Symptoms of salpingoophoritis and the main manifestations of the disease

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22.01.2020

Salpingoophoritis is one of the most common pathologies of the internal genital organs.

Salpingo-oophoritis is a unilateral or bilateral inflammation of the fallopian tubes and ovaries. This disease can occur in both acute and chronic forms.

Its development occurs due to the penetration of a pathogen (some anaerobes, gonococcus, as well as opportunistic bacteria). Infectious agents can also be ureaplasma, mycoplasma and chlamydia. Microbial associations are most often diagnosed.

Classification of salpingoophoritis

This pathology can occur in different ways.

According to the currently accepted classification, the following types of flow are distinguished:

• acute salpingoophoritis;
• subacute salpingoophoritis;
• chronic salpingoophoritis.

Diagnostics

The infection can penetrate downward - from the peritoneum, upward - from the uterus and vagina, with lymph - from the sigmoid colon and appendix. It is also possible to introduce infection through the hematogenous route.

Most often, microbes are acquired during abortions and difficult childbirths.

Inflammation of the tubes and ovaries rarely occurs in isolation; they have similar clinical manifestations and identical pathogenesis.

The acute course is characterized by sudden pain in the lumbar region and abdominal region (mainly the lower part). The patient has dyspepsia and urinary disorders. A rise in overall temperature is also characteristic.

Severe symptoms are explained by the activity of the infection and the general reaction of the body. The intensity of pain is directly dependent on the extent to which the inflammatory process has spread throughout the peritoneum.

The increase in size of the ovaries is caused by inflammatory exudation, as well as tissue infiltration by leukocytes.

Clinical signs may be somewhat erased if pus accumulates in the fallopian tubes. Clinical tests (blood) show increased ESR and pronounced leukocytosis.

The most common is chronic salpingoophoritis. This form in most cases is the result of untreated or undertreated acute inflammation. Chronic salpingoophoritis is characterized by a decrease in the mobility of the appendages.

In addition, during a palpation examination, the gynecologist detects pain of moderate intensity and compaction of organs. The cause is mainly adhesive processes. The pain tends to intensify before menstruation or after hypothermia.

Chronic salpingoophoritis is characterized by a long course with periodic exacerbations. For patients with this diagnosis, tubal infertility, ectopic pregnancies and miscarriages are very common.

Salpingoophoritis must be differentiated from pathologies with similar symptoms. In addition to necessarily interviewing the patient and collecting a detailed history, it is necessary to refer the patient for blood and urine tests, as well as resort to ultrasound.

Important: diagnosis can be carried out on the basis of the obtained medical history (use of an intrauterine device, abortion in the medical history, previously performed diagnostic curettage).

Ultrasound is an indispensable method when palpation is impossible due to severe pain in the patient’s lower abdomen.

Smears of the vaginal discharge, as well as the urethra and cervical canal (the junction of the vagina and uterus) are also sent to the laboratory for examination. This is necessary to identify the infectious agent and the degree of its sensitivity to antibiotic drugs.

A blood test must determine the leukocyte formula (in the presence of pathology, the number of leukocytes is increased).

In the process of the so-called Bimanual examination in the presence of salpingoophoritis reveals unilateral or bilateral enlargement of the appendages.

Please note: hysterosalpingography is simply an x-ray examination of the uterus and its appendages, which is carried out after the preliminary administration of a special x-ray contrast agent.

If there is a cycle disorder, then a number of additional studies are carried out - determining “pupil syndrome”, measuring rectal temperature and the degree of surface tension of mucus obtained from the cervical canal.

In some cases, diagnostic laparoscopy is necessary (an invasive procedure that requires certain preparation of the patient). Laparoscopy is used in extreme cases, when the diagnosis is in question.

Prevention

• The risk group for this disease includes patients suffering from sexually transmitted diseases, those who have undergone surgery on the organs of the reproductive system, those using intrauterine devices, as well as those who have had abortions and miscarriages.
• To prevent the inflammatory process in the ovaries and fallopian tubes, factors that provoke the disease should be excluded.
• These include:

• sexual infections;
• hypothermia;
• stress;
• consumption of spicy foods.

Important: all representatives of the fair sex should remember about rational contraception, and go for a preventive examination to a gynecologist every six months to a year.

Treatment of salpingoophoritis

An acute process is an absolute indication for placing the patient in a specialized hospital or hospital department. Patients suffering from acute salpingoophoritis are prescribed strict bed rest. According to indications, they are administered analgesics, as well as antibiotic and desensitizing therapy.

1. Of the antibiotics, the most effective are fluoroquinolones and broad-spectrum drugs.
2. As the acute process partially stops or attenuates, biostimulants are indicated.
3. In addition, PT procedures are indicated, which involve vibration massage, ultrasound on the lower abdomen, and electrophoresis.
4. Most often, doctors have to deal with the chronic (untreated or undertreated) form of acute salpingo-oophoritis.

For the treatment of such patients, balneotherapy and physiotherapy are most appropriate. Anti-inflammatory desensitizing and, if necessary, analgesic drugs are also prescribed.

