In the organs of the female reproductive system, many ailments can occur. Some of them, for example, malignant tumors, are fatal. Others lead to a fatal outcome in isolated cases, but without proper treatment, they cause serious complications, depriving a woman of a normal life and the opportunity to become a mother. Such diseases include endometritis, endometriosis, adnexitis. Symptoms are different. But there is a common symptom - pain in the lower abdomen. Endometritis is an inflammation of the endometrium, that is, the internal mucous layer of the uterus, which can occur both in women who have not given birth and in children. Moreover, endometrial inflammation is often provoked precisely by childbirth and abortion. Endometriosis is an ailment in which the endometrium is not just 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 disease adnexitis, symptoms at different stages of its course, treatment principles, the consequences to which it can lead, as well as signs that distinguish it from other diseases of the female reproductive organs.
general description
Another name for adnexitis is salpingoophoritis. This difficult-to-pronounce medical term is formed by the fusion 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 fallopian tubes and ovaries. But this term is rarely used. Most authors and medical publications prefer the shorter name of the disease - adnexitis.
Symptoms of this ailment that occurs on the left and right of the uterus may vary slightly. They can also be regarded as signs of completely different diseases that are 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 inflammation of the appendages. It should be noted that there are appendages of the uterus (fallopian or fallopian tubes and ovaries) and ovaries (include the rudimentary remains of the primary kidney and its ducts). When they talk about salpingo-oophoritis, 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:
Depending on the localization, these types of adnexitis are distinguished:
- Right-handed.
- Left-handed.
- Double sided.
- Mostly affected ovaries.
- Mostly affecting the fallopian tubes.
Depending on the nature of the inflamed tissue, adnexitis occurs:
Causes of occurrence
In most cases, inflammation in the appendages occurs due to the penetration of pathogenic microorganisms into their mucous membranes.
Any microbe that 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
- E. coli.
- Mycobacterium tuberculosis.
- Candida.
- Chlamydia
- Mycoplasmas.
- Treponema pallidum.
- Gardnerella.
These germs 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 lymphatic flow).
- Hematogenous (with blood flow). Most often, the fallopian tubes and ovaries infect tubercle bacilli that enter the blood from the lungs. But from other organs, various bacteria and viruses (Pseudomonas aeruginosa, herpes virus, enterococci, pneumococci, clubbsiella) can arrive in the organs of the female reproductive system.
Due to the fact that specific drugs must be selected to get rid of the disease (the destruction of various forms of microorganisms), it is impossible to treat adnexitis without the advice of a doctor. In women, the symptoms and signs of an ailment can reduce their manifestation, which, perhaps, will mean the transition of the acute form to a chronic, and not a cure. Therefore, courses of therapy are most often carried out in a hospital environment in order to regularly monitor how recovery is going.
For what reasons acute adnexitis may begin
The above list of microorganisms that can cause inflammation of the uterine appendages eloquently suggests 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 self-medicating, following the advice of "experienced".
If the bacteria that cause sexually transmitted diseases get into the vagina, sooner or later they will surely get to the fallopian tubes, through which they penetrate the ovaries. This should be understood by all women.
The cervix, being closed by means of the lower pharynx, inhibits the penetration of any infection from the vagina into the reproductive organs. But the pharynx is revealed during the period of 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:
- Immunity reduction.
- Stress.
- Chronic fatigue.
Another way contributing to the appearance of adnexitis is through operations on the digestive 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 with microorganisms. The manifestation may not begin suddenly, as in some other diseases (for example, appendicitis, shigellosis, flu). Often the acute form lasts several months. A woman observes a violation of the menstrual cycle, the appearance of signs of cystitis (frequent and painful urination), pains in the lower abdomen that appear 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 and right are slightly different. Very often bilateral adnexitis is observed 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, giving out to the anus and vagina. On palpation, the abdominal muscles under the navel become tense, discharge increases, and increased leukocytosis is detected in the blood.
If adnexitis is on the right, symptoms are expressed in pain on the right side, which can be mistaken for attacks of appendicitis. You can distinguish these two ailments by additional signs. So, with appendicitis in most cases, vomiting, nausea is observed. For inflammation of the appendages, this is not characteristic, but with adnexitis, women almost always experience pain during intercourse and discharge is observed (profuse leucorrhoea with impurities of pus, and sometimes blood). Exclude appendicitis should be a surgeon.
With adnexitis on the left, women experience pulling pain, respectively, on the left side of the navel. They almost always intensify during intercourse, menstruation, ovulation.
In addition to pain and discharge, the symptoms of acute adnexitis are as follows:
- Prostration.
- Heat.
- Headache.
- Lack of appetite.
- Overwork.
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 either side and profuse purulent discharge, you should immediately consult 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 copious 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 consider below, is fraught with irreversible pathological changes in the reproductive organs of women.
This process usually begins with the mucosa of the fallopian tubes. Further, even in the acute form of the course of the disease, inflammation passes to muscle tissue. As a result, the fallopian tubes become swollen. Doctors can observe this when examining a woman on a gynecological chair and when palpating the problem area of the lower abdomen.
Without treatment, microbes penetrate further into the ovaries, and together with serous fluid, into the peritoneal tissue, causing their suppuration.
