Issue №6-22, 2023

Original article

https://doi.org/10.38025/2078-1962-2023-22-6-8-20

Effectiveness of Sanatorium Treatment Programs for Women with Chronic Endometritis: a Prospective Randomized Study

View article (Download PDF file)



Download XML file

1 ORCIDTatiana V. Konchugova, 1 ORCIDNatalya V. Kotenko, 1 ORCIDOlga V. Yurova, 1 ORCIDOlga O. Borisevich

1National Medical Research Center for Rehabilitation and Balneology


ABSTRACT

INTRODUCTION. The problem of recurrent antibiotic-resistant urogenital infections is increasing, and standard therapy is becoming ineffective. Sanatorium-resort treatment of chronic inflammatory diseases of the pelvic organs in women allows us to solve these problems with the help of natural and preformed physical factors.

AIM. To study the clinical effectiveness of comprehensive sanatorium treatment programs in patients with chronic endometritis.

MATERIALS AND METHODS. A prospective randomized trial included 73 patients, aged 35 ± 10 years, diagnosed with chronic endometritis. The control group (n = 25) received «basic» therapy with amplipulstherapy, sodium chloride baths. The comparison group (n = 24) received «basic» therapy and manual therapy. The main group (n = 24) received «basic» therapy, high-intensity pulsed magnetic field and manual therapy. Diagnostic criteria: immunohistochemical examination of the endometrium, echographic examination, dopplerometry of pelvic vessels, laser Doppler flowmetry.

RESULTS AND DISCUSSION. After treatment, an increase in the uterine arterial perfusion index was noted in all groups compared with baseline values. The median indicator increased in the study groups by 2.36 times, 2.4 times, and 2.6 times, respectively (p < 0.05). The decrease in the maximum peak speed in the comparison group and the main group exceeded the indicators of the control group (p < 0.001). The systolic-diastolic ratio decreased in the comparison group and the main group (p < 0.05). A decrease in stagnation in the venular microcirculation, a normotonic type of microcirculation, improvement in endothelial function (p < 0.01) were revealed in the main group.

CONCLUSION. An algorithm has been developed. In case of endometrial hypoplasia, decreased uterine perfusion, increased uterine artery resistance index, «basic» therapy is recommended, including sodium chloride baths and amplipulstherapy. With an increase in the maximum peak blood flow rate, an increase in the systolic-diastolic ratio, it is necessary to add a course of manual therapy to the «basic» therapy. When detecting violations of venous outflow, it is recommended to include high-intensity pulsed magnetic therapy.


KEYWORDS: inflammatory diseases of the pelvic organs, chronic endometritis, recurrent infections, spa treatment, natural and preformed physical factors

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation: Konchugova T.V., Kotenko N.V., Yurova O.V., Borisevich O.O. Effectiveness of Sanatorium Treatment Programs for Women with Chronic Endometritis: a Prospective Randomized Study. Bulletin of Rehabilitation Medicine. 2023; 22(6):8-20. https://doi.org/10.38025/2078-1962-2023-22-6-8-20 (In Russ.)

Для корреспонденции: Nataliya V. Kotenko, E-mail: kotenkonv@nmicrk.ru



Список литературы:

  1. Tillotson G.S., Zinner S.H. Burden of antimicrobial resistance in an era of decreasing susceptibility. Expert Review of Anti-infective Therapy 2017; 15(7): 663–76. https://doi.org/10.1080/14787210.2017.1337508
  2. Morehead M.S., Scarbrough C. Emergence of Global Antibiotic Resistance. Primary Care. 2018; 45(3): 467–84.https://doi.org/10.1016/j.pop.2018.05.006
  3. Whiteside S.A., Razvi H., Dave S. et al. The microbiome of the urinary tract—a role beyond infection. Nat Rev Urol. 2015; 12(2): 81–90. https://doi.org/10.1038/nrurol.2014.361
  4. Peterson J., Garges S., Giovanni M. et al. NIH HMP Working Group the NIH Human Microbiome Project. Genome Research. 2009; 19(12): 2317–2323. https://doi.org/10.1101/gr.096651.109
  5. Van Oostrum N., De Sutter P., Meys J., Verstraelen H. Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis. Human Reproduction (Oxford, England). 2013; 28(7): 1809–1815. https://doi.org/10.1093/humrep/det096
  6. Радзинский В.Е. и др. Прегравидарная подготовка: клинический протокол. М.: Редакция журнала StatusPraesens, 2016. 80 с. [Radzinsky V.E. et al. Pregravidar preparation: clinical protocol. M.: Editorial office of the journal StatusPraesens, 2016. 80 p. (In Russ.).]
  7. Радзинский В.Е. Акушерская агрессия. StatusPraesens. 2011. 688 c. [Radzinsky V.E. Obstetric aggression. Status Praesens. 2011. 688 p. (In Russ.).]
  8. Радзинский В.Е. и др. Прегравидарная подготовка. Клинический протокол Междисциплинарной ассоциации специалистов репродуктивной медицины (МАРС). Версия 2.0. 2020. [Radzinsky V.E.et al. Pregravidar training. Clinical protocol. Interdisciplinary Association of Reproductive Medicine Specialists (MARS). Version 2.0. 2020. (In Russ.).]
  9. Xiao B. et al. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Sci Rep. 2016; 6: 26674. https://doi.org/10.1038/srep26674
  10. Hoffman S.J., Outterson K., Rottingen J.-A. et al. An International Legal Framework to Address Antimicrobial Resistance. Bull World Health Organ. 2015; 93(2): 66. https://doi.org/10.2471/BLT.15.152710
  11. Буланов М.Н. Ультразвуковая гинекология: курс лекций. 2-е изд., перераб. и доп. М.: Видар-М, 2012. 555 с. [Bulanov M.N. Ultrasound gynecology: a course of lectures. 2nd ed., reprint. and add. Moscow: Vidar-M, 2012. 555 p. (In Russ.).]
  12. Смирнова Д.В., Герасимов А.М., Кулида Л.В. и др. Подготовка эндометрия к беременности у пациенток с хроническим эндометритом и бесплодием. Российский вестник акушера-гинеколога. 2022; 22(6): 76–83. [Smirnova D.V., Gerasimov A.M., Kulida L.V., et al. Endometrial preparation for pregnancy in patients with chronic endometritis and infertility. Russian Bulletin of Obstetrician-Gynecologist. 2022; 22(6): 76–83. https://doi.org/10.17116/rosakush20222206176 (In Russ.).]
  13. Ali Zarad C. Role of uterine artery Doppler in assessment of unexplained infertility Egyptian Journal of Radiology and Nuclear Medicine. 2021: 52–59. https://ejrnm.springeropen.com/articles/10.1186/s43055-021-00430-3
  14. Саморуков А.Е. Применение мануальной терапии в лечении хронических воспалительных заболеваний репродуктивной системы женщин. Арбатские чтения: Сб. науч. тр. Знание. М., 2020; (2): 85–90. [Samorukov A.E. he use of manual therapy in the treatment of chronic inflammatory diseases of the reproductive system of women. Arbat readings: Collection of scientific papers. Znanie. M., 2020; (2): 85–90. (In Russ.).]
  15. Баринов А.Н. Диагностика и лечение тазовой боли. Медицинский совет. 2015; 10: 66–76. [Barinov A.N. Diagnosis and treatment of pelvic pain. Medical advice. 2015; 10: 66–76. https://cyberleninka.ru/article/n/diagnostika-i-lechenie-sindroma-hronicheskoy-tazovoy-boli (In Russ.).]
  16. Борисевич О.О., Фесюн А.Д., Котенко Н.В. и др. Эффективность комплексных программ прегравидарной подготовки с применением хлоридных натриевых ванн, электроимпульсной терапии и мануальной терапии: рандомизированное клиническое исследование. Врач. 2023; (34); 9: 38–42. [Borisevich O.O., Fesyun A.D., Kotenko N.V. et al. The effectiveness of complex programs of pregravidar preparation using sodium chloride baths, electric pulse therapy and manual therapy: a randomized clinical trial. Doctor. 2023; (34); 9: 38–42. https://doi.org/10.29296/25877305-2023-09-08 (In Russ.).]
  17. Tettambel M.A. An osteopathic approach to treating women with chronic pelvic pain. The Journal of the American Osteopathic Association. 2005; 105: 20–22.
  18. Aragona S.E., Mereghetti G., Lotti J. et al. Electromagnetic field in control tissue regeneration, pelvic pain, neuro-inflammation and modulation of non-neuronal cells. Journal of biological reguators and homeostftic Agents. 2017; 31(Suppl. 2): 219–225.



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.