Ovaries are directly tied with uterine tubes by means of which they unite to a uterus therefore ovaries and uterine tubes conditionally combine in one education – uterus appendages.
Inflammation of appendages of a uterus call an adnexitis, the second name of the same disease – a salpingo-oophoritis, a salpingitis (an inflammation of uterine tubes) formed by words + an oophoritis (an inflammation of ovaries). The salpingitis and an oophoritis extremely seldom meet separately, in view of close connection with each other therefore their combined inflammation is united in one nosological unit – an adnexitis, an inflammation of appendages.
Penetration of an infection into uterus appendages is the reason of an adnexitis. It can occur in two ways, ascending and descending. The genital way of penetration of an infection to appendages when as a result of hit in external genitals, through a vagina and a uterus the infectious agent gets into ovaries and uterine tubes is called ascending. The descending way, this penetration of an infection into area of appendages from primary inflammatory center which is available in an organism with a blood flow or a lymph.
The most frequent activator of an adnexitis is the urogenital infection, or in abbreviated form UGI. It is group of the microorganisms combined by a preferential way of infection, namely sexual. Gonokokk, trichomonads, mycoplasmas, ureaplasmas and some other activators concern to them. Infection with the descending way is caused, as a rule, by streptococci or colibacillus.
The most important condition of emergence of an adnexitis is easing of the general and local immunity: the infectious disease postponed the day before, overcooling, non-compliance with rules of personal hygiene, the unprotected sexual contacts with doubtful partners and other manifestations of an unhealthy way of life. The psychology of relations between the sexes has to exclude similar contacts.
Symptoms of an adnexitis depend on that, in an acute or chronic form the disease proceeds.
Adnexitis symptoms in an acute form: emergence of severe pains in the bottom of a stomach, from the right or left side. Severe pain, the aching and pulling character, can give to a sacrum, a waist, a rectum. There are vulval allocations serous (in the form of an ichor) or purulent character. The acute adnexitis is followed by sharp deterioration in the general state, fever, head and muscular and joint pains, breakdown develop.
In the absence of adequate treatment, the adnexitis passes into a chronic form. Quite often there is initially chronic adnexitis which did not have the expressed acute form. Adnexitis symptoms in a chronic form are less expressed, especially general manifestations. The main symptom of a chronic adnexitis are the pulling aching pains in the bottom of a stomach, less intensive, than at an acute adnexitis. They appear periodically, usually before periods or after it. A sign of a chronic adnexitis are also painful feelings during sexual intercourse (dispareuniya).
As for a chronic adnexitis commissural process and structural disturbances in fabric of appendages is inherent, disturbances of a menstrual cycle appear: amenorrhea, oligomenorrhea, dysmenorrhea and so forth. The chronic adnexitis can become aggravated after the postponed general diseases, as a result of overcooling or the postponed stress, in this case symptoms of an adnexitis correspond to an acute current. Sometimes the chronic adnexitis can proceed asymptomatically, and the disease comes to light at inspection concerning infertility. Infertility as a result of the broken function of ovaries or impassability of uterine tubes - a frequent symptom of an adnexitis in the chronic started form.
Statement of the correct diagnosis at an adnexitis is quite difficult as the signs of an acute abdomen characteristic of an adnexitis in an acute form, are inherent to many acute diseases of bodies of a small pelvis, and adnexitis symptoms in a chronic form are, as a rule, not expressed.
As diagnosis of an adnexitis conduct the gynecologic examination including the laboratory analysis of vulval allocations, a blood analysis and urine, including бакпосев urine. Detection of microorganisms, typical for an adnexitis, in urine and vulval contents can indicate the available adnexitis, but nevertheless these signs are not specific, as well as the signs of inflammatory reaction of an organism revealed in blood.
Some symptoms of a chronic adnexitis can be found by means of ultrasonography.
The exact diagnostic method excluding a mistake is the laparoscopy to which resort in doubtful cases. This endoscopic research allowing to visualize uterine tubes and ovaries and directly to find inflammation signs: accumulations of pus and a serous exudate, the inflamed mucous membrane at an acute adnexitis, and commissural process with change of structure of fabrics of appendages at a chronic adnexitis.
Treatment of an adnexitis in an acute form demands hospitalization as the acute adnexitis is fraught with serious complications: purulent fusion of ovaries, formation of purulent cavities in pipes (пиосальпингс), peritonitis, etc. The bed rest is appointed, anesthesia is carried out both by means of medicines, and by applying of a bubble with ice to the area of the struck appendage. For removal of an inflammation antibiotics of a broad spectrum of activity, antiinflammatory drugs are appointed. At detection of purulent process apply surgical treatment of an adnexitis: by means of laparoscopic access evacuate pus accumulation, antibacterial drugs enter directly into the struck area.
Treatment of an adnexitis of a chronic current is carried out according to the similar scheme, however antibacterial drugs are selected taking into account sensitivity of the activator, as anti-inflammatory drugs corticosteroids are appointed, the fortifying and immunostimulating therapy is carried out. Physiotherapeutic treatment of an adnexitis is shown: mud cure, a paraffinotherapy, magnetotherapy, the microwave oven - and UVCh-therapy, etc.
National treatment of an adnexitis is used quite widely, especially it is justified at a chronic adnexitis. National treatment of an adnexitis in an acute form is not recommended as there is a high risk of development of heavy, life-threatening complications or transition of an acute adnexitis to chronic.
As national treatment of an adnexitis apply broths and infusions of officinal herbs of antiinflammatory action which use for syringing, enemas or trays. Such action the pharmaceutical camomile, a St. John's Wort, a train, a sage, a calendula, an acorus, juice a kalanchoe, an eucalyptus, a pea tree medicinal, a yarrow, a gold mustache and others possess.
As the fortifying and immunostimulating national treatment of an adnexitis accept inside aloe juice (pure or in a proportion 1:1 with honey), infusion of a purple cone-flower purple, infusion of a ginseng, a mummy, and also honey and other products of beekeeping.
National treatment of the adnexitis proceeding in a chronic form can be carried out parallel to medicamentous or to the periods of remissions that allows to lower medicinal load of an organism.
The most high temperature of a body was recorded at Uilli Jones (USA) who came to hospital with a temperature of 46,5 °C.
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