General Gynecology · Infections
Abstract
Objective
The aim: To determine the role of infectious diseases as the cause of the Cervical, Ovarian and Breast hyperplasia in Ukraine.
Materials and Methods
We conducted a retrospective multicenter cohort study from January 1st, 2020 to December 31st, 2022. This study included patients aged 20-59 years with a diagnosis of hyperproliferative pathology of the women reproductive organs without atypia, who sought medical care for hyperplastic processes admitted to the 12 hospitals from 9 regions of Ukraine.
Results
We had examined 4,713 women; out of which 81.1% met the clinical definition of female reproductive organs hyperplasia. Of all hyperplasia cases, most frequently recorded types were breast hyperplasia (41,7%), followed by cervical hyperplasia (31,1%) and ovarian hyperplasia (27,2%). History of Cervicitis (p<0.001), Vaginal cuff infection (p<0.001), Oophoritis (p<0.001), and Mastitis (p<0.001) were identified as independent risk factors of Cervical, Ovarian and Breast hyperplasia.
Conclusions
This study showed that surgical site infections after obstetric and gynecological operations are is the cause of Cervical, Ovarian and Breast hyperplasia. Therefore, early detection and treatment SSIs can reduce the risk of hyperplasia these organs.
Topics
By this author
Mental Health · Postpartum Depression
Perinatal mental health and reproductive behavior among women in wartime Ukraine: a cohort study protocol
Krupelnytska L et al., 2026 · Frontiers in psychiatry · Free full text on PubMed Central
War reshapes the conditions under which reproductive decisions are made and pregnancy is experienced. Prolonged insecurity, displacement, economic instability, disruption of healthcare, and reduced social support may lead women and families to postpone pregnancy or face pregnancy and childbirth under constrained conditions. These challenges highlight the need for research on how war-related stress and trauma affect women's reproductive behavior and perinatal mental health. This prospective cohort study will recruit at least 328 women through healthcare institutions providing reproductive and perinatal care. Eligible participants will include non-pregnant women, pregnant women, and women within the first year postpartum. Where feasible, partners of enrolled women will also be included to provide complementary dyadic data. Participants will be followed from baseline to 3, 6, and 12 months. Data will be collected through web-based questionnaires and routine clinical records. No experimental intervention will be delivered, and participation in the study will not modify standard clinical care. Repeated measures will capture mental health, reproductive intentions and behavior, war-related and perinatal experiences, and key sociodemographic and obstetric characteristics. Primary analyses will use mixed-effects models to examine mental-health trajectories, with reproductive status modeled both as a baseline cohort characteristic and, where participants change status during follow-up, as a time-varying covariate; reproductive transitions will also be examined as secondary longitudinal outcomes. This protocol addresses an important gap by using a longitudinal design to examine women's experiences in a wartime setting. By situating mental health within disrupted reproductive plans, insecurity, healthcare strain, and family-level experiences, the study may help identify how armed conflicts shape both psychological vulnerability and reproductive decision-making. The findings may inform more responsive care for women affected by war. ClinicalTrials.gov; identifier: NCT07551934.
Infections · Vaginal and Cervical Infections
Urinary tract infections in pregnant women from the Russian--Ukrainian military conflict regions: A multicenter study (2022-2025)
Salmanov AG et al., 2026 · Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
To estimates of the prevalence rate of urinary tract infections (UTIs) in pregnant women from the Ukrainian-Russian military conflict regions and antimicrobial resistance of causing pathogens. Materials and Retrospective multicenter cohort study was conducted from April, 2022 to May, 2025.The study population consisted of 2,576 pregnant women from the Ukrainian-Russian military conflict regions. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST guidelines. Among 2,576 pregnant women, 1,002 (38.9%) UTIs were observed. The most frequently reported UTI types were cystitis (48.4%) and asymptomatic bacteriuria (39%). Of all UTI cases, 14.6% were defined as acute pyelonephritis. The most common causative agents of UTIs were Escherichia coli (27.6%), Klebsiella pneumoniae (13.9%), Proteus mirabilis (11.2%), Coagulase-negative staphylococci (8.7%), Enterococcus faecalis (8.5%), Enterobacter spp. (7.2%), and Pseudomonas aeruginosa (6.6%). Methicillin-resistance S. aureus (MRSA), vancomycin resistance enterococci (VRE), and extended spectrum beta-lactamases (ESBL) production among Enterobacteriales was found observed in 11.3%, 9.1%, and 29.4% isolates, respectively. Carbapenem resistance was identified in 13.7% of P. aeruginosa strains. This study findings demonstrate the high rate of UTIs in pregnant women from the Ukrainian-Russian military conflict regions and many cases are caused by pathogens that are resistant to antibiotics. Strategies for deterrence include optimal hygiene practices to minimize the risk of bacterial colonization and ascending infection.
