Recurrent vaginal dysbiosis as a manifestation of pelvic floor failure in its initial forms

Annotation. The problem of pelvic organ prolapse remains the focus of attention of obstetricians and gynaecologists and doctors of related specialties, as its share is 28-39% among gynecological diseases. The lack of approaches to prevention in young women and the prevalence of conservative and wait-and-see tactics contribute to the progression of this condition. The aim of this study was to assess the state of the vaginal mucosal microbiome as a key symptom in the early forms of pelvic floor dysfunction in patients of early reproductive age. A comprehensive perineological examination and assessment of the urogenital tract microflora was performed in two groups: the main group (40 women with pelvic floor failure) and the control group (40 patients without pelvic floor failure). For statistical analysis of data, we used Microsoft Office Excel software using the parameters of mean, standard deviation (SD), probability of differences in study results (p≤0.05) relative to the indicators of different groups, Pearson's correlation coefficient (χ2) and odds ratio (OR); with a confidence interval (CI) at the level of 95% and defined it as a standard error of ±1.96. The results of the study showed that vaginal gaping (52.5%) allows us to consider this symptom as a trigger for pelvic floor descent and a manifestation of the initial form of failure. The assessment of complaints demonstrated a high frequency of pathological vaginal discharge (62.5%), burning and itching sensation (47.5%), sexual discomfort (27.5%), and chronic pelvic pain syndrome (32.5%). The acidity of the vaginal discharge from the vaginal vault is high (1.6 times), the leukocyte reaction of the contents is high (2.3 times), the proportion of cervical inflammation and TORH infections is three times higher, and the titer of Lactobacillus spp. is reduced. In the group of patients with pelvic floor failure, bacterial vaginosis (35.0%) and aerobic vaginitis (30.0%) dominate. So vaginal gaping and its diagnostic criteria are the earliest pathognomonic sign of pelvic floor descent and are detected in more than half of the patients (52.5 %).