In the modern medical practice, anti-progestogen therapy is widely used where RU-486 (mifepristone) is one of its variants. However, the potential of this therapy in the treatment of various pathologies is far from exhausted. In the general medical practice, it is possible to use mifepristone (RU486 metabolite) to control hyperglycemia in patients with Cushing’s syndrome, in the treatment of endogenous hypercorticism syndrome and metastatic cancer (melanoma, breast cancer, meningioma and other localizations). In the gynecological practice, it is used for contraception and early termination of pregnancy. Of particular interest is the use of antigestagens in the therapy of uterine leiomyoma. In recent years, the conservative treatment of uterine leiomyoma, aimed at the restoration and preservation of women’s reproductive health, has become a priority task for specialists. Therapy with antigestagens, in particular mifepristone, is seen as a possible worthy alternative to invasive methods of treating uterine fibroids, in which there are still many “white spots” that need to be studied.
Introduction. Infectious inflammatory and dysbiotic diseases of the vagina represent a major concern facing obstetric and gynecological science. Individually, the two most common specific diseases can be distinguished, namely: bacterial vaginosis (BV) and nonspecific vaginitis (NV). The therapeutic strategy for these diseases requires a word of clarification and adjustment.Objective. To conduct a comparative analysis of treatment with the combination drug Orcepol WM (ciprofloxacin (500 mg) and ornidazole (500 mg)) and a combination of monopreparations in a dosage form similar to Orcepol WM.Materials and methods. As a comparison object, we used the method of simultaneous administration by patients of tablet forms of ciprofloxacin and ornidazole as mono-preparations in a dosage of 500 mg similar to Orcepol. The study included 64 patients with diagnoses of “bacterial vaginosis” or “nonspecific vaginitis” or "decompensated mixed vaginal dysbiosis". The average age of the patients was 35.34 ± 5.95 years. The patients were divided into two groups: group 1 (n = 32) received the combination drug Orcepol WM, group 2 (n = 32) received ciprofloxacin and ornidazole with two mono-preparations. The drugs were prescribed as a five-day course, two times a day. The patients were followed up by a doctor during two visits and one remote interview on day 30–45 after the end of treatment (visit 2).Results. In both groups, all patients received a full course of antibacterial therapy. There were no adverse drug reactions. In both groups, there was an improvement in clinical symptoms from the first to the second visit: discomfort, itching, burning, dyspareunia, hyperemia of the mucous membrane against the background of normalization of laboratory findings of the vaginal microbiocenosis condition. At the same time, the best results were higher in group 1. Manifestation of mycotic vaginitis with the development of strong clinical symptomatology on days 3 and 4 of treatment respectively were recorded in 4 (12.5%) patients from group 1 and 7 (21.9%) from group 2. The results of comparative observation showed that the number of relapses after the end of therapy were the same in group 1 (8 out of 32 patients, 25%) and in group 2 (9 out of 32 patients, 28%). The relapse occurred on average day 12 and 17 after the end of therapy, respectively.Сonclusion. Thus, the use of Orcepol WM showed a greater therapeutic efficacy as compared to the use of tablet forms of ciprofloxacin and ornidazole in similar dosages as a single-drug administration, which can be explained by a stronger patients' adherence to the treatment.
Relevance. Due to the high prevalence of uterine fibroids in women of reproductive age and the negative impact on reproductive health, one of the priority tasks of specialists is to search not only for new therapeutic methods, but also for ways to prevent this disease. Aim. To determine the role of vitamin D deficiency in the risk of uterine fibroids recurrence after surgical treatment in women of reproductive age. Materials and methods. A comparative analysis of the recurrence rate of uterine fibroids in patients of reproductive age after surgical treatment. The study involved 49 women of reproductive age 20-39 years (average age 31.5±4.3 years) with unrealized reproductive plans. All underwent surgical treatment in the scope of laparoscopic conservative myomectomy for uterine fibroids with different symptoms. All patients were given vitamin D levels. Results. In 93.5% of cases, the risk of recurrence of uterine fibroids increases at vitamin D levels below 34.5 ng/ml, when reaching 38.6 ng/ml and above, the risk of reformation of nodes is minimal. Conclusions. When the vitamin D level exceeds 38.6 ng/ml, it is possible to minimize the risk of recurrence of uterine fibroids in women of reproductive age, thereby avoiding repeated surgical interventions and associated complications.
Pelvic organ prolapse is a common benign disease among women that is characterized by an isolated or combined descent of the anterior, posterior vaginal wall, uterus, and vaginal dome after hysterectomy. Given the fact that most of the operations are performed among middle-aged and elderly patients, the probability of detecting previously undiagnosed tumor of the abdominal cavity and pelvic region increases, which may be due to the limited volume of basic preoperative diagnosis. The purpose of our report is to draw the attention of clinicians to the problem of insufficient examination of women when planning treatment of pelvic organ prolapse on the example of our experience in managing a patient with this pathology in combination with pelvic tumor.
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