DIFFERENTIATED ALGORITHM OF MANAGEMENT OF PATIENTS OF REPRODUCTIVE AGE WITH UTERINE LEIOMYOMA WITH DIFFERENT TYPE OF VAGINAL BIOCENOSIS
DOI:
https://doi.org/10.11603/24116-4944.2018.1.8793Keywords:
algorithm of reference, uterine leiomyoma, vaginal biocenosis.Abstract
The aim of the study – to develop an algorithm for the prevention and treatment of vaginal biocenosis disorders in women of reproductive age, patients with uterine leiomyoma.
Materials and Methods. 216 women of reproductive age, patients with uterine leiomyoma, were examined. The material from the vagina, cervical canal, urethra, tissues of leiomatous nodes has been bacteriologically examined.
Results and Discussion. In patients with uterine leiomyoma, the ІІ degree of “purity” of the vagina predominated – an “intermediate type” of the smear (46.8 %). Bacterial vaginosis was diagnosed in 42.6 % of cases, vaginitis – in 10.2 %. A significant difference was found between the frequency of detection of Mycoplasma hominis in the vaginal contents, cervical canal and tissues of the leiomatous nodes, where the detection rate was 28.9 % and 27.6 % higher, Ureaplasma urealyticum – by 30.2 % and 28.4 %, Virus papilloma homynis oncogenic types – by 18.8 % and 18.2 %, respectively. Algorithms for diagnosis, prevention and therapy of vaginal biocenosis disorders in women of reproductive age, patients with uterine leiomyoma have been developed, improved and applied.
Conclusions. A differentiated algorithm for managing women of reproductive age, patients with uterine leiomyoma, consisted in monitoring the biocenosis of the vagina 2 to 3 times a year, and the preventive use of probiotics. Etiotropic therapy of dysbiosis of the vagina, vaginitis should begin with the 5th day of therapy with probiotics. Prospects for further development will be studies of retrospective analysis of medical records of women of reproductive age, patients with uterine leiomyoma.
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