To the content
1 . 2025

The use of the combined immunomodulatory medicine in the complex postoperative treatment of patients with extragenital diseases

Abstract

This article presents the experience of the combined immunomodulatory medicine in the complex postoperative therapy of patients with extragenital diseases of varying severity after planned gynecological operations. The combined medicine effectiveness in the improvement of surgical intervention results and in the reduction of postoperative complications was assessed.

The aim of the study was to assess the effectiveness and safety of the combined immunomodulatory medicine in the complex treatment of postoperative gynecological patients with extragenital diseases of varying severity.

Material and methods. A total of 101 women aged 35 to 72 years, who underwent elective surgical treatment, participated in the study.

The patients were randomly divided into 4 groups. Two main groups included patients after total laparotomic hysterectomy (n=31) for uterine fibroids and patients after vaginal hysterectomy (n=29) for complete/incomplete prolapse of the vaginal and uterine walls. Main group patients in addition to the antibacterial therapy received the combined immunomodulatory medicine (human recombinant interferon alpha-2b + metronidazole + fluconazole, Vagiferon) in the form of vaginal suppositories. Comparison group patients underwent similar surgical operations, but received only basic therapy (without the study medicine) in the postoperative period (n=20 and n=21, respectively).

Results. The use of the combined medicine (human recombinant interferon alpha-2b + metronidazole + fluconazole) in the complex treatment of patients with extragenital diseases of varying severity after gynecological operations allows us to reduce the severity of general and local body reactions in the early postoperative period, improving their course and minimizing the severity of reactive events (normalization of temperature at subfebrile and febrile values on 2–4 days of the postoperative period despite higher baseline values of acute-phase proteins), as well as decrease the systemic (primarily antibacterial) medication burden.

Conclusion. The use of the combined medicine (human recombinant interferon alpha-2b + metronidazole + fluconazole, Vagiferon) in the form of vaginal suppositories in the complex therapy of patients with extragenital diseases of varying severity after gynecological surgeries is safe, effective and helps to reduce the systemic medication burden and shorten the duration of hospitalization.

Keywords: conditionally pure gynecological operations; postoperative period; complex treatment; interferon alpha-2b; metronidazole; fluconazole; Vagiferon

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Concept and design of the study – Dikareva L.V.; сollection and processing of materials – Tishkova O.G., Vlasova N.A., Leonov D.A. Petunina E.S., Skripkina V.M.; statistical data processing – Tishkova O.G.; text writing, editing – Dikareva L.V.

For citation: Dikareva L.V., Tishkova O.G., Vlasova N.A., Skripkina V.M., Leonov D.A., Petunina E.S. The use of the combined immunomodulatory medicine in the complex postoperative treatment of patients with extragenital diseases. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2025; 13 (1): 78–85. DOI: https://doi.org/10.33029/2303-9698-2025-13-1-78-85 (in Russian)

