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 (VZPO) in women occupy the 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 with erased forms they do not go to the doctor. The increase in the number of VZPO in all countries of the world is a consequence of increased migration of the population, changes in the sexual behavior of young people, violations of the environment and a decrease in immunity.

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

VZPO can arise under the influence of mechanical, thermal, chemical factors. The most significant is infectious. Depending on the type of pathogen, VZPO are divided into specific - (gonorrhea, tuberculosis, diphtheria) and non-specific. Various cocci, candida, chlamydia, mycoplasma, ureaplasma, Escherichia coli, Klebsiella, Proteus, corynebacteria (gardnerella), viruses, Trichomonas, etc. are considered to be the causes of nonspecific inflammatory diseases. Along with absolute pathogens, opportunistic microorganisms also play an important role in the occurrence of VZPO, living in certain parts of the genital tract. However, this division is conditional, since VZPO cause associations of microorganisms. The causative agents of VZPO are transmitted sexually, less often - household (mainly in girls when using common hygiene items). Conditionally pathogenic 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 preventing the entry and spread of infection in the body. The activation of conditionally pathogenic 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 responses.

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 microbiocenosis belongs to lacto- and bifidobacteria, which create a natural barrier to pathogenic infection. The vaginal rod-shaped bacteria also include actinomycetes, corynebacteria, bacteroids, fusobacteria.

The second place in the frequency of detection in the vagina belongs to cocci - epidermal staphylococcus, hemolytic and non-hemolytic streptococci, enterococci. Enterobacteria, Escherichia 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 prevails 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 primarily affected by the level of estrogens in the body. So, with physiological hypoestrogenia 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, the number of lactobacilli becomes negligible. The epithelium of the vagina with hypoestrogenism is thin, pH 7.0. The species composition of the vaginal microflora changes with the use of antibiotics, hormonal contraceptives, douching or vaginal treatment with antiseptic and antibacterial drugs.

The cervical canal serves as a barrier between the lower and upper parts of the genital tract, and the border is the internal os of the uterus. Cervical mucus contains biologically active substances in high concentration. Cervical mucus provides activation of non-specific defense factors (phagocytosis, synthesis of opsonins, lysozyme, transferrin, which are 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.

The spread of infection is also prevented by:

• . rejection of the functional layer of the endometrium during menstruation, along with the microorganisms that got 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 can be passive and active. Passively, the microorganisms that cause the disease spread canalicularly along the length through the cervical canal into the uterine cavity, into the tubes and the abdominal cavity, hematogenously or lymphogenously. Active transport of infection is carried out on the surface of spermatozoa and Trichomonas, where special receptors are located.

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

• . various intrauterine manipulations - probing of the uterus, diagnostic curettage of the uterine mucosa, hysterography, hydrosonography, hysteroscopy, artificial abortions, the introduction of intrauterine contraceptives. During intrauterine manipulations, an infection occurs from the outside or from the vagina into the uterine cavity, which then enters the abdominal cavity through the fallopian tubes;
• . menstruation, which often precedes an ascending infection. During menstruation, the blood alkalizes the acidic contents of the vagina, 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 violates the natural protective barriers;
• . operations on the organs of the abdominal cavity and the organs of the small pelvis, in which the possibility of contact between the abdominal cavity and the external environment is of particular importance;
• . foci of chronic infection, metabolic and endocrine disorders, nutritional deficiencies or imbalances, 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 severe clinical symptoms, subacute with blurred manifestations and chronic.

According to 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 boundary of which is the internal uterine os.

Symptoms of inflammatory diseases of the genital organs in women:

Nonspecific inflammatory diseases of the lower genital tract

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

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

Diagnosis of vulvitis is based on complaints, anamnesis data, gynecological examination. Additional methods include bacterioscopic and bacteriological examination of the discharge of the external genital organs to identify the causative agent of the disease.

Treatment of vulvitis consists primarily in the elimination of the associated pathology that caused it. In addition, sitz baths and washing the vagina with infusion of herbs (chamomile, calendula, sage, St. Taking into account the selected microflora, antibacterial drugs are prescribed. Preference is given to complex drugs 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 applied topically to accelerate reparative processes. With severe itching of the vulva, antihistamines are used (diphenhydramine, suprastin, tavegil, etc.), local anesthetics (5% anesthesin ointment).

Bartholinitis - inflammation of the large gland of the vestibule of the vagina. The inflammatory process in the cylindrical 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 edema of the excretory duct of the gland, purulent discharge with pressure are determined. The formation of an abscess leads to a worsening of the condition. Weakness, malaise, headache, chills, fever up to 39 ° C appear, pains in the area of ​​the Bartholin's gland become sharp, pulsating. On examination, edema and hyperemia are noted in the middle and lower thirds of the large and small labia on the side of the lesion, a painful tumor-like formation that closes the entrance to the vagina. Surgical or spontaneous opening of the abscess leads to an improvement in the condition and the gradual disappearance of the symptoms of inflammation.

Treatment of bartholinitis is reduced to the appointment of antibiotics, taking into account the causative agent of the disease, symptomatic agents. Sedentary baths with antiseptics are prescribed locally, applications of anti-inflammatory ointments (levomekol), 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.

With the formation of an abscess of 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 - inflammation of the vaginal mucosa, one of the most common diseases in patients of the reproductive period, is caused by various microorganisms, may result from the action of chemical, allergic, thermal, mechanical factors. In the acute stage of the disease, patients complain of itching, burning in the vaginal area, purulent or serosiopurulent discharge from the genital tract, pain in the vagina during intercourse (dyspareunia). Colpitis is often combined with vulvitis, endocervicitis, urethritis. During a gynecological examination, attention is drawn to swelling and hyperemia of the vaginal mucosa, which bleeds easily when touched, purulent overlays and pinpoint hemorrhages on its surface. In a severe course 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, occur periodically, the main complaint is serous-purulent discharge from the genital tract. Hyperemia and edema of the mucous membrane decrease, in the 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, anamnesis data, gynecological examination. An additional research method is colposcopy, which helps to 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 infection, and on the other, at eliminating concomitant diseases. Etiotropic therapy consists in the appointment of antibacterial drugs that act on pathogens. For this purpose, both local and general therapy are used. Washing or douching of the vagina is prescribed with antiseptic solutions, decoctions of herbs 2-3 times a day, a solution of chlorophyllipt (1 tablespoon of a 1% alcohol solution per 1 liter of water). Prolonged douching (more than 3-4 days) is not recommended, because it disrupts the restoration of the natural biocenosis and normal acidity of the vagina. With senile colpitis, it is advisable to use estrogens topically, which increase the biological protection of the epithelium - ovestin in suppositories, ointments.

