Oophoritis is an ovarian disease of an infectious-inflammatory nature. It is the most common among other pathologies of the female reproductive system and, in the absence of qualified treatment, can cause infertility.
It mainly affects women of reproductive age, but can occur at an earlier or later age.
Next, we will consider the specifics of the disease, treatment of oophoritis, drugs and antibiotics to quickly relieve the inflammatory process.
How does oophoritis manifest?
Oophoritis occurs when infected with pathogens. These can be pathogens that cause sexually transmitted diseases (syphilis, gonorrhea), intracellular microorganisms (chlamydia, ureplasma, mycoplasma), fungi (candida), opportunistic microorganisms (gardnerella, E. coli).
Infection occurs through sexual contact (unprotected contact), during surgical interventions (abdominal surgery, abortion), during installation or removal of the uterine device.
The household route of infection is extremely rare, for example, when using someone else's towel or in common areas (bathhouse, swimming pool).
If treatment is untimely or incomplete, the acute disease quickly becomes chronic, and then simple hypothermia or even stress is enough to cause an exacerbation.
Symptoms of oophoritis are as follows:
- Pain in the lower abdomen, where the ovaries are located. The pain can be unilateral or bilateral, depending on the type of inflammation; sometimes discomfort is felt in the lumbar region. The pain is aching in nature and radiates to the leg or thigh.
- Pathological discharge from the external genital tract not associated with ovulation. They can be of different colors, from milky white to yellowish or greenish, and also have an unpleasant odor (depending on the causative agent of the infection).
- During an acute inflammatory process, body temperature may rise. With exacerbation of chronic oophoritis, the temperature is rare, the maximum rises to subfebrile values.
- With inflammation of the ovaries, women experience pain during sexual intercourse.
- If the disease has become chronic, unpleasant symptoms from the nervous system are possible - depressed mood, irritability, fatigue, decreased libido.
Directions of treatment
Antibiotics
The main direction in the treatment of oophoritis is antibiotics. They differ in pharmacological groups, scope of action, side effects and other criteria.
A specific drug is prescribed only after tests have been carried out to determine the type of pathogen (bacterial culture, smears for flora). Despite the fact that most modern antibiotics have a complex effect and several types of microorganisms are sensitive to them, a gynecologist can prescribe two drugs at the same time.
The most effective for oophoritis are cephalosporins and penicillins. Tetracyclines are sometimes used, but they have a lot of side effects and are therefore used extremely rarely, in emergency cases.
Metronidazole is almost always used to eliminate the inflammatory process in the ovaries and/or appendages. It is prescribed simultaneously with drugs such as Clindacin, Gentamicin, Unidox Solutab, Hemomycin, etc. An improved analogue of Metronidazole is Trichopolum. It is easier to tolerate by the body and does not cause nausea or loss of appetite.
Antibacterial drugs are used in the form of tablets, injections, and local drugs are also prescribed - vaginal suppositories. Several forms can be combined at once.
Features of the use of various forms of antibiotics
No. | Candles | Injections | Pills |
Efficiency | They have an antibacterial effect at the local level. Used in combination with other forms of medications | High efficiency due to rapid absorption into the blood | Highly effective, but the effect takes a little longer than injections |
Difficulty of application | Candles are easy to use, usually used once a day, at night. | Require special skills, it is difficult to give an injection without outside help | Easy to use, but you need to drink them 2-3 times a day |
Price | Varies depending on the drug and the active substance, not the release form | ||
Side effect | It also depends not on the form of release, but on the specific drug. But suppositories can cause itching and burning in the vagina | ||
Effect on the gastrointestinal tract | Absent | Absent | May irritate the mucous membranes of the stomach |
After treatment with antibiotics, the balance of the natural microflora of the intestine and vagina is disrupted, and this happens not only after vaginal suppositories, but also after other forms of drugs. To restore the microflora, you can use products with lactobacilli - Bifidumbacterin, Bifiform, Linex, Acylact, etc.
Antibiotics are prescribed without fail; without them, inflammation cannot be stopped. In case of chronic oophoritis, they are used only during periods of exacerbation, and even then not always. Recently, some doctors have been inclined to believe that a long course of oophoritis causes pathogen resistance to antibiotics, therefore it is preferable to treat this disease with other methods.
Other methods
In addition to antibacterial therapy, gynecologists prescribe anti-inflammatory drugs, biogenic stimulants, immunomodulators, as well as drugs to prevent the development of adhesions. Treatment of chronic oophoritis also includes non-traditional methods - physiotherapy and sanatorium-resort treatment.
- Anti-inflammatory drugs are prescribed for any form of oophoritis . The most popular in the form of rectal suppositories are Indomethacin, Diclofenac, Movalis. They contain non-steroidal anti-inflammatory components and have an analgesic effect. But each of these drugs has disadvantages. For example, Indomethacin has a lot of side effects and is not well tolerated by everyone; Diclofenac is contraindicated in people with hypertension or a tendency to high blood pressure, and Movalis is a non-steroidal anti-inflammatory drug and cannot be used simultaneously with all types of antibiotics. So the choice of a specific medicine remains with the doctor, taking into account the individual characteristics of the patient. One of the most popular drugs in this group is Diclofenac. It is available in the form of injections, rectal suppositories, tablets, gels and ointments for external use. Diclofenac in the treatment of adnexitis is most preferable in the form of injections or suppositories. It has an analgesic, anti-inflammatory and antipyretic effect, which is especially necessary in the presence of fever (in acute form). But the drug has one significant drawback - Diclofenac is contraindicated for people with hypertension of any degree and a tendency to high blood pressure. If it is impossible to use Diclofenac, Indomethacin or Movalis may be prescribed.
