Authors
Agabeygi Y.1, Saveliev V.V.2, Kalugina M.V.3, Murakov S.V.4, Pustovalov D.A.1, Popkov S.A.1
1 Russian University of Medicine, Moscow
2 Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky, Krasnoyarsk
3 Kuban State Medical University, Krasnodar
4 Academy of Postgraduate Education under the Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies of FMBA of Russia, Moscow
Abstract
Background: Urogenital chlamydia is one of the most prevalent sexually transmitted infections, often asymptomatic and associated with infertility and pregnancy loss. Treating chlamydial cervicitis in women with cicatricial cervical deformity is particularly challenging, as structural abnormalities promote chronic infection and reduce the effectiveness of standard antibiotic therapy.
Aims: To improve treatment outcomes for chlamydial infections of the lower genital tract in women with cicatricial cervical deformity through a combined approach that includes reconstructive surgery.
Materials and methods: This single-center, nonrandomized, prospective study enrolled 91 women aged 18 to 45 years with laboratory-confirmed urogenital Chlamydia trachomatis infection. Participants were allocated into three groups: group A (n = 30) included women with cicatricial cervical deformity who underwent reconstructive surgery (Eltsov-Strelkov technique) combined with antibiotic therapy (doxycycline, 100 mg twice daily for 21 days); group B (n = 31) consisted of women with cicatricial cervical deformity who received antibiotic therapy alone; group C (n = 30, control) comprised women with normal cervical canal architecture treated with doxycycline only. Recurrence of chlamydial infection was assessed clinically and by polymerase chain reaction (PCR) at 1- and 12-months posttreatment.
Results: At 1 month posttreatment, the efficacy of doxycycline monotherapy in women with cicatricial cervical deformity (group B) was 83.3%, compared with 96.7% in patients with normal cervical anatomy (group C). The combined approach in group A achieved a 96.8% success rate. At 12 months, a significant decrease in treatment efficacy was observed in group B, dropping to 76.7% (p<.05), while the outcomes in group A remained stable (96.8%) and were comparable to those in the control group (96.7%).
Conclusions: Combining reconstructive surgery with antibiotic therapy significantly improves treatment outcomes for urogenital chlamydia in women with cicatricial cervical deformity by reducing recurrence and enhancing local immune responses.
Keywords: chlamydia infections, cervix uteri, reconstructive surgical procedures, anti-bacterial agents, doxycycline, recurrence.
References
1. Batkaev EA, Ryumin DV. Aktual’nye voprosy antibiotikoterapii pri urogenital’nom khlamidioze. Ginekologiya. 2002; 4(2): 78-84. (In Russ.)
2. Bondarenko GM, Nikitenko IN. Kompleksnoe lechenie urogenital’noi khlamidiinoi i mikoplazmennoi infektsii. Ukrainskii zhurnal dermatologii, venerologii, kosmetologii. 2010; 4: 92-97. (In Russ.)
3. Tirskaya YuI, Rudakova EB, Shakina IA, Tsygankova OYu. Rol’ tservitsitov v akushersko-ginekologicheskoi praktike. Lechashchii vrach. 2009; 10: 24. (In Russ.)
4. Molochkov VA. Urogenital’nyi khlamidioz. Moscow: Binom; 2006. 208 p. (In Russ.)
5. Mylonas I. Female genital Chlamydia trachomatis infection: where are we heading? Arch Gynecol Obstet. 2012; 285: 1271-1285.
6. Rodrigues R, Sousa C, Vale N. Chlamydia trachomatis as a Current Health Problem: Challenges and Opportunities. Diagnostics (Basel). 2022; 12(8): 1795. doi: 10.3390/diagnostics12081795.
7. Aksenova OA. Sovremennye aspekty kliniki, diagnostiki i lecheniya bakterial’nogo vaginoza u zhenshchin reproduktivnogo vozrasta. [avtoreferat] Moscow; 2006. 24 p. (In Russ.)
8. Aksenova OA, Litvinova NA, Molochkov VA, et al. K otsenke sostoyaniya mikroflory genital’nogo trakta u zhenshchin s pomoshch’yu PTsR. Rossiiskii zhurnal kozhnykh i venericheskikh boleznei. 2005; 6: 60-66. (In Russ.)
9. White JA, Dukers-Muijrers NHTM, Hoebe CJPA, Kenyon CR, Ross JDC, Unemo M. 2025 European guideline on the management of Chlamydia trachomatis infections. Int J STD AIDS. 2025; 0(0): 1-16. doi: 10.1177/ 09564624251323678.
10. Murakov SV. Sovremennye aspekty diagnostiki i lecheniya khlamidiinogo tservitsita. Izvestiya vysshikh uchebnykh zavedenii. Severo-Kavkazskii region. Seriya: Estestvennye nauki. 2010; 3(157): 123-125. (In Russ.)
11. Molochkov AV, Murakov SV, Popkov SA, editors. Urogenital’nyi khlamidioz. Uchebnoe posobie. Moscow; 2014. (In Russ.)
12. Batkaev EA, Murakov SV, Glebova LI, et al. Optimizatsiya lecheniya khlamidiinogo tservitsita na fone deformirovannoi sheiki matki: problema dermatovenerologii, immunologii i ginekologii. Vestnik poslediplomnogo meditsinskogo obrazovaniya. 2011; 1: 11-12. (In Russ.)
13. Batkaev EA, Murakov SV, Kozmenko MA, Popkov SA. Rubtsovaya deformatsiya sheiki matki kak odna iz prichin retsidivirovaniya khlamidiinogo tservitsita: diagnostika i lechenie. Vestnik poslediplomnogo meditsinskogo obrazovaniya. 2012; 1: 53. (In Russ.)
14. Isakov VA, Kulyashova LB, Berezina LA, et al. Patogenez, diagnostika i terapiya urogenital’nogo khlamidioza: rukovodstvo dlya vrachei. AB Zhebrun, editor. Saint Petersburg; 2010. 112 p. (In Russ.)
