Principles and methods of treatment of diseases in gynecology. Prevention of inflammatory diseases of the female genital organs

Mankind got acquainted with sexual diseases in ancient times. Some archaeologists note that there are remains of ancient people with bone changes characteristic of advanced syphilis. But most are inclined to the American origin of this disease, which was brought by the discoverers of America to Spain. Wars contributed to the spread of a new disease far inland. And in the preventive measures then only one thing was listed - the absence of extramarital affairs. Modern microbiology and medicine have developed more advanced prevention of sexually transmitted infections.

What about sexually transmitted infections?

Initially, genital infections were called venereal. This term was proposed in 1527 by the French scientist Jean de Betancourt. In Roman mythology, Venus was the goddess of spring and flowering, but under the influence of the culture of Ancient Greece, they began to attribute the properties of Aphrodite, the goddess of love, to her. The appearance of these diseases directly depended on the existing sexual relations.

Venereal diseases included:

• gonorrhea;
• chancroid;

But in modern realities, this list is much wider. Therefore, the term "venereal diseases" was replaced by "sexual". Sexually transmitted infections (STIs) do not necessarily cause changes in the reproductive organs. Sometimes it's just one of the ways the pathogen enters the body.

This is a list of the most common diseases, but there are other pathogens that can be brought in, for example, after a vacation in a hot tropical climate.

Diseases that can be obtained during sex are dangerous by the transition to a chronic form and the development of complications. Some of them, such as syphilis, are easily cured with modern antibiotics. And diseases such as HIV, hepatitis, herpes and other viruses remain with a person forever. Their transition to a latent form grants relief, but when immunity is weakened, they make themselves felt. Bacterial infections are at high risk of developing resistance to the most modern drugs. And this is a negative impact on reproductive health.

HIV infection refers to an incurable pathology that can be contained in its progression, but cannot be completely stopped. This is a deadly disease, and death does not come from the virus itself, but from banal infections that the immune system of a healthy person can handle.

Therefore, the prevention of genital infections should be in the first place, regardless of gender.

Simple steps to...

The World Health Organization assigns one of the main places in prevention to propaganda. Primary prevention is based on educational work among certain groups of the population. These include teenagers, sex workers. But words and posters alone are not enough. Although they help many people learn about the likelihood of contracting various infections during sexual contact.

Preventive conversations and reducing the number of partners

You need to think about safety in advance. First of all, infection can be prevented by simply reducing connections. In this regard, the ancestors were right, who considered close relationships before marriage unacceptable.

For those who are already married, the main way to secure themselves and their families is marital fidelity. Why is the whole family considered in such a question? The answer is simple. Some diseases, such as gonorrhea ( / ), endanger not only parents, but also children. For boys, due to the peculiarities of the structure of the genital organs, infection from parents is not typical. But the girls will definitely be called to the dermatovenerological dispensary for examination. The reason is a short urethra and the absence of protective factors in the vagina, as in an adult woman. Therefore, gonorrhea can be transmitted to the daughter when using a common washcloth, through the rim of the toilet bowl, or simply with hands.

Prevention with barrier contraception

Prevention measures for genital infections include the use of. These include male and female condoms. The greatest danger is vaginal and anal contact without protective equipment.

Male and female condoms

A condom does not provide 100% protection. Someone believes that this is due to the presence of pores that are larger than viruses, and as if they are able to "slip" into them. But these speculations are not supported by scientific data. In addition, for infection with various types of viruses, a certain number of pathogens is needed.

You are much more likely to get infected if you use a condom incorrectly. Therefore, in the absence of experience, you need to read the instructions. The condom must be used in such a way that it does not slip or break.

Latex can damage some medicines that are used vaginally. Women need to carefully read the instructions for medicinal preparations.

There is also a condom that can be used in women. It is placed in the vagina and put on the cervix in advance. After sex, it is carefully removed. Those men who neglect their own barrier means can be offered this option to their partner.

HPV vaccination

It is known that with an increase in the number of partners, the risk of infection with the human papillomavirus increases. This infection, depending on the type of pathogen, can lead to the development of cervical cancer. Parents can keep their daughters safe through outreach and vaccinations. A vaccine against oncogenic strains of the human papillomavirus has been developed. It must be done and then repeated before the girl's sexual life begins, so that the immunity has time to form. The optimal age would be 10-12 years.

Use of spermicides

Contraceptives have protective properties. These are pills, suppositories, creams to prevent unwanted pregnancy. But in addition to the destruction of spermatozoa, they can affect the pathogens of gonorrhea and syphilis. Other infections do not respond to these substances.

Pharmatex is a spermicidal agent, available in various forms (capsules, tablets, cream)

The drugs are sold in a pharmacy, the instructions indicate how long before sexual intercourse they need to be placed in the vagina. For a cream, it is directly in front of it, while for a candle and a tablet, it takes time to dissolve. Usually it is from 10 to 20 minutes. The following items are on sale:

• Contraceptin-T;
• Sterile;
• Pharmatex.

Spermicides are destroyed by soap, so you need to take a shower after intercourse without hygiene products.

…and after

In cases where the likelihood of infection is thought about after unprotected contact, there are emergency measures to prevent sexual infections. The algorithm of actions depends on the time when the decision was made about the possibility of infection. The most optimal period is the first 2 hours after intercourse. If time is lost, then you should not try to prevent infection by emergency means. Medications that can be taken within 72 hours will help.

If infection has occurred, then the belated use of medications will only blur the clinical picture. Diagnostics will not be as effective.

Emergency prevention

You can prevent the development of infection yourself. First you need to wash your hands and go to the toilet. A stream of urine can wash out some of the microorganisms that have not yet had time to attach to the wall of the urethra.

Then you need to wash the inguinal region with soap, wipe the external genitalia with cotton wool soaked in Chlorhexidine, Miramistin. Women need douching, which is also carried out with an antiseptic solution. If these drugs were not available at home, then a pale pink solution of potassium permanganate can be prepared. Be sure to strain the finished liquid through several layers of gauze or bandage to filter out undissolved crystals. They can cause chemical burns.

For douching, 150-200 ml of any of the solutions is enough. It is also necessary to introduce an antiseptic into the urethra, but this is problematic to do without outside help. Therefore, in case of emergency procedures, you can consult a doctor. To wash the urethra, use 1 ml of one of the antiseptic solutions.

In men, for prevention, the urethra is washed with 500 ml of a solution of Miramistin or Chlorhexidine. It is impossible to do this on your own, so they resort to medical help. For the procedure, an Ersmarch mug is used. After washing, a few drops of Protargol or Miramistin are instilled into the urethra, its opening is slightly pinched so that the drug works better. After the procedures, regardless of gender, it is not recommended to urinate for 2-3 hours.

For independent measures, pharmacies sell candles for the prevention of genital infections:

• Hexicon;
• Povidone-iodine.

Similar drugs exist for men. But they are produced in the form of thin sticks, introduced into the urethra.

If time is lost (medication)

After more than 2 hours after unprotected contact, it is pointless to use emergency measures. The main pathogens have already penetrated the epithelium and local remedies will not work on them. Therefore, special pills are used to prevent sexually transmitted infections. The choice of drug depends on the type of pathogen. It is difficult to guess it on your own, but it may turn out that the sexual partner belatedly reported that he had an infection. Then the drug is chosen as follows:

• Gonorrhea - a single dose of 400 mg of Cefixime;
• Syphilis - intramuscular injection of 2.4 million units of benzathine benzylpenicillin;
• Chlamydia - take 1 g of Azithromycin once orally;
• Trichomonas - once inside 2 g of Tinidazole.

In unexplained cases, combined preparations are used. For example, Saphocid. It is effective against the main bacteria that cause genital infections, as well as fungi. The package contains 4 tablets that must be taken at the same time.

Preparations for the prevention of sexually transmitted infections

Prevention of bacterial infections can be supplemented with antiviral protection:

• Interferon inducers: Neovir, Amiksin;
• Interferon-alpha: Viferon, Vagiferon;
• Antiviral spray Epigen Intim.

Local remedies for viruses are also best attributed to emergency remedies that are used within the first 2 hours. If more time has passed, then you need to switch to tablet preparations. The same applies to the Epigen spray, which must be sprayed onto the genitals immediately after intercourse.

If there is any suspicion

Emergency and delayed STI prevention measures are not 100% guaranteed to prevent infection. Also, they do not cancel the use of barrier methods of protection. But what if a lot of time has passed?

When infected with certain types of pathogens, the first symptoms will appear after a few days. You should be alert if the following symptoms are present:

• itching and burning in the vagina;
• discharge from the genital tract in a woman, which differs from the usual intensity, consistency, color (there may also be discharge from the urethra);
• seals in the inguinal lymph nodes;
• rashes on the genitals.

With a viral infection, it takes much longer for the appearance of clinical signs of the disease. They may not affect the genitals, but manifest themselves as damage to other organs:

• liver with hepatitis;
• fever of unknown origin, frequent colds with HIV;
• the appearance of erosion on the cervix with.

Therefore, a diagnosis is necessary. But immediately after intercourse, it is meaningless. It takes time for the infection to spread throughout the body, and it takes time for the immune system to react to it. Therefore, if you suspect a bacterial infection, you can be diagnosed no earlier than 2 weeks later. The term for the manifestation of a reaction to HPV, herpes, hepatitis is at least 3 months. HIV infection appears only after 6 months. But in this case, a single study may not be enough, because there is a period of the course of the disease when antibodies are no longer detected in the blood. The study can be done both in the clinic at the place of residence, and in private laboratories, where anonymity is guaranteed.

From an early age, parents should instill in the girl the strict implementation of hygiene procedures, which the woman should subsequently carry out regularly, since this is the main rule for the prevention of inflammation of the genital organs. A woman needs to carry out hygiene of the genital organs at least 2 times a day. The external genital organs are poured with warm boiled water and soap. It is imperative to wash yourself from the vagina to the anus, and not vice versa, so that the contents of the anus do not get on the genitals. The vagina should not be affected, as it is a self-cleaning organ. Douching (i.e. washing the vagina with a stream of water or a solution from a rubber bulb) can be done only as directed by a doctor. For this purpose, boiled water and a boiled tip are used. It is necessary to monitor the cleanliness of linen, which should be made of natural materials, fit snugly to the body and protect the genitals well from dirt and bacteria. Change underwear daily. A woman needs to have a separate washcloth, towel, bed linen.

Infectious diseases of a general nature can also affect the state of the female genital area. Infectious diseases are dangerous because they can cause inflammatory or ulcerative complications in the genitals. When the ulcers heal, scar tissue forms, which narrows the vagina, which further makes a normal sexual life almost impossible.

It is necessary to empty the bladder and intestines on time. Restraint of the urge to urinate and defecate can lead to a violation of the position of the uterus (bending), blood circulation in the pelvic organs and cause permanent changes in the genitals.

It is necessary to spend a lot of time (at least 4 hours a day) in the fresh air. It is very useful to engage in light sports and physical education, but overwork and heavy lifting should be avoided, as this can lead to prolapse or even prolapse of the uterus.

During menstruation, special care must be taken to cleanliness. At this time, the genital canal becomes available for the penetration of pathogenic microbes, and the strength of the body's defenses decreases. During menstruation, it is necessary to wash at least 3-4 times a day, thoroughly washing the external genitalia with soap, and then gently blot them with a towel. A lot of hygiene products are intended to absorb spotting. During menstruation, the girl should be protected from the cold, should not go in for sports and physical education, do not take a bath, do not go to the sauna.

A woman should pay special attention to the hygiene of sexual life. Before sexual intercourse, both partners must take a shower and thoroughly wash their genitals with soap and water. If hygiene rules are not followed, microbes that cause inflammatory diseases can enter the genitals of a woman. In order to prevent sexually transmitted diseases, sexual contact with unfamiliar partners or partners should be avoided if they are suspected of having a sexually transmitted disease. Reliable prevention of infections is the use of barrier methods of contraception (condoms that must be worn before sexual intercourse).

During menstruation, it is better not to have sexual intercourse, since at the moment the mucous membrane of the vagina and uterus are most susceptible to infection. A woman in the reproductive period must be protected from unwanted pregnancy with the help of contraceptives. The method of contraception is selected individually for each woman, after examination by a gynecologist and the necessary examination.

Prevention of unwanted pregnancy is the prevention of abortion, as it is the real cause of various inflammatory diseases and complications. In the post-abortion period, a woman must follow special hygiene rules.

The length of the post-abortion period, during which the body must fully restore its strength, is 4-5 weeks. In the first time after an abortion, a woman needs to be provided with a sparing regimen. In the post-abortion period, a woman should pay special attention to the cleanliness of underwear and bedding, body hygiene. It takes at least 3-4 weeks to restore the inner surface of the uterine wall damaged during abortion, therefore, for this period, sexual activity is completely excluded. Failure to comply with this condition can contribute to the entry of infections into the unhealed genitals of a woman. After an abortion, it is imperative to try to prevent a new onset of an unplanned pregnancy, since a second abortion is allowed only six months after the previous one, and with each subsequent abortion, the risk of serious complications increases.

Prevention of inflammatory periodontal diseases

Grudyanov A.I., Ovchinnikova V.V.
Prevention of inflammatory periodontal diseases. - M.: LLC "Medical Information Agency", 2007. - 80 p.

The manual is devoted to the prevention of inflammatory periodontal diseases. The importance of the problem is determined by the prevalence of these diseases throughout the world, the severity of their course, and the negative impact on human health. The authors focused on primary prevention. The guide covers the pathogenesis of inflammatory periodontal diseases and professional oral hygiene. Separate chapters are devoted to the prevention of hypersensitivity of dental tissues, the prophylactic use of antiseptic drugs. Hygiene means for the prevention of inflammatory periodontal diseases are described.

For dentists and medical students.

UDC 616.31-089.23 BBK 56.6
ISBN 5-89481-499-5

List of abbreviations

Chapter 1. Pathogenetic basis of inflammatory periodontal diseases

Chapter 2

2.1. Oral hygiene

2.1.1. Oral hygiene training

2.1.2. Approaches to the choice of means of individual hygiene prevention

2.2. Personal oral hygiene products

2.2.1. Toothbrushes

2.2.2. Interdental oral hygiene products.

2.2.3. Toothpastes

2.3. halitosis

2.4. Prevention of hypersensitivity of dental tissues

2.5. Prophylactic use of antiseptic drugs

Chapter 3. Professional oral hygiene

Conclusion

Bibliography

ABBREVIATION LIST

INTRODUCTION

The problem of prevention of parodoptal diseases occupies one of the leading places in modern dentistry. The importance of this problem is determined by the prevalence of periodontal diseases throughout the world, the severity of their course, and the negative impact on human health. According to different authors, the prevalence of periodontal disease reaches 98%. According to statistics, 90% of the adult population in industrialized countries have more or less pronounced clinical signs of gingivitis, 50% of the population have symptoms of moderate periodontitis, and 3% of the population suffer from severe periodontitis. Recently, a severe course of periodontitis has been more often noted, and the number of people with aggressive forms of periodontitis has increased. Due to the fact that the treatment of advanced forms of periodontitis requires significant time expenditures of specialists, which increase as the process becomes more difficult, the full provision of patients with appropriate medical care is a problem that cannot be solved in any country in the world. Therefore, it is obvious that only the prevention of inflammatory periodontal diseases that is started in a timely manner and carried out in an appropriate amount can provide an effect that the most complex and expensive medical interventions can achieve only on a very limited scale. The volume and structure of the periodontal service should be focused on therapeutic and preventive interventions. The time spent by specialists on conducting primary and repeated courses of preventive and therapeutic interventions was studied. For professional hygiene treatment, 2.5 U IiT is required for primary and repeated courses. For the treatment of chronic catarrhal gingivitis, respectively, 5.75 and 1.75 UET; for the treatment of mild periodontitis 9.75 and 5.75 UET; medium degree 14.2 and 7.4 UET; severe, "57.5 and 2.5 UET, respectively. These figures justify the need for the development of preventive measures.

