Adnexitis and fever when it goes away. Chronic right-sided adnexitis: symptoms and treatment, signs. Depending on this they distinguish

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What is adnexitis?

Causes of adnexitis

The infectious process leads to the accumulation of exudate (inflammatory fluid), which accumulates in the cavity of the pipes. If the infection further becomes chronic, the exudate can cause the development of adhesions. Adhesions are connective tissue cords that develop as a result of the inflammatory process. These adhesions can close the lumen of the tubes and cause their obstruction.
The cause of the inflammatory process can be a variety of microorganisms, but the greatest role in the occurrence of adnexitis belongs to chlamydia and gonococci.

Microorganisms involved in the development of adnexitis are:

• chlamydia;
• gonococci;

Characteristics of the main pathogens of adnexitis

Development of adnexitis

Another reason for the development of adnexitis may be the activation of a woman’s natural flora with decreased immunity. So, it could be bacterial vaginosis, in which there is an imbalance of good and bad microflora of the vagina. It is known that the normal vaginal microflora includes not only lactobacilli and bifidobacteria, but also clostridia, peptostreptococci, and bacteroides. These bacteria are found in small quantities and do not cause harm if the immune system is strong. However, with a decrease in the immune properties of a woman’s body, the number of these bacteria increases, and the concentration of lactobacilli and bifidobacteria decreases. Under these conditions, opportunistic flora, which normally does not cause harm, can become activated and cause the development of adnexitis.

Symptoms of adnexitis

Symptoms of adnexitis are:

• adhesions;
• urinary disorders;
• symptoms of intoxication.

Pain with adnexitis

Characteristics of pain with adnexitis

Adhesions with adnexitis

The causes of adhesions are most often surgical interventions, but in the case of chronic adnexitis, the main cause is the inflammatory process. During the period of acute adnexitis, a large amount of fluid accumulates in the cavity of the fallopian tubes. With adequate treatment, this fluid resolves and the patency of the tubes is restored. However, in a chronic course, due to the large exudation of fibrin, this liquid becomes viscous and thick. It begins to glue the walls of the fallopian tubes together, and the fallopian tubes become motionless and stop moving. The movement of the fallopian tubes is normally ensured by the “capture” of a mature egg and its transport into the tubal cavity. Further, thanks to the active movements of the fallopian tube, the already fertilized egg migrates into the uterine cavity itself. Thus, a healthy and patent fallopian tube is part of the reproductive system.

During the adhesive process, the fallopian tubes become denser, become immobile and cease to perform their main function. Also, connective tissue fibers solder together not only the walls of the pipes, but also the pelvic organs. The cords stretch from the fallopian tubes to the ovaries, blocking the abdominal end of the fallopian tube. A syndrome called tubal obstruction develops.

Urinary disorders with adnexitis

Symptoms of intoxication with adnexitis

Symptoms of intoxication in acute adnexitis are:

• elevated temperature;
• weakness and feeling of weakness;

Endometritis with adnexitis

Treatment of endometritis combined with adnexitis
The disease progresses very rapidly and requires powerful antibiotic therapy. Combinations of two or three antibiotics are used. Cephalosporins are most often used in combination with aminoglycosides and metronidazole. An example of such a combination is cefotaxime 1 gram 4 times a day intramuscularly + gentamicin 80 milligrams 3 times a day also intramuscularly + 100 milliliters of metrogil intravenously. The body is also detoxified with solutions of hemodez, glucose and unithiol with ascorbic acid.

Cystitis and adnexitis

It should be noted that due to the close proximity of the genital organs and organs of the excretory system, this often happens. Very often, pathogenic flora from the vagina migrates to the urethra and vice versa.

Treatment of cystitis
A wide range of medications and procedures are used in the treatment of cystitis. First of all, you need a pastel regime and plenty of drinking. To relieve pain, antispasmodic drugs are recommended, such as no-shpa, papaverine. Elimination of the infection itself is carried out with penicillins, furadonin, canephron. Treatment regimens are individual and depend on the characteristics of each organism.

