Perioperative sanitation of women with nonspecific vulvovaginitis and bacterial vaginosis

Khashukoeva A.Z., Markova E.А., Beslangurova Z.A., Lyafisheva D.M., Shokulova Z.Kh.

1) N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia; 2) Russian Gerontology Research and Clinical Center, Separate Structural Division, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia; 3) Maikop State Technological University, Ministry of Education and Science of the Russian Federation, Maikop, Russia; 4) “Moi Doktor” (My Doctor) Medical Center, Maikop, Russia
Elective operative care in gynecological practice deserves no less attention than emergency interventions. Potential risks of postoperative pyoseptic complications can be reduced by the prophylactic sanitation of the vaginal tract.
Objective: To evaluate the efficiency of preoperative sanitation of the vaginal tract with the combined drug Targifort in female patients with different forms of a gynecological disease who were elected to receive operative treatment.
Materials and methods: A clinical and laboratory examination and preoperative preparation of the vaginal tract were made in 96 patients aged 28 to 62 years with a number of gynecological diseases who were assumed to receive surgical treatment. During their preoperative preparation, the women were diagnosed with nonspecific vaginitis and vulvovaginitides of various etiologies. For prophylaxis, prior to surgery and to reduce postoperative complications, all the patients underwent local sanitation with the combined drug Targifort (metronidazole 500 mg, chloramphenicol 200 mg, natamycin 150 mg, hydrocortisone acetate 15 mg) as one suppository overnight for 10 days. The standard routine diagnosis spectrum was used. During the therapy, changes in clinical manifestations were assessed before surgical treatment and in the postoperative period.
Results: The decreased volume of vaginal discharge was found in 92.4% of the patients. Complaints of itching, burning, and discomfort in the vulvar area were noted to disappear in 78.2 and 66.4% of the women. “Amine” odor was gone in the all women receiving the therapy. The vaginal microflora spectrum was assessed immediately after therapy (before surgical treatment) and at 3–4 weeks after surgery. Normocenosis was obtained in 91.4% of the patients. This condition was retained in 88.2% of the women following surgery. The spectrum of the opportunistic vaginal flora was diverse prior to therapy. After vaginal sanitation, there was a reduction in the obligate anaerobic, facultative anaerobic flora, and fungal one. факультативно-анаэробной флоры и грибковой флоры.
Conclusion: Targifort confirmed its clinical efficacy and therapeutic safety and it can be recommended for the therapy of mixed vaginitis, vulvovaginal candidiasis and bacterial vaginosis in the perioperative period to prevent postoperative complications.

Authors' contributions: Khashukoeva A.Z., Markova E.A., Beslangurova Z.A. – concept of the article; Markova E.A., Lyafisheva D.M., Shokulova Z.Kh. – material collection and processing, writing the text; Khashukoeva A.Z., Beslangurova Z.A. – literature review, approval of the final version of the article; Khashukoeva A.Z., Markova E.A., Lyafisheva D.M. – material analysis; Markova E.A., Shokulova Z.Kh. – statistical data processing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
Ethical Approval: The investigation has been approved by the Local Ethics Committee, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia.
Patient Consent for Publication: The patients have signed an informed consent form to the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Khashukoeva A.Z., Markova E.А., Beslangurova Z.A., Lyafisheva D.M., Shokulova Z.Kh. Perioperative sanitation of women with nonspecific vulvovaginitis and bacterial vaginosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (5): 115-122 (in Russian)


preoperative preparation
aerobic vaginitis
bacterial vaginosis
nonspecific vaginitis