Prevention is a system of state, social, hygienic and medical measures aimed at ensuring a high level of health and preventing diseases.

Depending on the degree of coverage of the population and the existing types of preventive measures, there are three levels of prevention of dental diseases:

• individual;
• collective;
• mass.

At a meeting of experts of the World Health Organization (Moscow, 1977), the following classification of types of prevention was adopted depending on the goals pursued and the stages of implementation of preventive measures.

• primary prevention - a system of measures aimed at preventing dental diseases by eliminating the causes and conditions of their occurrence, as well as increasing the body's resistance to the effects of adverse factors in the natural, industrial and domestic environment;
• secondary prevention - a set of measures aimed at preventing relapses and complications of diseases;
• tertiary prevention - a system of measures aimed at the rehabilitation of the dental status by preserving the functionality of the organs and tissues of the maxillofacial region, mainly by the method of replacement.

Primary prevention, in turn, is divided into two components:

• etiotropic, i.e. aimed at reducing the intensity of action or completely eliminating the influence of pathological causative factors. Actually, we are talking about the impact, first of all, on the microbial factor or on a combination of microbial and viral factors, as well as on situations that enhance their pathological effect on periodontal tissues;
• pathogenetic, i.e. aimed at eliminating the inflammatory changes in the periodontium caused by the causative factor and preventing their subsequent aggravation.

Primary prevention of periodontal disease involves:

• teaching the basics of individual oral hygiene, monitoring the quality of its implementation and the desirable achievement of sustainable motivation for its constant implementation;
• carrying out professional hygienic treatment of the oral cavity with a certain frequency;
• elimination of violations of the soft tissue architectonics of the vestibule of the oral cavity, abnormal attachment of cords and frenulums (short cords and frenulums; small vestibule of the oral cavity);
• according to indications - timely orthodontic treatment in order to normalize the distribution of mechanical load on the teeth and at the same time eliminate (in case of crowding of teeth) conditions for enhancing the activity of microbial influences. In fact, other measures pursue the same goals: maintaining the oral cavity in a sanitized state, eliminating supracontacts and functional selective grinding of teeth, timely orthopedic treatment - before the occurrence of lesions in periodontal tissues.

The listed preventive measures should be carried out among all segments of the population, regardless of age, it is especially necessary for people suffering from endocrine diseases, pregnant women, and those with bad habits, since in conditions of reduced resistance, all potentially pathogenic moments are realized especially actively. In this regard, it is logical that, along with the elimination of the causative factors of periodontal disease, one of the important, if not the main task, is the implementation of measures that can increase the body's resistance to existing adverse factors. In other words, prevention should be comprehensive.

CHAPTER 1
PATHOGENETIC BASES OF INFLAMMATORY PARODONTAL DISEASES

1.1. Mechanisms of development of inflammatory periodontal diseases

The periodontium performs a number of important functions: barrier, trophic, plastic, shock-absorbing function of the reflex regulation of masticatory pressure. During inflammation of the periodontal tissues, these functions are disturbed, the degree of which increases with the duration of the inflammation, especially when the inflammatory destruction of the soft tissues is accompanied by the destruction of the bone of the alveolar processes, which causes tooth mobility, a significant damage to the functional activity of the masticatory apparatus - up to tooth loss. It is characteristic that as the local inflammatory reaction becomes more severe and generalized, its detrimental effect on the state of the general defense mechanisms of the body and a number of organs and systems simultaneously increases - i.e. a vicious circle is formed, which significantly complicates the solution of medical problems.

According to the modern point of view, the main cause of the development of gingivitis and periodontitis is a microbial infection. Moreover, pathological changes in the periodontium can occur even with a certain sharp increase in the number of ordinary microorganisms, but especially when so-called people-to-pathogenic microbes appear in their composition, however, it should be borne in mind that the implementation of the pathogenic effect of microbial accumulations occurs only if there is a sharp decrease in local and general defense mechanisms.

In periodontal diseases, several types of bacteria are most often identified among oral microorganisms: from gram-negative anaerobes, these are bacteroids: Porphyromonas gingivalis, Porphyromonas melaninogenica; anaerobospirilla, spirochetes, fusobacteria and gram-positive anaerobic and microaerophilic microorganisms of actiomycete groups (A. naeslundii, A. vis-cosus, A. israelii) and streptococci. The most typical plaque microorganisms in periodontal lesions are Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Veillonella parvu-la, Fusobacterium nucleatum, and Peptostreptococcus micros. The main periodontal pathogenic role is played by anaerobic microorganisms: Actinobacillus actinomycetemcomitans, Porphyrimonas gingivalis, Prevotella intermedia, etc. A feature of the action of these anaerobes is that they secrete extremely active endotoxins and enzymes that damage the cells and intercellular structures of all periodontal tissues, including bone.