• In many cases, the effect of psychotherapeutic procedures has been experimentally proven.
• Plisov Vladimir, medical observer

Source: https://myt-mrgk.ru/ginekologiya/salpingooforit-simptomy-i-lechenie.html

Salpingoophoritis: stages, causes, symptoms, treatment

Salpingo-oophoritis is an inflammatory process that progresses in the ovaries and fallopian tubes. It appears due to the entry of the pathogen from the peritoneum, vagina, or appendix. The pathogen can also penetrate the fallopian tubes and ovaries by hematogenous means.

The cause of the development of the disease is, as a rule, gonococcus. The disease can also be caused by streptococcus, enterococcus, chlamydia or E. coli.

After this, pathological formations with pus or serous content begin to develop in the affected areas.

Causes

Among the main reasons that cause bilateral salpingoophoritis are:

• hypothermia (caused, for example, by wearing thin tights in cold weather);
• casual sex. Sexual contact during menstruation can also lead to the development of pathology;
• various stresses.

As a rule, the pathogen penetrates the tissues of the genital organs through:

• lymph (together with lymph flow);
• blood (hematogenous route);
• ascending route (from the vagina through the cervical canal, and then into the uterine cavity and tubes);
• in a descending manner (through the abdominal cavity from the sigmoid or cecum).

After pathogenic microorganisms enter the mucous membrane, inflammation begins there, which spreads to the muscle structures.

After some time, the abdominal cavity, the surface of the ovaries and other nearby tissues are involved in the inflammatory process.

After ovulation occurs, infectious bacteria enter the corpus luteum and continue to develop in the ovaries. As a result, the affected areas of the tubes and ovaries merge into one tissue.

Stages and types of disease

There are three stages of development of the disease (depending on the nature of the course):

• acute stage. At this stage of the progression of the pathology, the patient feels sharp and severe pain in the lower abdomen, which is accompanied by an increase in temperature and vaginal discharge that has an unpleasant odor. The pain sometimes radiates to the lower back. If acute salpingoophoritis is not treated, it turns into a subacute form;
• subacute stage. Develops in the fallopian tubes or ovaries. The infection can enter the genitals from other organs affected by the pathogen, as well as through lymph or blood. Symptoms of the subacute stage of development of the disease include high temperature, chills, general weakness, and bloating of the lower abdomen. In addition, the patient is bothered by pain in the lower abdomen, especially during sexual intercourse. The subacute period is characterized by long-term remissions;
• chronic stage. It develops if the patient does not consult a doctor in time. Chronic salpingoophoritis is characterized by the presence of symptoms such as pain in the lower abdomen or lumbar region, problems with menstruation. Remission of the disease can take place over several years. An exacerbation of the process can occur at any time, but most often it occurs during the cold season.

Depending on the location, the following types of inflammatory process are distinguished:

• left-sided - occurs when the left fallopian tube is damaged;
• right-sided - occurs when the pathogen affects the right fallopian tube;
• bilateral - develops with simultaneous damage to both fallopian tubes. It is a more severe form of the disease. A characteristic symptom of bilateral salpingoophoritis is an increase in 2 appendages. If a woman progresses with this particular form of the disease, she will not be able to get pregnant until she is completely cured of it. In this case, you should immediately contact a medical facility for diagnosis and treatment. As a rule, this pathology is completely eliminated surgically.

Symptoms of the disease

Salpingo-oophoritis

There are the following main general symptoms of the disease:

• Fatigue sets in quickly;
• temperature rises;
• there is constant weakness;
• disturbances appear in the digestive tract (colitis or enteritis);
• diseases of the urinary system, such as cystitis or pyelonephritis, appear.

Local symptoms of the disease include:

• menstrual irregularities (polymenorrhea or algomenorrhea);
• aching pain in the groin area, which can radiate to the lower back and sacrum;
• discharge that is serous or purulent in nature, as well as an unpleasant odor.

If you do not pay attention to these symptoms and do not undergo adequate treatment in a timely manner, infertility may develop.

Therefore, patients who cannot become pregnant should also be examined by a doctor for the presence of this disease. According to statistics, the symptoms of the disease in about 5% of women are very pronounced.

Conservative methods do not always have the desired effect, so they resort to a surgical method - removal of the fallopian tube.

It is possible to get pregnant while suffering from this disease, but not every woman decides to do this, since the risk of developing an ectopic pregnancy is very high.

Salpingo-oophoritis and pregnancy can exist together, but getting pregnant in the presence of this pathology is always very difficult. But it’s even harder to bear a child.

Diagnostics

Diagnosis of the disease is carried out on the basis of a study of the woman’s medical history, as well as the disease itself.

A specialist can make a preliminary diagnosis of “acute salpingoophoritis” if he finds in the medical history information about previous abortions, difficult births, and the use of an IUD to prevent pregnancy.

It is also important to take into account the presence of symptoms characteristic of bilateral salpingoophoritis - pain in the lower abdomen, increased body temperature, etc.

Also, during the diagnosis, research is carried out in the laboratory.

The doctor also takes a swab from the vagina and cervical canal. Such an analysis makes it possible to identify the pathogen, as well as determine which medications it is sensitive to.

During the diagnosis, hysterosalpingography is performed. This technique is very informative. A special contrast agent is injected into the uterine cavity, after which an X-ray is taken.

Such a disease may require additional consultation of the patient with specialists other than the gynecologist (surgeon and urologist).

Treatment of the disease

Treatment of chronic salpingoophoritis, as well as its other varieties, is carried out using several methods. This diagnosis is not a death sentence. As a rule, a woman who is diagnosed with acute or chronic salpingoophoritis will be sent to hospital.

