How does adnexitis manifest in women. Adnexitis is a complete description of a gynecological disease. Causes of inflammation of the fallopian tubes and ovaries

Inflammation of the female genital organs is a fairly common phenomenon, it also applies to the uterine appendages. If the process has affected only the uterine (fallopian) tubes, the pathology is called sappingitis, if the ovaries are affected - oophoritis. Usually these diseases develop simultaneously and have similar symptoms and treatment, so they are combined into the concept of salpingo-oophoritis or adnexitis.

The reasons

Most often, inflammation of the appendages is caused by:

Infectious agents - chlamydia, gonococci, enterococci, Staphylococcus aureus, Escherichia or tubercle bacillus can provoke adnexitis. Pathogenic flora is transmitted from a partner during intercourse or penetrates from the external environment under certain conditions. Hematogenous or lymphogenous infection is also possible, when pathogens are transferred to the appendages from any focus of infection in the body with the blood or lymph flow.
Medical manipulations - abortion, diagnostic curettage of the uterus, installation of a spiral, delivery by caesarean section. Such an intervention leads to injury to the mucous membrane, which facilitates the penetration of infection into the body.
Too rapid resumption of sexual activity after childbirth or gynecological operations.
Reduced immunity - chronic diseases, hypothermia, poor nutrition, insufficient rest, stress.
Non-compliance with the rules of personal hygiene.
genetic predisposition.

Forms and symptoms

The intensity of manifestations of adnexitis depends on the nature of its course:

Spicy

This form is characterized by:

Severe, sharp pains in the lower abdomen. They are usually aching in nature and may radiate towards the perineum, rectum, lower back, or umbilical region.

Unusual mucous or purulent discharge from the vagina. Often accompanied by itching or burning sensation, unpleasant odor, yellowish-green or gray color.

Pain when urinating.
Increase in body temperature up to 38-39 degrees, chills.
Signs of intoxication of the body - headache and muscle pain, weakness.
Symptoms of peritoneal irritation - protective tension of the muscles of the abdominal wall during palpation.

Chronic

The symptoms of this form are:

Constant aching or dull pain in the abdomen.
Menstrual disorders - too heavy periods, spotting in the middle of the cycle, pain during menstruation, less often - a decrease and irregularity of discharge.
Disorder of sexual function - decreased desire, pain during intercourse.
The appearance of exacerbations on the background of stress or hypothermia. They manifest themselves in the form of a deterioration in well-being, increased pain, a slight increase in temperature to 37-38 degrees, the appearance of mucopurulent discharge. After 3-5 days, the intensity of symptoms decreases.

Subacute

This term sometimes refers to acute adnexitis that has not been fully cured or a harbinger of chronic.

Kinds

Depending on the nature of the spread, adnexitis can be:

Right-sided - lesions of the fallopian tube and ovary on the right side. Pain in this type of disease can be confused with acute appendicitis.
Left-sided - inflammation of the tube and ovary on the left side.
Bilateral - the defeat of the appendages on both sides.

What is dangerous

Ignoring the signs of acute adnexitis in the absence of complications leads to a decrease in symptoms after 8-12 days and the flow of the disease into a chronic form. Such recurrent inflammation of the appendages negatively affects the health of a woman:

Spikes (strands). Prolonged inflammation leads to damage to epithelial cells and triggers the adhesive process - the growth of connective tissue that prevents the mobility of organs. Adhesions can block the lumen of the fallopian tubes from the inside, as well as splice the ovary, tubes, uterus and other organs of the small pelvis.
Sactosalpinx- a bag-like formation in the cavity of the fallopian tubes, in which pus (pyosalpinx) or serous fluid (hydrosalpinx) accumulates.
Problems with conception and childbearing. They are noted as a result of obstruction of the fallopian tubes due to adhesions.
Abscess - tubo-ovarian or ovarian. It is a cavity with an accumulation of pus, limited by a membrane. Pathology is characterized by severe pain, nausea, vomiting, temperature above 38 degrees. On palpation, a painful induration is determined. The danger of an abscess is that it can break through, causing the spread of pus throughout the body. In this case, death is possible.
Spread of infection. From a chronic focus, the infection can flow to other organs, which causes colitis, cholecystitis, pyelonephritis, peritonitis, and liver dysfunction.
neuroses. Constant pain, relapses of the disease affect the woman's condition with constant fatigue, sexual dysfunction, decreased performance, increased conflicts in the family and at work, and sleep disturbance.

Diagnostics

The diagnosis is made on the basis of a comprehensive examination:

Interrogation and collection of anamnesis- involves the analysis of the patient's complaints and obtaining information about previous manipulations on the uterus (installation of the spiral, childbirth, surgery).
Look at the chair- is carried out to assess the sensitivity of the uterus and appendages, determine their shape, volume and mobility. With a two-handed gynecological examination (with one hand, vaginal probing is performed, with the other - external palpation of the abdominal cavity), pain and enlargement of the appendages are revealed.
Laboratory research- include bacterial culture, microscopy and PCR diagnostics of smears. Designed to identify the causative agent of infection.
Ultrasound examination (ultrasound)- it is necessary to identify inflammatory formations (purulent or liquid), differentiation of adnexitis from other diseases. Conducted by a vaginal probe.
Laparoscopic diagnostics- allows you to examine the uterine appendages using optical equipment.
Magnetic resonance imaging (MRI)- gives the most accurate results, but has a high price.

Treatment

Approaches to the treatment of acute and chronic forms of the disease are slightly different.

Acute adnexitis

Involves the placement of the patient in the hospital. Among the methods of treatment are the following:

Preparations

The basis of treatment are antibacterial agents, which are prescribed depending on the causative agent of the disease.

If it was not possible to determine the cause of the disease, broad-spectrum antibiotics are used:

For oral use, there are medicines in the form of tablets, capsules, powder - Azithromycin, Amoxiclav, Amoxicillin, Augmentin, Biseptol, Vilprafen, Doxycycline, Metronidazole, Monural, Nolicin, Ofloxacin, Rulid, Sumamed, Tavanic, Trichopolum, Flemoxin Solutab, Cefotaxime, Ceftriaxone, Tsiprolet.
For local treatment, vaginal and rectal suppositories are used - Hexicon, Poligynax, Terzhinan.
Solutions are administered intravenously or intramuscularly - Amikacin, Gentamicin, Cefazolin.

The following groups of drugs can be used simultaneously:

Non-steroidal anti-inflammatory drugs - Voltaren, Galavit, Genferon, Diclofenac, Ibuprofen, Indomethacin, Nise, Naklofen, Nimesulide. They have analgesic properties, eliminate inflammation.
Absorbable preparations - Biostrepta, Lidaza, Longidase, Terrilitin.
Desensitizing (antihistamine) drugs - Betamethasone, Tavegil.
After eliminating acute symptoms, apply:
Vitamins A, E, C, group B. You can also take multivitamin complexes.
Biogenic stimulants are substances of animal and plant origin that stimulate the immune system and accelerate the processes of tissue regeneration (placental injections, aloe).

Operation

It is indicated in the presence of purulent forms of inflammation to eliminate the source of infection:

Laparoscopy- a low-traumatic method of removing pus, followed by treatment of the focus of infection with antiseptic and antibacterial agents. During surgery, separation of adhesions may be performed to restore tubal patency.
Puncture- provides for the puncture of the vaginal vaults and the evacuation of the contents of the saccular tumor with a needle and a syringe attached to it.
Adnexectomy- removal of appendages with extensive inflammation with their purulent fusion. The most common method of surgical intervention is laparoscopic, when instruments for excision of organs and a camera for visual control of the operation are inserted through small incisions in the abdominal cavity.

Physiotherapy

The procedures are aimed at reducing tissue exudation, have a resolving and analgesic effect, and prevent the formation of adhesions.

