Parametritis is an inflammation of the parameter, which is accompanied by purulent discharge. The parametre is a connective tissue that is located around the uterus and cervix.
Mostly this disease occurs as a complication after abortions, performed without observing all sanitary and hygienic norms, the same applies to childbirth. Any internal interventions during the course of such a disease provoke its active development. Therefore, the introduction of internal contraceptives, surgical interventions in the vagina and abdominal walls, dilatation of the cervix, scraping of different types, and performing operations to remove any gynecological tumors in the case of diagnosing parametritis is prohibited. It is interesting that the described disease can be provoked by the inflammatory process in the neighboring organs of the pelvis of a woman, and also can arise as a complication after the development of angina or influenza.
Of the four kinds of parametritis: anterior, posterior, left-sided and right-sided, more often than not women face lateral parametrists, which predominate in ninety percent of cases. Scientists share three stages of the parametrite flow.
In the second stage, the infiltrate can be inflamed, thus determining the purulent form of the disease.
Classification of existing parametrites.
According to the location of inflammation in the ovary cellulose specialists distinguish the anterior, posterior, lateral right-sided and lateral left-sided parametrites. In the case of anterior parametritis, the location of the infiltrate is in front of the uterus, it provokes smoothing of the anterior vaginal fornix. Parametrization of the posterior arrangement implies the spread of the inflammatory process to uterine-rectal tissue, the infiltration of which can lead to a decrease in the lumen of the rectum. Parametric subtypes: lateral left and right side – inflammations that have limitations at the top, bottom, front, so the infiltrate is located on the side of the uterus, left or right, thus smoothing the vaginal vaults from the side.
By the criterion of the stage of the origin of the disease, the primary and secondary parameters are divided, which is accompanied by genital inflammations. During the course of the disease, the diagnosis may sound like an acute, subacute or chronic parameter.
Prognosis and prevention of parametrite disease.
Successful treatment of parametris depends not so much on the massive therapeutic effect and medical intervention as on the degree of neglect of the disease. At the first stage of development, the described disease does not bring much anxiety to a woman, and is easily and without complications curable. While at the stage of formation of purulent formation, and even more so of its rupture, it gives a lot of pain and additional problems. Treatment parametritis of the second and third stages takes a lot of effort and time, in most cases, requiring surgical intervention and drainage, which in itself is no longer safe.
Measures for the prevention of parametrics include simple criteria, which are very easy to adhere to: compliance with asepsis in gynecological examinations, avoidance of abortions (especially community-acquired), proper delivery and, most importantly, careful treatment of their health.
The causes of the parametrite.
Most often, the main cause of the parametris will be purulent lesions of the uterine appendages, which tighten the inflammatory process of parametric fiber. A similar process occurs due to the spread of inflammation along the lymphatic vessels and veins from infected fiber. Infection of the cellulitis occurs lymphogenically. There is a possibility of inflammatory infection of the perinatal fiber during the process of abortion or childbirth, but such cases are very rare.
In the process of parametrit development, doctors distinguish several stages.
The primary stage of parametritis is the stage of exudation, the onset of the disease.
The stage of strengthening exudate – infiltration – there is a replacement of exudate with an infiltrate, which is usually much denser. Usually at this moment the disease begins to be treated and the acute inflammation of the appendages occurs, accompanied by a decrease in the level of the parametrite. Accordingly, the progression of the disease in such cases ends at this stage – the infiltrate in the parameter area slowly decreases.
Formation of a number of purulent microabscesses of infiltrate tissues, and in rare situations – complete melting of the fiber of the parameter.
Symptoms of parametrite.
Usually the flow in the body of the parametrite is accompanied by the same phenomena that are observed in any inflammatory process. At an early stage of development, this disease manifests itself as a constant acute pain in the lower abdomen, which sometimes can be given to the sacrum or loin. The development of parametrite is associated with an increase in body temperature by two to three degrees above normal, the appearance of general weakness in the body, a strong thirst, bright headaches. Also, patients may be troubled by difficulty urinating and defecation, a rapid heart rate.
