Salpingo. That it is a chronic, bilateral, acute, symptoms, diagnosis, treatment, causes of women

In gynecological practice is quite common inflammatory diseases of the various structures of the reproductive system. One of the most common and most important is salpingo. Every adult woman is important to know what it is and how it is shown, since the pathology can occur at any age and can have serious health consequences.

What is salpingo

Oophoritis (adnexitis) - this infectious inflammatory changes in the uterine appendages (ovaries, fallopian tubes, and ligaments), resulting from exposure to pathogenic microflora. Initially affects the fallopian tubes, and then joined to inflammation of the ovaries.

Salpingo accompanied by swelling of the ovaries and the accumulation of these muco-purulent content. Salpingo causes abnormalities in the reproductive system, due to obturation of the fallopian (uterine) tubes. Because of this, the egg hard to penetrate into the uterine cavity, which leads to the development of pregnancy, localized outside the uterine cavity.

Causes and factors of development

The main etiological factor in the occurrence salpingoooforita is the introduction of the infectious agent in the mucous membranes of the uterine appendages.

The main pathogens causing oophoritis, are:

1. staphylococcal and streptococcal flora;
2. E. coli;
3. chlamydial infection;
4. gonococcal pathogen;
5. Koch's bacillus.

Pathogens first 2 groups fall into ascending path appendages and tubercle bacillus - hematogenous route of infected foci (with blood in pulmonary tuberculosis, intestine, kidney)

Risk factors include women of reproductive age:

• fatigue;
• a sharp decline in the state of immune defense;
• sexually transmitted diseases;
• frequent change of sexual partners;
• poor diet;
• chronic fatigue.

ATThis category also includes women:

• undergone supercooling ;.
• recently undergone an abortion;
• often exposed to stressful situations.

Salpingo - it is a woman's disease, is an acute and chronic form may lead to serious health problems in women (adhesions, chronic pelvic pain), and even infertility.

development mechanism

There are several mechanisms of disease development. The most common infections are appendages of the ascending and descending pathways. Ascending path characterized by penetration of pathogenic bacteria from the lumen of the uterus from the vagina fallopian tubes of the cervix channel.

Pervasive inflammatory-exudative process involves all the walls of the fallopian tubes with the development of salpingitis, and then affects the whole structure of the ovary develops oophoritis. Later in the process it goes to the mother ligaments and develops salpingo.

Leading role for chlamydial and gonococcal pathogens. They provoke the formation of inflammatory fluid that accumulates in tubular structures of the uterus and may cause adhesion (blocking) and obstruction of the lumen of the fallopian tube. This in turn causes the formation saktosalpinskov - saccular "balls" in the cavity of the fallopian tube.

Accumulations mucopurulent fluid leads to the development piosalpinks (pus in the pipe). If the fluid is serous in nature, that develops hydrosalpinx.

Microbe enters the ovarian tissue, produces toxins that contribute to the formation of purulent cavities - abscesses. These abscesses can merge with each other and melted ovarian tissue. Ovary takes the form of a bag filled with pus.

Untreated progressive and long oophoritis tubo-ovarian abscess may occur. With such a combination occurs abscess piosalpinks with ovarian abscess. When you break an abscess infectious agents penetrate into the abdominal cavity, namely in the pelvic cavity.

This leads to the formation of pelvioperitonita - inflammatory changes in the pelvic peritoneum. Untreated captured and other parts of the abdominal cavity. Late diagnosis pelvioperitonita can lead to interintestinal abscesses, purulent inflammatory changes recto-uterine pouch.

Niskhodyashy path is to spread pathogens from colon structures of the peritoneum, or lymphogenous way. Most often this inflammation blind and sigmoid colon.

If you frequently change partners and sexual intercourse during the menstrual cycle is a high risk of penetration of microorganisms into the uterus and its appendages.
Stages and types of oophoritis (adnexitis) - common pathology that causes infertility.

Adrift release:

1. acuteadnexitis - rapidly growing clinical signs of disease.
2. subacuteadnexitis - a moderate increase in clinical symptoms.
3. chronic adnexitis - is a frequent outcome of acute adnexitis in incomplete cure it.

