Symptoms and treatment of inflammation of the ovaries and appendages. Treatment of inflammatory processes of the female genital organs. Depending on the location of the inflammation process

Inflammatory diseases of the genital organs in women

What is Inflammatory diseases of the genital organs in women -

Inflammatory diseases of the genital organs (IDG) in women occupy first place in the structure of gynecological pathology and account for 60-65% of visits to antenatal clinics. It is possible that there are more sick people, since often when the forms are erased they do not go to the doctor. The increase in the number of VZPOs in all countries of the world is a consequence of increased population migration, changes in the sexual behavior of young people, environmental damage and decreased immunity.

What provokes / Causes of Inflammatory diseases of the genital organs in women:

VPOs can occur under the influence of mechanical, thermal, and chemical factors. The most significant is infectious. Depending on the type of pathogen, VZPOs are divided into specific (gonorrhea, tuberculosis, diphtheria) and nonspecific. The causes of nonspecific inflammatory diseases are considered to be various cocci, candida, chlamydia, mycoplasma, ureaplasma, Escherichia coli, Klebsiella, Proteus, Corynebacteria (Gardnerella), viruses, Trichomonas, etc. Along with absolute pathogens, opportunistic microorganisms also play an important role in the occurrence of VPO, living in certain areas of the genital tract. However, such a division is arbitrary, since VZPOs are caused by associations of microorganisms. The causative agents of VZPO are transmitted sexually, less commonly - through household contact (mainly in girls when using common hygiene items). Opportunistic microorganisms become causative agents of VZPO under certain conditions that increase their virulence, on the one hand, and reduce the immunobiological properties of the macroorganism, on the other.

Factors that prevent the entry and spread of infection in the body. The activation of opportunistic microorganisms and the spread of infection are prevented by the properties of the vaginal microflora - the creation of an acidic environment, the production of peroxides and other antimicrobial substances, inhibition of adhesion for other microorganisms, activation of phagocytosis and stimulation of immune reactions.

Normally, the vaginal microflora is very diverse. The vaginal microflora contains gram-positive and gram-negative aerobes, facultative and obligate anaerobic microorganisms. A large role in the microbiocenosis belongs to lacto- and bifidobacteria, which create a natural barrier to pathogenic infection. Vaginal rod-shaped bacteria also include actinomycetes, corynebacteria, bacteroides, and fusobacteria.

The second place in the frequency of detection in the vagina belongs to cocci - epidermal staphylococcus, hemolytic and non-hemolytic streptococci, enterococci. Enterobacteriaceae, E. coli, Klebsiella, mycoplasma and ureaplasma, as well as yeast-like fungi of the genus Candida, are found in small quantities and less frequently. Anaerobic flora predominates over aerobic and facultative anaerobic flora. The vaginal flora is a dynamic, self-regulating ecosystem.

The quantitative and qualitative composition of the vaginal flora is influenced primarily by the level of estrogen in the body. Thus, with physiological hypoestrogenism in girls of the neutral period and in postmenopausal women, obligate anaerobes predominate in the vagina, the total number and qualitative diversity of microorganisms decrease, and the number of lactobacilli becomes negligible. The vaginal epithelium with hypoestrogenism is thin, pH 7.0. The species composition of the vaginal microflora changes when using antibiotics, hormonal contraceptives, douching or treating the vagina with antiseptic and antibacterial drugs.

The cervical canal serves as a barrier between the lower and upper genital tracts, and the border is the internal os of the uterus. Cervical mucus contains biologically active substances in high concentrations. Cervical mucus ensures the activation of nonspecific protective factors (phagocytosis, synthesis of opsonins, lysozyme, transferrin, harmful to many bacteria) and immune mechanisms (complement system, immunoglobulins, T-lymphocytes). Hormonal contraceptives cause thickening of the cervical mucus, which becomes difficult for infectious agents to pass through.

The spread of infection is also prevented by:

• . rejection of the functional layer of the endometrium during menstruation along with microorganisms that have entered there;
• . good blood supply to the uterus;
• . plastic properties of the pelvic peritoneum, limiting the inflammatory process to the pelvic area.

Pathogenesis (what happens?) during Inflammatory diseases of the genital organs in women:

Ways of spread of infection. The transfer of infection from the lower genital tract to the upper genital tract can be passive or active. Passively, the microorganisms that cause the disease spread canalicularly along the cervical canal into the uterine cavity, into the tubes and abdominal cavity, hematogenously or lymphogenously. Active transport of infection occurs on the surface of sperm and trichomonas, where special receptors are located.

The spread of infection in the genital tract is facilitated by:

• . various intrauterine manipulations - uterine probing, diagnostic curettage of the uterine mucosa, hysterography, hydrosonography, hysteroscopy, artificial abortions, introduction of intrauterine contraceptives. During intrauterine manipulation, infection is introduced from the outside or from the vagina into the uterine cavity, which then enters through the fallopian tubes into the abdominal cavity;
• . menstruation, which often precedes an ascending infection. During menstruation, the blood alkalizes the acidic contents of the vagina, and a large wound surface forms in the uterine cavity. Microorganisms easily penetrate from the vagina into the upper genital tract, causing an acute inflammatory process;
• . childbirth predisposing to inflammation of the uterus and appendages, as this disrupts natural protective barriers;
• . operations on the abdominal organs and pelvic organs, in which the possibility of contact of the abdominal cavity with the external environment is of particular importance;
• . foci of chronic infection, metabolic and endocrine disorders, insufficiency or imbalance of nutrition, hypothermia, stress, etc.

Classification. As mentioned above, depending on the pathogen, inflammatory diseases of the genital organs can be specific and nonspecific.

According to the clinical course, inflammatory processes are divided into acute with pronounced clinical symptoms, subacute with mild manifestations and chronic.

Based on the localization of the pathological process, inflammatory diseases of the lower (vulvitis, bartholinitis, colpitis, endocervicitis, cervicitis) and upper sections (endomyometritis, salpingoophoritis, pelvioperitonitis, parametritis) of the genital organs are distinguished, the border of which is the internal uterine pharynx.

Symptoms of Inflammatory diseases of the genital organs in women:

Nonspecific inflammatory diseases of the lower genital tract

Vulvitis is inflammation of the external genitalia (vulva). In women of the reproductive period, vulvitis often develops secondary to infection of the skin of the external genitalia by pathogenic microorganisms found in vaginal discharge during colpitis, endocervicitis, endometritis, adnexitis, and is combined with damage to the vagina (vulvovaginitis). Primary vulvitis occurs in adults with diabetes, poor hygiene (diaper rash due to obesity), thermal, mechanical (injuries, abrasions, scratching), and chemical effects on the skin of the external genitalia.

In acute vulvitis, patients complain of itching, burning in the external genital area, and sometimes general malaise. Clinically, the disease is manifested by hyperemia and swelling of the vulva, purulent or serous-purulent discharge, and enlarged inguinal lymph nodes. In the chronic stage, clinical manifestations subside, itching and burning appear periodically.

Diagnosis of vulvitis is based on complaints, medical history, and gynecological examination. Additional methods include bacterioscopic and bacteriological examination of the discharge of the external genitalia to identify the causative agent of the disease.

Treatment of vulvitis consists primarily of eliminating the concomitant pathology that caused it. In addition, sitz baths and vaginal rinsing with infusion of herbs (chamomile, calendula, sage, St. John's wort), antiseptic solutions (dioxidine 0.5% solution; furatsilin 1:5000; potassium permanganate 1:6000 - 1:8000, etc.) are prescribed. Taking into account the isolated microflora, antibacterial drugs are prescribed. Preference is given to complex medications that are effective against many pathogenic bacteria, fungi, trichomonas - polygynax, terzhinan in the form of suppositories in the vagina, 1 daily for 10 days. After the inflammatory changes subside, ointments with vitamins A, E, solcoseryl, Actovegin, sea buckthorn oil, rosehip oil, etc. are used topically to accelerate reparative processes. For severe itching of the vulva, antihistamines (diphenhydramine, suprastin, tavegil, etc.) and local anesthetics (5% anesthetic ointment) are used.

Bartholinitis is an inflammation of the large gland of the vaginal vestibule. The inflammatory process in the columnar epithelium lining the gland and surrounding tissues quickly leads to blockage of its excretory duct with the development of an abscess.

With bartholinitis, the patient complains of pain at the site of inflammation. Hyperemia and swelling of the excretory duct of the gland, purulent discharge when pressed, are determined. The formation of an abscess leads to a worsening of the condition. Weakness, malaise, headache, chills, fever up to 39 ° C appear, pain in the Bartholin gland area becomes sharp and throbbing. On examination, swelling and hyperemia are noted in the middle and lower thirds of the labia majora and labia minora on the affected side, as well as a painful tumor-like formation covering the entrance to the vagina. Surgical or spontaneous opening of the abscess leads to an improvement in the condition and the gradual disappearance of symptoms of inflammation.

Treatment of bartholinitis comes down to prescribing antibiotics, taking into account the causative agent of the disease, and symptomatic remedies. Locally, sitz baths with antiseptics, applications of anti-inflammatory ointments (levomekol) are prescribed, and an ice pack is applied to reduce the severity of inflammation. In the acute phase of the inflammatory process, physiotherapy is used - UHF on the area of ​​the affected gland.

When an abscess forms in the Bartholin gland, surgical treatment is indicated - opening the abscess with the formation of an artificial duct by suturing the edges of the mucous membrane of the gland to the edges of the skin incision (marsupialization). After the operation, the sutures are treated with antiseptic solutions for several days.