Infections · Pelvic Inflammatory Disease
Complications and adverse outcomes related to induced abortion in female from the Ukrainian-Russian military conflict regions: A multicentre study
Salmanov AG et al., 2025 · Wiadomosci lekarskie (Warsaw, Poland : 1960)
To provide an overview of complications and adverse outcomes related to induced abortion in female from the Eastern and Southern Ukrainian-Russian military conflict regions. Material and This are a multicentre combined retrospective and prospective cohort study. All women who underwent induced abortion in Eastern and Southern Ukrainian-Russian military conflict regions between 2022 and 2024 are included in the study. A total of 14,196 induced abortion were performed, 10,630 (74.9%) complications cases were observed. The most complication were infections (71.1%), cervical injury (6.6%), incomplete abortion (5.4%), hemorrhage (5.2%), and uterine perforation (4.9%). The most common infection related to induced abortions was endometritis (21.6%), cervicitis (17.8%), vaginal cuff infections (16.3%), peritonitis (12.3%) and pelvic abscess (10.7%), followed by adnexa utery (8.1%), parametritis (6.7%), salpingitis (5.1%), sepsis (1.3%) and other (0.2%) infections. The main risk factors was increased maternal age, surgical abortion approach, increased gestational age, prior cesarean delivery, presence of a bleeding disorder, fetal demise before the abortion, lack of healthcare facilities, lack of essential medication, lack of personnel and equipment, and surgical inexperience. This study findings demonstrate the high rate of complications related to induced abortion in the Ukrainian-Russian military conflict regions. The ongoing war has led to a decline in the quality of healthcare services and main reason for the high rate of complications and adverse outcomes related to induced abortion in female from the military conflict regions.
Pathophysiology · Origin Theories
Obstetric and gynecological surgical procedures, and surgical site infections as risk for the development of endometriosis: a multicenter study
Salmanov AG et al., 2025 · Wiadomosci lekarskie (Warsaw, Poland : 1960)
Aim this study was to evaluate the incidence of endometriosis in women with a recent history of surgical site infections (SSIs), and obstetric and gynecological surgical procedures. Materials and A retrospective multicenter cohort was conducted on patients who have had obstetric or gynecological surgical procedures performer from January 2022 to December 2024 in 16 hospitals from six Ukrainian regions. Definitions of SSIs were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. The criteria for endometriosis were adapted from the ESHRE endometriosis guideline. The study included 33,126 reproductive women with endometriosis who had 16,724 obstetric and 32,383 gynecologic surgical procedures. The incidence of endometriosis in women with history of obstetric and gynecologic surgical procedures, and SSIs was 25.5% [95% confidence interval (CI), 24.3-26.4], 33.3% (95% CI, 33.0-33.6), and 22,1% (20.8-24.2), respectively. Multivariate analysis identified SSIs, obstetric and gynecological surgical procedures as three factors positively associated with the risk of endometriosis. Factors that increased the odds of endometriosis was SSIs (adjusted odds ratio [AOR], 3.76; 95% CI, 2.29-6.20), and obstetric and gynecological surgical procedures (AOR, 7.91; 95% CI, 3.68-37.3). An SSIs and obstetric and gynecological surgery history increased the odds of an endometriosis >7-fold in the cohort (AOR, 7.96; 95% CI, 3.64-37.2). Obstetric and gynecological surgical injury, and the inflammation resulting from SSIs may play a role in developing endometriosis.