Antibiotics and antibacterial agents are used in the form of suppositories, vaginal tablets, ointments, gels. Widespread for the treatment of colpitis received complex preparations - terzhinan, polygynax, ginalgin. In anaerobic and mixed infections, betadine, flagyl, clion, metronidazole, dalacin are effective. Local treatment is often combined with general antibiotic therapy, taking into account the causative agent of the disease.

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

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

Diagnosis of endocervicitis is helped by bacteriological and bacterioscopic examination of discharges from the cervical canal in order to select therapy, as well as cytological examination of smears from the cervix, which detects cells of a cylindrical and stratified squamous epithelium without signs of atypia, an inflammatory leukocyte reaction.

Treatment of endocervicitis in the acute phase consists in the appointment of antibacterial agents, taking into account the sensitivity of the pathogens. Topical treatment is contraindicated due to the risk of ascending infection. In the chronic stage, with 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 with damage to both the functional and basal layers. Acute endometritis, as a rule, occurs after various intrauterine manipulations - abortion, curettage, the introduction of intrauterine contraceptives, and also 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 sanious-purulent discharge from the genital tract. The acute stage of the disease lasts 8-10 days and ends, as a rule, with recovery. Less common is the generalization of the process with the development of complications (parametritis, peritonitis, pelvic abscesses, thrombophlebitis of the veins of the small pelvis, sepsis) or inflammation becomes subacute and chronic. Gynecological examination reveals an enlarged, soft consistency, painful or sensitive uterus, especially in the area of ​​\u200b\u200bthe ribs of the uterus (but the course of large lymphatic vessels). In a clinical blood test, leukocytosis, a shift of the leukocyte formula to the left, lymphopenia, and an increase in ESR are detected. Ultrasonic scanning determines the angle of the M-echo. The endoscopic picture during hysteroscopy depends on the causes that caused endometritis. In the uterine cavity, against the background of hyperemic and edematous mucous membrane, scraps of necrotic mucosa, elements of the fetal egg, remnants of placental tissue, foreign bodies (ligatures, intrauterine contraceptive, etc.) can be determined.

Chronic endometritis occurs more often due to inadequate treatment of acute endometritis, which is facilitated by repeated curettage of the uterus for bleeding, suture material after cesarean section, intrauterine contraceptives. Chronic endometritis is a clinical and anatomical concept. The role of infection in maintaining chronic inflammation is highly questionable. However, in chronic endometritis, there are morphological signs: lymphoid infiltrates, stromal fibrosis, sclerotic changes in spiral arteries, plasma cells, gland atrophy, or, conversely, mucosal hyperplasia with the formation of cysts. In the endometrium, the number of receptors for sex steroid hormones decreases, resulting in the inferiority of the transformations of the uterine mucosa during the menstrual cycle. The clinical course is latent. The main symptoms of chronic endometritis include menstrual disorders - heavy, prolonged menstruation (hyperpolymenorrhea) or metrorrhagia due to impaired mucosal regeneration and reduced uterine contractility. Patients are disturbed by pulling, aching pains in the lower abdomen, serous-purulent discharge from the genital tract. Often in the anamnesis there are indications of spontaneous abortions (as a result of a violation of the implantation of the fetal egg). Chronic endometritis can be suspected on the basis of history, clinic, gynecological examination (slight increase and induration of the uterine body, serous-purulent discharge from the genital tract). However, final verification of the diagnosis requires a histological examination of the endometrium.

Salpingoophoritis (adnexitis) - inflammation of the uterine appendages (tubes, ovaries, ligaments), occurs either ascending or descending, secondary to inflammatory-altered abdominal organs (for example, with appendicitis) or hematogenously. With ascending infection, the infection penetrates from the uterus into the lumen of the fallopian tube, involving all layers (salpingitis) in the inflammatory process, and then, in half of the patients, the ovary (oophoritis) together 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 (sactosalpinx) are formed. The accumulation of pus in the tube leads to the formation of pyosalpinx, serous exudate - to the formation of hydrosalpinx.

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

Sometimes an inflammatory conglomerate is formed in the area of ​​the uterine appendages, which is found as a volumetric tubo-ovarian formation. One form of complication of acute adnexitis is a tubo-ovarian abscess resulting from the melting of the adjacent walls of the pyovar and pyosalpinx.

Under certain conditions, through the fimbrial section of the tube, as well as in case of rupture of an ovarian abscess, pyosalpinx, tubo-ovarian abscess, the infection can penetrate into the abdominal cavity and cause inflammation of the peritoneum of the small pelvis (pelvioperitonitis), and then other floors of the abdominal cavity (diffuse or diffuse peritonitis) with the development abscesses (rectovaginal deepening, interintestinal).

The clinic of acute salpingo-oophoritis (adnexitis) includes pain in the lower abdomen of varying intensity, fever up to 38-40 ° C, chills, nausea, sometimes vomiting, purulent discharge from the genital tract, dysuric phenomena. The severity of clinical symptoms is due, on the one hand, to the virulence of pathogens, and on the other hand, to the reactivity of the macroorganism.

On examination, the tongue is moist, covered with a white coating. Palpation of the abdomen may be painful in the hypogastric region. Gynecological examination reveals purulent or sanious-purulent discharge from the cervical canal, thickened, edematous, painful uterine appendages. During the formation of pyosalpinx, pyovar, tubo-ovarian abscesses in the area of ​​​​the uterine appendages or posterior to the uterus, motionless, voluminous, painful, without clear contours of the formation of an uneven consistency, often forming a single conglomerate with the body of the uterus, can be determined. In the peripheral blood, leukocytosis, a shift of the leukocyte formula to the left, an increase in ESR, the level of C-reactive protein, and dysproteinemia are detected. Urinalysis may show an increase in 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 reveals an increase in the number of leukocytes, coccal flora, gonococci, Trichomonas, mycelium and spores of a yeast-like fungus. A bacteriological study of the flora of secretions from the cervical canal does not always help to identify pathogens of adnexitis. More accurate results are obtained by microbiological examination of the flora from the contents of the fallopian tubes and the 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 with the formed inflammatory tubo-ovarian formations. Free fluid in the small pelvis in combination with a purulent formation in the uterine appendages most often indicates its rupture.

