

How to Cite

Татарчук, Т. Ф., Калугіна, Л. В., Петрова, Г. А., Радченко, В. В., Шаверська, В. В., Сорокіна, А. М., & Смирнова, О. В. (2020). Vaginal discharge syndrome. Problem with many unknowns. REPRODUCTIVE ENDOCRINOLOGY, (53), 94–100. https://doi.org/10.18370/2309-4117.2020.53.94-100

Issue

No. 53 (2020)

Section

Inflammatory diseases

License

Copyright (c) 2020 Т. Ф Татарчук, Л. В. Калугіна, Г. А. Петрова, В. В. Радченко, В. В. Шаверська, А. М. Сорокіна, О. В. Смирнова

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