Treatment optimization of patients with genital endometriosis

Keywords: Adenomyosis, genital chronic inflammatory diseases, cytokine imbalance, antimicrobial therapy, relapse of the disease


The aim of the research: to optimize the treatment of patients with combined genital pathology, including internal endometriosis (adenomyosis) and inflammatory diseases.

Materials and methods: prospective study has been conducted on 160 women with adenomyosis. There were 24 (15 %) patients with the I degree of adenomyosis spreading, 72 (45.0 %) women with the II degree, 33 (20.6 %) patients with the III degree, and 31 (19.4 %) woman with the IV degree of adenomyosis spreading. Microbial flora analysis included bacterioscopic, bacteriological research methods with determination of sensitivity to antibiotics, and PCR method.

The concentration of cytokines in the culture medium (supernatant) was determined by the enzyme immunoassay.

Results: the obtained data from the study indicate a high percentage of the combination of adenomyosis with chronic inflammatory diseases of the pelvic organs. An immuno-inflammatory reaction preceding adenomyosis is accompanied by the violation of the local cytokine balance. In turn, the increased activity of cytokines and the presence of infectious agents can participate in the relapse of endometriosis.

 Conclusion: considering the immuno-inflammatory reaction, accompanied by the violation of the local cytokine balance in the development of adenomyosis. The study substantiates the necessity of using antimicrobial therapy in patients with combined genital pathology, including adenomyosis and inflammatory diseases


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Author Biographies

Nikolay Shcherbina, Kharkiv National Medical University

Department of Obstetrics and Gynecology No. 1

Anastasiia Chekhunova, Kharkiv National Medical University

Department of Obstetrics and Gynecology No. 1


Lin, W.-C., Chang, C. Y.-Y., Hsu, Y.-A., Chiang, J.-H., Wan, L. (2016). Increased Risk of Endometriosis in Patients With Lower Genital Tract Infection. Medicine, 95 (10), e2773. doi:

Bukulmez, O., Hardy, D. B., Carr, B. R., Word, R. A., Mendelson, C. R. (2007). Inflammatory Status Influences Aromatase and Steroid Receptor Expression in Endometriosis. Endocrinology, 149 (3), 1190–1204. doi:

Clement, P. B. (2007). The pathology of endometriosis – A survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Advances in Anatomic Pathology, 14 (4), 241–260. doi:

Prokhorova, M. V., Manukhin, I. B., Gevorkyan, M. A., Smirnova, S. O. (2013). Suppressive therapy for chronic pelvic pain in patients with external genital endometriosis. Obstetrics and gynecology, 9, 101–104.

Bourdon, M., Santulli, P., Chouzenoux, S., Maignien, C., Bailly, K., Andrieu, M. et. al. (2018). The Disease Phenotype of Adenomyosis-Affected Women Correlates With Specific Serum Cytokine Profiles. Reproductive Sciences, 26 (2), 198–206. doi:

Ozcelik, K., Capar, M., Ucar, M. G., Cakur, T., Ozcelik, F., Ilhan, T. T. (2016). Are cytokine levels in serum, endometrial tissue, and peritoneal fluid a promising predictor to diagnosis of endometriosis-adenomyosis? Clinical and Experimental Obstetrics & Gynecology, 43 (4), 569–572.

Wang, X.-Q., Zhou, W.-J., Luo, X.-Z., Tao, Y., Li, D.-J. (2017). Synergistic effect of regulatory T cells and proinflammatory cytokines in angiogenesis in the endometriotic milieu. Human Reproduction, 32 (6), 1304–1317. doi:

Zaynetdinova, L. F., Telesheva, L. F., Koryaushkina, A. V. (2020). Features of local immunity in women with endometriosis and genital infection. Russian Journal of Infection and Immunity, 10 (1), 145–158. doi:

Nowak, N. M., Fischer, O. M., Gust, T. C., Fuhrmann, U., Habenicht, U.-F., Schmidt, A. (2008). Intraperitoneal inflammation decreases endometriosis in a mouse model. Human Reproduction, 23 (11), 2466–2474. doi:

Koninckx, P. R., Ussia, A., Tahlak, M., Adamyan, L., Wattiez, A., Martin, D. C. et. al. (2019). Infection as a potential cofactor in the genetic-epigenetic pathophysiology of endometriosis: a systematic review. Facts Views and Vision in Obgyn, 11 (3), 209–216.

