Inflammation of the appendages in women - symptoms and treatment regimen. Inflammatory diseases of the female genital organs. Classifications of inflammatory processes in gynecology

When problems occur in the reproductive system, the entire body is involved in the pathological process.

Causes of inflammatory diseases in women

Inflammation is most often caused by an infection introduced into the urogenital tract from the outside.

There may be several ways for pathogens to enter.

Sexual transmission - during sexual contact from an infected person to a healthy person.
Ascending path - with poor personal hygiene, microbes penetrate deeper from the external genitalia and anal area.
Mechanical way - in the presence of damage to the mucous membrane, the use of untreated douching tips, inept placement of barrier contraceptives, etc.
The medical path is in case of insufficiently professional placement of intrauterine devices, or carrying out medical manipulations with a non-sterile instrument.
Endogenous pathway - in the presence of inflammatory foci with menstrual blood, during childbirth, etc.
Spontaneous path - with a decrease in protective barriers in the genital organs (acidic environment of the vagina, disruption of the mucous plug in the cervical canal, etc.

Causative agents of inflammatory diseases in women

Pathological processes in the urogenital tract are divided into specific and nonspecific. They are determined by the type of infectious pathogen that caused the inflammation.

Specific ones are caused by the penetration of microflora that multiply mainly in the genitals - gonococci, trichomonas, chlamydia, mycoplasmas, etc.

Nonspecific ones can affect many other body systems (oropharynx, digestive tract, respiratory tract, etc.). These are staphylococci, streptococci, Pseudomonas aeruginosa and Escherichia coli, etc.

Since the latter often act as a united front, they are called mixed-type bacteria.

The body's response to inflammatory diseases in women

Inflammation, which many people habitually call a disease, is actually a protective reaction of the body. This natural mechanism is called immunity. It is the immune cells that attack the emerging enemies and try to destroy them by increasing the temperature at the site of penetration and thus prevent their spread further.

The outcome of the defense depends on the activity of killer cells, their number, strength and diversity. If uninvited guests are successfully neutralized, the disease will not develop. If there are more pathogenic pathogens than defenders, they will win, cause intoxication of the body and lead to illness.

Doctors have defined this “warfare” between microbes and immune cells as immunological reactivity, which can be strong or weak. It is to increase the number of protective cells that measures called strengthening the immune system are aimed.

Often, when a pathological focus appears in the genitals, the nervous, vascular, and endocrine systems are affected, which determines the clinical picture of the disease.

Localization of inflammatory diseases in women

Gynecologists make a diagnosis according to the location where the inflammation occurs. In fact, such a division has practically no meaning for a woman, since several organs are involved in the pathological process at once.

Nevertheless, it is useful to know the decoding of the diagnosis.

Features of inflammatory diseases in women

Vulvitis occurs due to injury or insufficient hygiene of the perineal area. In girls, vulvitis is associated with weakness of specific immunity, the presence of other inflammatory foci and anatomical features of the structure of the external genitalia (thin skin, weak epithelial cover, numerous glands, etc.)

Vulvovaginitis It develops more often in older women, which is due to endocrine diseases, dietary errors, and hormonal imbalances.

Middle-aged women rarely suffer from inflammation of the external genitalia due to the characteristics of the epithelial tissues, which over time become resistant to infections.

Colpitis It is one of the most common gynecological pathologies. The disease is usually associated with a violation of the barrier function of the vagina, a decrease in its ability to self-cleanse, which allows microbes to freely penetrate deep into the genital organs.

Cervicitis is a consequence of inflammation of the vaginal mucosa if there are microdamages in the mucous membrane of the canal and cervix. Cervicitis can lead to cervical erosion (epithelial ulceration). When erosion occurs, the damaged area becomes covered with mucus with an alkaline reaction. And an alkaline environment, unlike an acidic one, serves as an excellent incubator for the proliferation of pathogenic microflora, which will subsequently cause inflammation!

Endometritis how an independent disease can occur after childbirth. However, most often the infection is introduced during the placement of uterine devices, operations and other medical (surgical and diagnostic) procedures. Among the causes of endometritis are sexual relations during menstruation.

Salpingitis begins after endometritis: the infection from the uterus spreads to the fallopian tubes. Salpingitis is dangerous due to the formation of adhesions in the tubes, preventing the passage of the egg into the uterine cavity. This is one of the most common causes of female infertility.

Oophoritis It is rarely primary, since the ovaries are quite reliably protected from microbes by a dense membrane. But with the invasion of an abundance of pathogenic flora from the fallopian tubes, the ovaries also become inflamed, causing adnexitis.

Signs and symptoms of inflammatory diseases in women

How do inflammatory processes in a woman’s urogenital tract make themselves felt? Most often, itching, burning, discharge and pain in the lower abdomen occur, and sometimes menstrual function and libido (sexual desire) are disrupted.

Beli- secretion of viscous transparent secretion of the gonads in moderate quantities is the norm for the female body. However, sometimes leucorrhoea has a yellow-greenish tint, which indicates the presence of pus at the site of inflammation, and has an unpleasant odor.

The smell may have diagnostic value. Thus, the smell of fish comes from Trichomonas and Gardnerella. The sour smell of curdled discharge occurs due to candidiasis (thrush of fungal etiology). A sharp, unpleasant odor may indicate vaginal dysbiosis.

Discharge in women may not have a pathological origin. Thus, an increase in the formation of secretions often occurs under nervous tension - stress, for example. Such leucorrhoea stops on its own after the cause disappears. In girls of puberty, leucorrhoea signals hormonal changes.

Each woman usually determines for herself that leucorrhoea is abnormal. This is a reason to immediately contact a gynecologist, since sometimes they talk not about an inflammatory process, but an oncological process.

Pain- a common symptom of trouble. Dull and aching, sharp and nagging, temporary and permanent, aggravated by colds and stress, physical fatigue and sexual intercourse, local and diffuse, premenstrual and accompanied by headaches along with insomnia - all of them sharply reduce life comfort, impair the ability to work and sometimes bring a woman down. to depression.

Itching and burning occur exclusively due to pathology in the reproductive system; this does not happen normally.

In most cases, the cause lies in infection, less often in violation of hygiene rules, and even less often in mechanical damage (for example, when rubbing underwear). Sometimes this result is achieved by the use of certain medications and rarely by the use of inappropriate intimate hygiene products.

Often itching and burning accompanies disorders in other body systems. They appear with diabetes, hepatitis, abnormalities in the functioning of the endocrine glands, sudden changes in hormonal levels (for example, during menopause), mental illness, etc.

Specific infection

The same and even more acute manifestations are associated with specific inflammatory diseases of the female genital organs. Their appearance is associated with infections that are predominantly sexually transmitted, but still this variant of infection is far from the only one. These include chlamydia, ureaplasmosis, gardnerellosis, genital herpes, trichomoniasis, mycoplasmosis, cytomegalovirus, HIV, etc., as well as venereal gonorrhea and syphilis.

Inflammations caused by one pathogen are called monoinfections; a combination of microorganisms provokes mixed infections.

