CHARACTERISTICS OF THE VAGINAL BIOCENOSE OF WOMEN OF EARLY REPRODUCTIVE AGE WITH ENDOCERVICOSIS
Authors: KUPCHAK I.M. 
Published: March 2023

Purpose. To study the state of the vaginal ecosystem in nulliparous women with endocervicosis by improving diagnostic methods.

Materials and methods. The contingent of the study was 142 women of early reproductive age (20-24 years old), who did not give birth, 112 with a histologically established diagnosis of endocervicosis. In all 142 examined women, the determination of vaginal biocenosis was carried out by means of bacterioscopy of smears with determination of the degree of purity and bacteriological examination of discharge, determination of HPV of high carcinogenic risk.

The proposed comprehensive approach to the treatment of young women with endocervicosis who did not give birth consisted of the following. Destruction of the pathological focus was carried out by the method of argon plasma coagulation (APC) of tissues using the Fotek-EA 142 apparatus. In the postoperative period, vaginal suppositories were prescribed for this group of patients on the 10th day after the procedure, once a day for 10 days. One suppository contains two active substances: dexpanthenol 100 mg, chlorhexidine bigluconate - 16 mg and a polyethylene oxide base. Dexpanthenol normalizes cell metabolism, stimulates the regeneration of mucous membranes, increases the strength of collagen fibers and accelerates mitosis. In addition, an antiseptic was prescribed, which shows activity against gram-positive and gramnegative bacteria.In order to treat the human papillomavirus in this group, together with the interferon drug, the drug tyloron was prescribed in the generally accepted dosage.

Research results. Sexually transmitted infections play an important role in the occurrence and progression of background cervical pathology. When conducting an in-depth analysis of vaginal microbiocenosis with the help of bacteriological research in patients with endocervicosis, in significant concentrations, an increase in the quantitative indicators of contamination of the vagina with conditionally pathogenic microorganisms was established relative to the diagnostic level. A high degree of infection with chlamydia, genital mycoplasmas, pathogenic strains of ureaplasma, trichomonads, herpes virus infections creates a risk group upon occurrence and the development of infertility, miscarriage and other perinatal pathology in patients with endocervicosis who did not give birth. Clinically significant and, especially, high viral load in HPV-infected young women with endocervicosis occurs in a significant percentage of cases. The results of the cytological characteristics of smears of the exo- and endocervix indicate that 12 women (21.82%) of the I group and 10 women (17 .54%) of the II group during the cytological diagnosis changes characteristic of the IIa class were established. In 32.73% of cases of group I and 33.33% of group II, cytograms show varieties of pathological keratinization, namely hyperkeratosis, parakeratosis, dyskeratosis. In 38.18% of patients of the I group and in 40.35% of the II group, cells with characteristic manifestations of damage by the human papilloma virus are found in cytological preparations.

Conclusion. Thus, women with endocervicosis who have not given birth need more careful observation and effective treatment.