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CURRENT UNDERSTANDING OF THE ETIOLOGY, PATHOGENESIS,
DIAGNOSIS AND TREATMENT OF CHRONIC NONSPECIFIC
CERVICITIS
Adizova Z.O.
Amanboeva F.B.
Doctor of Medicine
An A.V.
Tashkent Medical Academy, Tashkent, Uzbekistan
https://doi.org/10.5281/zenodo.15039794
Relevance
.Currently, cervicitis of nonspecific etiology is one of the urgent
problems of modern gynecology due to the extremely high frequency of their
occurrence, a tendency to chronic recurrent course, negative effects on
reproductive health, and the risk of developing a number of complications. The
role of disorders of vaginal microbiocenosis and local immune status in the
development of chronic nonspecific cervicitis (HCV) has been convincingly
demonstrated.
Replacement of lactobacilli mainly by anaerobic microorganisms
(Ureaplasma, Mycoplasma, Gardnerella vaginalis, Prevotella, Peptostreptococcus
spp. and Bacteroides spp.), characteristic of bacterial vaginosis, is extremely
common in patients with HCV. Of particular importance from the point of view
of clarifying the pathophysiological mechanisms of development and the
development of new diagnostic and prognostic markers, as well as the
personalization of HCV therapy, is the study of cytokine status. Cervicitis and
other inflammatory diseases of the lower genital tract are characterized by an
increase in the expression of pro-inflammatory cytokines with simultaneous
inhibition of the formation of anti-inflammatory cytokines.
Purpose
.To develop practical recommendations for women with chronic
nonspecific cervicitis
Materials and methods
.The comparison group included 30 patients with
chronic nonspecific cervicitis who were treated according to the generally
accepted treatment method for this pathology. The main group consisted of 67
patients with chronic nonspecific cervicitis who received immunocorrective
therapy (Pavisin) and vitamin-metabolic (Vitamin B complex) therapy. For a
more accurate study of the complex treatment of chronic nonspecific cervicitis,
the patients of the main group were divided into three subgroups.
The first subgroup (n=21) used the combined Vitamin B complex, the
second (n=22) underwent immunocorrection with Pavisin, and the third (n=24)
used Vitamin B complex and Pavisin.
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The first stage of the examination of the patients was a simple colposcopy.
Ectopia of the cylindrical epithelium was detected in 26 (38.8%) patients of the
main group and 12 (40%) of the comparison group. Violation of the organ
architecture in the form of ectropion and/or cicatricial deformity was noted in 4
(6.0%) patients of the main group and 2 (6.6%) of the comparison group.
Cervical hypertrophy was diagnosed in 18 (26.9%) patients of the main group
and 8 (26.6%) of the comparison group, and cervical hypertrophy in
combination with cicatricial deformity was noted in 4 (6.0%) patients of the
main group and 2 (6.6%) of the comparison group. The revealed cervical
hypertrophy was regarded as a sign of a long-term ongoing chronic
inflammatory process. Thus, the presence of ectopia of the cylindrical epithelium
and a change in the normal anatomical structure of the cervix are key factors
predisposing to the occurrence of chronic inflammatory diseases of the cervix.
Analysis of the results of bacterioscopic examination of cervical secretions
indicates that the majority of patients have moderate leukocytosis in their
smears, indicating a chronic course of the inflammatory process.
Thus, the study of the species composition of the microflora of the vagina
and cervix in women with chronic cervicitis showed that there were no
significant differences between the groups of patients with this disease. The
persistence of opportunistic pathogenic microorganisms in the cervical canal
and vagina in chronic cervicitis can cause activation of local immunopathological
processes in patients of both groups.
In the majority of patients, chronic nonspecific cervicitis was characterized
by a low-symptomatic course and an erased clinical picture - in 19 (63.3%)
patients of the comparison group and 40 (59.7%) of the main group. In patients
of both groups with chronic nonspecific cervicitis, regardless of the clinical
severity of the inflammatory process, an increase in the percentage of
neutrophils was noted in cytograms with a decrease in the number of their lysed
forms compared with the control group.
Conclusions
. Changes in the quantitative and qualitative composition of the
cellular elements of cervical secretions in chronic nonspecific cervicitis in
women of reproductive age are associated with the severity of the inflammatory
process of the cervical mucosa. The traditional treatment of patients with
chronic nonspecific cervicitis does not eliminate pathological disorders of local
immunoregulatory mechanisms and is accompanied by an insufficient decrease
in the content of pro- and anti-inflammatory elements.
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