Adnexitis or salpingoophoritis is a unilateral or bilateral, combined inflammation of the ovaries and fallopian (fallopian) tubes that form the uterine appendages. The inflammatory process not only negatively affects a woman’s quality of life, but can also disrupt it reproductive functions. Most often the disease occurs among young women. The development of such a disease can be provoked by various pathological microbes - gonococci, streptococci, etc.
We will look in more detail about what kind of disease this is, what symptoms women have, as well as treatment for adnexitis later in the article.
Adnexitis: what is it?
Adnexitis is a disease of the genital organs of the female body, in which the uterine appendages, which are the ovaries and fallopian tubes, become inflamed. The second name for the same disease is salpingoophoritis, formed by the words salpingitis (inflammation of the fallopian tubes) + oophoritis (inflammation of the ovaries).
Salpingitis and oophoritis are extremely rare to occur separately, due to their close relationship with each other, therefore their combined inflammation is combined into one nosological unit - adnexitis, inflammation of the appendages.
When the disease occurs, the epithelium of the fallopian tubes is destroyed, as a result of which the walls are impregnated with waste products of infecting microorganisms, which, as a result, leads to inflammation.
According to statistical data, in every fifth case this pathology leads to infertility. Most often, experts diagnose this disease in young sexually active women aged 20 to 30 years.
- Adnexitis (ICD 10) - code N 70.
To exclude the disease, it is necessary to visit your local gynecologist every year. A periodic routine examination can diagnose dangerous diseases in time, so treatment will be faster and less expensive.
Classification
Adnexitis is classified according to the nature of its spread, the type of course, and less often - according to the infectious pathogen.
The types of salpingoophoritis are as follows:
- Acute adnexitis, or having a chronic course;
- Unilateral or bilateral adnexitis;
- Serous or purulent process;
- Predominant damage to the tubes (salpingitis) or ovary (oophoritis).
Previously, subacute adnexitis was diagnosed as untreated acute or a harbinger of chronic; but currently only these two forms are used to make a diagnosis.
Acute adnexitis
In most cases, bilateral inflammation of the appendages is observed in combination with inflammation of the uterus. This disease most often occurs with menstrual irregularities (algomenorrhea and menorrhagia).
In acute adnexitis, due to the inflammatory fluid accumulating in the fallopian tube, saccular formations appear with the accumulation of pus in them. The disease can cause a complication - the so-called tubo-ovarian abscess, as a result of which the infection can penetrate into abdominal cavity, which will cause inflammation of the peritoneum, and as a result, peritonitis with various abscesses.
The consequences of peritonitis are:
- the formation of adhesions that are localized in the fallopian tubes;
- increased risk of ectopic pregnancy;
- infertility.
Ignoring the signs of acute adnexitis in the absence of complications leads to a decrease in symptoms after 8-12 days and the disease becoming chronic.
Chronic form
Chronic adnexitis is most often the result of an untreated acute process and occurs with relapses resulting from the influence of nonspecific factors (stressful situations, hypothermia, overwork, etc.). In its chronic form, adnexitis causes anxiety in the form of a “dull pain” that is constant.
Reasons
In healthy female body the ovaries and fallopian tubes are sterile, so adnexitis can develop only after infection penetrates from adjacent structures (uterine cavity, vagina), or from distant foci of chronic inflammation through blood or lymph.
Most cases of adnexitis are provoked not by a foreign infection, but by the vagina’s own opportunistic microflora.
The causative agents of the pathological process during adnexitis can enter the fallopian tubes in the following ways:
- hematogenous (with blood flow);
- lymphogenous (with lymph flow);
- descending (from the sigmoid or cecum along the peritoneum);
- ascending (from the vagina into the cervical canal, then into the uterine cavity, fallopian tubes and ovaries).
The infection can spread upward through inflammation of the vagina, cervix or uterus, and downwardly from other, higher-lying organs (for example, with appendicitis).
U healthy woman the introduction of pathogens into the appendages is prevented by a system of protective barriers, through which only aggressive gonococcus is able to penetrate. Other microorganisms gain access to them as a result of some failure in protection.
The causes of adnexitis may be:
- promiscuous sex life;
- sexual intercourse during menstruation without a condom;
- hypothermia of the body against the background of weak immunity;
- inflammatory diseases of the female genital area suffered in the past.
The state of immunity plays an important role, since if a woman is constantly under stress, she is more susceptible to adnexitis.
First signs
The infectious agent causes swelling of the tissues of the uterine appendages, which manifests itself as pain. A serous or purulent secretion is released, sometimes mixed with blood. The first signs of adnexitis are as follows ( we're talking about about acute adnexitis):
- Stomach ache;
- Increase in temperature;
- Bloating, nausea or vomiting.
Symptoms of adnexitis in women
The severity of the manifestation of this disease depends on the extent to which the inflammatory process is widespread, what pathogen caused it, as well as on the individual condition of the patient, in particular, on her immunity.
With adnexitis, inflammation is present in both the ovaries and tubes. The infection is initially localized in the cavity of the fallopian tubes, and then relatively quickly rises to the ovaries. Therefore, the inflammatory process in both structures develops according to a single scenario.
At the early stage of the disease, symptoms of adnexitis in women are characterized by:
- tension in the abdominal wall,
- sharp pains,
- urination disorder (painful and frequent),
- general well-being is disturbed.
In addition to pain, fever and bloating, may bother unpleasant discharge from the genital tract, serous, sanguineous or even purulent in nature.
Symptoms of acute adnexitis
Among the local signs there are:
- pain of various types and intensity in the lower abdomen, sometimes radiating to the thigh or lower back;
- significant decrease in libido, discomfort on the right or left during sexual intercourse;
- discharge from the genitals of a mucous or purulent nature (leucorrhoea), sometimes mixed with blood.
Acute purulent adnexitis, in addition to severe pain, is accompanied by severe fever and symptoms of intoxication, which makes it similar to any acute inflammatory process of the abdominal cavity and complicates the initial diagnosis.
It is precisely because of the clinical picture of the “acute abdomen” that right-sided adnexitis often imitates acute or right-sided renal colic.
Symptoms of the chronic form
The chronic form of the disease is characterized by dull pain that appears constantly. At the same time, women's menstrual cycle and sexual function are disrupted. Sometimes chronic adnexitis can be asymptomatic, and the disease is detected during an examination for infertility. Infertility as a result of impaired ovarian function or obstruction of the fallopian tubes is a common symptom of adnexitis in a chronic advanced form.
Right-sided adnexitis is accompanied by:
- Pain in this form of adnexitis is localized on the right and can mimic acute appendicitis.
- The nature of the pain is nagging or burning, and can radiate to the rectum or sacrum.
Left-sided adnexitis:
- The pain is localized on the left and is pulling, stabbing or cutting in nature.
- They can also radiate to the tailbone or rectum.
Bilateral adnexitis:
- This syndrome is characterized by acute pain, symptoms of peritoneal irritation, and muscle tension in the anterior abdominal wall (stomach).
- always occurs acutely with severe symptoms of intoxication. Sometimes it can give a picture of an acute abdomen.
Complications
In addition to problems with conception, which are caused by the adhesive process in the tubes, there are other complications:
- The likelihood of developing an ectopic pregnancy increases tenfold due to adhesions and narrowing of the passage in the fallopian tubes.
- Infertility, disruption of the production of sex hormones by the ovaries.
- Purulent complications requiring surgical treatment including removal of the fallopian tubes.
Diagnostics
If you suspect adnexitis, or the symptoms listed above in one way or another indicate the presence of problems, you should contact a gynecologist. Only he can make a final diagnosis of adnexitis, taking into account the symptoms, as well as the data obtained on the basis of a series of analyzes and studies aimed at identifying the problem.
Diagnosis of adnexitis is based on collecting anamnesis, complaints, and gynecological examination. The following laboratory tests are also indicated:
- general blood and urine analysis;
- biochemical blood test (C-reactive protein, blood sugar, total protein, etc.);
- smear of vaginal discharge for flora, tank. culture and antibiotic sensitivity testing;
- Ultrasound of the pelvic organs;
- laparoscopy (in difficult cases);
- tuberculin test (if tuberculosis infection is suspected).
In the diagnosis of adnexitis (both acute and chronic) important point is to collect the woman’s complaints, since it is the details of the development of the disease and microsymptoms that make it possible to exclude other diseases with similar manifestations.
If a woman is at risk (wears an IUD, suffers from sexually transmitted infections, or has had an abortion), it is recommended to visit a gynecologist at least 2 times a year.
Treatment of adnexitis
Only a qualified specialist, based on the tests and examination of the patient, can prescribe the most effective treatment in each specific case. Adnexitis is a very serious disease, which, in the absence of adequate and well-chosen therapy, can lead to very sad complications, including such a terrible diagnosis as infertility.
Treatment of the disease has the following goals:
- elimination of inflammation;
- elimination of pain;
- increasing immunity;
- restoration of genital functions;
- normalization of the activity of the nervous, endocrine and other systems.
When treating acute adnexitis, hospitalization is necessary, since the acute form of adnexitis can have serious consequences and complications: the formation of purulent cavities in the tubes, purulent melting of the ovaries, etc.
The patient is prescribed bed rest, medications are used for pain relief, and broad-spectrum antibiotics and anti-inflammatory drugs are used to eliminate the inflammatory process.
Treatment of the acute form of left-sided or right-sided adnexitis should be carried out in a hospital setting, with the obligatory prescription of antibiotics and anti-inflammatory drugs, for example:
- Metronidazole,
- Oflaxacin.
Local treatment is carried out by prescribing baths or douching with disinfectant solutions (furacilin, dimexide, dioxidin, chlorophyllipt), as well as decoctions medicinal herbs(celandine, calendula, rose petals, chamomile, sage, yarrow, etc.).
After adnexitis, that is, after eliminating all inflammatory manifestations in acute form, the following may be prescribed:
- biostimulants, for example Ovariamin,
- physiotherapeutic treatment (electrophoresis, vibration massage, etc.),
- stimulation of ovulatory function (drug Clofit).
Drugs for the treatment of adnexitis in the chronic stage should be selected according to the goals of therapy, namely:
- eliminate inflammation;
- increase immunity;
- sanitize existing infectious foci of other localization;
- eliminate hormonal disorders;
- restore normal menstrual cycle;
- adjust the functioning of the endocrine system.