Mixed infections arise due to the hidden course of many diseases, the longer incubation period that some strains of microbes acquire, and due to the tendency to self-medicate (especially with antibiotics) at the first signs of trouble.

Mixed infections are difficult to diagnose, take longer to treat and cause more complications.

Find to defuse

Patient question

Doctor's answer

It is necessary because it helps to identify hidden infectious agents and disarm (treat) them before pregnancy occurs.

PCR (polymerase chain reaction) is a very accurate diagnostic method in which the DNA of pathogenic microflora is scanned, which allows one to accurately determine the type of pathogenic microorganism.

PCR diagnostics have proven themselves to be excellent, and therefore deservedly enjoy the respect of gynecologists, who often have to deal with disguised sexually transmitted diseases (asymptomatic chlamydia, ureaplasmosis, genital herpes, etc.).

The reliability of the method approaches 100% accuracy.

PCR diagnostics are also used in pulmonology (for lung diseases) to determine viral and bacterial pathogens of pneumonia and detect tuberculosis. In hematology, PCR helps determine the presence of cytomegaloviruses and oncoviruses. And infectious disease doctors use the rapid PCR method in their practice to diagnose diphtheria, viral hepatitis B, C and G, and salmonellosis.

To carry out diagnostics using the PCR method, biological material is taken - blood, saliva, urine, or a piece of human tissue.

Preventing vaginal infections

To avoid vaginal infections, and if they occur, to shorten the treatment time, girls and women should follow certain rules.

You should try not to constantly wear thick synthetic tight-fitting panties. Such underwear does not provide air circulation in the genital area and does not absorb moisture. Since infectious agents, and especially fungal flora, multiply most actively in a humid environment, during the greenhouse effect, preference should be given to breathable fabrics. Panties made of cotton or at least with a cotton insert will prevent the formation of an alkaline environment on the vaginal mucosa. The unpleasant putrid smell of natural discharge, which even healthy women often complain about, indicates the formation of an alkaline environment favorable for fungal infection.
You should not walk for a long time in a wet swimsuit. In addition to creating a greenhouse environment for microbes, as discussed above, there is another risk. You can get colds in the pelvic organs. Immunity will drop, and bacteria will multiply so that they cause inflammation.
After water procedures, it is necessary to thoroughly wipe the perineum with a dry towel, and always with movements from front to back, in order to avoid the transfer of intestinal bacteria from the anal area to the genitals.
It is very important to use toiletries alone.
You need to be careful when choosing intimate hygiene products: avoid scented tampons, colored toilet paper, soaps, gels and sprays with fragrances and other substances that can cause irritation to the mucous membranes.
To avoid discomfort, it is better to use cotton tampons instead of synthetic ones during menstruation. Super-absorbent tampons, as well as those that remain in the vagina for more than 12 hours, disrupt drainage and promote the growth of fungal microorganisms.
Those women who are accustomed to using tampons during menstruation should use them only during the day. At night, preference should be given to pads.
If any discomfort occurs in the urogenital tract, you should immediately consult a doctor. If it is an infection, you need to start treating it immediately to avoid big troubles.
If an infectious pathogen is detected during examination, the sexual partner will also have to be treated. Even if he was not the cause of the disease, the pathogenic microbial flora migrated to him.
If you have candidiasis, it is useful to avoid excess sweets. Refined sugar, according to many doctors, can support chronic fungal infections.
For the same reason, it is necessary to limit the consumption of bread, mushrooms, alcoholic beverages, canned foods and spicy foods.
The menu should include more dairy products, fish, potatoes, citrus fruits and legumes. Consume at least 2 glasses of fermented milk products (especially those enriched with bifidobacteria) per day. This helps prevent dysbiosis in the external genitalia.

Conservative therapy for inflammation of the appendages

Acute inflammation of the appendages and exacerbation of the chronic process requires hospitalization, especially if the relapse is caused by a sexually transmitted infection.

In case of severe pain, the patient is prescribed bed rest with cold procedures (ice pack) to suppress the inflammatory process.

On the first day, when tests have not yet been carried out and the type of pathogen is unknown, the woman is prescribed broad-spectrum antibiotics, since it is urgent to localize the inflammation.

Commonly used are oxacillin sodium salt, ampiox or ampicillin. Then drugs are added, taking into account the type of microbes, specifically designed against this type of microorganisms.

Cephalosporins are effective - cephaloridin, cephalexin, cefazolin, as well as antibiotics of the aminoglycoside group - neomycin, gentamicin, kanamycin sulfates. Levomycetin is also used.

Antibiotic therapy should not be stopped even after the acute symptoms of inflammation have subsided. The course is usually 10-14 days, and for chlamydial infection - up to 3 weeks.

When pathogens are clearly resistant to antibiotics, nitrofurans are added to the treatment regimen. Although this group of antimicrobial drugs is inferior in clinical effectiveness to most antibiotics, at high concentrations they have a fairly wide spectrum of action and suppress both anaerobic flora and bacteria, and in addition fungi that cause casdidiasis. Furazolidone and nifuratel actively fight Trichomonas and Giardia.

In parallel with antibacterial drugs, medications that prevent the development of fungal infections are prescribed, since antibiotic therapy poses a threat of candidiasis and dysbacteriosis. Usually these are nystatin and levorin.

If inflammatory processes in the ovaries and tubes give rise to high temperature, fever, chills, the doctor prescribes drug detoxification with rheopolyglucin, hemodez, glucose solution with vitamins administered intravenously.

In case of severe pain, analgesic drugs are prescribed (analgin, butadione, amidopyrine, etc.), in case of drug allergies, desensitizing drugs are prescribed (diphenhydramine, suprastin, tavegil). If the adhesive process is noticeably expressed, enzymes are used - ronidase, lidase, as well as vitreous body and aloe that stimulate the body's defense reactions.

Physiotherapeutic procedures are widely used to resolve adhesions: pulsed currents, magnetic fields, UHF. During the recovery period, chloride, sodium, and sulfide sitz baths are beneficial.

Therapeutic mud, ozokerite (a natural mineral substance of the petroleum group), paraffin are used for local effects in the form of applications.

To restore functional disorders, acupuncture is often prescribed.

With proper treatment in a hospital, as well as patient and careful compliance with doctor’s orders during the home period of rehabilitation and recovery, inflammation in the female reproductive organs can be managed. But if persistent infertility has developed due to the chronicity of the process, the prognosis is not so favorable. In some cases, it is not possible to get rid of adhesions in the abdominal cavity.

Medical preventive measures

In order to reduce the risk of developing gynecological diseases, you need to:

visit a gynecologist 2 times a year;
regularly do histological analysis to detect atypical cells;
go to see the same doctor, who can monitor your health over time;
if possible, choose the most qualified doctor;
If you experience any discomfort in the genital area, immediately seek medical advice;
Follow the assigned recommendations carefully and in a timely manner.

Are vaginal infections classified as sexually transmitted diseases?

Patient question

Is a vaginal infection a sexually transmitted disease and can a woman spread it to her partner?