Salpingo classified according to localization. It can be one-sided and double-sided.

symptoms

Salpingo - it is an inflammatory disease of the uterus, including the ovaries, fallopian the pipe and the surrounding tissue, which is common in modern gynecological practice. Clinical symptoms is dependent on the flow and localization.

For acute salpingoophoritis following clinical features are typical:

1. Pain syndrome. Characterized by pain in the lower abdomen of various character (aching, stabbing).
2. Pathology of ovarian-menstrual cycle and impaired fertility appear delayed menstruation, severe pain during menses and copious. decreased libido and desire for sex partner for fear of discomfort and pain during sexual intercourse.
3. intoxication syndromeManifesting a persistent increase in body temperature to febrile figures 38-40⁰, General weakness, nausea, dizziness.
4. pus from the vagina and other genital tract.
5. dizuricheskie disorderCharacterized by intense pain during urination, frequent tenesmus, urinating in small portions.
6. dyspeptic syndrome (Single vomiting, taste perversion).

It's important to know! Clinic acute stage depends on a condition of the immune system and the virulence of the pathogen. If the state of immunity weakened sharply, that the virulence is high, which leads to severe disease.

In acute adnexitis high risk of developing ovarian abscess, tubo-ovarian abscess and pelvioperitonita. This is due to rupture of the fallopian tube and hit its contents into the free peritoneal cavity.

Acute salpingo combines two successive phases:

1. toxic - pronounced intoxication syndrome, the leading role is played by aerobic microorganisms.
2. sepsis - join anaerobic microbes, enhanced clinical symptoms, developing an abscess with subsequent perforation.

Subacute salpingo characterized by less severe clinical symptoms. This step can proceed in both acute and chronic.

chronic salpingo

Salpingo chronic genesis is the outcome of the first two pathological states, if they have not recovered. Characterized by frequently occurring retsividami. They arise because of the stress, hypothermia and physical fatigue.

Chronic oophoritis may have two phases: remission and exacerbation. During remission of clinical manifestations almost not expressed. Adnexitis detect possible only with the help of diagnostic methods.

acute period includes the following symptoms:

1. general weakness, lethargy;
2. the occurrence of pain in the lower abdomen can be periodic or permanent, often unilateral pain;
3. sukrovichnogo selection character from the vagina;
4. hyperthermia.

In addition menstrual cycle can be broken, there are:

• more abundant bleeding of 150-200 ml per day;
• uterine bleeding;
• a small amount of the selected blood during menstruation;
• severe pain during the menstrual cycle.

It is also characterized by pain during intercourse, decreased libido, impaired digestive and urinary functions (by type of colitis, cystitis, pyelonephritis).

Whether happens during pregnancy?

Salpingo - this is the inflammation of the uterus, which can occur during pregnancy. abdominal organs located close to each other. In the presence of inflammation in one organ inflammation may capture and another. Important diagnosis and treatment adnexitis in the early stages of the disease during pregnancy.

This is due to the fact that it can lead to spontaneous abortion, ectopic pregnancy, infection and even death of the fetus.

Diagnostics

If you experience these symptoms should seek to consult a gynecologist in the clinic in the community. After collecting complaints, identify possible causes of the disease, the doctor must conduct a general and gynecological examination.

At the general survey language in patients lined with plaque. When palpation study notes local pain in the lower lumbar column in the pelvic area. Often, the pain may radiate to the back and suprapubic region.

When gynecological examination revealed vaginal and cervical canal sukrovichno-purulent nature. In the study in the mirror can be seen in the increased thickness of the uterine appendages. they are often swollen and painful.

In the formation of abscesses and piosalpinks palpation can feel great in volume, painful "tumor" are not displaced, have indistinct contours and different texture. they often merge with the body of the uterus and form a dense conglomerate.

