Prevention of infectious complications after genital prolapse surgery
Dobrokhotova Yu.E., Lapina I.A., Tyan A.G., Taranov V.V., Chirvon T.G., Glebov N.V., Kaykova O.V.
Objective: To improve the outcomes of correction of genital prolapse by modifying the colporrhaphy technique and prescribing Epigen Intim spray as an anti-inflammatory and regenerating agent in the postoperative period.
Materials and methods: The study included 60 perimenopausal patients with signs of POP-Q stage 2 or higher cystocele/rectocele. The traditional colporrhaphy technique was used in group 1, and subfascial dissection of tissues was performed in group 2. After discharge from the hospital, the postoperative stage of patients in group 2 was modified: they used Epigen Intim spray for a prolonged period of time, twice a day for 45 days.
Results: In 45 days after the treatment, the signs of complications in the form of hematoma, compaction and edema in the area of postoperative sutures were noted in 10% of cases among the patients of group 1; there were complaints of pelvic pain in three cases in group 1, and only in one case in group 2 (3.3%). The analysis of the vaginal microbiome using PCR showed that the ratio of normoflora/opportunistic microorganisms had a more favorable profile in group 2 (Lactobacillus spp. – 106.5 (68.6%) in group 1, 107.2 (78.3%) in group 2). Moreover, various dynamics of Veillonella spp. and Gardnerella vaginalis concentrations was revealed (102.6 in patients with complications versus 100.7 in uncomplicated patients; 105.1 versus 102.7 in group 1 and 102.4 in group 2).
Conclusion: The surgical correction of genital prolapse requires an efficient approach; therefore, it is necessary to apply the optimal technique of colporrhaphy due to subfascial dissection of tissues and choose the proper postoperative tactics. The use of special medications, such as Epigen Intim spray with anti-inflammatory and regenerating effects after subfascial colporrhaphy allows patients to adapt the state of the vaginal microbiome and accelerate tissue regeneration, which can reduce the risk of complications.
Authors’ contributions: The authors declare the compliance of their authorship according to the international ICMJE criteria. All authors made a substantial contribution to prepare the article. Dobrokhotova Yu.E., Lapina I.A., Tyan A.G., Taranov V.V., Chirvon T.G., Glebov N.V., Kaykova O.V. – developing the concept of the article, obtaining and analyzing real data, writing and editing the text of the article, checking and approving the text of the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia.
Patient Consent for Publication: The patients provided an informed consent for 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: Dobrokhotova Yu.E., Lapina I.A., Tyan A.G., Taranov V.V., Chirvon T.G.,
Glebov N.V., Kaykova O.V. Prevention of infectious complications after genital prolapse surgery.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (4): 139-146 (in Russian)
https://dx.doi.org/10.18565/aig.2024.70
Keywords
pelvic organ prolapse
subfascial dissection
postoperative rehabilitation
activated glycyrrhizic acid
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Received 22.03.2024
Accepted 16.04.2024
About the Authors
Yulia E. Dobrokhotova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynaecology, Pirogov Russian National Research Medical University,1 Ostrovityanova str., Moscow, 117997, Russia, Pr.Dobrohotova@mail.ru, https://orcid.org/0000-0002-7830-2290
Irina A. Lapina, Dr. Med. Sci., Proferssor, Department of Obstetrics and Gynaecology, Pirogov Russian National Research Medical University,
1 Ostrovityanova str., Moscow, 117997, Russia, doclapina@mail.ru, https://orcid.org/0000-0002-2875-6307
Anatoly G. Tyan, PhD, GK MEDSI, doctortyan@yandex.ru, https://orcid.org/0000-0003-1659-4256
Vladislav V. Taranov, PhD., Assistant of the Department of Obstetrics and Gynaecology, Pirogov Russian National Research Medical University,
1 Ostrovityanova str., Moscow, 117997, Russia, vlastaranov@mail.ru, https://orcid.org/0000-0003-2338-2884
Tatiana G. Chirvon, PhD, Assistant of the Department of Obstetrics and Gynaecology, Pirogov Russian National Research Medical University,
1 Ostrovityanova str., Moscow, 117997, Russia, tkoltinova@gmail.com, https://orcid.org/0000-0002-8302-7510
Nikita V. Glebov, Doctor of Gynecological Department, GK MEDSI, glebov.nv@medsigroup.ru, https://orcid.org/0000-0002-7072-6953
Olesya V. Kaykova, Head of Gynecological Department, GK MEDSI, kajkova.ov@medsigroup.ru
Corresponding author: Irina A. Lapina, doclapina@mail.ru
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