Doctor's answer

Among the three most common vaginal infections (bacterial vulvovaginitis, trichomoniasis and thrush), only trichomoniasis has recently been classified as a sexually transmitted disease, and even then conditionally.

However, doctors believe that the development of bacterial vulvovaginitis is almost always closely related to sex, since most women acquire pathogenic microflora through contact with a sexual partner.

How are these conditions different? The fact is that the bacteria that cause inflammation in women of the lower part of the urogenital tract are most often harmless for men and do not lead to the development of an inflammatory process in them in the genitourinary organs.

But the causative agents of sexually transmitted diseases affect both partners equally.

Overdiagnosis

Patient question

Gynecologists working in medical centers are convinced that every woman of the childbearing period should be examined every six months for the presence of sexually transmitted infections. Many paid tests and diagnostic methods are prescribed. Is this always justified?

Doctor's answer

Detection of sexually transmitted infections is carried out only for certain indications. If a woman lives in a marriage and there are no symptoms of an inflammatory process in the urogenital tract, reproductive function is not impaired, there is no point in additional examinations to detect infections.

Some microorganisms are saprophytes, that is, they live in the body almost constantly. Any analysis will reveal their presence, but such flora should be dealt with only if it is activated, which threatens the disease.

Sometimes, to make an accurate diagnosis, you really need to undergo a series of examinations. For example, with chlamydia, before making a diagnosis, it is necessary to confirm the presence of the disease using two or three diagnostic methods.

If information about the presence of an infectious pathogen is obtained by one method, this does not mean that the woman has developed chlamydia. However, even with one insufficiently reliable study, a diagnosis is often made and strong doses of antibiotics are prescribed. And this leads to genital candidosis and other undesirable consequences.

Unfortunately, there is a tendency towards unreasonable examinations and overdiagnosis of infections in the medical world. Overdiagnosis, i.e. excessive prescription of additional, sometimes completely unnecessary, tests and examinations often leads to an erroneous medical conclusion.

Typically, indications for infectious disease testing are symptoms of an inflammatory process in the urogenital tract, infertility, or recurrent miscarriage.

Gynecological fees

Patient question

Will herbal medicine help? Tell me, what herbal remedy can I buy at the pharmacy for vaginal inflammation?

Doctor's answer

Pharmacies sell special gynecological collections of medicinal herbs that have antiseptic properties, selected according to their composition in certain proportions. It includes yarrow, chamomile, St. John's wort, sage, and sometimes nettle is added. You can buy such preparations and use them for vaginal douching according to the recipe indicated on the package. But herbal medicine cannot always relieve the inflammatory process.

In this case, you need to find out what is causing the inflammation. If this is a banal colpitis and there are no pathogenic (infectious) microorganisms, then it makes sense to use herbal decoctions. Although it is necessary to warn: you should not get carried away with douching, because this washes out the normal flora of the vagina.

Among all gynecological diseases, inflammation of the uterine appendages is very common. Inadequate and untimely treatment of the inflammatory process threatens a number of consequences and complications, including the likelihood of the disease becoming chronic.

According to statistics, about 20% of women who overcome andexitis remain infertile.

What is inflammation of the uterine appendages? The uterine appendages include the ligaments, ovaries and fallopian tubes. Their inflammation is called salpingo-ophritis or andexitis. The course of the disease can occur with the development of an inflammatory process on one side (with unilateral salpingo-ophritis) and on both (with bilateral andexitis). Next, we will describe the symptoms, causes and treatment features of inflammation of the uterine appendages.

Inflammation of the appendages: causes

In the appendages of the uterus, the role of causative agent of the inflammatory process is conditionally pathogenic and pathogenic microorganisms that can, under certain conditions, cause disease. Specific adnexitis is caused by gonococci, tuberculosis bacillus and diphtheria bacteria. Nonspecific salpingo-ophritis is caused by streptococci, staphylococci, mycoplasmas, chlamydia, E. coli, viruses, fungi and other microorganisms. Often the disease occurs due to an association of microorganisms. Infection can enter the uterine appendages in various ways:

lymphogenous– through lymphatic vessels;

hematogenous– through blood vessels (with tuberculosis of the uterine appendages);

ascending– from the cervix and vagina;

descending– from other inflamed organs (sigmoid colon, appendix).

Factors that contribute to the development of the disease:

hypothermia, stress;

chaotic sex life;

violation of personal hygiene rules;

weakening of the body's immunity - diabetes, HIV infection, recent infectious disease;

carrying out intrauterine procedures: insertion and removal of the IUD, curettage of the uterine cavity, abortion, hysteroscopy, metrosalpingography;

appendectomy;

complicated childbirth.

Symptoms of adnexitis (inflammation of the appendages):

Acute adnexitis

The clinical picture of acute salpingoophritis is very characteristic. The onset of the disease is acute, there is an increase in body temperature to 38-39 degrees and chills appear with suppuration of the appendages. Sharp, sharp pain occurs in the lower abdomen.

Depending on whether the process is unilateral or bilateral, pain may be localized in one or both iliac regions. The pain radiates to the sacral region, rectum, and can spread to the lower extremities.

At the initial stage of the disease, palpation of the anterior abdominal wall allows one to determine its tension. Symptoms of peritoneal irritation and severe pain are observed. Sometimes signs of urination disorder (frequent and painful) appear. The patient's general condition worsens: headache, nausea and vomiting, and loss of appetite.

A gynecological examination reveals purulent or serous-purulent discharge in the cervical canal. When palpated, the area of the appendages is painful, their contours and sizes are difficult to clearly determine, the appendages are enlarged, pasty, and their mobility is limited. A general blood test indicates an acceleration of ESR and leukocytosis. There is also an increase in the level of C-reactive protein in the blood.

Chronic adnexitis

With poor quality treatment of acute inflammation of the uterine appendages or complete absence of therapy, the process may become chronic. The clinical picture of chronic salpingo-ophritis is vague; the disease has periodic phases of exacerbation (usually in autumn and spring).

There is a pain syndrome, its severity does not correspond to disorders in the appendages. Chronic inflammation of the uterine appendages is characterized by dull aching pains that are localized in the lower abdomen and radiate to the vagina and lower back.

There is a disturbance in the menstrual cycle, which is manifested by oligomenorrhea (short, infrequent menstruation, polymenorrhea (heavy menstruation), almenorrhea (painful menstruation. Any of the menstrual dysfunctions is caused by functional and structural changes in the ovaries (lack of ovulation, hypoestrogenism).

Sick women may have complaints of lack or decreased sexual desire, pain during intercourse (dyspareunia). The long-term existence of chronic andexitis negatively affects the digestive (colitis, enterocolitis), urinary (pyelonephritis, cystitis), endocrine and nervous (depression, neuroses) systems. Such patients often experience decreased ability to work, and conflicts in the family are common.

Exacerbation of the process causes an increase in body temperature to sub-reflex levels (up to 38 degrees). During a gynecological examination, mucopurulent discharge is released from the cervical canal, sclerotic changes (heaviness) are detected in the area of the appendages, upon palpation the patient feels pain, the appendages are limited in mobility, and pain occurs when the uterus is displaced behind the cervix (due to the development of adhesive disease).