The most informative in the diagnosis of acute adnexitis is laparoscopy. Laparoscopy allows you to determine the inflammatory process of the uterus and appendages, its severity and prevalence, to conduct a differential diagnosis of diseases with a picture of "acute abdomen" to determine the correct tactics. In acute salpingitis, edematous hyperemic fallopian tubes, the outflow of serous-purulent or purulent exudate from the fimbriae and its accumulation in the rectovaginal cavity are detected endoscopically. The ovaries may be enlarged as a result of secondary involvement in the inflammatory process. The pyosalpinx is visualized as a retorto-shaped thickening of the tube in the ampullar section, the walls of the tube are thickened, edematous, compacted, the fimbrial section is sealed, there is pus in the lumen. Piovar looks like a volumetric formation of the ovary with a purulent cavity with a dense capsule and fibrin overlays. When a tubo-ovarian abscess is formed in the area of ​​the uterine appendages, a purulent cavity is formed, there are extensive adhesions between the tube, ovary, uterus, intestinal loops, and the pelvic wall. The prolonged existence of a tubo-ovarian abscess leads to the formation of a dense capsule that delimits 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, revealed during laparoscopy in the case of acute inflammation of the uterine appendages, can also be noted during abdominal dissection, performed to remove the focus of inflammation. Obtaining purulent contents from volumetric formations of the uterine appendages during their puncture through the posterior fornix of the vagina aimingly 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, a decrease in the body's reactivity, and the properties of the pathogen. Chronic salpingo-oophoritis 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 plexus, and be accompanied by psycho-emotional (irritability, nervousness, insomnia, depressive states) and autonomic disorders. Pain intensifies after hypothermia, stress, menstruation. In addition, in chronic salpingo-oophoritis, there are menstrual dysfunctions such as menometrorrhagia, hypomenstrual and premenstrual syndromes, accompanied by anovulation or corpus luteum insufficiency. Infertility in chronic adnexitis is explained by both a violation of steroidogenesis by the ovaries and a tubal-peritoneal factor. Adhesions in the uterine appendages can cause an ectopic pregnancy. Frequent exacerbations of the disease lead to sexual disorders - decreased libido, dyspareunia.

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

Diagnosis of chronic salpingo-oophoritis can be extremely difficult, since chronic pelvic pain with periodic intensification is also found in other diseases (endometriosis, ovarian cysts and tumors, colitis, pelvic plexitis). Certain information that allows to suspect chronic inflammation of the uterine appendages can be obtained from a bimanual examination of the pelvic organs, hysterosalpingography and hydrosonography. Gynecological examination reveals limited mobility of the body of the uterus (adhesions), the formation of an elongated shape in the area of ​​​​the uterine appendages (hydrosalpinx). Hystero-salpingography and hydrosonography help to identify the adhesive process in tubal-peritoneal infertility factor (accumulation of contrast in closed cavities).

With a long course of the disease with periodic pains in the lower abdomen with the ineffectiveness of antibiotic therapy, laparoscopy should be resorted to, which allows you to visually determine the presence or absence of signs of chronic adnexitis. These include adhesions in the pelvis, hydrosalpinx, interligamentous cavities on the fallopian tubes filled with serous exudate (hydatids). The consequences of acute salpingo-oophoritis, often of gonorrheal or chlamydial etiology, are adhesions between the surface of the liver and the diaphragm (Fitz-Hugh-Curtis syndrome).

Pelvioperitonitis (inflammation of the pelvic peritoneum) occurs a second time when pathogens penetrate from the uterus or its appendages. Depending on the pathological contents in the small pelvis, serous-fibrinous and purulent pelvic peritonitis are distinguished. The disease begins acutely with the appearance of sharp pains in the lower abdomen, fever up to 39-40 ° C, chills, nausea, vomiting, loose stools. Physical examination reveals a moist, white-coated tongue. The abdomen is swollen, takes part in the act of breathing, on palpation it is painful in the lower sections, the symptoms of peritoneal irritation (including Shchetkin-Blumberg's symptom) are expressed there to varying degrees, tension of the anterior abdominal wall is noted. Palpation of the uterus and appendages during gynecological examination sometimes fails due to severe pain, the posterior fornix is ​​smoothed due to the accumulation of exudate in the rectovaginal cavity. A blood test shows signs of inflammation. Of the additional diagnostic methods, transvaginal ultrasound scanning should be indicated, which helps to clarify the condition of the uterus and appendages, to determine the free fluid in the small pelvis. The most informative diagnostic method is laparoscopy. There is hyperemia of the peritoneum of the small pelvis and adjacent intestinal loops. As 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 through the posterior fornix of the vagina, inflammatory exudate can be aspirated. Conduct bacteriological analysis of the obtained material.

Parametritis - inflammation of the tissue surrounding the uterus. It occurs when the infection spreads from the uterus after childbirth, abortion, curettage of the uterine mucosa, operations on the cervix, when using an IUD. The infection penetrates into the parametric fiber by the lymphogenous route. Parametritis begins with the appearance of an infiltrate at the site of the lesion, then the formation of a 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. With exudate suppuration, purulent parametritis occurs, which can be resolved with the release of pus into the rectum, less often into the bladder, 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 side of the lesion, impaired passage of urine, and even the development of hydronephrosis. In the diagnosis of the disease, an important role is played by a bimanual and rectovaginal examination, which determines the smoothness of the lateral fornix of the vagina, a dense, motionless, slightly painful parametrium infiltrate 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 noted with a shift of the leukocyte formula to the left, an increase in ESR.

With suppuration of parametric fiber, the patient's condition deteriorates sharply - chills, hectic fever appear, and symptoms of intoxication intensify. In the case of the development of fibrotic changes in the area of ​​the parametrium, a dense cord is palpated, the uterus is displaced towards the lesion.

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, adherence to a diet with a predominance of easily digestible proteins and vitamins. An ice pack is placed on the hypogastric region.

The central place belongs to antibiotic therapy. The drug is chosen taking into account the spectrum and mechanism of action, pharmacokinetics, side effects, as well as the etiology of the disease. In connection with the polymicrobial etiology of the disease, drugs or their combinations that are effective against most possible pathogens should be used. In order to treat acute inflammatory processes of the internal genital organs, antibiotics of the penicillin series, cephalosporins, fluorohipolones, aminoglycosides, lincosamines, macrolides, 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, which destroy the beta-lactam ring of penicillins. In this sense, combinations of penicillins with beta-lactamase inhibitors (inhibitor-protected penicillins) - amoxicillin / clavulanate, ticarcillin / clavulanate, piperacillin / tazobactam, ampicillin / sulbactam are preferred.