After eliminating the acute symptoms of adnexitis, the following are prescribed:

Ultrasound is the impact of mechanical vibrations of ultrahigh frequency.
Phototherapy is treatment with ultraviolet radiation.
Electrophoresis - the effect of electrical impulses. It is desirable to carry out procedures with iodine, potassium, magnesium, zinc.
UHF therapy - the use of high frequencies of the electromagnetic field.
Vibromassage - excitation of nerve endings through vibrations.
Paraffin and balneotherapy - thermal compresses from molten paraffin, ozocerite or therapeutic mud.
Douching (irrigation of the vagina) with mineral, sulfide, sodium chloride waters.

Chronic adnexitis

Treatment of this form of adnexitis is associated with some problems:

Due to prolonged inflammation, a tissue barrier is formed around the focus, which not only prevents the spread of infection, but also makes it difficult to accumulate the required amount of medication in the right place.
Local immunity decreases, the body ceases to resist infection.
If left untreated for a long time, pathogenic organisms from the focus of inflammation can develop resistance to antibiotics.

Therefore, before antibacterial therapy, preparation is carried out:

Immunostimulation - Likopid, Polyoxidonium, Timalin. Designed to improve the immune response.
Local treatment - tampons, douching and baths with medicines: Chlorophyllipt, Vishnevsky ointment, herbal decoctions (calendula, chamomile, sage). It is carried out to restore the vaginal microflora.

Therapy during periods of exacerbations of chronic adnexitis coincides with the treatment of the acute form.

Folk remedies

Traditional medicine methods will help relieve symptoms and alleviate the condition with inflammation of the appendages. However, before using them, you need to consult a doctor - many herbs have a strong effect and can worsen the patient's condition:

Juniper berries. To prepare an anti-inflammatory decoction, pour 1 tablespoon of berries with 1 cup of boiling water, boil for 5-7 minutes in a water bath, let cool and drain. Take 1 tablespoon 3 times a day.
Upland uterus (ortilia lopsided). 100 grams of dried flowers of the plant pour 0.5 liters of vodka, leave for a month in a dark, dry place, stirring occasionally. Take alcohol tincture 1 teaspoon 3 times a day 30 minutes before meals. To prepare an aqueous infusion, pour 10 grams of dry grass with 1 cup of boiling water, leave to cool, squeeze and drink 1 tablespoon 3-4 times a day. For douching, a decoction is prepared - 10 grams of the plant for 2 cups of boiling water, boil for 5 minutes and strain thoroughly.
Melilot officinalis, coltsfoot and centaury. Mix the dry grass of plants in equal proportions, pour 2 tablespoons of the collection into 0.5 liters of boiling water, leave for 1 hour, strain. Drink infusion of 1/3 cup 4-6 times a day.
Garlic. Has antimicrobial activity. Squeeze the juice from 1 clove of garlic, mix with water, apply on a cotton swab and insert into the vagina for 2 hours. The procedure should be carried out no more than 3 times a week in order to avoid burns of the mucosa.
Plantain and aloe. They relieve pain, promote the resorption of adhesions and scars. 2 tablespoons of plantain pour 0.5 liters of water, boil for 2-3 minutes, squeeze and add 10-15 drops of aloe juice. Use a daily douche.

Diet

Proper nutrition with adnexitis increases the body's resistance to infectious agents. During the period of acute and exacerbations of chronic forms, the diet should be hypoallergenic and exclude the following products:

egg whites;
fatty meats;
mushrooms;
chocolate and other sweets;
citrus, red berries;
products with dyes, flavors, preservatives, sweeteners;
a large amount of salt.

The diet should include:

foods high in vitamin C - rose hips, currants, kiwi, pomegranate;
boiled and stewed vegetables rich in fiber - zucchini, eggplant, cabbage, beets, carrots;
greens - parsley, dill, lettuce, spinach, onion;
vegetable oils - linseed, olive, sunflower, pumpkin;
lean meats and fish;
cereals in the form of cereals - buckwheat, oatmeal, wheat, oatmeal;
fermented milk products with bifido- and lactobacilli - kefir, fermented baked milk, yogurt, cottage cheese;
liquid in the form of fruit and vegetable juices, compotes, still water, herbal and green teas.

During the period of remission, strict adherence to the diet is not required, but nutrition should be balanced, with a sufficient amount of nutrients.

During pregnancy

Adnexitis often becomes an obstacle to pregnancy. The cause of infertility may be:

Ovarian dysfunction- prolonged inflammation leads to thickening of the walls of the ovaries and causes menstrual disorders. One of them is anovulation - the inability of a mature egg to leave the ovary. In this case, the follicles, from which the eggs do not come out, increase in size and fill with fluid, turning into cysts.

Violation of motor activity and patency of the fallopian tubes. Inflammation leads to damage to the epithelial cells lining the cavity of the tube, and starts the adhesive process - the growth of connective tissue that blocks the lumen of the tube. As a result, the egg cannot get from the ovary to the fallopian tube for fertilization.

Ectopic pregnancy. According to various sources, from 15 to 50% of women with adnexitis are at risk of developing this pathology. It occurs when adhesions interfere with the migration of a fertilized egg into the uterine cavity, and implantation (attachment of the egg to the walls of the organ and further development of the embryo) occurs in the fallopian tube.

Adnexitis during pregnancy can significantly complicate its course and lead to the following pathologies:

Miscarriage- inflammation impairs the work of the corpus luteum in the production of progesterone, and without this hormone, implantation of the egg and further successful pregnancy are impossible.
Low location of the placenta is formed if, due to the inflammatory process, implantation has occurred in the lower part of the uterus. An anomaly can provoke bleeding at different stages of pregnancy and childbirth.
intrauterine infection- the penetration of pathogenic organisms from the focus of inflammation to the fetus.
Early rupture of amniotic fluid. It leads to weak labor activity, can cause fetal hypoxia.
Infection of the child during childbirth. Occurs if the infection has spread to the birth canal. A caesarean section is performed to avoid infection.
Exacerbation of adnexitis. Perhaps at conception in the period of remission.

Adnexitis detected during pregnancy should be treated in a hospital setting.

Girls

Inflammation of the appendages is possible in young girls or adolescents who are not sexually active.

The causes of the disease are:

insufficient hygiene of the genitals;
transmission of infection from the mother during childbirth;

the spread of infection from other foci of inflammation in the body, both in the pelvic organs (cystitis, pyelonephritis, appendicitis), and in other parts of it (angina, tonsillitis, otitis media).

In girls, inflammation occurs with fever, pain, impaired urination, and purulent vaginal discharge is possible. In adolescents, the presence of inflammation may also be indicated by the absence of menstruation up to 15 years, irregular periods with long delays, impaired puberty (underdeveloped mammary glands, excessive hair growth on the face and body).

When the first symptoms of the disease appear, you should contact a pediatric gynecologist. Modern techniques allow for effective diagnosis and treatment without traumatizing the child.

Prevention

To prevent the development of the disease, you must adhere to some rules:

have a permanent sexual partner, use condoms for casual relationships;
treat any diseases in time, exclude the possibility of hypothermia, after treatment of adnexitis, make sure that the disease is completely eliminated;
minimize nervous tension and stress;
stop drinking excessive alcohol;
adhere to proper nutrition with enough vitamins and minerals;
monitor weight, play sports, have a good rest;
visit a gynecologist regularly.

If a woman is at risk (wears a spiral, suffers from sexual infections, had an abortion), it is recommended to visit a gynecologist at least 2 times a year.

Which woman has not experienced at least some pain in the lower abdomen? Who has not heard the common expression "inflammation in a woman's way." Many women know firsthand about chronic inflammation of the appendages (adnexitis), experiencing pain for years and not going to the doctor. But is it really so harmless chronic adnexitis and how realistic it is to defeat it - we propose to figure it out together.

Inflammation of the uterine appendages is a very common ailment. With inflammation, only the pipes speak of salpingitis, and with damage to the ovaries, the term "oophoritis" is used. Most often, both of these diseases occur simultaneously, then the woman is diagnosed with "salpingoophoritis" or "adnexitis".

With the diagnosis of "adnexitis", the pathology has already spread to the ovaries with the fallopian tubes. As a result, fluid (exudate) accumulates in the appendages. The types of adnexitis are considered right-sided, left-sided or bilateral ailment. There are also two main forms of the disease (acute and chronic). Chronic adnexitis occurs as a complication of acute untreated salpingo-oophoritis.

