Pyometra
Description:
Pyometra (pyometra; Greek pyon pus + mztra a uterus) — the accumulation of pus in a cavity of the uterus arising at penetration into a uterus of pyogenic microflora (a streptococcus, staphylococcus, colibacillus) and disturbance of outflow of purulent exudate.
Anatomic features of a uterus
Pyometra reasons:
Activators - associations of microorganisms with dominance of "own" opportunistic flora, in particular obligate anaerobic microorganisms. Decrease in immune factors of protection of an organism is noted.
Provocative factors: an atresia or an obliteration of the cervical channel as a result of age atrophic changes. Therefore the so-called "senile" pyometra is more often observed.
The pyometra can be one of endometrial cancer symptoms also.
Pyometra symptoms:
Classical symptoms of a pyometra - existence of the colicy pains in the bottom of a stomach which are followed by emergence sometimes enough plentiful purulent discharges and symptoms of purulent intoxication (temperature increase, oznoba, feeling of weakness, "weakness").
However now, especially at senile age, the erased course of a disease .chashche meets. As a rule, subfebrile condition, periodically - purulent discharges from a genital tract concerning which patients most often also see a doctor takes place. Sometimes the asymptomatic course of process when the pyometra is a find at ultrasonography meets.
As it was told above, the pyometra can be one of cardinal symptoms of endometrial cancer. A syndrome, specific to a hysterocarcinoma, - existence of the colicy pains in the bottom of a stomach giving to the lower extremities. Blood impurity in pus also often demonstrates existence of tumoral process and disintegration of a tumor.
Diagnosis:
In a hospital for the purpose of specification of the reason of development of a pyometra carry out the uterus ekhografiya allowing to determine the uterus sizes, thickness of its walls, the sizes and contents of a cavity of the uterus. In case of need conduct additional examination. So, at suspicion on the suppurated submucosal myomatous node uterine probing and hysteroscopy are shown; at suspicion of endometrial cancer — hysteroscopy and a diagnostic separate scraping of a mucous membrane of a body and the channel of a neck of uterus.
Treatment of a pyometra:
Treatment is defined by features of a basic disease. At the pyometra which developed in a postabortion or puerperal period in connection with difficulty of outflow of contents of a uterus tool inspection of a cavity of the uterus and removal of the late parts of a placenta, clots with the subsequent washing by its antiseptic solutions is shown. At the suppurated submucosal myomatous node because of danger of development of peritonitis and sepsis urgent operation is required. Treatment of the pyometra caused by a malignant tumor of an endometria is performed according to the general principles of therapy of this disease.
The forecast depends on a basic disease. Prevention includes the actions directed to the prevention of infection at the time of delivery and abortion, early identification and treatment of tumors of a uterus.
