Neimark O. The management of cervical intraepithelial neoplasia (CIN) in women of reproductive age with trichomoniasis

Over the past few years, Ukraine has been experiencing an unfavorable epidemiological situation concerning sexually transmitted infections. Among these, genital human papillomavirus infection (HPV) holds a prominent place in its structure. In cases of precancerous conditions and cervical cancer, oncogenic types of the human papillomavirus (HPV) are detected in almost 100% of cases. However, the relationship between viral load and the presence of cervical inflammation caused by Trichomonas invasion remains insufficiently studied in the pathogenesis of cervical intraepithelial neoplasia (CIN). Importantly, in practical gynecology, there is no consensus on the management of women with CIN in the context of HPV infection combined with genitourinary trichomoniasis. This has motivated the goal of the research: to improve the effectiveness of the treatment of cervical intraepithelial neoplasia associated with human papillomavirus in reproductive-aged women by developing and implementing a pathogenetically justified algorithm of diagnostic and therapeutic preventive measures for genitourinary trichomoniasis. Genital trichomoniasis is a common disease of the genitourinary system and refers to sexually transmitted infections. About 170 million people in the world get infected every year, and 40-50% of patients with mixed urogenital infection are diagnosed with Trichomonas. The importance of the problem is determined not only by the danger to health and epidemiological significance, the emergence of mental and sexual disharmony in the family, but also by severe complications which manifest by infertility, pathology of pregnancy and childbirth, and the birth of sick infants. Recently, hydrosalpinx is an often diagnosed, the main cause of which is Trichomonas infection. Formed as a result of inflammation of the fallopian tubes, the mating process leads to the development of female infertility. In almost all cases of missed pregnancy up to twelve weeks and ectopic pregnancy, Trichomonas are found. Therefore, improving the effectiveness of the diagnosis and treatment of genital trichomoniasis is an extremely urgent issue in terms of maintaining reproductive health.