Changes of Vaginal Microecology of Women with Intrauterine Adhesions

Reproductive tract infection is one of the important causes of intrauterine adhesions (IUA). The evaluation of vaginal microecology could provide significant guidance for the treatment of reproductive tract infection. This study aimed to investigate the correlation between IUA and vaginal microecology.

Patients who came to the gynecology department of our hospital from March 2020 to February 2022 and were diagnosed with IUA were selected as the research subjects (n=150). Patients with normal uterine cavity were selected as the control group (n=150). All research subjects underwent hysteroscopy and vaginal microecological examination. The vaginal pH, hydrogen peroxide (H2O2), leukocyte esterase (LE), sialidase (SNA), 3-glucuronidase (GUS), and acetylglucosidase (NAG) of the participants were recorded and analyzed, respectively. Vulvovaginal candidiasis (VVC), trichomonas vaginitis (TV), and bacterial vaginosis (BV) were evaluated and diagnosed separately.

The incidence of abnormal vaginal microecological morphological and functional indicators in the IUA group was remarkably higher than that in the control group, mainly manifested as relatively high pH value, reduction of Lactobacillus, increased ratio of flora density I, IV and flora diversity I, IV, higher detection rate of TV and BV. In addition, the increase in the positive rate of H2O2, LE, SNA, and NAG were observed in IUA patients.

Vaginal microecological imbalance is closely related to the occurrence of IUA, which should cause clinical concern.