Diseases Of The Reproductive System

Chronic adnexitis( salpingo-oophoritis)

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

Chronic adnexitis( salpingo-oophoritis)

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

The development mechanism of

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

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Causes of

The causes of chronic adnexitis can be different, as well as its symptoms and therapies. Most often, the appearance of the disease affects the mixed microflora, which can include such pathogens as: enterococcus, gonococcus, chlamydia, escherichia, tubercle bacillus, Staphylococcus aureus, Escherichia coli and others.

This microflora easily attaches itself to spermatozoa or adheres to Trichomonas, using them as transport, to penetrate the epididymis and ovaries. There is also the possibility of infection without "intermediaries" - at the confluence of certain factors.

If the intestinal or tubercle bacillus is present in the body, infection can be introduced into the appendages through blood or lymph.

Chronic adnexitis( salpingo-oophoritis)

Factors that can provoke inflammation can be abortion, the presence of an intrauterine device, postpartum complications, and previous gynecological surgery. Do not overlook the hereditary factor. It should be noted that with climacteric, salpingo-oophoritis does not occur.

Symptoms of

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

  1. Chronic adnexitis( which can exacerbate).
  2. Acute adnexitis.

Chronic adnexitis

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

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

  • complaints of a persistent nature, dull pains that occur before the onset of menstruation or during, and also during hypothermia. Pain in adnexitis can be given in the sacrum, in the perineum or vagina, in the lumbar region;
  • appearance of minor mucous discharge, the number of which increases with exacerbation;
  • causes menstrual dysfunction: menstruation becomes painful and irregular, prolonged and plentiful, and can stop at all;
  • a violation in sexual life: the libido is reduced, pain occurs when the sexual intercourse is committed. 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 sexual intercourse without the use of contraceptives);
  • disorders of the nervous system( fatigue, insomnia, chronic fatigue, irritability, moodiness);
  • appearance of concomitant diseases( dysbiosis of the vagina, adhesive processes and others).

Chronic adnexitis( salpingo-oophoritis)

Acute adnexitis

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

  • pain in adnexitis of the acute course are strongly pronounced, and localized in the lower abdomen. With right-sided salpingo-oophoritis, severe pain can be taken for an attack of appendicitis;
  • temperature increase to high values ​​(38 ° C and above), with a strong sweating and chills;
  • urination disorder;
  • no monthly( monthly may be absent or be very scarce);
  • symptoms of intoxication( nausea, vomiting);

Diagnosis of

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

  • examination of the gynecologist. When the uterus feels with both hands, painful patches are found in 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 had 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 analysis should be carried out for all women when they begin to have sex. The microflora is examined with the help of a microscope, due to which possible changes in the cellular composition of the mucous membranes are revealed, which is especially important in the early diagnosis of oncology;
  • taking swabs from the vagina for bacteriological examination. The purpose of the analysis is to identify the causative agents of infection 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;

Chronic adnexitis( salpingo-oophoritis)

  • ultrasound of the pelvic organs and kidneys. This study may show that the ovaries are enlarged and their contours are blurred;
  • MRI and CT are performed, if necessary, mainly to clarify the diagnosis;
  • if the diagnosis gives uncertain results, then laparoscopy is performed in such cases. The essence of the method is that a special probe with a camera is inserted into the abdominal cavity, through a small hole. This method of diagnosis allows us to examine in detail and examine 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 acute inflammation of the appendages is carried out strictly in a hospital environment, 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 on the lower abdomen, a hot-water bottle with ice should be applied.

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

  • penicillins and their combinations;
  • tetracyclines;
  • cephalosporins II and III generation;
  • aminoglycosides( kanamycin, amikacin and gentamicin).It is necessary to take into account the negative impact of these drugs on the auditory nerve and kidneys.
  • more modern method - macrolides( spiramycin, clarithromycin, azithromycin);
  • fluoroquinolones( ciprofloxacin, ciprolet, etc.)
  • after 5 days of antibiotic treatment, antifungal agents are prescribed( nystatin, fluconazole and others);
  • in severe cases, antibiotics are injected into the appendages themselves. Puncture is performed through the posterior vaginal vault;
  • for severe pain, it is advisable to prescribe analgesic medications - analgesics( nimesulide, analgin, etc.);
  • acute salpingo-oophoritis is considered a pathology of a serious nature, in the absence of treatment of which, a fatal outcome may occur. Therefore, intensive treatment of chronic adnexitis should be prescribed - anti-inflammatory therapy combined with measures that reduce intoxication.

Chronic adnexitis( salpingo-oophoritis)

Chronic form

How to cure chronic adnexitis? Since this form of the disease is not as intense as acute, and can occur with more smoothed symptoms, the treatment will also be performed by other methods:

  • in the treatment of chronic adnexitis, often prescribed autohemotherapy. The essence of the method consists in the reverse introduction of venous blood into the muscle. Such therapy stimulates the defenses of the body, thereby reducing the likelihood of relapse of the disease. Autohemotherapy is often combined with the intake of calcium preparations.
  • with exacerbation of chronic adnexitis, antibiotics from the group of nitrofurans( 5-NOC or nitroxoline) can be prescribed by a doctor. These drugs remove the infection of the urinary system, and thus prevent the occurrence of inflammation;
  • if necessary, therapy of infectious diseases caused by bacteria or viruses, as well as concomitant, previously treated or not - pathologies( cervical leukoplakia, adhesions, fibromioma);
  • if in adnexa, with chronic adnexitis, obstruction begins to form, drugs that have a dissolving effect are used: aloe extract, lidase, trypsin, plasmin and others).The purpose of these medications is especially important if the patient is pregnant. Also, these drugs are able to restore the menstrual cycle;
  • in situations when the usual anti-inflammatory therapy, with chronic adnexitis, does not give results, the doctor can prescribe hormonal( glucocorticosteroid) drugs. But it is worth considering that such treatment can cause a lot of side effects. Also, they can not be taken against the background of cervical leukoplakia, as hormones can provoke unwanted cell division.
  • at the onset of the remission phase, when the salpingo-oophoritis can be considered cured, vitamins C, E, B1 and A are necessarily prescribed. It is also possible, in some situations, to use multivitamins.
  • if salpingo-oophoritis is accompanied by diseases, inflammation, cervix and vagina, douching with antiseptic compounds and suppositories with anti-inflammatory effect can be used;

Chronic adnexitis( salpingo-oophoritis)

Physiotherapy

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

  • UHF on the ovaries region;
  • laser irradiation of blood;
  • therapy with oxygen in a pressure chamber( oxigenobarotherapy).

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 of ​​the appendages. This procedure treats chronic inflammation of the appendages well, and first of all reduces the production of estrogens, relaxes muscle spasms, and prevents the formation of adhesions;
  • inductothermy - a method of deep heating of tissues under the influence of a high-frequency magnetic field. This procedure has vasodilator, anti-inflammatory, bacteriostatic, analgesic, resolving, relieving spasms, and also improving, chronic adnexitis treatment, action;
  • ultrasound therapy in pulsed mode.

Local treatment of

In the treatment of gynecological diseases, the introduction of medical formulations into the vagina is often used:

  • using a special tube with 2 lumens, the doctor introduces the broths of various medicinal herbs deep into the vagina. As a means for decoction, you can use: flowers of acacia or chamomile, eucalyptus leaves. The course lasts no less than 10 days;
  • after applying decoction of medicinal herbs, a tampon impregnated with a solution of dimexide with water is introduced into the vagina in a ratio of 1: 3.An antibiotic and a resolving agent( lidase, trypsin) are added to this solution. Such therapy favorably affects the vaginal mucosa.
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