Keywords : chronic inflammation of the uterine appendages
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 3, Pages 2754-2766
One of the most pressing problems in modern gynecology is the problem of chronic inflammation of the appendages. Every obstetrician-gynecologist has to deal with a complaint of pain in the lower abdomen in women every day. About 39% of women experience pelvic pain caused by inflammation of the uterine appendages periodically, while 12% of patients experience pain for at least 5 days every month, and another 12% suffer from persistent pelvic pain . Chronic pelvic pain occupies a special place among the variety of clinical manifestations of gynecological diseases and is considered by most researchers as one of the leading symptoms of inflammatory diseases of the pelvic organs: chronic salpingitis and oophoritis, pelvic peritoneal adhesions, chronic endometritis. However, the presence of a "routine" gynecological pathology cannot always explain the development of pain in the lower pelvis. Pelvic pain is an indication in 12% of all hysterectomies. For this reason, the aim of our study was to optimize the treatment of chronic inflammatory diseases of the uterine appendages to improve the quality of life and prevention of pelvic pain. The object of the study was 100 women with chronic salpingoophoritis complicated by pelvic pain, who were divided into three groups according to the method of treatment. During the study, we used, along with general clinical research methods and examination for sexually transmitted infections, special research methods, such as: studying the intensity of pain on the VAS scale, bacterioscopic and bacteriological examination of vaginal contents, ultrasound scanning and Doppler studies, estradiol, progesterone, testosterone, FSH, LH, DHEAS-S, TSH, prolactin and cortisol in the blood serum, the content of prostaglandins F2α, E2 and growth factors in the serum. In addition, the level of immunoglobulin A (IgA), the concentration of the main cytokines (IL 1β, IL6) in the blood serum were determined. The resulting material was subjected to automated statistical processing. After the examination, the patients received the necessary treatment, which included antibiotic-anti-inflammatory therapy (ceftriaxone, doxycycline, metronidazole), 20 procedures of pharmaco-physiotherapeutic intravaginal electrotherapy with the drug Glutoxim in an amount of 1 ml of 1% solution, intravaginal ultrasound therapy, synbiotic Bifiten. Based on the results of the data, the effectiveness of the use of the developed pharmaco-physiotherapeutic method (91%) was proved in comparison with intravaginal ultrasound therapy (74%) and, especially, drug therapy (40%).