References

  1. Podzolkova N.M., Glazkova O.L., Kuznetsov R.E., Ignatchenko O.Yu., Poletova T.N. Preoperative preparation and postoperative care of patients in a gynecological clinic. Moscow: GEOTAR-Media, 2020. 190 p. (in Russian)
  2. Tapil'skaia N.I., Glushakov R.I., Semenova I.V., Lisianskaia A.S. Use of Genferon in the combination treatment of patients with postoperative complications occurring after apparently pure gynecological operations. Russian Bulletin of Obstetrician-Gynecologist. 2011;11 (6): 61–5. (in Russian)
  3. Seikina V.A. Accelerated recovery program in surgical treatment of women with severe forms of prolapse of female genital organs: Autoabstract of Diss. Volgograd, 2022. 21 p. (in Russian)
  4. Smirnova A.V., Malyshkina A.I., Kolganova I.A., et al. Characteristics of the pelvic organ dysfunctions in patients before and after genital prolapse surgery. Russian Journal of Woman and Child Health. 2022;5(3): 194–200. DOI: 10.32364/2618-8430-2022-5-3-194-200 (in Russian)
  5. Counihan T.C., Fravuzza J. Fast track colorectal surgery. Clin Colon Rectal Surg. 2009; 22; 1: 50–72.
  6. Zonea P., Stigler J., Maly T. et al. Do we really apply fast track surgery? Bratisl Lek Listy. 2008; 109 (2): 61–6.
  7. Kulakov V.I., Adamyan L.V., Mynbaev O.A. Surgical treatment of prolapse and prolapse of the vagina and uterus. Operative gynecology – surgical energies. Moscow, 2000. P. 741–60. (in Russian)
  8. Radzinsky V.E., Orazov M.R., Toktar L.R., et al. Ed. by V.E. Radzinsky. Perineology. Aesthetic gynecology. Moscow, 2020. 408 p. (in Russian)
  9. Balan V.E., Amirova Zh.S., Kovalev L.A., Krasnopol'skaia I.V., Ermakova E.I. Specific features of therapy for disordered urination in menopausal women. Russian Bulletin of Obstetrician-Gynecologist. 2015; 15 (3): 29–34. DOI6 https://doi.org/10.17116/rosakush201515329-34 (in Russian)
  10. Eliseev D.E., Kholodova Zh.L., Abakumov R.S., Filyaeva Yu.A. Preoperative preparation of patients with prolapse of pelvic organs and genital fistulas. RMJ. 2018; 5 (I): 41–4. (in Russian)
  11. Gromov M.I., Kaplina E.N. Application of immunomodulators in surgical practice. Modern Problems of Science and Education. 2006; 5: 52–4. (in Russian)
  12. Posiseeva L.V., Vasilyeva T.P., Filkina E.V., Chumakov A.S. Interferons in obstetrics and gynecology. Practical Medicine. 2013; 7 (76). (in Russian)
  13. Chernousov A.F., Khorobrykh T.V., Vetshev F.P. Immunodeficiency in surgical gastroenterology. Bulletin of Surgical Gastroenterology. 2008; 2: 4–6 (in Russian)
  14. Arzhaeva I.A., Salov I.A., Tyapkina D.A., Boroday A.A. The current state of the problem of inflammatory diseases of the uterine appendages: diagnosis and treatment. Medical Alphabet. 2022; (24): 48–53. DOI: https://doi.org/10.33667/2078-5631-2022-24-48-53 (in Russian)
  15. Amidonova I.P., Posiseeva L.V. Optimization of treatment of viral diseases of the genitals. Russian Bulletin of Obstetrician-Gynecologist. 2015; 6: 100–4. (in Russian)
  16. Aminodova I.P., Posiseeva L.V. The effectiveness of Vagiferon in the treatment of non-pregnant women with acute vaginitis and concomitant cervicitis. Remedium. Konsilium. Akusherstvo i ginekologiya [Remedium. Consilium. Obstetrics and Gynecology]. 2017; 3 (153): 22. (in Russian)
  17. Kravchenko E.N. Immuno-correcting therapy in comprehensive treatment of nonspecific bacterial vaginitis. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2015; 1: 49–53. (in Russian)
  18. Kravchenko E.N., Krivchik G.V., Kuklina L.V., Sinitsina S.S., Lebed E.M., Muravieva N.G. The effectiveness of the combined medicine interferon alpha-2b + metronidazole + fluconazole in the treatment of vaginal infections. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2023; 11 (2): 28–34. DOI: https://doi.org/10.33029/2303-9698-2023-11-2-28-34 (in Russian)
  19. Metelkina S.A., Averina D.M., Kuptsova L.V., Guryev D.L. Experience of the combined medication Vagiferon for local use in non-pregnant women with acute nonspecific bacterial vaginitis and candida vaginitis. Meditsinskiy almanakh. Ginekologiya [Medical Almanac. Gynecology]. 2015; 4: 89–92. (in Russian)
  20. Olina A.A., Meteleva T.A. Current possibilities in the treatment of nonspecific vaginal infectious diseases. Russian Bulletin of Obstetrician-Gynecologist. 2016; 16 (6): 89–94. DOI: https://doi.org/10.17116/rosakush201616689-94 (in Russian)
  21. Rogozhina I.E., Stolyarova U.V., Neifeld I.V. Optimization of treatment of cervical pathology in women with recurrent non-specific cervicitis and vaginitis. Farmateka. 2017; 3 (336): 31–5. (in Russian)
  22. Boyko E.L., Malyshkina A.I. Experience of the combined medication Vagiferon® in non-pregnant women. Infectious diseases: News, Opinions, Training. 2017; 1: 1–8. (in Russian)
  23. Minaev S.V., Isaeva A.V., Obedin A.N., Bolotov Yu.N., Bochnyuk E.A., Chintaeva L.A., Gudiev Ch.G. C-reactive protein – the main marker of the dynamics of acute inflammatory processes in clinical conditions. Medical Bulletin of the North Caucasus. 2011; 2: 95–9. (in Russian)
  24. Grishina T.I. Clinical significance of disorders of immunity in surgical interventions (literature review). Andrology and Genital Surgery. 2000; 2: 14–6. (in Russian)
  25. Instructions for medical use of the medicine Vagiferon® (LP-001339). (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Institute in the Russian People?s Friendship University named after P. Lumumbа
geotar-digit
Journals of «GEOTAR-Media»