Cephalosporins are also low-toxic and effective against many pathogens of inflammatory diseases of the internal genital organs, but are inactive or inactive against enterococci, methicillin-resistant staphylococci, chlamydia, mycoplasmas, and some anaerobes. Currently, for the treatment of acute endomyometritis, adnexitis, especially complicated ones, third-generation cephalosporins (ceftriaxone, cefotaxime, cefoperazone) are used.

Fluoroquinolone antibiotics have a wide 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 ciprofloxacin, ofloxacin.

Of the antibiotics of other groups, gentamicin, netilmicin, amikacin (aminoglycosides), lincomycin, clindamycin (lincosamines), spiramycin, azithromycin, erythromycin (macrolides), doxycycline (tetracyclines) are prescribed.

The possibility of 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 (metronidazole) derivatives, 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. With a pronounced inflammatory process, antibacterial drugs begin to be administered parenterally and continue until 24-48 hours after clinical improvement (body temperature is not higher than 37.5 ° C, leukocytosis in peripheral blood is not more than 10-109 / l) with the transition to oral administration. In 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 antibiotic therapy is 7-14 days.

According to the European Guidelines for Pelvic Inflammatory Disease 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 (may be given orally), then doxycycline 100 mg PO twice a day + + metronidazole 400 mg orally 2 times a day - 14 days in total;
• . 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, can be in a single dose), then either clindamycin 450 mg PO 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 is not possible, 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), anaerobic bacteria (metronidazole).

With an unexpressed inflammatory reaction, treatment can be carried out on an outpatient basis, prescribing antibiotics inside. The European Guidelines for Pelvic Inflammatory Disease and Perihepatitis (2001) suggest the following regimens for outpatient treatment:

• . ofloxacin 400 mg po bid + metronidazole 500 mg po bid for 14 days;
• . ceftriaxone 250 mg IM once or cefoxitin 2 g IM with probenicid 1 g po once, followed by doxycycline 100 mg po bid + metronidazole 400 mg bid for 14 days.

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

With a pronounced general reaction and intoxication, infusion therapy is prescribed to detoxify, improve the rheological and coagulation properties of blood, eliminate electrolyte disorders (isotonic solutions of sodium chloride and glucose, disol, trisol, Ringer's solution, hemodez, rheopolyglucin, rheogluman, glucose-novocaine mixture, heparin , fraxiparin, 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 focus of inflammation and increases the effectiveness of antibiotic therapy.

The inflammatory process causes increased sensitivity to tissue decay products and microbial cell antigens. In this regard, in order to desensitize the body, it is necessary to use antihistamines. In addition, antihistamines reduce the body's response to histamine, relieve spasm of smooth muscles, 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, increase nonspecific resistance of the body, gamma globulin, levamisole, T-activin, thymalin, thymogen, leukinferon, interferon, endogenous interferon synthesis stimulators (cycloferon, neovir), vitamins C, E, group B, adaptogens.

Extremely effective, regardless of the etiology of inflammation, is the reinfusion of blood irradiated with ultraviolet rays. Extracorporeal ultraviolet irradiation of the patient's own blood is carried out, followed by its reinfusion. The procedure has a multilateral effect: it eliminates hemorheological and coagulation disorders, promotes hemoglobin saturation with oxygen, an increase in the number of erythrocytes, detoxifies the body, activates the immune system, increases nonspecific resistance, and gives bactericidal and virocidal effects.

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

In the treatment of endometritis, it is advisable to carry out hysteroscopy with washing the uterine cavity with antiseptic solutions, removing, if necessary, the remains of the fetal egg, placental tissue, and foreign bodies.

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

With pyosalpinxes, pyovars, abscesses of the rectovaginal recess, purulent formations can be punctured through the posterior fornix of the vagina under the control of ultrasound scanning. When puncturing, 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 the acute effects 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 prevalence of the inflammatory process, lies in the ability to produce lysis of adhesions, open or remove purulent tubo-ovarian formations, perform directed drainage and sanitation of the abdominal cavity, perform 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, various therapeutic manipulations 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, 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, treatment failure within 24 hours after drainage of the abdominal cavity using a laparoscope, if it is impossible to perform laparoscopy. Laparotomy access is also used in patients with purulent tubo-ovarian formations in pre- and postmenopause, if necessary, removal of the uterus.

The volume of the operation is determined by the age of the patient, the degree of destructive changes and the prevalence of the inflammatory process, comorbidities. Extirpation of the uterus with appendages on one or both sides is performed when the uterus is a source of an inflammatory process (endomyometritis, panmetritis against the background of IUD, 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 for organ-preserving operations or, in extreme cases, to preserve ovarian tissue. Surgical intervention ends with drainage of the abdominal cavity.

It is necessary to identify the sexual partners of a patient with acute OI and offer to be tested for gonorrhea and chlamydia. Partners are advised to avoid sexual intercourse until the end of treatment. All sexual partners should receive empiric treatment for chlamydia due to varying sensitivity of diagnostic tests. If adequate screening for gonorrhea in a sexual partner is not possible, empiric treatment of the infection should be considered.

The treatment of chronic VZPO includes the prevention of relapses, the elimination of pain, the normalization of menstrual and reproductive functions.

Therapy 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 VZPO 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 the residual effects of the inflammatory process, pain. Non-steroidal anti-inflammatory drugs are used (predominantly administered rectally), vitamins, antioxidants, immunostimulants, stimulators of endogenous interferon synthesis. It is also recommended the introduction of tampons with drugs into the vagina (balsamic liniment according to Vishnevsky, levomekol, etc.). At the same time, menstrual irregularities are corrected.

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

Which doctors should be contacted 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 effects of inflammatory pathogens of a particular organ. The disease is very common and is in first place 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 bacillus, fungi, viruses. They enter the genitals through 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 the elimination of the cause that provoked the development of the inflammatory process. In addition, treatment of 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 genital organs with a warm solution of potassium permanganate, boric acid, Chlorhexidine.
• External treatment with antibacterial drugs: Macmirror.
• Use of vaginal suppositories: Terzhinan, Polygynax.
• The use of vitamin complexes, which include vitamin A and E.
• In the presence of manifestations, the drug Solcoseryl or sea buckthorn oil is used.
• Antihistamines, if there are complaints of itching: Suprastin, Tavegil, Desloratadine.
• In some cases, it is advisable to prescribe hormonal drugs for both local treatment and oral administration. Such treatment may be required during the treatment of patients of older age groups.

The exact treatment regimen is determined on an individual basis after a comprehensive examination.