The following methods are now used to treat the disease:

• non-drug treatment. It is carried out if the patient has chronic salpingoophoritis. In this case, UHF therapy, electrophoresis or magnetic therapy are used. Also, as physiotherapeutic methods of treatment, the doctor may prescribe diadynamic currents or treatment in a sanatorium to the patient;
• drug treatment. Prescribed for acute illness. The main group of drugs used to destroy the pathogen are antibiotics. Broad-spectrum antimicrobial drugs are used. There are several treatment regimens: the first involves the use of cefotaxime, ceftriaxone and other antibiotics. The second regimen involves taking lincosamides or fluoroquinolones. Quite often, to prevent the spread of chlamydial disease, the patient is also prescribed a macrolide or doxycycline;
• surgical intervention. Such treatment of salpingoophoritis is used if conservative therapy does not have the desired effect on the patient’s health. The laparoscopy method is used. In this case, the patient is injected into the peritoneal area with a solution of antibiotics.

Laparoscopy

Inpatient treatment usually takes from one week to 10 days. Afterwards, when the patient’s health improves and the inflammatory process is eliminated, the woman is discharged.

Among the folk remedies, the following are distinguished:

• drinking potato juice on an empty stomach. To get potato juice, you need to grate several potatoes on a fine grater, squeeze, and mix the resulting liquid thoroughly before drinking (the starch contained there can settle to the bottom too quickly). To diversify the taste of this folk remedy, it is recommended to add carrot juice or any other juice. Taking this folk medicine helps eliminate the symptoms of the disease;
• Mix elecampane proportionally with meadowsweet and kermek. Add marin root to the resulting product, and then pink radiola. Infuse for a week in a 50-degree alcohol solution, and then drink the resulting tincture on an empty stomach in the morning and evening;
• meadow cornflower mixed with clematis grass, as well as tenacious. Pour the mixture with one liter of hot water and leave overnight, after boiling for 5 minutes. It is recommended to drink this folk remedy before meals 3 or 4 times a day, 100 grams each time.

It is worth remembering that folk remedies can only alleviate symptoms, and their use must be agreed upon with the attending physician.

Otherwise, uncontrolled use of any prescriptions can lead to complications. Under no circumstances should you self-medicate.

It is necessary to contact a qualified specialist to carry out a diagnosis, identify the cause of the development of the pathology, and begin treating the disease.

Disease prevention

To ensure that salpingoophoritis never bothers a woman, she needs to adhere to a few simple rules:

• use contraception during sexual intercourse. This includes barrier type contraception (condoms), as well as local type (ointments, suppositories - popularly called “suppositories”, tablets for vaginal use). They must be used starting from the first sexual intercourse and in any cases when a woman does not plan to conceive a child. You must always remember that the integrity of your partner is not a 100% guarantee that he will not have sexually transmitted infections;
• go with your partner for examination. You can be examined by a urologist before your first intimate relationship takes place. It is worth noting that only one sexual act, during which contraception was not used, can trigger the transmission of the disease;
• avoid genital-anal sexual intercourse if hygienic procedures have not been carried out, as well as in cases where contraception is not used;
• develop a diet for yourself that will include all the necessary vitamins and microelements. This is necessary to maintain proper levels of immunity. You can seek help from a nutritionist. He will help you create a rational menu.

If the first symptoms of the disease appear, you should immediately consult a doctor.

Source: https://SimptoMer.ru/bolezni/zhenskie-zabolevaniya/1029-salpingooforit-simptomy

Right-sided salpingoophoritis

Content :

1. Right-sided salpingoophoritis
2. Etiopathogenesis
3. Symptoms
4. Treatment

Right-sided salpingoophoritis is a pathological process of the uterine appendages, which includes both the ovary and the fallopian tube, which has an inflammatory genesis.

Since inflammation can be aseptic, and can also be infectious, the term “infectious-inflammatory process” is often applied to salpingo-oophoritis.

A process that is caused by exposure of tissue to microorganisms that have a detrimental effect on cells and tissues.

When diagnosed with salpingoophoritis on the right, it is the uterine appendages on the same side that are affected, while the left tube and ovary remain intact. However, this does not mean at all that infection with the same flora cannot occur from the opposite side.

Etiopathogenesis of the disease right-sided salpingoophoritis

The etiological causes of right-sided, in fact, as well as left-sided, are all provoking factors that contribute to the penetration of pathogenic microorganisms to the fallopian tubes and ovaries.

These can be performed abortions, and fractional diagnostic curettage, which are performed quite often in order to obtain information about the state of the uterine cavity, namely the endometrium and the mucous membrane of the cervical canal, hysteroscopic studies, as well as the installation of a seemingly harmless intrauterine device - this a factor that, if the production technology is violated, can provoke the occurrence of a completely serious pathological condition.

However, not only any interventions can cause such a process in the area of ​​the appendages. Violation of hygiene standards regarding the female genital organs can also serve as a trigger for infectious flora to enter the uterine appendages.

The pathogenetic moments that occur during the manifestation of salpingoophoritis occur when pathogenic microorganisms multiply on the surface of the mucous membrane of the fallopian tubes, as well as the ovary itself.

The waste products of microbes begin to affect the mucous membrane and the ovary itself, as well as the entire body as a whole. At the site of their reproduction, the reaction of the body itself begins in response to the action of foreign agents.

