{
  "abstract": "Objective of the study: to systematically evaluate the efficacy and safety of adjunctive distrept-enzymes H46A streptokinase-streptodornase therapy in women with gynecological disorders and to interpret the available clinical evidence within the context of current concepts of inflammation, fibrinolysis, extracellular DNA, immunothrombosis, and adhesion biology. Materials and methods. PubMed, Embase, CENTRAL, Scopus, Web of Science, Europe PMC, ClinicalTrials.gov and additional sources were systematically searched from database inception through 2026 without language restrictions. The review followed PRISMA 2020 recommendations and was prospectively designed according to Cochrane methodology. Randomized controlled trials evaluating distrept-enzymes H46A streptokinase-streptodornase therapy in women with postoperative gynecological complications, pelvic inflammatory disorders, endometriosis-associated symptoms or related reproductive conditions were eligible. Primary outcomes included postoperative recovery, inflammatory resolution, pelvic pain, adhesion-related outcomes and reproductive preservation. Results. The review demonstrated consistent clinical improvements associated with adjunctive distrept-enzymes H46A streptokinase-streptodornase therapy across multiple gynecological settings. Compared with standard management alone, enzymatic therapy was associated with higher rates of complete hematoma resolution, greater reductions in C-reactive protein concentrations, faster functional recovery, improved quality of life, and clinically meaningful reductions in pelvic pain. Improvements in dyspareunia, dysuria and dyschezia were also observed among women with endometriosis-associated symptoms. No evidence suggested an increased frequency of serious adverse events, clinically significant bleeding or treatment discontinuation attributable to therapy. Formal pooled meta-analysis, estimation of between-study heterogeneity and prediction intervals were not appropriate because each outcome was represented by only one independent comparative study. Conclusions. The currently available randomized evidence suggests that distrept-enzymes H46A streptokinase-streptodornase therapy may accelerate postoperative recovery and resolution of pelvic inflammatory disease while supporting preservation of reproductive anatomy and function. Contemporary understanding of fibrinolysis, extracellular DNA, and immunothrombosis provides a strong biological rationale for these clinical observations. Nevertheless, the certainty of evidence remains limited by the small number of independent randomized studies, underscoring the need for multicenter trials.",
  "abstract_shown": true,
  "affiliations": [
    "Shupyk National Healthcare University of Ukraine; Kyiv City Center of Reproductive and Perinatal Medicine, Kyiv",
    "SI «Ukrainian Center of Motherhood and Childhood of the NAMS of Ukraine»; SSI «Center of Innovative Medical Technologies of the NAS of Ukraine», Kyiv",
    "Charité – Universitätsmedizin Berlin, Berlin",
    "National Pirogov Memorial Medical University, Vinnytsya",
    "Shupyk National Healthcare University of Ukraine, Kyiv",
    "SI «Institute of Pharmacology and Toxicology of the NAMS of Ukraine», Kyiv"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "V.V. Kaminskyi",
      "orcid": "0000-0002-5369-5817"
    },
    {
      "affs": [
        1
      ],
      "name": "T.F. Tatarchuk",
      "orcid": "0000-0002-5498-4143"
    },
    {
      "affs": [
        2
      ],
      "name": "A.D. Ebert",
      "orcid": "0000-0002-3935-0046"
    },
    {
      "affs": [
        3
      ],
      "name": "O.O. Protsepko",
      "orcid": "0009-0005-3436-9273"
    },
    {
      "affs": [
        4
      ],
      "name": "D.G. Konkov",
      "orcid": "0000-0002-9375-7509"
    },
    {
      "affs": [
        5
      ],
      "name": "V.V. Samsonova",
      "orcid": "0000-0002-3794-2101"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4rehqkfsjwafp.bib",
  "cited_by": 0,
  "doi": "10.18370/2309-4117.2026.85.37-50",
  "fulltext_url": "https://reproduct-endo.com/article/view/377809",
  "id": "4rehqkfsjwafp",
  "issns": [
    "2309-4117",
    "2411-1295"
  ],
  "landing_url": "https://doi.org/10.18370/2309-4117.2026.85.37-50",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RG1-991"
    ],
    [
      "openalex",
      "2746|Intestinal and Peritoneal Adhesions"
    ]
  ],
  "openalex": "W7223575448",
  "pdf_url": "https://reproduct-endo.com/article/download/377809/360429",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": "Publishing House TRILIST",
  "ris": "https://research.draconitic.com/paper/4rehqkfsjwafp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:46:44Z",
      "native_id": "7064aca2180a4fe8a09220dce25b12f4",
      "source": "doaj",
      "url": "https://doi.org/10.18370/2309-4117.2026.85.37-50"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Intestinal and Peritoneal Adhesions",
      "subfield": "surgery"
    }
  ],
  "title": "Clinical efficacy and biological rationale of adjunctive distrept-enzymes H46A streptokinase-streptodornase therapy in gynecology: a systematic review with quantitative synthesis",
  "title_text": "Clinical efficacy and biological rationale of adjunctive distrept-enzymes H46A streptokinase-streptodornase therapy in gynecology: a systematic review with quantitative synthesis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:44Z",
  "url": "https://research.draconitic.com/paper/4rehqkfsjwafp",
  "venue": "Репродуктивная эндокринология",
  "versions": []
}