Colpitis is an inflammation of the vaginal mucosa, one of the most common diseases in patients of the reproductive period, caused by various microorganisms, and can occur as a result of chemical, allergic, thermal, and mechanical factors. In the acute stage of the disease, patients complain of itching, burning in the vaginal area, purulent or serosio-purulent discharge from the genital tract, pain in the vagina during sexual intercourse (dyspareunia). Colpitis is often combined with vulvitis, endocervicitis, and urethritis. During a gynecological examination, attention is drawn to swelling and hyperemia of the vaginal mucosa, which bleeds easily when touched, purulent deposits and pinpoint hemorrhages on its surface. In severe cases of the disease, desquamation of the vaginal epithelium occurs with the formation of erosions and ulcers. In the chronic stage, itching and burning become less intense and occur periodically; the main complaint remains serous-purulent discharge from the genital tract. Hyperemia and swelling of the mucous membrane decrease; in places of erosion, infiltrates of the papillary layer of the vagina can form in the form of point elevations above the surface (granular colpitis).

Diagnosis of colpitis is based on complaints, medical history, and gynecological examination. An additional research method is colposcopy, which helps detect mild signs of the inflammatory process. To identify the causative agent of the disease, bacteriological and bacterioscopic examination of discharge from the vagina, urethra, and cervical canal is used.

Treatment of colpitis should be comprehensive, aimed, on the one hand, at fighting the infection, and on the other, at eliminating concomitant diseases. Etiotropic therapy consists of prescribing antibacterial drugs that affect the causative agents of the disease. For this purpose, both local and general therapy are used. Prescribe washing or douching of the vagina with antiseptic solutions, herbal decoctions 2-3 times a day, chlorophyllipt solution (1 tablespoon of 1% alcohol solution per 1 liter of water). Long-term douching (more than 3-4 days) is not recommended, since it disrupts the restoration of the natural biocenosis and normal acidity of the vagina. For senile colpitis, it is advisable to topically use estrogens that help increase the biological protection of the epithelium - Ovestin in suppositories and ointments.

Antibiotics and antibacterial agents are used in the form of suppositories, vaginal tablets, ointments, and gels. Complex drugs - terzhinan, polygynax, ginalgin - have become widespread for the treatment of colpitis. For anaerobic and mixed infections, betadine, flagyl, Klion, metronidazole, dalacin are effective. Local treatment is often combined with general antibiotic therapy, taking into account the causative agent of the disease.

After antibacterial therapy, eubiotics (bifidumbacterin, lactobacterin, biovestin) are prescribed, which restore the natural microflora and acidity of the vagina.

Endocervicitis is an inflammation of the mucous membrane of the cervical canal that occurs as a result of trauma to the cervix during childbirth, abortion, diagnostic curettage and other intrauterine interventions. The affinity for the columnar epithelium of the cervical canal is especially characteristic of gonococci and chlamydia. Endocervicitis often accompanies other gynecological diseases, both inflammatory (colpitis, endometritis, adnexitis) and non-inflammatory etiology (cervical ectopia, eroded ectropion). In the acute stage of the inflammatory process, patients complain of mucopurulent or purulent discharge from the genital tract, less often of dull nagging pain in the lower abdomen. Examination of the cervix with the help of speculum and kolyusoscopy reveals hyperemia and swelling of the mucous membrane around the external pharynx, sometimes with the formation of erosions, serous-purulent or purulent discharge from the cervical canal. Chronization of the process leads to the development of cervicitis. Inflammation spreads to the underlying tissue of the cervix, infiltrates occur, and subsequently hyperplastic and dystrophic changes. Chronic cervicitis causes hypertrophy and hardening of the cervix and the appearance of cysts.

The diagnosis of endocervicitis is helped by bacteriological and bacterioscopic examination of discharge from the cervical canal for the purpose of selecting therapy, as well as cytological examination of smears from the cervix, which detects cells of cylindrical and stratified squamous epithelium without signs of atypia, and an inflammatory leukocyte reaction.

Treatment of endocervicitis in the acute phase consists of prescribing antibacterial agents, taking into account the sensitivity of the pathogens. Local treatment is contraindicated due to the risk of ascending infection. In the chronic stage, for background diseases of the cervix, after sanitation of the genital tract, surgical methods are used - cryodestruction, radiosurgery, laser therapy, diathermocoagulation, conization of the cervix.

Nonspecific inflammatory diseases of the upper genital tract (pelvic organs)

Endometritis is an inflammation of the uterine mucosa affecting both the functional and basal layers. Acute endometritis, as a rule, occurs after various intrauterine manipulations - abortion, curettage, insertion of intrauterine contraceptives, as well as after childbirth. The inflammatory process can quickly spread to the muscle layer (endomyometritis), and in severe cases, affect the entire wall of the uterus (panmetritis). The disease begins acutely with an increase in body temperature, the appearance of pain in the lower abdomen, chills, purulent or purulent discharge from the genital tract. The acute stage of the disease lasts 8-10 days and usually ends with recovery. Less commonly, the process generalizes with the development of complications (parametritis, peritonitis, pelvic abscesses, thrombophlebitis of the pelvic veins, sepsis) or inflammation becomes subacute and chronic. A gynecological examination reveals an enlarged, soft consistency, painful or sensitive uterus, especially in the area of ​​the uterine ribs (but along the large lymphatic vessels). A clinical blood test reveals leukocytosis, a shift in the leukocyte formula to the left, lymphopenia, and an increase in ESR. Ultrasound scanning determines the angle of the M-echo. The endoscopic picture during hysteroscopy depends on the causes of endometritis. In the uterine cavity, against the background of hyperemic and edematous mucous membrane, scraps of necrotic mucosa, elements of the fertilized egg, remnants of placental tissue, foreign bodies (ligatures, intrauterine contraceptive, etc.) can be detected.

Chronic endometritis occurs more often as a result of inadequate treatment of acute endometritis, which is facilitated by repeated curettage of the uterus due to bleeding, suture material after cesarean section, and intrauterine contraceptives. Chronic endometritis is a clinical and anatomical concept. The role of infection in maintaining chronic inflammation is highly questionable. However, with chronic endometritis there are morphological signs: lymphoid infiltrates, stromal fibrosis, sclerotic changes in the spiral arteries, plasma cells, gland atrophy or, conversely, hyperplasia of the mucous membrane with the formation of cysts. In the endometrium, the number of receptors for sex steroid hormones decreases, resulting in inferior transformation of the uterine mucosa during the menstrual cycle. The clinical course is latent. The main symptoms of chronic endometritis include menstrual irregularities - heavy, prolonged menstruation (hyperpolymenorrhea) or metrorrhagia due to impaired regeneration of the mucous membrane and decreased contractility of the uterus. Patients are bothered by nagging, aching pain in the lower abdomen, serous-purulent discharge from the genital tract. There is often a history of spontaneous abortions (as a result of impaired implantation of the fertilized egg). Chronic endometritis can be suspected based on medical history, clinical findings, and gynecological examination (slight enlargement and hardening of the uterine body, serous-purulent discharge from the genital tract). However, final verification of the diagnosis requires histological examination of the endometrium.

Salpingo-oophoritis (adnexitis) - inflammation of the uterine appendages (tubes, ovaries, ligaments), occurs either in an ascending or descending manner, secondary to inflammatory changes in the abdominal organs (for example, with appendicitis) or hematogenously. With an ascending infection, the infection penetrates from the uterus into the lumen of the fallopian tube, involving all layers in the inflammatory process (salpingitis), and then in half of the patients the ovary (oophoritis) along with the ligamentous apparatus (salpingoophoritis). Inflammatory exudate, accumulating in the lumen of the fallopian tube, can lead to an adhesive process and closure of the fimbrial region. Saccular formations of the fallopian tubes (sactosalpinxes) are formed. The accumulation of pus in the tube leads to the formation of pyosalpinx, serous exudate - to the formation of hydrosalpinx.

When microorganisms penetrate the ovarian tissue, purulent cavities (ovarian abscess) can form in it, and when they merge, the ovarian tissue melts. The ovary turns into a saccular formation filled with pus (pyovar).

Sometimes an inflammatory conglomerate forms in the area of ​​the uterine appendages, detected as a large tubo-ovarian formation. One form of complication of acute adnexitis is a tubo-ovarian abscess, which occurs as a result of melting of the contacting walls of the piovar and pyosalpinx.

Under certain conditions, through the fimbrial section of the tube, as well as when an ovarian abscess, pyosalpinx, tubo-ovarian abscess ruptures, the infection can enter the abdominal cavity and cause inflammation of the pelvic peritoneum (pelvioperitonitis), and then other floors of the abdominal cavity (diffuse or diffuse peritonitis) with the development abscesses (rectovaginal recess, interintestinal).

The clinical picture of acute salpingoophoritis (adnexitis) includes pain in the lower abdomen of varying intensity, increased body temperature to 38-40 ° C, chills, nausea, sometimes vomiting, purulent discharge from the genital tract, and dysuric phenomena. The severity of clinical symptoms is determined, on the one hand, by the virulence of the pathogens, and on the other, by the reactivity of the macroorganism.

On examination, the tongue is moist and covered with a white coating. Palpation of the abdomen may be painful in the hypogastric region. A gynecological examination reveals purulent or sanguineous-purulent discharge from the cervical canal, thickened, swollen, painful uterine appendages. When pyosalpinx, piovar, tubo-ovarian abscesses form in the area of ​​the uterine appendages or posterior to the uterus, motionless, voluminous, painful, without clear contours formations of uneven consistency can be identified, often forming a single conglomerate with the body of the uterus. In the peripheral blood, leukocytosis, a shift in the leukocyte formula to the left, an increase in ESR, the level of C-reactive protein, and dysproteinemia are detected. Urinalysis may show increased protein, leukocyturia, bacteriuria, which is associated with damage to the urethra and bladder. Sometimes the clinical picture of acute adnexitis is erased, but there are pronounced destructive changes in the uterine appendages.