Colpitis with adnexitis

If colpitis is not treated in time, the infection rises up the genital tract, reaching the body of the uterus and its appendages. In this case, bacteria cause inflammation in the fallopian tubes with the development of salpingitis, and then in the ovaries with the development of oophoritis. Thus, adnexitis develops as a consequence of untreated inflammation of the vaginal mucosa. The main symptoms include dull pain in the lower abdomen, which radiates to the sacrum.

Treatment of colpitis
In the treatment of colpitis, antibacterial drugs from the group of fluoroquinolones are used. These include ofhor, tiphlox. Antibiotics are combined with antimicrobial suppositories, such as terzhinan, polygynax and always metronidazole.

Bilateral adnexitis

Examination of a patient with bilateral adnexitis
Due to severe and acute pain that provokes muscle tension (tension develops as a defensive reaction), examination of the patient is difficult. The abdomen is tense, hard, almost board-shaped. The patient's condition with bilateral adnexitis varies from moderate to severe. Blood pressure drops and heart rate increases by 10 beats for every degree increased. The tongue becomes dry and coated, the pulse quickens.

Right-sided adnexitis

Left-sided adnexitis

Acute adnexitis

Symptoms of acute adnexitis

Symptoms of acute adnexitis are:

• pain in the lower abdomen, which can radiate to the rectum;
• urinary disorders;
• weakness, malaise;
• fever, chills;
• menstrual irregularities.

Ultrasound of acute adnexitis

Laparoscopy of acute adnexitis

The stages of the laparoscopic picture for acute adnexitis are:

• Stage 1– the fallopian tube is slightly swollen;
• Stage 2– the fallopian tube is enlarged in size;
• Stage 3– the fallopian tubes become covered with purulent plaque;
• Stage 4– purulent tumor-like formations form in place of the uterine appendages;
• Stage 5– rupture of the fallopian tube and the development of peritonitis.

Chronic adnexitis

• changes in the structure of the mucous membrane of the fallopian tubes;
• dysfunction of the fallopian tubes and ovaries;
• proliferation of connective tissue and formation of sclerotic processes;
• the formation of peritubular (around the tubes) and periovarial (around the ovaries) adhesions;
• development of tubal obstruction;
• often the formation of hydrosalpinx (fluid accumulation in the pipes).

Symptoms of chronic adnexitis

There are two types of chronic adnexitis - exudative and sclerotic. In the first option, fluid accumulates in the uterine appendages. The inflammatory process is infectious and toxic in nature. The main complaint of patients in this case is nagging pain, and laboratory tests reveal changes in the blood picture. In the second option, complaints are reduced to a deterioration in well-being, neurotic reactions, and unstable mood.

Diagnosis of chronic adnexitis

Treatment of chronic adnexitis

Physiotherapeutic methods for treating chronic adnexitis are:

• ultrasound in pulsed mode;
• electrophoresis;
• acupuncture;
• radon, iodine-bromine, sodium chloride baths.

Electrophoresis
For chronic adnexitis, electrophoresis with iodine, zinc, magnesium and amidopyrine is recommended. It is recommended to use the vaginal electrophoresis technique or inject solutions into the rectum.

Radon, iodine-bromine, sodium chloride baths
Iodine-bromine, sodium chloride, and hydrogen sulfide baths are especially effective in reducing ovarian function. Vibration massage is also recommended.

Drug treatment of chronic adnexitis
Drug treatment of chronic adnexitis is indicated during its exacerbation, as well as if adequate treatment has not been undertaken previously.

Drugs that are used in the treatment of chronic adnexitis are:

• antibiotics;
• medications that stimulate blood circulation;
• medications that stimulate metabolism;
• tissue preparations.

Indications for surgery for chronic adnexitis are:

• massive adhesive process;
• frequent exacerbations of the inflammatory process;
• secondary infertility of tubal origin (tubal obstruction);
• the formation of abscesses in the ovaries or tubes.