Chronic adnexitis differs from acute in lesser severity of symptoms. However, to cure this type of pathology is much more difficult and troublesome.

The reasons

What factors can provoke adnexitis? For inflammation to occur in the female genital area, pathogenic microflora must settle. The ingestion of infectious agents (gonococcus, Staphylococcus aureus, enterococcus, chlamydia, Escherichia coli, herpevirus, etc.) into the body of a woman can occur in different ways:

sexually;
from the external environment;
through the lymph
through the blood;
ascending path (through the uterine neck);
descending path (from pathologically altered adjacent organs - for example, the sigmoid or rectum).

The mucous plug of the cervix serves as a natural barrier to microbes. However, during some natural processes (menstruation, childbirth, sexual intercourse) or clinical situations (abortion, curettage, insertion of a spiral), its integrity is violated and the path for infection becomes open.

In addition, favorable conditions for bacterial reproduction should arise in the appendages. For this, the following conditions must occur in the body:

traumatization of the uterine mucosa during menstruation or due to any medical manipulations (curettage, installation of a spiral, abortion, caesarean section);
decreased immunity (with stress, overwork, from malnutrition, with a heavy load or poor ecology);
violation of personal hygiene;
a shift in the acid-base environment of the vagina (leads to the reproduction of microflora);
tight trousers or underwear (as a result, the absence of air and the accumulation of secretions);
prolonged sitting in the cold (as a result - stagnation of blood and an impetus to infection);
multiple sexual partners and unprotected intercourse;
premature onset of sexual activity (after surgical interventions in gynecology, childbirth or abortion);
the presence of such diseases in the family.

On the advice of gynecologists, in addition to the timely treatment of any acute inflammation in gynecology, daily washing of the genitals with a weak solution with optimal acidity (Ph4 acid) is necessary.

Symptoms

Unlike acute, chronic adnexitis has a more "blurred" symptomatology.

For the chronic form of adnexitis, periodic alternations of intensification of symptoms (exacerbation) and their subsidence (remission) are typical.

Chronic adnexitis is characterized by such manifestations:

a symptom of pelvic pain in the lower third of the abdomen from inflammation (pulling-aching nature) on the right or left (with bilateral adnexitis of pain on both sides of the abdomen);
pain can radiate to the kidneys or back;
increased pain at the time of intimacy, before menstruation, after exercise;
change in the usual cycle of menstruation (abundant or meager discharge, "daub" in the middle of the cycle, pain at the time of menstruation);
chills and fever (up to 37-37.5 degrees);
weakness;
the appearance of abundant vaginal discharge (sometimes purulent).
development of an imbalance of the central nervous system (deterioration of sleep, irritability, depressive manifestations);
disorders of sexual function (soreness at the time of sex, decreased desire);
the appearance of disorders in the digestive (gastritis, colitis) and genitourinary systems (pyelonephritis, cystitis).

After 3-5 days, all of the above manifestations are reduced.

For chronic adnexitis, increased pain before menstruation is typical.

Chronic adnexitis can have the following types of course:

neurovegetative: when a woman's quality of life decreases, mood and performance deteriorate, vascular and hormonal disorders occur;
infectious-toxic: when painful manifestations and inflammatory changes in the appendages progress, and the blood count indicates inflammation.

What is dangerous chronic adnexitis

Since chronic adnexitis is characterized by periodicity, many women suffer pain and do not go to the gynecologist. However, over time, the patient's condition worsens, and the symptoms of the disease intensify. What can untreated adnexitis lead to?

Endlessly stretching chronic inflammation does not bring anything good to a woman. A permanent infectious focus in the body leads to between the internal organs (in the pelvic area, between the bladder and appendages). The accumulated pus in the appendages provokes ovarian fusion (ovarian or ovarian abscess) with saccular forms of tubal formations.

With a large accumulation of exudate or pus, a formidable complication is possible in the form of rupture of the ovary. As a result - peritonitis, infection of the abdominal cavity and small pelvis, inter-intestinal abscess. Such a dangerous condition can cost the life of the patient. Here's a "harmless" adnexitis for you ...

But still, such serious complications in the "chronicle" of adnexitis are not so common.

Much more often, neglected "blooming" salpingo-oophoritis constantly undermines women's health and well-being, problems with childbirth, and sexual disorders.

Possible consequences

Chronic adnexitis is fraught with such complications:

Pathology of pregnancy (with, provoking miscarriages and ectopic pregnancies). A variety of infertility in chronic inflammation refers to mixed types and is very difficult to correct. This is the result of anatomical and functional disorders of the uterus and appendages. In this case, the function of the ovaries is disturbed (the menstrual cycle changes, anovulation occurs, bleeding or non-cyclic discharge occurs).
Recurrence of neglected pathological processes of the fallopian tubes (obstruction, sclerosis, adhesions in the periovarian region, the formation of infiltrates).
The spread of ovarian-tubal pathology to neighboring urinary and digestive organs (cholecystitis, colitis, pyelonephritis).
Due to frequent exacerbations and pain, the woman's well-being noticeably worsens, neurotic reactions and excessive emotionality on everyday issues appear. Nervousness and hyperexcitability lead to conflict in the team and family, poor sleep, and decreased performance.
There is a deterioration in the quality of sexual life due to hormonal disorders and pathological changes in the female organs. A woman loses sexual desire, soreness with intimacy prevents her from getting satisfaction.

Diagnostics

What to expect for a woman who is suspected of having adnexitis?

As a rule, the doctor listens to the patient's complaints and offers several types of examinations. These include:

two-handed gynecological examination (a method for identifying areas of pain);
laboratory diagnostics: to detect pathological microflora, PCR smear, smears from the vagina, uterine neck and urethra;
Ultrasound scanning to determine inflammatory formations: pyosalpinx (accumulation of pus), hydrosalpinx (accumulation of fluid);
laparoscopy (according to indications): microsurgery through a puncture in the abdominal wall to clarify the diagnosis;
(x-ray of the uterus with a contrast agent) to check and the degree of neglect of the pathology;
functional tests to check the functioning of the ovaries (rectal temperature, tension of the cervical discharge, "pupil symptom");
MRI (expensive, but allows for an accurate diagnosis of the condition of the appendages).

How is adnexitis treated?

Treatment of the "chronicle" of the appendages can be carried out on an outpatient basis or in a hospital setting. It is important for such patients to undergo a course of treatment at balneological resorts at least once a year using mud therapy and physiotherapy aimed at resolving the pathological process.

Pharmacological agents

Antibiotics (not always used). If it is still advisable, the patient is prescribed tests with a biomaterial culture so that the drug is chosen correctly. Usually, antibiotics are connected in the presence of secondary infections against the background of the disease (chronic, etc.)

Of the antibiotics used for adnexitis: azithromycin, amoxiclav, zomax, cedex, vilprafen, sumamed, monural, tsiprolet, etc.

With an exacerbation of the process, it is not uncommon to use a stationary regimen with the use of infusion solutions, desensitizing therapy.
Immunomodulatory drugs for "revitalization" of immunity: lycopid, thymalin, polyoxidonium.
Anti-inflammatory "non-steroids" (nimesulide, naklofen, nise).
Resolving therapy (lidase, wobenzym, longidase, biostrepta).
Antihistamines (loratadine, diazolin, tavegil).
After the subsidence of pain manifestations, autohemotherapy is prescribed (the introduction of one's own blood to the patient).
Biostimulants with absorbable effect and to improve regeneration (aloe, placenta, vitreous in the form of injections).
Local therapy in the form of the use of suppositories (vaginal and anal) with anti-inflammatory and resolving adhesions effect: indomethacin, diclofenac, hexicon, longidase; tampons, baths and douches with herbal decoctions, Vishnevsky ointment, chlorophyllipt.