Basic tests that must be prescribed by a doctor for suspected acute salpingo:

1. Complete blood count (characterized by signs of inflammation: increased levels of leukocytes ≥9 * 10⁹/ L, increase in erythrocyte sedimentation rate ≥12 mm / hour).
   
2. Biochemical analysis of blood (increasing amounts of C-reactive protein, reduction of albumins and globulins).
3. Smear from the vagina and endocervix (increase in white blood cells, the detection of pathogenic organisms, pathogen detection).
4. Bacteriological examination of discharge from the genital tract (detection and identification of the type of pathogen - bacteria, fungi of the genus Candida).

By instrumental methods include:

1. Diagnostic laparoscopy or puncture. This minimally invasive surgery, which is performed under anesthesia by using special tools for the inspection of the pelvic cavity. Use a video camera and instruments for the collection of material and send it to the bacteriological examination. Are assessing the prevalence of inflammatory process, identifying pelvioperitonita, the state of the fallopian tubes, the presence of exudate different character in the pelvic cavity, sealing and flushing the uterus, presence of pus in their lumen, the formation of adhesions., revealing perforation holes.
2. Ultrasound diagnostics allows visualization of the fallopian tubes (they expanded, edematous, may be obturated) inspect small cavity pelvis (identifying purulent and purulent exudate sukrovichnogo, definition of localization of abscesses formed, and their structures).
3. CT scan - Visualization of the abdominal cavity and defining pathological inflammatory foci.

Chronic salpingo difficult to diagnose. Symptoms of chronic adnexitis are not specific to this disease. Pain in the lower abdomen occur in endometrial tumors, pelvic neuralgia. Diagnosis is bimanual pelvic examination, ultrasound and hysterosalpingography conduct.

During a pelvic exam reveals:

• limited movement of the uterus due to a number of adhesions;
• uterine appendages elongated.

Hysterosalpingography visualize adhesions in appendages. Currently rarely used. Also for differintsialnoy diagnosis is diagnostic laparoscopy.

tactics of treatment

salpingoophoritis acute treatment is carried out in stationary conditions. Assign sparing diet with digestible food and liquid (fruit drinks, teas). Create favorable conditions for the patient's mental health. Diet excludes allergenic foods - eggs, chocolate, beets, sweet.

The remission of chronic adnexitis hospital treatment is not carried out. For prophylaxis assigned different physiotherapy.

The stationary phase of deterioration recommended medication. After calming down process continues and the patients are written outpatient treatment.
medication

The main groups of drugs for the treatment salpingoophoritis are:

1. Antibacterial drugs (aimed at destroying the pathogen).
2. Nonsteroidal anti-inflammatory agents (reduce the inflammatory process, have antipyretic and analgesic effects).
3. Desensitizing drugs (inhibit immune and allergic inflammation).

The choice of antibacterial agent depends on the agent. Until then, have not yet reached the results of bacteriological seeding prescribe broad-spectrum antibiotics.

Antibiotics Table:

1. Penicillins - Augmentin, Amoxiclav, oxacillin;

2. Cephalosporins - ceftriaxone, cefepime;

3. Fluoroquinolones - ciprofloxacin, norfloxacin, Avelox;

4. Macrolides and azalides - Erythromycin, Azithromycin.

For anti-inflammatory drugs include ibuprofen, analgin, indomethacin. By desensebilizuyuschim drugs - diphenhydramine, tavegil, suprastin.

local treatment

Local treatment is the irrigation of the vagina through a tube with two lumens. Must be purchased at the pharmacy herb has anti-inflammatory effect (chamomile, eucalyptus, acacia flowers). It is necessary to make a decoction of herbs: 200 g of grass to fill in 1 liter of water. Then, 10 liters of water heated to 40 degrees. Mix all the ingredients. The procedure is performed every day for 7-14 days.

Irrigation can not be performed during the menstrual cycle, as increased cervical permeability of microbial pathogens.

In pregnancy, irrigation is not prohibited, but it must be justified by any significant reasons. With irrigation, without a doctor's advice can infect the fetus, resulting in the formation of his will be broken in the physical plane.

