Problem of urogenital mixed infections in reproductive aged women in current gynecology

N Y Bysaha,О О Korchynska

doi:10.18370/2309-4117.2019.50.38-42

Abstract

A tendency of annual growth in inflammatory diseases of female genital organs is being observed now, and these diseases have a long-term recrudescent character with the inflammatory process chronization. Physicians of all specialties in a world medical practice prefer the term “pelvic inflammatory disease”. Goal of this literature review was to generalize the up-to-date data on the problem of the urogenital mixed infections in women of reproductive age. Reviewing both foreign and domestic literature sources published in recent 10 years on the problem of urogenital mixed infections in women of reproductive age. Рelvic inflammatory diseases is a group of diseases (independent nosological entities) of the upper region of female reproductive tract that combine endometritis, salpingitis, oophoritis, tubo-ovarian abscess and pelvis peritonitis. The highest it risks was noticed among the younger women of reproductive age (below 25) with unprotected sexual relationships and numerous sexual partners. Three different levels of genital organ disorders are distinguished dependent of the infection process localization: the lower level, the upper level and the mixed one, i.e. the combination of the lower and the upper levels. Vulvitis, vulvovaginitis, vaginitis and endocervicitis belong to the lower level of genital organ disorders, salpingo-oophoritis, endometritis, metroendometritis and pelvioperitonitis belong to the upper one, while the mixed level includes disorders of both upper and lower genital tracts. Considerable anatomic and functional changes in pelvic organs are formed in 1–2 years from the moment of the genital inflammatory disease beginning and traditionally are not detected at the initial stages of their progress, being, in most cases, accompanied by the reproductive and sexual health disorders. The mucous membranes of urinary tracts, vagina and uterine cervix are populated by various microorganisms that are in a constant antagonism or synergism with each other. Colonization resistance of the vagina and urinary tract mucous membranes provides the natural microbiocenosis stability, prevents pathogenic microorganism colonization and active reproduction of the conditionally pathogenic microflora.

Highlights

According to current researchers data more than 60 phenotypes of microorganisms may be present in vaginal microbiocenosis, their set is relatively stable if woman remains healthy during a considerable period of time
Mucus is produced in the uterine cervical canal being enriched with proteases and bactericide enzymes working as the protective filter, first and foremost, against the microbes that enter together with spermatozoids the upper regions of genital organs
The above barriers are transparent for some factors capable of entering the upper regions of genital organs in a transcanalicular way, as well as through the emdometrium, more probably, during the instrumental interventions [7, 29]

Summary

Introduction

According to current researchers data more than 60 phenotypes of microorganisms may be present in vaginal microbiocenosis, their set is relatively stable if woman remains healthy during a considerable period of time. This period before and during menstruation should be deemed critical and favorable for infection dissemination into the upper regions of genital organs, urethra, urinary bladder and kidneys.

Results

Conclusion