Complications of adnexitis

The danger of salpingoophritis lies in the following complications:

the risk of ectopic pregnancy;
transition to a chronic form;
female infertility due to anovulation, obstruction of the fallopian tubes, development of adhesions;
the formation of a tubo-ovarian formation, represented by purulent melting of the ovary and tube with the formation of an abscess.

From the doctor's practice:

For the first time I had to deal with a tubo-ovarian complication in the third month of independent work. At night, a young woman was admitted to the clinic with severe symptoms of peritoneal irritation (pelvioperitonitis), severe pain in the lower abdomen and intoxication syndrome.

She was previously diagnosed with acute pelvioperitonitis, acute andexitis with a complication in the form of a tubo-ovarian formation. In such cases, the patient must be treated for two hours (intravenous infusions with antibiotics to reduce pain and relieve intoxication), and then undergo emergency surgery. After 2 hours, I went for the operation with the surgeon on duty. After cutting my stomach, I almost grabbed my head. There are adhesions all around, there is a massive purulent effusion in the abdomen, on one side the appendages are not visible at all, only some kind of conglomerate of the small and large intestines, the omentum and supposed appendages is noticeable. With difficulty, together with the young surgeon, we figured out what was what and what needed to be cut off. Despite the fact that the operation took 2.5 hours, we managed to complete it successfully. We cut through the adhesions, removed what was needed, washed the abdominal cavity and drained it. As a result, the woman was diagnosed with gonorrhea. It should be said that the operation was very difficult, not every doctor with experience will undertake this. Subsequently, I had to operate on many tubo-ovarian abscesses, and fortunately, I never encountered such advanced cases again.

Treatment of salpingoophoritis

To treat inflammation of the appendages, inpatient conditions are required. It begins with a diet that limits the consumption of carbohydrates, pepper and salt, as well as bed rest.

In the acute form of andexitis and exacerbation of the chronic form, patients are prescribed a cold compress on the lower abdomen (to relieve pain and inflammation).

The main point in treating inflammation is taking antibiotics.

They are selected with a maximum half-life and a wide spectrum of action. Since the disease is often caused by the accumulation of several types of microorganisms, 2 or more drugs are prescribed during antibiotic treatment:

lincomycin – 3 r. per day 0.6 g. i/m;

Cefazolin – 2 r. per day 1 g. IM and ciprofloxacin 2 r. per day 100 ml intravenously;

clindamycin – 2 r. per day 2 grams. together with gentamicin;

Cephobid – 1 g twice a day. together with gentamicin;

klaforan – 2 r. per day 0.5 - 1 g. v/i and 3 r. per day gentamicin 80 mg.

Watch a video about inflammation of the appendages in women and draw your own conclusions

The doctor necessarily prescribes metrodinazole 3 times to the patient. per day 500 mg orally or metrogil 2 r. per day, 100 ml IV (if there is suspicion of an anaerobic infection).

Detoxification therapy is also carried out (intravenous administration of glucose, saline solutions, hemodesa, rheopolyglucin and other substances in a volume of up to 2-3 liters).

In order to relieve pain and reduce signs of inflammation, anti-inflammatory non-steroidal drugs are prescribed in tablets - Ibuprofen (Faspic, Nurofen, Ibuklin), Ketorolac (Ketarol, Ketanov), Diclofenac (Ortofen, Naklofen, Voltaren, Diclak) and rectal suppositories - Diclofenac, Indomethacin, Paracetamol.

Vitamins (group B, vitamin C) are also prescribed.

Antihistamines (cetrin, pipolene, suprastin) and other allergy tablets.

Video from Malysheva on this topic:

To relieve the acute process and treat chronic inflammation in the phase without complications, physiotherapy is widely used: electrophoresis of zinc and copper according to the phases of the menstrual cycle, ultrasound, electrophoresis with iodine or lidase, pulsed high-frequency currents (DDT, SMT). Also used in rehabilitation therapy are injections of aloe, Longidase, FIBS, autohemotherapy, immunomodulators, etc. For the chronic form of andexitis, spa treatment is recommended - medicinal baths, paraffin, mud and douching.

Among all gynecological diseases, inflammation of the genital organs takes almost the first place both in the frequency of manifestation and in the severity of the course. The causative agents of inflammation can be a wide variety of microbes, most often streptococci, staphylococci, gonococci, E. coli, tubercle bacilli, fungi, and viruses. They enter the genitals during sexual intercourse and other means. When an inflammatory process occurs in the genital organs, the main thing is a violation of the integrity of their covering. This disorder occurs when the external genitalia rub against uncomfortable (tight) clothing, during rough sexual intercourse, during prolonged presence of foreign bodies in the genitals (contraceptive caps, IUDs, etc.), during diagnostic or surgical intervention performed in violation of rules of asepsis.

Favorable conditions for the occurrence of inflammatory processes are created when the genital organs are burned with hot water or a strong solution of disinfectants, which can occur during vaginal douching. Inflammations can occur at any period of a woman’s life, from birth to old age. In the vast majority of cases, they are observed in women of childbearing age.

The inflammatory process in the genitals, despite its apparent local nature, is always a consequence of a general weakening of the body. Poor working and living conditions contribute to inflammation.

Endometritis (inflammation of the lining of the uterus)

In acute endometritis, there is an increase in temperature, general malaise, pain in the lower abdomen, often extending to the sacrum and thighs. The disease begins with the release of leucorrhoea, at first normal, white, and then taking on a yellowish-dirty appearance with a characteristic odor. Subsequently, the discharge becomes purulent and foul-smelling.

In chronic endometritis, a disorder of the menstrual cycle is observed. The cause of the disease may be gonorrhea, infection introduced by unclean instruments, hypothermia of the lower abdomen (especially during menstruation) or a consequence of abortion. The main thing is to catch the disease at the very beginning. We need peace. Be sure to contact a specialist. To relieve pain, you can syringe the vagina with a solution of tannin and eat as much asparagus, which is very useful for all kinds of diseases of the uterus.

Perimetritis (inflammation of the peritoneal lining of the uterus)

The uterus is fixed in the pelvic area with the help of the peritoneum, ligaments, fascia and pelvic floor muscles. The peritoneum covers the anterior and posterior surfaces of the uterus.

The inflammatory process, localized in the uterus and its appendages, can spread to their peritoneal integument. The initial acute period is characterized by a swollen and tense abdomen, sharp pain in the abdomen, especially in the lower part, high temperature, rapid pulse, vomiting, intestinal atony and associated flatulence. At the same time, frequent and painful urge to urinate, pain and stool retention begin.

If perimetritis is not treated, it becomes chronic, often with serious consequences. If it is not possible to get medical help, the following is recommended: lie on your back more, put an ice bag on your lower abdomen for 30 - 40 minutes. with a break of 15 - 20 minutes. If you are constipated, you should take castor oil. Do enemas every day. If a woman (not a girl) has inflammation of the uterus, she should douche with warm water and chamomile.

