CHRONIC ENDOMETRITIS AS A CAUSE OF RECURRENT CYSTITIS COMPLICATED BY PELVIC PAIN SYNDROME IN REPRODUCTIVE-AGE WOMEN

Objective. To substantiate the need for one-stage combination treatment of chronic endometritis and chronic cystitis complicated by chronic pelvic pain syndrome. Subjects and methods. One hundred reproductive-age women with chronic endometritis and chronic cystitis complicated by pelvic pain syndrome underwent comprehensive examination and treatment. The authors evaluated symptoms and quality of life, filled in an urination diary, made physical, external genital, and vaginal examinations, and small pelvic ultrasonography, and studied the microflora in the vagina, cervical canal, and urethra by polymerase chain reaction, and laser Doppler flowmetry 4 weeks and within a year after the termination of treatment. The latter included antibiotic (safocid), immunomodulatory (lavomax), local (urocystic and uterine instillations, vaginal sanitation), resorption (longidase) therapies, phytotherapy, and physiotherapy. Results. After treatment, the signs of chronic endometritis and chronic cystitis disappeared in 68 and 72 patients, respectively. 76% of patients achieved a positive effect of combination treatment. Conclusion. The proved association of chronic endometritis with recurrent cystitis necessitates combination treatment (use of combined antibiotics to treat inflammatory processes in the genitals and urinary bladder, local intrauterine and intravesical instillations, resorption therapy, application of physical factors with further courses of immunomodulation, vitamin therapy, and, if possible, sanatorium-spa rehabilitation).

chronic endometritis, chronic cystitis, chronic pelvic pain syndrome