Since microorganisms are constantly present in the gingival region, their destruction by bactericidal components of saliva, phagocytic cells (neutrophils, macrophages), presenting cells (the so-called "dendritic cells") occurs constantly. However, up to a certain level, signs of inflammation are not detected clinically, and the gum tissue has a normal appearance. After the number of microorganisms exceeds a certain critical mass, or if periodontal pathogenic species appear in their composition, a clinically visible inflammatory reaction in the form of gingivitis develops. It should be said that the subsequent progression of the process is not always necessary, but still in the vast majority of cases, if at this stage adequate therapeutic effects are not carried out in a timely manner, then the inflammation spreads to the underlying structures of the periodontium - gingivitis turns into periodontitis. Thus, gingivitis and periodontitis have a single multifactorial nature. But in addition to the mandatory presence of a causative microbial factor, the probability of transformation of gingivitis into periodontitis and the speed of this transition itself is influenced by the state of the sympathetic-adrenal, endocrine systems, autoimmune processes, "local" protection factors, etc. It is quite legitimate to consider them as a consequence of the maladjustment of the body under the influence of adverse factors: acute and chronic stress, metabolic disorders, involutive processes, etc., which act from the inside, creating a favorable background for the implementation of external factors. First of all, this is facilitated by a violation of oxygen metabolism due to the action of the listed factors, namely: oxygen saturation of tissues increases without sufficient provision for its utilization, the concentration of reactive oxygen species increases, endoperoxides are formed, which have a toxic effect on tissues.

It should be said that one of the very important reasons for the prevalence of inflammatory periodontal diseases is that in the vast majority of cases they both occur and proceed without significant pain. Often, the only symptoms of their presence in a person for a long time are: bleeding gums of varying intensity, moreover, periodically decreasing and very uneven, and bad breath (halitosis). This explains the fact that in the absence of great difficulties in the effective prevention of gingivitis and periodontitis, in fact, this is not very realistic, since patients turn to specialists only at the stage of deep lesions, since they sincerely believe that it is sharp tooth mobility or abscess formation that are the first signs diseases. In connection with the above, it becomes clear that, along with the components of preventive measures listed above, perhaps the most important is the promotion of knowledge among the entire population about this group of diseases - i.e. information using all available means!

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GBOU SPO SK "Stavropol Basic Medical College"

Nursing "Obstetrics and Pediatrics"

" PeculiaritiesPprophylaxisinflammatorydiseaseswomen'sgenitalbodies"

Students Fedorchenko Victoria

Specialty 060501 Nursing

group 462d9

Content

• List of abbreviations
• Introduction

List of abbreviations

VZPO - inflammatory diseases of the genital organs

CZPO - chronic diseases of the genital organs STIs - sexually transmitted infections

CVIG - chronic inflammatory diseases of the genitals Ultrasound - ultrasound

EUSI - endoscopic ultrasound examination

Introduction

RelevanceTopics. Inflammatory diseases of the female genital organs occupy the 1st place among all gynecological pathology. 40% of patients in the hospital are patients with VZPO. Growth is associated with the sex revolution. The growth of vector-borne infections, that is, sexually transmitted infections, is on the rise. In 99%, the infection enters the female genital organs sexually, but there is also a lymphogenous path - this is primarily from the intestines; hematogenous route - mainly tuberculosis, when the focus of infection in the genitals is the second focus, and the first focus is extragenital; along the length - for example, from the inflamed appendicular process, with colitis, with intestinal pathology and the intracanalicular path with a specific infection (gonococcus). Most often, inflammatory processes are of infectious origin, much less often they develop due to mechanical, thermal, chemical and other influences.

It has now been proven that the inflammatory process is due to the presence of a mixed infection. A special place is occupied by sexually transmitted diseases, these include: gonorrhea, chlamydia, trichomoniasis, syphilis, viral infection.

Often, the inflammatory process is caused by conditionally pathogenic microorganisms - staphylococcus aureus, streptococcus, E. coli, mycoplasma, ureoplasma, yeast-like fungi and others, sometimes in combination with vaginal and / or intestinal dysbacteriosis. In other words, this flora also exists in a certain amount in healthy people, but as a result of exposure to adverse factors, diseases of the genital organs occur.

Identification of the cause of the disease is one of the important conditions that determine the choice of rational therapy. Risk factors for infection of the genital organs include: early sexual activity, frequent change of sexual partners, refusal of barrier methods of contraception (condom), non-observance of personal hygiene rules, low social standard of living.

Targetcoursework.

To study the features of the occurrence of inflammatory organs of the female reproductive system.

Taskscoursework.

1. Conduct a review of the scientific literature on the problem of the occurrence of inflammatory organs of the female reproductive system.

2. Analyze the varieties of inflammatory diseases of the female genital organs.

3. Reflect the research methods used in the work.

Methodsresearch:

· theoretical analysis of medical literature on this topic;

Empirical observation, additional research methods;

Practicalmeaningcoursework:

· A detailed disclosure of material on this topic will improve the quality of nursing care in the prevention of inflammatory organs of the female reproductive system.

Chapter 1

Characterizing the features of the female body, one should initially know well their anatomical and morphological features:

the main internal genital organs of a woman are: the uterus - the organ of intrauterine gestation and the ovaries, in which the maturation of the embryonic egg and the production of female sex hormones (folliculin and luteohormone) occur, which, together with the hormones of the pituitary gland, determine the features of the external appearance of a woman (development of the mammary glands, distribution of subcutaneous fat). fiber, hair growth).

The uterus (uterus) is a muscular hollow organ located in the small pelvis of a woman. The uterus has a pear-shaped shape, its length is 7-8 cm, 2/3 of the length falls on the body, 1/3 on the neck (girls have an inverse relationship). Anatomically, the uterus is divided into the body (corpus uteri), the isthmus (isthmus uteri) and the neck (cervix uteri). The upper part of the body of the uterus above the place of attachment of the fallopian tubes is called the bottom (fundus uteri).

The cervix has two parts - vaginal and supravaginal. The vaginal part of the cervix is ​​located in the lumen of the vagina and is accessible for inspection using vaginal mirrors. The supravaginal part is located above the place of attachment to the neck of the walls of the vagina (vaginal vaults).