Physiotherapy

Physiotherapy to obtain an analgesic-absorbable result, with the effect of reducing exudation and resorption of adhesions. Here they use electrophoresis with drugs in its composition (lidase, magnesium, potassium), phototherapy, DDT, ultrasound, UHF therapy.

The use of therapeutic mud (in the form of tampons or applications on the projection of the abdomen), therapeutic baths, paraffin, vaginal irrigation with mineral water.

Special gymnastics and gynecological massage, vibration massage.

Treatment with traditional medicine recipes

Independent use of traditional medicine does not find support among doctors. But with a complex intake with drug treatment, many recipes have confirmed their effectiveness.

A mixture for douching from mallow flowers and oak bark (1 tsp), sage and chamomile (1.5 tsp each), walnut leaf (2.5 tsp). All components are mixed and poured with boiling water (1 liter). After infusion, the drug is filtered. It is used for baths or douching.
Douching with chamomile infusion and soaking tampons with it (2 tablespoons per glass of boiling water).
: alcohol tincture inside (20-40 drops three times a day before meals for 3 weeks) and its water infusion for douching.
Propolis tampons with honey. To do this, mix propolis with honey (50 gr each). The mixture is heated over low heat and mixed. Then, before going to bed, a gauze swab is immersed in the mixture and inserted into the vagina while warm. The tampon should be in the vagina all night. In the morning it is removed and douched with one of the medicinal solutions. Tampons are used for about 3 weeks (outside of menses). The method is considered quite effective.
With infertility against the background of adnexitis, many herbalists consider Matron's infusion to be an effective remedy.

Surgical treatment for adnexitis

The operation is one of the exceptional methods of treatment for the ineffectiveness of conservative therapy. This can be used:

puncture (puncture of the vaginal fornix and removal of the sac with purulent contents using a needle with a syringe);
laparoscopy (removal of pus or separation of adhesions through micro-holes in the abdominal cavity, treatment of the infectious focus with antiseptics);
adnexectomy (with advanced pathology and purulent fusion of the appendages - their removal during abdominal surgery or in a gentle way with laparoscopy).

Prevention

There are rules that should be followed to prevent the development of adnexitis. Their points are:

The presence of a permanent partner for intimacy.
Competent contraception to prevent abortion, use of a condom during casual sexual contact.
Avoid hypothermia, nervous stress, overwork.
Do not wear tight underwear and clothing.
Treatment of any acute gynecological inflammation.
Mandatory daily washing, timely replacement of pads during menstruation.
A visit to the gynecologist at least twice a year.

A woman at any age should not neglect her health and ignore the pain in the lower abdomen. Chronic adnexitis is insidious, and its complications can turn a woman into a neurotic, deprive her of the happiness of motherhood and sexual pleasure. Health to you and female happiness!

Adnexitis is understood as one- or two-sided inflammation of the appendages (fallopian tubes and ovaries), which is caused by various microorganisms.

There are acute and chronic adnexitis. The latter is the most common gynecological disease, which is characterized by the frequent occurrence of relapses.

From the article you will find out what are the most common causes that ignite the focus of inflammation in the appendages, how the infection and further development of the disease proceed, and what types of adnexitis are divided into.

It also provides detailed information about the course of the disease during pregnancy and the approach of modern medicine to this issue.

Causes of inflammation of the fallopian tubes and ovaries

The ovarian tubes and ovaries are normally sterile and do not contain pathological microorganisms. However, under certain conditions, for example, if the rules of intimate hygiene are not followed, microorganisms get there and cause an inflammatory process.

Ordinary bacteria can act as such agents, which normally inhabit the vagina and, under certain conditions, expand the zone of their localization (decreased immunity). Such microorganisms include staphylococci, peptostreptococci, bacteroids. Most often, these bacteria act together, which exacerbates the clinical picture of the disease.

Another and most likely cause of adnexitis are pathogens that are sexually transmitted. In most cases, they refer to "latent infections" - chlamydia, ureaplasma, mycoplasma, Trichomonas, gonococci.

If these bacterial agents enter the female genital tract, they tend to enter the tubes and uterine cavity, as they die in the acidic environment of the vagina. Infection is also facilitated by pathogens such as worms and protozoa.

Risk factors for the development of inflammation include any intrauterine interventions (violation of sterility, a high probability of infection from the outside), the presence of several sexual partners, past inflammatory diseases of the female genital organs, hypothermia, postponed childbirth.

The mechanism of the development of the disease

Under the influence of infectious pathogens, inflammation occurs on the mucous membrane of the fallopian tube, which is characterized by the following symptoms: redness (hyperemia), microcirculation disorders (changes in the walls of small vessels leading to malnutrition of the organ), edema, accumulation of pathological fluid (exudation), cellular infiltration ( change in cell structure).

Inflammation gradually spreads to the muscular membrane of the organ, where edema occurs. As a result, the fallopian tube lengthens and thickens, there is a characteristic soreness in the groin. Together with the contents of this organ, microbes enter the abdominal cavity, affect its outer membrane (serous), as well as the peritoneum surrounding it.

There is perisalpingitis (inflammation of the structures surrounding the fallopian tube) and pelvioperitonitis (inflammation of the pelvic peritoneum). After the ovarian follicle ruptures, pathogens get inside it, infect its granulosa membrane and salpingo-oophoritis (an inflammatory process in the ovary) occurs.

With suppuration, a tubo-ovarian tumor can form. As a result of gluing of the fallopian tubes altered by inflammation, an adhesive process occurs with the Douglas peritoneum, the appendicular process (secondary appendicitis can often occur), and adjacent intestinal loops.

Symptoms and signs of adnexitis

The first symptom of acute adnexitis is severe pain localized in the lower abdomen, accompanied by a pronounced increase in temperature up to 38 ° C (in some cases with chills), a deterioration in the general condition, urinary function disorders, and sometimes bloating.

There is a violation of the menstrual cycle, while menstruation becomes painful and longer, intermenstrual bleeding may occur. Patients complain of pain during urination, sometimes on leucorrhoea (purulent discharge).

Also, abdominal pain occurs during sexual intercourse and persists for a certain time after it. The acute form is characterized by a lesser severity of symptoms, while the pain is constant, aching. Exacerbation of the chronic process is observed after stress, hypothermia. In some cases, the only sign that allows you to suspect this disease is infertility.

Acute and subacute adnexitis

The acute form is characterized by a pronounced clinical picture. Among the main symptoms, there are pains in the lower abdomen (intense, radiating to the lumbar region, anus), nausea (almost always not accompanied by vomiting), bloating, fever, urination disorders, fever and general weakness.

The causative agent of this form of the disease are chlamydia, mycoplasmas (in every tenth case), enterococci, streptococci, anaerobes (bacteroids, peptococci, clostridia).

Allocate early and late complications. The first group includes tubovarial abscesses, the second - the transition to chronic forms with periodic exacerbations, as well as infertility. Pus accumulating in the uterine appendages can spread to the bladder, peritoneum, rectum, which leads to the development of dangerous conditions that require immediate surgical intervention.

Subacute adnexitis in clinical manifestations has practically no significant differences from the acute form of this disease. It is characterized by a lower intensity of manifestation of some symptoms and the frequency of their occurrence (pain, pathological discharge, fever).

Chronic

The chronic form of adnexitis develops only if its acute form has not been subjected to timely and adequate therapy. The most dangerous causative agent of this disease is chlamydia, which leads to the formation of connective tissue, adhesions, obstruction of the fallopian tubes, hydrosalpinx.

At the same time, the process is of a sluggish nature with an erased clinical picture. As a result, the patient cannot see a doctor in time, which leads to the development of a chronic form of the disease with characteristic anatomical changes.

In addition to chlamydia, chronic adnexitis can be caused by gonococci, mycoplasmas, herpes simplex virus of the second type.

This disease is characterized by periodic alternation of stages of temporary remission and exacerbation. Relapses occur after stressful situations, hypothermia, overwork and other predisposing factors.

The main symptoms of chronic adnexitis are pain in the lower abdomen, caused by adhesive processes that radiate to the anus, menstrual irregularities, the appearance of premenstrual syndrome, purulent vaginal discharge, fever, impaired functioning of the organs of the urinary and digestive systems.