Inflammatory mediators and tissue factors begin to be released, as a result of which the immune system is activated, swelling occurs, and, so to speak, a confrontation between the body and these bacteria begins.

At this stage of the disease, a woman may either not feel anything at all, or feel a feeling of slight discomfort on the side from which such changes occur.

If the tube on the right and the ovary on the right are affected, salpingoophoritis is considered right-sided.

Symptoms of right-sided adnexitis

In fact, among the existing classification of salpingoophoritis according to its localization, right-sided inflammation of the appendages is the most insidious problem that arises among gynecologists and surgeons. Since the clinical symptoms of this kind of disease are similar to acute surgical pathology, which many people know about and fear it like fire.

All symptoms accumulate and are limited to the right iliac region. It is in this place that the signs of such a pathology as acute appendicitis are mainly located.

The symptoms of right-sided salpingoophoritis almost completely repeat the symptom complex of appendicitis, which is why, according to statistics, there are more registered cases in gynecological hospitals of right-sided adnexitis, since everyone confuses it with inflammation of the appendiceal process.

And for some reason society is afraid of appendicitis much more than adnexitis. Although the consequences of the latter can be very sad.

In some cases, the clinical picture is so similar that surgeons go to the operating room due to a preliminary diagnosis of appendicitis, and then they call gynecologists to take over, since during a laparotomy (opening the anterior abdominal wall and gaining access to the abdominal organs) during the audit it is established that that the inflammatory process affected not the appendicular part of the intestine, but the uterine appendages on the right side.

Symptoms of right-sided salpingoophoritis include:

• Pain syndrome, which is localized precisely in the right iliac region, that is, in the lower abdomen, more on the right. The pain can be either nagging or acute, disrupting the general condition of the body. It is this symptom of adnexitis on the right side that makes people think about appendicitis.
• Increased body temperature. There are also signs characteristic of these similar pathological processes. The temperature can either rise to 37-38 degrees or be within 40 degrees.
• General weakness. This symptom is caused by the release of toxins that are formed during the life of bacteria, as well as when they die, either under the influence of antibiotics or human immunity.
• Nausea and vomiting can also be caused by the same intoxication mentioned in the previous paragraph.

As you can see, the main part of the symptoms, which are the most noticeable, are entirely similar to the symptom complex of acute appendicitis.

This is why it is so important to seek medical help promptly.

It is the moment of diagnosis that is one of the most critical parts in forming a diagnosis.

Examination and palpation of the abdomen, gynecological examination, ultrasound and clinical laboratory research are the main points that must be carried out for a qualitative differential diagnosis of right-sided salpingoophoritis.

Right-sided salpingoophoritis: treatment

Therapy for right-sided salpingoophoritis without a complicated course should include antibacterial, infusion, anti-inflammatory, and antihistamine therapy. In case of complicated forms of inflammation of the appendages, a surgical method of therapy cannot be excluded.

Source: https://salpingooforit.ru/pravostoronnij-salpingooforit.html

Salpingo-oophoritis

Salpingo-oophoritis (andexitis) is an inflammation of the ovaries and fallopian tubes in women.

According to statistics, salpingoophoritis is the most common among pelvic diseases in women of childbearing age.

Salpingo-oophoritis is often diagnosed when planning pregnancy in young women, when visiting specialized gynecology and urology clinics with a complaint of infertility.

Salpingoophoritis can be caused by various types of microorganisms, including opportunistic ones, provided that the general resistance of the body is reduced. For this reason, taking into account the etiology, andexitis is divided into specific and nonspecific forms. 1.

The specific form is caused by forms of the pathogen that are sexually transmitted:

a) Chlamydia. Due to the prevalence of chlamydial infection, one of the most common causes of salpingoophoritis ;

b) Trichomoniasis; c) Gonorrhea;

2. Nonspecific form. It can develop as a result of exposure to normal vaginal microflora with a decrease in the body's immune defense. Most often these are: a) Streptococci; b) Staphylococcus; c) Enterococci; d) Escherichia;

e) Yreaplasmosis;

e) Mycoplasmosis. Most often, microbial associations—communities of microorganisms (a combination of several etiological factors)—play a major role in the development of the disease. According to localization, adnexitis can be: a) unilateral - the appendages are affected only on one side, it is rare. One-sided often turns into two-sided andexit. b) bilateral - damage on both sides, occurs much more often than unilateral. According to the clinical course:

a) Acute form. In the acute form, women complain of sharp pain in the lower abdomen, which radiates to the sacrum and anus. A mucous discharge from the vagina appears.

Often patients complain of algomenorrhea - pain during menstruation, heavy in nature with menorrhagia.

If done incorrectly, acute andexitis becomes chronic and is a complex problem in gynecology.

b) Chronic form. The chronic form is characterized by frequent relapses that occur during hypothermia, stress, and weakened immunity. Chronic inflammation can cause intestinal dysfunction (colitis) and the development of diseases of the urinary system (cystitis, urethritis, pyelonephritis, ectopic pregnancy, infertility). Pathogenesis.

Then the muscular layer of the fallopian tube is affected, which thickens and lengthens, becoming painful on palpation. When the contents of the tube enter the ovary, inflammation develops and cysts may form.

There are frequent cases of damage to the peritoneum and the development of peritonitis.

