Подходы к лечению инфекций нижних мочевыводящих путей у женщин репродуктивного возраста

Abstract

Infections of urinary tracts (IUT) occupy a priority place both in the level of their outspread and the emergence of recurrences of the disease in ambulatory and stationary practice of a doctor; they are conditioned by inflammatory process, mostly of bacterial genesis, developed in different anatomic parts of urinary system – from fascia renalis to external urethral opening and often combined with pelvic inflammatory diseases. Purpose of research: to evaluate the effectiveness of complex therapy of chronic recidivating cystitis in combination with pelvic inflammatory diseases in women of reproductive age. Materials and Methods. A complex clinical and microbiological examination of 39 women aged from 18 to 39 having chronic reccurent cystitis in combination with pelvic inflammatory diseases in the observation dynamics (before and after the course of anti-inflammatory therapy with the inclusion of Tiflox and probiotic Lactovit Forte) was carried out. Results. As a result of the carried out research the symptomatic development of chronic reccurent cystitis at the background of latent development of pelvic inflammatory diseases was established. In the etiological spectre of chronic reccurent cystitis there were more often microorganisms (mostly E.coli – 82.1%) in the monoculture of critical and high number of microbs, and in 17 (43.5%) mixt-infection was established. Concordance when establishing Chlamydia (7.7%), Mycoplasmas (5.1%), Ureaplasmas (10.3%), Candida (33.4%), and Gardnerella vaginalis (10.3%) both in the biomaterial from urethra and genitals in comparison with the spectre of clinical characteristics certified the presence of interconnection of urinary and reproductive systems, which has to be considered when conducting complex anti-inflammatory therapy. Conclusion. Treatment of chronic reccurent cystitis should be conducted considering the heaviness and level of changes in the inflammatory process both from the side of urinary and reproductive systems in a single context. Only after the clinical analysis of all factors in combination it is possible to determine the tactics of treatment of infections of urinary system in women of reproductive age with the prescription of grounded and adequate therapy. Key words: infections of lower urinary tracts, pelvic inflammatory diseases, women of reproductive age, diagnostics, treatment of acute and chronic recurrent cystitis, Tiflox, Lactovit Forte.