The exacerbation of the inflammatory process is confirmed by the appearance of pain, fever, the presence of pathological secretions. Vivid symptoms last a week, then fade, but this does not mean at all that the disease has passed completely.

Among the consequences of a chronic form, one can single out the proliferation of connective tissue, which can lead to a narrowing of the lumen of the fallopian tube. Similar processes in the ovaries lead to compaction of the follicle capsule, as a result, it does not burst during ovulation. As a result, the maturation of the egg and its further passage through the fallopian tube becomes impossible. This condition is called tubal infertility.

In addition, for the same reason, ovarian cysts can form. If the egg is released into the fallopian tube, then an ectopic pregnancy develops, as it cannot pass into the uterus. As a result, a rupture of the fallopian tube may occur, so urgent surgical intervention is necessary.

The adhesive process often captures the surrounding peritoneum, in a similar way the body limits the spread of the inflammatory process, however, the mobility of the internal organs worsens. In chronic adnexitis, other inflammatory diseases are often observed: cystitis, pyelonephritis, colitis.

double sided

With bilateral adnexitis, the uterine appendages are affected on both sides. Initially, the disease, as a rule, develops in the fallopian tubes, then goes to the ovaries.

Often with this pathological condition, other diseases of the organs of the female reproductive system are also detected, for example, endometritis (inflammation of the uterine mucosa).

The main causative agents of bilateral adnexitis are gonococcus, Koch's bacillus, chlamydia.

The pathogen enters the appendages due to inflammation of organs - both neighboring (proctitis, appendicitis), and distant (pneumonia, tonsillitis) or after unprotected intercourse.

The most common clinical signs of this disease are pain in the lower abdomen, which can have varying intensity, fever, malaise and general weakness, acute abdomen syndrome (nausea + vomiting + pain + tension in the abdominal muscles).

With double sided the highest risk of infertility(due to the development of the adhesive process), in addition, this form often takes on a subacute and chronic character.

Right-sided and left-sided adnexitis

With unilateral adnexitis, the inflammatory process occurs in the uterine appendages either on the right or on the left. Its causative agents are staphylococcus aureus, E. coli, streptococcus.

This disease is characterized by pain at the site of the pathological process. If they have a high intensity, then it is quite difficult to determine their location, since they can give to neighboring areas - the anus, lower back.

The body temperature also rises, there is a feverish state and chills. Sometimes there is bloating, violation of urination. With the development of chronic unilateral adnexitis, as in other forms of this disease, there is an proliferation of connective tissue and the formation of adhesions.

These processes result in tubal infertility, as well as ectopic pregnancy. Relapses of the disease are accompanied by symptoms similar to those in acute forms of the unilateral appearance, only they are less intense.

Exacerbation of the disease

Exacerbations of adnexitis are observed during hypothermia of the body, various psycho-emotional traumas, and stressful situations. They are characterized by a pronounced clinical picture, but sometimes they can be somewhat blurred.

The main symptoms are pain in the lower abdomen, which can radiate to the lumbar region, sacrum, nausea, fever, urination disorders, and nausea.

The length of periods of exacerbations in chronic adnexitis and the frequency of their occurrence can be varied and is determined by the state of the body's immune system, the duration of exposure to the provoking factor, as well as the timeliness and adequacy of the treatment.

How does adnexitis affect pregnancy

The presence of chronic adnexitis can cause infertility, tubal obstruction and, as a result, ectopic pregnancy. Therefore, pregnancy in this condition in many cases is unfavorable with the development of complications, in particular with the development of tubal abortion, rupture of the tube and the development of peritonitis.

However, if an acute form developed during this period, then with adequate and timely treatment, the development of pathological conditions can be avoided and the pregnancy will pass without any complications. When performing surgical interventions for chronic adnexitis, aimed at restoring the patency of the fallopian tubes, a positive result can also be observed regarding a possible pregnancy and the course of this period.

Methods of treatment of the disease depending on the stage

Treatment of adnexitis is determined by the nature of the disease (chronic, acute). And also from a specific pathogen, the presence of concomitant pathological conditions, the severity of the main clinical symptoms.

In all cases, you must consult a doctor, because self-medication guarantees only a temporary improvement, but the inflammation does not go away, it acquires a protracted, chronic course with rather serious consequences.

Acute therapy is always carried out in a hospital. Bed rest is prescribed, cold is applied to the lower abdomen for one to two days. In addition to all this, sedatives (motherwort tincture) drugs, antihistamine drugs (diphenhydramine), vitamins (ascorbic acid, rutin), a special diet are shown.

Antibiotics with a long decay period also play an important role. Their type is determined depending on the specific pathogen, the dosage is selected in such a way as to ensure the maximum concentration in the pathological focus.

The effectiveness of adnexitis therapy can be improved during laparoscopy - this procedure allows you to perform a puncture or remove pathological formations.

For the treatment of chronic adnexitis, drug and non-drug therapy is used, while taking into account the neglect of the pathological process and its other clinical features.

During the period of remission, in order to eliminate the pain symptom in the lower abdomen, ultrasound therapy, water and mud therapy, and acupuncture are performed. Antibiotics are prescribed during the period of exacerbation, if competent antibacterial therapy has not been carried out in the acute stage. They are also used in the application of techniques that activate metabolism, blood supply, since relapses of acute inflammation are not excluded.

Surgical intervention is performed only for certain indications (massive formations, pronounced adhesions, frequent exacerbations). It is preferable to carry out organ-preserving operations so that in the future the childbearing function is not difficult or excluded. But in some cases, the removal of the uterus, ovaries, fallopian tubes is not excluded.

To improve the results, chronic adnexitis therapy is best done in special resort conditions, combining all of the above methods with massage, exercise therapy, psychotherapist consultations, and diet.

Antibiotic treatment

The use of antibiotics is one of the most important measures in the treatment, since this disease is caused by microbes. The most commonly used drugs are kefosol, gentamicin, amoxicillin or ceframesin. If the disease is severe, then azithromycin or doxycycline is prescribed.

In mild cases, antibiotics may be given orally. In the rest - only intravenously or intramuscularly. Antibiotic therapy should be combined with the use of drugs of other pharmacological groups, physiotherapy and vitamins. Chronic adnexitis requires long-term therapy under medical supervision.

Treatment with candles

With adnexitis, suppositories are used as a topical treatment with antibiotics. This improves the effectiveness of therapy. In some cases, they are intended to relieve severe pain. The following drugs are most often used: movalis, fluamisin, indomethacin, diclofenac, voltaren.

Pain during breastfeeding is haunted by many mothers, pumping with a breast pump is a modern way out of the situation.

Treatment of adnexitis with folk remedies

Adnexitis should in no case be treated with folk remedies. However, various herbal preparations can be a good addition to professional prescriptions in the development of chronic forms of the disease, when it is important to exclude the occurrence of relapses. The fixed assets include juniper berries, goose cinquefoil grass, medicinal sweet clover, centaury, coltsfoot flowers, forest hay, fresh milk.

In the organs of the female reproductive system, many ailments can occur. Some of them, for example, malignant tumors, are fatal. Others lead to death in isolated cases, but without proper treatment they cause serious complications that deprive a woman of a normal life and the opportunity to become a mother. These diseases include endometritis, endometriosis, adnexitis. Their symptoms are different. But there is a common symptom - pain in the lower abdomen. Endometritis is an inflammation of the endometrium, that is, the inner mucous layer of the uterus, which can occur both in women who have not given birth and in those who have children. Moreover, inflammation of the endometrium is often provoked by childbirth and abortion. Endometriosis is a disease in which the endometrium not only becomes inflamed, but can grow outside the uterus, sometimes capturing the ovaries and even the intestines. With this pathology, infertility occurs. This article will describe in detail the adnexitis disease, the symptoms at different stages of its course, the principles of treatment, the consequences to which it can lead, as well as the signs that distinguish it from other diseases of the reproductive organs of a woman.

general description

Another name for adnexitis is salpingoophoritis. This difficult to pronounce medical term is formed by the merger of two simpler ones - salpingitis, which is an inflammatory process in the fallopian tubes, and oophoritis - inflammation of the ovaries. Thus, salpingoophoritis covers problems with both the fallopian tubes and the ovaries. But this term is rarely used. Most authors and medical publications prefer the shorter name of the disease - adnexitis.

