The completed international project “Human Microbiome” and the theory of bacterial infection made it possible to look at the problem of
The completed international project “Human Microbiome” and the theory of bacterial infection made it possible to look at the problem of recurrent endometriosis from a different angle, thanks to the study of the connection between the microbiota and various pathological conditions. The study of the endometrial microbiota opens up new opportunities in elucidating the pathogenesis of endometriosis, and some studies may have an impact on the support and regulation of the immune response, as well as ensure the progression and recurrent course of the disease. The purpose of the study – to determine the features of the clinical picture and microbiota of the reproductive tract in patients with recurrent deep endometriosis. Materials and methods. The main group consisted of 32 patients of reproductive age who underwent repeated surgery due to relapse of deep endometriosis. The comparison group included 51 women without relapse of the disease within a year after the primary operation. Surgical treatment was carried out laparoscopically and consisted of the maximum possible excision of endometrioid infiltrates and ovarian endometriomas within healthy tissue. An analysis of the somatic and gynecological anamnesis and a questionnaire on the visual analogue scale (VAS) for pelvic pain syndrome were carried out. The composition of the microbiota of the genital tract from the uterine cavity and vagina was assessed using quantitative real-time PCR using standard methods. Results and discussion. The results of the study indicate that patients with recurrent deep endometriosis have distinctive clinical manifestations of the disease and significant differences in the spectrum of microbiota of the genital tract. A significant increase in the total volume of bacterial mass (TBM) was found in patients with relapse of deep endometriosis in the uterine cavity and vagina, p < 0.05. Against the background of an increase in the volume of bacterial mass (MBV), a significant decrease in Lactobacillus spp. in the uterine cavity and vagina in patients with recurrent deep endometriosis and a significant predominance of representatives of opportunistic bacteria. Conclusions. The recurrent course of deep endometriosis is accompanied by quantitative changes in the balance of the microbiota of the genital tract, and the regulation of normobiota may be a key point in the application of methods for preventing relapses of the disease, and certain microorganisms can become a promising diagnostic marker of endometriosis.