Folk remedies used for inflammation and uterine prolapse

It is advisable to supplement folk remedies for the treatment of uterine prolapse and prolapse with therapeutic exercises. Kegel exercises will strengthen your vaginal muscles. To eliminate uterine prolapse in folk medicine, the following recipes are used:

Decoction of birch and alder bark
Drink a decoction of March birch and alder bark as tea, 0.5 cups 2 times a day after meals for inflammation of the peritoneal lining of the uterus.
Viburnum common
Decoction of viburnum flowers: brew a tablespoon of flowers with a glass of boiling water, boil for 10 minutes, drink 3 tablespoons 3 times a day as an anti-inflammatory agent and a means of increasing the tone of the uterine muscles.
St. John's wort
Pour a tablespoon of herb into a glass of boiling water, boil for 15 minutes, strain. Drink 1/4 cup 3 times a day for inflammation of the genital organs.
Wintergreen
Use for inflammation of the appendages, infertility, tubal obstruction, inflammatory disease of the uterus, and chronic inflammation of the bladder. See "Inflammation of the uterine appendages."
Common barberry
In folk medicine, barberry fruits are used for high blood pressure, and a decoction of the root is used for diseases of the female genital organs. One to two tablespoons of barberry per 0.5 liters of boiling water (daily requirement). There are no contraindications.
Sweet clover
For internal use, pour 2 teaspoons of the herb into one and a half cups of boiling water; Drink the infusion in 3 doses, 20 - 40 minutes. before meals. For external use, pour 2 tablespoons of the herb into 2 cups of boiling water. Use to reduce the excitability of the central nervous system in cases of neurasthenia, hysteria, migraines, insomnia, as well as menstruation disorders and inflammatory diseases of the female genital organs.
Infusion and decoction of sweet clover, as well as ointment from its flowers, can be used in the treatment of furunculosis, purulent wounds, otitis media, etc.

Contraindications: pregnancy, kidney disease. Sweet clover is a poisonous plant. As the dose increases, headache, nausea, and bleeding gums may occur. It is advisable to use sweet clover only in harvests.
Decoction of the herb St. John's wort
Pour one tablespoon of herb into a glass of boiling water, boil for 15 minutes, strain. Drink 1/4 cup 3 times a day for inflammation of the genital organs.
Lemons and oranges
Grate half a lemon with the peel and mix with sugar. Take 1 teaspoon 3 times a day. Lemons and oranges are useful for early stages of hypertension, diseases of the female genital organs and enlarged thyroid gland.
Decoction of Datura leaves
Take 20 g of leaves in a bucket of water. Use for sitz baths and douching for partial uterine prolapse. Caution - the plant is very poisonous!
Decoction of laurel leaves
Take 20 g of laurel in a bucket of water. Use for sitz baths for diseases of the uterus and bladder.
Rose hollyhock or black mallow flowers
Mix with lard and turpentine, apply to the lower abdomen. This remedy relieves inflammation of the uterus.

Inflammation of the uterine appendages, alternative treatment

The internal genital organs of women include the ovaries, fallopian tubes, uterus, and vagina. The ovary is a paired female reproductive gland located in the small pelvis on both sides of the uterus.

The ovaries are usually involved in the inflammatory process along with the tubes and other organs adjacent to them. The disease is expressed mainly in disruption of their function. Microbes can be introduced into the ovaries from adjacent organs (tubes, intestines, peritoneum), as well as through blood and lymphatic vessels. Inflammation of the ovary always occurs with simultaneous inflammation of the fallopian tube adjacent to it. Therefore, they talk about inflammation of the ovary and tube or inflammation of the uterine appendages. In most cases, acute inflammation later becomes chronic. Inflammation can be promoted by non-compliance with the rules of personal hygiene and sexual hygiene. Acute inflammation can also be caused by a cold, cold feet during menstruation, or douching with cold water after intercourse.

In the acute stage of the disease, pain is very pronounced, especially in the lower abdomen. Sometimes the pain is cramping in nature. In the chronic stage, patients are bothered by dull pain that intensifies during physical exertion and menstruation, when the body temperature simultaneously rises. Pain is felt in the sacrum and hips. If measures are not taken, painful and irregular menstruation begins, and sometimes an abscess appears in the ovary, which can reach a significant size.

First of all, it is necessary to cleanse the stomach well, but not with castor oil, and stay in bed, if possible, especially at high body temperatures.

Place an ice pack on your stomach. For severe pain, take 0.01 g of caffeine 3 times a day. It is not difficult to get rid of acute inflammation, you just need to be treated carefully, but chronic inflammation flares up again, for example, with a cold. For chronic inflammation, it is best to take mud baths, as well as potassium iodide 3 times a day, 0.1 g. For women, hot douching and complete abstinence from sexual intercourse until the pain stops are also useful.

Treatment of inflammation of the appendages with folk remedies

Folk remedies for the treatment of inflammation of the appendages go well with drug treatment. Below you will find the most effective folk remedies for treating inflammation of the uterine appendages.

Fresh aloe leaf juice
Take a dessert spoon orally 2-3 times a day before meals.
Walnut
Pour a tablespoon of dried and crushed walnut leaves into a glass of boiling water. Leave for 4 hours. Drink in a day.
pharmaceutical camomile
The oldest effective way to treat inflammation of the appendages: boil 1.5 tablespoons of dry chamomile in a porcelain cup, cover with a saucer, and wrap. Leave for 20 minutes. During this time, do a cleansing enema with warm water. Take the strained chamomile decoction at a temperature of 37°C into a syringe No. 3 and insert it into the anus. After this, lie on your side and wait until everything is absorbed. If you don't succeed the first time, do the same a second time. The chamomile decoction should be completely absorbed. The nagging, debilitating pain will immediately subside. Do this procedure every evening, if possible, several times a day. In this way you can cure and. Chamomile enemas improve facial skin.
Wintergreen rotundifolia
- Brew wintergreen as tea; you can mix it with tea along with St. John's wort. This tasty, beautiful, aromatic drink after long-term use (several months) of 3 - 4 cups a day helps in the treatment of chronic inflammation of the appendages, especially if you combine tea with wintergreen and St. John's wort with chamomile enemas.
- Pour one or two teaspoons of dry wintergreen leaves into 1 cup of boiling water, leave, covered, for 2 hours, strain. Take 1/4 cup 3 times a day.
- Tincture: 50 g of wintergreen leaves, pour 0.5 liters of vodka; leave for 2 weeks in a dark place. Take 30 - 40 drops 3 times a day.
Sweet clover herb, coltsfoot flowers (equal parts).
Pour one tablespoon of the mixture into a glass of boiling water. Boil. Take 3 - 4 tablespoons 5 times a day. Treatment period is 2 - 3 weeks.
Use for inflammation of the appendages. In this case, complete abstinence from sexual activity is recommended.
Yarutka field
One of the cooking methods: pour one and a half tablespoons of dried herbs with a glass of boiling water and leave for 4 hours in a tightly sealed container. Strain. Drink 1 teaspoon every 3-4 hours 4-5 times a day. Drink an infusion of the herb for inflammation of the appendages and uterine cancer.
Contraindicated for pregnant women (it has an abortifacient effect).
Small-leaved linden
Prepare an infusion of flowers at the rate of 2 - 3 tablespoons of raw materials per 2 cups of boiling water. Take orally. For external use, pour 4 - 5 tablespoons of flowers with 2 cups of boiling water; insist. Use the infusion for inflammation of the female genital organs.