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

Folk remedies

• 20 g of noble laurel per bucket of water. Use for sitz baths in diseases of the uterus and bladder.
• A tablespoon of St. John's wort herb pour 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 chopped walnut leaves with a glass of boiling water. Insist 4 hours. Drink for a day.
• Take 1 part sweet clover grass and 10 parts coltsfoot grass. Pour a tablespoon of the mixture with a glass of boiling water. Insist on a water bath for 15 minutes, cool and strain. Drink 1/2 cup 3 times a day for inflammation of the appendages.
• The juice of fresh aloe leaves is taken orally in a dessert spoon 2-3 times a day before meals.
• From vulvitis there is an effective infusion, which is prepared within an hour. It will relieve both pain and unpleasant tickling. All other remedies for inflammation of the labia are prepared from a week to a month. Grind the root of badan thick-leaved, pour 200 ml of boiling water and cover the vessel with a lid. Leave to stand at room temperature. After an hour, you can make lotions. The more often the procedure is carried out, the faster the itching will pass.
• Pass the raw pumpkin through a meat grinder, squeeze the juice from the pulp and consume it in large quantities.
• Pour a teaspoon of blueberry leaves with 1 cup of boiling water, leave for 30 minutes, strain. Apply for external treatment of wounds, ulcers, as well as for douching as an astringent, antiseptic and anti-inflammatory agent.
• An infusion of small-leaved linden flowers is prepared at the rate of 2-3 tablespoons of raw materials for 2 cups of boiling water. Take inside. For external use, pour 4-5 tablespoons of flowers with 2 cups of boiling water, insist. The infusion is used for inflammation of the female genital organs.
• Barberry helps well: pour 1/2 teaspoon of dry roots with 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 grass and pour a glass of boiling water, leave for 1 hour, strain.
• Use the flowers and leaves of the mint. Lasnotka is taken both internally and externally - in the form of douching for inflammation of the genital organs. Infusion for internal use: pour 2-3 tablespoons of herbs into 0.5 liters of boiling water in a thermos (daily rate), insist. For external use, double the amount of herb.
• Pour a tablespoon of yarrow herb with 1 cup of boiling water, boil for 10 minutes. Drink 1/3 cup 2-3 times a day before meals. Infusions and decoctions of yarrow are used as a means of hemostatic and accelerating blood clotting in external and internal bleeding (uterine bleeding from inflammatory processes and fibromyomas, intestinal, hemorrhoidal).
• The flowers of the sweet clover, the herb of the centaury ordinary, the flowers of the common coltsfoot - equally. Pour a tablespoon of the mixture with a glass of water, boil for 15 minutes and strain. Take 1/3 cup 6 times a day for inflammation of the ovaries.
• 10 g of corn columns with stigmas pour 200 ml of boiling water. Prepare a decoction. Take 1 tablespoon every 3 hours. Use in women's diseases as a hemostatic, sedative, diuretic and choleretic agent.
• Pour 10 g of the herb of the tripartite sequence with 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 genital organs.
• In inflammatory processes of the female genital organs, a decoction of blackthorn roots is used against whiter. 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 decoction is diluted with boiled water 1:1.

Inflammation of the appendages in women is an infectious pathology, while the process affects the ovaries or fallopian tubes, but not the uterus itself. The penetration of the pathogen into the body occurs in various ways.

The disease can proceed for a long time without symptoms, 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 develop inflammation of the appendages, and what is it? In medicine, this disease is called salpingo-oophoritis. 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 opportunistic 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.

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

• ascending (pathogenic microbes from the vagina enter 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 passes to healthy tissues);
• 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;
• weakening of the immune system;
• 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 gone through menopause turn to doctors for help.

Symptoms of inflammation of the appendages

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

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

For acute form women complain of the following symptoms:

• tense abdomen in the lower sections;
• , giving sometimes to the legs or lower back;
• elevated body temperature (it can reach 39 degrees);
• change in the menstrual cycle (the occurrence of sudden bleeding or delayed menstruation);
• vaginal discharge that is different from normal (they may be greenish-purulent or yellowish, profuse or frothy).

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

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

During the period of exacerbation, all the 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.

In connection with the structural and functional transformations in the ovaries (lack of ovulation, hypoestrogenism), chronic inflammation of the appendages in women is accompanied by menstrual irregularities, which is manifested by oligomenorrhea (scanty menstruation), polymenorrhea (abundant menstruation), algomenorrhea (painful menstruation). Also, patients may complain of a lack or decrease in sexual desire, the appearance of pain during intercourse.

Diagnostics

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

• Ultrasound of the uterus and appendages;
• PCR diagnostics (vaginal smear), which allows to establish genital infections;
• colposcopy (examination of the vagina and its walls);
• bakposev;
• tomography;
• laparoscopy.

Signs of inflammation of the appendages can be determined by the results of a blood test. In inflammatory processes, the blood formula changes significantly,. In addition, during a gynecological examination at a gynecologist's appointment, 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, in which there is obstruction of the fallopian tubes and anovulation;
• a fairly high risk of ectopic conception;
• purulent complication (tubo-ovarian formation) - purulent fusion of the ovaries and tubes, followed by an abscess.

Prevention

1. Regularly visit the gynecologist, without resisting the examination on the chair, take smears.
2. Avoid hypothermia by dressing appropriately for the weather, changing after swimming, avoiding sitting on cold objects.
3. If abortion is necessary, do it early or with medication or mini-abortion (avoid curettage).
4. Treat teeth, intestines and other foci of chronic infection.
5. Use barrier methods of contraception.
6. Timely treat gynecological diseases.
7. Follow the rules of a healthy diet.
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 adherence to medical prescriptions.

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 are antibiotics. They are selected with a wide spectrum of action and a maximum half-life. In addition, the woman herself needs to monitor her lifestyle (proper nutrition, abstinence from sexual activity, physical education, smoking and alcohol should be avoided).

The disease cannot be started, since the inflammatory process soon passes into the chronic stage, which leads to infertility.

Antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages is 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 particular woman is determined by a specialist, however, we will give you the most commonly prescribed pairs of medicines:

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

The first three to four days before the condition normalizes, all these drugs are administered as injections. Then you can switch to tablet forms and reduce the dose.

Concomitant treatment

In addition to the appointment 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 with the help in the form of tablets. These are Diclofenac, Ibuprofen, Ketarol and other drugs. Be sure to prescribe vitamins C and B, as well as allergy pills.

