Comprehensive approach to the treatment of atrophic colpitis and stress urinary incontinence
Authors: Benyuk V.O. , Goncharenko V.M. , Kovaliuk T.V.  , Oleshko V.F. , Beniuk S.V. , Puchko M.S. , Rossovska M.Ye. 
Published: February 2024

Stress urinary incontinence and atrophic colpitis are among the most common pathologies in women in late reproductive and premenopausal age, which occur against the background of the progression of estrogen deficiency in late reproductive age. In recent years, laser energy has been actively used in clinical practice to correct the manifestations of genitourinary syndrome. A special feature of laser technology is the use of a package (sequence) of laser pulses with a low energy density, the duration and frequency of which are programmed in such a way that, providing a deep thermal effect, tissue ablation is not allowed.The objective: to evaluate the effectiveness of an integrated approach in the treatment of atrophic colpitis and stress urinary incontinence in women of late reproductive and premenopausal age.Materials and methods. 69 women aged 45-55 years with manifestations of GUS were examined. In all women, the intensity of vaginal symptoms, the effect of urinary incontinence on quality of life, urinary incontinence symptoms, female sexuality, vaginal pH were examined, and light-microscopic and morphometric studies of vaginal biopsies were performed. For the purpose of treatment, women were offered 3 sessions of therapy, of a CO2-laser and the appointment of vaginal suppositories, which include natural substances with expressed regenerative, antiseptic, anti-inflammatory and immunostimulating properties. The total duration of treatment was 8 months.Results. The average pH value of vaginal contents in patients with Hus was 4.9±0.3. Complaints of burning and tingling, dryness and itching in the vagina and external genitalia prevailed among vaginal smptomas. On the D.Barlow scale 6 (8.7%) and 12 (17.4%) respondents rated their symptoms at 1 and 2 points. According to the results of the UDI-6 questionnaire, a significant majority of women complained of loss of urine associated with coughing, sneezing or laughing, loss of urine associated with the need for urgent urination, and loss of a small amount of urine not associated with physical activity. Light-microscopic and morphometric analysis of biopsies revealed the presence of significant thinning of the vaginal epithelium with a decrease in the cells of the intermediate line, a decrease in the content of glycogen in the cytoplasm and smoothness of the basal relief.Conclusions. The effectiveness of the proposed treatment complex is confirmed by a significant decrease in the number of vaginal symptoms, an increase in the number of women who evaluated the intensity of existing symptoms on a D Barlow scale scores of 1 and 2 points, a decrease in the number of women with urinary incontinence symptoms in the UDI-6 questionnaire, and an increase in the number of women with mild to mild urinary incontinence in the ICIQ-SF questionnaire. The positive effect of the proposed combined complex on the condition of the vaginal mucosa was confirmed by activation of remodeling processes, which was reflected in an increase in the proliferative activity of multilayer flat non-keratinized epithelium in response to photothermal laser exposure.