Suppositories for chronic adnexitis

How to use vaginal phytosuppositories?
Before using a phytosuppository, it is necessary to toilet the genitals. After removing the suppository from the plastic shell, you need to wash your hands with soap and lie down on the bed. Pull your legs to your chest and insert the phytosuppository, pushing it deep into the vagina with your finger. Maintain a horizontal position for 15–20 minutes so that the dissolved drug does not leak out. Then it is recommended to use a pad so that residual discharge (which is normal) does not stain the laundry.

Types of phytocandles
Depending on the natural component, several types of phytocandles are distinguished.

Types of natural-based vaginal suppositories are:

• with oak bark– have bactericidal and anti-inflammatory effects;
• with propolis– have a regenerative and absorbable effect;
• with walnut extract– promote the healing of the epithelium, relieve fever and stop inflammatory processes;
• with hog queen– produce an analgesic effect and improve the functionality of the uterine appendages;
• with belladonna– relieve pain and reduce inflammation.

Adnexitis during pregnancy

During pregnancy, adnexitis can be both acute and chronic. An acute inflammatory process in the uterine appendages is caused by the activation of pathogenic flora in the internal genital organs. These can be chronic cystitis, vaginitis, cervicitis. A poorly treated infection can lie low and wake up when the woman’s immunity decreases. In this case, pathogenic microorganisms rise up the genital tract (ascending route of infection). Reaching the uterine appendages, they provoke the development of inflammation initially at the level of the fallopian tube mucosa. After this, inflammation also affects the ovaries with the development of oophoritis. However, most often, during pregnancy there is an exacerbation of existing chronic adnexitis. This is why it is so important to treat chronic infections before planning a pregnancy.

Symptoms of adnexitis during pregnancy

Complications with adnexitis

• pyosalpinx;
• hydrosalpinx;
• tubo-ovarian abscess;
• obstruction of the fallopian tubes.

Pyosalpinx

Hydrosalpinx

Tuboovarian abscess

Tubal obstruction

However, after inflammatory processes in the uterine appendages, patency and motor activity in the tubes are disrupted. Obstacles called adhesions form in the cavity. They either close the ampullary end of the tube, making it impossible for the egg to enter the tube. Or they close the lumen of the fallopian tube from the inside, which makes it impossible for the egg and sperm to meet. Also, adhesions, which are fibers of connective tissue, can wrap around the outside of the pipe. In this case, they compress and deform it, making its lumen narrow. The movement of germ cells through such pipes is also impossible.
Treatment for obstruction of the reproductive tubes often involves surgery. Excision and removal of adhesions are performed, after which the patency of the tubes is restored.

Diagnosis of adnexitis according to ICD

Ultrasound for adnexitis

Normal ovarian indicators on ultrasound are:

• length- from 20 to 37 millimeters;
• width- from 18 to 30 millimeters;
• thickness- from 16 to 22 millimeters;
• volume- within 10 cubic centimeters.

Laparoscopy for adnexitis

Tests for adnexitis

Medical examination for adnexitis

Identifying the source of infection in adnexitis

Laboratory diagnostic methods for adnexitis

Another name for it is salpingoophoritis, which is inflammation of the uterine appendages (fallopian tubes and ovaries). Girls and even girls suffer from it more often than adult women. Pain with adnexitis can be severe and require drug treatment.

Symptoms of inflammation of the appendages

This disease is divided into 3 types:

1. Spicy.
2. Chronic.

Each type has its own symptoms, but a common feature is pain in the lower abdomen, purulent vaginal discharge and decreased libido. The disease can be unilateral or bilateral, when the pain is localized on the right, left or both sides. Since the symptoms of adnexitis are similar to signs of other inflammatory processes in the female body, diagnosis is carried out using ultrasound, laparoscopy, tests and palpation.

Characteristic pain with adnexitis

The cause of the disease can be:

Acute and subacute forms of the disease are characterized by pain in the lower abdomen, radiating to the back, lower back, tailbone, thigh, sacrum or buttocks. All this is accompanied by chills, fever, and sweating. You are worried about muscle contractions, purulent discharge with an unpleasant odor, and painful sensations when urinating. General intoxication of the body occurs. Exacerbation of inflammation leads to.