The symptoms of this ailment, which has arisen to the left and right of the uterus, may differ slightly. They can also be regarded as signs of completely different diseases not related to gynecology. Only a doctor can accurately diagnose. Without treatment, adnexitis is fraught with infertility, and in some cases - the development of peritonitis.

Many women know this disease as It should be noted that there are appendages of the uterus (fallopian or fallopian tubes and ovaries) and ovaries (include rudimentary remnants of the primary kidney and its ducts). When talking about salpingoophoritis, they mean pathological processes in the fallopian tubes and in the ovaries with all their appendages.

Classification

Depending on the nature of the course and symptoms, adnexitis can be:

Sharp.
Chronic.

Depending on the location, these types of adnexitis are distinguished:

Right hand.
Left side.
Double sided.
Mainly affecting the ovaries.
Predominantly affecting the fallopian tubes.

Depending on the nature of the inflamed tissue, adnexitis happens:

Serous.
Purulent.

Causes

In most cases, inflammation in the appendages occurs due to the penetration of pathogenic microorganisms into their mucous membranes.

Any microbe that has made its way from the vagina into the fallopian tubes, and then into the ovaries, can act as a pathogen. The type of pathogen practically does not affect the nature of the symptoms of adnexitis, but determines the choice of therapeutic agents. Most often, the disease is caused by such microorganisms:

Streptococcus.
Gonococcus.
Staphylococcus.
Escherichia coli.
Mycobacterium tuberculosis.
Candida.
Chlamydia.
Mycoplasmas.
Pale treponema.
Gardnerella.

These microbes can get into the appendages in the following ways:

Ascending, that is, from the cervix.
Descending - from the inflamed sections of the gastrointestinal tract, anatomically located near the appendages.
Lymphogenic (with lymph flow).
Hematogenous (with blood flow). Most often, tubercle bacilli that enter the blood from the lungs infect the fallopian tubes and ovaries. But from other organs, various bacteria and viruses (Pseudomonas aeruginosa, herpes virus, enterococci, pneumococci, Klabsiella) can arrive in the organs of the female reproductive system.

Due to the fact that specific preparations must be selected to get rid of the disease (destruction of various forms of microorganisms), it is impossible to treat adnexitis without the recommendations of a doctor. In women, the symptoms and signs of the disease can reduce their manifestation, which may mean the transition of an acute form to a chronic one, and not a cure. Therefore, courses of therapy are most often carried out in a hospital in order to regularly monitor how the recovery is going.

For what reasons can acute adnexitis begin?

The above list of microorganisms that can cause inflammation of the uterine appendages eloquently indicates that this disease occurs in almost 100% of cases in people suffering from sexually transmitted diseases (gonorrhea, trichomoniasis, mycoplasmosis, chlamydia, and others), which patients either do not treat at all, or engage in self-treatment, following the advice of "experienced".

If bacteria that cause sexually transmitted diseases have entered the vagina, sooner or later they will definitely get to the fallopian tubes, through which they will penetrate into the ovaries. All women should understand this.

The cervix, being closed by means of the lower pharynx, inhibits the penetration into the reproductive organs of any infection from the vagina. But the pharynx opens during menstruation, on certain days of the menstrual cycle. Contribute to infection in an ascending way and such situations:

Intrauterine device.
Childbirth.
abortion.
Aggressive sexual intercourse.

The causes of infection by the lymphogenous or hematogenous route can be as follows:

Decreased immunity.
Stress.
Chronic fatigue.

Another way that contributes to the appearance of adnexitis is operations on the gastrointestinal tract, in which a large area of the abdominal cavity is affected.

The pathogenesis of acute adnexitis

This form of the disease develops immediately after infection of the appendages by microorganisms. Manifestation may not begin suddenly, as with some other diseases (eg, appendicitis, shigellosis, influenza). Often the acute form lasts for several months. A woman observes a violation of the menstrual cycle, the appearance of signs of cystitis (frequent and painful urination), pain in the lower abdomen that appears after performing heavy physical exertion, after hypothermia. If inflammation is observed on one side of the uterus, it is called unilateral adnexitis. Symptoms on the left side and on the right side are somewhat different. Very often there is bilateral adnexitis, when the fallopian tubes and ovaries are affected both on the left and on the right. In this case, the woman feels pain in the lower abdomen, extending into the anus and vagina. On palpation, the abdominal muscles below the navel tense, the discharge increases, and increased leukocytosis is detected in the blood.

If the adnexitis is on the right, the symptoms are expressed in painful sensations on the right side, which can be mistaken for attacks of appendicitis. These two ailments can be distinguished by additional signs. So, with appendicitis, in most cases, vomiting and nausea are observed. This is not typical for inflammation of the appendages, but with adnexitis, women almost always experience pain during intercourse and discharge is observed (abundant leucorrhoea with impurities of pus, and sometimes blood). The surgeon must rule out appendicitis.

With adnexitis on the left, women experience pulling pain, respectively, on the left side of the navel. They almost always increase during intercourse, menstruation, ovulation.

In addition to pain and discharge, the symptoms of acute adnexitis are as follows:

Prostration.
Heat.
Headache.
Lack of appetite.
Brokenness.

These signs are not leading in the definition of adnexitis and may indicate dozens of other diseases. However, they worsen the general condition of the patient, complicate the diagnosis. If women have such symptoms, especially pain in the lower part of the peritoneum on any side and copious purulent discharge, you should immediately contact a gynecologist.

Chronic adnexitis, symptoms in women, treatment

If you do not cure this disease, but only drive it inside, using drugs that block its main symptoms (pain and heavy discharge), a chronic form of adnexitis develops. It is characterized by a sluggish course, blurred symptoms and can last for years, during which remissions and exacerbations are observed.

However, inflammation of chronic adnexitis, the symptoms and treatment of which we will consider below, is fraught with irreversible pathological changes in the reproductive organs of a woman.

This process, as a rule, begins with the mucosa of the fallopian tubes. Further, even in the acute form of the course of the disease, inflammation passes to the muscle tissue. As a result, the fallopian tubes become swollen. This can be observed by doctors when examining a woman on a gynecological chair and during palpation of the problem area of the lower abdomen.

Meanwhile, in the fallopian tubes, the process of adhesion occurs, adhesions are formed. They are a very important symptom of chronic right-sided and left-sided adnexitis, depending on where the focus of inflammation is observed. Adhesions in the fallopian tubes are one of the causes of infertility, which should be taken into account by women who do not attach importance to inflammation of the appendages.

Other signs of chronic adnexitis include:

Constant body temperature around 37 degrees Celsius.
Dull or aching pain in the side where the inflammatory process takes place (in the lower abdomen with bilateral adnexitis). These sensations are intensified during menstruation, during physical activity, during sexual intercourse.
Allocations may be present, but their number is not critical, so many women do not attach importance to them.
In the blood test, there is always an increased ESR.

Relapses can be due to any condition that reduces immunity, hypothermia, as well as various diseases (not gynecological) that a woman has.

With relapses, the symptoms of adnexitis in the chronic form are the same as in the acute form.

Treatment of chronic adnexitis is carried out only in the complex. Both medical methods and homeopathy, physiotherapy, herbal treatment are used.

Subacute adnexitis

The transitional form between acute and chronic forms is subacute adnexitis. The symptoms in this case are the same as during the exacerbation of the disease, but they are slightly less pronounced. Women may experience:

Elevated temperature.
Pain in the lower abdomen from the inflamed area.
General malaise.
Bloating.
Profuse purulent discharge.
Menstrual disorders.
Itching in the vagina.