When removing an acute process and in the treatment of chronic inflammation of the appendages without exacerbation, physiotherapy is widely used: electrophoresis of copper and zinc in the phases of the menstrual cycle, electrophoresis with lidase or iodine, ultrasound, high-frequency pulsed currents (SMT, DDT). Also in the rehabilitation treatment, immunomodulators, autohemotherapy, injections of aloe, FIBS, Longidase and so on are used. In chronic adnexitis, spa treatment is indicated - mud, paraffin, therapeutic baths and douching.

Candles 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 such suppositories that are able to strengthen the immune system, and this is very important for any illness. Also, these drugs cleanse the body of harmful substances.

All candles 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 of finely chopped buckthorn roots, Chernobyl and peony, add 3 teaspoons of burnet roots and elecampane. After that, pour 2 tablespoons of the resulting mixture with half a liter of boiling water. Boil for half an hour on low heat, and then let cool for half an hour. After strain and you can add a little honey for taste. Take the drug should be half a cup 3-4 times a day.
2. One tablespoon chopped dry grass boron uterus pour a glass of boiling water. Insist 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 monthly course of treatment of adnexitis with a pine forest uterus, it is advisable to drink another infusion for 2 months - from the field yarutka grass. 1 st. l. herbs pour a glass of boiling water, 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 have started in them). Tincture of them has excellent antiseptic, anti-inflammatory and analgesic properties. A liter jar is filled with inflorescence balls, filled with vodka and sent for 15 days to a dark, cool place. The lower abdomen is rubbed with this tincture, and the inflorescences are applied in the form of compresses.
4. Take flowers of coltsfoot, sweet clover, centaury in equal proportions. Mix, pre-grinding, pour boiling water, let it brew for an hour, then strain the broth through gauze and drink half a glass twice a day. During treatment, abstinence from sexual intercourse is recommended.

Remember that folk remedies are only an addition, and in no way can replace drug therapy prescribed by a specialist.

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

Adnexitis (another name for salpingoophoritis) is 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. Significantly more often pains appear periodically, less often they disturb invariably. Pain often continues to exist after the disappearance of indicators of the inflammatory response and can intensify with cooling, various diseases, physical and emotional overload, etc.

Indicators of inflammation of the appendages
In the treatment of inflammation of the appendages, it is possible to use traditional medicine recipes as an aid.
Herbal tea: prepare a collection of 200 g of wild rose, 20 g of grass meadowsweet, daisy and cuff. Two tablespoons of crushed tea collection pour 0.5 liters of hot water, leave for 5 hours, then bring to a boil, cool and strain. Prepared tea to drink during the day. Prepare and drink a drink for 2-3 weeks.
Decoction for douching: mix an equal amount of knotweed herb and horsetail, calendula and yarrow inflorescences, flowers of white lamb and wood mallow. Pour two tablespoons of the crushed mixture with 1 liter of boiling water, insist, wrapped for an hour, strain, cool to body temperature. Do douching for a long time (at least 4 weeks, and preferably until complete recovery).

Symptoms of inflammation of the appendages depend on the form of the disease, and it may be chronic or acute. There is such a thing as a latent (hidden, sluggish) disease.

The acute form of inflammation of the appendages is accompanied by the following symptoms:
pain in the lower abdomen, from time to time extending to the lower back and legs;
discharge from the genital tract;
increase in temperature;
pain during 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 at the end of a poorly treated, undertreated or not treated acute inflammation at all. Symptoms of chronic inflammation may be slightly pronounced: the temperature fluctuates around 37 degrees, the lower abdomen periodically hurts, slight 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, adhesive processes develop, leading to infertility. That is why it is fundamentally important to systematically visit a gynecologist, in addition, in the absence of complaints, the doctor will be able to find, in addition, a hidden disease in a timely manner.

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 your sanitary pads as often as possible, at least twice a day. Avoid thong panties: the narrow strip that connects the front and back for 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 both specific venereal diseases and diseases caused by conditionally pathogenic flora (gonococcus, trichomonads, mycoplasmas, ureaplasmas, chlamydia, gardnerella, candida, etc.).
Nervous tension. The lifestyle of a modern working lady adversely affects the immune system and weakens the body's natural defenses. A banal hypothermia of the legs, arms, lower back, severe stress (besides a simple fright) is enough to cause inflammation of the appendages.
Hormonal disorders are directly related to the neuropsychic state of the lady. 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, open spontaneously, which threatens with very strong 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 emotional relief, but also physical, 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 influenza transferred on the legs. In addition, harmless herpes on the lip can be reflected in the inflammation of the appendages in a week or two.

Treatment of inflammation of the appendages

With proper treatment, acute symptoms of inflammation are removed after a couple of days. But this does not mean that it is possible to stop treatment.
After the circumstances of the disease are clarified, the gynecologist prescribes a treatment that is contained in anti-inflammatory, antimicrobial and restorative therapy. The healing process is long enough, but in no case is it forbidden to interrupt it, 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 the chronic form and adhesive processes - preventive courses of physiotherapy for 1.5-2 years;
with the formation of adhesions ((adhesion of the walls of the fallopian tubes and ovaries) endoscopic surgery for their dissection;
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 frequency 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 a violation of menstrual function. The existence of a persistent focus of inflammation in the small pelvis leads to disruption of the menstrual cycle in 45-55% of patients, which manifests itself in the form of a regular cycle, poor or, conversely, heavy menstruation, painful menstruation. There may be premenstrual or postmenstrual discharge.

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

In fact, every fourth lady suffering from chronic inflammation of the uterus and / or appendages has leucorrhoea. They can be serous or purulent, their number, in addition, may be different 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, highlander grass 5 parts
Immortelle baskets, birch leaves, strawberry leaves, corn stigmas, coltsfoot leaves, mint grass, yarrow, bean leaves in 2 parts, knotweed, nettle, string, rosehip fruits in 3 parts, mountain ash fruits
Lavender herb, 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 each, yarrow 2 parts
Valerian root, lemon balm leaves 2 parts each, cuff herb, nettle 3 parts each
Licorice root, string grass, Manchurian aralia root, horsetail grass, rose hips, immortelle baskets, elecampane root, alder seedlings 1 part each

Preparation of fees: 2 tablespoons of pre-crushed (in a coffee grinder or meat grinder) collection, pour 1 liter of boiling water, bring to a boil, simmer for 10 minutes. in a sealed container, drain together with the grass in a thermos, insist overnight. Take during the day 100-150 ml in 30 minutes. 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 that has come, herbal medicine should be continued for at least 12 months. In the future, switch to preventive intake of fees in 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.

