- Adnexitis symptoms
- Adnexitis reasons
- Treatment of the Adnexitis
The adnexitis - an inflammation of appendages of a uterus (a pipe, an ovary, ligaments), arises either the ascending, or descending way for the second time from the inflammatory changed abdominal organs (for example, at appendicitis) or gematogenno. At the ascending infection microorganisms get from a uterus into a gleam of a uterine tube, involving in inflammatory process all layers (salpingitis), and then at a half of patients - and an ovary (oophoritis) together with the copular device (an adnexitis, a salpingo-oophoritis). Inflammatory exudate, accumulating in a gleam of a uterine tube, can lead to adhesive process and closing of fimbrialny department. There are meshotchaty formations of uterine tubes (sactosalpinx). Accumulation of pus in a pipe leads to formation of a pyosalpinx, serous exudate - to formation of a hydrosalpinx.
At penetration of microorganisms into ovary tissue in it purulent cavities (ovary abscess) at which merge there is a fusion of ovarian fabric can be formed. The ovary turns into the meshotchaty education filled with pus. One of forms of a complication of an acute adnexitis is tubo-ovarian abscess.
Under certain conditions through fimbrialny department of a pipe, and also as a result of a rupture of abscess of an ovary, a pyosalpinx, tubo-ovarian abscess the infection can get into an abdominal cavity and cause an inflammation of a peritoneum of a small pelvis (pelviperitonitis), and then and other floors of an abdominal cavity (peritonitis) with development of abscesses of rectovaginal deepening, interintestinal abscesses.
Symptoms of an acute adnexitis include pains in the bottom of a stomach of various intensity, fervescence to 38-40 °C, a fever, nausea, sometimes vomiting, purulent discharges from a genital tract, the dysuric phenomena. Expressiveness of symptoms is caused, on the one hand, by virulence of activators, and with another - reactivity of a macroorganism.
In peripheral blood reveal a leukocytosis, a deviation to the left, increase in SOE, level of S-reactive protein, a disproteinemia. The analysis of urine can show increase in protein, a leukocyturia, a bacteriuria that is connected with damage of an urethra and bladder. Sometimes the clinical picture of an acute adnexitis erased, but is the expressed destructive changes in uterus appendages.
The bacterioscopy of smears from a vagina and the cervical channel allows to reveal increase in number of leukocytes, coccal flora, gonokokk, trichomonads, a pseudo-mycelium and disputes of a drozhzhepodobny mushroom. The bacteriological research of allocations from the cervical channel not always helps to reveal the adnexitis activator. More exact results are yielded by a microbiological research of the contents of uterine tubes and an abdominal cavity received at a laparoscopy, a laparotomy or a puncture.
At ultrasonography expanded uterine tubes, free liquid in a small basin (inflammatory exudate) can be visualized.
The chronic adnexitis is a consequence of the postponed acute or subacute inflammation of appendages of a uterus. It is necessary to refer inadequate treatment of an acute adnexitis, decrease in reactivity of an organism, property of the activator to the reasons of synchronization of inflammatory process. The chronic adnexitis is followed by development of inflammatory infiltrates, connecting fabric in a wall of uterine tubes and formation of a hydrosalpinx. Commissural process in a small basin between a pipe, an ovary, a uterus, a basin wall, a bladder, an epiploon and loops of intestines becomes the investigation of the postponed acute or subacute inflammation of appendages of a uterus. The disease has a long current with periodic aggravations.
Patients show complaints to the stupid, aching pains in lower parts of a stomach of various intensity. Pains can irradiate in a waist, a rectum, in a hip, i.e. on the course of pelvic textures and to be followed psychoemotional (irritability, nervousness, sleeplessness, depressions) and vegetative disturbances. Pains amplify after overcooling, stresses, periods. Besides, at a chronic adnexitis disturbances of menstrual function as menometrorrhagias, opso-and oligomenorrheas, the premenstrual syndrome caused by anovulation or insufficiency of a yellow body are observed. Infertility at a chronic adnexitis is explained both by disturbance of a steroidogenesis in ovaries, and a pipe and peritoneal factor. Commissural process in appendages of a uterus can become the reason of an extrauterine berebennost. Frequent exacerbations of a disease lead to sexual frustration - to decrease in a libido, dispareuniya.
Aggravations of a chronic adnexitis arise in connection with strengthening of pathogenic properties of the activator, a reinfitsirovaniye, decrease in immunobiological properties of a macroorganism. At an oboreniya pains amplify, overall health is broken, temperature can increase, purulent discharges from a genital tract are noted.
The most common cause of an adnexitis it is considered to be infections, sexually transmitted, especially chlamydias. Streptococci, gonokokk, colibacilli, clostridiums, etc. can become other activators of inflammatory process staphylococcus. Communication with tuberculosis, appendicitis is not excluded.
Mechanical damage of appendages of a uterus, for example, as a result of abortion, installation or removal of an intrauterine spiral, childbirth does not become rare the adnexitis reason (Cesarean section). In the first five days after such manipulations rest and preventive procedures is shown, however without observance of medical recommendations emergence of complications including pathological process in uterine tubes or ovaries is possible.
Along with the main reasons, mark out also risk factors which existence weakens protective properties of an organism and provokes development of an inflammation. Especially often occur among them:
* overcoolings (are most dangerous during menstrual bleeding),
* long use of Naval Forces (more than five years without removal)
* smoking (changes structure of cervical slime — a natural barrier from infections)
* the accompanying gynecologic diseases
* endocrinology diseases.
Treatment of the Adnexitis:
Treatment of an adnexitis – a package of measures, directed to identification and suppression of an infestant. Only the doctor, after capture of a smear and definition of sensitivity of the activator to antibiotics, can pick up necessary drug.
Treatment of an adnexitis (special acute) includes:
- antibiotics of a broad spectrum of activity
- protivospalitelny drugs
- the desensibilizing means
At purulent forms of an inflammation of appendages use a laparoscopy during which delete pus and administer the antibacterial drugs directly in the inflammation center. The bed rest is necessary for patients. When the acute inflammation is removed apply physical therapy and biostimulators. If a disease not to treat, then it passes into a chronic form. During aggravations of the woman complain of severe pain in the bottom of a stomach, periods become painful and long.
Treatment of an adnexitis (chronic) consists in:
- antiinflammatory therapy
- the desensibilizing therapy
- use of anesthetics
- reception of vitamins and immunostimulators
- physical therapy
- use of mud and ozokeritny applications
- passing of a course of vaginal trays and gynecologic massage
The chronic inflammation of appendages without the corresponding treatment leads to emergence of commissures, disturbance of passability of uterine tubes, an extrauterine pregnancy, infertility.