Diagnosis and treatment of subacute adnexitis are carried out according to the same principle as in the acute form of the course of the disease. Due to the similarity of symptoms, at the moment, many experts do not consider the subacute form, although earlier it was considered a harbinger of chronic adnexitis or the result of an undertreated acute one.

Diagnostics

Without consulting a doctor, it is impossible to carry out independent and symptoms (mainly), and the realization of the fact that, due to the circumstances (for example, unprotected sex with an unfamiliar man), diseases of the genital organs may occur, should lead the woman to an appointment with a gynecologist. This is necessary at least in order to determine the cause of the appeared purulent discharge and pain.

In acute and subacute forms of adnexitis, the doctor first of all conducts a differential diagnosis, which allows you to exclude from the anamnesis:

Acute appendicitis.
Ectopic pregnancy.
Peritonitis.
Rupture of the ovaries.

A woman is assigned tests:

General urine and blood.
Biochemical blood.
Vaginal smear.
Ultrasound of the pelvic organs.
Laparoscopy.
tuberculin test.
Sonography (determines thickenings in the fallopian tubes).
Hysteroscalpinography (determine the patency in the pipes).
Vaginal ultrasound.

Acute treatment

The doctor prescribes the treatment of adnexitis based on the test results and symptoms. At home, a woman will have to follow all the recommendations of her gynecologist. Often, the course of therapy includes intramuscular and intravenous injections, for which the patient will have to visit the manipulation room in the clinic. In many cases, adnexitis is treated in a hospital. This applies primarily to pregnant women who undergo therapy only in a hospital.

Since the disease is caused by the penetration of microbes into the appendages, the main direction of treatment is antimicrobial therapy. To prescribe an effective drug, it is necessary to test for bacterial resistance to antibiotics, but in practice this is not always done. Basically, the treatment is carried out according to the established scheme. For antibiotic therapy, drugs are used:

Penicillins ("Oxacillin", "Ampicillin").
Tetracyclines ("Doxycycline", "Tetracycline").
Fluoroquinolones ("Oflaxacin" and analogues).
Macrolides ("Erythromycin", "Azithromycin").

Anti-inflammatory drugs and biogenic stimulants are also prescribed:

"Sulfadimethoxin".
Biseptol.
"Plasmol".
"Vitreous body".

Homeopathic treatment of adnexitis, the symptoms and course of which indicate an acute form, is not performed, since the very concept of "homeopathy" means therapy in small doses, that is, very moderate.

As an integrated approach to treatment, patients are prescribed physiotherapy procedures (electrophoresis, UHF, mud therapy).

Treatment of the chronic form

Doctors say it's much easier to treat the acute form when the germs are active than when they are "sleeping."

In the treatment of exacerbations of chronic adnexitis, the same antibiotics are used, the list of which is given above. During the period of remission, maintenance and restorative therapy is performed without the use of antimicrobials. In the chronic form, homeopathy is also successfully used to treat adnexitis. The symptoms of the disease with a sluggish course are strongly lubricated, last for a long time. Many women get used to them and no longer pay attention to them. Homeopathic remedies made from natural ingredients can have a therapeutic effect when taken for an arbitrarily long time without adversely affecting the patient's body.

In the chronic form of inflammation of the appendages, physiotherapy procedures are very useful, as well as visits to resorts and sanatoriums.

Symptoms of adnexitis in women and treatment with candles

With all forms of the disease, candle therapy brings a very tangible effect. Their action is aimed at the destruction of microbes and the removal of inflammation.

The benefit of suppositories is that they act bypassing the gastrointestinal tract, thereby not irritating its mucous membranes.

For therapeutic effects, suppositories are placed in close proximity to the focus of inflammation. Despite the obvious advantages of these drugs, you cannot use them on your own initiative, since even candles have their own contraindications. Only the attending gynecologist should prescribe them.

Depending on the type of effect on the inflamed mucous membranes of the appendages (relieve inflammation, pain, fever, itching in the genitals) and symptoms, the treatment of adnexitis in women with candles is prescribed either with their rectal or vaginal administration. Drugs are used:

"Voltaren". Rectal suppositories. Able to eliminate systemic pathologies in many organs. Detrimental to microbes, have an analgesic effect. You can use them in the morning and evening.
Movalis. Rectal suppositories. They have anti-inflammatory and analgesic effects. Use 1 time per day.
"Hexicon". Vaginal suppositories. They are allowed to be used by pregnant women. They have anti-inflammatory and antibacterial effects.
Fluomizin. Vaginal suppositories. Helps to get rid of many types of bacteria. Used 1 time per day.
"Indomethacin". Rectal suppositories. They have analgesic, anti-inflammatory effects.
"Polygynax". Vaginal suppositories. They have anti-inflammatory, antifungal effect.

Each of these medications has contraindications and side effects. So, "Hexicon" (according to the reviews of patients) in pregnant women can create a threat of miscarriage, "Indomethacin" - severe intoxication and a noticeable burning sensation in the anus, "Movalis" is inconvenient to use, as it leaks a lot.

ethnoscience

With symptoms of adnexitis, treatment and folk remedies can help alleviate the condition, which is why it is welcomed by many doctors. However, one should not completely rely only on the recipes of healers. Therapy with decoctions and infusions should take place as part of a comprehensive treatment.

Physicians from the people advise:

Tampons with aloe juice and cabbage. They are placed overnight in the vagina.
Take mummy inside. Now such a drug can be bought in ordinary pharmacies. It is produced in tablets. You need to drink them on an empty stomach, drink milk or juice.
Brew teas from chamomile, St. John's wort, sage, Ivan-tea, boron uterus. These herbs can be used alone or combined. You can combine chamomile, St. John's wort, sage.
Do sitz baths. To do this, prepare a decoction of marshmallow, oregano, oak bark. Take dry herbs in a ratio of 1:4:6 (teaspoons), brew 1 liter of boiling water. A warm bath is done twice a day.

Patients' opinions

There are many reviews about adnexitis in women, symptoms and treatment of the disease. Those women who happened to face this problem share their memories of their feelings during the disease, tell how the diagnosis was carried out, and report on the treatment that helped them. Based on these reviews, we can conclude that adnexitis is completely cured if all the recommendations of doctors are followed. The course of therapy is not easy. It includes intramuscular and intravenous injections, taking pills, herbal treatment, the use of candles, physiotherapy procedures. Many women who completed the course were able to become mothers. Everyone who started treatment on time returned to a normal happy life without adnexitis.

Adnexitis (salpingoophoritis) is an inflammatory process that involves the appendages (fallopian tubes) and ovaries. In the acute phase, there are: pain in the lower abdomen, which may be stronger at the site of inflammation, symptoms of intoxication, fever. Also, during this period, menstrual function is often disturbed.

For the chronic stage of adnexitis, with recurrent exacerbations, the clinical picture is less pronounced than for the acute one. If timely treatment of chronic inflammation of the fallopian tubes (appendages) is not carried out, the course of the disease can lead to the appearance of adhesions in the appendages, as well as adhesions that cause infertility or ectopic pregnancy.

Development mechanism

The inflammatory process in salpingo-oophoritis provokes an infection that has fallen on the mucous membrane of the appendage, after which the process begins to spread to the muscle and serous layers. As a result, the surrounding tissues are affected: the peritoneum and the ovarian membrane. When ovulation begins, the infection directly penetrates the corpus luteum or follicle, and continues to multiply in the body of the ovary. When the inflammatory process covers the ovary and the appendage, then after a while they become soldered, as a result of which the patency of the appendages is limited.

Causes

The causes of chronic adnexitis can be different, as well as its symptoms and treatments. Most often, the onset of the disease is affected by a mixed microflora, which includes such pathogens as: enterococcus, gonococcus, chlamydia, Escherichia, tubercle bacillus, Staphylococcus aureus, E. coli and others.

This microflora easily attaches to spermatozoa or sticks to Trichomonas, using them as a transport to penetrate into the appendages and ovaries. There is also the possibility of infection without "intermediaries" - with a combination of certain factors.

If there is an E. coli or tubercle bacillus in the body, then infection can be introduced into the appendages through the blood or lymph.