Bacterioscopy of smears from the vagina and cervical canal can reveal an increase in the number of leukocytes, coccal flora, gonococci, Trichomonas, mycelium and spores of a yeast-like fungus. Bacteriological study of the flora of discharge from the cervical canal does not always help to identify the causative agents of adnexitis. More accurate results are obtained by microbiological examination of the flora from the contents of the fallopian tubes and abdominal cavity obtained during laparoscopy, puncture or surgery, since the coincidence with the flora of the cervical canal is 10-25%.

An ultrasound scan may show dilated fallopian tubes. The value of ultrasound increases in cases of formed inflammatory tubo-ovarian formations. Free fluid in the pelvis in combination with purulent formation in the uterine appendages most often indicates its rupture.

Laparoscopy is the most informative in diagnosing acute adnexitis. Laparoscopy makes it possible to determine the inflammatory process of the uterus and appendages, its severity and prevalence, and to carry out a differential diagnosis of diseases with a picture of an “acute abdomen” to determine the correct tactics. In acute salpingitis, edematous hyperemic fallopian tubes, the flow of serous-purulent or purulent exudate from the fimbrial sections and its accumulation in the rectovaginal cavity are revealed endoscopically. The ovaries may be enlarged as a result of secondary involvement in the inflammatory process. Pyosalpinx is visualized as a retort-shaped thickening of the tube in the ampullary section, the walls of the tube are thickened, swollen, compacted, the fimbrial section is sealed, and there is pus in the lumen. Pyovar looks like a voluminous formation of the ovary with a purulent cavity that has a dense capsule and fibrin overlays. When a tubo-ovarian abscess forms in the area of ​​the uterine appendages, a purulent cavity is formed, there are extensive adhesions between the tube, ovary, uterus, intestinal loops, and pelvic wall. The long-term existence of a tubo-ovarian abscess leads to the formation of a dense capsule delimiting the purulent cavity (purulent cavities) from the surrounding tissues. When such purulent formations rupture, there is a perforation on their surface, from which pus enters the abdominal cavity.

The above changes in the internal genital organs, identified during laparoscopy in the case of acute inflammation of the uterine appendages, can also be noted during transection performed to remove the source of inflammation. Obtaining purulent contents from space-occupying formations of the uterine appendages during puncture through the posterior vaginal fornix, targeted or under ultrasound control, also indirectly confirms the inflammatory nature of the disease.

Chronic adnexitis is a consequence of acute or subacute inflammation of the uterine appendages. The reasons for the chronicity of the inflammatory process include inadequate treatment of acute adnexitis, decreased reactivity of the body, and properties of the pathogen. Chronic salpingoophoritis is accompanied by the development of inflammatory infiltrates, connective tissue in the wall of the fallopian tubes and the formation of hydrosalpinxes. Dystrophic changes occur in the ovarian tissue; due to the narrowing of the lumen of blood vessels, microcirculation is disrupted, resulting in a decrease in the synthesis of sex steroid hormones. The consequence of acute or subacute inflammation of the uterine appendages is an adhesive process in the small pelvis between the tube, ovary, uterus, pelvic wall, bladder, omentum and intestinal loops. The disease has a protracted course with periodic exacerbations.

Patients complain of dull, aching pain in the lower abdomen of varying intensity. Pain can radiate to the lower back, rectum, thigh, i.e. along the pelvic plexuses, and is accompanied by psycho-emotional (irritability, nervousness, insomnia, depression) and autonomic disorders. The pain intensifies after hypothermia, stress, and menstruation. In addition, with chronic salpingoophoritis, menstrual dysfunction such as menometrorrhagia, hypomenstrual and premenstrual syndromes, accompanied by anovulation or insufficiency of the corpus luteum, are observed. Infertility in chronic adnexitis is explained by both a violation of ovarian steroidogenesis and a tubo-peritoneal factor. Adhesions in the uterine appendages can cause ectopic pregnancy. Frequent exacerbations of the disease lead to sexual disorders - decreased libido, dyspareunia.

Exacerbations of chronic adnexitis occur due to an increase in the pathogenic properties of the pathogen, reinfection, and a decrease in the immunobiological properties of the macroorganism. With an exacerbation, pain intensifies, general health is disturbed, the temperature may rise, and purulent discharge from the genital tract is noted. An objective examination reveals inflammatory changes in the uterine appendages of varying severity.

Diagnosis of chronic salpingoophoritis can be extremely difficult, since chronic pelvic pain with periodic intensification occurs in other diseases (endometriosis, ovarian cysts and tumors, colitis, pelvic plexitis). Certain information to suspect chronic inflammation of the uterine appendages can be obtained from a bimanual examination of the pelvic organs, hysterosalpingography and hydrosonography. A gynecological examination reveals limited mobility of the uterine body (adhesions), elongated formations in the area of ​​the uterine appendages (hydrosalpinx). Hysterosalpingography and hydrosonography help to identify the adhesive process in tubo-peritoneal factor infertility (accumulation of contrast in closed cavities).

In case of a long-term course of the disease with periodic pain in the lower abdomen and antibiotic therapy is ineffective, one should resort to laparoscopy, which allows one to visually determine the presence or absence of signs of chronic adnexitis. These include adhesions in the pelvis, hydrosalpinxes, interligamentous cavities on the fallopian tubes filled with serous exudate (hydatids). The consequences of acute salpingoophoritis, most often of gonorrheal or chlamydial etiology, are considered to be adhesions between the surface of the liver and the diaphragm (Fitz-Hugh-Curtis syndrome).

Pelvioperitonitis (inflammation of the pelvic peritoneum) occurs secondary to the penetration of pathogens from the uterus or its appendages. Depending on the pathological contents in the pelvis, serous-fibrinous and purulent pelvioperitonitis are distinguished. The disease begins acutely with the appearance of sharp pain in the lower abdomen, an increase in body temperature to 39-40 ° C, chills, nausea, vomiting, and loose stools. During physical examination, a moist tongue coated with a white coating attracts attention. The abdomen is swollen, takes part in the act of breathing, is painful on palpation in the lower parts, symptoms of peritoneal irritation are expressed to varying degrees there (including the Shchetkin-Blumberg symptom), and tension in the anterior abdominal wall is noted. Palpation of the uterus and appendages during gynecological examination is sometimes unsuccessful due to severe pain; the posterior fornix is ​​smoothed due to the accumulation of exudate in the rectovaginal cavity. A blood test reveals signs of inflammation. Additional diagnostic methods include transvaginal ultrasound scanning, which helps clarify the condition of the uterus and appendages and determine free fluid in the pelvis. The most informative diagnostic method is laparoscopy. There is hyperemia of the pelvic peritoneum and adjacent intestinal loops. As the acute phenomena subside, inflammation is localized in the pelvic area as a result of the formation of adhesions of the uterus and appendages with the omentum, intestines, and bladder. When puncturing the abdominal cavity, inflammatory exudate can be aspirated through the posterior vaginal fornix. A bacteriological analysis of the obtained material is carried out.

Parametritis is an inflammation of the tissue surrounding the uterus. Occurs when infection spreads from the uterus after childbirth, abortion, curettage of the uterine mucosa, operations on the cervix, or when using an IUD. The infection penetrates the parametrial tissue through the lymphogenous route. Parametritis begins with the appearance of infiltration at the site of the lesion, then the formation of serous inflammatory exudate. With a favorable course, the infiltrate and exudate resolve, but in some cases, fibrous connective tissue develops at the site of inflammation, which leads to a displacement of the uterus towards the lesion. When exudate suppurates, purulent parametritis occurs, which can resolve with the release of pus into the rectum, less often into the bladder, and abdominal cavity.

The clinical picture of parametritis is caused by inflammation and intoxication: fever, headache, poor health, dry mouth, nausea, pain in the lower abdomen. Sometimes infiltration of the parametrium leads to compression of the ureter on the affected side, disruption of urine passage, and even the development of hydronephrosis. In the diagnosis of the disease, an important role is played by bimanual and rectovaginal examination, which determines the smoothness of the lateral vault of the vagina, a dense, motionless, low-painful infiltrate of the parametrium at the site of the lesion, sometimes reaching the pelvic wall. Percussion over the superior anterior iliac spine on the side of the parametritis reveals dullness of percussion sound (Genter's symptom). In the blood, leukocytosis is observed with a shift in the leukocyte formula to the left, and an increase in ESR.

With suppuration of the parametrial tissue, the patient's condition sharply worsens - chills, hectic fever appear, and symptoms of intoxication intensify. If fibrous changes develop in the area of ​​the parametrium, a dense cord is palpated, the uterus is displaced towards the affected side.

Treatment of inflammatory diseases of the genital organs in women:

Treatment of inflammatory diseases of the internal genital organs is carried out in a hospital. The nature and intensity of complex therapy depend on the stage and severity of the inflammatory process, the type of pathogen, the immunobiological resistance of the macroorganism, etc. It is important to create mental and physical rest and follow a diet with a predominance of easily digestible proteins and vitamins. An ice pack is placed on the hypogastric region.

Antibacterial therapy plays a central role. The drug is selected taking into account the spectrum and mechanism of action, pharmacokinetics, side effects, as well as the etiology of the disease. Due to the polymicrobial etiology of the disease, drugs or combinations thereof should be used that are effective against most possible pathogens. For the treatment of acute inflammatory processes of the internal genital organs, penicillin antibiotics, cephalosporins, fluorochipolones, aminoglycosides, lincosamines, macrolides, and tetracyclines are used.

Antibiotics of the penicillin group (oxacillin, ampicillin, amoxicillin, carbenicillin, ticarcillin, piperacillin) are considered the least toxic and are active against gram-positive and gram-negative anaerobes. However, many microorganisms have developed resistance to penicillins as a result of the synthesis of beta-lactamases that destroy the beta-lactam ring of penicillins. In this sense, combinations of penicillins with beta-lactamase inhibitors (inhibitor-protected penicillins) are preferred - amoxicillin/clavulanate, ticarcillin/clavulanate, piperacillin/tazobactam, ampicillin/sulbactam.