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

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

Take in equal parts sweet clover grass and coltsfoot flowers. Brew 1 tablespoon of the mixture with 1 cup 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 in equal parts a coltsfoot leaf, sweet clover grass, chamomile flowers, calendula flowers and centaury grass. Pour 2 tablespoons of the mixture with 0.5 liters of boiling water and leave for 2 hours.
Take 0.3 cups 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 flowers of mallow forest and oak bark, 3 parts of a page of sage, 5 parts of chamomile flowers. Prepare a decoction of 2 tablespoons of the mixture in 1 liter of water. Use for douches and vaginal tampons.

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

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

Herbs can be used in combination with other medicines.

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

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

In case of inflammation of the appendages and whites, you should chew fresh juniper berries (instead of a decoction) 3 times a day (instead of a decoction), starting with 4 berries, increase their intake by 1 every time, bringing it to 13, and then reduce it 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 stalks, leave for 2 hours and strain.

For inflammation of the appendages, brew 2 cups of boiling water 2 tbsp. goose cinquefoil herbs and insist 1 hour.

Drink on an empty stomach and before each meal glass 4 times a day. At night, douching from a more concentrated infusion. Brew 0.5 l of boiling water 5 tbsp. herbs and insist overnight in a thermos.

In case of inflammation of the ovaries, mix 20 g of sweet clover herb, centaury herb and coltsfoot flowers each. Brew 1 cup boiling water 1 tbsp. mixture, insist 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 1st.l. 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 pot and place the patient over the steam. Repeat the procedure until the inflammation ends.

Pour hot water over unwashed sheep's wool and place the diseased over the steam.

For inflammation of the ovaries and infertility, mix 50 g of coltsfoot leaves, sweet clover grass, chamomile flowers, calendula flowers and centaury grass. Brew 0.5 l 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 rose hips and dark currant berries. Brew 20 g of the mixture with 1 cup of boiled water, leave for 1 hour, strain. Add sugar. Drink by? glass 3-4 times a day.
Pour 1 cup boiling water over 1 tbsp. dried and crushed walnut leaves. Insist 4 hours. Drink for the day.

Brew 1.5 tbsp. dry chamomile in a porcelain cup, cover with a saucer, wrap. Insist 20 min. During this time, make a cleansing enema with hot water. Strained chamomile broth at a temperature of 37 C is drawn into syringe No. 3 and inserted 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. Chamomile decoction should be completely absorbed. The pulling debilitating pain will immediately depart. Do this procedure any evening, if possible, daily. This is the oldest effective method for treating inflammation of the appendages. So, it is possible to cure hemorrhoids.

Brew wintergreen leaves like 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 intake (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 cup boiling water 1-2 tsp. dry wintergreen leaves, insist, wrapped for 2 hours, strain. Accept by? glass 3 times a day for 30 minutes. before meals.

In case of inflammation of the appendages and cancer of the uterus, pour 0.5 liters of vodka into 50 g of wintergreen leaves, leave for 14 days in a black place. Take 30-40 drops 3 times a day.

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

be guided to use as many gourds as possible in all kinds. It is useful to pass a raw pumpkin through a meat grinder, squeeze out juice from the pulp, which can be used a lot.

Use in any form of cranberries, blueberries, mountain ash and blackberries.

Drink a broth of corn columns and stigmas.

Take inside a dessert spoon 2-3 times a day for 30 minutes. juice of fresh aloe leaves before meals.

For inflammation of the female genital organs, brew 2 cups of boiling water 2-3 tbsp. small-leaved linden flowers, leave for 20 minutes, strain. Take in by? glass 3-4 times a day for 30 minutes. before meals, inside.

For external consumption 4-5 tbsp. linden flowers pour two cups of boiling water, insist.
Externally, linden flowers are used in the form of lotions and poultices for mastitis, ulcers, burns, and for washing the head with hair loss. There are no contraindications.

Boil forest hay in a suitable vessel; place the patient over the steam. Repeat the procedure daily until the inflammation heals.

The patient is placed over the steam, where the gorse is boiled, filled with olive oil.

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

Herbal collection for douching with adnexitis traditional medicine recipe:
Traditional medicine for the treatment of adnexitis recommends taking herbs: chamomile pharmacy 1 part, nettle leaves 3 parts, highlander grass 5 parts. 2 tbsp. spoons of the mixture pour 1 liter of boiling water, insist 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 douche :
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. tablespoons of the mixture per 200 ml of boiling water. Insist in a thermos for 30-40 minutes. Strain, cool, apply 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, nettle 1 part each, yarrow 2 parts. 1 st. a spoonful of the mixture in 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 :
Fibroma, erosion, adnexitis traditional medicine treats so crush 50 g of bergenia root, put in an enamel pan and pour 300 g of hot water. Allow to infuse for 8 hours.
If there is a 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: put a teaspoon of bergenia on cotton wool and wrap it with two layers of sterile cotton wool and gauze. Soak a tampon in bergenia extract, wring out lightly and insert into the vagina. Place a pillow under your buttocks all night.
At one point, take inside a thick extract of bergenia 1-1.5 teaspoons one hour before meals for three days, then pause for 3 days. And again a course of treatment.
In addition, drink a tincture of root marin prepared according to this recipe: finely chop 50 g of root, put in a black bottle and pour 0.5 l of vodka. Allow to stand 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.
Fibroma treatment in this way will take 6-8 weeks, inflammation of the appendages (adnexitis) 3-4 weeks, adhesive process 3-4 weeks, erosion treatment will take 2-3 weeks. All herbs are sold in pharmacies. Check with your gynecologist during treatment

Wormwood from inflammation of the appendages

A very effective folk remedy for treating inflammation of the appendages with the help of 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 down over it for twenty minutes .. Relief will come no sooner than after six such procedures.

Ortilia is one-sided from all troubles!

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

A decoction of it can be made like this: grind the grass in a coffee grinder and pour one tablespoon of grass with a glass of boiling water. Strain after 2 hours. It is necessary to take the remedy in a third of a glass half an hour before meals.

In order to prepare an infusion on alcohol, half a liter of vodka 50 grams of grass. 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 one hour before meals.

Bulldenezh tincture for inflammation of the appendages

In May-June, it is possible to notice how bulldenezh blooms with white balls - this is one of the varieties of viburnum. If there are insects on the flower, then discard such plants. Place the bulldenezh 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. Put the composition for 15 days in a black place.

Such a folk remedy helps with inflammation of the appendages. At the end of rubbing, the flowers should be put 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 dish, lie on your back, moisten the cloth in paraffin, and then lubricate the lower abdomen with it from left to right. It needs to be lubricated quickly. The first time the paraffin is still warm, but later it cools down quickly. After smearing the belly with paraffin, wrap yourself in a warm blanket and wait in this position until the paraffin has cooled.