The serous membrane is formed by the peritoneum, passing from the anterior abdominal wall to the bladder and uterus, thus forming the vesicouterine cavity. Passing from the uterus to the rectum, the peritoneum forms recto-uterineorDouglas space.

The lateral surfaces of the uterus are not covered by the peritoneum.

The muscular membrane consists of three layers of muscles that have different directions: external (superficial), - longitudinal and oblique, middle (vascular) - circular and longitudinal, internal (subvascular) - predominantly circular. Longitudinal bundles predominate in the bottom and body of the uterus, and circular ones in the isthmus and cervix.

The mucous membrane of the uterus consists of two layers - functional where the cyclical changes associated with the menstrual cycle occur, and basal, which is adjacent directly to the myometrium. The endometrium contains glands that secrete secretions.

The internal genital organs of a woman are in close contact with the intestines and urinary organs, resulting in a woman at any age inflammatoryprocessesWithintestinesandurinarybodiesmayspreadon thegenitalbodies.

The uterus is a muscular organ and the tone of the muscles largely depends on the tone of the entire muscles of the woman. With an increase in the tone of the muscles of the whole body, the tone of the uterus also increases, which often helps to eliminate a number of congestive menstrual disorders.

Chapter 2. Classification of infectious and inflammatory diseases of the uterus and vagina

Inflammatory diseases - this is a general name for a variety of diseases of the female genital organs - the uterus, uterine appendages: fallopian tubes and ovaries. Sometimes inflammation affects the entire pelvic region.

These diseases of the female genital organs occupy a special place. Their significance is primarily due to the fact that these diseases affect organs and tissues related to the reproductive system. Inflammatory diseases are dangerous because they are one of the leading causes of infertility, ectopic pregnancy, menstrual dysfunction, sexual dysfunction, endometriosis, tumors, and many other complications.

Inflammatory diseases are the result of infection not only with bacterial infections, but also with sexually transmitted diseases.

2.1 All female diseases are usually divided into two main groups: specific and non-specific

To specific diseases include more serious sexually transmitted infections (STIs), namely:

gonococcus (causative agent of gonorrhea);

trichomonas;

pale treponema;

chlamydia;

mycoplasmas;

ureaplasma.

Treatspecificdiseases is usually more difficult. The main problem is that, being a carrier of one of the listed pathogenic infections inflammatorydiseasesgenitalbodies, a woman may not be aware of this. Sometimes the course of the disease is accompanied by itching, irritation, pathological discharge, but this does not always happen. An infection can be detected only with the help of a comprehensive analysis for STIs. The presence of an inflammatory process is also indicated by an increased number of leukocytes in the urine test.

Concerning non-specificinflammatorydiseases, in gynecology these include:

vaginal candidiasis (thrush);

gardnerellosis;

coli;

enterococci;

staphylococci;

streptococci;

proteins and some others.

All of these nonspecific diseases are caused by opportunistic bacteria. This means that these bacteria can stay in the body for some time without causing any harm. However, it is worth any failure to occur (it can be elementary hypothermia, hormonal failure, decreased immunity) - and the bacterium begins its pathogenic action.

Some gynecologists also classify inflammatorydiseaseswomen'sbodies by localization inflammatoryprocesses (inlowerorupperdepartmentsgenitalbodies) which are acute and chronic and due to the occurrence (postoperative, postpartum, etc.).

Mechanismimplementationtransferinfections:

inflammatory disease of the penis

1. Spermatozoa are carriers of infection; they have a negative charge that attracts microbes - they are thus the transport of micro-organisms.

2. Flagella - Trichomonas - are active transport for microbes.

There is also a passive way of spreading the infection. Microorganisms enter actively - sexually, and then passively spread through the genitals.

Factorsconducivedisseminationinfections:

1. Intrauterine interventions: abortions, diagnostic curettage, hysterosalpingography, that is, all invasive procedures: probing the uterine cavity, setting and removing an intrauterine contraceptive, childbirth and miscarriages.

2. Hypothermia.

3. Weakening of the body as a result of a chronic infection of an extragenital nature.

Protectivefactorsorganism:

1. The vagina and its contents, that is, the biocenosis of the vagina

leucorrhoea, which secrete the glands of the vagina in the amount of 1-2 ml per day, are normal. Anything more is pathological leucorrhea.

The microflora of the vagina, which is represented by aerobes and anaerobes, but there is a dynamic balance between saprophytic groups and conditionally pathogenic groups (aerobic microbes prevail over anaerobic ones).

· sufficient content of lactobacilli - lactic fermentation sticks, which create an acidic pH environment in the vagina due to their metabolism and acidic pH is thus a protective barrier to the penetration of microorganisms.

mucous plug - bactericidal plug of the cervical canal; cork is of great importance in preventing the generalization of infection. The use of oral contraceptives, especially by women with chronic inflammatory diseases (CIIG) of the genitals, reduces the risk of relapses and exacerbations of the inflammatory process.

endometrium: the functional layer of the endometrium is rejected monthly, the body is being cleansed, and a lymphocytic shaft is formed in place of the torn endometrium. For the generalization of infection, the relationship of macro - and microorganism is necessary. The aggressiveness of the microorganism determines its virulence and reactivity of the macroorganism. In women with severe purulent complications, they were identified in the study of the association of microbial flora, and the combination of aerobes and anaerobes (+) their immunity state is sharply reduced, thus the state of the macro- and microorganism determines the further development of the disease.

