The effectiveness of complex therapy in the treatment of nonspecific vaginitis in women of reproductive age
DOI:
https://doi.org/10.34287/MMT.4(55).2022.6Abstract
Objective. One of the most common gynecological pathologies among women of reproductive age is non-specific vaginitis. Bacterial vaginosis and aerobic vaginitis cause many obstetric and gynecological complications, and disease recurrence remains high. The aim of the study is to assess the effectiveness of complex therapy in the treatment of non-specific vaginitis in women of reproductive age.
Materials and Methods. 160 women (100%) were examined, which were divided into 2 clinical groups with subgroups: the main group - 94 (58.8 %) patients with nonspecific vaginitis, who received treatment according to developed clinical diagnostic algorithms and schemes. The comparison group included 66 (41.2 %) patients with nonspecific vaginitis, who received treatment according to known protocols. Research methods: general (collection of complaints and anamnesis, gynecological examination, assessment of microscopy of vaginal smears according to the Amsel, Nugent and Donders criteria), laboratory (determination levels of follicle-stimulating, luteinizing hormones, prolactin, estradiol, adrenaline, noradrenaline, cortisol, magnesium in the blood), statistical.
Results. Treatment of non-specific vaginitis according to complex schemes in the main group showed a significant decrease in the average follicle-stimulating hormone indicators – by 2.7 times, luteinizing hormone – by 2.6 times, prolactin – by 1.3 times (р<0,05) compares to the indicators before treatment. The estradiol level in the main group probably increased 1.3 times (р<0,05). The magnesium level also increased by an average of 1.4 times (р<0,05). Complex therapy in the main group significantly reduced the adrenaline levels by an average of 1.6 times, noradrenaline by 2.4 times, and cortisol by 1.8 times compared to the values before treatment (р<0,05). The proposed complex schemes are likely to improve the clinical effectiveness of drug treatment of non-specific vaginitis in the near and distant periods, which is accompanied by faster disappearance of complaints and normalization of the local condition during the gynecological examination (p<0,05), restoration of the vaginal microflora (p<0,05), a decrease frequency of recurrence in the main group of patients (c2=4,32; p<0,05).
Conclusions. It is appropriate to use complex treatment of bacterial vaginosis and aerobic vaginitis in women of reproductive age.
References
Javed A, Parvaiz F, Manzoor S. Bacterial vaginosis: An insight into the prevalence, alternative treatments regimen and it's associated resistance patterns. Microb Pathog. 2019; 127: 21-30. doi: 10.1016/j.micpath.2018.11.046.
Jones A. Bacterial Vaginosis: A Review of Treatment, Recurrence, and Disparities. The Journal for Nurse Practitioners. 2019; 15(6): 420-423. http://doi.org/10.1016/j.nurpra.2019.03.010.
Ma X, Wu M, Wang C et al. The pathogenesis of prevalent aerobic bacteria in aerobic vaginitis and adverse pregnancy outcomes: a narrative review. Reprod Health. 2022; 19, 21. https://doi.org/10.1186/s12978-021-01292-8.
Redelinghuys MJ, Geldenhuys J, Jung H et al. Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities. Front. Cell. Infect. Microbiol. 2020; 10:1-20. http://doi.org/10.3389/fcimb.2020.00354.
Sonthalia S, Aggarwal P, Das S et al. Aerobic vaginitis - An underdiagnosed cause of vaginal discharge - Narrative review. Int J STD AIDS. 2020; 31(11): 1018-1027. http://doi.org/10.1177/0956462420913435.
Alisoltani A, Manhanzva MT, Potgieter M et al. Microbial function and genital inflammation in young South African women at high risk of HIV infection. Microbiome. 2020; 8(1): 1-21. https://doi.org/10.1186/s40168-020-00932-8.
Skafte-Holm A, Humaidan P, Bernabeu A et al. The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women Undergoing IVF-Treatment: A Systematic PRISMA Review and Meta-Analysis. Pathogens. 2021; 10(3): 1-16. http://doi.org/10.3390/pathogens10030295.
Coudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020; 245: 143-148. http://doi.org/10.1016/j.ejogrb.2019.12.035.
Vodstrcil LA, Muzny CA, Plummer EL et al. Bacterial vaginosis: drivers of recurrence and challenges and opportunities in partner treatment. BMC Med. 2021; 19: 1-12. https://doi.org/10.1186/s12916-021-02077-3.