All clinical symptoms of salpingoophoritis can be divided into general and local or local: Local manifestations: 1. Intense aching pain in the groin area with irradiation to the sacrum, intensifying before and after menstruation, as well as with intercurrent diseases. 2.

Leucorrhoea (mucous, serous, purulent) – vaginal discharge; 3. Menstruation disorders: a) Polymenorrhea - heavy menstruation; b) Aldismenorrhea - pain during menstruation; c) Oligomenorrhea – absence of menstruation. 4. Ovarian function, anovulation; 5.

Complaints about the inability to get pregnant, early miscarriages and ectopic pregnancies.

1. General inflammatory symptoms (fever, malaise, weakness, fatigue) 2. Digestive dysfunction (enteritis, colitis); 3. Disorders of the urinary system (bacteriuria, cystitis, pyelonephritis). With a long course of the disease, the nervous, vascular and endocrine systems may gradually become involved. Therefore, over time, the disease can become systemic, which greatly complicates the diagnosis of salpingoophoritis. The diagnostic criteria for salpingoophoritis are: 1. Fever (38°C and above); 2. Leucorrhoea of ​​a purulent nature; 3. Dysmenorrhea; 4. Pain in the area of ​​the appendages, enlargement of the appendages 5. Leukocidosis (10*109/l or more); 6. Acceleration of ESR. Diagnostic studies that complement the clinical picture:

• If salpingoophoritis is suspected, the patient should undergo tests:
• 9. Ultrasound of the pelvis

1. General blood test. 2. Fasting blood glucose test. 3. Biochemical blood test: a) C-reactive protein b) RW, HIV; c) HbsAg d) IgA, IgM, IgG; 4. Coagulogram. 5. General blood test 6. Vaginal smear for microflora; 7. Culture of vaginal discharge for microflora and sensitivity to antibiotics. 8. Smear for oncocytology;

Treatment of salpingoophoritis is prescribed immediately after diagnosis, taking into account all the features of the clinical course of the disease. In this case, the following types of therapy are performed: 1.

Antibiotic therapy: Antibiotic therapy is carried out depending on the results of cultures for the sensitivity of the flora to antibiotics.

Until the final result of the above-mentioned studies is obtained, therapy is carried out with broad-spectrum antibacterial drugs.

a) In an acute process, a group of drugs with a blocking effect of histamine H1 receptors (tavegil, pheniramine, cetirizine, loratodine) is most often used. b) In case of a long-term chronic process, when the disease does not respond to typical treatment, glucocorticoids are prescribed to help reduce inflammation: Betameson (celoston); Triamcinolone (bermecort, delficort). 3. Anti-inflammatory therapy (NSAIDs): a) Diclofenac (Voltaren, Diclac, Ortofen); b) Piroxicam (toldin, pixicam); c) Naproxen (pronaxen) d) Nimesulide 4. Vitamin therapy: a) B vitamins (thiamine, pyridoxine); b) Vitamin A (retinol acetate); c) Vitamin E (tocopherol acetate); d) Multivitamin complexes. 5. Enzyme therapy: Enzymes have anti-inflammatory, decongestant, secondary analgesic and immunomodulatory effects. They increase the production of alpha interferon and have a resolving effect. a) Wob-enzyme (contains a complex of enzymes: lipase, papain, amylase, bromelain, trypsin); b) Serratiopeptidase (Serta); c) Terrilin in the form of vaginal and rectal suppositories; d) Lyophilized lidase powder for subcutaneous and intravenous use; 6. Biogenic stimulants. These substances of plant and animal origin, when introduced into the body, have a stimulating effect, accelerating regeneration processes. The following are used: a) Biogenic stimulants made from blood components: Polybiolin (made from placental blood); Plazmol (made from human blood); Placenta extract; Vitreous extract; b) Biostimulants made from plants: Aloe extract; Phibs; Peat; Humisol. 7. Gynecological massage has a beneficial effect in complex therapy. 8. Physiotherapy: a) Local cryotherapy - cold treatment; b) Local exposure to UHF electric field; c) Oxygen barotherapy - special procedures in a pressure chamber; d) Autotransfusion of own blood irradiated with ultraviolet light. c) Electrophoresis with medicine - due to the created electric field, the medicine is better absorbed into the tissue; d) Ozokerite – treatment by heating with special complexes of mountain paraffins; c) Mud therapy.

Salpingo-oophoritis is a serious disease, which, if left untreated, can become chronic and subsequently cause serious complications.

Salpingo-oophoritis can become a big problem during pregnancy , causing an ectopic pregnancy, as well as being the cause of such a serious complication as infertility.

Therefore, this disease must be taken with due seriousness and treatment must be started on time by going to specialized clinics, undergoing tests on time, thereby preventing the process from becoming chronic.

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Source: http://andromedica.ru/ginekologiya/salpingooforit/

Chronic adnexitis (salpingoophoritis): symptoms and treatment, complications

The leading place among inflammatory pathologies in gynecology is occupied by adnexitis, which is also known as the diagnosis of salpingoophoritis. The disease affects the uterine tubes and ovaries, making it one of the main causes of female infertility.

Adnexitis what is it

Before you find out how to correctly recognize and treat the disease, you need to know what salpingoophoritis is.

Under the influence of various infections penetrating from the lower genitalia, inflammation of the fallopian tube begins.

