Chronic Endometritis

Sardo, Attilio Di Spiezio; Palma, Federica; Calagna, Gloria; Zizolfi, Brunella; Bifulco, Giuseppe

doi:10.5772/63023

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…To date, CE is an anatomo-clinical entity displaying a number of paradoxical features. In fact, histological diagnosis of CE is mainly based on the presence of plasma cells, normally absent or very low in the endometrium [23,[49][50][51][52][53][54]. Therefore, this definition does not take into consideration the other impaired inflammatory parameters of the endometrium.…”

Section: The Concept Of Impaired Inflammatory State Of the Endometriummentioning

confidence: 99%

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Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions

Drizi¹,

Djokovic²,

Laganà³

et al. 2020

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New insights into the complex and fine-regulated inflammatory mechanisms involved in the endometrium reveal multiple facets to the problem of endometrial inflammation. However, the entity termed chronic endometritis is to date restricted to infectious etiology and managed with antibiotics. Conversely, the concept of impaired inflammatory state of the endometrium (IISE) provides a more global approach to defective endometrial inflammation, considering both infectious and non-infectious etiology. A non-systematic review was done through a search on MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database and Web of Science, research registers. Pertinent original and review articles, published in English or French until December 31, 2019, were selected. A compelling body of evidence demonstrates transient, repeated and persistent IISE to be a major factor of most problematic disorders in obstetrics/gynecology, such as endometrial polyps, unexplained infertility, miscarriage, placenta-related pathology and endometrial cancer. When scheduled accordingly, hysteroscopy can play a key role in the IISE assessment. Robust data suggests the pertinence of minimal-effective anti-inflammatory regimens for therapeutic IISE targeting. This review provides a comprehensive update on the multiple facets of inflammation in the endometrial physiology and pathology. Further research is needed to improve classification, diagnosis and treatment of IISE.

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Section: The Concept Of Impaired Inflammatory State Of the Endometriummentioning

confidence: 99%

“…In addition, hysteroscopic diagnosis of CE is consensually based on the presence of strawberry pattern, focal hyperemia, hemorrhagic spots, micro-polyps and stromal edema [51,53,55,56] (Fig. 4).…”

Section: The Concept Of Impaired Inflammatory State Of the Endometriummentioning

confidence: 99%

Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions

Drizi¹,

Djokovic²,

Laganà³

et al. 2020

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“…Some researchers consider this disease to be just an inflammatory reaction requiring administration of antibiotic therapy [2,3,5,6], others look at chronic endometritis as an autoimmune process, in which using antibiotics is irrational [7][8][9].…”

Section: Treatment Of the Hypoplastic Variant Of Chronic Endometritismentioning

confidence: 99%

“…The literature [3,4,9] provides data on the attempts to restore the endometrium by introducing immunomodulators, stem cells and by means of physiotherapy [2,5]. The authors have studied the possibilities of managing the hypoplastic variant of chronic endometritis without antibacterial therapy.…”

Section: Treatment Of the Hypoplastic Variant Of Chronic Endometritismentioning

confidence: 99%

Treatment of the Hypoplastic Variant of Chronic Endometritis: Arguments Against Antibacterial Therapy

Katkova¹,

Grechkanyov²,

Kachalina³

et al. 2016

Sovrem Tehnol Med

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The aim of the investigation was to provide a rationale for refusal from antibacterial therapy in the hypoplastic variant of chronic endometritis.Materials and Methods. The study involved 116 patients with burdened reproductive history (infertility, miscarriage, IVF and ET failures), who were diagnosed with the hypoplastic variant of chronic endometritis after complex examination (hysteroscopy, morphology and immunohistochemistry of the endometrium). The study was carried out in two stages. At the first stage, the patients were examined and the autoimmune genesis of the disease was proved. At the second stage, the patients were divided into two groups, the main group (84 women) and the control (32 women). The patients in the control group received conventional antibiotic therapy with simultaneous administration of trophotropic medications (placenta hydrolysate laennec, phlebotonic diosmin 600). In the main group we used no antibiotic therapy having included only immunomodulating trophotropic agents in the treatment.Results. It was established that conventional therapy exerted no effect on the endometrial cell composition (CD3 + , CD4 + , CD8 + , CD56 + ) and humoral immunity indices. When using only immunomodulating trophotropic agents, positive tendencies were observed in normalization of the endometrial cell composition, autoimmunization indices decreased (IgG), the myometrium and endometrium blood supply improved, the endometrium proved to increase in thickness.Conclusion. The hypoplastic variant of chronic endometritis is a typical autoimmune process, in which administration of antibiotics is useless. At the same time, the positive tendencies revealed while using immunomodulating trophotropic agents have demonstrated expediency of their introduction.

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“…However, clinical practice gives us some evidence of their important role. Some evidence-based studies show an increase in the frequency of implantation and an improvement in reproductive outcomes in assisted reproductive technology programs after antibiotic therapy [2,3].…”

Section: Introductionmentioning

confidence: 99%

Organizational and Socio-Psychological Difficulties of Management of Patients with Chlamydia Infection

Fedorova¹

2023

Infectious Diseases

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Lack of detection of chlamydia infection does not correspond to the high prevalence of its clinical manifestations. It is associated with a frequent asymptomatic course, the prevalence of persistent forms of infection and difficulties in their diagnosis. Unification of approaches to diagnosis and therapy of chlamydial infections without taking into account the topical diagnosis leads to insufficient therapy. It is difficult to find a balance between the need for long-term antibiotic therapy for chlamydial persistence and the dangers of its consequences. Difficulties in the treatment of chlamydia infection are also associated with socio-psychological factors: low efficiency and even inexpediency of etiotropic therapy of chlamydia in polygamous relationships, promiscuous behavior; poor synchronization of partner therapy, often treating only one partner in a couple; orientation of patients towards short-term “pill” therapy, which is not sufficiently effective for chronic persistent chlamydia with significant morphological changes in the genitals; low compliance of male partners to therapy in a couple “by contact” in the absence of clinically apparent manifestations; peculiarities of public consciousness regarding chlamydia infection. As a result, therapy often only stops exacerbations of inflammation and does not eliminate the infection completely.

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Chronic Endometritis

Cited by 7 publications

References 22 publications

Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions

Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions

Treatment of the Hypoplastic Variant of Chronic Endometritis: Arguments Against Antibacterial Therapy

Organizational and Socio-Psychological Difficulties of Management of Patients with Chlamydia Infection

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