IMPROVEMENT OF CERVICAL EPITHELIUM REPAIR AND PREVENTION OF COMPLICATIONS AFTER ELECTROSURGICAL TREATMENT

Abstract

The problem of optimization the management of women with cervical pathology after destructive methods of treatment is actual because of its high frequency. We used vaginal suppositories "Giaval" after loop electroexcision of the cervix to prevent complications and recurrences, accelerate the regeneration of the cervical epithelium, prevention of infectious complications.
 Aim. Study of the clinical effectiveness of the drug with hyaluronic acid to improve reparative processes in the cervical mucosa in the postoperative period.
 Materials and methods. The object for the prospective research of the clinical effect of the drug with hyaluronic acid "Giaval" were 50 women who underwent loop FOTEK E81MV loop electroexcision of the cervix with the presence of CIN I and CIN II according to cytomorphological examination and colposcopy and the presence of LSIL after histological examination. The work was carried out on the clinical basis of the Department of Obstetrics and Gynecology named after I.D. Lanovoho IFNMU. According to the principle of simple randomization, patients were divided into two equal clinical groups, depending on the prescribed treatment. The main (first) clinical group (n = 25) included patients who from 7 days after electroexcision were prescribed vaginal suppositories "Giaval" for 1 suppository in the vagina at night for 15 days. In the control (second) group, women received Methyluracil suppository twice a day for 10 days. The control examination, bacterioscopic, cytological examination and extended colposcopy were performed 6 weeks after treatment and then once every 3 months during the year. During the analysis of the effectiveness of treatment, the results of cervical epithelialization were evaluated according to the following criteria: full effect, absent or incomplete effect, recurrence. Variational and statistical processing of research results were performed using the programs SPSS Statistics 22 and StatSoft Statistica.
 Results. During examination patients of both groups, no significant difference in the anamnesis or objective data were found. In the patients of the first group already on the third day using of vaginal suppositories "Giaval" there was a sharp decrease in vaginal discharge in contrast to the control group, where the discharge was intensive and continued for about a week. Lower abdominal pain bothered 3 (12%) women in the control group. Six weeks after PEE in the main clinical group, complete epithelialization was observed in 23 women (92%) who received postoperative treatment with Giaval. At the same time, in patients of the control group complete epithelialization was observed in only 17 women (68%), in the rest incomplete epithelialization was observed on the background of inflammatory smear type. The period of complete repair of postoperative wound defects of the cervix was 39.3 ± 1.8 and 47.4 ± 2.3 days, respectively in patients of the first and second groups.
 Six months after treatment all women in the main group had normal colposcopy and cytology. Abnormal colposcopy and cytology after treatment, which was considered a relapse, was diagnosed in 2 (8%) patients of the second group. Cervical stenosis was also diagnosed in 6 (24%) patients in the same group.
 Conclusions. Using of vaginal suppositories "Giaval" improves the repair of the epithelium of the cervical mucosa, reduces the duration of vaginal discharge, normalizes the biocenosis of the vagina, which increases the effectiveness of treatment and reduces the frequency of postoperative complications, improve women's quality of life. The use of "Giaval" suppositories are safe and comfortable for women as it has no side effects.