Through the lumen of the affected appendage, the infection spreads to the outer serous layer of the ovary. When a follicle ruptures during ovulation, internal infection of the gland occurs. A combined lesion of the adnexal organs of the uterus occurs, which is called salpingoophoritis or adnexitis.

First signs

The form of salpingoophoritis depends on the severity of the symptoms of the infectious process: it can acquire an acute, subacute and chronic course. 

The initial symptoms of acute salpingoophoritis are sudden pain in the lower abdomen from the appendages and severe fever.

The disease must be distinguished from diverticulitis, acute appendicitis, intestinal and renal colic - the symptoms of these pathologies are very similar.

Sluggish or chronic adnexitis passes from an acute form with ineffective treatment. For a long time it does not have a pronounced clinical picture, but it causes disruptions in the menstrual cycle and tubal-ovarian infertility. During periods of exacerbation in chronic salpingoophoritis, the symptoms do not differ from those in the acute form of the disease.

Causes

The etiological causes of adnexitis are specific and nonspecific infections.

A specific form of salpingoophoritis is caused by a certain type of pathogen; it is characterized by special specific symptoms and highly targeted antibacterial therapy. Such infections include:

• Gonococcus.
• Tuberculosis bacillus.
• Diphtheria corynebacterium.

Nonspecific salpingoophoritis is caused by many different microorganisms, and for any pathogen, the symptoms of adnexitis will be the same. Among the infections that cause nonspecific salpingoophoritis, the main ones are:

• Streptococci.
• Staphylococci.
• Escherichia coli.
• Pseudomonas aeruginosa.

In this case, a combination of infectious agents is possible, which requires the use of several antibiotics with different spectrums of action.

Acute adnexitis

The main causes of acute salpingoophoritis are:

• Promiscuous sexual intercourse without using a condom.
• Neglect of intimate hygiene rules.
• Surgical interventions in the pelvic cavity.
• Placement of a contraceptive IUD.
• Complicated abortions and difficult births.
• Therapeutic and diagnostic curettage (scraping) of the uterine endometrium.
• Previous diseases (tuberculosis, diphtheria, pneumonia).

Important! For the development of adnexitis, a decrease in immunity is necessary, which is provoked by hypothermia, physical and mental stress, smoking and alcohol abuse, and chronic somatic diseases.

Chronic form

Chronic salpingoophoritis occurs with inadequate treatment of the acute form of the disease. In this case, symptoms of adhesions in the uterine appendages and abdominal cavity are observed, which becomes the cause of infertility.

Symptoms of acute adnexitis

Symptoms of acute salpingoophoritis develop quickly. With severe fever, pain in the appendage area and severe intoxication develop.

Acute pain with adnexitis occurs suddenly, is localized in the lower abdomen and lower back, and can radiate to the anus. There is a painful urge to urinate, diarrhea or constipation.

Vaginal discharge with adnexitis is purulent, yellow in color and has a foul odor.

Vaginal discharge with adnexitis is purulent, yellow in color and has a foul odor.

With superficial and deep palpation of the lower abdomen in the area of ​​the appendages, sharp pain occurs, and characteristic symptoms of peritonitis appear - inflammation of the layers of the peritoneum.

Symptoms of acute right-sided salpingoophoritis can be confused with appendicitis. The final diagnosis is established after all necessary diagnostic studies have been carried out. Acute bilateral salpingoophoritis is characterized by symptoms of diffuse inflammation of the peritoneum and extremely severe intoxication.

Symptoms of the chronic form

Chronic adnexitis is described by the following symptoms:

• Aching, mild pain in the iliac region, a constant pulling sensation.
• Violation of the monthly cycle: delay in the onset of menstruation, changes in the color and volume of discharge, exacerbation of pain during ovulation and menstruation.
• Unpleasant sensations and pain during sex (dyspareunia).
• Mucopurulent discharge from the genital tract.
• Development of defecation and urination disorders.

Important! Chronic and subacute salpingoophoritis provoke the formation of adhesions in the epididymis and peritoneum, which can lead to the development of ectopic pregnancy or infertility.

Exacerbations of chronic adnexitis occur, as a rule, when the immune system is suppressed due to hypothermia, acute respiratory viral infections, and stress. Manifestations of chronic salpingoophoritis in the remission stage may be minimal; pathology is revealed only when diagnosing the causes of infertility.

Diagnosis of adnexitis

In acute salpingo-oophoritis, the typical clinical picture comes to the fore with the development of symptoms of an acute abdomen.

A two-handed examination cannot give a clear picture of the disease due to the fact that the pelvic peritoneum is involved in the process, swelling and inflammation of all underlying tissues occurs.

Upon examination, the speculum reveals pus in the vagina and signs of inflammation of the cervical canal. With exacerbation of chronic adnexitis, a gynecological examination gives similar results.

When diagnosing adnexitis, the gynecologist takes smears to determine the type of infection and its susceptibility to antibacterial drugs.

When diagnosing adnexitis, the gynecologist takes smears to determine the type of infection and its susceptibility to antibacterial drugs.

It is possible to perform culdocentesis - a puncture of the posterior vaginal vault for the purpose of aspiration of pathological fluid. With diffuse salpingo-oophoritis, pus will be detected in it.

