Application of laser radiation in treatment of inflammatory diseases of the uterine appendages

Abstract

Aim : assessing efficacy and safety of intravenous laser blood irradiation (ILBI) in patients with inflammatory diseases of the uterine appendages (IDUA). Materials and Мethods . There were enrolled 130 women with IDUA divided into 3 groups: group 1 (main group) – 40 patients who received traditional drug therapy combined with ILBI; group 2 (comparison group) – 40 patients who received only traditional drug treatment; group 3 (control group) – 50 patients who received no treatment. All patients underwent a standard clinical and laboratory examination, pelvic ultrasound examination, morphology assessment of peripheral blood erythrocytes, and examination of serum cytokine level. Pain intensity was assessed using the Verbal Rating Scale (VRS). In patients of groups 1 and 2, all clinical and laboratory parameters were determined at hospital admission and discharge (on day 7–10), and revealing potential long-term consequences and the onset of pregnancy were analyzed by telephone survey (3–6 months after treatment). Results . In group 1, 7–10 days after treatment, there were revealed normalized parameters of general blood test (90 % of patients), as well as erythrocyte dry mass (35.42 ± 1.98 pg), the normal discocyte count (87,5 % of women) and the size erythrocyte central cavity (60 % of women). Also, the coagulogram parameters returned to normal range; cytokine level decreased as follows: interleukin-1β (70.46 ± 6.08 pg/ml), interleukin-6 (10.86 ± 1.26 pg/ml), tumor necrosis factor-α (5.82 ± 1.48 pg/ml). According to ultrasound data, the presence of hydatids of the fallopian tubes and hydrosalpinxes was not noted, the ovarian volume and the tubal thickness decreased; pathology of the pelvic organs was not detected in 72.5 % of women. 85.5 % of patients in group 1 had decreased and increased level of Gram-negative and Gram-positive as well as Lactobacilli, respectively, that was higher by 15.5 than in group 2. After 3–6 months of discharge from hospital, 35 % of subjects in group 1 became pregnant that was by 2.5-fold more common than in patients who received only traditional drug therapy. In addition, complications and exacerbations in group 1, were not observed in 92.5 % of cases exceeding by 1.3-fold those found in group 2. Conclusion . Conducting ILBI in patients with IDUA leads to normalized erythrocyte morphology, hemostasiogram parameters, serum cytokine levels, decreased inflammatory changes in the uterine appendages, emptying of hydrosalpinxes, pain relief assessed by VRS, normalized menstrual-ovarian function, and vaginal microbiocenosis. While applying standard drug therapy combined with ILBI, exacerbations and complications were less common, and pregnancy occurred more often 3–6 months after treatment.