Abstract
<jats:p>Background. Bacterial vaginosis (BV) is a highly prevalent polymicrobial condition among women of reproductive age, characterized by an imbalance of the vaginal microbiota and associated with increased risks of obstetric and gynecological complications. Disruption of the normal vaginal flora, driven by the predominance of anaerobic microorganisms, significantly affects overall well-being and quality of life (QoL) in women of childbearing age. Contemporary approaches to the diagnosis and treatment of BV require a comprehensive assessment of therapeutic effectiveness, including patient-reported QoL outcomes. Objective. To evaluate the dynamics of QoL in women with BV at different stages of therapy using various treatment strategies with the help of a standardized questionnaire. Material and Methods. A randomized study involving 95 women aged 18–45 years with a verified diagnosis of BV was conducted. The participants were randomly allocated into three groups: Group I (n=35) received conventional therapy; Group II (n=30) received an anti-recurrence treatment regimen; Group III (n=30) received anti-recurrence therapy combined with radiosurgical and cryotherapeutic management of complicated cervical ectopy. QoL was assessed using a specialized validated questionnaire before treatment and longitudinally over a 9-month follow-up period. Results. Combined therapy (Group III) resulted in normalization of QoL in 84.5% of cases, with a recurrence rate of 23.3%, whereas conventional therapy (Group I) was ineffective (100% recurrence rate). Management of recurrences in Groups I and II using the developed anti-recurrence regimen combined with radio wave surgery and cryodestruction of the cervical canal achieved a cumulative therapeutic success rate of 83.5% (95% CI: 75.4–91.7%; p<0.05). Cox proportional hazards modeling confirmed an 8.6-fold reduction in recurrence risk with comprehensive therapy compared to conventional treatment (p<0.05). Improved therapeutic efficacy was associated with a shift in the leading QoL predictor from the social to the psychological domain. Conclusions. Combined BV therapy incorporating recurrence prevention ensures sustained remission (23.3% recurrence rate) and normalization of QoL in 84.5% of patients, in contrast to conventional monotherapy (100% recurrence rate). The anti-recurrence strategy reduces the risk of disease relapse by 8.6-fold (p<0.05). The emergence of the mental component justifies the need for a multidisciplinary approach with mandatory QoL assessment in BV management.</jats:p>