Related research
Infections · Vaginal and Cervical Infections
VULVOVAGINAL CANDIDIASIS AFTER GYNECOLOGICAL SURGERIES AND ADVERSE PREGNANCY OUTCOME IN UKRAINE: A MULTICENTRE STUDY
Salmanov AG et al., 2023 · Wiadomosci lekarskie (Warsaw, Poland : 1960)
The To investigate the epidemiology and microbiology of vulvovaginal candidiasis (VVC) after gynecological surgeries, and adverse pregnancy outcomes in Ukraine. Materials and Multicenter prospective cohort study was conducted from January 2020 to December 2022 and recruited pregnant and non-pregnant women aged 15-65 years who had sought medical help for vaginal dysbiosis the seven medical clinic from five regions of Ukraine. Between 2020 and 2022, 2,341 women were followed in gynecological practices, and 1,056 (41.5%) women were diagnosed with VVC during the same period. Of the total VVC cases, 31.9% were in non-pregnant and 68.1% in pregnant women. The use of antibiotics (OR=3.48), use hormonal contracep¬tives (OR=2.75) and pregnancy (OR=1.13) were associated with an increase in the risk of VVC diagnosis. Diabetes mellitus (OR=0.44) were additional risk factors. The most common pathogen of VVC was C. albicans, Nakaseomyces glabratus (C. glabrata), followed by Pichia kudriavzevii (C. krusei), C. parapsilosis, C. tropicalis, C. kefyr, C. guillieromondii, C. lusitaniae, and C. rugosa. We found no significant difference in adverse pregnancy outcomes between Candida-positive and Candida-negative women. Vulvovaginal candidiasis after gynecological surgeries in Ukraine is a common medical problem in women that is associated with significant morbidity, and hence frequent medical visits. High prevalence rate of vulvovaginal candidiasis in the present study warrants, the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Ukraine.
Infections · Vaginal and Cervical Infections
PREVALENCE OF AEROBIC VAGINITIS AFTER GYNECOLOGICAL SURGERIES AND ASSOCIATED ADVERSE PREGNANCY OUTCOME IN UKRAINE
Salmanov AG et al., 2023 · Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
To determine prevalence of Aerobic Vaginitis (AV) after gynecologic surgery, risk factors and antimicrobial resistance of responsible pathogens, and adverse pregnancy outcomes in Ukraine. Materials and Multicenter retrospective cohort study was conducted from January 2020 to December 2022 in fifteen medical clinics from eight regions of Ukraine. Smears were analyzed using Donders' classification method and Dong's modified AV diagnosis for Gram stains. Definitions of HAIs were adapted from the CDC/NHSN. Antibiotic susceptibility testing of bacteria was determined by Kirby-Bauer disc diffusion test according to the protocol of the EUCAST. Prevalence of AV among women's undergoing gynecologic surgery in Ukraine was 68.7%. Of the total AV cases, 70.3% were in non-pregnant and 29,7% in pregnant women. The most common pathogen of AV was Escherichia coli, followed by Enterococcus faecalis, Streptococcus agalactiae, Staphylococcus aureus, Enterococcus faecium, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Among the S. aureus strains, 11,6% of MRSA (Methicillin resistant S.aureus) were isolated whereas none of the CoNS were cefoxitin resistant. History of vaginal infection, history of post-operative infection and antibiotic use acted as an important risk factor of AV incidence rate. The presence of AV worsened pregnancy outcomes, by increasing the incidence of preterm birth, the premature rupture of membranes, miscarriage, neonatal jaundice, and neonatal infection. Aerobic Vaginitis after gynecological surgeries in Ukraine is a common medical problem in women that is associated with significant morbidity, adverse pregnancy outcome, and hence frequent medical visits.
