Table 2.

Data extracted from studies using culture-based technology to investigate the uterine, vaginal, endocervical, endometrial and gut microbiome and uterine leiomyoma (uterine myoma, uterine fibroid).

Author, date, country	Study aim	Sample		Age	Detection method	Material	Study findings	Abundance of microbiota		Conclusions of the study
		Studied group, Subjects, n	Control group, Subjects, n					Increased	Reduced
Teisala; 1987; Finland (Teisala, 1987)	To evaluate microbiological and histopathological findings from different levels of the endometrial cavity	10 menstruating women for hysterectomy indication 8 – uterine fibroids 2 – chronic pelvic pain		Range 36-49	Microbiological techniques	Tissue specimens from fundal, middle, and cervical area of the endometrium after removing the uterus.	Negative cultures of aerobic, anaerobic, and facultative bacteria			Negative culture results of C. trachomatis, N. gonorrhoeae, M. hominis, U. urealyticum. Endometrial cavity of a nonpregnant uterus is sterile.
Bertazzoni Minelli et al.; 1990; Italy (Minelli et al., 1990)	To assess the composition of the fecal flora in patients with breast cancer and uterine leiomyoma in comparison with a group of healthy women	18 patients with breast cancer 18 with uterine leiomyoma	30 healthy women	Range 25-52	Microbiological techniques	Stool sample, the first admission day		Anaerobic lactobacilli, streptococci (Enterococcus faecium) in groups of women with breast cancer and uterine leiomyoma	Peptoniphilus asaccharolyticus and P. saccharolyticus in groups of women with breast cancer and uterine leiomyoma	Fecal bacteria reduce estrone to estradiol. The presence or absence of some bacterial species is important in modulating estrogen metabolism. The microflora may influence the metabolism of sex steroid hormones.
Mikamo et al.; 1993; Japan (Mikamo et al., 1993a)	To identify the intrauterine bacterial flora in diabetic patients with various postoperative complications	Diabetic patients with abdominal hysterectomy because of uterine myoma 10 diabetic patients	Non-diabetic control patients 20 controls	Range 35-45	Quantitative bacteriological assay Anaerobic bacteria – RapID ANA II identification system (Innovative Diagnostic System, Inc., Atlanta, GA) combined with gas-liquid chromatography (GLC)	Swab from the endometrial cavity	Bacteria detected in the uterine endometrial cavity; 10 of ten diabetic patients with uterine myoma and 3 non-diabetic controls	Enterobacteriaceae (Escherichia coli, Proteus spp., Enterobacter cloacae, and Klebsiella pneumoniae		Antimicrobial Enterobacteriaceae prevention of postoperative infections in gynecologic procedures in diabetic patients.
Mikamo et al.; 1993; Japan (Mikamo et al., 1993b)	To identify the intrauterine bacterial flora in patients with uterine endometrial cancer	Patients with uterine endometrial cancer 20 – uterine endometrial cancer	Patients without complications other than uterine myoma 20 controls	Range 44-69	Quantitative bacteriological assay Anaerobic bacteria – RapID ANA II identification system (Innovative Diagnostic System, Inc., Atlanta, GA) combined with gas-liquid chromatography (GLC)	Endometrial cavity with a polyester fiber swab	Enterobacteriaceae, Streptococcus agalactiae and anaerobic bacteria detected in all patients with uterine endometrial cancer Patients without complications other than uterine myoma – no detection of bacteria	Enterobacteriaceae, Streptococcus agalactiae and anaerobic bacteria		Products ofaerobicand anaerobic bacteria considered to contribute to endometrial carcinogenesis. Uterine endometrial cancer provides favorable conditions for bacterial growth.
Møller et al.;1995; Denmark (Møller et al., 1995)	To evaluate whether the uterine cavity is non-sterile, in contradiction to previous suggestions	99 women admitted for hysterectomy 34 patients with uterine fibromyoma 29 patients with persistent irregular vaginal bleeding 10 patients with malignancy of the cervix (carcinoma in situ cervicis uteri)		Range 29-84	Microbiological techniques Histological examination	Cervical specimens Endometrial specimens	25% of all the patients harbored one or more microorganisms in the uterus	Gardnerella vaginalis, Enterobacter and Streptococcus agalactiae		Uterine cavity colonized with potentially pathogenic organisms. Inflammation of the uterine cavity should be evaluated via hysteroscopic examination before hysterectomy.