Endometritis is an inflammatory disease of the endometrium that affects the inner layer of the uterine mucosa. Quite often, endometritis occurs in conjunction with the inflammatory process of its muscle layer. The ICD-10 code for chronic endometritis is N71.1.
During the menstrual cycle, the endometrium changes in the structure, which grows anew after each rejection, so that the substrate is prepared for a fertilized egg. The norm is the uterine cavity, which is lined with endometrium. Thus, it protects against any infections. However, under certain conditions, one can still observe the entry of an infectious pathogen directly into the uterus, which subsequently develops as an inflammation of its inner layer. Ultimately, acute or chronic endometritis begins to develop, the ICD-10 code of which is N71.1.
Features of the disease
Endometritis often provokes a miscarriage, is the cause of infertility, failure in IVF, and also manifests itself in the form of all kinds of complications during pregnancy, during childbirth. In some cases, the disease can lead to complications even in the postpartum period. Therefore, it is not always possible to say with certainty whether pregnancy takes place after chronic endometritis. In order to accurately answer this question, a specialist must conduct a series of examinations.
The number of cases of development of endometritis, proceeding in acute form, is about 2% of all gynecological diseases. As for chronic endometritis, this disease occurs in 14% of cases. It is the chronic form that poses a real threat to women's health. Even moderate chronic endometritis can provoke infertility in women.
However, most often diagnosed with postpartum endometritis, which develops in almost 20% of cases with independent childbirth, as well as in 40% of cases after cesarean section.
Development reasons
Before considering the treatment regimen for chronic endometritis, it is necessary to understand the causes that provoke this ailment. The main reason lies in damage to the structure of the endometrial layer, as well as infection. In addition, in the development of the disease, a special role is played by the reduction of the barrier mechanism of local protection, which would prevent the entry of various harmful bacteria into the internal genital organs. Infectious agents can be distributed in several ways:
- Hematogenous.
- Lymphogenic.
- On the ascending path, the route of which lies from the vagina or from the cervical canal.
Depending on the causative agent, the disease is divided into two main groups:
- Specific, which is associated with the reproduction in the uterus of various pathogenic organisms: fungi, bacteria, protozoa, parasites, mixed flora and viruses.
- Nonspecific, which is caused by the use of the intrauterine device, disturbances in the functional state of the microflora, irradiation of the zone in the projection of the uterus, and hormonal failure.
In general, the following categories of women are affected by this ailment:
- Patients who have ever suffered a miscarriage or have an abortion.
- Women who are in the period of menstruation. Since the uterus has a wound surface from the inside, blood secretions wash off the secret of the specular canal, which provokes alkalization of the mucous membrane in the vagina, as well as a decrease in its protective functions. For the same reason, endometritis begins to develop after menstruation.
- Those women who have ever had traumatic injuries that can result from curettage, after performing a probe in the uterine cavity, during hysterosalpingographic examinations, during a biopsy, if the technique of douching was violated, as in this case mechanical damage or chemical and thermal burn.
- Women who wear an intrauterine device. The fact is that the spirals that have been in the uterus for a long time are a source of inflammation, and also contribute to the infection getting along the threads in an ascending way. Therefore, endometritis disease is considered an indication for removal of the intrauterine device.
- All patients who once suffered birth tears or had complications in the form of wound infection.
- Women who suffer from chronic inflammation of the cervix.
- Patients with a history of bacterial vaginosis or candidiasis.
- Women who once suffered an STD.
- Patients who carry genital herpes virus or cytomegalovirus.
- Those women who have fibroids or uterine polyps.
- Those patients who do not observe the hygiene of the genitals.
- Women who use tampons, which they change less often than every 5 hours. It is important to note that if you do not follow the rules for using tampons, this can lead to the development of toxic shock syndrome.
- Those women who experience chronic stress can weaken the body and increase the risk of infection.
Before embarking on a treatment regimen for chronic endometritis, it is necessary to identify the main cause of the development of this disease.
Clinical picture
As mentioned earlier, according to the nature of the course, the disease is divided into two main forms: chronic and acute. It is worthwhile to become more familiar with both varieties of this ailment.
Acute endometritis
The development of this disease is facilitated by all the factors listed above. Therefore, oral history taking will help the attending specialist greatly facilitate the diagnosis. Symptoms of the disease, as a rule, appear already in the first week after carrying out diagnostic manipulations, abortion, childbirth and so on. With the development of acute endometritis, patients should pay attention to certain symptoms, which are as follows:
- Headache, general well-being, loss of appetite.
- Increase in body temperature to 39 degrees.
- Aching and drawing pains localized in the lower abdomen. They can be expressed to a lesser or greater degree, and also give to the zone of the lower back and sacrum.
- Discharges that have an unpleasant odor that look like a mixture of blood and pus.
- Quite rarely, but still there is uterine bleeding.
It is important to note that the treatment regimen for chronic endometritis or acute should be prescribed immediately after the diagnosis. At the same time, therapy is aimed at combating the infection and preventing possible complications.
The acute stage of the disease, on average, lasts for one week or a little more. As a rule, patients can easily cure this disease if they follow the recommendations of a specialist regarding therapy.
