COMBINED USE OF IMMUNOMODULATORS AND ANTIVRAL DRUGS IN THE COMBINATION TREATMENT OF PELVIALGIAS OF VIRAL ETIOLOGY
Objective. To determine the clinical and endoscopic efficiency of the combined use of the immunomodulator Lavomax and the antiviral drug valacyclovir in patients with chronic endometritis and cystitis complicated by pelvialgias in the presence of genital herpes. Subjects and methods. One hundred patients of reproductive age from 25 to 40 years who suffered from chronic endometritis and chronic cystitis complicated by chronic pelvic pain syndrome were examined. Of them 16 patients had herpes simplex virus type 2 (HSV-2) that had been detected by examinations of their biopsy specimens obtained from the uterus and urinary bladder, by using polymerase chain reaction (PCR). The patients took valacyclovir 500 mg twice daily for 10 days, then the same dose once daily as suppressive therapy for 10 days. Lavomax tablets 125 mg were used as an immunomodulatory drug. The patients received them once daily for the first two days, then every 48 hours. They took a total of 20 tablets. All the patients were diagnosed with chronic endometritis and chronic cystitis on the basis of their complaints, gynecological examination data, the clinical manifestations and endoscopic pattern of the diseases, and subsequent morphological study. Results. During a control examination after 6 months of the performed treatment, 11 (68.75%) patients noted no recurrences of inflammatory diseases, 12 (75%) observed pain syndrome relief, 14 (87.5%) had no persistent dysuria, and dyspareunia disappeared in 80%. Control hysteroscopic and cystoscopic patterns in 15 (93.7%) patients corresponded to the normal state of the mucosae. The biopsy specimens were PCR negative for HSV-2. Conclusion. The tactics of an obstetrician/gynecologist and an urologist, which is based on the package of therapeutic and prophylactic measures to diagnose and treat viral pelvialgias, makes it possible to reduce the frequency of complications that give rise to pelvic pains, to improve female reproductive function, and to eliminate persistent dysuria.