You should eat as much pumpkin as possible in all types. It is useful to pass raw pumpkin through a meat grinder and squeeze out the juice from the pulp, which is consumed in large quantities.
Drink the broth of corn columns with silks.
Take rose hips and black currants in equal parts. Mix; Pour 20 g of the mixture into a glass of water. Add sugar. Drink half a glass 3-4 times a day.
It is advisable to consume the fruits of cranberries, blueberries, rowan berries and blackberries in any form.
Take 1 part of sweet clover herb and 10 parts of coltsfoot herb. Pour one tablespoon of the mixture into a glass of boiling water. Leave in a water bath for 15 minutes, cool, strain. Drink half a glass 3 times a day.
Use linden flowers externally in the form of lotions and poultices for ulcers, burns, and also for washing your hair in case of hair loss. There are no contraindications.
Boil forest hay in a suitable vessel; Place the patient over steam. Repeat the procedure every day until the inflammation is cured.
Place the patient over steam, where gorse is cooked, doused with olive oil.
Pour hot water over unwashed sheep wool and place the affected wool over steam.
Boil fresh cabbage, pour milk; Place the patient over steam.

Vaginal douching

The procedure can be performed by the patient herself at night before bedtime. Place a douching mug filled with boiled water or a medicinal composition, cooled to the desired temperature, 0.5 - 1 m above the place where the patient lies. The patient's pelvis can be raised slightly: it is best to place a regular bedpan under the sacrum, where the washing liquid will drain. After this, insert a glass tip into the depths of the vagina and release a stream of water. Douching should be carried out in such a way that the entire procedure lasts at least 10-15 minutes. If there is not enough liquid in the mug for douching, it should be added.

The temperature of the liquid during the first procedure should not be higher than 37 - 38°C. In subsequent days, it should be gradually increased to the limit that the patient is able to tolerate - up to 45 - 48 ° C and higher.

Lubricating the perineum with Vaseline reduces sensitivity to heat.

If during treatment the patient’s body temperature increases even slightly or abdominal pain intensifies, the temperature of the douched liquid should be temporarily reduced. After douching, it is recommended to place a heating pad or a circular warming compress on the entire lower abdomen and sacrum to delay heat transfer.

Collections of medicinal herbs used for vaginal douching

White nettle, dead nettle
Use jasmine flowers and leaves. Take yasnotka both internally and externally - in the form of douching for inflammation of the genital organs. Infusion for internal use: pour 2-3 tablespoons of the herb into 0.5 liters of boiling water in a thermos (daily dose). Insist. For external use, double the amount of herb.
Sweet clover (yellow), centaury (grass, flowers) - equally divided in total.
Grind everything well and mix. Pour one tablespoon of the mixture with 1 glass of boiling water, leave, covered, for 1 hour, strain. Take 1/3 cup per day for three to four weeks. In this case, complete abstinence from sexual activity is recommended for the period of treatment.
Chernobyl, grass - 5 parts, speedwell, grass - 5 parts, chamomile, inflorescences - 5 parts, sweet clover, grass - 1 part. Take 5 tablespoons of the mixture, pour 1 liter of boiling water.
Leave for 25 minutes. During this time, do a cleansing enema. Drink half a liter of the decoction hot at night. Use 300 ml of decoction (37.5°C) for douching of the vagina, insert 150 ml of decoction into the posterior passage and lie on your side.
Just a few days of carefully performing this procedure will give you the opportunity to lead a normal life after an exacerbation of inflammation of the appendages. But to be cured completely, you should repeat this procedure 2 - 3 times a week for 2 months.
Blueberry leaf infusion
Pour one teaspoon of raw material into 1 glass of boiling water, leave for 30 minutes, strain. Use for external treatment of wounds, ulcers, as well as for douching as an astringent, antiseptic and anti-inflammatory agent.

Inflammation of the appendages in women is a group of diseases that affect the fallopian tubes (salpingitis) and ovaries (andexitis, oophoritis). The main consequence is infertility, and if inflammation of the appendages is not treated, this disease can lead to the death of the patient.

Advice! Be sure to consult a doctor if you experience abdominal pain accompanied by an increase in temperature, as well as if there is a change in the nature of discharge from the genital tract.

Diseases affecting the fallopian tubes and ovaries are called inflammation of the appendages

Typically, inflammation is localized simultaneously in both the fallopian tube and the ovary (in medical terms salpingo-oophoritis, or adnexitis), often against this background endomeritis develops (inflammation of the uterine tissue). Inflammation of the appendages in women is manifested primarily by pain in the lower abdomen and increased body temperature. Since the fallopian tubes and ovaries are paired organs, andexitis can be one- or two-sided.

The inflammatory process in the appendages can lead to such dangerous complications as:

tubal and abdominal pregnancy as a result of obstruction of the fallopian tubes;
infertility (with complete obstruction) – observed in every fifth patient who has undergone andexitis;
the phenomenon of partial intestinal obstruction - inflammation can spread to the peritoneal tissue, forming adhesions, thereby disrupting the functioning of the lower intestines;
purulent inflammation both in the uterus itself and in the abdominal cavity ().
tubo-ovarian formations, expressed by purulent melting in the ovaries and fallopian tubes with the development of an abscess.

Salpingo-oophoritis is a fairly common disease, and almost every third woman has inflamed appendages at least once in her life. Women of all ages suffer from this disease, but more often young women - unfortunately, many girls prefer to dress more beautifully than warmly. Despite the seriousness of the disease, patients often put off going to the doctor until the last minute, that is, until the moment when the pain becomes unbearable or the inflammation becomes chronic. To avoid a severe course of the disease and dangerous complications, it is important to consult a specialist in time.

Causes and factors provoking the inflammatory process in the appendages

Inflammation of the appendages in women can have the most unexpected causes, however, there are a number of very specific factors under which the pelvic organs can become inflamed.

Here are the main ones:

The impetus for the development of the disease is very often hypothermia: sitting in the cold, clothing that is not suitable for the weather, clothing with an open stomach, wet or insufficiently warm shoes. A healthy body, in principle, is able to protect itself from an infection that has penetrated from the outside, but stress from hypothermia weakens its protective systems and microorganisms take over.

Hypothermia is one of the main factors of inflammation of the appendages in women

Promiscuous unprotected sexual intercourse, which entails the addition of sexually transmitted infections, including dangerous sexually transmitted diseases, often makes itself felt by inflammation of the appendages;
Inflammation of the appendages can develop as a consequence of difficult childbirth;
The ovary can also become inflamed with appendicitis, since the tissues of these organs are located very close;
The development of the disease is also provoked by termination of pregnancy (natural or artificial), and other surgical interventions in the uterus;
Failure to comply with personal hygiene rules can also become a trigger for the development of infection and inflammation;
Weakened due to a previous (or chronic) illness, as mentioned above, does not give the body the opportunity to overcome the developing disease;
Hormonal disorders lead to hypertrophic and other disorders in the tissues of the female genital organs, against the background of which an inflammatory process can develop;
Severe stress or nervous tension also act as factors that weaken the immune system with all the ensuing consequences.