The chronic form of the disease is characterized by aching pain in the lower abdomen, migrating to the sacrum.

The pain becomes more intense and is accompanied by nausea, diarrhea or dizziness. The menstrual cycle is disrupted. During intimacy, there is severe discomfort and chest pain. The general condition is characterized by apathy and irritability. The woman gets tired quickly, she is overly aggressive and is in a stressful state.

If the pain radiates to the left or right side, this indicates unilateral adnexitis. If it hurts on both sides, then it’s bilateral.

How to relieve pain

Salpingoophoritis is a dangerous disease for women. Due to disturbances in the reproductive system, the consequences can be dire. At the first signs of inflammation, you should contact a gynecologist, who will prescribe a special course of therapy based on test results and the patient’s medical history. Timely medical care will help prevent the development of chronic adnexitis.

Treatment of infectious diseases is based mainly on antibiotics. Preparations of almost all antibacterial groups are used:

• aminoglycosides;
• macrolides;
• tetracyclines;
• penicillins;
• fluoroquinolones;
• lincosamides.

The main antimicrobial medications include:

• Erythromycin;
• Ampicillin;
• Gentamicin;
• Ofloxacin;
• Tetracycline;
• Roxithromycin and others.

Also, in combination with them, medications are used that restore the healthy microflora of the vagina.

Treatment includes antiviral, anti-inflammatory drugs and immunomodulators. The duration of the course is about 10-12 days. Physiotherapy is used to eliminate residual pain and improve blood microcirculation in the pelvis.

It is also necessary to take vitamin complexes, which are also selected individually.

If adhesions are found in the tubes, suppositories or laparoscopy are used to remove them. Among the folk remedies, chamomile, aloe juice or honey, as well as douching or steam baths based on medicinal herbs, help well.

Conclusion

As part of preventive measures, it is necessary to adhere to proper nutrition to improve immunity. It is recommended to include more fresh vegetables, herbs, and fruits in your diet. It is important not to abuse alcohol, fatty and salty foods, and give preference to baked or boiled foods.

You should not engage in active sports while you are ill, as exercises that involve the abdominal muscles can cause heavy bleeding and increased pain.

A prerequisite is compliance with hygiene rules and the use of underwear made from natural fabrics. You need to avoid hypothermia, dress according to the season, especially paying attention to your legs. Be sure to visit a gynecologist for a preventive examination once every six months. Timely assistance will help avoid consequences such as infertility or ectopic pregnancy.

Adnexitis is an inflammatory and infectious process in the appendages. The disease is acute at first, then becomes chronic. Treatment of adnexitis depends on the nature of its course and includes taking medications, physiotherapy, and the use of traditional methods. In severe cases, surgery is performed.

The second name for adnexitis is salpingoophoritis. This is a very common gynecological disease among young women. With bilateral inflammation, there is a risk of development.

Treatment tactics will be selected depending on the symptoms of adnexitis. The acute form of the disease is accompanied by general malaise, like a cold: the temperature rises, headaches and muscle pain develop, chills, nausea, and vomiting.

Specific symptoms of adnexitis include constant or periodic pain in the lower abdomen, radiating to the lower back, thigh and rectum, as well as depressive symptoms, neurotic feelings, sleep disturbances, irritability, and tearfulness. As the disease progresses to a subacute form, pain and temperature decrease.

Chronic adnexitis is a consequence of undertreated acute adnexitis.

In relapses it manifests itself as follows::

• health worsens, weakness increases;
• temperature increases to 38° C;
• sexual desire decreases;
• the functioning of the digestive organs is disrupted (colitis, gastritis);
• the functions of the urinary system are disrupted (pyelonephritis).

During periods of remission, adnexitis reminds itself of itself with a constant dull pain in the lower abdomen, which intensifies during physical activity, sexual intercourse, emotional experiences, and hypothermia. Possible. Depending on whether the adnexitis is left-sided, right-sided or bilateral, pain can be felt in one side or in the entire lower abdomen.

With adnexitis, both appendages or one may be inflamed.

