Background: Inflammatory diseases of the pelvic organs today remain an urgent problem because of the persistent chronic course with frequent relapses, blurred clinical picture, presence of pain syndrome and subacute forms against the background of altered immunological reactivity, and resistance to therapy.

The aim of the study was an optimization of approaches to the treatment of chronic salpingo-oophoritis in women of reproductive age on the basis of the study of certain links of pathogenesis by using a complex preparation containing streptokinase and streptodornase and evaluation of its effectiveness.

Methods: 161 women were examined, including 105 healthy women and 56 women with chronic salpingo-oophoritis in the exacerbation stage, who were divided into 2 groups: comparison group – 21 patients who received standard treatment for 14 days, and study group – 35 patients who, in addition to standard therapy, used the combined preparation with streptokinase and streptodornase for 3 weeks. Levels of C-reactive protein and ferritin in blood serum were determined; functioning of the lipid peroxidation–antioxidant protection (LPO–AOD) system, state of endogenous intoxication, concentration of pro- and anti-inflammatory cytokines, vaginal microbiocenosis, and quality of life were assessed.

Results: In patients with exacerbation of chronic salpingo-oophoritis, hemogram disorders, decreased ferritin content, activation of lipid peroxidation, increased level of endotoxemia, predominance of pro-inflammatory cytokines, changes in the vaginal microbiome against the background of suppression of secretory immunoglobulin A, and deterioration of quality of life were revealed. The use of the combined preparation containing streptokinase and streptodornase in the therapy of patients with exacerbation of chronic salpingo-oophoritis made it possible to reduce the frequency of relapses by 3.5 times compared with standard treatment, to normalize hemogram indices, LPO–AOD indices, endotoxemia, cytokine concentration, vaginal microbiocenosis, and to improve the patients’ quality of life.