Dynamics of symptoms of genitourinary menopausal syndrome and the frequency of recurrence of lower urinary tract infection in women in periand postmenopausal patients with combined therapy with Trioginal®

Material and methods. The study included patients (n=164) in peri- and postmenopause, having a laboratory-confirmed picture of the genitourinary menopausal syndrome - atrophic vulvovaginitis and suffering from recurrent lower urinary tract infections (UTI) - cystitis and urethritis. All patients underwent standard antibacterial therapy (ABT) UTI in accordance with the results of bacteriological urine culture according to Russian clinical guidelines on urology. Against the background of ABT, 164 patients received additional therapy with Trioginal® (the study group - SG) containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini 35 (LCR 35) lactobacillus strain. Trioginal® was administered intravaginally in two stages: for 20 days, 2 capsules per day, then for 10 days, 1 capsule per day. In the comparison group - CG (n=67) with ABT, Ovipol Klio® (estriol monopreparation) was additionally intravaginally used in two stages: for 14 days, 1 suppository per day, then for 2 weeks, 1 suppository 2 times a week. The control group consisted of 30 patients receiving only standard ABT UTI, local hormone therapy for vulvovaginal atrophy (VVA) was not performed. The observation period was 12 months after the end of the course of therapy. At all stages of treatment, a subjective and objective assessment of the severity of urination disorders and urogenital atrophy (UDI-6 questionnaire), their impact on the quality of life of patients (questionnaire IIQ-7), indicators of bacteriuria, bacterial urine culture and vaginal biocenosis, frequency of undesirable phenomena were carried out. According to the initial characteristics of the group of patients were comparable. Results. At all stages of the study, in the group of patients who received therapy with the use of the Trioginal® drug, there was a significant improvement in the clinical picture of urination disorders compared to the CG and the control (main) group - MG (in SG - 18% at the end of therapy versus 100% before the start of therapy; CG - 26 % versus 100% respectively; Ledger - 58% versus 100% respectively; p<0.05); quality of life indicators - IIQ-7 score (SG - 67±6.8 at the end of therapy versus 96±8.1 before the start of therapy; TOS - 68±5,6 against 93±7.2, respectively; MG - 66±4, 3 against 41±4.4, respectively; p<0.05); symptoms of BBA (IG - 39% at the end of therapy versus 100% before starting therapy; HS - 62% versus 71%, respectively; HA - 96% versus 100%, respectively; p<0.05); indices of vaginal biocenosis (in SG, normocenosis was observed in 69% after termination of therapy versus 56% before its beginning; HS - 51% versus 57%, respectively; HA - 56% versus 61%, respectively; p<0.05). The most significant criterion was a significant reduction in the growth of pathogenic flora (in SG - 4% at the end of therapy versus 100% before the start of therapy; HS - 12% versus 100%, respectively; MG - 26% versus 100%, respectively; p<0.05). At the time of inclusion in the study, in all three groups, 100% of the patients with urinary tract infections - UTI (cystitis, urethritis) had a recurring nature - at least 3 episodes of relapses in the last year. During the period of treatment and observation (12 months), no episodes of recurrence of UTI were observed in MG in 100% of patients; in the CG, 47% of patients had a recurrence of UTI during the observation period; in GK, recurrence of UTI was noted in 62% of patients. Conclusions. Thus, the use of the drug Trioginal® in the complex therapy of recurrent cystitis and urethritis in women with peritoneal and postmenopausal VVA improves the outcomes of treatment with UTI and improves the symptoms of VVA, reduces the frequency of relapses and can be recommended for use in complex therapy of recurrent lower UTI (cystitis and urethritis ) in women with symptoms of genitourinary menopausal syndrome in peri- and postmenopausal periods.

genitourinary menopausal syndrome, vulvovaginal atrophy in peri- and postmenopausal disease, recurrent lower urinary tract infections, recurrent cystitis, recurrent urethritis, vaginal biocenosis