Important! At menopause, some solutions are forbidden. It is necessary to consult a gynecologist, so that it appreciated the state of the mucous membrane of the uterus and the drug selected for irrigation.

Surgery

In the initial stages salpingooforitat laparoscopy is performed for diagnostic purposes. Surgeons perform abdominal lavage antiseptic and antibacterial agents.

With the progression adnexitis and tubo-ovarian abscess formation operation is performed under general anesthesia to remove purulent cavities formed, washing the peritoneal cavity and drainage tubes for setting the full discharge of accumulated pus.

pelvic massage

Gynecological massage is performed as a prophylactic measure. It is conducted in the office of a gynecologist, on the couch or in the gynecological chair. Most often it is carried out, nurses and midwives, doctors less often. A woman seated in the gynecological chair. Nurse disinfects hands, putting on gloves, carries out the disinfection of gloves and genital tract of the patient.

One hand inserted into the vagina, and the second is located in the abdomen. Gentle massage begins to carry out the procedure. After heating nurse doing stretching, pressing and other movements. Patients may feel discomfort and pain. The massage length from 4 to 15 minutes.

Positive massage effects are reduction and improvement of microcirculation vascular lower floor, the acceleration of metabolic processes and prophylaxis of gynecological diseases.

physiotherapy

Physiotherapy aimed at improving the general condition and increase the effect of therapy provided. physiotherapy techniques for each patient are selected individually.

One of the most important methods are:

1. magnetotherapy is the impact of magnetic fields on the human body, and providing a metabolic regeniruyuschey action.
2. Physiotherapy It allows you to improve your condition, improve blood circulation and metabolism of the body.
3. electrophoresis carried out during remission of the disease. The method is based on subcutaneous administration of drugs by the electric current. He has antiotechnoe action.
   
4. Water therapy. Water bath with herbal extracts have anti-inflammatory and immune-stimulating effects.

plasmapheresis

Plasmapheresis - a method of cleaning the blood from bacterial agents and their toxins. After consultation Transfusiologist and in the absence of contraindications (sepsis, allergies, blood clotting disorders, bleeding of various nature) is carried out plasmapheresis. Blood purification is carried out using a transfusion of fresh frozen plasma.

Biostimulyators

Biostimulants - are drugs of plant and animal origin, has a pronounced regenerative effect and rapid epithelialization of damaged cells and tissues. When salpingo use aloe and plazmol.

ethnoscience

In addition to medical and surgical treatment, a specific role for national processes of medicine:

1. Herbal psyllium, flax seed, mint. The same ratio of 5 g pour 300 ml hot water. Must insist 1-2 hours. After the sieve and mixed with 20 g of honey. The resulting liquid was divided into 3 doses and 3 times a day.
2. Anise and honey. 50 g aniseed powder and 200 g of honey mix until homogenous. Taken daily for 1 hour. l. three times a day.
3. Herbal tea from the upland uterus. It should sage, camomile upland uterus and fill in 1 liter of hot water. Insist during the day. Take 1 cup three times a day.
4. Ichthyol compresses with ointment. It is necessary to form of bandage - a tampon, which cause ihtiolovaya ointment. Applying a tampon need on the painful area of ​​the abdomen. After wrap up this place a scarf. Compresses better to do at night.
5. Tampons Sea Buckthorn. On the sterile swab to put the oil of sea buckthorn, enter a tampon into the vagina. It is recommended to carry out the procedure at night for 4-7 days.

complications

At a late diagnosis and adequate treatment of this disease can lead to complications.

It can be:

• pelvioperitonit;
  
• tubo-ovarian abscess;
• infertility;
• ectopic pregnancy;
• violation of ovarian-menstrual cycle;
• reduction or disappearance of libido.

Caused symptoms similar to clinical pathology, should make a woman see a gynecologist. Early treatment and confirmation of the diagnosis allows you to assign an effective treatment that will salpingoophoritis hinder the development of complications and ensure the restoration of disturbed functions in body.

Author of the article: olga6870 (Olga Morozova)

Registration of the article: Lozinski Oleg

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