Chronic endometritis
Before you study the treatment regimen for chronic endometritis, you should familiarize yourself with the symptoms of this form of the disease. As a rule, the chronic form is considered the result of improper treatment of acute endometritis or the absence of therapy for the disease. Symptoms of chronic endometritis are as follows:
- Long and irregular menstruation.
- A significant change in the amount of discharge during critical days.
- Increased soreness during menstruation.
- Changes in the shade of menstrual flow, which turn brown due to the presence of purulent contents.
- Change in the nature and shade of the secretion of the vagina, as well as the uterine neck. The secret becomes a greenish tint and foamy.
- Perhaps bleeding from the penis, which is observed outside the menstrual period.
In this case, it is worth paying attention to the fact that the degree of the course of this process will be determined by the duration and depth of the developed changes in the structure of the endometrium. To achieve successful remission of chronic endometritis, it is necessary to seek the help of a specialist in time when the first signs of pathology appear.
Diagnostics
Diagnosis with different forms of endometritis will also be different. Diagnostic methods of the acute process are based on the following points:
- A thorough history.
- Analysis of patient complaints and symptoms.
- Gynecological examination, during which the size of the uterus, soreness, discharge, which can be serous-purulent or sucrose, is revealed.
- General blood test data.
- Information obtained after the ultrasound procedure.
- Results of smear bacterioscopy.
Speaking about whether chronic endometritis can be cured, it should be noted that for successful therapy it is necessary to undergo a diagnosis in time. Diagnosis of a chronic form involves the following procedures and tests:
- Hysteroscopy, ultrasound, during which signs of hemorrhage, fibrous adhesions, growths of the cystic nature, including polyps, thickening of the uterine mucosa, and also signs of inflammation of the myometrium are detected.
- Immunocytochemical analysis, which gives very accurate results.
- Diagnostic curettage.
- Bacterioscopy.
- Histological examination.
Treatment features
Thanks to modern medicine, it is possible to successfully treat chronic endometritis, reviews of patients and doctors confirm this. However, in order to completely overcome this disease, therapy should be comprehensive. Many have already cured chronic endometritis. Reviews from these women suggest that treatment is based on:
- Immunomodulating therapy.
- The use of antifungal, antiviral, antiparasitic drugs. The most effective of them are Terbinafine, Flucostat, Clotrimazole.
- Fortifying procedures.
- Physiotherapeutic methods of treatment.
- Hormone therapy.
- Sanatorium therapy.
Phased therapy
Therapy for this unpleasant disease should be carried out in stages. It will look like this:
- Elimination of the main causative agent of the development of the disease or a maximum decrease in its activity.
- Restoring the normal state of the endometrium, for which the hormones estradiol and progesterone are used, as well as metabolic preparations, for example, Inosine, vitamins, calf blood hemoderivative, ascorbic acid.
- Drugs are taken that can restore metabolism.
- In parallel with this, absorbable preparations are prescribed, for example, aloe in ampoules or "Longidaza".
In chronic endometritis, the treatment regimen plays an important role, so it must be followed.
The use of folk remedies
It is worth paying attention to the fact that for the treatment of this disease, the use of folk remedies should be carried out in combination with the main therapy. As folk remedies for the treatment of chronic endometritis, baths are used, made on the basis of tinctures from medicinal fees. To do this, 6 tablespoons of the drug collection must be poured with two liters of boiling water, put on fire, boil over low heat for a quarter of an hour. After that, remove the container and put it overnight in a warm place. After 3 weeks, you can already observe the effect of such treatment. A lasting result can be achieved with prolonged and regular use of the product.
Compositions of herbal infusions
Mix 50 g of cuff leaves, birch leaves, geraniums, blueberries, oak bark, tansy, violet and chamomile flowers.
Mix 50 g of calendula, the root of the serpentine mountaineer, plantain, yarrow, repeshka, thyme and bird cherry fruit.
Mix 50 g of wormwood, marshmallow root and aspen buds.
Mix 50 g of leaves of fireweed, incense root, violet and lavender.
Mix 50 g of flax seeds, viburnum bark, celandine grass, clover and horsetail flowers.
Mix 50 g of nettle, birch leaves, bird cherry, coltsfoot, coriander and juniper fruits.
Mix 50 g of St. John's wort, moron root, meadowsweet, calendula, dandelion root, mint, blueberry leaves.
It is worth paying attention that before using the collection for the treatment of focal chronic endometritis, it must be carefully ground.
Features of prevention
In order to prevent this disease, experts recommend that you always follow the rules of personal hygiene of external organs related to the genital area, especially with regard to the period of menstruation. You should also always protect yourself to prevent the onset of an unplanned pregnancy, as a result of which abortion often occurs. In order to avoid STD infection, an additional condom must be used. In addition, it is important to prevent postpartum infection, as well as infection after abortion.
In conclusion, it is worth noting that chronic endometritis is a dangerous disease, since the lack of treatment can provoke infertility in women. Therefore, when the first signs and symptoms appear, you must immediately contact a medical institution.