- Biogenic stimulants are preparations of plant or animal origin that can improve the trophism of tissues of internal organs, accelerate regeneration processes and thereby recovery. One of the most common drugs in this group is aloe extract. It is available in the form of intravenous and intramuscular injections, is well tolerated by the body, and improves blood circulation. It has few side effects due to its natural plant origin, and also has a moderate immunostimulating effect.
- Immunomodulators are drugs aimed at strengthening the body’s immune forces to fight infection. In case of acute inflammation, they are rarely prescribed, since antibiotics cope well with the infection, but in the chronic course of the disease they cannot be avoided.
- Adhesions form in chronic oophoritis, but rarely in the case of a single acute inflammation. In this case, the drug Longidaza is widely used. These are rectal suppositories that can reduce existing adhesions and prevent the appearance of new ones.
- Physiotherapy helps eliminate the inflammatory process at the cellular level and can be prescribed for any form of oophoritis and at any stage of its course. Laser, ultrasound, and electrophoresis are often used.
- Sanatorium-resort treatment is indicated for chronic oophoritis during remission; during exacerbation it is contraindicated. They use various anti-inflammatory baths, balneotherapy, acupuncture and other procedures.
In the treatment of oophoritis, it is important to consult a doctor in a timely manner and follow an integrated approach to treatment, since this insidious disease can lead to infertility or problems with conception. And in case of inflammation, you cannot do without antibiotics. With a responsible attitude towards your health, oophoritis is completely curable.
Source: https://oyaichnikah.ru/zabolevaniya/vospalenie/ooforit-antibiotiki.html
Oophoritis - what kind of disease is this and what is its danger?
Some women do not know that oophoritis is a disease during which the ovaries become inflamed. Often the inflammatory process spreads to the uterine tubes. This leads to inflammation of the ovaries. Because of this disease, the tubes become welded to the ovaries. After this, a tubo-ovarian formation appears between them.
Types of disease
There are different classifications of this disease. Oophoritis is divided into two types:
- Specific. The disease appears due to sexually transmitted infections.
- Non-specific. Caused by bacteria that are found in the intestines or vagina. This form of the disease may be preceded by abortion, various gynecological manipulations and decreased immunity.
According to the nature of their course, several forms of oophoritis are distinguished:
- Acute form. During acute oophoritis, there are very pronounced symptoms, which manifest themselves in the form of muscle and headache, general weakness and fever. All this negatively affects the general condition of the patient.
- Chronic form. In this case, the symptoms are not very pronounced. Only during exacerbations are minor pains in the lower abdomen observed.
- Subacute form. Develops against the background of mycotic infection or tuberculosis. It is quite rare.
The ovaries are a paired organ, so sometimes not all ovaries are affected, but only part of them. On this basis, the following forms of oophoritis are distinguished:
- double-sided;
- left-handed;
- right-sided
Causes of oophoritis
Such inflammation necessarily appears due to some reason. The ovaries are located in such a way that the primary penetration of infection into them is impossible.
Inflammation of the ovaries appears in the uterine tubes. However, this is not the only source of inflammation. The disease can even appear due to appendicitis.
In this case, inflammation appears due to staphylococci, streptococci and E. coli.
Oophoritis can occur if a person has infections. Infectious agents include various viruses.
There are factors that contribute to the appearance of oophoritis. These include:
- sexual contacts without protection;
- long-term use of an intrauterine device;
- non-regular sexual partners;
- stress, which negatively affects the protective properties of the immune system;
- smoking and drinking alcohol, which, when ingested, contributes to changes in the composition of mucus;
- problems with the genitourinary system;
- presence of chronic infections;
- problems with the endocrine system;
- hypothermia.
In addition, ovarian inflammation can be caused by diseases such as tuberculosis, gonorrhea, chlamydia, mycoplasmosis and trichomoniasis.
Mechanism of disease development
The spread and development of infection in the body does not occur immediately. First it enters the uterine cavity and spreads to the tubes. At the very beginning of the development of the disease, the mucous membrane suffers. After this, the muscular and serous layers are affected. The fallopian tube becomes denser and lengthens. Inside, purulent fluid appears and is secreted.
Over time, the process moves to the ovaries. Their tissues are damaged by the pus that is released from the fallopian tubes. This leads to the appearance of adhesions. Sometimes changes can even affect the surrounding peritoneum.
This process is called periadnexitis. The secretion that has accumulated as a result of the development of infection may contain pus or be completely transparent. Pus accumulated in the ovaries leads to the appearance of pyovar. If the infection continues to develop, it will spread beyond the ovary, which will lead to the appearance of pelvioperitonitis.
Symptoms of ovarian inflammation
The disease has various symptoms. The acute form is expressed by the following symptoms:
- sexual intercourse is accompanied by field sensations;
- bleeding between periods;
- fever and fever;
- often purulent and serous discharge comes out of the genital tract;
- pain when urinating;
- The lower abdomen can be very painful, sometimes the pain extends to the lower back and sacrum.