Operation
Surgical treatment is carried out if necessary at any stage of adnexitis:
- In the acute period, laparoscopic surgery is performed to remove space-occupying formations - hydro- and pyosalpinx, ovarian abscess. The tube is usually removed completely, the ovary is operated on as sparingly as possible, preserving all viable tissue.
- For chronic adnexitis restore patency of the fallopian tubes, if possible.
If a disease is detected, you must adhere to all recommendations and prescriptions of your doctor.
Maintaining a proper diet
Nutrition during the treatment of adnexitis should not only be regular, but also rational, completely balanced. Thanks to good nutrition, the body's resistance to pathogens will increase and metabolic processes in the inflamed area will improve.
During acute and exacerbation of chronic forms, the diet should be hypoallergenic and exclude the following products:
- egg whites;
- fatty meats;
- mushrooms;
- chocolate and other sweets;
- citrus fruits, red berries;
- products with dyes, flavors, preservatives, sweeteners;
- a large amount of table salt.
The diet should contain foods with high content vitamin C to strengthen the immune system and speed up recovery. These products include:
- currants (red and black),
- citrus,
- strawberry,
- sweet pepper,
- mulberry,
- cranberry,
- kiwi,
- pomegranate, etc.
For a normal protein balance, you should eat lean varieties of meat and fish (beef, rabbit, turkey, hake, whiting, pollock, etc.). Be sure to include greens in your dishes: spinach, parsley, basil, cilantro, feathers onions, leek and others.
Folk remedies
Please note: apply means according folk recipes it is possible only for chronic adnexitis, which is in remission, or during the recovery period after treatment of acute adnexitis, when the peak of inflammation has already passed.
- Herbal infusions of chamomile, calendula or celandine are douched. To do this, one tablespoon of the selected herb is brewed with a glass of boiling water. The cooled broth is used for the procedure in accordance with the rules.
- Traditional therapy for chronic adnexitis uses it quite often medicines, prepared from only one plant. For example, consider a decoction based on calendula. This plant is most often recommended for warming and anti-inflammatory baths, as calendula has pronounced antibacterial activity.
- You can carry out baths from a series- the decoction is prepared according to classic recipe: a tablespoon of dry raw materials per glass of water, boil for 10 minutes, leave for 2 hours.
Treatment of adnexitis folk remedies using chamomile or calendula is recommended as an adjunct to the main drug therapy.
Prevention
The risk group for the development of adnexitis includes women suffering from sexually transmitted infections, using intrauterine contraceptives, undergoing surgery on the reproductive organs, and also after pregnancies that ended in induced or spontaneous abortions.
To do this, a woman must follow several simple rules:
- observe the rules of intimate hygiene;
- give preference to loose-fitting underwear made from natural fabrics;
- dress according to the season and do not sit in the cold even in warm weather;
- use protective equipment during sexual intercourse;
- undergo regular preventive examinations with a gynecologist.
By following simple rules, you can be completely confident in maintaining your women's health. Be healthy!
Adnexitis is a unilateral or bilateral inflammation of the appendages, including the fallopian tubes and ovaries. Inflammation of this type is formed due to the influence of various microorganisms, which can be transmitted in acute or chronic form. It should be noted that adnexitis, the symptoms of which are quite common among women, defining the disease itself as one of the most common gynecological diseases, is also characterized by the occurrence of frequent relapses. Moreover, this inflammation, as a rule, affects both organs at once, and its danger lies in the formation of subsequent infertility for every fifth sick woman.
Etiology of adnexitis
Dwelling on this disease in more detail, we note that the severity of manifestations characteristic of adnexitis is based on the specific degree of prevalence of inflammation. Not the least role in this is played by the pathogen itself and general condition the body against the background of its immunity. The pathogens in particular are the most various types microbes and bacteria, which include chlamydia, gonococci, tuberculosis microbacteria and others.
When the disease occurs, the epithelium of the fallopian tubes is destroyed, as a result of which the walls are impregnated with waste products of infecting microorganisms, which, as a result, leads to inflammation.
Forms and symptoms of the disease
As already noted, adnexitis is characterized by symptoms based on the specific pathogen affecting the area. At the same time, the symptoms of acute adnexitis are characterized by a general malaise, which makes it similar to a cold. In particular, these include high fever and headaches, chills and body aches, nausea and even vomiting.
Along with this, there are also specific types of symptoms that act as aching and periodic (often constant) pain in the lower abdomen, and these pains can radiate to the thigh or lower back, as well as to the rectum. Additionally, we note such symptoms characteristic of adnexitis as irritability and nervousness, insomnia and depression. As for such a form as subacute adnexitis, its symptoms follow from the previous form, but in this case there is a decrease in pain and temperature, which are generally characteristic of it.
Another form of the disease is chronic adnexitis. It develops mainly from the acute form in its untreated stage. Periods of exacerbation that characterize chronic adnexitis have the following symptoms: deterioration in overall health, weakness, increased temperature (up to 38°C). It is noteworthy that about 40% of the total number of women diagnosed with chronic adnexitis are faced with a disorder in sexual function, and they also experience a lack of sexual desire. Violations in organ functions often occur digestive system(for example,), urinary system (, etc.).
