The ovaries are directly connected to the fallopian tubes, by means of which they are connected to the uterus, therefore the ovaries and fallopian tubes are conditionally combined into one formation – the appendages of the uterus.
Inflammation of the appendages of the uterus is called adnexitis, the second name of the same disease is salpingoophoritis, formed by the words salpingitis (inflammation of the fallopian tubes) + oophoritis (inflammation of the ovaries). Salpingitis and oophoritis are extremely rare, because of close connection with each other, so 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 the infection into the appendages of the uterus. This can happen in two ways, ascending and descending. The genital way of penetrating the infection to the appendages is called ascending, when the infectious agent penetrates into the ovaries and fallopian tubes as a result of getting into the external genitalia, through the vagina and the uterus. The downward path is the penetration of the infection into the appendages from the primary inflammatory focus in the body with the blood or lymph flow.
The most frequent causative agent of adnexitis is urogenital infection, or abbreviated UGI. This is a group of microorganisms, united primarily through infection, namely sexual. These include gonococci, trichomonads, mycoplasmas, ureaplasma and some other pathogens. Infection by a descending route causes, as a rule, streptococci or E. coli.
The most important condition for the onset of adnexitis is the weakening of general and local immunity: the infectious disease that was carried out the previous day, hypothermia, non-observance of personal hygiene rules, unprotected sex with dubious partners, and other manifestations of unhealthy lifestyles. The psychology of relations between the sexes should exclude such contacts.
Symptoms of adnexitis.
Symptoms of adnexitis depend on whether the disease is acute or chronic.
Symptoms of adnexitis in an acute form: the appearance of severe pain in the lower abdomen, from the right or left side. The pain is strong, aching and drawing character, can give in the sacrum, loin, rectum. There are vaginal discharge of serous (in the form of a syphilis) or purulent. Acute adnexitis is accompanied by a sharp deterioration of the general condition, there is a fever, head and musculo-articular pain, a decline in strength.
In the absence of adequate treatment, adnexitis passes into a chronic form. Often there is primarily chronic adnexitis, which did not have a pronounced acute form. Symptoms of adnexitis in the chronic form are less pronounced, especially common manifestations. The main symptom of chronic adnexitis are pulling aching pains in the lower abdomen, less intense than with acute adnexitis. They appear periodically, usually before or after menstruation. Sign of chronic adnexitis are also painful sensations during sexual intercourse (dyspareunia.
Since chronic adnexitis is associated with adhesions and structural disorders in the tissues of the appendages, there are irregularities in the menstrual cycle: amenorrhea, oligomenorrhoea, dysmenorrhea, etc. Chronic adnexitis can worsen after general diseases, as a result of hypothermia or transferred stress, in this case the symptoms of adnexitis correspond to acute flow. Sometimes chronic adnexitis can be asymptomatic, and the disease is revealed when examining infertility. Infertility due to impaired ovarian function or obstruction of the fallopian tubes is a common symptom of adnexitis in a chronic, neglected form.
Diagnosis of adnexitis.
The formulation of the correct diagnosis with adnexitis is rather complicated, since the signs of an acute abdomen, characteristic of adnexitis in acute form, are common to many acute diseases of the pelvic organs, and the symptoms of adnexitis in chronic form are usually not expressed.
As a diagnosis of adnexitis, a gynecological examination is carried out, including a laboratory analysis of vaginal discharge, a study of blood and urine, including bacussis of urine. Detection of typical microorganisms for urine and vaginal contents may indicate an existing adnexitis, but still these signs are not specific, as well as signs of an inflammatory reaction of the body, detected in the blood.
Some symptoms of chronic adnexitis can be detected using ultrasound.
The exact method of diagnosis, eliminating the error, is laparoscopy, which is used in doubtful cases. This is an endoscopic study that allows visualization of the fallopian tubes and ovaries and directly reveals signs of inflammation: pus and serous exudate accumulation, inflamed mucous membrane in acute adnexitis, and adhesive process with a change in the structure of appendage tissues in chronic adnexitis.
Treatment of adnexitis.
Treatment of adnexitis in acute form requires hospitalization, since acute adnexitis is fraught with serious complications: purulent melting of the ovaries, the formation of purulent cavities in the tubes (pyosalpings), peritonitis, and the like. The bed rest is prescribed, anesthesia is carried out with the help of medicines, and by applying a bladder with ice to the area of the affected appendage. For the removal of inflammation, antibiotics of a broad spectrum of action, anti-inflammatory drugs are prescribed. When a purulent process is detected, surgical treatment of adnexitis is used: with the help of laparoscopic access, a collection 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, anti-inflammatory agents are prescribed corticosteroids, general restorative and immunostimulating therapy is performed. The physiotherapeutic treatment of adnexitis is shown: mud therapy, paraffin therapy, magnetotherapy, microwave and UHF therapy, and others.
Folk treatment of adnexitis.
The popular treatment of adnexitis is used quite widely, especially it is justified in chronic adnexitis. Folk treatment of adnexitis in acute form 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 of adnexitis apply decoctions and infusions of medicinal herbs of anti-inflammatory action, which are used for syringing, enemas or trays. Such an action is possessed by pharmacy chamomile, St. John’s wort, turn, sage, calendula, air, Kalanchoe juice, eucalyptus, caragana officinalis, yarrow, golden mustache and others.
As a fortifying and immunostimulant folk treatment of adnexitis, aloe vera juice (pure or in a 1: 1 ratio with honey), infusion of echinacea purpurea, ginseng infusion, mummies, as well as honey and other bee products are ingested.
Folk treatment of adnexitis, which occurs in a chronic form, can be carried out in parallel with drug therapy or during periods of remission, which allows to reduce the drug load on the body.