Symptoms of chronic oophoritis include:
- problems with the menstrual cycle;
- relapses of the disease that appear after severe hypothermia;
- sexual intercourse is accompanied by pain in the lower abdomen.
If the disease is not cured in time, exacerbations may occur. They have the following symptoms:
- the appearance of white discharge;
- decreased libido, problems with sexual function;
- ovarian function is impaired;
- severe pain that may be in the vagina and lower abdomen;
- increased pain before the onset of menstruation.
During an examination by a gynecologist, it may be discovered that the size of the ovaries has increased. Sometimes the chronic form is the cause of disturbances in the neuropsychological sphere of a person. Disorders include increased irritability, sleep problems, decreased levels of performance, and fatigue. Sometimes the chronic form does not have pronounced symptoms.
If some of the above symptoms are detected, it is recommended to consult a gynecologist.
Oophoritis during pregnancy
Disturbances in the functioning of the ovaries have a bad effect on the course of pregnancy in women. The ovaries are responsible for producing the required amount of sex hormone. The maturation and release of the egg also depend on them. All this affects not only the pregnancy itself, but also fertilization. Sometimes the disease leads to infertility in a woman.
If chronic oophoritis does not lead to infertility, then before conception you must make an appointment with a doctor for examination. This will avoid the following complications:
- Hormonal imbalance, which sometimes leads to miscarriage.
- Infertility. Due to impaired functioning of the ovaries, problems with the production of eggs may occur, which make the process of ovulation impossible.
- Ectopic pregnancy.
- Oophoritis often leads to the appearance of adhesions. Because of them, fertilization can occur in the fallopian tube rather than in the uterus.
- Fetal infection. It is carried out due to an infection that is present in the woman’s body. In this case, infection occurs not only during pregnancy, but also during childbirth.
It is for these reasons that it is better to visit a doctor before planning a pregnancy.
Diagnosis of the disease
Diagnosing this disease is difficult. The most common symptom of the disease is acute pain in the abdominal area. It can also appear in other diseases. Other signs of oophoritis can appear in various diseases of the abdominal organs.
Oophoritis is often diagnosed if a woman complains of problems with her menstrual cycle. To establish the most accurate diagnosis, the following examinations are carried out:
- Carrying out analyzes in the laboratory. They are done to determine the level of white blood cells in the urine and blood. It increases if there is inflammation of the ovaries.
- Gynecological history. Determines the location and nature of pain.
- Ultrasound. It is carried out to examine the pelvic organs.
- Gynecological examination. Abnormalities in uterine mobility and ovarian size are checked.
- Hysterosalpingoscopy. With its help, you can identify modifications of the uterine tubes.
The most informative and effective diagnostic methods include laparoscopy. During which a visual examination of the uterus, its tubes and ovaries takes place. It is performed if the patient has pain in the lower abdomen. During the examination, the doctor may identify adhesions and low patency of the fallopian tubes.
Treatment methods
Most often, the course of treatment consists of antibiotics. Many of them are in the group of penicillins and cephalosporins. The most popular drugs include Cefatoxime, Timentin and Amoxiclav.
Antimicrobial agents are also used during treatment. They are very effective in treating the chronic form of the disease. Medicines such as Tinidazole and Metromindazole are often used.
Oophoritis is accompanied by severe pain. To relieve them, drugs related to anti-inflammatory non-steroidal drugs are used. This group includes Ibuprofen, Indometac and Diclofenac. In gynecology, suppositories or tablets with indomethacin are often used.
Treatment of the disease must be carried out comprehensively. The bulk of treatment is aimed at treating the infection, with additional measures aimed at supporting the body's immune system.
To increase the effectiveness of the immune system, immunomodulating agents and vitamins are prescribed. Many gynecologists use the drug Vagilac, which places lactobacilli in the vagina.
This allows the natural acidic environment to be restored.
Care should be taken to ensure that the ovaries are completely “rested” from the resulting inflammatory shock. In this case, combined oral contraceptives will help. With their help, the menstrual cycle is regulated, which allows you to preserve the required number of eggs.
Prevention of oophoritis
To avoid the appearance of this pathology, you need to follow some rules. These include the following points:
- you should lead an active lifestyle;
- avoid hypothermia;
- do not forget about personal hygiene;
- use different methods of contraception;
- be regularly examined by a gynecologist.
The above rules must be followed from adolescence. It is very important that parents explain to teenage girls how to prevent the occurrence of inflammatory processes. This will help in the future to avoid the occurrence of diseases such as oophoritis.
Source: https://zdorovaya-ya.ru/zabolevaniya/ooforit/chto-takoe-ooforit.html
Oophoritis
Update date: 05/14/2019
Oophoritis is an inflammation of the ovaries that occurs against the background of a particular infection. It is rarely an independent disease; more often it is a secondary pathology.
If a woman has a history of acute or chronic inflammatory diseases of the genitourinary system, then it is possible that this process will spread along an ascending path to other organs of the reproductive system and disrupt their vital functions.
Inflammation of the ovaries, or oophoritis, is usually classified as a disease of septic etiology. What does this mean? In most cases, ovarian inflammation is caused by a pyogenic infection of various origins (aerobic or anaerobic).
This pathology occurs if, for a number of reasons, the patient’s tissue integrity is compromised. Thus, oophoritis is often observed in women after childbirth, abortion operations or other surgical interventions.
