Experience of application of hormonal and probiotic therapy in the complex treatment of women in periand postmenopausal with chronic recurrent bacterial cystitis in the background of vulvovaginal atrophy


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Introduction. Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used. Materials and methods. The study included 60 women aged with the diagnosis: «Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage». The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment. Results. At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05). Conclusion. Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.

Full Text

Restricted Access

About the authors

A. V Kuzmenko

FGBOU VO «Voronezh State Medical University named after N.N. Burdenko»

Email: kuzmenkoav09@yandex.ru
MD, associate professor, Head of Department of Urology

V. V Kuzmenko

FGBOU VO «Voronezh State Medical University named after N.N. Burdenko»

Email: kuzmenkovv2003@mail.ru
MD, professor at the Department of Urology

T. A Gyaurgiev

FGBOU VO «Voronezh State Medical University named after N.N. Burdenko»

Email: tima001100@mail.ru
Ph.D., associate professor at the Department of Urology

References

  1. Аляев Ю.Г., Глыбочко П.В., Пушкарь Д.Ю. Урология. Российские клинические рекомендации. М.: ГЭОТАР-Медиа, 2018
  2. Гаджиева З.К., Казилов Ю.Б. Особенности подхода к профилактике рецидивирующей инфекции нижних мочевыводящих путей. Урология 2016;3:65-76
  3. Кузьменко А.В., Гяургиев Т.А., Кузьменко В.В. Эффективность применения фосфомицина трометамола при остром неосложненном цистите. Урология. 2018;6:70-75
  4. Кузьменко А.В., Гяургиев Т.А., Кузьменко В.В. Эффективность применения комплексных фитопрепаратов в лечении неосложненной инфекции нижних мочевыводящих путей у женщин. Урология 2018;4:10-13
  5. Казилов Ю.Б., Гаджиева З.К. Распространенность различных нарушений мочеиспускания. Урология 2016;5:109-114
  6. Кузьменко А.В., Гяургиев Т.А., Кузьменко В.В. Хронобиологический подход к терапии хронического рецидивирующего бактериального цистита в стадии обострения. Урология. 2017;2:60-65
  7. Балан В.Е., Есефидзе З.Т., Гаджиева З.К. Заместительная гормонотерапия урогенитальных расстройств. Consilium Medicum 2001;7:4
  8. Пушкарь Д.Ю., Гвоздев М.Ю.Динамика симптомов генитоуринарного менопаузального синдрома и частоты рецидивов инфекций нижних мочевых путей уженщин в пери- и постменопаузе на фоне комбинированной терапии препаратом Триожиналь. Гинекология 2018;20(6):67-72
  9. Балан В.Е., Ковалева Л.А., Тихомирова Е.В. Генитоуринарный или урогенитальный синдром возможности длительной терапии. Consilium Medicum. 2016;12:98-101
  10. Ермакова Е.И. и др. Генитоуринарный менопаузальный синдром: диагностика и принципы лечения (краткие клинические рекомендации). Российский вестник акушера-гинеколога, 2017; 7(6):89-95
  11. Горбунова Е.А., Аполихина И.А. Атрофический цистоуретрит как одна из граней генитоуринарного синдрома. Эффективная фармакотерапия. 2015;36:32-39
  12. Andrew M. Kaunitz, JoAnn E. Manson. Management of Menopausal Symptoms. Obstet Gynecol 2016;126(4):859-876.
  13. Rahn D.D., Carberry C., Sanses T.V., Mamik M.M., Ward R.M., Meriwether K.V., Olivera C.K., Abed H., Balk E.M., Murphy M.; Society of Gynecologic Surgeons Systematic Review Group. Vaginal Estrogen for Genitourinary Syndrome of Menopause: A Systematic Review. Obstet Gynecol 2014;124(6):1147-1156.
  14. Erekson E.A., Yip S.O., Wedderburn T.S., et al. The VSQ: a questionnaire to measure vulvovaginal symptoms in postmenopausal women. Menopause. 2013;20(9):973-979.
  15. Utian W.H., Maamari R. Attitudes and approaches to vaginal atrophy in postmenopausal women: a focus group qualitative study. Climacteric. 2014;17(1):29-36.
  16. Santoro N., Epperson C.N., Mathews S.B. Menopausal Symptoms and Their Management. Endocrinol Metab Clin North Am. Author manuscript 2015;44(3):497-515.
  17. Barlow D.H., Samsioe G., Van Geelen J.H. A study of European women’s experience of the problems of urogenital ageing and its management. Maturitas. 1997;27:239-247.
  18. Iosif C.S., Batra S., Ek A., Astedt B. Estrogen receptors in the human female lower urinary tract.Am J. Obstet Gynecol. 1981;141:817-820.
  19. Wurz G.T., Kao C.J., DeGregorio M.W. Safety and efficacy of ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy due to menopause. Clin Interv Aging. 2014;9:1939-1950.
  20. Nappi R.E., Panay N., Bruyniks N., Castelo-Branco C., De Villiers T.J., Simon J.A. The clinical relevance of the effect of ospemifene on symptoms of vulvar and vaginal atrophy. Climacteric. 2015;18(2):233-240.
  21. Parsons C.L. The role of the urinary epithelium in the pathogenesis of interstitial cystitis/prostatitis/urethritis. Urol. 2007;69(4): 9-16.
  22. Балан В.Е., Есефидзе З.Т., Гаджиева З.К. Нарушения мочеиспускания в климактерии и принципы их лечения. РМЖ. 2000;8(7)
  23. Аляев Ю.Г., Балан В.Е., Гаджиева З.К. Особенности кровотока нижних мочевых путей при различных видах недержания мочи у женщин в климактерии. АГ-инфо (журнал российской ассоциации акушеров-гинекологов). 2003;1:139
  24. Аляев Ю.Г., Балан В.Е., Гаджиева З.К., Локшин К.Л., Чалый М.Е. Роль состояния кровотока нижних мочевых путей в развитии урогенитальных расстройств у женщин в климактерии. Регионарное кровообращение и микроциркуляция. 2005;1(13):15
  25. Аляев Ю.Г., Балан В.Е., Винаров А.З., Гаджиева З.К., Локшин К.Л., Чалый М.Е. Медикаментозная комбинированная терапия стрессового недержания мочи у женщин в климактерическом периоде. Гинекология. 2001;3(3):102-107

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies