Preventive therapy for postoperative complications in patients with old ruptures of the cervix uteri

Objective. To present the experience with intravaginal Gaynomax in the complex preoperative preparation of patients with cicatricial deformity of the cervix uteri. Materials and methods. Fifty patients with old ruptures of the cervix uteri were examined and treated. The patients’ mean age was 32.5±5.6 years. Before surgery, the patients underwent an analysis of the vaginal microbiome by real-time PCR diagnosis using Femoflor 16 test systems and bacterial culture from the cervical canal. As preparation for elective surgery, the patients with an abnormal vaginal microbiome received a short 3-day regimen with the intravaginal administration of a combination of thioconazole and tinidazole. All the patients underwent Emmet's operation. Results. Exploring the composition of the vaginal microbiota revealed that 30 patients had the following dysbiotic conditions: Gardnerella vaginalis 105 in 8 (40%) women; Escherichia coli 105 in 5 (25%), which totaled 65%; at the same time 7 (35%) of them had vaginal dysbiosis associated with a combination of several pathogens: Gardnerella vaginalis, Enterobacterium spp., Streptococcus spp., Klebsiella pneumonia, and Candida albicans. No specific infections were detected in the patients. The control examination made within 2 weeks after surgical treatment showed suture competences and no signs of inflammation in the study group. Conclusion. A wide antimicrobial spectrum and the efficiency of short exposure to a combination of thioconazole and tinidazole allow it to be recommended for use while preparing for elective surgery to restore the integrity of the cervix uteri with old ruptures.

cervix uteri, Emmet’s operation, vaginal microbiome