There are cases when oophoritis and other inflammations of the reproductive system occur against the background of chronic infectious diseases or acute appendicitis.
In the practice of gynecologists, clinical cases quite often occur when it comes to salpingoophoritis, a disease of the uterine appendages, which is characterized by the simultaneous involvement of both the ovaries and fallopian tubes in the pathological process.
The cause of inflammation of the ovaries, as already mentioned, is various infectious agents. Among others, the most significant etiological significance are:
- staphylococci;
- streptococci;
- chlamydia;
- Trichomonas;
- coli;
- mycoplasma;
- mushrooms of the genus Candida;
- tuberculosis, etc.
These microorganisms multiply rapidly in the human body, especially under certain “predisposing” circumstances. Scientists have found that oophoritis is more common in patients with immunodeficiency of various origins. There are also a number of factors that can contribute to the development of this kind of inflammatory diseases:
- nervous fatigue;
- excessive physical activity;
- general hypothermia of the body;
- various endocrinological problems;
- the woman has an intrauterine device;
- poor nutrition and lack of vitamins and microelements;
- chronic infectious diseases.
Oophoritis can affect both ovaries at the same time or only one of them. If both ovaries are affected, then bilateral oophoritis is diagnosed. With appendicitis, right-sided oophoritis often occurs. Bilateral inflammation of the ovaries most often occurs in cases where infection occurs through the bloodstream or lymph flow.
What happens when the ovaries become inflamed? It all starts with the fact that the infectious agent enters the woman’s vaginal mucosa.
A woman's vagina is a favorable habitat for pathogenic microflora. Without exception, all pathogens love warmth and moisture.
Thus, a woman’s vagina, which is covered with a mucous membrane, is a kind of “resort” for various kinds of bacteria.
If the patient’s immune status is low for one reason or another and is not able to restrain the growth of these microorganisms, then they multiply very quickly, which leads to the occurrence of an inflammatory process.
From the vagina, microorganisms easily and easily penetrate the fallopian tubes, where inflammation quickly develops with the formation of large amounts of pus. At the same time, the fallopian tube becomes thicker and longer, and excess pus flows out, and under its influence, ovarian tissue can dissolve.
The ovary becomes infected and an inflammatory process begins, which, in the absence of adequate therapy, rapidly spreads to other organs and tissues of the abdominal cavity.
All symptoms of the disease directly depend on the nature of the inflammatory lesion of the ovaries, the localization of the pathological process and the stage of the disease.
At its onset, the disease may occur with mild or no symptoms at all.
The patient may be alerted to pain in the lower abdomen, purulent or foamy vaginal discharge that has an unpleasant odor and a characteristic color. This is how most infectious diseases of the reproductive system begin.
In the acute stage of ovarian oophoritis, the patient may experience an increase in body temperature to subfebrile or febrile levels, as well as nausea, vomiting and sharp pain in the iliac region.
In the subacute stage, the patient feels relief and improvement in general condition, body temperature decreases, however, this is not a sign of cure.
On the contrary, the pathological process is in full swing, and if you do not promptly seek help from specialists and begin adequate treatment, the disease enters the chronic stage.
Bilateral oophoritis on palpation is characterized by painful sensations and enlarged uterine appendages. In this case, accumulations of pus can be felt as small compactions.
Left-sided oophoritis differs in that the pain is localized in the left iliac region and can radiate to the lower back.
Right-sided inflammation of the ovary, on the contrary, is characterized by pain on the right side and requires differential diagnosis with acute appendicitis.
Inflammation of the ovaries can make a woman's life unbearable. She may experience symptoms such as:
- frequent and very painful urination;
- menstrual irregularities with constant uterine bleeding between menstruation;
- fatigue and deterioration of general condition;
- pain during sexual intercourse, etc.
All these debilitating symptoms lead to the fact that a woman may experience sleep disturbances, various neurological disorders, and since sexual intercourse causes pain, sexual desire also decreases.
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Various research methods are used to diagnose the disease. First of all, palpation, manual examination of the patient and history taking are performed. When collecting anamnesis, special attention is paid to the presence of acute or chronic infectious diseases in a woman, abortion or complicated childbirth, intrauterine device, etc.
After this, laboratory tests are prescribed. Bacteriological culture of vaginal discharge, a smear from the cervix and urethra, and general blood and urine tests are of important diagnostic importance. Bacteriological studies are carried out to identify the causative agent of infection.
As additional methods for studying this ovarian disease, enzyme immunoassays, polymerase chain reaction and other specific laboratory research methods can be prescribed, which help to very accurately determine the presence or absence of various infections in a woman’s body.
If tuberculosis, gonorrhea or other signs of specific inflammatory processes are suspected, additional studies are prescribed.
In the acute stage of oophoritis, a significant increase in the erythrocyte sedimentation rate, leukocytosis, as well as a shift in the leukocyte formula to the left can be detected in the blood. In the subacute stage of ovarian inflammation, blood counts may be within normal limits, however, this does not mean that the patient is completely healthy.
Great importance is given to visualizing instrumental research methods, namely ultrasound and laparoscopy. An ultrasound scan examines the pelvic organs, which makes it possible to characterize their structural changes, the localization of the inflammatory process in the ovaries and its spread to other internal organs.
Laparoscopy is a diagnostic procedure that involves inserting a special device equipped with a miniature video camera directly into the organ being examined through incisions in the abdominal wall. The image from the camera is transmitted to the screen, and it allows you to enlarge the image 6 times.
Such a study allows a thorough examination of the uterine cavity and its appendages, which is impossible with manual examination.
Laparoscopy also helps to identify obstruction of the fallopian tubes and inflammation of the uterine appendages, the presence of pus or inflammatory effusion in the ovaries or fallopian tubes, as well as the presence of adhesions in both the organs of the reproductive system and the pelvic organs.
The first and most basic rule that should be followed when treating various diseases is to never self-medicate.
At the first symptoms of ovarian inflammation, which were mentioned above, you should immediately consult a gynecologist.
If the doctor, after carrying out all the necessary diagnostic measures, confirms that you have oophoritis, treatment will have several directions and depend on the stage of the disease and the nature of the clinical course of the disease.
The presence of an acute inflammatory process in the ovaries or fallopian tubes is an indication for hospitalization of the patient. The patient is prescribed rest and bed rest, a cold heating pad on the stomach and symptomatic therapy (painkillers, antispasmodics, etc.).
In addition, intensive antibacterial therapy is carried out aimed at eliminating the infectious agent that caused the inflammation. For this purpose, antibiotics and sulfonamide drugs are used, which are selected individually.
Dosages of drugs and duration of treatment are also very individual. Physiotherapeutic procedures during the acute period are contraindicated for patients.
General strengthening therapy is used, which helps strengthen the body's defenses (vitamins and mineral complexes, antihistamines, etc.).
In the subacute period of ovarian inflammation, various physiotherapeutic procedures are carried out with great care and under the constant supervision of medical personnel:
- electrophoresis of potassium iodide and calcium chloride;
- mud therapy;
- diathermy;
- magnetic therapy;
- laser therapy;
- hirudotherapy;
- gynecological massage, etc.
Ovarian oophoritis often has a recurrent course and becomes chronic. If the patient experiences a relapse of the disease, treatment should be started immediately.
In the absence of adequate therapy, ovarian inflammation can cause conditions that threaten the patient's life. If a woman is diagnosed with sexually transmitted infections, both sexual partners are treated.
Patients are advised to have sexual rest for the entire period of treatment.
In order to prevent inflammatory diseases of the reproductive system in women, simple recommendations from gynecologists should be followed:
- be selective in choosing sexual partners and use condoms every time you have sexual intercourse;
- observe the rules of genital hygiene;
- undergo scheduled and unscheduled preventive examinations by a gynecologist.
Only early diagnosis gives patients a chance for successful treatment and restoration of vital functions. Timely diagnosis helps prescribe adequate treatment and avoid negative consequences.
Inflammatory diseases of the ovaries often cause very serious health problems. In women, oophoritis can cause infertility. In addition, inflammation of the ovaries and fallopian tubes threatens the occurrence of ectopic pregnancy.
Normally, the fallopian tubes are lined with ciliated epithelium, which helps the egg move through the fallopian tube into the uterus itself. In the presence of inflammation, such movement is difficult or completely impossible, and then there is a risk of ectopic pregnancy.
Rupture of the fallopian tubes during ectopic pregnancy is characterized as a condition that threatens the patient’s life.
The sooner a woman consults a gynecologist and begins treatment, the greater her chances of a full recovery. During treatment, you must strictly follow the doctor’s recommendations and under no circumstances interrupt treatment, even if all symptoms of the disease have disappeared. Treatment of both sexual partners is often necessary.
If you lead a healthy lifestyle, adhere to the principles of a healthy diet, monitor the state of your immunity and support it in every possible way, avoid casual relationships, unplanned pregnancies and abortions, then inflammatory diseases of the reproductive system can be avoided.
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice. Consult your doctor for diagnosis and treatment.
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Source: https://www.medcentrservis.ru/disease/ooforit/
Oophoritis: symptoms and treatment of acute and chronic oophoritis of the ovaries
Oophoritis is a long-term inflammation that affects the female paired sex glands - the ovaries. In women of fertile age, oophoritis contributes to the development of various hormonal imbalances, menstruation and phases leading to infertility.
The gradual development of chronic bilateral oophoritis, accompanied by an abscess, can be fatal. Diseases associated with oophoritis are much more common: endometritis, adnexitis , myometritis, etc.
Read more about what it is and how to cure oophoritis later in the article.
Chronic oophoritis: what is it?
Chronic oophoritis is a sluggish inflammatory process in the ovaries. It is rarely diagnosed in isolation. Most often accompanied by damage to the fallopian tubes. In this case, they talk about inflammation of the ovarian appendages (chronic adnexitis).
When the peritoneal tissue covering the ovaries is involved in the pathological process, perioophoritis is diagnosed.
Most often it is secondary and develops as a result of the spread of infection. Both ovaries can be involved in the inflammatory process - bilateral oophoritis - and only one of the paired glands.
The disease is often diagnosed in women who are sexually active. In the absence of therapy, it can provoke secondary infertility.
Mechanism of disease development
The spread and development of infection in the body does not occur immediately. First it enters the uterine cavity and spreads to the tubes. At the very beginning of the development of the disease, the mucous membrane suffers. After this, the muscular and serous layers are affected. The fallopian tube becomes denser and lengthens. Inside, purulent fluid appears and is secreted.