Cephalosporins are also low-toxic and effective against many pathogens of inflammatory diseases of the internal genital organs, but have little or no activity against enterococci, methicillin-resistant staphylococci, chlamydia, mycoplasmas, and some anaerobes. Currently, third generation cephalosporins (ceftriaxone, cefotaxime, cefoperazone) are used for the treatment of acute endomyometritis, adnexitis, especially complicated ones.

Fluoroquinolone antibiotics have a broad spectrum of antimicrobial activity. They are most effective against gram-negative bacteria, less active against staphylococci and have little effect on anaerobes. The most commonly used drugs are ciprofloxacin and ofloxacin.

Antibiotics from other groups include gentamicin, netilmicin, amikacin (aminoglycosides), lincomycin, clindamycin (lincosamines), spiramycin, azithromycin, erythromycin (macrolides), doxycycline (tetracyclines).

The possibility of the participation of gonococci and chlamydia in the acute inflammatory process of the internal genital organs suggests a combination of antibiotics that are effective against these microorganisms. It is advisable to combine antibiotics with nitroimidazole derivatives (metronidazole), which are highly active in the treatment of anaerobic infections. Thus, for the treatment of acute inflammatory diseases of the internal genital organs, combinations of inhibitor-protected penicillins with doxycycline or macrolides are preferable; III generation cephalosporins with doxycycline or macrolides and metronidazole; lincosamines with aminoglycosides and doxycycline or macrolides. In case of a pronounced inflammatory process, antibacterial drugs begin to be administered parenterally and continue for up to 24-48 hours after clinical improvement (body temperature no higher than 37.5 ° C, leukocytosis in peripheral blood no more than 10-109/l) with a transition to oral administration. For complicated forms of acute inflammatory processes of the internal genital organs, carbapenem antibiotics can be prescribed - imipenem or meropenem with the widest spectrum of antimicrobial activity among beta-lactam antibiotics (gram-positive and gram-negative aerobes, anaerobes). The total duration of antibacterial therapy is 7-14 days.

According to the “European Guidelines for Pelvic Inflammatory Diseases and Perihepatitis” (2001), the following inpatient treatment regimens exist:

• . cefoxitin 2 g IV 4 times a day (or cefotetan 2 g IV 2 times a day) + doxycycline 100 mg IV 2 times a day (can be given orally), then doxycycline 100 mg orally 2 times a day + + metronidazole 400 mg orally 2 times a day - only 14 days;
• . clindamycin 900 mg IV 3 times a day + gentamicin IV (first loading dose 2 mg/kg, then 1.5 mg/kg 3 times a day, possible in one dose), then either clindamycin 450 mg orally 4 times per day or doxycycline 100 mg orally 2 times a day + metronidazole 400 mg orally 2 times a day - the duration of the entire course is 14 days.

Alternative schemes:

• . ofloxacin 400 mg IV 2 times a day + metronidazole 500 mg IV 3 times a day for 14 days;
• . ciprofloxacin 200 mg IV 2 times a day + doxycycline 100 mg IV (or orally) 2 times a day + metronidazole 500 mg IV 3 times a day.

If such treatment cannot be carried out, then antibiotics are prescribed for 14 days. In this case, it is necessary to use drugs that are effective against N. gonorrhoeae (fluoroquinolones, cephalosporins), C. trachomatis (tetracyclines, macrolides), and anaerobic bacteria (metronidazole).

If the inflammatory reaction is not pronounced, treatment can be carried out on an outpatient basis, prescribing antibiotics orally. The European Guidelines for Pelvic Inflammatory Disease and Perihepatitis (2001) suggest the following outpatient treatment regimens:

• . ofloxacin 400 mg orally 2 times a day + metronidazole 500 mg orally 2 times a day for 14 days;
• . Ceftriaxone 250 mg intramuscularly once or cefoxitin 2 g intramuscularly with probenecid 1 g orally once, and then doxycycline 100 mg orally 2 times a day + metronidazole 400 mg 2 times a day for 14 days.

In order to prevent and treat possible fungal infections, it is recommended to include antithymic drugs (nystatin, levorin, diflucan, nizoral, orungal, etc.) in the treatment complex.

In case of severe general reaction and intoxication, infusion therapy is prescribed for the purpose of detoxification, improving the rheological and coagulation properties of the blood, eliminating electrolyte disturbances (isotonic solutions of sodium chloride and glucose, disol, trisol, Ringer's solution, hemodez, rheopolyglucin, reogluman, glucose-novocaine mixture, heparin , fraxiparine, clexane), restoration of acid-base balance (5% sodium bicarbonate solution), elimination of dysproteinemia (plasma, albumin solution). Infusion therapy, by reducing blood viscosity, improves the delivery of antibiotics to the site of inflammation and increases the effectiveness of antibacterial therapy.

The inflammatory process causes increased sensitivity to tissue decay products and microbial cell antigens. In this regard, in order to hyposensitize the body, it is necessary to use antihistamines. In addition, antihistamines reduce the body's response to histamine, relieve spasm of smooth muscles, and have an anti-inflammatory effect, reducing capillary permeability. Non-steroidal anti-inflammatory drugs (indomethacin, voltaren, ibuprofen, piroxicam) effectively reduce the symptoms of inflammation (pain, swelling). To correct impaired immunity, interferon status, and increase nonspecific resistance of the body, gamma globulin, levamisole, T-activin, thymalin, thymogen, leukinferon, interferon, stimulators of the synthesis of endogenous interferon (cycloferon, neovir), vitamins C, E, group B, adaptogens.

Reinfusion of blood irradiated with ultraviolet rays is extremely effective, regardless of the etiology of inflammation. Extracorporeal ultraviolet irradiation of the patient's own blood is performed, followed by its reinfusion. The procedure has a multifaceted effect: eliminates hemorheological and coagulation disorders, promotes saturation of hemoglobin with oxygen, increases the number of red blood cells, detoxifies the body, activates the immune system, increases nonspecific resistance, and provides bactericidal and virucidal effects.

In the acute phase of the inflammatory process, physiotherapy can be prescribed - UHF currents to the hypogastric area; subsequently, when signs of inflammation subside, electrophoresis of potassium iodide, copper, zinc, magnesium, phonophoresis of hydrocortisone, alternating magnetic fields, as well as local absorbable procedures (microclysters with chamomile, tampons with balsamic liniment according to Vishnevsky in the vagina).

When treating endometritis, it is advisable to perform hysteroscopy with washing the uterine cavity with antiseptic solutions, removing, if necessary, the remains of the fertilized egg, placental tissue, and foreign bodies.

The effectiveness of conservative therapy should be assessed after 12-48 hours. Improvements in general well-being, a decrease in temperature, the disappearance of symptoms of peritoneal irritation, and normalization of hematological parameters are prognostically significant. The lack of effect of conservative therapy in patients with pelvioperitonitis for 12-24 hours, the increase in local and general symptoms of inflammation, and the inability to exclude rupture of a purulent tubo-ovarian formation serve as indications for surgical treatment.

For pyosalpinxes, pyovars, and abscess of the rectovaginal recess, puncture of purulent formations can be done through the posterior vaginal fornix under the control of ultrasound scanning. During puncture, aspiration of the contents is carried out, followed by bacteriological examination and washing of purulent cavities with antiseptics or antibiotic solutions. This tactic allows you to eliminate acute symptoms of the inflammatory process and, if necessary, perform organ-preserving operations in the future.

The best results in the treatment of acute inflammatory diseases of the uterine appendages are obtained by laparoscopy. The value of laparoscopy, in addition to assessing the severity and extent of the inflammatory process, lies in the ability to lyse adhesions, open or remove purulent tubo-ovarian formations, perform targeted drainage and sanitation of the abdominal cavity, carry out intra-abdominal perfusion and infusion of various medicinal solutions. To preserve reproductive function in the future, dynamic laparoscopy is advisable, during which the rate of regressive changes in inflammation is recorded and various therapeutic procedures are performed: separation of adhesions, aspiration of pathological effusion, washing of the abdominal cavity with antiseptics. Dynamic laparoscopy increases the effectiveness of anti-inflammatory therapy and prevents the formation of adhesions, which is especially important for patients planning pregnancy.

Transsection (lower median laparotomy) is indicated for rupture of a purulent tubo-ovarian formation, diffuse or diffuse peritonitis, intra-abdominal abscesses, ineffective treatment within 24 hours after drainage of the abdominal cavity using a laparoscope, and if it is impossible to perform laparoscopy. Laparotomy access is also used in patients with purulent tubo-ovarian formations in pre- and postmenopause, if it is necessary to remove the uterus.

The extent of the operation is determined by the patient’s age, the degree of destructive changes and the prevalence of the inflammatory process, and concomitant pathology. Extirpation of the uterus with appendages from one or both sides is carried out when the uterus is the source of the inflammatory process (endomyometritis, panmetritis against the background of ICH, after childbirth, abortion and other intrauterine interventions), there are concomitant lesions of the body and cervix, with diffuse peritonitis, multiple abscesses in the abdominal cavity. In patients of reproductive age, one should strive to perform organ-conserving operations or, as a last resort, to preserve ovarian tissue. The surgical intervention is completed with drainage of the abdominal cavity.

It is necessary to identify the sexual partners of a patient with acute VZPO and offer to undergo testing for gonorrhea and chlamydia. Partners are advised to avoid sexual intercourse until the end of treatment. Empirical treatment against chlamydia should be given to all sexual partners due to the varying sensitivity of diagnostic tests. If adequate screening for gonorrhea in a sexual partner is not possible, empirical treatment for this infection should be performed.