Infections · Vaginal and Cervical Infections
PREVALENCE OF HEALTHCARE-ASSOCIATED CERVICITIS AND ANTIMICROBIAL RESISTANCE OF THE RESPONSIBLE PATHOGENS IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2019-2021)
Salmanov AG et al., 2022 · Wiadomosci lekarskie (Warsaw, Poland : 1960)
The To obtain the first estimates of the current prevalence of healthcare-associated cervicitis (HACs) and antimicrobial resistance of responsible pathogens in Ukraine. Materials and We conducted a retrospective multicentre cohort study was based on surveillance data from January 1st, 2019 to December 31st, 2021 in Ukraine. Antibiotic susceptibility testing was determined by Kirby-Bauer disc diffusion test according to the protocol of the European Committee on Antimicrobial Susceptibility Testing. Of the 6,885 participants in this study, 1746 women (25.5%) met the clinical definition of cervicitis. Prevalence of HACs and cervcits caused sexually transmitted pathogens were 12.7% and 8.3%, respectively. The incidence of HACs among women with a history of gynecological procedures was 25.4%. The main causes of HACs were legal induced abortions (28.8%), vaginal hysterectomy (23.9%), and postpartum instrumental examination (12.8%). The predominant pathogens of HACs were: Escherichia coli, Enterobacter spp., Klebsiella spp., Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis. Methicillin-resistance was observed in 20.8% of S. aureus (MRSA). Vancomycin resistance was observed in 7.4% of isolated enterococci (VRE). Resistance to third-generation cephalosporins was observed in 13.1% Klebsiella spp. and E.coli 17.5% isolates. Carbapenem resistance was identified in 11.6% of P.aeruginosa isolates. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (33.5%, vs 8.7%). The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 34.6%. This study showed that the prevalence of healthcare-associated cervicitis in Ukraine is high, and many cases were caused by antibiotic-resistant pathogens.
Infections · Vaginal and Cervical Infections
HEALTHCARE-ASSOCIATED BACTERIAL VAGINOSIS AFTER GYNECOLOGICAL SURGERIES AND ASSOCIATED ADVERSE PREGNANCY OUTCOME IN UKRAINE
Salmanov AG et al., 2023 · Wiadomosci lekarskie (Warsaw, Poland : 1960)
The To determine the prevalence of healthcare-associated bacterial vaginosis after gynecological surgeries and associated adverse pregnancy outcomes in Ukraine. Materials and Multicenter retrospective cohort study was conducted from January 2019 to December 2021 in eleven medical centers from eight regions of Ukraine. Vaginal cultures were obtained preoperatively from 3,502 women undergoing gynecologic surgery. Diagnosis of Bacterial Vaginosis is based on the Nugent and Amsel criteria. Healthcare-associated bacterial vaginosis (HA BV) was diagnosed in 1,498 of 3,502 women, giving a prevalence rate of 42.8%. HA BV was significantly associated with preterm birth (risk ratio [RR], 2.68; 95% confidence interval [CI], 1.44-4.98), miscarriage (RR, 6.11; 95% CI, 3.22-14.11), low birth weight (RR, 3.20; 95% CI, 1.29-7.94), and premature rupture of membranes (RR, 6.75; 95% CI, 3.11-14.67). The HA BV after gynecological surgeries prevalence is high in Ukraine, with a concomitant adverse pregnancy outcome, including preterm birth, low birth weight, premature rupture of membranes, and miscarriage. A significant number of cases of bacterial vaginosis are associated with long-term use of antibiotics to treat post-operative infections.
General Gynecology › Infections › Pelvic Inflammatory Disease
Aidyn G Salmanov, Volodymyr Artyomenko, Svitlana Y Hladenko, Irina M Koctjuk, Andrii O Marchenko, Galina O Tolstanova, Svitlana M Korniyenko
A Salmanov, V Artyomenko, S Hladenko, I Koctjuk, A Marchenko, G Tolstanova, S Korniyenko
PMID 37057766 37057766 DOI 10.36740/wlek202303101 10.36740/wlek202303101 Salmanov et al. 2023, Salmanov 2023