Over time, the process moves to the ovaries. Their tissues are damaged by the pus that is released from the fallopian tubes. This leads to the appearance of adhesions. Sometimes changes can even affect the surrounding peritoneum.
This process is called periadnexitis. The secretion that has accumulated as a result of the development of infection may contain pus or be completely transparent. Pus accumulated in the ovaries leads to the appearance of pyovar. If the infection continues to develop, it will spread beyond the ovary, which will lead to the appearance of pelvioperitonitis.
Causes
Chronic oophoritis forms as a response to exposure to infectious agents. The causes of the pathology may be:
- diseases from the STD group;
- activation of opportunistic microflora;
- tuberculosis bacteria.
Predisposing factors are:
- inflammation of the female reproductive system, in particular cervicitis, vaginitis and others;
- diseases of the pelvic organs, for example, an attack of acute appendicitis;
- surgical interventions - abortion, difficult childbirth, etc.;
- variety of sexual partners;
- deterioration of immune defense.
In exceptional cases, it develops as a secondary process.
Causes of oophoritis
Typically, the onset of the inflammatory process appears due to the action of infectious antigens on the ovaries. The main causative agents of inflammation are:
- Mycobacterium tuberculosis. According to statistics, in 32% of cases in women, a specific oophoritis with one or two-sided inflammation is detected. Characteristic features are tuberculous tubercles, homogeneous or layered caseomas;
- sexually transmitted infections. The presence of various harmful microorganisms affects both glands simultaneously;
- pathogenic bacteria contribute to the activation of inflammation.
The ovaries are protected from harmful microorganisms by the dense outer capsule and the physiological characteristics of the location. Therefore, to activate inflammation, the following can help:
- pathological diseases of the female reproductive system. Oophoritis is found in women with secondary manifestations of colpitis, endometritis, cervicitis, etc.;
- inflammation of the pelvic organs. Acute limited and diffuse peritonitis, inflammation of the peritoneum, ascites (abdominal edema), peritoneal cancer, etc. can contribute to the occurrence of chronic bilateral oophoritis;
- tumor-like formations of the ovaries. Tumors are divided into: epithelial. The main components are the cells lining the outside of the ovaries;
- germinogenic. Consist of cells that produce eggs;
- stromal. Tumors are formed from ovarian cells responsible for the production of female sex hormones - progesterone and estrogen.
Provoking factors for the development of the disease
In addition to the reasons, there are some factors that can contribute to the development of oophoritis. Provoking factors are:
- the active spread of harmful pathogens is caused by: complicated childbirth;
- abortions performed;
- abrasion, etc.;
Classification
It is customary to distinguish the following types of inflammation:
- right-sided;
- left-handed;
- bilateral oophoritis;
- acute form.
Right-sided oophoritis
Right-sided oophoritis is characterized by damage to the right ovary. Signs of the chronic course of the disease are:
- cycle disorders;
- pain in the right lower quadrant of the abdomen (projection of the right ovary), intensifying before menstruation;
- problems with conception;
- lack of sexual arousal and libido;
- pathological vaginal leucorrhoea.
Left-sided oophoritis
Left-sided oophoritis is expressed in the formation of pain in the lower left part of the abdomen. The symptoms accompanying the pathology are no different from right-sided inflammation of the gland.
Bilateral oophoritis
Bilateral oophoritis is a lesion of both ovaries. The course of the disease is hidden. Symptoms of bilateral oophoritis are absent or insignificant for a long period.
Prevention of oophoritis
To avoid the appearance of this pathology, you need to follow some rules. These include the following points:
- you should lead an active lifestyle;
- avoid hypothermia;
- do not forget about personal hygiene;
- use different methods of contraception;
- be regularly examined by a gynecologist.
The above rules must be followed from adolescence. It is very important that parents explain to teenage girls how to prevent the occurrence of inflammatory processes. This will help in the future to avoid the occurrence of diseases such as oophoritis.
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Symptoms
The disease occurs in three stages: acute, subacute and chronic inflammation. Each of them has characteristic features.
In acute oophoritis, the symptoms will be as follows:
- high body temperature;
- weakness;
- feverish conditions;
- deviations in the gastrointestinal tract;
- myalgia;
- pain when urinating;
- purulent vaginal leucorrhoea;
- uterine bleeding;
- pain syndrome of varying intensity and localization - bilateral oophoritis is characterized by pain in the lower abdomen;
- inability to perform sexual intercourse as a result of severe pain.
Signs of chronic oophoritis include:
- abnormalities in the menstrual cycle;
- discomfort during sex;
- frequent relapses;
- dull pain in the groin area, intensifying before menstruation;
- constant vaginal discharge;
- problems with conception.
Chronic inflammation of the ovaries occurs latently and is an advanced form.
Symptoms of oophoritis
All symptoms and signs of oophoritis completely depend on the stage, nature of the inflammation and location of the pathology. Initially, the disease has mild symptoms or no symptoms at all.
A woman begins to be disturbed by aching or cramping pain in the lower abdomen, discharge mixed with pus, which has a characteristic odor and hue. Such symptoms appear in most infectious diseases of the reproductive system.
At the acute stage, a woman may experience an increase in temperature to high levels and the appearance of sharp pain in the iliac region on the left or right.
Diagnostics
Diagnosis of pathology includes the following activities:
- Collection of complaints.
- Examination in a gynecological chair. During a bimanual examination, the gynecologist determines changes in the condition of the appendages. They are swollen and dense. During palpation they are painful, mobility is limited.
- General blood analysis. There are signs of an inflammatory process.
- Ultrasound of the pelvic region. Enlargement of the ovaries is recorded, the surface is smoothed. There is a change in the echogenic structure due to the presence of fibrous areas. When the fallopian tubes are involved in the process, there are signs of inflammation and changes in the condition of the endometrial layer.
- Vaginal smear examination. Helps in identifying the pathogen.
In some cases, a woman is prescribed laparoscopy. During the procedure, disturbances in the patency of the fallopian tubes and the development of adhesive disease are detected.
Diagnosis of the disease
It is difficult even for an experienced clinician to recognize chronic or subacute oophoritis that occurs with erased symptoms.
Outside of exacerbation of chronic oophoritis, laboratory parameters (general blood count, urine test, blood biochemistry, etc.) do not change.
- Bimanual examination
- Data from a “two-handed” gynecological examination are not enough to make a diagnosis.
- In some cases, the examination does not find any deviations from the norm.
- In others, it reveals limited mobility of the uterus and/or pain, heaviness, and compaction in the area of the uterine appendages.
- Ultrasound
- Ultrasound examination of the pelvic organs in the diagnosis of chronic oophoritis is ineffective (≈55%).
- Indirect echo signs of oophoritis (identified in only half of the patients):
- Increased ovarian size
- Ball-shaped form of an inflamed ovary
- Fuzzy contours, thickening of the outer membrane of the ovary
- Echo heterogeneity or hypoechogenicity of the ovarian stroma
- Absence or poor visualization of follicles in the ovary
- Free fluid in the pelvis
- Pain during transvaginal ultrasound
- Urogenital flora smear This is a bacteriological examination of a smear from the urethra, vagina and cervical canal.
- Examination of smears under a microscope can detect a large number of leukocytes (a sign of inflammation), dysbacteriosis, pathogenic microorganisms (STIs)
- PCR diagnostics
If necessary, an ultra-precise examination of vaginal discharge is carried out for ureaplasma, mycoplasma, chlamydia, cytomegalovirus, herpes virus, HPV, etc. using the polymerase chain reaction method.
- CT or MRI of the pelvis with contrast
- Computer or magnetic resonance imaging with intravenous contrast is a good help to clarify the diagnosis of chronic oopharitis, to distinguish it from tumors and other diseases of the appendages.
- Needle biopsy of the ovary
- Ovarian biopsy followed by histological examination is the gold standard for diagnosing autoimmune chronic oophoritis.
- Laparoscopy
- Laparoscopy is the most effective method for detecting chronic oophoritis.
- Indications for therapeutic and diagnostic surgery:
- Persistent pain syndrome that is not amenable to drug treatment
- Suspicion of a dangerous complication of chronic oophoritis
- Infertility
Source: https://gb4miass74.ru/bolezni/ooforit-chto-eto.html
What is oophoritis, its symptoms and treatment
Oophoritis is an inflammation in the hormonally active and reproductive organ of the female body.
The causative factors of the disease are microbes that enter the pelvis in various ways, and manifestations of the disease include disturbances in menstrual and reproductive function.
The main signs of oophoritis - pain, changes in menstruation, vaginal leucorrhoea and infertility - are explained by the lack of ovulation and the inflammatory process in the reproductive system.
It is extremely rare that there is an isolated lesion of only one fallopian tube or one of the ovaries: oophoritis is almost always combined with salpingitis and endometritis, forming an acute or chronic bilateral or unilateral inflammatory process.
Causal factors
Inflammation without microbes occurs extremely rarely: the main causative factor of oophoritis in women is the penetration of pathogenic microorganisms into the area of the fallopian tubes and ovaries. Acute inflammation is most often caused by microbes that are classified as sexually transmitted infections:
- gonococci;
- chlamydia;
- Trichomonas.
For the occurrence of oophoritis, one reason is not enough. Contributing and provoking factors play an important role in the occurrence of inflammation in the ovary:
- inflammatory processes in the lower parts of the female genital organs (vulvitis, colpitis, cervicitis);
- trauma to the vagina and uterus during childbirth or medical abortion;
- long-term wearing of an intrauterine contraceptive device;
- diagnostic or therapeutic procedures;
- decreased immunity;
- chronic diseases that contribute to any inflammatory processes (diabetes mellitus, anemia, metabolic syndrome).
Inflammation usually begins at the time of ovulation. The release of an egg in the middle of the cycle is always a small tear in the ovarian tissue. Oophoritis in one of the ovaries appears precisely at the site of injury, and then the inflammatory process spreads and the formation of an acute disease.
Variants of inflammation
Treatment and the choice of diagnostic methods depend on the form of oophoritis: primary acute inflammation requires mandatory effective therapy in a gynecological hospital.
Variant of oophoritis Symptoms Treatment tacticsSpicy | Pronounced manifestations of the disease | Hospitalization |
Subacute | Mild signs of inflammation | Possibility of treatment in a clinic |
Chronic | Minimal manifestations | Course therapy on an outpatient basis |
Exacerbation of a chronic process | Symptoms of oophoritis can be bright or faded | In case of severe symptoms, treatment of oophoritis is carried out in a hospital |
Oophoritis can be on one side (right or left) or on both (bilateral). Of great importance are the complications that arise in the absence of correct and timely treatment (formation of a purulent tumor).
