Many ailments can occur in the organs of the female reproductive system. 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 disease adnexitis, the symptoms at different stages of its course, the principles of treatment, the consequences to which it can lead, as well assigns that distinguish it from other diseases of the female reproductive organs.
General Description
Another name for adnexitis is salpingo-oophoritis. 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 an inflammation of the appendages. It should be noted that there are appendages of the uterus (fallopian or fallopian tubes and ovaries) and ovaries (include rudimentary remains of the primary kidney and its ducts). When they talk 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 localization, these types of adnexitis are distinguished:
- Right side.
- Left side.
- Double-sided.
- Mainly affecting the ovaries.
- Mainly affecting the fallopian tubes.
Depending on the nature of the inflamed tissue, adnexitis happens:
- Serous.
- Purulent.
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 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.
- E. 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 parts 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.
In viewThe 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 persons suffering from sexually transmitted diseases (gonorrhea, trichomoniasis, mycoplasmosis, chlamydia, and others), which patients either they don’t treat at all, or they self-medicate, following the advice of “experienced” people.
If bacteria that cause venereal disease got into the vagina, sooner or later they will definitely get to the fallopian tubes, through which they will penetrate into the ovaries. This should be understood by all women.
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.
- Birth.
- Abortions.
- Aggressive intercourse.
The causes of infection by the lymphogenous or hematogenous route can belike this:
- 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.
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 slightly 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 adnexitis is on the right, symptoms expressed in painful sensations on the right side, which can be mistaken for attacks of appendicitis. These two ailments can be distinguished by additional features. So, with appendicitis, in most cases, vomiting and nausea are observed. For inflammationappendages, this is not typical, 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 with intercourse, menstruation, ovulation.
Besides pain and discharge, the symptoms of acute adnexitis are as follows:
- Failure.
- Heat temperature.
- Headache.
- Lack of appetite.
- Broken.
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 these 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 usually begins with the lining 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.
Without treatment, microbes penetrate further into the ovaries, and together with the serous fluid - into the tissues of the peritoneum, causing them to suppurate.
Meanwhile, the process of adhesion occurs in the fallopian tubes, 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 considered 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 intensify during menstruation, during physical activity, during sexual intercourse.
- Discharges may be present, but their amount 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 caused by any condition that reduces immunity, hypothermia, as well as various diseases (not gynecological) that the woman has experienced.
When relapse symptoms of adnexitisin chronic form the same as in acute.
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:
- Fever.
- Pain in the lower abdomen from the inflamed area.
- General malaise.
- Bloating.
- Profuse purulent discharge.
- Irregular menstruation.
- 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.
Diagnosis
Without consulting a doctor, you cannot self-treat adnexitis at home. Both the symptoms (mostly) and the awareness of the fact that due to the circumstances (for example, unprotected sex with an unfamiliar man) diseases of the genital organs can 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 subacuteforms 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.
Woman is being tested:
- Common urine and blood.
- Biochemical blood.
- Vaginal swab.
- Ultrasound of the pelvic organs.
- Laparoscopy.
- Tuberculin test.
- Echography (determines thickenings in the fallopian tubes).
- Hysteroscalpinography (determine the patency in the pipes).
- Vaginal ultrasound.
- MRI.
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. Used for antibiotic therapypreparations:
- Penicillins (Oxacillin, Ampicillin).
- Tetracyclines ("Doxycycline", "Tetracycline").
- Fluoroquinolones ("Oflaxacin" and analogues).
- Macrolides ("Erythromycin", "Azithromycin").
Also prescribed anti-inflammatory drugs and biogenic stimulants:
- "Sulfadimetoksin".
- "Biseptol".
- Plasmamol.
- "Vitreous".
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
According to doctors, it is much easier to treat the acute form when the microbes 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 healing effect when taken for an arbitrarily long time without adversely affecting the patient's body.
In chronic forminflammation of the appendages are very useful physiotherapy, 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 a therapeutic effect, 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 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 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 in the 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 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, "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.
Traditional medicine
With symptoms of adnexitis, treatment and folk remedies can help alleviate the condition, therefore 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.
Healers from the people advise:
- Tampons with aloe juice and cabbage. They are placed overnight in the vagina.
- Take Shilajit 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, hogweed. 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.
Patient opinions
Eata lot of 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.