In its chronic form, adnexitis causes anxiety in the form of a “dull pain” that is constant. Moreover, such pain can intensify during physical activity, during sexual intercourse or menstruation, under the influence of stress and during hypothermia. Again, if we are talking about a chronic form, adnexitis provokes in this case symptoms in the form of menstrual disorders. Their severity lies in the scarcity of discharge or in its abundance, and in both cases, menstruation, as a rule, is extremely exhausting.
It should be noted that with prolonged adnexitis, there is a risk of infertility, which is formed due to the soldering of the tubes during their prolonged inflammation, which ultimately leads to their obstruction. By the way, it also happens that infertility is the only sign indicating the presence of adnexitis.
As we have already noted, bilateral adnexitis often occurs, but the course of the disease in a unilateral form is not uncommon. In the case of unilateral adnexitis, pain symptoms are localized in pain on a specific side, however, with nagging, strong pain, it is not always possible to determine this.
Diagnosis of adnexitis
Adnexitis, the symptoms of which the patient experiences, can be diagnosed not only based directly on them, but also on the results of special diagnostic studies. These include a two-manual gynecological examination, as well as a study based on smears taken from the urethra, cervix and vagina. Adnexitis can also be detected by prescribing a microbiological study aimed at studying the contents of the fallopian tubes, and, finally, by using ultrasound for this purpose.
To determine the presence of purulent formations, as well as to conduct a detailed examination of the fallopian tubes, along with intracavitary treatment in the case of inflammation of the appendages, laparoscopy is used, which acts as the most effective method for diagnosing acute adnexitis. But to determine the overall patency along with the degree of pathology of the fallopian tubes, a uterine X-ray examination allows for the introduction of a contrast agent; the research process itself is called hysterosalpingography.
If adnexitis is suspected, special functional tests are performed, in which the rectal temperature is measured, the pupil symptom is determined, as well as the tension of the cervical mucus. Adnexitis can also be determined by a blood test, which examines leukocytosis, indicators of an increase in the total amount of protein, bacteriuria and leukocyturia associated with damage to the bladder and urethra.
Treatment of adnexitis
The subacute stage of the disease requires a gradual transition to physiotherapeutic procedures, which are also prescribed in the case of chronic adnexitis. This particularly includes ultrasound and mud therapy, as well as a number of other methods. Note that the sooner adnexitis, the symptoms of which are taken into account by the doctor, is detected, and the sooner its treatment begins, accordingly, the less likely it is that the uterine appendages will suffer damage in the form of scar changes, which, in turn, , will define infertility as a more stable diagnosis.
Most often, treatment is based on antibacterial therapy, in which antibiotics corresponding to the cephalosporin or penicillin group are prescribed. The duration of the course is about 14 days, after which adnexitis and its symptoms disappear.
Also mandatory are drugs that help inhibit the growth of anaerobic bacteria. To eliminate symptoms characteristic of general intoxication, intravenous vitamins and solutions are used. With the development of peritonitis, as well as with the formation of purulent sacs, treatment is carried out surgically.
Features of remission
As for the time of remission, resorption therapy is relevant here, for which magnetic therapy and mud tampons, suppositories and ultrasound, physiotherapy and electrophoresis are used. Spa treatment also has a beneficial effect. Considering the chronic form of adnexitis, its symptoms and treatment determine, accordingly, the need to increase the period for remission, for which they use hormonal contraceptives. The duration of their use can be about 6-8 months, and sometimes this period is longer.
If you suspect adnexitis, or the symptoms listed above in one way or another indicate the presence of problems, you should contact a gynecologist. Only he can make a final diagnosis of adnexitis, taking into account the symptoms, as well as the data obtained on the basis of a series of analyzes and studies aimed at identifying the problem.
The female reproductive system is susceptible to many diseases that are sexually transmitted or are the result of unfavorable factors, including injuries, complications after pregnancy and childbirth.
Adnexitis, the symptoms and treatment of which has many nuances, is one of the most common diseases that affects most women aged 20-30 years.
The disease is characterized by inflammatory processes that occur in the ovaries and fallopian tubes. In addition, adnexitis is called salpingoophoritis. Adnexitis, the symptoms of which are individual in nature, in the absence of adequate, timely treatment, can cause dangerous consequences, including infertility and miscarriage if a woman is pregnant.
Right- or left-sided adnexitis, as a rule, begins with the fallopian tube. In this case, the disease is characterized by an acute course and pronounced pain in the ovarian area. The infection enters the fallopian tubes from the genital tract or through the bloodstream. Adnexitis is caused by pathogenic bacteria and microorganisms such as streptococci and staphylococci.
In some cases, the disease is a consequence of ongoing diseases that are sexually transmitted. For example, due to gonorrhea, syphilis or chlamydia. The source of the disease can only be identified through diagnostics, which includes tests and smears. Only on the basis of the information received can we deliver accurate diagnosis and prescribe adequate treatment.
Risk factors include women who have an ectopic device installed, an abortion, or an endoscopic examination of the genitourinary organs. Curettage of the uterus can also become a source of adnexitis. These procedures significantly increase the risk of pathogenic bacteria entering the uterine cavity and fallopian tubes. In this case, inflammatory processes can occur in both pipes, or only in one.