The hipster will help the ladies

Thigh must be collected during its flowering. The crushed grass is taken in the amount of one tablespoon and poured with a liter of water, then boiled for ten minutes. The medicine is drunk with honey throughout the day. The sediment from the broth is not required to be drained. Douche with this decoction in the morning for 20 days.

The femur helps with all sexual infections. In addition, he treats cysts, fibroids, menstrual disorders, mastopathy, uterine cancer, 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 on low heat, and at the end, allow to cool for half an hour. At the end, strain and have the opportunity to add a little honey for taste. Take the drug should be half a cup 3-4 times a day.

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

Put 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 until the broth is completely cold, douche with it. Perform the procedure about three times. At the end of such procedures, dress up warmly and do not sit in the cold.

And the second method is contained in the following. Make a swab with thread. Crush the garlic and pour hot water over it. There will be a solution that should pinch the tongue. Soak a tampon in this solution and insert it into your vagina for two to three hours. Well, if the procedure will be performed at the end of a bowel movement. Do the treatment until you get better. It is possible to do this procedure three or seven times during the month just for prevention.

Drink the yaruka field

It is necessary to take the dry grass of the field yarutka, 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 dishes in which you brewed the grass must be well closed and wrapped in a warm towel. Later, strain the decoction and drink one teaspoonful in thirty minutes. before meals four times a day. It is necessary to be treated within two months.

With inflammation of the ovaries, it is necessary that the stomach is cleared. 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 douches. In addition, take potassium iodide three times a day. It is better, while you feel discomfort and pain, to refrain from sexual intercourse.

With such a disease, eat pumpkin more often: perhaps eat it raw or use pumpkin juice, and make a decoction of corn cobs hair.

Folk method for inflammation of the appendages

In the old days, at a time when the appendages of the ladies were inflamed, they used such a 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, an ointment will be required. This ointment is placed on the bottom of the dish, poured with boiling water. Now the patient needs to cover his back with a belly with a handkerchief and sit on the pot to steam. In 20 minutes. running to bed. Every day before going to bed, do this procedure - 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 decreases. The disease is manifested by a variety of symptoms: from pulling pains in the lower abdomen and scanty discharge to menstrual irregularities and acute inflammation. Therefore, only a comprehensive diagnosis, including laboratory, differential and instrumental research methods, helps to make the correct diagnosis. The main link in the 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 pulling, sometimes intensifying, pain in the lower abdomen, a 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, relapses last up to seven days. In half of the cases, a menstrual cycle disorder is 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 the acute and in the chronic form 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 pathognomonic symptoms of the disease at each stage.

The toxic stage is characterized by symptoms of intoxication of the body. Moderately elevated, high, sometimes very high body temperature (up to 40-41 degrees) is characteristic. Chills, bloating and soreness of the abdomen, dysuric disorders (impaired urination), dyspeptic symptoms (diarrhea, vomiting) are observed. On the part of the reproductive system, abundant discharge, strong, localized or diffuse pains are noted, bleeding is possible. Symptoms persist for 1-1.5 weeks, then the disease can move to the second (septic stage), complete recovery (with adequate therapy for inflammation of the appendages) or chronicity of the pathology (with partial triggering of internal immune defense mechanisms).

The septic stage is characterized by aggravation of symptoms, weakness, dizziness, attachment of anaerobes with the formation of a purulent tubo-ovarian formation with the threat of perforation. It is possible to further spread the inflammatory process to the organs of the small pelvis and peritoneum with the occurrence of pelvioperitonitis, which threatens the life of the patient.

Symptoms of inflammation of the appendages in the chronic phase in some cases are unexpressed. Dull, intensifying pains occur periodically, coincide with one or another phase of the cycle. There is a slight increase in temperature, menstrual dysfunction, problems in the genital area (painful 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 the excretory system (pyelonephritis, recurrent cystitis, etc.) can occur.

Complications of inflammation of the appendages

Peritonitis can become a formidable complication of acute inflammation of the appendages with untimely therapy. 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 ovarian damage is associated with a decrease in the physiological function of the fallopian tubes (contractility, impaired activity of the ciliated layer) or their complete obstruction. Failures in the menstrual cycle, lack of ovulation lead to serious functional and anatomical changes in the female reproductive system.

The formation of infiltrates, a frequent consequence of chronic inflammation of the appendages, 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, 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 an adhesive process. The procedure allows you to combine a diagnostic study with therapeutic manipulations. With the help of X-ray examination of the uterus with the use of 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 a hospital 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 the excretory function. The main treatment for adnexitis is antibacterial etiotropic therapy, depending on the diagnosed pathogen: penicillins, tetracyclines, macrolides, aminoglycosides, fluoroquinolones. If there is a risk of anaerobic infection, a combination of various groups of antibiotics is prescribed, for example, metronidazole (intravenously, orally) is added to the above drugs.

Conservative therapy also includes painkillers, drugs that relieve the effects and consequences of intoxication (infusion therapy). With a purulent complication 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 by puncture of the posterior vaginal fornix with possible subsequent administration of drugs. With advanced inflammation, when there is a risk of purulent fusion, surgical removal of the appendages is indicated.

After leveling the acute signs of inflammation of the appendages, a course of physiotherapeutic procedures is prescribed: ultrasound, electrophoresis using Mg, K, Zn preparations, vibromassage. The same methods, along with etiotropic antibiotic therapy, are indicated in the treatment of inflammation of the appendages in a chronic form. A sanatorium rehabilitation treatment is prescribed, which promotes the resorption of the adhesive process and prevents the formation of adhesions. Resorts are preferred, where mud therapy, paraffin treatment, therapeutic baths and irrigation with sulfide and sodium chloride mineral waters are used as medical procedures.

Prediction and prevention of inflammation of the appendages

With timely primary treatment with symptoms of acute inflammation of the appendages and adequate therapy, complete clinical recovery occurs in about 10 days. Adnexitis in the stage of chronicity requires regular examinations and maintenance therapy, sanatorium and rehabilitation measures, systematic monitoring of the patient's condition.

In order to prevent the occurrence of recurrence of inflammation of the appendages, especially for patients at risk (using IUDs, having unsuccessful pregnancies and abortions in anamnesis), it is necessary to exclude factors provoking the disease - hypothermia, stress, sexually transmitted infections. It is recommended to use rational methods of contraception, in a timely manner to conduct a comprehensive adequate therapy for diseases of the pelvic organs, taking into account the pathogens 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.