Ultrasound for symptoms of acute salpingoophoritis is not very informative. Noticeable changes in the appendages are observed with prolonged inflammation. Ultrasound signs of adnexitis in this situation can include thickening of the fallopian tube and visualized adhesions in the pelvis. Complicated forms of adnexitis with the formation of ulcers are clearly visible.

Blood tests in acute salpingoophoritis will reflect inflammation: an increase in ESR, leukocytes, and the appearance of biochemical markers of inflammation. Chronic salpingoophoritis will only manifest itself as an acceleration of ESR in a general blood test.

Laparoscopy will absolutely help in making a diagnosis of adnexitis - examination of the abdominal and pelvic areas with a medical endoscope inserted through a puncture in the anterior abdominal wall.

Treatment

Depending on the form and severity of the process, various treatment tactics for salpingoophoritis are chosen. Acute and subacute adnexitis, as well as exacerbations of the chronic form, require treatment in a hospital setting.

The first step is antibiotic therapy. Treatment of adnexitis of a specific type (tuberculosis, gonorrhea, diphtheria) is carried out according to generally accepted protocols for the treatment of these infections. To eliminate the symptoms of salpingoophoritis caused by nonspecific flora, antibiotics are selected taking into account the most likely pathogens.

To eliminate the symptoms of salpingoophoritis caused by nonspecific flora, antibiotics are selected taking into account the most likely pathogens.

The main combinations of drugs for the treatment of acute adnexitis:

• III generation cephalosporins (Ceftriaxone, Ceftazidime) + Metronidazole.
• II generation cephalosporins (Cefuroxime) + tetracyclines (Tetracycline, Doxycycline).
• Lincosamides (Clindamycin) + Monobactams (Aztreonam).
• Fluoroquinolones (Ciprofloxacin) + Metronidazole.

Treatment of salpingoophoritis with antibiotics is a long process, taking at least 7-10 days. This therapy negatively affects the microflora of the intestines and vagina. To prevent dysbiosis, eubiotics (Bifidumbacterin, Bifikol, Acylact) are prescribed simultaneously with antibiotic treatment.

Symptoms of intoxication complicate adnexitis.

To eliminate them, detoxification treatment is required. Solutions of sodium chloride and glucose, protein and plasma replacement drugs are administered intravenously. At the same time, non-steroidal anti-inflammatory drugs (Diclofenac, Indomethacin, Nurofen) are prescribed.

To restore ovarian function, hormonal treatment of chronic adnexitis is prescribed. Combined estrogen-gestagen drugs are used contraceptively for at least 6 months.

Operation

Surgical treatment of adnexitis involves laparoscopy. It is a diagnostic operation that helps to accurately establish the diagnosis of salpingoophoritis in women.

Laparoscopy is a diagnostic operation that helps to accurately establish the diagnosis of salpingoophoritis in women.

But if an irreversibly altered fallopian tube is found, complicated forms of the disease develop, it is possible to remove the appendage as a source of infection in the pelvis.

Diet for adnexitis

Nutrition for adnexitis in women does not require particularly strict restrictions. During the acute phase of the disease and aggravated symptoms of chronic adnexitis, it is recommended to avoid heavy foods (fried foods, pickles, smoked meats).

You should include in your diet foods rich in vitamin C (citrus fruits, black currants, bell peppers, parsley) and fiber (fresh vegetables and fruits, bran, cereals).

Fluid consumption during salpingoophoritis should be at least 2.5 liters per day.

To normalize intestinal function during salpingoophoritis, it is recommended to consume low-fat fermented milk products (kefir, fermented baked milk, natural yogurt, ayran), and add a small amount of vegetable oil (olive, flaxseed or sunflower) to dishes. Vegetable and fruit juices will be useful.

Forecast

It is possible to cure adnexitis with timely recognition of the symptoms of the disease and timely initiation of correct treatment. This allows salpingo-oophoritis not to become chronic or worsen by the development of purulent complications or inflammation of the peritoneum.

The adhesive process, which is one of the symptoms of chronic adnexitis, affects the possibility of conception and increases the risk of ectopic pregnancy.

Treatment of adhesions is a long process that involves the use of enzyme preparations (Longidaza, Wobenzym) and physiotherapeutic procedures.

Knowing how salpingoophoritis can be treated, it is also necessary to find out how to prevent it. Prevention of adnexitis consists of the following measures:

• Compliance with the rules of intimate hygiene.
• Using a condom during sexual intercourse.
• Preventive treatment with antibiotics for any gynecological interventions.
• Increasing the body's defenses.

Complications with adnexitis

In severe cases of adnexitis in women, irreversible changes in the appendages and their purulent lesions may develop.

Pyosalpinx

In acute adnexitis, adhesion of the walls and fusion of the fallopian tube is possible. Pus begins to accumulate inside it, and pyosalpinx occurs. Its symptoms are similar to those of adnexitis, but the intoxication is more pronounced.

With the development of symptoms of pyosalpinx, there is a threat of rupture of the infected pipe with the development of purulent-septic complications. Therefore, treatment of the disease is carried out only in a hospital.

Combinations of antibiotics and detoxification therapy are prescribed. In this case, the effect is assessed within a few days after treatment, without waiting for the end of the full course of antibacterial therapy.

All affected tissue is removed. In women of fertile age, they try to preserve the uterus by removing only the modified appendages. If a septic condition, fistula, or damage to the periuterine tissue develops, a hysterectomy is performed - removal of the entire uterus.

