Bulletin of Rehabilitation MedicineBulletin of Rehabilitation Medicine2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology62741310.38025/2078-1962-2023-22-6-8-20Research ArticleEffectiveness of Sanatorium Treatment Programs for Women with Chronic Endometritis: a Prospective Randomized StudyKonchugovaTatiana V.<p>Dr.Sci. (Med.), Professor, Chief Researcher of the Department of Physiotherapy and Reflexology, Head of the Department of Rehabilitation Medicine, Physical Therapy and Medical Rehabilitation, National Medical Research Center for Rehabilitation and Balneology</p>kotenkonv@nmicrk.ruhttps://orcid.org/0000-0003-0991-8988KotenkoNatalya V.<p>Ph.D. (Med.), Leading Research, Department of Somatic Rehabilitation, Reproductive Health and Active Longevity, National Medical Research Center for Rehabilitation and Balneology</p>kotenkonv@nmicrk.ruhttps://orcid.org/0000-0001-6501-791XYurovaOlga V.<p>Dr.Sci. (Med.), Professor, Deputy Director for Educational and Scientific Activities</p>kotenkonv@nmicrk.ruhttps://orcid.org/0000-0001-7626-5521BorisevichOlga O.<p>Research Fellow, Department of Somatic Rehabilitation, Reproductive Health and Active Longevity</p>kotenkonv@nmicrk.ruhttps://orcid.org/0000-0002-3175-6308National Medical Research Center for Rehabilitation and Balneology260220242268202402202424022024Copyright © 2024, Konchugova T.V., Kotenko N.V., Yurova O.V., Borisevich O.O.2024<p><strong>INTRODUCTION</strong>. 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.</p> <p><strong>AIM. </strong>To study the clinical effectiveness of comprehensive sanatorium treatment programs in patients with chronic endometritis.</p> <p><strong>MATERIALS AND METHODS. </strong>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.</p> <p><strong>RESULTS AND DISCUSSION. </strong>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.</p> <p><strong>CONCLUSION. </strong>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.</p>inflammatory diseases of the pelvic organschronic endometritisrecurrent infectionsspa treatmentnatural and preformed physical factorsвоспалительные заболевания органов малого тазахронический эндометритрецидивирующие инфекциисанаторно-курортное лечениеестественные и преформированные физические факторы1.Tillotson G.S., Zinner S.H. Burden of antimicrobial resistance in an era of decreasing susceptibility. 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