Treatment of chronic VPOs includes prevention of relapses, elimination of pain, normalization of menstrual and reproductive functions.

Treatment of exacerbations of chronic inflammation of the uterine appendages is carried out in a antenatal clinic or in a hospital according to the same principles as the treatment of acute inflammation.

The main role in the treatment of chronic VPO without exacerbation belongs to physiotherapy - electrophoresis of copper, zinc, magnesium, potassium iodide, phonophoresis of hydrocortisone, lidase, alternating magnetic fields, laser therapy, etc. It is advisable to prescribe therapeutic massage, including gynecological, balneotherapy, mud therapy.

Drug therapy is aimed at increasing the immunobiological resistance of the body, eliminating residual effects of the inflammatory process, and pain. Non-steroidal anti-inflammatory drugs (administered mainly rectally), vitamins, antioxidants, immunostimulants, stimulators of endogenous interferon synthesis are used. It is also recommended to insert tampons with medications into the vagina (balsamic liniment according to Vishnevsky, levomekol, etc.). At the same time, correction of menstrual irregularities is carried out.

Restoration of reproductive function is possible after laparoscopic or microsurgical separation of adhesions, fimbrioplasty, salpingostomy, which is performed in patients under 35 years of age. If surgical treatment of tubo-peritoneal infertility is ineffective, in vitro fertilization is indicated.

Which doctors should you contact if you have Inflammatory diseases of the genital organs in women:

Gynecologist

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Other diseases from the group Diseases of the genitourinary system:

Inflammation of the female genital organs accompanied by a vascular-tissue reaction to the influence of pathogens that cause inflammation of a particular organ. The disease is very common and ranks first among gynecological diseases.

Depending on the location of the inflammation, there are:

• endometritis (inflammation of the uterus)
• cervicitis (inflammation of the cervix)
• adnexitis (salpingoophoritis - inflammation of the uterine appendages)
• oophoritis (inflammation of the ovaries)
• salpingitis (inflammation of the fallopian tubes)
• pelvioperitonitis (inflammation of the pelvic peritoneum)

Causes of the disease

A variety of microbes, most often streptococci, staphylococci, gonococci, E. coli, tubercle bacilli, fungi, viruses. They enter the genitals during sexual intercourse and other means.

Symptoms

In acute inflammatory processes, pain is observed in the lower abdomen, often radiating to the lower back, sacrum and hips; temperature increase; purulent discharge.

Treatment

Treatment of inflammation of the female genital organs begins with eliminating the cause that provoked the development of the inflammatory process. In addition, treatment for possible concomitant diseases may be required. Drugs that can be used during treatment:

• Antibacterial/antiviral drugs are selected taking into account the causative agent of the disease.
• Immunostimulants: Timalin, Echinacea.
• Washing the external genitalia with a warm solution of potassium permanganate, boric acid, and chlorhexidine.
• External treatment with antibacterial drugs: Macmiror.
• Use of vaginal suppositories: Terzhinan, Polygynax.
• The use of vitamin complexes, which include vitamin A and E.
• If there are lesions, use the drug Solcoseryl or sea buckthorn oil.
• Antihistamines, if there are complaints of itching: Suprastin, Tavegil, Desloratadine.
• In some cases, it is advisable to prescribe hormonal drugs both for local treatment and for oral administration. Such treatment may be required during the treatment of patients in older age groups.

The exact treatment regimen is determined individually after a comprehensive examination.

In acute cases of the disease, bed rest and abstinence from sexual activity are required.

Folk remedies

• 20 g of bay laurel per bucket of water. Use for sitz baths for diseases of the uterus and bladder.
• Pour a tablespoon of St. John's wort herb with a glass of boiling water, boil for 15 minutes, strain. Drink 1/4 cup 3 times a day for inflammation of the genital organs.
• Pour a tablespoon of dried and crushed walnut leaves into a glass of boiling water. Leave for 4 hours. Drink in a day.
• Take 1 part of sweet clover herb and 10 parts of coltsfoot herb. Pour a tablespoon of the mixture into a glass of boiling water. Leave in a water bath for 15 minutes, cool and strain. Drink 1/2 cup 3 times a day for inflammation of the appendages.
• Take the juice of fresh aloe leaves orally, a dessert spoon, 2-3 times a day before meals.
• There is an effective infusion for vulvitis, which can be prepared within an hour. It will relieve both pain and unpleasant tickling. All other remedies for inflammation of the labia take from a week to a month to prepare. Grind the bergenia root, pour 200 ml of boiling water and cover the vessel with a lid. Leave to sit at room temperature. After an hour, you can make lotions. The more often the procedures are performed, the faster the itching will go away.
• Pass the raw pumpkin through a meat grinder, squeeze the juice out of the pulp and consume it in large quantities.
• Pour 1 cup of boiling water over a teaspoon of blueberry leaves, 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.
• Prepare an infusion of small-leaved linden flowers at the rate of 2–3 tablespoons of raw material per 2 cups of boiling water. Take orally. For external use, pour 4-5 tablespoons of flowers with 2 cups of boiling water and leave. Use the infusion for inflammation of the female genital organs.
• Barberry helps well: pour 1/2 teaspoon of dried roots into a glass of water, boil for 30 minutes, strain and take 1 teaspoon 3 times a day.
• We also recommend drinking lemon balm infusion 1/2 cup 3 times a day before meals. To prepare the infusion, take 4 teaspoons of dry herb and pour a glass of boiling water, leave for 1 hour, strain.
• 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), leave to infuse. For external use, double the amount of herb.
• Pour a tablespoon of yarrow herb into 1 cup of boiling water and boil for 10 minutes. Drink 1/3 glass 2-3 times a day before meals. Infusions and decoctions of yarrow are used as a hemostatic agent and accelerate blood clotting during external and internal bleeding (uterine bleeding from inflammatory processes and fibroids, intestinal, hemorrhoidal).
• Flowers of sweet clover, herb of centaury, flowers of coltsfoot - equally. Pour a tablespoon of the mixture into a glass of water, boil for 15 minutes and strain. Take 1/3 cup 6 times a day for inflammation of the ovaries.
• Pour 10 g of corn stalks with stigmas into 200 ml of boiling water. Prepare a decoction. Take 1 tablespoon every 3 hours. Use for women's diseases as a hemostatic, sedative, diuretic and choleretic agent.
• Pour 10 g of herb tripartite into a glass of water at room temperature, boil in a water bath for 15 minutes, strain and cool. Take a tablespoon 3 times a day for uterine bleeding and inflammation of the genitals.
• For inflammatory processes of the female genital organs, a decoction of thorn roots is used against leucorrhoea. Pour 5 g of roots or bark of branches with 1 glass of water and boil for 15 minutes. Drink in small sips, like tea. For douching, the broth is diluted with boiled water 1:1.

Inflammation of the appendages in women is an infectious pathology, and the process affects the ovaries or fallopian tubes, but not the uterus itself. Penetration of the infectious agent into the body occurs in various ways.

The disease can proceed without symptoms for a long time, sometimes characterized by the appearance of pain in the lower abdomen and menstrual irregularities. Treatment is aimed at destroying the pathogen and restoring the function of the uterine appendages.

Causes

Why do women experience inflammation of the appendages, and what is it? In medicine, this disease is called salpingoophoritis. If the inflammation affects only the fallopian tubes, then salpingitis is diagnosed. An inflammatory process that affects only the ovaries is called oophoritis.

The development of the inflammatory process in the uterine appendages occurs under the influence of pathogenic and conditionally pathogenic microorganisms. There are two types of disease:

• specific adnexitis caused by diphtheria bacteria, tuberculosis bacillus, gonococci;
• nonspecific salpingoophoritis, caused by viruses, fungi, E. coli, streptococci, staphylococci, mycoplasmas, chlamydia and other microorganisms.

Penetration of infection into the uterine appendages can occur in the following ways:

• ascending (pathogenic microbes from the vagina penetrate the uterus, bypassing the cervical canal, into the tubes, and then can enter the ovaries);
• descending (there is already inflammation in the abdominal cavity, which gradually spreads to healthy tissue);
• hematogenous (microbes enter the fallopian tubes and ovaries with blood from other internal organs).

The likelihood of inflammation of the appendages increases with the action of provoking factors on the body:

• hypothermia;
• weakened immunity;
• using a contraceptive method such as an intrauterine device;
• unprotected sex;
• childbirth or abortion.

• acute;
• chronic;
• latent (asymptomatic, or sluggish).

The disease can be diagnosed at any age. Both young girls who are not sexually active and older women who have reached menopause turn to doctors for help.

Symptoms of inflammation of the appendages

In the case of inflammation of the appendages in women, the presence of certain symptoms depends on certain factors:

• pathogenicity of the ingested microorganism, its type;
• on the course of the disease, whether it is an acute process, with pronounced symptoms, or chronic, with erased, barely noticeable symptoms;
• the girl’s body’s ability to resist microorganisms and fight the inflammatory process, from the state of the immune system.

In acute form women complain of the following symptoms:

• tense abdomen in the lower regions;
• , sometimes radiating to the legs or lower back;
• increased body temperature (it can reach 39 degrees);
• changes in the menstrual cycle (sudden bleeding or delayed menstruation);
• vaginal discharge that is different from normal (it may be greenish-purulent or yellowish, thick or foamy).

An incompletely cured disease in the acute period can develop into chronic inflammation of the appendages, the symptoms of which depend on the period of remission or exacerbation. Every second woman with chronic adnexitis experiences the following pathological changes:

• menstrual irregularities;
• sexual function disorder;
• concomitant diseases of the urinary organs (,), etc.

During the period of exacerbation, all symptoms characteristic of acute adnexitis resume.