Glukhov, E. Yu., Oboskalova, T. A., Urakov, A. V. (2014). Possibilities of argon plasma coagulation in the combination therapy of severe endometriosis. Obstetrics and gynecology, 2, 53–56.

Sugimoto, K., Nagata, C., Hayashi, H., Yanagida, S., Okamoto, A. (2015). Use of dienogest over 53 weeks for the treatment of endometriosis. Journal of Obstetrics and Gynaecology Research, 41 (12), 1921–1926. doi:

Frackiewicz, E. J., Zarotsky, V. (2003). Diagnosis and treatment of endometriosis. Expert Opinion on Pharmacotherapy, 4 (1), 67–82. doi:

Adamyan, L. V., Aznaurova, Y. B. (2015). Molecular aspects of endometriosis. Problemy Reproduktsii, 21 (2), 66–77. doi:

Adamian, L. V., Kulakov, V. I., Andreeva, E. N. (2006). Endometriosis. Moscow: Medicine, 411.

Alkatout, I., Wedel, T., Maass, N. (2018). Combined treatment of endometriosis: radical yet gentle. Aktuelle Urologie, 49 (1), 60–72. doi:

Soares, S. R., Martínez-Varea, A., Hidalgo-Mora, J. J., Pellicer, A. (2012). Pharmacologic therapies in endometriosis: a systematic review. Fertility and Sterility, 98 (3), 529–555. doi:

Lykov, A. P., Sakhno, L. V., Kozlov, V. A. (1998). Production of cytokines (interleukins 1 and 2, tumor necrosis factor  by blood mononuclear cells in the Chernobyl accident liquidators. Immunology, 4, 56–57.

Glants, S. M. (1999). Biomedical statistics. Moscow: Praktika, 459.

Xie, Q., He, H., Wu, Y., Zou, L., She, X., Xia, X., Wu, X. (2019). Eutopic endometrium from patients with endometriosis modulates the expression of CD36 and SIRP‐α in peritoneal macrophages. Journal of Obstetrics and Gynaecology Research, 45 (5), 1045–1057. doi:

Sukhikh, G. T., Sotnikova, N. Y., Antsiferova, Y. S., Posiseeva, L. V., Veryasov, V. N., Vanko, L. V. (2004). Cytokine Production by Immunocompetent Cells of Peritoneal Fluid in Women with External Genital Endometriosis. Bulletin of Experimental Biology and Medicine, 137 (6), 568–571. doi:

Kodati, V. L., Govindan, S., Movva, S., Ponnala, S., Hasan, Q. (2008). Role of shigella infection in endometriosis: A novel hypothesis. Medical Hypotheses, 70 (2), 239–243. doi:

Khan, K. N., Fujishita, A., Hiraki, K., Kitajima, M., Nakashima, M., Fushiki, S., Kitawaki, J. (2018). Bacterial contamination hypothesis: a new concept in endometriosis. Reproductive Medicine and Biology, 17 (2), 125–133. doi:

Tai, F.-W., Chang, C., Chiang, J.-H., Lin, W.-C., Wan, L. (2018). Association of Pelvic Inflammatory Disease with Risk of Endometriosis: A Nationwide Cohort Study Involving 141,460 Individuals. Journal of Clinical Medicine, 7 (11), 379. doi:

Chadchan, S. B., Cheng, M., Parnell, L. A., Yin, Y., Schriefer, A., Mysorekar, I. U., Kommagani, R. (2019). Antibiotic therapy with metronidazole reduces endometriosis disease progression in mice: A potential role for gut microbiota. Human Reproduction, 34, 1106–1116. doi:

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How to Cite
Shcherbina, N., & Chekhunova, A. (2021). Treatment optimization of patients with genital endometriosis. EUREKA: Health Sciences, (3), 3-8.
Medicine and Dentistry