A Systematic Review of Autoimmune Oophoritis Therapies.

Autoimmune primary ovarian insufficiency (POI) is a devastating disease with limited clinical guidance. The objective of this systematic review was to identify treatments for autoimmune POI and analyze their efficacy. A comprehensive search of CINAHL, Cochrane, Embase, PubMed, Scopus, and Web of Science was performed from inception to April 2022. English language publications that evaluated women with autoimmune POI after a documented intervention were included. Animal models of autoimmune POI were also included. Risk of bias was assessed with the SYRCLE's risk of bias tool for animal studies or the NIH Quality Assessment Tool for Case Series as appropriate. Twenty-eight studies were included in this review, with 11 RCTs, 15 case reports, and 2 case series. Seventeen studies were in humans, and 11 were in animal models. No completed RCTs, cohort studies, or case-control studies were identified in humans. In observational human studies, corticosteroids were effective in select patients. In many case reports, adequate treatment of comorbid autoimmune conditions resulted in return of menses, hormonal normalization, or spontaneous pregnancy. In terms of assisted reproductive technologies, there was case report evidence for both in vitro fertilization (IVF) and in vitro maturation (IVM) in women wishing to conceive with their own oocytes. Ovulation induction, IVF, and IVM resulted in a total of 15 pregnancies and 14 live births. In animal models, there was additional evidence for stem cell therapies and treatments used in traditional Chinese medicine, although this research may not be generalizable to humans. Furthermore, litter size was not evaluated in any of the animal studies. Additional research is needed to establish the efficacy of current treatments for autoimmune POI with a controlled experimental design and larger sample size. Additionally, there is a critical need to develop novel therapies for this condition, as understanding of its pathophysiology and  available tools to modulate the immune response have progressed.

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study.

BACKGROUND/AIM: We aimed to assess the value of early laparoscopic therapy in management of tubo-ovarian abscess (TOA) or pelvic abscess. METHODS: This was a retrospective study of all consecutive patients who were initially diagnosed with TOA or pelvic abscess at the local hospital between January 2010 and December 2014. The risks of operation and recurrence were analyzed using logistic analyses. RESULTS: The durations of body temperature > 38.0°C (p = 0.001) and hospitalization (p < 0.001) were longer in the conventional group versus the early laparoscopy group. In the conventional group, 15 (50%) patients finally underwent laparoscopic exploration. The abscess size in the late laparoscopic group was significantly larger than the successful antibiotic treatment group (6.3 ± 1.5 vs. 4.9 ± 1.2 cm, p = 0.010). Abscess > 5.5 cm was independently associated with antibiotic failure (OR 4.571; 95% CI 1.612-12.962). Compared with late laparoscopy, early laparoscopy was associated with a shorter operation time (p = 0.037), less blood loss (p = 0.035), and shorter durations of body temperature > 38.0°C (p < 0.001) and hospitalization (p < 0.001). The cost was the lowest in the patients successfully treated conservatively. CONCLUSION: Early laparoscopic treatment is associated with shorter time of fever resolution, shorter hospitalization, and less blood loss compared with conventional treatment for TOA or pelvic abscess.

Chrono- and Immunocorrection of Inflammatory Disorders of Internal Reproductive Organs in Women of Reproductive Age.

We compared the effectiveness of immunomodulators used in the treatment of patients with chronic salpingitis and oophoritis with or without changes in succinate dehydrogenase (SDH) activity in blood lymphocytes at incubation with the drug. Diurnal variations in individual reaction of SDH in blood lymphocytes to thymalin or ridostin were revealed. In the groups of women receiving ridostin or thymalin during the reaction of lymphocyte SDH to it, improvement of clinical laboratory and immunological parameters was observed in the majority of the patients and no effect was found in a lesser group of patients than in the groups treated with drugs during the absence of lymphocyte SDH reaction thereto. The timing of the presence of SDH reaction to drugs in the immunocompetent cells makes it possible to set the optimal daily regime of their application and to select a drug that would be most effective in each particular case.

Effects of acupuncture and electroacupuncture on estradiol-induced inflammation and oxidative stress in health rodents

PURPOSE:To investigate the effects of classical acupuncture (Ac) and electroacupuncture (EAc) on estradiol-induced inflammation and oxidative stress in health rodents. METHODS: Twenty-four eight-week old female rats were treated with estradiol valerate (EV) 4.0 mg i.m. single dose and randomly assigned to four groups (n=6): G1(control), G2 (Ac), G3 (EAc 2 Hz) and G4 (EAc 100 Hz). After 60 days all rats were anesthetized with chloral hydrate 10% (0.1 ml/30 g weight of the animal) and submitted to Ac/EAc for twenty minutes. The procedures were repeated on days three, five, seven and nine of the study. The equivalent of the human right ST-36 (Zusanli) and SP-6 (Sanyinjiao) acupoints were chosen for needling and electrical stimulation. On the 10th day of the experiment, all rats were anesthetized for collection of blood and tissues (ovaries) samples for biochemical analysis and histological examination. RESULTS:Glutathione (GSH) and malonaldehyde (MDA) concentrations increased significantly in all groups (plasma and ovary) while myeloperoxidase (MPO) activity decreased significantly in all groups compared with control group (G1). CONCLUSIONS:Both classical acupuncture and electroacupuncture decrease systemic and local oxidative stress and ovary inflammation in healthy rats exposed to estrogenic stimulation. EAc enhances lipid peroxidation at systemic and local levels in female rats exposed to estrogenic stimulation.

