Prevention of infectious complications after genital prolapse surgery
- Authors: Dobrokhotova Y.E.1, Lapina I.A.1, Tyan A.G.2, Taranov V.V.1, Chirvon T.G.1, Glebov N.V.2, Kaykova O.V.2
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Affiliations:
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
- Group of companies MEDSI
- Issue: No 4 (2024)
- Pages: 139-146
- Section: Exchange of Experience
- URL: https://journals.eco-vector.com/0300-9092/article/view/632147
- DOI: https://doi.org/10.18565/aig.2024.70
- ID: 632147
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Abstract
Objective: To improve the outcomes of correction of genital prolapse by modifying the colporrhaphy technique and prescribing Epigen Intim spray as an anti-inflammatory and regenerating agent in the postoperative period.
Materials and methods: The study included 60 perimenopausal patients with signs of POP-Q stage 2 or higher cystocele/rectocele. The traditional colporrhaphy technique was used in group 1, and subfascial dissection of tissues was performed in group 2. After discharge from the hospital, the postoperative stage of patients in group 2 was modified: they used Epigen Intim spray for a prolonged period of time, twice a day for 45 days.
Results: In 45 days after the treatment, the signs of complications in the form of hematoma, compaction and edema in the area of postoperative sutures were noted in 10% of cases among the patients of group 1; there were complaints of pelvic pain in three cases in group 1, and only in one case in group 2 (3.3%). The analysis of the vaginal microbiome using PCR showed that the ratio of normoflora/opportunistic microorganisms had a more favorable profile in group 2 (Lactobacillus spp. – 106.5 (68.6%) in group 1, 107.2 (78.3%) in group 2). Moreover, various dynamics of Veillonella spp. and Gardnerella vaginalis concentrations was revealed (102.6 in patients with complications versus 100.7 in uncomplicated patients; 105.1 versus 102.7 in group 1 and 102.4 in group 2).
Conclusion: The surgical correction of genital prolapse requires an efficient approach; therefore, it is necessary to apply the optimal technique of colporrhaphy due to subfascial dissection of tissues and choose the proper postoperative tactics. The use of special medications, such as Epigen Intim spray with anti-inflammatory and regenerating effects after subfascial colporrhaphy allows patients to adapt the state of the vaginal microbiome and accelerate tissue regeneration, which can reduce the risk of complications.
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About the authors
Yulia E. Dobrokhotova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: Pr.Dobrohotova@mail.ru
ORCID iD: 0000-0002-7830-2290
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynaecology
Russian Federation, MoscowIrina A. Lapina
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Author for correspondence.
Email: doclapina@mail.ru
ORCID iD: 0000-0002-2875-6307
Dr. Med. Sci., Proferssor, Department of Obstetrics and Gynaecology
Russian Federation, MoscowAnatoly G. Tyan
Group of companies MEDSI
Email: doctortyan@yandex.ru
ORCID iD: 0000-0003-1659-4256
PhD, GK MEDSI
Russian Federation, MoscowVladislav V. Taranov
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: vlastaranov@mail.ru
ORCID iD: 0000-0003-2338-2884
PhD., Assistant of the Department of Obstetrics and Gynaecology
Russian Federation, MoscowTatiana G. Chirvon
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: tkoltinova@gmail.com
ORCID iD: 0000-0002-8302-7510
PhD, Assistant of the Department of Obstetrics and Gynaecology
Russian Federation, MoscowNikita V. Glebov
Group of companies MEDSI
Email: glebov.nv@medsigroup.ru
ORCID iD: 0000-0002-7072-6953
Doctor of Gynecological Department
Russian Federation, MoscowOlesya V. Kaykova
Group of companies MEDSI
Email: kajkova.ov@medsigroup.ru
Head of Gynecological Department
Russian Federation, MoscowReferences
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