OBJECTIVE

To determine the composition of cervical canal microbiota in women with chronic pelvic pain (CPP) associated with chronic inflammation and «small forms» of external endometriosis.

MATERIAL AND METHODS

183 patients were examined: the main group — 95 women of reproductive age with chronic pelvic pain associated with the initial stages (I-II stages rAFS, 1996) of external endometriosis, the comparison group — 88 patients, in whom chronic pelvic pains (CPP) appeared after inflammatory diseases of internal genital organs, but during the last year there was no exacerbation of inflammatory processes. All women in the groups were examined with their written informed consent in accordance with the current protocols and standards (clinical recommendations «Inflammatory diseases of female pelvic organs» since 2021). (01.07.2021) and clinical recommendations «Endometriosis» since 2020 (02.11.2020), approved by the Ministry of Health of the Russian Federation). The microbiota of the cervical canal was evaluated using PCR-verification of femoflor-16. Statistical processing of the study results was performed using the MedCalc program (version 15.2).

RESULTS

The study of the extended bacteriologic profile — femoflor-16 testified that the number of lactobacilli in both groups of women was significantly reduced. Thus, the share of Lactobacillus spp. in the microbial landscape in the main group amounted to 54.66±1.68%, in the comparison group — 46.94±1.61% (p=0.001), which was an indicator of moderate dysbiosis in both groups, although there was a statistically significant difference: in the comparison group the share of patients with moderate dysbiosis was higher. Among facultative-anaerobic microorganisms, high statistical significance was obtained for the content of Staphylococcus spp. their share in the main group was 1.9789±0.1504%, while in the comparison group — 3.7159±0.3801% (p<0.0001). In the structure of obligate-anaerobic microorganisms, a high statistical difference was obtained in the content of Megasphaera spp., Veilonella spp., Dialister spp., their total proportion was 0.6421±0.07619% in the main group and 2.5000±0.3237% in the comparison group (p<0.0001). At the same time, women in the main group had a statistically higher proportion of Peptostreptococcus spp. — 3.3864±0.3254% versus 0.7895±0.07161% in the comparison group (p<0.0001). There were no statistically significant differences between the groups for the other components of the microbial landscape, including mycoplasmas and yeast-like fungi.

CONCLUSION

At the general high content of bacterial mass in all examined women with CPP, representatives of normal microbial flora predominate in the cervical canal in the patients of the main group, while in the patients of the comparison group there are significantly more both facultative-anaerobic and obligate-anaerobic microorganisms.