Initially, inflammation appears on the mucous membrane of the fallopian tube. Over time, the lesions spread to its walls. This process is accompanied by the accumulation of serous fluid or pus in the lumen. When inflammatory lesions cover the fallopian tubes and ovaries, the disease is called salpingoophoritis.
Therefore, in some cases it is better to refrain from these procedures than to suffer from unpleasant symptoms of the disease later. Chronic adnexitis may have less pronounced symptoms, so you need to monitor your health. And if the first signs are detected, you must urgently visit a gynecologist who will conduct an examination and prescribe effective treatment.
To exclude the disease, it is necessary to visit your local gynecologist every year. A periodic routine examination can diagnose dangerous diseases in time, so treatment will be faster and less expensive.
Symptoms
Adnexitis has pronounced symptoms and first manifestations. First of all, a woman develops a high temperature. Sometimes it can exceed 39.5 0 C. In addition, the symptoms are accompanied by painful sensations in the lower abdomen, which gradually move to the lower back and sacrum. Most often, the disease can be confused with acute appendicitis, since their symptoms have similar features.
The main symptoms that are characteristic of adnexitis are:
- menstrual irregularities;
- aching pain during menstruation;
- bleeding;
- painful sensations when urinating;
- unpleasant discharge, which can be either watery or purulent;
- pain during and after sexual intercourse.
Chronic adnexitis, the symptoms and treatment of which have a number of features, may be accompanied by an asymptomatic course. But with a relapse, a sudden onset of symptoms is possible, ignoring which can lead to disastrous consequences. The chronic form of the disease must be treated.
Without surgical treatment, chronic adnexitis can lead to infertility, and for a woman reproductive age- This is a big problem that will take a lot to eliminate. cash, effort and time. Therefore, every woman should monitor her health and visit a gynecologist at the first sign. He, in turn, will make an accurate diagnosis and prescribe effective treatment.
Factors such as constant stress, depression, unhealthy lifestyle, abuse of bad habits, and hypothermia can aggravate the disease. Inflammatory processes occurring in the appendages are fraught with serious complications.
Acute adnexitis, inflammation can spread to the abdominal cavity. In this case, peritonitis may develop, which can only be treated surgically. The operation is performed urgently, and after it long-term treatment will be required to restore the normal functioning of the genitourinary system.
The consequences of peritonitis are:
- the formation of adhesions that are localized in the fallopian tubes;
- increased risk of ectopic pregnancy;
- infertility.
In most cases, infertility is the only factor that allows one to suspect bilateral adnexitis. The disease is very dangerous and requires urgent drug treatment. It is extremely rare that surgery is used for this. But with an advanced form, this is the only way out, when purulent fluid collects in the uterine cavity and labor.
There are many factors that provoke the development of an unpleasant disease. These include:
- infectious diseases that are transmitted through sexual contact;
- frequent change of sexual partner;
- sexual intercourse without using contraception;
- failure to comply with personal hygiene rules;
- decreased immunity after gynecological operations, abortion or childbirth.
In this case, the immune system plays a primary role. If a woman is in a state of constant stress, then the risk of developing the disease is more than 70%. In addition, women who do not dress appropriately for the weather and are subject to frequent hypothermia may develop a chronic form of the disease.
Left- or right-sided adnexitis can be provoked by an intrauterine device, so there is no need this procedure It's better not to do it. To avoid getting pregnant, you can use alternative methods of contraception, including birth control pills or a condom.
Effective Treatments
In order to cure adnexitis, an integrated approach is required. It includes drug therapy and physical procedures. Many women struggle with the symptoms of the disease using folk remedies. Today, there are many recipes that can effectively treat adnexitis, including the chronic form. But use traditional methods always fraught with adverse consequences and risks.
Application medicinal herbs, natural ingredients can provoke allergic reaction. With a disease such as adnexitis, the symptoms and antibiotic treatment of which are closely related, can be eliminated only after a rehabilitation course. It includes taking antibiotics, as well as drugs that increase the protective functions of the immune system.
Treatment of adnexitis: drugs
In the treatment of the disease, antibacterial therapy is most often used, which includes antibiotics based on penicillin or cephalosporin. The most effective course of treatment is 2-week therapy. But if the symptoms of the disease remain the same, then re-treatment is prescribed.
If the disease is severe, the doctor may also prescribe medications such as:
- painkillers and analgesics;
- anti-inflammatory drugs;
- immunity boosting agents.
Only after the symptoms have been eliminated can physiotherapeutic procedures begin. In addition, you can cope with adnexitis using external products, which include suppositories, gels and creams for the intimate area. Suppositories for adnexitis can eliminate unpleasant sensations that are localized in the vagina.
Treatment of acute adnexitis is carried out urgently, since untimely treatment may result in the formation of purulent fluid in the fallopian tubes and melting of both ovaries. In order to get the effect of treatment, bed rest is required.
General strengthening and immunostimulating therapy is also used. The main physiotherapeutic procedures that are carried out for the disease are magnetic therapy, mud therapy, and paraffin therapy.
