• Reparative therapy for recurrent complicated cervical ectopy in women of reproductive age
To content

Reparative therapy for recurrent complicated cervical ectopy in women of reproductive age

HEALTH OF WOMAN. 2017.10(126):58–62; doi 10.15574/HW.2017.126.58

Mazur Yu. Yu., Pyrohova V. I.
Lviv national medical University named Danylo Galitsky

Complicated cervical ectopy in combination with microbiota and vaginal immunity disturbances can create favorable conditions for human papillomavirus infection and its persistence, which in the light of the high frequency of cervical ectopy recurrence causes the urgency of existing diagnostic and therapeutic approaches improvement.
The objective: was to evaluate the effectiveness of reparative drugs to optimize the healing of the cervix after cryodestruction in case of the recurrent complicated cervical ectopy in women of reproductive age.
Materials and methods. Comprehensive examination and treatment of 104 women aged from 29 to 40 years with recurrent cervical ectopy was carried out according to the current recommendations of the Ministry of Health of Ukraine. The examination methods included: questioning, bacterioscopic, cytological examination, colposcopy with Swede score performing, pH-metry of the vaginal environment. Depending on the treatment technique, the patients were randomly divided into three groups (37, 35 and 32 patients respectively). Patients of the main group (group 1) after the cervical cryodestruction of the cervix inserted the pessaries on the basis of Triticum vulgare, the patients of the comparison group (group 2) inserted methyluracil suppositories, respectively, 1 pessary (suppository) per vaginum for 10 days after invasive treatment, women who refused to take medication after the cryodestruction formed the control group (group 3).
Results. In patients of the main group, the lymphorrhea on average lasted 6.5±0.1 days less, the rejection of the colliquative scab was reported 2.0±0.1 days faster and complete epithelization of the cervix – 4.6±0.9 days faster (in comparison with the control group, p<0.05). The patients of the main group also presented better dynamics of the cervical defect area reduction. Thus, on the 7th day the cervical defect area in the patients of the main group decreased on average 10.0±2.6%, on the 14th day – 3.6±1.3%, on the 21st day – 11.7±1.5% more (in comparison with the control group), and on the 30th day complete epithelization of the cervix was achieved in all of the main group patients.
Conclusions. Complicated recurrent cervical ectopy requires a complex personalized diagnostic and treatment approach. Invasive treatment in this category of patients should be justified and accompanied by a set of measures aimed, in particular, to create the optimal conditions for the cervical epithelium regeneration. The use of reparative therapy can reduce the duration of lymphorrhoea, accelerate the rejection of the colliquative scab and ultimately achieve complete epithelization of the cervix. The proposed diagnostic and therapeutic measures will allow to reduce the incidence of post-operative complications as well as the frequency of cervical ectopy relapse.
Key words: recurrent cervical ectopy, cryodestruction, reparative therapy, vaginal suppositories.

REFERENCES

1. The Order of the Ministry of Health of Ukraine from 31.12.2004 № 676 «On approval of clinical protocols for obstetric and gynecological care». Electronic resource. Access mode: http://www.moz.gov.ua/ua/portal/dn_20041231_676.html

2. Batsylova OV. 2008. Medico-psychological peculiarities of reproductive health of youth in modern conditions. Collection of scientific works of H.S. Kostyuk Psychology Institute ed. SD Maksimenko. 10(9):63-72.

3. Korniyenko VV. 2013. Plannimetry of the burn wound surface using chitosan membranes. Journal of Clinical and Experimental Medical Research. 1(4):390-397.

4. Voloshina NN, Lutsenko NS. 1998. Complex cryosurgical treatment of the cervix uteri background diseases in conditions of papillomavirus infection. Problems of Cryobiology. 2:64-67.

5. Voloshina NN. 2010. Features of cervical reparation after complex treatment. Zaporizhzhia Medical Journal. 12(5):84-87.

6. Ozolinya LA. 2015. Management of patients with complicated form of cervical ectopy. Women's health. 3:56–59.

7. Kachalina TS, Vaganova SYe, Kochenov VI et al. 2009. The combined cryosurgical treatment method of benign cervical diseases. Practical medicine. 2(34):92–97.

8. Kulavskiy VA, Nasyrova SF. 2000. Cervical pseudo-erosion in nulliparous women. Ufa:153.

9. Khvorostukhina NF, Mikheyeva YuV, Novichkov DA. 2014. Analysis of the causes of recurrent cervical ectopy after coagulation. Fundamental research. 10(3):562-566.

10. Bowring J, Strander B, Young M et al. 2010. The Swede score: evaluation of a scoring system designed to improve the predictive value of colposcopy. J. Low. Genit. Tract Dis. 14(4):301–305. https://doi.org/10.1097/LGT.0b013e3181d77756; PMid:20885156

11. Nayar R, Wilbur D. 2015. The Bethesda System for Reporting Cervical Cytology. Springer International Publishing:321. https://doi.org/10.1007/978-3-319-11074-5

12. Shakuntala Baliga B. 2011. Principles and Practice of Colposcopy. JP Medical Ltd:295.

13. Trejo SÓP, Hurtado RH, López VJL et al. 2000. Reepithelization effect of Triticum vulgare after cervix cautherization. Rev. Fac. Med. UNAM. 43(3):84-86.