Important! It should be understood that the slightest oversight of one’s own body can result in the development of pathology of the organs of the reproductive system for a woman.

The doctor can only determine the causative agent of the disease. They may be:

pathogenic and conditionally pathogenic microorganisms;
sexually transmitted pathogens;
enterococci;
various viruses, including those from the herpes group;

fungi;
tuberculosis bacillus;
coli and so on.

However, as a rule, these are so-called “microbial associations”, which include several representatives of different groups of microorganisms.

Depending on the type of infection, the symptoms of the disease manifest themselves differently. For example, if the causative agent is gonococcus, the signs of the inflammatory process will be clearly expressed, if chlamydia is more blurred, the disease develops almost asymptomatically.

There are three ways of developing the disease:

With an ascending infection, microorganisms penetrate the uterus through the vagina, but there is a fairly acidic environment in it, and the microbes move further into the more “comfortable” fallopian tubes, and through them into the ovaries.
The descending path is when there is already an inflammatory process in the abdominal cavity (appendicitis, for example) and pathogenic microbes move to nearby tissues of the ovaries and fallopian tubes.
Hematogenous route - when an infection enters the tissues of the appendages along with blood. With this development of events, the cause of adnexitis may even be caries.

Symptoms

There are acute and chronic forms of inflammation.

The acute form of adnexitis is characterized by:

Aching pain, sharp or dull, localized in the lower abdomen, sometimes radiating to the lower back. The pain syndrome will be more pronounced during menstruation;
Pain during physical activity, during bowel movements, urination;
Fever up to forty degrees, weakness and chills;
Nausea and vomiting;
Discharge: profuse leucorrhoea, purulent discharge - depending on the causative agent of the infection;
Cycle disorders due to ovarian dysfunction and hormonal imbalance;
Decreased or complete absence of sexual desire, pain during intercourse.

Note! If you have severe pain in the lower abdomen, you should immediately contact a medical facility for a diagnosis, since the symptoms of inflammation of the appendages are similar to the symptoms of appendicitis!

The chronic form occurs due to an undertreated (or not treated at all) acute form of inflammation of the appendages. In this case, frequent relapses are observed.

In the chronic or latent form of inflammation of the appendages in women, the symptoms are less pronounced, the temperature may be low-grade, and lethargy and irritability are observed. Chronic inflammation of the appendages is dangerous because pathological processes occur in the body, weakening and destroying it, but due to sluggish symptoms, the patient is in no hurry to consult a doctor, which ultimately leads to serious complications.

Note! The listed symptoms are common to many other diseases, so it is important to conduct a thorough diagnosis to rule out other diseases.

You should not engage in self-diagnosis based on information from the Internet. You can write to a medical forum about the symptoms that worry you, this will provide some psychological relief, but will not cancel your visit to.

To make an accurate diagnosis, the results of an examination by a gynecologist are necessary - a manual examination helps to immediately determine the glands enlarged as a result of edema. A number of laboratory tests are also required. The diagnosis is clarified according to the data of an ultrasound examination of the pelvic organs, computed tomography, etc. They do urine and blood tests, and a vaginal smear for flora. If necessary, laparoscopy is prescribed in some cases. Having made a diagnosis, the doctor determines treatment. Symptoms and treatment, respectively, are individual in each case.

Treatment and prevention

Treatment for adnexitis is prescribed in a comprehensive manner, but the main drug in combination therapy is antibiotics.

In acute cases of the disease, it is necessary to observe bed rest and adhere to a diet: completely eliminate salty, spicy, sweet foods; it is recommended to drink plenty of fluids and eat foods rich in fiber.

Depending on the results of laboratory tests, two, sometimes even three types of antibiotics are usually prescribed, in the form of injections for the first few days, when the inflammatory process subsides. According to the doctor's instructions, you can take the drugs orally. The following antibiotic combination schemes are used:

Claforan + Gentamicin;
Cephobid + Gentamicin;
Clindamycin + Gentamicin;
Cefazolin+Ciprofloxacin;
Lincomycin, Ofloxacin, Doxycyline.

All of the drugs listed are potent broad-spectrum antibiotics.

Protected penicillins such as Amoxiclav are also used;
Latest generation cephalosporins, in particular Ceftriaxone.
For anaerobic type infections - or Metrogyl.

Along with the antibiotic, antimycotic agents are prescribed:

Diflucan;
Nystatin.

The prescribed therapeutic complex may contain non-steroidal painkillers and anti-inflammatory drugs:

Ibuprofen;
Ketorol;
Ortofen;
Nurofen et al.

To avoid the development of allergic reactions, patients are prescribed medications (suprastin, pipolfen, etc.)
For local treatment, douching with solutions of chlorophyllipt, potassium permanganate, and chamomile decoction is used, as well as vaginal suppositories - hexicon, nystatin, terzhinan and others.

Physiotherapy in combination with the main treatment gives a good effect. Electrophoresis and heating are often used.
Folk remedies for inflammation of the appendages will help speed up the healing process.

Note! If you decide on your own initiative to supplement your treatment with these medications, you should definitely consult with your doctor!

Use herbal infusions and decoctions;
Freshly squeezed aloe juice is used as medicine;
Both compresses and steam baths with chamomile decoction are popular - in each case the method is selected individually.
One of the most popular folk remedies for chronic inflammation of the appendages is a steam bath with wormwood. To prepare it, pour two liters of water into an enameled cylindrical container, bring to a boil, then add 40-50 grams (half a glass) of wormwood herb. Immediately after this, remove the container from the heat, allow to cool slightly and brew. When the water has cooled to an acceptable temperature (so that it is still very warm, but it is no longer possible to get burned), place a towel on the edges of the container and sit over it. Such procedures are very often carried out by lovers of herbal medicine for inflammation of the appendages, and they are also effective for.
Wormwood is also used as a decoction for douching;
A decoction of wormwood, prepared according to the instructions on the pharmaceutical package, is taken orally in a tablespoon three times a day.
Collections of medicinal herbs are widely used, which include herb, yarrow, St. John's wort, horsetail, elecampane root, calendula flowers, ect.

Important! Under no circumstances should this method be used for acute processes and polycystic ovary syndrome, as well as any neoplasms.

Results

To prevent such an unpleasant disease as adnexitis, a woman needs to carefully monitor her own body. First of all, hypothermia should not be allowed. It is also necessary to avoid stress and overwork if possible. It is important to eat varied and on time, do physical exercise, but observe reasonable moderation. Naturally, it is necessary to observe the rules of personal hygiene and avoid unprotected sexual relations with non-regular partners.

Important! In some cases, inflammation of the appendages occurs with mild symptoms or is completely asymptomatic. Do not neglect preventive examinations; be sure to visit a gynecologist every six months.

The slightest signs of inflammation of the appendages in a woman, even minor pain in the lower abdomen should be a reason to visit a doctor - it is better to be safe than to undergo long and painful treatment.