Chronic adnexitis

Chronic adnexitis develops as a result of untimely or poor-quality treatment of the acute form of the disease; it occurs with periodic seasonal exacerbations. This form of inflammation of the appendages is characterized by the presence of dull, aching pain in the lower abdomen, radiating to the vagina and lumbar region. Palpation of the abdomen determines moderate pain.

Due to structural and functional transformations in the ovaries (lack of ovulation, hypoestrogenism), chronic inflammation of the appendages in women is accompanied by menstrual irregularities, which are manifested by oligomenorrhea (scanty periods), polymenorrhea (heavy periods), algomenorrhea (painful periods). Patients may also complain of a lack or decrease in sexual desire, pain during intercourse.

Diagnostics

The above symptoms may also be present in other diseases of the genital organs, so only a gynecologist can make an accurate diagnosis after examining the patient, collecting anamnesis, and the results of laboratory and instrumental studies:

• Ultrasound of the uterus and appendages;
• PCR diagnostics (vaginal smear), which allows you to identify sexually transmitted infections;
• colposcopy (examination of the vagina and its walls);
• bacterial sowing;
• tomography;
• laparoscopy.

Signs of inflammation of the appendages can be determined by the results of a blood test. During inflammatory processes, the blood formula changes significantly. In addition, during a gynecological examination at an appointment with a gynecologist, a woman feels severe pain in the ovaries and uterus.

Consequences

Any inflammation of the appendages is dangerous because the following complications are possible:

• development into a chronic form;
• infertility as a result of the adhesive process, which causes obstruction of the fallopian tubes and anovulation;
• quite high risk of ectopic conception;
• purulent complication (tubo-ovarian formation) - purulent melting of the ovaries and tubes, followed by an abscess.

Prevention

1. Visit a gynecologist regularly, do not resist an examination in the chair, and take smears.
2. Avoid hypothermia by dressing appropriately for the weather, changing clothes after swimming, and avoiding sitting on cold objects.
3. If termination of pregnancy is necessary, do it early or with the help of medications, or a mini-abortion (avoid curettage).
4. Cure teeth, intestines and other foci of chronic infection.
5. Use barrier methods of contraception.
6. Treat gynecological diseases in a timely manner.
7. Follow the rules of healthy eating.
8. Follow the rules of intimate hygiene.
9. Avoid douching.
10. Avoid stress.

Thus, inflammation of the appendages is a serious disease that requires timely treatment, which involves strict compliance with medical instructions.

Treatment of inflammation of the appendages

When diagnosing inflammation of the appendages, treatment in women should be comprehensive: a combination of medications with physiotherapy, gynecological massage, osteopathy, and physiotherapy.

The main point in the treatment of inflammation is antibiotics. They are selected with a wide spectrum of action and maximum half-life. In addition, the woman herself needs to monitor her lifestyle (proper nutrition, abstinence from sexual activity, physical exercise, smoking and alcohol should be stopped).

The disease cannot be neglected, since the inflammatory process soon becomes chronic, which leads to infertility.

Antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages are the first and main condition that must be met for a favorable outcome of the disease. How to treat inflammation of the appendages, the dosage and number of doses for each individual woman is determined by a specialist, but we will give you the most commonly prescribed pairs of medications:

1. Nitroimidazole derivatives (for example, Metronidazole) to eliminate anaerobic flora that can live in an oxygen-free environment, such as gonococci (the causative agents of gonorrhea);
2. Inhibitor-protected penicillins (Amoxiclav), 3rd generation cephalosporins (Ceftriaxone), macrolides (Erythromycin), etc., which affect aerobic (living in an oxygen environment) flora;
3. Antifungal drugs (eg, Diflucan, Nystatin).

For the first three to four days until the condition normalizes, all these drugs are administered by injection. Then you can switch to tablet forms and reduce the dose.

Concomitant treatment

In addition to the prescription of antibacterial drugs, detoxification therapy is carried out (intravenous infusions of saline solutions, glucose, hemodez, rheopolyglucin and others in a volume of 2 - 3 liters).

Relief of pain and reduction of the inflammatory process is carried out using tablets. These are Diclofenac, Ibuprofen, Ketarol and other drugs. Be sure to prescribe vitamins C and B, as well as allergy pills.

When relieving an acute process and in the treatment of chronic inflammation of the appendages outside of exacerbation, physiotherapy is widely used: copper and zinc electrophoresis according to the phases of the menstrual cycle, electrophoresis with lidase or iodine, ultrasound, high-frequency pulsed currents (CMT, DDT). Also used in rehabilitation treatment are immunomodulators, autohemotherapy, injections of aloe, FIBS, Longidase, etc. For chronic adnexitis, sanatorium-resort treatment is indicated - mud, paraffin, medicinal baths and douching.

Suppositories for inflammation of the appendages

To reduce signs such as inflammation, pain, swelling, and temperature, special suppositories are used that can relieve inflammation. They can also prescribe suppositories that can strengthen the immune system, and this is very important for any illness. Also, such drugs cleanse the body of harmful substances.

All suppositories are prescribed by a doctor, but in any case such treatment will be additional.

Folk remedies

At home you can use some folk recipes:

1. Take 4 teaspoons finely chopped buckthorn, Chernobyl and peony roots, add 3 teaspoons of burnet and elecampane roots. After this, pour 2 tablespoons of the resulting mixture with half a liter of boiling water. Boil for half an hour over low heat, and then let cool for half an hour. Afterwards, strain and you can add a little honey for taste. You should take the product half a glass 3-4 times a day.
2. One tablespoon chopped dry boron uterus grass pour a glass of boiling water. Leave for 2 hours. Strain. Take 1/3 cup 3 times a day half an hour before meals. The course of treatment is 1 month. After a month's course of treating adnexitis with boron uterus, it is advisable to drink another infusion for 2 months - from the grass of the field grass. 1 tbsp. l. pour a glass of boiling water over the herbs, leave for 4 hours, strain. Drink 1 tsp. 30 minutes before meals 4 times a day.
3. Buldenezh should be collected at the very beginning of flowering (until insects infest them). A tincture of them has excellent antiseptic, anti-inflammatory and analgesic properties. A liter jar is filled with inflorescence balls, filled with vodka and sent to a dark, cool place for 15 days. This tincture is rubbed on the lower abdomen, and the inflorescences are applied in the form of compresses.
4. Take flowers of coltsfoot, sweet clover, centaury in equal proportions. Mix, after crushing, pour boiling water, let it brew for an hour, then strain the broth through cheesecloth and drink half a glass twice a day. During treatment, abstinence from sexual intercourse is recommended.

Remember that folk remedies are only a supplement and cannot in any way replace drug therapy prescribed by a specialist.

The most common circumstances of exacerbation of inflammatory diseases of the uterus and appendages are nonspecific factors, such as overwork, hypothermia, stressful situations, negative emotions, extragenital diseases.

Adnexitis (another name for salpingoophoritis) inflammation of the uterine appendages (fallopian tubes and ovaries)

The most constant and characteristic manifestation of adnexitis is pain. Pain, in most cases, is localized in the lower abdomen and can radiate to the lumbar or sacral spine. Much more often pain appears periodically, less often it disturbs invariably. Pain often continues to exist after the disappearance of indicators of the inflammatory reaction and can intensify with cooling, various diseases, physical and emotional overload, etc.

Indicators of inflammation of the appendages
When treating inflammation of the appendages, it is possible to use traditional medicine recipes as aids.
Herbal tea: prepare a mixture of 200 g of rose hips, 20 g of meadowsweet herb, daisy and mantle. Pour two tablespoons of crushed tea collection into 0.5 liters of hot water, leave for 5 hours, then bring to a boil, cool and strain. Drink the prepared tea throughout the day. Prepare and drink the drink within 2-3 weeks.
A decoction for douching: mix an equal amount of knotweed and horsetail herbs, calendula and yarrow inflorescences, white damselfish flowers and wild mallow. Pour two tablespoons of the crushed mixture into 1 liter of boiling water, leave, covered, for an hour, strain, cool to body temperature. Do douching for a long time (at least 4 weeks, and preferably until complete recovery).

The symptoms of inflammation of the appendages depend on the form of the disease, and it can be chronic or acute. There is also such a thing as a latent (latent, sluggish) disease.

The acute form of inflammation of the appendages is accompanied by the following symptoms:
pain in the lower abdomen, sometimes radiating to the lower back and legs;
discharge from the genital tract;
increase in temperature;
painful sensations during sexual intercourse;
menstrual irregularities in the form of bleeding or delayed menstruation (inflamed ovarian tissue is not able to regulate the menstrual cycle normally).

The chronic form of inflammation of the appendages, in most cases, begins after the end of an acute inflammation that is not well treated, undertreated, or not treated at all. The symptoms of chronic inflammation may be slightly expressed: the temperature fluctuates around 37 degrees, the lower abdomen periodically hurts, minor discharge is observed, lethargy and irritability appear.

Latent, sluggish, asymptomatic form of inflammation of the appendages is the most terrible. The inflammatory process in the body practically does not make itself felt, proceeds slowly, but correctly and heartlessly affects the appendages. The disease progresses, adhesions develop, leading to infertility. This is why it is fundamentally important to systematically visit a gynecologist; in addition, in the absence of complaints, the doctor will be able to promptly find a hidden disease.

Be careful! Inflammation of the appendages is one of the most common causes of infertility. no less dangerous is the fact that this disease triples the risk of developing an ectopic pregnancy.