Treatment at home should be carried out only after consulting a specialist. It is necessary to discuss with your doctor all the procedures that you will perform at home. Most folk methods are designed to eliminate signs of the chronic form of the disease.
Acute adnexitis is strictly prohibited from being treated with folk remedies. An acute disease should be treated only under the supervision of a doctor, otherwise dangerous complications may arise that can be harmful and life-threatening.
The most common folk remedies used at home are baths made from decoctions and tinctures using medicinal herbs. These include St. John's wort, yarrow, chamomile flowers, string and calendula. Moreover, douching and enemas using aloe juice and Kalanchoe are allowed. Douches made from eucalyptus and sage help well, as they have an anti-inflammatory and antibacterial effect.
To boost immunity, you can use aloe juice, mumiyo or echinacea tincture. But such methods must be approached extremely carefully, as they can provoke the development of allergies.
To identify adnexitis at an early stage, you should undergo a routine examination by a gynecologist annually. If symptoms of the disease are detected, he will be able to prescribe the most prompt, effective treatment. During a gynecological examination, a smear is taken from the patient for testing. It can be used to determine the vaginal flora. If the development of pathogenic bacteria at an increased rate is observed, then the woman is referred for diagnostic laparoscopy.
Endoscopic examination of the ovaries and fallopian tubes can detect manifestations of the inflammatory process. Moreover, using the procedure, it is possible to identify the accumulation of pus, serous fluid, as well as adhesions, which are accompanied by changes in the structure of muscle tissue.
Diagnosing the disease is very difficult, since its symptoms are similar to those of other diseases of the genitourinary system. Symptoms of the chronic form may be mild. To identify pathogenic microorganisms You need to take blood and urine tests.
Prevention measures
Prevention of adnexitis has a number of features. To prevent the development of the disease, a woman must avoid abortions, as they are often accompanied by unpleasant complications. If termination of pregnancy is prescribed according to indications, then it must be done in a specialized clinic. A prerequisite is compliance with the rules of personal hygiene after surgery.
In addition, a woman should avoid unprotected sex with a casual partner. Otherwise, there is a high risk of getting sick venereal diseases, which provoke adnexitis. It is advisable to use barrier contraceptives, including a disposable condom.
Adnexitis (salpingoophoritis) is an inflammation of the ovaries and fallopian tubes, which most often affects women of reproductive age. However, signs of adnexitis can be diagnosed in girls 10-12 years old and in women over 60. Adnexitis, the symptoms of which depend on the form and severity of the disease, requires immediate treatment.
Adnexitis and salpingitis occupy leading positions among other pathologies of the female genital area. In this article we will understand what adnexitis is, how to treat it and what drugs are used for this.
According to the International Classification of Diseases (ICD), ovarian adnexitis has a code of 70 and implies not only inflammation of the ovaries, but also of the fallopian tubes.
Adnexitis in women (salipingoophoritis) varies depending on the location. So, it can be one-sided or two-sided. The latter poses the greatest danger, since when it becomes chronic it can cause obstruction of both fallopian tubes and, as a consequence, infertility.
Depending on the symptoms of salpingoophoritis, acute, subacute and chronic are distinguished.
Reasons for appearance
Modern medicine claims that salpingo-ophritis is caused solely by infection in the pelvic organs.
So, the following causes of adnexitis are distinguished:
Symptoms of adnexitis
Symptoms and treatment will differ depending on the nature of the disease: acute, subacute or chronic.
Acute adnexitis
In acute salpingoophoritis, the presence of severe pain in the lower abdomen on the right, left or both sides is noted, depending on where the inflammation is localized. Sometimes there is an increase in body temperature up to 38 degrees. Vaginal discharge of a pathological nature appears. If normal discharge during ovulation is of a uniform consistency of transparent or milky color, then discharge during adnexitis acquires a yellowish or greenish tint and may be accompanied unpleasant smell and have a cheesy consistency. Acute salpingitis and oophoritis in some cases are accompanied by itching of the external genitalia.
Foci of inflammation in the ovaries and fallopian tubes
Pain with adnexitis is dull, aching in nature and can radiate to the buttocks, tailbone or thigh. In acute salpingoophoritis, the symptoms are much more intense than in chronic salpingo-oophoritis, but they disappear faster with proper treatment. In the chronic course of the disease, discomfort may persist for two subsequent cycles after taking antibacterial therapy.
Chronic adnexitis
The symptoms of chronic salpingoophoritis are not as pronounced as acute ones, and practically do not disrupt the usual order of life. However, in this case, treatment of adnexitis is more complicated and takes more long time. There is no increase in temperature with a chronic disease, but patients experience aching pain of moderate intensity, scanty discharge not associated with ovulation, which can be observed even at the beginning of the cycle. Menstruation becomes abundant or, conversely, scanty, the cycle is not constant. The pain during this period is intense, accompanied by dizziness, nausea, and diarrhea.
Patients often complain of a depressed state, excessive irritability or even aggressiveness, lethargy, apathy, and rapid fatigue. With this type of disease, sexual desire is reduced or completely absent, and during sexual intercourse there may be unpleasant sensations (dryness or burning in the vagina, discomfort in the lower abdomen).
