Endometriosis as a fibroinflammatory disease: enzyme therapy in comprehensive management. An Expert Council Resolution
This Resolution was prepared following the Expert Council meeting entitled «Endometriosis as a Fibro-Inflammatory Disease: The Role of Enzyme Therapy in the Comprehensive Management of Endometriosis-Associated Conditions,» held on June 3, 2026, at the V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation, as part of the XXIX International Congress «New Technologies in the Diagnosis and Treatment of Gynecological Diseases» with an International Course in Endoscopy. The document summarizes current evidence on the clinical heterogeneity of endometriosis, the mechanisms underlying inflammation, fibrogenesis, and postoperative adhesion formation, and addresses surgical and conservative treatment, chronic endometritis, endometriosis-associated infertility, and preparation for assisted reproductive technology programs. Following the discussion, the Expert Council noted the pathophysiological rationale for including bovhyaluronidase azoximer in the comprehensive treatment of endometriosis and associated conditions. Experimental and clinical evidence supports considering enzyme therapy as a promising adjunct to surgical and hormonal treatment targeting the inflammatory, fibrotic, and adhesive components of the disease. Potential areas of its application include postoperative management, pelvic adhesions, and concomitant chronic inflammatory diseases of the pelvic organs.
Authors
- N. I. Tapilskaya (ORCID: https://orcid.org/0000-0001-5309-0087)
- Yu.E. Dobrokhotova (ORCID: https://orcid.org/0000-0002-7830-2290)
- G.R. Bayramova (ORCID: https://orcid.org/0000-0003-4826-661X)
- И.И. Баранов (ORCID: https://orcid.org/0000-0002-9813-2823)
- V. V. Korennaya (ORCID: https://orcid.org/0000-0003-1104-4415)
- С О Дубровина (ORCID: https://orcid.org/0000-0003-2424-2672)
- Е. Н. Андреева (ORCID: https://orcid.org/0000-0001-8425-0020)
- V. F. Bezhenar (ORCID: https://orcid.org/0000-0002-7807-4929)
- George Kasyan (ORCID: https://orcid.org/0000-0001-7919-2217)
- Е. Н. Карева (ORCID: https://orcid.org/0000-0002-9441-3468)
- Maria I. Yarmolinskaya (ORCID: https://orcid.org/0000-0002-6551-4147)
- L.V. Adamyan (ORCID: https://orcid.org/0000-0002-3253-4512)
- Gennady Sukhikh (ORCID: https://orcid.org/0000-0003-0214-1213)
Institutions
- Rostov State Medical University (RU)
- Sechenov University (RU)
- First Pavlov State Medical University of St. Petersburg (RU)
- Pirogov Russian National Research Medical University (RU)
- Research Institute of Obstetrics and Gynecology named after D.O. Ott (RU)
- Ministry of Health of the Russian Federation (RU)
- Scientific Research Institute of Healthcare Organization and Medical Management (RU)
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov of the Ministry of Healthcare of the Russian Federation (RU)
- City Clinical Hospital (RU)
- National Medical Research Center of Cardiology (RU)
- North-Western State Medical University named after I.I. Mechnikov (RU)
Publication Details
- Journal
- Russian Journal of Human Reproduction
- Published
- 2026-09-16
- DOI
- https://doi.org/10.17116/repro20263204118
- Primary Topic
- Endometriosis Research and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00