Hydrosalpinx

Chronic periadnexitis leads to the formation of adhesions in the fallopian tubes. At the same time, their epithelium begins to actively produce mucus, which is unable to drain. The pipe becomes mucus and ceases to perform its function, hydrosalpinx develops.

This complication does not have pronounced symptoms. It is characterized by nagging abdominal pain, watery discharge from the genital tract, and rarely, low-grade body temperature. Hydrosalpinx is often found when determining the causes of infertility during a gynecological examination or ultrasound.

Treatment of the disease involves surgery. Laparoscopic operations are performed to separate adhesions, and in case of irreversible changes in the tube, it is removed. In the postoperative period, antibiotics, physiotherapy and enzymatic treatment of adhesions are prescribed.

Tuboovarian abscess

When the integumentary epithelium of the ovaries is involved in salpingoophoritis, especially if there are cystic formations on it, tubo-ovarian abscesses may develop. These are delimited cavities in the appendage area filled with pus.

The symptoms of a tubo-ovarian abscess are no different from the signs of adnexitis. In this case, there is a high risk of abscess breakthrough with the formation of peritonitis, sepsis and infectious-toxic shock.

Due to the severity of possible complications, surgical treatment of the disease is mandatory. Laparoscopic removal of the tubes is performed with drainage for drainage of purulent contents. If the uterus becomes infected or symptoms of sepsis develop, a hysterectomy is performed.

Tubal obstruction

Chronic adnexitis is often complicated by adhesions in the area of ​​the appendages and peritoneum of the small pelvis. This leads to the development of infertility or ectopic pregnancies. The egg either does not enter the tube at all when its lumen is closed, or the fertilized one remains in the appendage or exits into the abdominal cavity.

The proportion of tubal-peritoneal infertility is 30% of all cases. At the same time, the chronic salpingo-oophoritis that caused it may pass without symptoms, which makes it difficult to find the cause.

Sometimes a symptom of adhesions can be painful periods and pain during the intermenstrual period.

Treatment of fallopian tube obstruction is complex. It is based on reconstructive plastic surgery to restore the lumen of the tube. Laparoscopically, adhesions are destroyed, the entrance to the funnel part of the tube is restored, or a new hole is created in it. At the same time, the concomitant pathology of the uterus and appendages is eliminated:

• Myomatous nodes.
• Foci of endometriosis.
• Ovarian cysts.

In the postoperative period, antibiotic therapy, physiotherapy, and prevention of adhesions (plasmapheresis, enzyme treatment) are carried out. If there are no positive results from treatment of tubal infertility for 6-12 months, IVF (in vitro fertilization) is prescribed.

Adnexitis is a pathology that requires immediate treatment. If the first symptoms of inflammation of the appendages occur, you should immediately seek help from a doctor.

Untreated salpingoophoritis can develop into a sluggish form, causing infertility, and also provoke the development of purulent complications that are life-threatening.

Source: https://VrachMatki.ru/adneksit/adneksit-lechenie

Salpingoophoritis: causes of the disease, main symptoms, treatment and prevention

A disease of the female reproductive system, characterized by inflammation of the fallopian tubes and ovaries, can cause infertility.

The following microorganisms can cause the disease: chlamydia, gonococci, mycoplasmas, in some cases staphylococci, E. coli, streptococci. Provoking factors include: frequent hypothermia, overwork, stress, malnutrition, infectious diseases, abortion, multiple births, promiscuity without the use of condoms.

Symptoms of salpingoophoritis

Characteristic symptoms of the disease: pain in the lower third of the abdomen, which is noted both at rest and during physical activity, pain radiating to the lumbar region, sacral area and perineum, pain and discomfort during sexual intercourse, copious gray or green discharge from the genital tract colors with an unpleasant odor, increased body temperature, nausea, general weakness, malaise, impaired sexual function, chills, menstrual irregularities, irregular menstrual cycles, lack of pregnancy with regular sexual activity.

Diagnosis of salpingoophoritis

An analysis of the medical history and obstetric and gynecological history, a complete gynecological examination with bimanual vaginal examination, a general blood test, microscopy of a gynecological smear, a bacteriological examination of a gynecological smear, and an ultrasound examination of the pelvic organs are performed.

Treatment of salpingoophoritis

During treatment, antibiotic therapy (Tetracycline, Cefazolin), painkillers and anti-inflammatory drugs are used, and detoxification therapy is prescribed.

Methods of physiotherapy and restorative therapy are used, aimed at strengthening the general and immune forces of the body.

During therapy, you should abstain from sexual intercourse; it is necessary to treat both sexual partners.

Complications may develop: adhesions in the pelvis, obstruction of the fallopian tubes, menstrual irregularities, tubal infertility, cystitis, cervicitis.

Prevention of salpingoophoritis

It is necessary to exclude casual sex and use condoms during sexual intercourse.

and inflammatory diseases, especially of the pelvic organs, should be treated promptly

It is important to avoid hypothermia, observe the rules of intimate hygiene, avoid high physical activity, stress, and exclude abortions. Preventive examinations with a gynecologist every six months.

Source: https://www.obozrevatel.com/health/bolezni/salpingooforit-osnovnyie-prichinyi-razvitiya-simptomyi-bolezni-diagnostika-i-profilaktika.htm