MATERIAL AND METHODS

65 patients aged 49-65 years were examined with the confirmed diagnosis: postmenopausal atrophic vaginitis (ICD-10 N95.2). Patients of the 1st group (n=32) underwent intravaginal injection submucose multipoint injection of cross-linked collagen fraction gel into the composition with peptide complex (30-50 mg/g), uronic acids (0.8-1.2 mg/g) and hexosamines (2.0-3.0 mg/g) — SpheroGel MEDIUM with microparticle size 100-200 microns, patients of the 2nd group (n=33) — SpheroGel LONG gel with larger microparticle size 200-360 microns. The routine study was extended with the use of an adapted scale R. Nappi, et al. (2019) for objective assessment of complaints and clinical picture, the Female Sexuality Index (FSFI) questionnaire and the SF-36 quality of life questionnaire.

RESULTS

The average age of patients was 54.5±2.0 years, the average duration of postmenopause — 6.04±4.3 years, the duration of clinical manifestations of genitourinary menopausal syndrome ranged from 1 to 10 years (on average, 5.5±2.36 years). A significant decrease in the manifestations of this syndrome was noted at the end of collagenotherapy course and in a distant time — 12 weeks from its beginning. At the same time for the majority of symptoms at the end of therapy the tendency for improvement was noted in the 1st group (p>0.05), but the remote results were significantly better in the 2nd group (p<0.05). The most significant was a decrease in the severity of symptoms “irritation, burning, itching” and “blood secretion during intercourse”, dizuric symptoms changed slightly during the therapy. The index of female sexuality increased reliably from 7.92±3.83 and 8.69±3.15 points (1st and 2nd groups, respectively, p>0.05) before the start of therapy to 17.31±8.51 and 23.81±7.59 points (1st and 2nd groups, respectively, p<0.05) 12 weeks before the start of therapy, however, it did not reach 26.5 points as a limit for the selected method. Quality of life indicators improved 1.2-2 times by the criteria of “physical role”, “pain intensity”, “emotional role” (p<0.05), where in a remote period, 12 weeks from the beginning of therapy and within 2 months after its completion, treatment was more effective in the 2nd group (p<0.05).

CONCLUSION

Local collagen therapy may be an effective and safe variant of treatment of patients with genitourinary menopausal syndrome if there are contraindications to topical hormone therapy or if the patient refuses it. With the help of collagen-containing gel with microparticle size of 100-200 microns it is possible to achieve quick and significant effect in relieving or reducing symptoms of GUMS, but the need for repeated treatment arises after 3 months. Collagen-containing gel with microparticle size of 200-360 µm allows to achieve smoother improvement of symptoms, which lasts significantly longer.