From childhood, parents need to explain to girls how to properly take care of themselves, why they need to dress warmly and maintain hygiene. And, of course, do not forget to undergo a preventive examination with a gynecologist once every six months.

– an inflammatory process in the pelvis, localized in the ovaries and tubes (appendages). The causes of the pathology are bacteria and viruses that penetrate the appendages, and the main provoking factors are hypothermia, as a result of which general and local immunity is reduced. The disease manifests itself with a variety of symptoms: from nagging pain in the lower abdomen and scanty discharge to irregularities in the menstrual cycle and acute inflammatory phenomena. Therefore, only a comprehensive diagnosis, including laboratory, differential and instrumental research methods, helps to make the correct diagnosis. The main element of treatment is specific etiotropic therapy; outside the acute stage, prevention plays an important role. The disease also has other medical designations - adnexitis, salpingoophoritis (from a combination of the terms “salpingitis” - inflammation of the fallopian (fallopian) tubes and “oophoritis” - inflammation of the ovaries).

Clinical signs of chronic inflammation of the appendages are nagging, sometimes intensifying, painful sensations in the lower abdomen, periodic slight or moderate rise in body temperature (up to 38 degrees), discharge of varying degrees of intensity and color. Signs appear and disappear cyclically, with relapses lasting up to seven days. In half of the cases, menstrual irregularities are diagnosed. Possible menorrhagia - menstruation with significant blood loss; metrorrhagia - bleeding outside the cycle, oligomenorrhea may develop.

Symptoms of inflammation of the appendages

Inflammation of the appendages has a staged course, both in acute and chronic forms of the disease. Symptoms and treatment at each stage are specific. The acute course, as a rule, gives a clear picture of inflammation, which can be tracked by the pathognomonic symptoms of the disease at each stage.

The toxic stage is characterized by symptoms of intoxication of the body. Characterized by moderately elevated, high, sometimes very high body temperature (up to 40-41 degrees). Chills, bloating and abdominal pain, dysuric disorders (impaired urination), and dyspeptic symptoms (diarrhea, vomiting) are observed. On the part of the reproductive system, there is abundant discharge, severe, localized or diffuse pain, and bleeding is possible. Symptoms persist for 1-1.5 weeks, then the disease may progress to the second (septic stage), complete recovery (with adequate treatment for inflammation of the appendages) or chronicity of the pathology (with partial activation of the internal immune defense mechanisms).

The septic stage is characterized by worsening symptoms, weakness, dizziness, and the addition of anaerobes with the formation of a purulent tubo-ovarian formation with the threat of perforation. It is possible that the inflammatory process may further spread to the pelvic organs and peritoneum with the occurrence of pelvioperitonitis, which threatens the patient’s life.

Symptoms of inflammation of the appendages in the chronic phase in some cases are unexpressed. Dull, intensifying pain occurs periodically and coincides with one or another phase of the cycle. There is a slight increase in temperature, menstrual dysfunction, problems in the sexual sphere (painful sexual intercourse, decreased libido, etc.), deterioration in general well-being and decreased ability to work. With long-term chronic inflammation of the appendages without treatment, diseases of the gastrointestinal tract (colitis, etc.) and excretory system (pyelonephritis, recurrent cystitis, etc.) can occur.

Complications of inflammation of the appendages

Peritonitis can become a serious complication of acute inflammation of the appendages if therapy is not started in a timely manner. Chronic inflammation of the appendages is often complicated by infertility. Infertility of mixed origin, which is also caused by inflammation of the appendages, is very difficult to cure. This is due to the fact that hormonal dysfunction due to damage to the ovaries is associated with a decrease in the physiological function of the fallopian tubes (contractility, disruption of the activity of the ciliary layer) or their complete obstruction. Disruptions in the menstrual cycle and lack of ovulation lead to serious functional and anatomical changes in the female reproductive system.

The formation of infiltrates is a common consequence of chronic inflammation of the appendages and can be complicated by the development of sclerosis processes in the fallopian tubes. This is the main cause of ectopic (ectopic) pregnancy, the formation of painful adhesions. The spread of pathology to neighboring organs often causes the development of cholecystitis (acute and chronic), colitis, and pyelonephritis.

Diagnosis of inflammation of the appendages

Instrumental methods for diagnosing inflammation of the appendages can be used: diagnostic laparoscopy helps to identify purulent formations in the fallopian tubes, exclude or confirm the presence of adhesions. The procedure allows you to combine a diagnostic study with therapeutic procedures. Using an X-ray examination of the uterus using contrast - hysterosalpingography - the presence of pathological changes in the tubes is determined and their patency is assessed.

Treatment of inflammation of the appendages

Inflammation of the appendages in the acute phase is treated in an inpatient setting with the patient observing bed rest, physical and mental rest, a diet based on easily digestible food, an adequate drinking regime with an assessment of excretory function. The main treatment for adnexitis is antibacterial etiotropic therapy depending on the diagnosed causative agent of the disease: penicillins, tetracyclines, macrolides, aminoglycosides, fluoroquinolones. If there is a risk of anaerobic infection, a combination of different groups of antibiotics is prescribed, for example, metronidazole is added to the above drugs (intravenously, orally).

Conservative therapy also includes painkillers, drugs that relieve the effects and consequences of intoxication (infusion therapy). For purulent complications of inflammation of the appendages, surgical treatment is used. First of all, preference is given to low-traumatic gynecological surgery - laparoscopic manipulations, evacuation of the purulent contents of the saccular formation through puncture of the posterior vaginal fornix with the possible subsequent administration of medications. In case of advanced inflammation, when there is a risk of purulent melting, surgical removal of the appendages is indicated.

After eliminating acute signs of inflammation of the appendages, a course of physiotherapeutic procedures is prescribed: ultrasound, electrophoresis using Mg, K, Zn preparations, vibration massage. These same methods, along with etiotropic antibacterial therapy, are indicated in the treatment of chronic inflammation of the appendages. Sanatorium rehabilitation treatment is prescribed to promote the resorption of the adhesive process and prevent the formation of adhesions. Resorts that use mud therapy, paraffin therapy, medicinal baths and irrigation with sulfide and sodium chloride mineral waters as therapeutic procedures are preferred.

Forecast and prevention of inflammation of the appendages

With timely initial treatment of symptoms of acute inflammation of the appendages and adequate therapy, complete clinical recovery occurs in approximately 10 days. Adnexitis in the chronic stage requires regular examinations and supportive therapy, sanatorium and rehabilitation measures, and systematic monitoring of the patient’s condition.

In order to prevent relapses of inflammation of the appendages, especially for patients at risk (using IUDs, having unsuccessful pregnancies and abortions in history), it is necessary to exclude factors that provoke the disease - hypothermia, stress, sexually transmitted infections. It is recommended to use rational methods of contraception and promptly carry out complex adequate therapy for diseases of the pelvic organs, taking into account the causative agents of the pathology. A visit to the antenatal clinic at least once a year for a preventive examination by a gynecologist should become the norm for every woman who cares about her health.