The gynecologist, when examining the patient, observes a dense, fixed, very painful infiltrate that extends from a certain wall of the uterus to the pelvis. The uterus itself tends to make a slope in a healthy way.
In the next stage, in the absence of treatment, inflammation intensifies its effect on the patient’s body, its condition worsens, pains increase, chills appear, dysuric phenomena intensify, and the leukocyte formula shifts to the left. Vaginal examination reveals the softening of the infiltrate, its fluctuation, and the vagina demonstrates a pronounced overhang of its arch. A short improvement in physical condition can speak of a purulent breakthrough. This can be judged by detecting purulent discharge from the vagina or bladder. Less often, pus from the burst abscess can run upward, reaching the inguinal ligament and provoking flushing of the skin, as well as a noticeable asymmetry of the anterior abdominal wall.
On the course of the disease in the body of the parametrite, one can assume, having felt pain when urinating, which appears after the signs described above or simultaneously with them. The most dangerous subspecies of purulent parametritis is the lateral upper parameter, which is manifested by swelling of the thigh on the side of the uterine suppuration, accompanied by a sharp pain in the leg, expressed by thrombosis of the extremity and acute threat of thromboembolism in the patient.
In case of migration of the pus that breaks into the pericardial tissue, we can talk about acute paranephric. Symptoms of such complications are the growth of the tumor above the kidney, the restriction of movements resulting from severe pain in the ileum and an increase in body temperature more than three degrees above normal.
Diagnostics of parametritis.
The examination of patients for the presence of a parametr is carried out in several ways, depending on the degree of complication and development of the disease. The main pathology is determined by a gynecological examination of the doctor. Thus, the presence of a parameter is diagnosed, as well as the consistency of the infiltrate – from dense, woody to softened, festering. A sign of the disease for the doctor becomes, including, and the condition of the mucosa of the vaginal vault.
Mandatory procedure in this case is called vaginal-rectal ultrasound, during which determine the degree of abscess of the infiltrate and the state of the mucosa above it, indicating the presence or absence of inflammation on the walls of the rectum.
One of the additional methods for diagnosing a parametr is considered to be echography, in the course of which some signs of an inflammatory lesion of the cellular spaces of the pelvic organs are revealed.
Specialists consider the method of computed tomography to be particularly informative in the process of diagnosing parametric inflammation in patients. If the primary examination of the patient showed the presence of (or suspicion) purulent forms of complications, then this type of diagnosis, such as kidney echography, is indicated.
Doctors and gynecologists in the diagnosis for complications caused by parametrite widely use cystoscopy, laboratory tests and excretory urography (if the patient suffers hydronephrosis transformation of the kidneys.
Ways of treatment of parametritis.
Patients suffering from parametritis, with or without complications, are subject to mandatory hospitalization and follow-up in the hospital. The fight against the described disease depends on the degree of its spread and neglect. Acute pain is advised to remove the hot-water bottle with ice, in combination with classical therapeutic methods. At the stage of compaction, medication is supplemented with physiotherapy procedures, as well as with biogenic stimulants. A purulent parameter is subject to surgical treatment. For a start take a puncture of a purulent inflammation the turn of the vaginal vault. Opening of abscesses is also performed through the vagina, later performing drainage, which is accompanied by sanitizing measures: exposure to antibiotics, washing with a disinfectant solution.
It is necessary to supplement that at the stage of resorption of the infiltrate the treatment is carried out with the help of biostimulants, a therapeutic and physical complex, gynecological massage, electrophoresis, light therapy, magnetotherapy, etc. If the disease does not leave the patient for a long time and is accompanied by a syndrome of endogenous intoxication, its treatment is supplemented with plasmapheresis.
After getting rid of Parametita, a woman is recommended to undergo a rehabilitation course. This complex includes quite active measures: massages, hydrogen sulphide baths, mud tampons, mud baths, ultraphoonophoresis and some other methods.