Factors that can provoke inflammation can be abortions, the presence of an intrauterine device, postpartum complications, previous gynecological operations. Do not lose sight of the hereditary factor. It should be noted that with menopause, salpingo-oophoritis does not occur.

Symptoms

Salpingoophoritis, according to the nature of the course of the disease and symptoms, can be divided into 2 forms:

Chronic adnexitis (which may worsen).
Acute adnexitis.

Chronic adnexitis

This pathology is a consequence of acute salpingo-oophoritis. Previously, when diagnosing, they put such a form as subacute adnexitis, and considered it to be not treated acute. Now only chronic inflammation and acute are diagnosed.

Inflammation of the appendages can be: left-sided, right-sided and bilateral. Based on the complaints that can be heard from patients, we can name the main signs of chronic adnexitis:

complaints of a permanent nature, dull pain that occurs before the onset of menstruation or during, as well as during hypothermia. Pain with adnexitis can be given to the sacrum, to the perineum or vagina, to the lumbar;
the appearance of minor secretions of a mucous nature, the number of which increases with exacerbation;
menstrual dysfunction occurs: menstruation becomes painful and irregular, long and profuse, and may stop altogether;
violation in sexual life: libido decreases, pain appears during sexual intercourse. These disorders are caused by a violation of the functionality of the endocrine glands due to pathological changes in the ovaries (ovarian hypofunction);
with exacerbation of chronic salpingo-oophoritis, the temperature can reach 38-39 ° C;
infertility (pregnancy does not occur for 1 year or more, with regular intercourse without the use of contraceptives);
disorders of the nervous system (fatigue, insomnia, chronic fatigue, irritability, mood volatility);
the appearance of concomitant diseases (vaginal dysbiosis, adhesive processes, and others).

Acute adnexitis

The main signs of the acute phase of salpingo-oophoritis include:

pain in acute adnexitis is pronounced, and is localized in the lower abdomen. With right-sided salpingoophoritis, severe pain can be mistaken for an attack of appendicitis;
an increase in temperature to high rates (38 ° C and above), while there is severe sweating and chills;
violation of urination;
lack of menstruation (menstruation may be absent or very scarce);
symptoms of intoxication (nausea, vomiting);

Diagnostics

Before treating the above pathology, it is necessary to go through the following research steps:

examination by a gynecologist. When feeling the uterus with both hands, painful areas are found at the locations of the ovaries. If you feel pain on both sides, you can assume the presence of bilateral adnexitis. If the patient has already entered menopause, then other causes of pain should be sought, since the occurrence of salpingo-oophoritis during this period is unlikely;
taking and examining smears from the cervical canal for cytology. This test should be carried out for all women when they begin sexual activity. The microflora is examined with a microscope, which reveals possible changes in the cellular composition of the mucous membranes, which is especially important in the early diagnosis of oncology;
taking smears from the vagina for bacteriological examination. The purpose of the analysis is to identify infectious agents that cause inflammation of the appendages. Sometimes it becomes necessary to conduct a study to determine the level of antibodies to certain types of viruses;

Ultrasound of the pelvic organs and kidneys. This study may show that the ovaries are enlarged and blurred;
MRI and CT are performed if necessary, mainly to clarify the diagnosis;
if the diagnosis gives uncertain results, then in such cases laparoscopy is performed. The essence of the method is that a special probe with a camera is inserted into the abdominal cavity through a small hole. This diagnostic method allows you to examine in detail and study the state of the uterus, ovaries and appendages.

Treatment Methods

Treatment of chronic salpingo-oophoritis, as well as acute, is carried out in different ways, depending on the intensity of the disease.

acute form

Treatment of an acute form of inflammation of the appendages is carried out strictly in a hospital, under the close supervision of medical staff (staying in the hospital can take 1 month). A woman must comply with bed rest and a special diet. At the same time, about 4 times a day, a heating pad with ice should be applied to the lower abdomen.

With a pronounced inflammatory process, antibiotics of priority groups are used:

penicillins and combinations thereof;
tetracyclines;
cephalosporins II and III generation;
aminoglycosides (kanamycin, amikacin and gentamicin). The negative effect of these drugs on the auditory nerve and kidneys should be taken into account.
a more modern method is macrolides (spiramycin, clarithromycin, azithromycin);
fluoroquinolones (ciprofloxacin, ciprolet, etc.)
after 5 days of antibiotic treatment, antifungal agents (nystatin, fluconazole and others) are prescribed;
in severe cases, antibiotics are injected into the appendages themselves. The puncture is carried out through the posterior fornix of the vagina;
with severe pain, it is advisable to prescribe painkillers - analgesics (nimesulide, analgin, etc.);
acute salpingo-oophoritis is considered a pathology of a serious nature, if left untreated, death can occur. Therefore, intensive treatment of chronic adnexitis should be prescribed - anti-inflammatory therapy in combination with measures that reduce intoxication.

Chronic form

How to cure chronic adnexitis? Since this form of the disease is not as intense as the acute one, and can proceed with smoother symptoms, the treatment will be carried out by other methods:

in the treatment of chronic adnexitis, autohemotherapy is often prescribed. The essence of the method is the reverse introduction of venous blood into the muscle. Such therapy causes stimulation of the body's defenses, thereby reducing the likelihood of recurrence of the disease. Autohemotherapy is often combined with calcium supplementation.
with an exacerbation of chronic adnexitis, antibiotics from the nitrofuran group (5-NOC or nitroxoline) may be prescribed by a doctor. These drugs remove the infection of the urinary system, and thereby prevent the occurrence of inflammation;
if necessary, therapy is carried out for infectious diseases caused by bacteria or viruses, as well as concomitant, previously treated or not - pathologies (cervical leukoplakia, adhesive disease, fibroids);
if in the appendages, with chronic adnexitis, obstruction begins to form, drugs that have a resolving effect are used: aloe extract, lidase, trypsin, plasmol and others). The appointment of these drugs is especially important if the patient is planning a pregnancy. Also, these funds are able to restore the menstrual cycle;
in situations where conventional anti-inflammatory therapy, with chronic adnexitis, does not work, the doctor may prescribe hormonal (glucocorticosteroid) drugs. But it should be borne in mind that such treatment can cause a lot of side effects. Also, they should not be taken against the background of cervical leukoplakia, as hormones can provoke unwanted cell division.
upon the onset of the remission stage, when salpingo-oophoritis can be considered cured, vitamins are necessarily prescribed: C, E, B1 and A. It is also possible, in some situations, to use multivitamins.
if salpingo-oophoritis is accompanied by diseases of an inflammatory nature, the cervix and vagina, douching with antiseptic compounds and suppositories with anti-inflammatory action can be used;

Physiotherapy

During the acute phase of the course of the disease, physiotherapeutic methods are used:

UHF on the ovarian area;
blood irradiation with a laser;
oxygen therapy in a pressure chamber (oxygenobarotherapy).

When the acute phase of unilateral or bilateral adnexitis begins to pass, you can use:

electrophoresis with copper, magnesium, iodine and zinc on the area where the appendages are located. This procedure treats chronic inflammation of the appendages well, and primarily reduces the production of estrogens, relaxes muscle spasms, and prevents the formation of adhesions;
inductothermy is a method of deep heating of tissues under the influence of a high-frequency magnetic field. This procedure has a vasodilator, anti-inflammatory, bacteriostatic, analgesic, resolving, relieving spasms, as well as improving chronic adnexitis treatment, action;
ultrasound therapy in pulsed mode.

Local treatment

In the treatment of gynecological diseases, the introduction of therapeutic compounds into the vagina is often used:

using a special tube with 2 lumens, the doctor injects decoctions of various medicinal herbs deep into the vagina. As a decoction, you can use: acacia or chamomile flowers, eucalyptus leaves. The course lasts at least 10 days;
after applying a decoction of medicinal herbs, a swab soaked in a solution of dimexide with water is inserted into the vagina in a ratio of 1: 3. An antibiotic and a resolving agent (lidase, trypsin) are added to this solution. This therapy has a beneficial effect on the vaginal mucosa.