2.2 Symptoms and manifestations of inflammatory diseases of the female genital organs

Symptoms and manifestations of inflammatory diseases of the female genital organs:

Constant discharge from the vagina;

Itching of the genitals;

Discharge with smell;

Increased urination;

Soreness and burning during urination;

Pain during intercourse

Symptoms of inflammatory diseases of the internal pelvic organs often begin to manifest themselves during and immediately after menstruation. These are, as a rule, pains in the lower abdomen and pelvis, which may be accompanied by fever, high fever and nausea, vaginal discharge.

Allocations with candidiasis are often abundant - white flakes that look like cottage cheese - the so-called curdled discharge. With gardnerellosis, the discharge is often transparent, with an unpleasant (fishy) odor. Purulent discharge (thick, white-yellow or yellow-green) is characteristic of coccal microflora, but can also serve as a symptom of gonorrhea.

The classic signs of acute inflammation are redness, swelling, fever of the inflamed area, pain. The normal functioning of the inflamed organ is disrupted.

The reactions of the whole organism also change. The temperature rises. Complete blood count shows leukocytosis, accelerated ESR.

The severity of the reaction of the body depends on the pathogen and the cause of the disease, on the immunity of the body, on the degree of damage to the organ.

2.3 Inflammatory diseases of the lower genital tract

The lower female reproductive organs include the vulva, vulva, and vagina.

Inflammatory diseases of the lower genital organs are most characteristic of the reproductive period of a woman's life, but occur in young and old age. Vulvitis and vulvovaginitis account for about 65% of all diseases of the reproductive system in childhood and prepubertal age.

2.4 Inflammatory diseases of the upper genital tract (pelvic organs)

endometritis - inflammation of the lining of the uterus.

Acute endometritis, as a rule, occurs after various intrauterine manipulations - abortion, curettage, the introduction of intrauterine contraceptives, and also after childbirth. The inflammatory process can quickly spread to the muscle layer (endomyometritis), and in severe cases, affect the entire wall of the uterus (panmetritis). The disease begins acutely with an increase in body temperature, the appearance of pain in the lower abdomen, chills, purulent or sanious-purulent discharge from the genital tract.

Salpingoophoritis (adnexitis - inflammation of the uterine appendages (tubes, ovaries, ligaments), occurs either ascending or descending secondarily from inflammatory-altered abdominal organs (for example, with appendicitis) or hematogenously. With ascending infection, microorganisms penetrate from the uterus into the lumen of the fallopian tube, involving all layers (salpingitis) in the inflammatory process, and then in half of the patients, the ovary (oophoritis) along with the ligamentous apparatus (adnexitis, salpingo-oophoritis). Inflammatory exudate, accumulating in the lumen of the fallopian tube, can lead to an adhesive process and closure of the fimbrial region. There are saccular formations of the fallopian tubes (sactosalpinx). The accumulation of pus in the tube leads to the formation of pyosalpinx, serous exudate - to the formation of hydrosalpinx.

With the penetration of microorganisms into the tissue of the ovary, purulent cavities (ovarian abscess) can form in it, when they merge, the ovarian tissue melts. The ovary turns into a saccular formation filled with pus. One form of complication of acute adnexitis is a tubo-ovarian abscess.

Parametritis- inflammation of the tissue surrounding the uterus. It occurs when the infection spreads from the uterus after childbirth, abortion, curettage of the uterine mucosa, operations on the cervix, when using intrauterine contraceptives. The infection penetrates into the parametric tissue by the lymphogenous route.

Bacterialvaginosis is a vaginal disease caused by an alteration in the balance of bacteria that are naturally found in the vagina. While the thin, greyish-white, fishy-smelling discharge is nothing more than an annoyance to some women, bacterial vaginosis has been linked to pregnancy complications and infection following pelvic procedures or surgery.

Urogenitalchlamydia- one of the most common sexually transmitted diseases. Chlamydial urethritis is much more common than gonorrheal urethritis and can complicate the course of gonorrheal urethritis (mixed infection). More than half of the cases of non-gonococcal urethritis are caused by the microorganism Chlamydia trachomatis. It is the most common causative agent of inflammatory sexually transmitted diseases.

2.5 The relevance of the prevention of inflammatory diseases of the female genital organs

Due to the peculiarities of sexual behavior, smoking, unsatisfactory social status of patients, the relevance of the prevention of inflammatory diseases and their complications is obvious. The main condition is to prevent infection through casual sexual contact, the mandatory use of a condom and personal hygiene. It must be remembered that when taking hormonal contraceptives, the risk of sexually transmitted diseases does not decrease. Personal hygiene measures include rational nutrition, increasing the body's defenses, hardening, prevention of common infectious diseases, and, finally, taking care of the cleanliness of the body, and especially the genitals.

An important role is played by the quality and timeliness of the treatment of the detected disease simultaneously with the sexual partner, even if he has no complaints or the causative agent of the sexually transmitted disease has not been identified.

Prevention of exacerbations of chronic inflammatory processes consists in the correct organization of work, life and rest, in the elimination of the adverse effects of the external environment.

We must not forget that cooling, dampness, a sharp change in temperature, including prolonged exposure to the sun, physical activity, stress - all this can be a factor contributing to the exacerbation of chronic inflammatory processes in the genitals.

Women who have an inflammatory process following an abortion deserve special attention. The prognosis is even more unfavorable when inflammation of the genital organs occurs after an abortion, because. in this case, the likelihood of infertility is high. Hence the special role of social education, especially among young people.