  1. Kowalcek I., Mühlhoff A., Bachmann S., Gembruch U. Depressive reactions and stress related to prenatal medicine procedures. Ultrasound Obstet. Gynecol. 2002; 19(1): 18-23.
  2. Casarin J., Ielmini M., Cromi A., Laganà A.S., Poloni N., Callegari C., Ghezzi F. Post-traumatic stress following total hysterectomy for benign disease: an observational prospective study. J. Psychosom. Obstet. Gynaecol. 2022; 43(1): 11-7.
  3. Приказ Министерства здравоохранения Российской Федерации от 20.10.2020 № 1130н «Об утверждении Порядка оказания медицинской помощи по профилю "акушерство и гинекология"» (зарегистрирован 12.11.2020 № 60869). [Order of the Ministry of Health of the Russian Federation of 20.10.2020 No. 1130n "On Approval of the Procedure of Medical Care in the Profile of Obstetrics and Gynaecology" (registered on 12.11.2020 No. 60869). (in Russian)]. Available at:
  4. Аполихина И.А., Саидова А.С., Баранов И.И. Применение нового комбинированного препарата для местного применения (метронидазол + хлорамфеникол + натамицин + гидрокортизона ацетат) для лечения вагинитов различной этиологии. Акушерство и гинекология. 2020; 7: 143-50. [Apolikhina I.A., Saidova A.S., Kulikov I.A., Baranov I.I. The use of a new topical combination drug (metronidazole + chloramphenicol + natamycin + hydrocortisone acetate) for the treatment of vaginitides of various etiologies. Obstetrics and Gynecology. 2020; (7): 143-50. (in Russian)].
  5. Доброхотова Ю.Э., Иванова И.И. Возможности применения натамицина при лечении кандидозного вульвовагинита. РМЖ. Мать и дитя. 2018; 1(1): 76-81. [Dobrokhotova Yu.E., Ivanova I.I. Possibilities of using natamycin in the treatment of vulvovaginal candidiasis. Mother and Child. Russian Journal of Woman and Child Health. 2018; 1(1): 76-81. (in Russian)].
  6. Радзинский В.Е., ред. Обзор зарубежных клинических рекомендаций по лечению женщин с жалобами на выделения из влагалища. Акушерство и гинекология: новости, мнения, обучение. 2013; 1: 87. [Radzinsky V.E., ed. Review of foreign clinical recommendations for the treatment of women with complaints of vaginal discharge. Obstetrics and Gynecology: News, Opinions, Training. 2013; (1): 87. (in Russian)].
  7. Хашукоева А.З., Маркова Э.А., Дугиева М.З., Хлынова С.А., Каранашева А.Х. Алгоритм диагностики и лечения бактериального вагиноза. Акушерство и гинекология. 2021; 9(Приложение): 4-10. [Khashukoyeva A.Z., Markova E.A., Dugieva M.Z., Khlynova S.A., Karanasheva A.H. Algorithm of diagnosis and treatment of bacterial vaginosis. Obstetrics and Gynecology. 2021; 9(Suppl.): 4-10. (in Russian)].
  8. Ильина И.Ю., Доброхотова Ю.Э. Бактериальный вагиноз. Возможные пути решения проблемы. РМЖ. 2020; 11: 75-8. [Ilyina I.Y., Dobrohotova Y.E. Bacterial vaginosis. Possible solutions to the problem. RMJ. 2020; (11): 75-8. (in Russian)].
  9. Kenyon C., Colebunders R., Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am. J. Obstet. Gynecol. 2013; 209(6): 505-23.
  10. Han C., Wu W., Fan A., Wang Y., Zhang H., Chu Z. et al. Diagnostic and therapeutic advancements for aerobic vaginitis. Arch. Gynecol. Obstet. 2015; 291(2): 251-7.
  11. Pacha-Herrera D., Vasco G., Cruz-Betancourt C., Galarza J.M., Barragán V., Machado A. Vaginal microbiota evaluation and lactobacilli quantification by qPCR in pregnant and non-pregnant women: a pilot study. Front. Cell. Infect. Microbiol. 2020; 10: 303.
  12. Wang H., Huang Z., Wu Z., Qi X., Lin D. An epidemiological study on vaginitis in 6,150 women of reproductive age in Shanghai. New Microbiol. 2017; 40(2): 113-8.
  13. Sherrard J., Wilson J., Donders G.G.G., Mendling W., Jensen J. 2018 European IUSTI/WHO guideline on the management of vaginal discharge. Reprod. Endocrinol. 2019; 48: 34-41.
  14. Савельева Г.М., Сухих Г.Т., Серов В.Н., Радзинский В.Е., Манухин И.Б., ред. Гинекология. Национальное руководство. 2-е изд. М.: ГЭОТАР-Медиа; 2017: 1008с. [Savelieva G.M., Sukhikh G.T., Serov V.N., Radzinsky V.E., Manukhin I.B., eds. Gynecology. National Guide. 2nd ed. Moscow: GEOTAR-Media; 2017. 1008p. (in Russian)].
  15. Qi W., Li H., Wang C., Li H., Zhang B., Dong M. et al. Recent advances in presentation, diagnosis and treatment for mixed vaginitis. Front. Cell. Infect. Microbiol. 2021; 11: 759795.
  16. Kroon S.J., Ravel J., Huston W.M. Cervicovaginal microbiota, women's health, and reproductive outcomes. Fertil. Steril. 2018; 110(3): 327-36.
  17. Dieter A.A., Wilkins M.F., Wu J.M. Epidemiological trends and future care needs for pelvic floor disorders. Curr. Opin. Obstet. Gynecol. 2015; 27(5): 380-4.
  18. Набока Ю.Л., Рымашевский А.Н., Коган М.И., Боравлева О.А., Никитина Е.С. Бактериальная колонизация репродуктивного тракта женщин при пролапсе гениталий (предварительные результаты). Медицинский совет. 2014; 19: 53-5. [Naboka Y., Rymashevskiy A., Kogan M., Boravleva O., Nikitina E. Bacterial colonization of female reproductive tract in genital prolapse (preliminary results). Medical Council. 2014; (19): 53-5. (in Russian)].

Received 02.05.2023

Accepted 11.05.2023

About the Authors

Asiyat Z. Khashukoeva, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health
of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1; Russian Gerontological Research and Clinical Center, Pirogov Russian National Research Medical University,
Ministry of Health of Russia, 129226, Russia, Moscow, 1st Leonova str., 16, +7(916)340-38-13,,
Eleonora A. Markova, PhD, Assistant at the Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1,,
Zarema A. Beslangurova, PhD, Dean of the Faculty of Medicine, Maikop State University of Technology, 385000, Russia, Maikop, Pervomayskaya str., 191,,
Dzhemila M. Lyafisheva, obstetrician-gynaecologist, Medical Center «Moi Doktor», 385008, Russia, Maikop, Shkolnaya str., 196,,
Zarina Kh. Shokulova, 2nd year resident at the Department of Obstetrics and Gynaecology, Pirogov Russian National Research Medical University,
Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1,,

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.