Integrated approach to the management of patients having cicatricial deformity of the uterine cervix
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State Budget-Funded Institution of Healthcare of Moscow Region “Moscow Regional Research Institute of Obstetrics and Gynecology” of the Ministry of healthcare of Moscow Region, Moscow, Russia
State Budgetary Institution of Health Care Ministry of the Moscow Region «Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii», Moscow, Russia
Online publish date: 2019-11-15
Publish date: 2019-11-15
Electron J Gen Med 2019;16(6):em160
Cicatricial deformity of the uterine cervix is a relevant and understudied problem in medicine. It is important to conduct preoperative preparation aimed at creating a favorable background for operative treatment as well as to conduct post-operative treatment for improving and accelerating the reparative processes.

Improving the results of surgical treatment of cicatricial deformity of the uterine cervix with the help of preoperative preparation and evaluating the efficiency of application of the Flamena gel complex in the post-operative period.

There were 30 patients having cicatricial deformity of the uterine cervix aged 25 to 45 under observation. With all patients, the clinical, laboratory and instrumental examination was conducted which included: microscopic examination of the intensity of leukocytosis in the vaginal and cervical secretion, cytological examination, bacteriological inoculation from the cervical canal, the PCR method test for sexually transmitted infections (the STIs), detection of the human papillomavirus, the content of immunoglobulines (IgA, IgG, IgM) in the venous blood serum and in the mucous secretion of the cervical canal, colposcopy, ultrasonography, and histological examination of the uterine cervix.

After normalizing the biocenosis of the vagina, the Superlimf 25 units immunomodulating agent was prescribed to all patients, as another preoperative preparation stage. Then surgical treatment was performed. In the post-operative period, the Flamena gel complex was prescribed. The combined therapy contributed to improving the results of the surgical treatment.

The algorithm suggested by the authors which includes preoperative preparation, surgical treatment and post-operative care can be used as an integrated approach to the management of patients having cicatricial deformity of the uterine cervix.

Krasnopolskiy VI. Obligatory forms of precancer and invasive cervical cancer: a manual for doctors edited by the academician of the RAS. Moscow: SIMK; 2017.
Dubrovina SO, Ardintseva OA, Krasilnikova LV. On diagnostics, prevention and therapy of the uterine cervix pathology. Gynecology, 2018;20(5):33-6. https://doi.org/10.26442/2079-....
Bruni L, Barrionuevo-Rosas L, Albero G. WHO/ICO Information Centre on HPV and Cancer. Russian Federation: Human Papillomavirus and Related Cancers, Fact Sheet; 2017.
National Cancer Institute (NCI). Cancer Stat Facts: cervical cancer. NCI website. Available at: https://seer.cancer.gov/statfa... (Accessed June 28, 2018).
Melnikow J, Henderson JT, Burda BU. Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018;320(7):687-705. https://doi.org/10.1001/jama.2... PMid:30140883.
Mezhevitinova EA, Donnikov AE, Prilepskaya VN. Cervical dysplasia. The role of cytokine therapy in enhancing the efficiency of treatment. Obstetrics and gynecology: news, opinions, training, 2019;7(4):66-71.
Prilepskaya VN. Uterine cervix cancer prevention. Moscow: Medpress-inform; 2006.
Bairamova GR, Baranov II, Arslanyan KN, Amirkhanyan AS, Chernova VF. Diseases of the lower genitalia associated with the papilloma viral infection: radical treatment or immunotherapy? Obstetrics and gynecology: news, opinions, training. Analytical Reviews, 2017;4(18):13-9.
Wheeler CM, Hunt W.C., Schiffman M., Castle P.E. Human papillomavirus genotypes and the cumulative 2-years risk of cervical precancer. J. Infect. Dis, 2006;194:1291-9. https://doi.org/10.1086/507909 PMid:17041856.
Novikov AI, Kononov AV, Vaganova IG. Sexually transmitted infections and exocervix. Moscow: Medicina, 2010.
Sergheeva YuA, Gustovarova TA, Kuzminykh VV. Cicatricial deformity of the uterine cervix: risk factors, remote results of plastic surgery in the early postpartum period. Smolensk: Smolensk medical almanac; 2017.
Karakhalis LYu, Petrenko VS, Petrenko SI. The informative value of colposcopic examination in inflammatory diseases of the uterine cervix. Obstetrics and gynecology: news, opinions, training, 2019;7(4):20-4.
Marchetta J. Descamps P. Colposcopy. Techniques and diagnostics: a practical manual. Moscow: Medpress-Inform, 2014.
Girardi F, Reich O, Tamussino C, Pickel H. Burghardt’s colposcopy and cervical pathology. Moscow: Medpress-Inform, 2018.
Rogovskaya SI. Practical colposcopy. Moscow: GEOTAR-Media, 2018.
Prilepskaya VN. Diseases of the uterine cervix and genital infections. Moscow: GEOTAR-Media, 2016.
Abakarova PR, Prilepskaya VN, Mezhevitinova EA, Donnikov AE. Local cytokine therapy in the integrated treatment of HPV-associated diseases of the uterine cervix. Gynecology, 2019;21(1):28-32. https://doi.org/10.26442/20795....
Seresini S, Origoni M, Lillo F. IFN-gamma produced by human papillomavirus-18 E6-spesific CD4+ T-cells predicts the clinical outcome after surgery with high-grade cervical lesions. J Immunol, 2007;179:76-83. https://doi.org/10.4049/jimmun... PMid:17982110.
Chernova NI, Perlamutrov YuN, Petrova IS. The efficiency of the antimicrobial peptides complex in treatment of relapsing inflammatory diseases of the lower urogenital tract conditioned by a combined infection. Clinical dermatology and venereology, 2018;17(3):70-9. https://doi.org/10.17116/klind....