List of used literature

1. Obstetrics and gynecology / Per. from English. [S.P. Horses and others]; Under the editorship of G.M. Savelieva, L.G. Sichinava. - M.: GEOTAR Medicine, 1997. - 719 p.

2. Rehabilitation after inflammatory diseases of the female genital organs. Shevchuk A.I. - Publishing House U - Factoria, 2009. - 188 p.

3. Encyclopedia of health Cyril and Methodius. Collective edition - Moscow: NMG Publishing House, 2008. - 1000 p.

4. Gynecology. - Bodyazhina V.I., Zhmakin K.N. - M.: Medicine, 1977. - 415 p.

5. Gynecology. - Vasilevskaya L.N., Grishchenko V.I., Shcherbina N.A., Yurovskaya V.P. - Rostov-on-Don: Phoenix, 2002. - 576 p.

6. Popular medical encyclopedia. - Bakulev A.N., Petrov F.N. - M.: Medicine, 1961.

7. Gynecology / Ed. M.N. Vasilevskaya. - M.: Medicine, 1985. - 430 p.

8. Women's health. Levanova N.D., Ananyeva O.V. from the Home Encyclopedia of Health series. - N. Publisher: Internet edition, 2010. - 140 p.

9. The body of a woman [Guide to the female body: Per. from English]. - Minsk: Potpourri LLC, 1997. - 559 p.

10. Inflammatory diseases of the pelvic organs. Yaglov V.V., Prilepskaya V.N. - M.: GEOTAR - Media Medicine, 2010. - 128 p.

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Ever since Adam and Eve were allowed to be fruitful and multiply, this generally pleasant process has been accompanied by an ever-increasing set of very unpleasant consequences. Unwanted pregnancy seems to be the most visible of the problems. But venereal diseases and their complications can cause serious physical, psychological and moral suffering, from which not a single person of reproductive age is immune.

Only complete abstinence from sexual intercourse can to some extent exclude the possibility of infection with those types of diseases that are transmitted exclusively through sexual contact. However, you can love yourself as much as you like in solitude, avoiding all kinds of contact with other people, and then find yourself with syphilis, for example, which has penetrated into an unprotected organism through an almost innocent kiss.

An infected person can transmit a sexual infection not only through sperm or, but also through saliva, tears, urine or breast milk. You can get infected in the bath, sitting on a bare shelf, using other people's things: a towel, soap or a washcloth. These things must be strictly individual.

In addition to sexual intimacy, the exchange of infection is possible through household contact, as well as with the help of unsterilized medical and cosmetic instruments. It is not excluded the transmission of sexual diseases in utero from the mother through placental blood to an unborn person. It also risks becoming infected by passing through the birth canal of an infected woman.

Treatment of genital infections is too expensive, often ineffective. As you know, it is better to prevent than to treat any disease. This also applies to the sexual life of every person. Prevention of sexual diseases should come first in interpersonal relations between the sexes.

What to do in order not to get sick?

What needs to be done so that one by no means perfect day does not reveal the symptoms and manifestations of any sexual infection?

• Of course, the first step is to take a responsible approach to choosing a sexual partner. Accidentally met people who are in your bed can cause any sexually transmitted disease.
• You should always have at least one condom with you - a universal and first means of protection. It is better to attend, of course, to a large number of them, because one of them may turn out to be defective.
• You should not indulge in all serious, flaunt your courage and have sex with people at risk for diseases, both mild forms of STDs, and severe forms and especially dangerous diseases.
• It is important to observe the hygiene of the genital organs both on your own and demand it from a potential or existing partner. Many are ashamed to ask their partner to take a shower before intercourse. Your health is at stake, so shame is inappropriate here. Prevention of sexual diseases is impossible without hygiene.
• It is better to refuse sex with a partner, even with a condom, if you see a rash, blisters, sores or any plaque in his inguinal region or on the genitals, find unpleasant ones from your own genitals or partner's organs.
• Remember that you can become infected not only through ordinary sexual intercourse, but also during oral sex. For example, candidiasis or the well-known thrush can affect not only the genitals, but also the mucous membrane of the mouth.

Emergency Prevention Measures

The vast majority of sexual illnesses are exchanged between sexual partners during unprotected contact. For infection to occur, a sufficient number of pathogens must enter the body, overcoming immune and mechanical barriers.

Pathogenic viruses, bacteria and fungi are constantly present in limited quantities in each of us. For a disease to occur, their population must rise sharply, and weaken.

The best protection against all kinds of diseases remains nature's provided mechanisms for a well-functioning immune system. Effective means of emergency prevention of sexual diseases are mechanical (condoms) and chemical methods of protection (pastes and candles), as well as antiseptic preparations. Sometimes it is enough to go to the toilet after intercourse, clean the urethra from microorganisms with the help, wash the genitals with clean hands and soap, douche the vagina with a weak solution of furacilin or potassium permanganate.

If there is a strong feeling that troubles cannot be avoided, it is advisable to use the iodine preparation betadione in the next couple of hours after contact, which is able to cope with viruses, gonococcus bacteria and unicellular microorganisms, such as Trichomonas.

But it is wiser to avoid casual unprotected sexual intercourse, the measure of danger from which far exceeds the degree of dubious pleasure. Minimizing the likelihood of contracting sexual diseases is quite realistic if you lead an orderly and regular sex life with a partner who deserves love and trust.