Meanwhile, in the fallopian tubes, the process of adhesion occurs, adhesions form. They are a very important symptom of chronic adnexitis of the right and left, depending on where the focus of inflammation is observed. Adhesions in the fallopian tubes are one of the causes of infertility that 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 in the region of 37 degrees Celsius.
- Dull or aching pains in the side where the inflammatory process takes place (lower abdomen with bilateral adnexitis). These sensations intensify during menstruation, during physical exertion, during intercourse.
- Discharges may be present, but their number is not critical, so many women do not attach importance to them.
- An elevated ESR always occurs in a blood test.
Relapses can be caused by any condition that reduces immunity, hypothermia, as well as various diseases (not gynecological) that a woman has.
In relapses, the symptoms of adnexitis in the chronic form are the same as in acute.
Treatment of chronic adnexitis is carried out only in combination. Both medical methods and homeopathy, physiotherapy, herbal treatment are used.
Subacute adnexitis
The transitional form between acute and chronic forms is subacute adnexitis. Symptoms in this case are the same as during an exacerbation of an ailment, but they are slightly less pronounced. In women, I can observe:
- Fever.
- Pain in the lower abdomen from the inflamed area.
- General malaise.
- Bloating.
- Abundant purulent discharge.
- Menstrual irregularities.
- 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 untreated acute.
Diagnostics
Without consulting a doctor, you can not conduct an independent treatment of adnexitis at home. Both symptoms (mainly) and the realization that, due to circumstances (for example, unprotected sex with an unfamiliar man), genital diseases can occur, should lead the woman to 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 differential diagnosis, which allows to exclude from the anamnesis:
- Acute appendicitis.
- Ectopic pregnancy.
- Peritonitis.
- Ovarian rupture.
A woman is assigned tests:
- Common urine and blood.
- Biochemical blood.
- Smear from the vagina.
- Ultrasound of the pelvic organs.
- Laparoscopy
- Tuberculin test.
- Sonography (determines thickening in the fallopian tubes).
- Hysteroscalpinography (determine patency in the pipes).
- Ultrasound vaginal.
- MRI
Acute treatment
The doctor prescribes adnexitis treatment based on the testimony and symptoms. At home, a woman will have to follow all the recommendations of her gynecologist. Often, intramuscular and intravenous injections are included in the course of therapy, 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 penetration into the appendages of microbes, 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 the case. Basically, the treatment takes place according to the proven scheme. For antibacterial therapy, drugs are used:
- Penicillins ("Oxacillin", "Ampicillin").
- Tetracyclines (Doxycycline, Tetracycline).
- Fluoroquinolones (Oflaxacin and its analogues).
- Macrolides (Erythromycin, Azithromycin).
Anti-inflammatory drugs and biogenic stimulants are also prescribed:
- "Sulfadimethoxin."
- "Biseptolum."
- "Plazmol."
- "Vitreous body."
Treatment with adnexitis homeopathy, the symptoms and nature of the course of which indicate an acute form, are not performed, since the very concept of “homeopathy” means low-dose therapy, that is, very moderate.
As an integrated approach to treatment, patients are prescribed physiotherapeutic procedures (electrophoresis, UHF, mud therapy).
Chronic treatment
According to doctors, it is much easier to treat the acute form when microbes are active than when they “sleep”.
In the treatment of exacerbations of chronic adnexitis, the same antibiotics are used, the list of which is given above. During remission, supportive and restorative therapy is performed without the use of antimicrobials. In the chronic form, homeopathy has been successfully used to treat adnexitis. Symptoms of the disease with a sluggish course are very lubricated, lasting a long time. Many women get used to them and no longer pay attention to them. Homeopathic remedies made from natural ingredients can give a therapeutic effect when taken for an arbitrarily long time, without exerting a negative effect on the patient's body.
In the chronic form of inflammation of the appendages, physiotherapeutic procedures are very useful, as well as visits to resorts and sanatoriums.
Symptoms of adnexitis in women and candle treatment
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 use 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 a treating 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 suppositories is prescribed either with their rectal administration or with vaginal. Used drugs:
- Voltaren. Rectal suppositories. They are able to eliminate systemic pathologies in many organs. Fatal to germs, 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. Allowed their use by pregnant women. They have anti-inflammatory and antibacterial effects.
- "Fluomizine." Vaginal suppositories. They help get rid of many types of bacteria. Used once a 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, “Geksikon” (according to patients' reviews) 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 strongly follows.
ethnoscience
With the symptoms of adnexitis, treatment and folk remedies can help alleviate the condition, therefore it is welcomed by many doctors. However, one should not rely solely on the recipes of the healers. Therapy with decoctions and infusions should take place as part of a comprehensive treatment.
Doctors from the people advise:
- Tampons with aloe juice and cabbage. They are placed at night in the vagina.
- Take the mummy inside. Now such a drug can be bought at ordinary pharmacies. It is available in tablets. They need to be drunk on an empty stomach, washed down with milk or juice.
- Brew tea from chamomile, St. John's wort, sage, Ivan tea, pine forest uterus. These herbs can be used separately or to make fees. You can combine chamomile, St. John's wort, sage.
- Do sitz baths. , , . 1:4:6 ( ), 1 . .
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