Effect of antibiotic prophylaxis during hysteroresectoscopy on the recurrence of endometrial polyps

DOI

https://dx.doi.org/10.18565/aig.2024.337

Vanakova A.I., Dolgushina N.V., Denisov P.A., Goncharuk O.D., Muravieva V.V., Priputnevich T.V.
1) Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia

Background: Endometrial polyps (EP) are the most common type of benign intrauterine pathology and are characterized by a high risk of recurrence. One of the possible etiological factors for EPs is microbial infection. Administration of antibacterial drugs during hysteroresectoscopy (HRS) may reduce the frequency of EP recurrence.
Objective: To study the effect of antibiotic prophylaxis during hysteroresectoscopy for EPs on their recurrence rate.
Materials and methods: A prospective parallel-group study included 84 patients with EP confirmed by histological examination who were randomized into two groups based on the administration of antibiotic prophylaxis during HRS. Endometrial samples were obtained before the HRS. The composition of the endometrial microbiota was analyzed using culturomics with an extended set of selective and non-selective nutrient media. First-generation cephalosporins were administered intravenously in a single dose. The recurrence rate of EP was assessed 12–18 months after HRS.
Results: Chronic endometritis (CE) was associated with EP recurrence within 12–18 months after HRS. The overall recurrence rate was 25%, which was 2.8 times higher in the presence of CE (OR=2.8, 95% CI=0.9–8.4). Bacterial flora growth in the uterine cavity was observed in 40/84 (47.6%) patients with EP and in all 23 (100%) patients with CE. The predominant species were microorganisms of the Staphylococcus genus, which were detected 22 times more frequently in patients with CE (OR=22.3, 95% CI=7.3–68.4). Antibiotic prophylaxis during HRS did not reduce the overall recurrence rate of EP, but it did reduce the recurrence rate by five and seven times, respectively, in patients with CE and in those with microbial growth in the uterine cavity in addition to EP.
Conclusion: These findings confirm the role of microbial factors in the genesis of CE and associated EP, as well as the effectiveness of antibiotics in reducing the recurrence rate in patients with CE and bacterial microflora growth in the uterine cavity.

Authors' contributions: Dolgushina N.V. – conception and design of the study; Vanakova A.I. – material collection, drafting of the manuscript; Goncharuk O.D., Muravieva V.V. – laboratory part of the study; Denisov P.A. – statistical analysis, visualization; Muravieva V.V., Priputnevich T.V. – editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University) (Ref. No: 04-23 of 02.03.2023).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Vanakova A.I., Dolgushina N.V., Denisov P.A., Goncharuk O.D., Muravieva V.V., Priputnevich T.V.
Effect of antibiotic prophylaxis during hysteroresectoscopy on the recurrence of endometrial polyps.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (2): 59-67 (in Russian)
https://dx.doi.org/10.18565/aig.2024.337

uterine microbiota

endometrial polyps

chronic endometritis

antibiotic prophylaxis

Full text (in Russian)

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Received 28.12.2024

Accepted 12.02.2025

Angelina I. Vanakova, obstetrician-gynecologist, oncologist at the Department of Innovative Oncology and Gynecology, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4; PhD student at the Department of Obstetrics, Gynecology, Perinatology and Reproductology, IPE, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(903)108-17-90, angelinavanakova@gmail.com,
https://orcid.org/0009-0007-8048-1682
Nataliya V. Dolgushina, Dr. Med. Sci., Professor, Deputy Director, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4; Professor at the Department of Obstetrics, Gynecology, Perinatology and Reproductology, IPE, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, n_dolgushina@oparina4.ru, https://orcid.org/0000-0003-1116-138X
Pavel A. Denisov, Researcher at the Laboratory of Bioinformational Analysis, Institute of Microbiology, Antimicrobial Therapy and Epidemiology, V.I. Kulakov NMRC
for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, https://orcid.org/0000-0003-1813-6718
Olga D. Goncharuk, Head of the Laboratory of Medical Microbiology, Institute of Microbiology, Antimicrobial Therapy and Epidemiology, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, https://orcid.org/0000-0001-5876-8424
Vera V. Muravieva, PhD (Bio), Senior Researcher at the Laboratory of Molecular Microbiology, Institute of Microbiology, Antimicrobial Therapy and Epidemiology,
V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, https://orcid.org/0000-0003-0383-0731
Tatiana V. Priputnevich, Corresponding Member of the RAS, Dr. Med. Sci., Associate Professor, Director of the Institute of Microbiology, Antimicrobial Therapy and Epidemiology, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(910)414-56-16, priput1@gmail.com,
https://orcid.org/0000-0002-4126-9730

Effect of antibiotic prophylaxis during hysteroresectoscopy on the recurrence of endometrial polyps

Vanakova A.I., Dolgushina N.V., Denisov P.A., Goncharuk O.D., Muravieva V.V., Priputnevich T.V.

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