Adnexitis - what it is, knows not everyone, meanwhile, this disease is a frequent cause of female infertility and a number of disease states.
It can be caused by a whole complex of pathogens. The development of adnexitis often occurs against a background of decreased immunity caused by hypothermia, infection and avitaminosis.
Adnexitis is a woman's gynecological disease affecting the fallopian tubes. They cause an inflammatory process, which, if left untreated, can go into a slow form. It is already chronic adnexitis, it is much more difficult to treat it.
Reasons for
Why does adnexitis occur, and what is it? The causative agent of the disease is an infection( streptococci, gonococcus, staphylococcus, fungus, E. coli, tubercle bacillus), which has fallen into the appendages ascending or lymph-hematogenous.
In a healthy woman, the introduction of pathogens into the appendages is hindered by a system of protective barriers that only aggressive gonococci can penetrate through. Other microorganisms get access to them as a result of any failure in protection.
Possible causes of infection:
- General or local subcooling;
- Acute infectious diseases;
- Exacerbations of chronic diseases;
- Medical and diagnostic interventions in the uterus( abortion, endometrial scraping, hysteroscopy, intrauterine contraception);
- Operations on the abdominal cavity;
- Exchange disorders( diabetes, obesity);
- HIV infection.
By the nature of the spread of , adnexitis can be:
- One-sided. In this case, only the right ovary / oviduct or only the left one is affected. Right or left-sided adnexitis is always preferable to bilateral adnexitis, because with an unfavorable outcome of the disease it is possible to preserve the second ovary and the reproductive function;
- Double-sided. Both sides of the body are affected. Bilateral salpingo-oophoritis occurs as a consequence of a neglected disease or in associative infection( infection by several pathogens).
Symptoms of adnexitis
When an adnexitis occurs, the symptoms depend on the form of the disease. Typical is only the localization of pain - it captures the lower-abdominal parts of the abdomen with bilateral adnexitis and is felt more to the right or to the left with one-sided. Pain gives in the lower back, coccyx, anus, labia, perineum or in the thigh. Inguinal lymph nodes are often enlarged, bulge under the skin, painless.
For the acute and subacute form of , the course of salpingo-oophoritis is characterized by symptoms:
- febrile state, chills, body temperature can reach 38 - 40 degrees;
- secretion of pus from the genital tract;
- strong, cramping pain in the lower abdomen, in the sacrum;
- sweating;
- symptoms of general intoxication( muscle and headaches);
- strained muscles in the lower abdomen;
- pain syndrome with pressure on the abdomen;
- sometimes has difficulty urinating.
The main symptoms of chronic adnexitis :
- aching, blunt pain in the lower abdomen and in the sacrum;
- painful sensations at the time of sexual intimacy, as well as during defecation;
- malfunctions of the menstrual cycle;
- severe pain during menstruation( dysmenorrhea);
- mucopurulent leucorrhoea;
- with exacerbations, body temperature can reach up to 38 degrees.
With incomplete or inadequate treatment, salpingo-oophoritis( adnexitis) threatens to change into a chronic form, the function of the ovaries may be disrupted, the adhesion process may develop. To avoid chronic adnexitis and serious complications in the event of anxiety symptoms, it is necessary to consult a gynecologist.
After examining the patient, the gynecologist will put a preliminary diagnosis, and to confirm it he will take a smear for microflora, PCR for "hidden infections", will give a direction for a clinical analysis of blood and urine. In some cases, the doctor will recommend ultrasound - ultrasound of the pelvic organs.
How to treat adnexitis?
Adnexitis is a very serious disease that, in the absence of adequate and correctly selected therapy, can lead to very sad complications, up to such a terrible diagnosis as infertility. Therefore, it is recommended that women, when identifying signs of this disease, forget about such extreme options as self-medication by folk remedies or taking any medications on the advice of friends or acquaintances.
The acute stage of inflammation of the appendages is subject to inpatient treatment with the creation of conditions for the patient's physical and mental rest, the appointment of an easily digestible diet, adequate amounts of liquid( alkaline drink, fruit, tea), observation of excretory function.
The main link in the treatment of acute adnexitis is antibacterial therapy. As a rule, preparations of a wide spectrum, in average, but not the maximum dose, duration of a course not less than 1-2 weeks are appointed. A woman should understand that premature interruption of the course of antibiotics or self-reduction of the dose will lead to a worsening of the process and / or its transition to a chronic course. The antimicrobial agent is administered on the basis of an antibioticogram.
Basic antibiotics for adnexitis:
- penicillins( ampicillin, oxacillin, penicillin);
- tetracyclines( tetracycline, doxycycline);
- fluoroquinolones( ofloxacin);
- macrolides( azithromycin, erythromycin);
- imidazoles( metronidazole);
- Lincosamides( clindamycin);
- aminoglycosides( gentamicin, kanamycin).
The principle of treatment of chronic adnexitis is a combination of therapeutic effect on the appendages with simultaneous correction of disorders of various body systems. Such physiotherapeutic procedures are shown: UHF, ultrasound, electrophoresis, diadynamics, mud therapy, ozocerite, paraffin, mineral water baths. Vaginal irrigation, tampons and medicinal baths are used( rotokan, chlorophyllipt, Vishnevsky ointment, dimexid, decoctions of herbs).
At the stage of exacerbation of chronic adnexitis, therapeutic measures corresponding to the acute process( hospitalization, antibacterial, infusion, desensitizing therapy, vitamins) are carried out.
Forecast
Unhealed or inadequately treated acute adnexitis leads to a chronic process. Possible complications of the chronic course of the disease are the following:
- infertility( it develops due to obstruction of the fallopian tubes and chronic anovulation);
- development of adhesion process up to intestinal obstruction;
- ectopic pregnancy;
- threat of abortion and miscarriage;
- inflammation of neighboring organs( pyelonephritis, cystitis, colitis).
Prevention
As in many other cases, it is much better and easier to prevent the disease than to treat it. For this, a woman should follow a few simple rules :
- Exclusion of factors provoking the development of acute adnexitis and relapses of chronic inflammation of the appendages( hypothermia, stress, sexual infections, alcohol abuse, spicy food, etc.);
- Use of rational contraception, prevention of abortion;
- If necessary - drug abortion or mini-abortions;
- Conducting timely, rational and complete complex therapy of inflammatory diseases of the pelvic organs, including inflammation of the appendages, taking into account the pathogen.
Regular consultations of the gynecologist are also necessary every 6-12 months.