Effects of acupuncture and electroacupuncture on estradiol-induced inflammation and oxidative stress in health rodents.

PURPOSE: To investigate the effects of classical acupuncture (Ac) and electroacupuncture (EAc) on estradiol-induced inflammation and oxidative stress in health rodents. METHODS: Twenty-four eight-week old female rats were treated with estradiol valerate (EV) 4.0 mg i.m. single dose and randomly assigned to four groups (n=6): G1(control), G2 (Ac), G3 (EAc 2 Hz) and G4 (EAc 100 Hz). After 60 days all rats were anesthetized with chloral hydrate 10% (0.1 ml/30 g weight of the animal) and submitted to Ac/EAc for twenty minutes. The procedures were repeated on days three, five, seven and nine of the study. The equivalent of the human right ST-36 (Zusanli) and SP-6 (Sanyinjiao) acupoints were chosen for needling and electrical stimulation. On the 10th day of the experiment, all rats were anesthetized for collection of blood and tissues (ovaries) samples for biochemical analysis and histological examination. RESULTS: Glutathione (GSH) and malonaldehyde (MDA) concentrations increased significantly in all groups (plasma and ovary) while myeloperoxidase (MPO) activity decreased significantly in all groups compared with control group (G1). CONCLUSIONS: Both classical acupuncture and electroacupuncture decrease systemic and local oxidative stress and ovary inflammation in healthy rats exposed to estrogenic stimulation. EAc enhances lipid peroxidation at systemic and local levels in female rats exposed to estrogenic stimulation.

[Unilateral salpingian and ovarian TB, a rare form of extrapulmonary TB]. / Salpingo--ovarita bacilara unilaterala, forma, rara de tuberculoza extrapulmonara.

TB salpingitis and ovarian TB is a rare association of extrapulmonary tuberculosis, especially when the lesions are not associated with lung involvement. The correct therapy leads to the sterilization of the tuberculosis foci, although the risk of scars and adhesions is high, causing local functional disorders.

[Low-intensity laser irradiation in the combined treatment of depressive disoreders in patients with chronic salpingo-oophoritis].

This study was designed to evaluate the possibility to use low-intensity laser radiation in combined therapy of somatogenic depressions in patients having gynecological problems, such as inflammatory disease of uterine appendages. It was shown that the combined treatment including administration ofantidepressants significantly accelerated the development of beneficial changes and stabilized depressive manifestations. Inclusion of low-intensity laser irradiation in the combined therapy further improved its positive effect. Nevertheless, the complete recovery could not be achieved in the absence of specific antidepressant treatment despite the alleviation of depressive symptoms.

Tuboovarian abscess caused by Candida in a woman with an intrauterine device.

Candida infection should be considered in an individual with a pelvic abscess that is unresponsive to conventional antibiotic therapy, particularly in the presence of an intrauterine device. We present a case of a tuboovarian abscess caused by Candida species in a woman with an intrauterine device for >10 years. Surgical intervention followed by antifungal therapy resulted in a favorable outcome.

[Chronic salpingo-oophoritis: clinical and physiological rationale for therapeutic application of impulse low-frequency electrostatic field].

Significant alterations in arterial and venous circulation, primarily in the vascular bed of the small pelvis, were detected in 63 patients with chronic salpingo-oophoritis. All the women received intensive therapy with impulse low-frequency electrostatic field (ILFEF). In 52 women the exposure was abdominovaginal, in 11 women the exposure was preceded by placebo procedures. ILFEF produced marked and long-term positive effects (up to 18 months): pain relief, reduction of vegetative anxiety, increased uterine motility, softening and better elasticity of the commissures in the regions of the uterine appendages, normalization of the circulation in the vascular bed of the small pelvis. This therapy is pathogenetically sound as it rests on changes in activity of central regulation resultant from trigger stimulation and normalization of hemodynamics in the vascular bed of the small pelvis (in 76.6%) especially in the veins in response to stimulation of the sympathetic nerves in the inflammation focus.

[Amplipulse-magnetotherapy and iodine-bromine waters in combined treatment of patients with chronic nonspecific salpingo-oophoritis].

Amplipulse-magnetotherapy was used as monotherapy and in combined treatment of 110 patients with chronic nonspecific salpingo-oophoritis (CNSO). Clinical assessment shows that transcerebral amplipulse-megnetotherapy (TAMT) has a positive effects on the course of CNSO, reproductive system and psychoemotional status of the patients. The addition of physical and balneological factors to TAMT enhances and prolongs neurotropic, endocrine, analgetic and anti-inflammatory effects of TAMT.