Subacute adnexitis
Subacute adnexitis is rare. It combines signs of acute and chronic salpingo-oophoritis: sudden abdominal pain occurs, low-grade body temperature may rise. A feature of the subacute form of the disease is the rapid disappearance of painful sensations. This is where subacute salpingoophoritis is insidious: patients attribute symptoms to fatigue, stress, a cold, and rarely turn to a gynecologist. Therefore, the disease often becomes latent or chronic, which poses a great danger to the reproductive system. Therefore, it is so important to prevent the progression of the disease and its transition to a chronic form, go to the doctor on time, carry out diagnostic measures and treat salpingoophoritis.
Diagnosis of adnexitis
Diagnosis of adnexitis is carried out in several stages:
Ultrasound of the ovaries and fallopian tubes:
After carrying out all the diagnostic measures, the gynecologist tells you how to cure the disease and prescribes medications for adnexitis.
Salpingoophoritis: treatment
Treatment of adnexitis is based on several stages:
- infection control;
- relieving inflammation;
- correction of immunity;
- physiotherapy;
- preventing the occurrence of adhesions or combating existing adhesions.
In order to “kill” the infection, antibacterial therapy is prescribed. Typically modern antibacterial drugs with adnexitis, they have a complex effect on several groups of microorganisms simultaneously, but in order to avoid drug resistance of the infection, it is recommended to conduct additional research on the sensitivity of the identified pathogen to. The attending physician determines exactly what to treat and what medications are needed to treat adnexitis. Gynecologists usually prescribe two drugs from different groups, for example, penicillins and tetracyclines, or macrolides and penicillins.
It is recommended to take antibacterial therapy in the form of tablets or injections and combine it with intravaginal ones. Such drugs as Clindacin, Klion D, Terzhinan, Polygynax, Betadine are widely used. After taking these suppositories, it is advisable to use drugs to restore the vaginal microflora; the drugs Bifidumbacterin and Acylact are suitable for this.
Remember! Only a specialist can tell you how to treat adnexitis and what medications are needed for this.
Since herpes can also cause inflammation, the antiviral drug Acyclovir is prescribed.
Indomethacin rectal suppositories have proven themselves well for anti-inflammatory purposes. This remedy relieves existing inflammation well, relieves pain and is relatively inexpensive, but has many side effects and not suitable for everyone. Suppositories can be replaced with regular Diclofenac. But it is suitable only for those women who do not have problems with high blood pressure. Cycloferon is also widely used, shown as an immunomodulator for inflammation.
The treatment regimen for adnexitis also includes physiotherapy. After a course of drug treatment, residual effects often remain in the form of minor pain. To eliminate them, physiotherapy is prescribed (laser, electrophoresis with lidase, iodine or magnesium, microcurrents, UHF). Physiotherapy effectively relieves inflammation, improves blood microcirculation in the pelvic organs, and also has an analgesic effect.
Treatment of adnexitis at the last stage is the fight against adhesions. To resolve them, you can use Longidaza suppositories (1 time every 3 days, 10 pieces). If the adhesive process is severe, then the adhesions are dissected using laparoscopic surgery.
During treatment of adnexitis, it is not recommended to be sexually active, go to the sauna, swimming pools, or simply lie in a hot bath. Sometimes you can find advice on using heating pads or, conversely, ice at the site of pain, but gynecologists strongly do not recommend doing this.
During periods of remission, sanatorium-resort treatment of adnexitis is indicated.
Diet for adnexitis
Compliance with a special diet in the treatment of adnexitis is not a determining condition and is not necessary. However, the right diet can help restore the body's immune functions, making the fight against inflammation much faster.
The fundamental principles are based on proper nutrition: more fresh vegetables and fruits, less processed foods and sweets, fatty, spicy and salty. As for cooking methods, preference should be given to boiling and stewing; you can bake dishes in the oven with a minimum amount of oil. The daily calorie intake for women is 2300.
Prevention of adnexitis
Treatment of adnexitis also includes preventive measures that help prevent complications of the disease, unpleasant consequences and its transition to a chronic form.
Prevention of salpingoophoritis includes:
- Use of barrier methods of contraception (condom).
- Timely seeking medical help.
- An integrated approach to treatment.
- Avoiding hypothermia.
- The absence of stressful situations, nervousness and hysteria, which provoke an exacerbation of adnexitis.
Thus, the disease adnexitis requires timely contact with a medical institution, a comprehensive diagnosis and the use of an integrated approach to treatment. Only then will the chances of recovery be one hundred percent.
Watch the video “The diagnosis of “adnexitis” - what is it?:
Adnexitis is an inflammation of the uterine appendages, which include the fallopian tubes and ovaries.
Translated from Latin, salpinx means fallopian tube, and ovarium means ovary, so another name for adnexitis is salpingoophoritis.
Adnexitis, as a rule, affects women of reproductive age (20-35 years).
Types of adnexitis
According to the nature of the course, acute, subacute and chronic adnexitis are distinguished.
Depending on the involvement of the appendages on both or one side in the pathological process, adnexitis can be unilateral or bilateral.
Based on the reason that led to the onset of the disease, a distinction is made between nonspecific and specific (for example, gonorrheal) adnexitis.
Reasons
The cause of the development of adnexitis is pathogenic microorganisms.