Circumstances of inflammation of the appendages
The cause of inflammation of the appendages may be insufficient attention to the issue of personal hygiene. Try to change sanitary pads as often as possible, at least twice a day. Avoid thong panties: the narrow strip connecting the front and back of the underwear can become a direct path to the female genital organs for harmful microorganisms living in the rectum.
Sexually transmitted diseases are the most common cause of inflammation of the appendages. These include specific venereal diseases and diseases caused by conditionally pathogenic flora (gonococcus, trichomonas, mycoplasma, ureaplasma, chlamydia, gardnerella, candida, etc.).
Nervous overstrain. The lifestyle of a modern working woman has a detrimental effect on the immune system and weakens the body's natural defenses. Banal hypothermia of the legs, arms, lower back, severe stress (besides simple fear) is enough to cause inflammation of the appendages.
Hormonal disorders are directly related to the neuropsychic state of a woman. Against the background of hormonal emissions or, on the contrary, insufficient production of certain hormones, the menstrual cycle is disrupted, which is why small cysts can form in the appendages and unnecessary fluid accumulates. Inflammation begins, the cyst can grow, fester, and spontaneously open, which threatens very severe inflammation not only in the appendages, but also in nearby organs.
Unclaimed sexuality. The circumstance is quite rare, but it exists. Sexual contact is not only an emotional release, but also a physical one, associated with improved blood flow in the internal genital organs.
Viral diseases. Inflammation of the appendages may appear as a complication after the end of an acute respiratory viral infection or flu. In addition, harmless herpes on the lip can be reflected in inflammation of the appendages in a week or two.

Treatment of inflammation of the appendages

With proper treatment, acute symptoms of inflammation subside within a couple of days. But this does not mean that it is possible to stop treatment.
Once the circumstances of the disease are clarified, the gynecologist prescribes treatment, which includes anti-inflammatory, antimicrobial and restorative therapy. The healing process is quite long, but it is forbidden to interrupt it in any case, except if you think that you have fully recovered.

Treatment of inflammation of the appendages includes the following steps:
taking antibiotics;
physiotherapy;
when identifying indicators of a chronic form and adhesive processes, preventive courses of physiotherapy for 1.5-2 years;
when adhesions form ((sticking together of the walls of the fallopian tubes and ovaries), an endoscopic operation to dissect them;
sanatorium-resort and balneotherapy.

Be careful! According to statistics, in half of the cases, acute inflammation of the appendages becomes chronic due to an interrupted course of treatment.

In most cases, pain is accompanied by transformations in the neuropsychic state of patients (poor sleep, irritability, decreased ability to work, rapid fatigue, etc.).

The incidence of infertility in patients with adnexitis can be about 60–70%.

The third responsible manifestation of the chronic process in the uterus and appendages is menstrual dysfunction. The existence of a persistent focus of inflammation in the pelvis leads to disruption of the menstrual cycle in 45-55% of patients, which manifests itself in the form of irregular cycles, scanty or, conversely, heavy menstruation, painful menstruation. There may be premenstrual or postmenstrual discharge.

Sexual dysfunction occurs in 50-70% of cases and manifests itself in the absence or transformation of sexual desire, lack of orgasm, vaginismus, pain during sexual intercourse, which, in turn, is closely related to the psycho-emotional state of patients and the degree of decreased ovarian function.

In fact, every fourth woman suffering from chronic inflammation of the uterus and/or appendages experiences leucorrhoea. They can be serous or purulent; their number may also vary and is associated, in most cases, with the severity of the inflammatory process.

Treatment of adnexitis
Oak bark, chamomile flowers - 1 part each, nettle leaves 3 parts, knotweed grass 5 parts
Immortelle baskets, birch leaves, strawberry leaves, corn silk, coltsfoot leaves, mint grass, yarrow, bean leaves in 2 parts, knotweed, nettle, string, rosehip fruits in 3 parts, rowan fruits
Lavender grass, bird cherry flowers, wormwood herb 1 part each, oak bark, strawberry leaves 2 parts each, rose hips 3 parts
Oak bark 6 parts, oregano herb 4 parts, marshmallow root 1 part
Thyme, coltsfoot, marshmallow root 2 parts each, nettle, St. John's wort yarrow 1 part
Sweet clover flowers, coltsfoot leaves, centaury, nettle 1 part, yarrow 2 parts
Valerian root, lemon balm leaves 2 parts each, mantle herb, nettle 3 parts each
Licorice root, string grass, Manchurian aralia root, horsetail grass, rose hips, immortelle baskets, elecampane root, alder fruits, 1 part each

Preparation of the mixture: pour 2 tablespoons of pre-crushed (in a coffee grinder or meat grinder) mixture into 1 liter of boiling water, bring to a boil, simmer over low heat for 10 minutes. in a sealed container, pour it into a thermos along with the herbs, leave overnight. Take 100-150 ml per 30 minutes during the day. before meals. To improve the taste, you can add honey, sugar, jam. The course of treatment is 3-4 months. At the end of which they pause for 10-14 days, change the collection and continue treatment. Regardless of the improvement, herbal medicine should be continued for at least 12 months. In the future, switch to preventive doses in the spring and autumn (2 months each).

Boil fresh cabbage leaves in milk. Pour the contents into a suitable vessel and, sitting on it, take a steam bath.

Repeat the procedure until the inflammation ends.

In case of inflammation of the appendages, drink on an empty stomach juice obtained from 1 medium-sized whole raw potato (about 0.3 cups of juice). Before drinking, mix the juice well so that the settled starch becomes suspended.
The course of treatment must be carried out in late summer, autumn and winter - until March.

Take equal parts by weight of sweet clover herb, centaury herb and coltsfoot flowers. Pour 1 tablespoon of the mixture with 1 glass of boiling water, leave for 1 hour and strain. Take 0.3 cups 6 daily for 3-4 weeks.

Take equal parts of sweet clover grass and coltsfoot flowers. Brew 1 tablespoon of the mixture with 1 glass of boiling water and leave for 1 hour. Drink 3-4 tablespoons 5 daily. The course of treatment is 2-3 weeks with complete abstinence from sexual activity.

Take equal parts of coltsfoot leaf, sweet clover herb, chamomile flowers, calendula flowers and centaury herb. Pour 2 tablespoons of the mixture into 0.5 liters of boiling water and leave for 2 hours.
Take 0.3 cup 6 daily before meals and between meals for 1-2 months. During treatment, complete abstinence from sexual activity is required. Used for inflammation of the ovaries and infertility.

Take by weight 2 parts of wild mallow flowers and oak bark, 3 parts of sage leaves, 5 parts of chamomile flowers. Prepare a decoction of 2 tablespoons of the mixture per 1 liter of water. Use for douching and vaginal tampons.

Pour 1 bucket of boiling water over 50 g of juniper berries and stems, leave for 2 hours and strain. Use for baths.

Pour 2 tablespoons of cinquefoil herb with 2 cups of boiling water and leave for 1 hour. Drink on an empty stomach and before each meal 0.5 cups 4 times a day.
At night, douche with a more concentrated infusion: pour 5 tablespoons of the herb into 0.5 liters of boiling water and leave for 1 night in a thermos.

Herbal teas can be used in combination with other medications.

Improvement with herbal medicine occurs after 2-3 weeks of regular use of herbs. But a lasting effect can only be achieved with long-term and regular use of herbs (for 8-12 months or more).

For chronic inflammation, it is best to take mud baths and potassium iodide 3 times a day, 0.1 g. For women, in addition, warm douching and complete abstinence from sexual intercourse until the pain stops.

For inflammation of the appendages and leucorrhoea, you should chew fresh juniper berries (instead of a decoction) 3 times a day, starting with 4 berries, increase their intake by 1 each time, bringing it to 13, and then reduce to 4. It is also possible to use a decoction of juniper berries : 15 berries per 1 glass of water, leave for 4 hours. Drink 1 tbsp. 3 times a day. For external use, the decoction is prepared as follows: pour 1 bucket of boiling water over 50 g of juniper berries and stems, leave for 2 hours and strain.

For inflammation of the appendages, brew 2 cups of boiling water and 2 tbsp. cinquefoil herb and leave for 1 hour.

Drink on an empty stomach and before each meal? glasses 4 times a day. At night, douche with a more concentrated infusion. Brew 0.5 liters of boiling water 5 tbsp. herbs and leave overnight in a thermos.

For inflammation of the ovaries, mix 20 g of sweet clover herb, centaury herb and coltsfoot flowers. Brew 1 cup boiling water 1 tbsp. mixture, leave for 1 hour and strain. Take 1/3 cup 6 daily for 3-4 weeks.

Mix equal parts sweet clover with coltsfoot flowers. Brew 1 cup boiling water 1 tbsp. mixture and leave for 1 hour. Drink 3-4 tbsp. 5 daily. The course of treatment is 2-3 weeks (with complete abstinence from sexual activity).

Boil forest hay in a large saucepan and place the patient over the steam. Repeat the procedure until the inflammation ends.

Pour hot water over unwashed sheep wool and place the affected one over the steam.

For inflammation of the ovaries and infertility, mix 50 g of coltsfoot leaves, sweet clover herb, chamomile flowers, calendula flowers and centaury herb. Brew 0.5 liters of boiling water 2 tbsp. mixture and leave for 2 hours. Take 1/3 cup 6 daily before meals and between meals for 1-2 months (with complete abstinence from sexual activity during treatment).

Mix equal parts of rose hips and dark currants. Brew 20 g of the mixture with 1 glass of boiled water, leave for 1 hour, strain. Add sugar. Have a drink? glasses 3-4 times a day.
Pour 1 cup boiling water over 1 tbsp. dried and crushed walnut leaves. Leave for 4 hours. Drink in a day.

Brew 1.5 tbsp. dry chamomile in a porcelain cup, cover with a saucer, wrap. Leave for 20 minutes. During this time, do a cleansing enema with hot water. Take the strained chamomile decoction at a temperature of 37 C into syringe No. 3 and insert it into the anus. Then lie on your side and wait until everything is absorbed. If it doesn't work the first time, do the same a second time. The chamomile decoction should be completely absorbed. The nagging, debilitating pain will go away immediately. Do this procedure every evening, if possible, daily. This is the oldest effective method of treating inflammation of the appendages. So, it is possible to cure hemorrhoids.