Retroperitoneal fibrosis secondary to actinomycosis with no intrauterine device.

BACKGROUND: Actinomycotic pelvic infection usually occurs in the presence of an intrauterine device. It can result in pelvic inflammatory disease, tubo-ovarian abscess, and retroperitoneal fibrosis. CASE: A 35-year-old multipara who had never used an intrauterine device presented with a 5-month history of progressively worsening, colicky, right-sided abdominal pain, dysuria, weight loss, and constipation. She was found to have retroperitoneal fibrosis. The diagnosis of actinomycotic pelvic infection was made at laparotomy. CONCLUSION: Actinomycosis may be considered in the differential diagnosis of women with retroperitoneal fibrosis, even when there is no history of an intrauterine device.

[Electrophoresis of sulphide mud extract in combined therapy of chronic inflammatory diseases of uterine appendages (an experimental and clinical study)]. / Elektroforez ékstrakta ilovoi sul'fidnoi griazi v kompleksnoi terapii khronicheskikh vospalitel'nykh zabolevanii pridatkov matki (éksperimentalno-klinicheskoe issledovanie).

On the original experimental model of chronic inflammation of the ovaries and oviducts in white rats it was established that electrophoresis of 1% esobel solution prevents an increase in the specific volume of interstitial connective tissue, development of fibrosclerotic alterations and adhesive process. Peloidophysiotherapy normalizes growth and atresia of the ovarian follicular system. Thus, electrophoresis of 1% esobel solution is highly effective in combined treatment of chronic inflammatory diseases of the uterine appendages.

[The adaptogenic effects of hyperbaric oxygenation within the complex therapy of inflammation diseases of the internal female genitals]. / Adaptogennye éffekty giberbaricheskoi oksigenatsii v kompleksnoi terapii vospalitel'nykh zabolevanii zhenskikh polovykh organov.

The effects of hyperbaric oxygenation (HBO), when used jointly with the routine complex therapy, made in the clinical signs of inflammatory diseases of the internal female genitals as well as in the lipid peroxidation/antioxidant system were investigated within the case study. The reaction of the antioxidant system to the HBO action was found to depend on a degree of its original exhaustion. An opinion was put forward on the need in the individual approach to whether to add the HBO method to the complex therapy or not. If the reaction to the hyperbaric effects is positive, the HBO method must be used to the full extent. If there is progressing of the exhaustion degree of the antioxidant system, the HBO course must be interrupted.

[Immunological response of patient with chronic salphingo-oophoritis to interference currents used in electrical sleep and balneotherapy]. / Izmenenie immunologicheskikh pokazatelei u bol'nykh khronicheskim sal'pingooforitom pod vliianiem interferentsionnykh tokov po metodu electrosna i bal'neoterapii.

The study included 105 women of a reproductive age with chronic nonspecific salpingooophoritis. The women were transcerebrally exposed to interference currents (IC). The immunological examination revealed that IC have an immunocorrecting effect on both cellular and humoral links of the immune system, correct imbalance of the immunoregulatory subpopulations confirmed by increased immunoregulatory index. Inclusion of balneotherapy potentiates analgetic, anti-inflammatory effects of transcerebral IC therapy, regulates balance of immunoregulatory T-cell subpopulations due to better differentiation of T-lymphocytes in the thymus.

Tubo-ovarian abscess occurring 16 years after supracervical hysterectomy.

BACKGROUND: Supracervical hysterectomy is seldom performed and there are few reports of tubo-ovarian abscess (TOA) after supracervical hysterectomy. CASE: The case of a 49-year-old woman with a right TOA is reported. This patient had received a supracervical hysterectomy 16 years earlier due to rupture of the uterus. At this admission, she presented with complaints of, lower abdominal pain and fever. Bimanual and transvaginal ultrasound examinations demonstrated a tender mass in the right adnexal region. Laparotomy, pathologic examination and microbiologic study confirmed the diagnosis of right TOA. CONCLUSION: After supracervical hysterectomy, patients may develop endocervicitis, parametritis and/or TOA. This series may be a subtype of ascending infections in the female genital tract.

[Interference therapy in combined treatment of patients with chronic nonspecific salpingoophoritis]. / Iterferentsterapiia v kompleksnom lechenii bol'nykh khronicheskim nespetsificheskim sal'pingooforitom.

Neurotropic interference therapy (NIT) was studied as monotherapy and in combination with iodine-bromide water in 50 patients with chronic nonspecific salpingoophoritis. NIT was found effective in the above disease as it improved clinical picture, reproductive function, psychoemotional condition of the patients. The addition of iodine-bromide water to NIT potentiates and prolongs neurotropic, endocrine, analgetic and anti-inflammatory effects of NIT.