Symptoms of the disease
For oophoritis, all symptoms of inflammation are typical, but the severity of the manifestations depends on the variant of the disease, the type of microbes and immune defense.
The worst thing for a woman is acute gonorrheal salpingoophoritis, in which the symptoms are more pronounced and the risk of dangerous complications is highest.
Chlamydia creates conditions for chronic inflammation, forming in the future an adhesive process in the area of the uterine appendages and tubal infertility.
With oophoritis, the following symptoms are distinguished:
Pain
Pain in the abdomen, depending on the type of inflammation, can manifest itself:
- sharp, strong and constant;
- pulling sensations in the lower abdomen;
- pressing and dull pain;
- periodic wave-like unpleasant sensations;
- minor pain associated with physical activity or sexual intercourse.
Vaginal discharge
The inflammatory process in the female genital organs is almost always accompanied by vaginal leucorrhoea, which can be as follows:
- profuse purulent with an unpleasant odor;
- thick milk;
- copious mucous-milk with itching;
- curdled;
- milk mixed with blood;
- bloody or bloody.
Temperature
In case of exacerbation or acute oophoritis, a temperature reaction will necessarily occur. The following options are possible:
- high body temperature reaching 39-40°C;
- spasmodic reaction with an evening sharp rise in temperature and night chills;
- slight increase to 37-38°C;
- normal body temperature;
- reduction to 36°C.
Menstrual irregularities
Changes in the menstrual cycle are associated with disruption of the ovulation process and hormonal imbalance caused by inflammation of the ovaries. There are the following problems with menstruation:
- delayed menstruation;
- untimely arrival of critical days;
- heavy periods;
- prolonged bleeding after normal menstruation;
- random bleeding.
Childbearing problems
Hormonal disorders in the ovaries and lack of ovulation against the background of oophoritis are the cause of infertility. With proper treatment of acute inflammation, endocrine function is normalized and the ability to conceive is restored.
With chronic variants of the disease, especially with frequent relapses, the risk of irreversible infertility increases sharply.
With combined damage to the ovary and fallopian tubes, impaired fertility is caused by tubal obstruction.
Diagnosis of the disease
A good prevention of complications is the timely detection of oophoritis, therefore the diagnosis of the disease should include the following studies:
- examination by a gynecologist;
- taking smears for sexually transmitted infections;
- bacterial cultures from the endocervix and vagina;
- general clinical tests to identify the severity of inflammation;
- assessment of hormonal problems based on hormone fluctuations in the blood;
- ultrasound scanning.
In most cases, this is enough to assess the situation in the woman’s reproductive system. According to indications, the doctor may refer you for a tomography (if a tubo-ovarian tumor or cystic formations in the ovary are suspected). In difficult cases, diagnostic laparoscopic surgery will be required.
Treatment
A woman with oophoritis can be quickly and effectively treated in a hospital setting with round-the-clock monitoring. Mandatory hospitalization in a gynecological hospital is indicated in the following cases:
- detection of tubo-ovarian formation in the area of the uterine appendages;
- body temperature above 38°C;
- severe pain syndrome;
- heavy bleeding from the vagina;
- inability to make an accurate diagnosis in the clinic;
- no positive changes after 2 days (48 hours) of taking antibiotics.
Any type of acute inflammation requires antibiotic therapy. The doctor will prescribe several medications that must be taken for at least 10 days. In addition, the standard treatment regimen includes the following medications:
- antimicrobial agents;
- anti-inflammatory drugs;
- analgesics;
- antipyretics;
- enzyme preparations.
As the inflammation subsides and the general condition improves, the doctor will add:
- drugs to enhance immune defense;
- physiotherapeutic methods (magnetic therapy, electrophoresis, phonophoresis);
- vascular drugs to improve blood flow in the ovarian area;
- medications to restore intestinal microflora.
In case of chronic oophoritis with minimal symptoms and a cured infectious process, it is optimal to continue therapy in a sanatorium using baths, mud and physical factors that improve the functioning of a woman’s hormonal system and reduce the risk of adhesions in the fallopian tubes.
Complications
The ovaries are one of the most important reproductive organs for women. Oophoritis, as a manifestation of the inflammatory process of the uterine appendages, never goes away without a trace.
It is important to understand what it is, what the dangers of oophoritis are and what the consequences may be, in order to consult a doctor in a timely manner and strictly follow the recommendations of a treatment specialist.
The most unpleasant and dangerous for any woman:
- infertility;
- persistence of constant pain in the pelvis (chronic pelvic pain);
- formation of gynecological pathology (ovarian cyst, leiomyoma, endometriosis);
- ectopic pregnancy.
The infection that causes oophoritis is usually transmitted through sexual contact. At the first stage, acute inflammation usually occurs, which, if treated incorrectly or insufficiently, can become chronic oophoritis. Treatment in this case is complicated by hormonal and anatomical changes in the woman’s reproductive system.
With timely diagnosis of oophoritis and following all the specialist’s recommendations, the risk of complications is minimal, and the woman will be able to become pregnant and give birth to a healthy baby as she recovers.
Source: https://gynecologyhelp.ru/vospalenie-pridatkov/ooforit/chto-eto-takoe-simptomy-i-lechenie.html