Brew wintergreen leaves as tea; it is possible to mix it with tea instead of St. John's wort. This helps in the treatment of chronic inflammation of the appendages after a long period of use (a couple of months) of 3-4 cups per day, especially if you combine tea with wintergreen and St. John's wort with chamomile enemas.

Pour 1-2 tsp boiling water over 1 cup. dry wintergreen leaves, leave, wrapped for 2 hours, strain. Take according to? glasses 3 times a day for 30 minutes. before meals.

For inflammation of the appendages and uterine cancer, pour 0.5 liters of vodka with 50 g of wintergreen leaves and leave for 14 days in a dark place. Take 30-40 drops 3 times a day.

Pour 1 cup of boiling water over 1.5 tbsp. dried herb field grass and leave for 4 hours in a well-sealed container. Strain. Drink 1 tsp. every 3-4 hours and 4-5 daily. Contraindicated for pregnant women - miscarriage may occur.

be directed to use as much pumpkin as possible in all types. It is useful to pass the raw pumpkin through a meat grinder and squeeze out the juice from the pulp, which can be used a lot.

Use cranberries, blueberries, rowan berries and blackberries in any form.

Drink the infusion of corn stalks and stigmas.

Take a dessert spoon orally 2-3 times a day for 30 minutes. Before meals, juice fresh aloe leaves.

For inflammation of the female genital organs, brew 2-3 tablespoons of boiling water with 2 cups. small-leaved linden flowers, leave for 20 minutes, strain. Should I take it internally? glasses 3-4 times a day for 30 minutes. before meals, inside.

For external consumption 4-5 tbsp. pour linden flowers with two cups of boiling water and leave.
Externally, linden flowers are used in the form of lotions and poultices for mastitis, ulcers, burns, and for washing 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 daily until the inflammation heals.

Place the patient over steam, where gorse is cooked, doused with olive oil.

Boil fresh cabbage, add milk and place the sick one over the steam.

Herbal mixture for douching for adnexitis, traditional medicine recipe:
Traditional medicine for the treatment of adnexitis recommends taking herbs: chamomile 1 part, nettle leaves 3 parts, knotweed herb 5 parts. 2 tbsp. spoons of the mixture, pour 1 liter of boiling water, leave in a thermos for an hour. Use for douching 2 times a day. Use in the treatment of adnexitis.

Folk remedy for the treatment of adnexitis herbal mixture for douching :
Adnexitis can be cured with a folk remedy, for this you need to take oak bark 6 parts, oregano herb 4 parts, marshmallow root 1 part. Proportions 5 tbsp. spoons of mixture per 200 ml of boiling water. Leave in a thermos for 30-40 minutes. Strain, cool, and use for douching twice a day. Use in the treatment of adnexitis.
Traditional medicine proven recipe for tincture for the treatment of adnexitis:

Traditional medicine offers a proven tincture recipe. It is prepared from herbs: sweet clover flowers, coltsfoot leaves, centaury, 1 part nettle, 2 parts yarrow. 1 tbsp. spoon of the mixture per 500 ml of boiling water, leave for 30 minutes. strain, drink 100 ml 3 times a day. Use in the treatment of adnexitis.

Traditional medicine treats adnexitis bergenia, marin root :
Traditional medicine treats fibroids, erosions, adnexitis by crushing 50 g of bergenia root, putting it in an enamel pan and pouring 300 g of hot water. Allow to brew for 8 hours.
If there is discharge, douche twice a day with this solution: 2 tbsp. spoons of bergenia extract per liter of boiled water. At the end of the evening douching, make a tampon: place a teaspoon of bergenia on cotton wool and wrap it in two layers of sterile cotton wool and gauze. Soak a tampon in bergenia extract, wring it out lightly and insert it into the vagina. Place a pillow under your buttocks throughout the night.
At one point, take 1-1.5 teaspoons of thick bergenia extract orally an hour before meals for three days, then pause after 3 days. And again a course of treatment.
Additionally, drink a tincture of Maryina root prepared according to this recipe: finely chop 50 g of the root, put it in a black bottle and pour in 0.5 liters of vodka. Allow to stand for 10 days. Drink 30-40 drops 3 times a day half an hour before meals. The course of treatment is one month. If necessary, repeat the course at the end of the 10-day break.
Treatment of fibroma with this method will take 6-8 weeks, inflammation of the appendages (adnexitis) 3-4 weeks, adhesions 3-4 weeks, treatment of erosion will take 2-3 weeks. All herbs are sold in the pharmacy. During treatment, check with a gynecologist

Wormwood for inflammation of the appendages

A very effective folk remedy for treating inflammation of the appendages using wormwood. The recipe is not complicated but effective. In a bucket you need to bring two liters of water to a boil, and then throw a handful of wormwood in that direction, remove the bucket from the stove, put it on the floor and sit over it for twenty minutes. Relief will come no sooner than after completing six such procedures.

Ortilia is one-sided from all troubles!

There is such an excellent plant - one-sided ortilia, it is also called ramishia (hog queen). It can help not only with inflammation of the appendages and bleeding fibroids, but also with infertility, uterine infantility, tubal obstruction and toxicosis during pregnancy. It will also help with polyps and cervical erosion.

You can make a decoction from it like this: grind the herb in a coffee grinder and pour one tablespoon of the herb with a glass of boiling water. After 2 hours, strain. You need to take a third of a glass half an hour before meals.

To prepare an infusion with alcohol, use half a liter of vodka and 50 grams of herbs. The medicine should be infused in a black container for 14 days. It is recommended to take the tincture 3 times a day, 35 drops an hour before meals.

Tincture of buldenezh for inflammation of the appendages

In May-June, you can notice how buldenezh blooms in white balls - this is one of the varieties of viburnum. If there are insects on the flower, throw away such plants. Place the buldenezh in a jar to the top and fill it with alcohol, after which you need to close the jar. In most cases, half a liter of alcohol is poured into a liter jar. Place the composition in a dark place for 15 days.

This folk remedy helps with inflammation of the appendages. After rubbing, the flowers should be placed in a layer on the lower abdomen for 2 hours. A couple of days and everything passes.

About the treatment of appendages

It is necessary to melt four hundred grams of paraffin in an aluminum bowl, lie on your back, moisten the cloth in paraffin, and then lubricate the lower abdomen with it from left to right. Lubrication must be done quickly. The first time the paraffin is still warm, but later it cools down quickly. After you have lubricated your belly with paraffin, wrap yourself in a warm blanket and wait in this position until the paraffin cools down.

Bedrenets will help the ladies

Bedrenets must be collected during its flowering period. The crushed herb is taken in the amount of one tablespoon and poured into a liter of water, then boiled for ten minutes. The medicine is drunk with honey throughout the day. There is no need to drain the sediment from the broth. Douche with this decoction in the morning for 20 days.

Bedrenets provides assistance with all sexually transmitted infections. In addition, he treats cysts, fibroids, menstrual irregularities, mastopathy, uterine cancer, and obstruction of the fallopian tubes.

Chronic inflammation of the appendages

Chronic inflammation of the appendages can also be cured with herbs. Take 4 teaspoons of finely chopped buckthorn, Chernobyl and peony roots, add 3 teaspoons of burnet and elecampane roots. Then pour 2 tablespoons of the resulting mixture with half a liter of boiling water. Boil for half an hour over low heat, and when finished, allow to cool for half an hour. When finished, strain and you can add a little honey for taste. Take half a glass 3-4 times a day.

Onion and garlic
Two good folk methods for treating inflammation of the appendages. Both of these methods are quite simple and do not require a large amount of investment.

Place a huge onion in a liter of water in a coffee pot. Boil it until it softens. After the broth has cooled down a little, strain it, and before the broth becomes completely cold, syringe with it. Perform the procedure about three times. After completing such procedures, dress up warmly and do not sit in the cold.

And the second method is contained in the following. Make a tampon with thread. Crush the garlic and add hot water. There will be a solution that should pinch your tongue. Soak a tampon in this solution and insert it into the vagina for two to three hours. It is good if the procedure is performed after bowel movement is completed. Do the treatment until you recover. It is possible to do this procedure three or seven times a month just for prevention.

Drink the field jar

It is necessary to take dry grass of the field grass, pour one and a half tablespoons of this herb with a glass of boiling water and let it brew for four hours. Along with this, the container in which you brewed the herb must be well closed and wrapped in a warm towel. Later, strain the broth and drink one teaspoon per thirty minutes. before meals four times a day. Treatment is necessary for two months.

When the ovaries become inflamed, it is necessary for the stomach to be cleansed. To do this, place an ice pack on your belly. In addition, it is necessary to lubricate the lower abdomen with ichthyol ointment or ichthyol. Do not rub the ointment into these places.

If you have chronic inflammation, then do mud baths and warm douching. In addition, take potassium iodide three times a day. It is better to abstain from sexual intercourse while you feel discomfort and pain.

If you have this disease, eat pumpkin more often: perhaps eat it raw, or use pumpkin juice and make a decoction of corn cob hair.

Folk method for inflammation of the appendages

In the old days, when women's appendages became inflamed, they used this folk recipe. One tablespoon of dry mustard and the same amount of oak ash are mixed with two tablespoons of salt. They add little water, as a result there will be an ointment. This ointment is placed at the bottom of the dish and poured with boiling water. Now the patient needs to cover her back and stomach with a scarf and sit on the potty to steam. In 20 minutes. run to bed. Do this procedure every day before going to bed - and after 10 days you will forget about the appendages.

– 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.