Specific adnexitis is caused by gonococci, tuberculosis bacillus, and diphtheria pathogens.
Nonspecific adnexitis develops when streptococci, staphylococci, E. coli, mycoplasma and other bacteria penetrate into the uterine appendages.
The infection can spread upward through inflammation of the vagina, cervix or uterus, and downwardly from other, higher-lying organs (for example, with appendicitis).
Predisposing factors for adnexitis include:
- weakened immunity;
- hypothermia;
- stress;
- frequent and random change of sexual partners;
- unprotected sex during menstruation;
- failure to comply with personal hygiene rules;
- past infectious disease;
- chronic general, including endocrine, diseases;
- abortions and diagnostic uterine curettage;
- intrauterine device;
- hysteroscopy of the uterus and metrosalpingography.
Symptoms of adnexitis
Manifestations of the disease depend on its course.
Signs of acute form
Acute adnexitis and exacerbation of chronic adnexitis are characterized by
- a sharp increase in body temperature to 38 - 39 degrees,
- the appearance of signs of intoxication (nausea, vomiting, weakness, lack of appetite),
- pain in the lower abdomen.
The pain in acute adnexitis is cutting in nature and can radiate to the lower back and rectum.
Symptoms of urination disorders may occur (pain during urination, frequency).
On palpation, sharp pain and tension in the abdominal muscles are noted.
In advanced cases, signs of peritoneal irritation may appear (Shchetkin-Blumberg sign), which indicates peritonitis.
In severe cases, purulent melting of the uterine appendages (tubo-ovarian formation) develops, which requires emergency surgical intervention.
If treatment is untimely or inadequate, acute adnexitis becomes chronic.
Signs of chronic form
Chronic adnexitis is characterized by periodic aching or nagging pain in the lower abdomen, lower back, which radiates to the vagina, rectum and lower limb.
A characteristic symptom of the chronic process is dyspareunia (pain during sexual intercourse).
In addition, due to the formation of adhesions in the pelvic area and changes in ovarian function, menstrual irregularities develop such as oligomenorrhea (rare and scanty menstruation) and amenorrhea (absence of menstruation for 6 months or more).
Also, with chronic adnexitis, periods become painful. Pain in the chronic course of the disease intensifies after hypothermia, stressful situations, and before the onset of menstruation.
During a vaginal examination in case of acute or aggravated adnexitis, painful, enlarged ovaries and tubes are palpated in the area of the uterine appendages (due to the accumulation of fluid in them).
Chronic adnexitis without exacerbation is characterized by the presence of heaviness in the area of the uterine appendages, dense immobile ovaries, and shortening of the vaginal vaults.
Diagnostics
Diagnosis of adnexitis is based on collecting anamnesis, complaints, and gynecological examination. The following laboratory tests are also indicated:
- general blood and urine analysis;
- biochemical blood test (C-reactive protein, blood sugar, total protein, etc.);
- smear of vaginal discharge for flora, tank. culture and antibiotic sensitivity testing;
- laparoscopy (in difficult cases);
- tuberculin test (if tuberculosis infection is suspected).
Differential diagnosis of adnexitis is carried out with ovarian cysts, external endometriosis, appendicitis and lumbar osteochondrosis.
Treatment of adnexitis
Adnexitis is treated by a gynecologist.
Treatment of acute form
Patients with acute and exacerbation of chronic adnexitis are hospitalized. Rest, a hypoallergenic diet and cold on the lower abdomen are prescribed (to limit the inflammatory process and relieve pain).
First of all, treatment with broad-spectrum antibiotics is indicated:
- cephalosporins (kefzol, ceftriaxone),
- penicillins (ampiox, ampicillin),
- fluoroquinolones (ciprofloxacin),
- tetracyclines (doxycycline),
- aminoglycosides (gentamicin) and others.
Antibacterial treatment is carried out for 7-10 days.
In addition, detoxification therapy (intravenous saline, glucose) and anti-inflammatory drugs are prescribed locally (in rectal suppositories) and orally (indomethacin, diclofenac).
Taking vitamins, anti-allergenic and antifungal drugs is also indicated.
Treatment of the chronic form
Chronic adnexitis and rehabilitation after an acute process involves
- taking absorbable drugs (trypsin, Wobenzym),
- taking immune stimulants (Tactivin, vitreous, aloe extract)
- physiotherapy.
Physiotherapy includes medicinal electrophoresis (with lidase, aloe, plasmol and other drugs), UV irradiation, UHF and ultrasound on the lower abdomen.
For chronic adnexitis, therapeutic mud, paraffin therapy, therapeutic baths and irrigation with mineral waters are effective, and sanatorium-resort treatment is also recommended.
Complications and prognosis
Untreated or inadequately treated acute adnexitis leads to chronicity of the process. Possible complications of chronic adnexitis:
- infertility (develops due to obstruction of the fallopian tubes and chronic anovulation);
- development of adhesions up to intestinal obstruction;
- threat of miscarriage and miscarriages;
- inflammation of neighboring organs (pyelonephritis, cystitis, colitis).
The prognosis for acute and chronic adnexitis is favorable for life. With a chronic process, infertility occurs in 50% of patients.
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