Adnexitis
The ovaries are directly connected to the fallopian tubes, through which they are connected to the uterus, so the ovaries and fallopian tubes are conventionally combined into one formation - the uterine appendages.
Inflammation of the uterine appendages is called adnexitis, the second name of the same disease is salpingo-oophoritis, formed by the words salpingitis (inflammation of the fallopian tubes) + oophoritis (inflammation of the ovaries). Salpingitis and oophoritis are extremely rare separately, due to the close relationship with each other, therefore, their combined inflammation is combined into one nosological unit - adnexitis, inflammation of the appendages.
Causes of adnexitis
The cause of adnexitis is the penetration of infection into the uterine appendages. This can happen in two ways, upward and downward. Ascending is the genital pathway of infection to the appendages, when, as a result of entering the external genitalia, through the vagina and uterus, the infectious agent enters the ovaries and fallopian tubes. The descending path is the penetration of infection into the area of the appendages from the primary inflammatory focus in the body with the flow of blood or lymph.
The most common causative agent of adnexitis is urogenital infection, or abbreviated as UGI. This is a group of microorganisms united by the predominant route of infection, namely sexual. These include gonococci, Trichomonas, mycoplasma, ureaplasma and some other pathogens. Descending infection is usually caused by streptococci or E. coli.
The most important condition for the onset of adnexitis is the weakening of general and local immunity: an infectious disease transferred the day before, hypothermia, non-observance of personal hygiene rules, unprotected sex with dubious partners and other manifestations of an unhealthy lifestyle. The psychology of relations between the sexes should exclude such contacts.
Symptoms of adnexitis
The symptoms of adnexitis depend on whether the disease is in an acute or chronic form.
Symptoms of adnexitis in acute form: the appearance of severe pain in the lower abdomen, on the right or left side. The pain is severe, aching and pulling in nature, can be given to the sacrum, lower back, rectum. Vaginal discharge of a serous (in the form of an ichor) or purulent character appears. Acute adnexitis is accompanied by a sharp deterioration in general condition, fever, headaches and muscle-joint pains, and a breakdown appear.
In the absence of adequate treatment, adnexitis becomes chronic. Often there is primary chronic adnexitis, which did not have a pronounced acute form. Symptoms of chronic adnexitis are less pronounced, especially general manifestations. The main symptom of chronic adnexitis is nagging aching pains in the lower abdomen, less intense than in acute adnexitis. They appear intermittently, usually before or after menstruation. A symptom of chronic adnexitis is also painful sensations during intercourse (dyspareunia).
Since chronic adnexitis is characterized by an adhesive process and structural abnormalities in the tissue of the appendages, menstrual irregularities appear: amenorrhea, oligomenorrhea, dysmenorrhea, etc. Chronic adnexitis can worsen after general diseases, as a result of hypothermia or stress, in this case the symptoms of adnexitis correspond to acute downstream. Sometimes chronic adnexitis can be asymptomatic, and the disease is detected during examination for infertility. Infertility as a result of impaired ovarian function or obstruction of the fallopian tubes is a common symptom of adnexitis in a chronic advanced form.
Diagnosis of adnexitis
Making the correct diagnosis with adnexitis is quite difficult, since the signs of an acute abdomen, characteristic of acute adnexitis, are characteristic of many acute diseases of the pelvic organs, and the symptoms of chronic adnexitis are usually not pronounced.
As a diagnosis of adnexitis, a gynecological examination is carried out, including a laboratory analysis of vaginal discharge, blood and urine tests, including urine culture. The detection of microorganisms typical for adnexitis in the urine and vaginal contents may indicate the presence of adnexitis, but still these signs are not specific, as are the signs of the body's inflammatory reaction detected in the blood.
Some symptoms of chronic adnexitis can be detected with ultrasound.
An accurate diagnostic method that excludes error is laparoscopy, which is resorted to in doubtful cases. This is an endoscopic study that allows you to visualize the fallopian tubes and ovaries and directly detect signs of inflammation: accumulations of pus and serous effusion, inflamed mucous membrane in acute adnexitis, and adhesions with changes in the structure of the tissues of the appendages in chronic adnexitis.
Treatment of adnexitis
Treatment of adnexitis in acute form requires hospitalization, since acute adnexitis is fraught with serious complications: purulent fusion of the ovaries, the formation of purulent cavities in the tubes (pyosalpings), peritonitis, etc. Bed rest is prescribed, anesthesia is carried out both with the help of medicines and by applying an ice pack to the area of the affected appendage. To relieve inflammation, broad-spectrum antibiotics and anti-inflammatory drugs are prescribed. If a purulent process is detected, surgical treatment of adnexitis is used: with the help of a laparoscopic access, an accumulation of pus is evacuated, antibacterial drugs are injected directly into the affected area.
Treatment of chronic adnexitis is carried out according to a similar scheme, however, antibacterial drugs are selected taking into account the sensitivity of the pathogen, corticosteroids are prescribed as anti-inflammatory drugs, general strengthening and immunostimulating therapy is carried out. Physiotherapeutic treatment of adnexitis is shown: mud therapy, paraffin therapy, magnetotherapy, microwave and UHF therapy, etc.
Alternative treatment of adnexitis
Alternative treatment of adnexitis is used quite widely, it is especially justified in chronic adnexitis. Alternative treatment of acute adnexitis is not recommended, since there is a high risk of developing severe, life-threatening complications or the transition of acute adnexitis to chronic.
As a folk treatment for adnexitis, decoctions and infusions of medicinal herbs with anti-inflammatory action are used, which are used for douching, enemas or baths. Pharmaceutical chamomile, St. John's wort, string, sage, calendula, calamus, Kalanchoe juice, eucalyptus, caragana officinalis, yarrow, golden mustache and others have such an effect.
As a fortifying and immunostimulating folk treatment for adnexitis, aloe juice (pure or in a 1: 1 ratio with honey), infusion of Echinacea purpurea, infusion of ginseng, mummy, as well as honey and other beekeeping products are taken orally.
Alternative treatment of adnexitis, which occurs in a chronic form, can be carried out in parallel with medication or during periods of remission, which makes it possible to reduce the drug load on the body.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