Depending on this they distinguish:

• Bilateral adnexitis . The disease begins in the fallopian tubes and then spreads to the ovaries. This form is characterized by general malaise, fever, abdominal pain, abdominal muscle tension, nausea and vomiting. Most often, such inflammation occurs subacutely and chronically. With bilateral adnexitis, the risk of developing infertility is significantly higher than with unilateral adnexitis.
• Left-sided and right-sided adnexitis . Inflammation develops in one of the appendages. Characterized by pain on the side where the affected ovary is located, increased temperature, chills, and fever. Absolute infertility does not develop, but the process of conception becomes more difficult; more often than usual, pregnancy develops in the tube rather than in the uterus.

Treatment of acute adnexitis

Treatment of acute adnexitis is carried out in a hospital. Semi-bed rest, a special diet, and plenty of fluids are prescribed. It is necessary to monitor urinary function daily in order to detect a decrease in kidney function in time.

Depending on the clinical picture and diagnostic data, drug therapy and surgery are prescribed. At the recovery stage, a course of physiotherapy can be carried out, and traditional medicine can be used.

If acute adnexitis is treated incorrectly or completely absent, the disease becomes chronic. There is a risk of development, infertility, decreased ability to work, and decreased sexual desire.

Drug treatment

Adnexitis with acute symptoms requires treatment with antibiotics and the administration of infusion solutions. Additionally, medications that relieve pain and inflammation may be prescribed.

The basis of drug treatment for adnexitis is antibacterial drugs:

• penicillins (Amoxicillin);
• fluoroquinolones (Ciprofloxacin, Norfloxacin, Ofloxacin);
• macrolides (Erythromycin, Roxithromycin, Azithromycin);
• aminoglycosides (Tobramycin, Kanamycin);
• cephalosporins (Ceftriaxone, Cefixime, Suprax).

For adnexitis, antibiotics are often administered in the form of injections. It is preferable to use drugs with a long half-life (Ampicillin, Amoxicillin, etc.).

If the inflammation is severe, there is a risk of developing sepsis, then antibiotics are used in combinations or combination drugs are prescribed, for example. For adnexitis with a predominance of anaerobic pathogenic flora, Metronidazole (Trichopol) is prescribed in the form of tablets or intravenous infusions.

To eliminate the symptoms of intoxication, infusion therapy (droppers) is used. Glucose, Poliglyukin, Reopoliglyukin, Hemodez are administered intravenously. The total volume of solution is up to 2.5 liters per day.

Anti-inflammatory treatment of adnexitis is often carried out with rectal and vaginal suppositories, this makes it possible to achieve the maximum concentration of substances in the lesion. Voltaren, Movalis, Fluomizin, Diclofenac, Hexicon (vaginal tablets) may be prescribed. All these drugs not only reduce inflammation, but also relieve pain.

Surgery

For purulent forms of inflammation, the treatment regimen for adnexitis includes surgical intervention. Preference is given to low-traumatic procedures. The most common option is.

During the procedure, the doctor makes several punctures in the projection of the appendages and removes the accumulated pus. After this, he irrigates the inflammation areas with antiseptics and antibiotics. Another way to evacuate the tumor contents is puncture of the posterior vaginal fornix. After its completion, antibiotics are administered locally.

In severe cases of purulent inflammation, when renal failure increases, there is a threat of opening of an abscess, septic infection, the operation is performed in an open manner. During the procedure, the appendages are removed.

Physiotherapy

After the acute symptoms of the disease have been relieved, physiotherapeutic procedures are prescribed. They reduce the separation of exudate, relieve pain, prevent the formation of adhesions and enhance the effect of drugs.

Treatment of subacute adnexitis includes pulsed ultrasound sessions, electrophoresis with potassium, magnesium, zinc and vibration massage. After stabilization of the woman’s condition, she can be referred to sanatorium-resort treatment.

Traditional methods

Treatment of acute adnexitis with folk remedies is permissible only after discharge from the hospital and in combination with traditional medications prescribed by a doctor.

Herbal infusions will help speed up recovery:

• Collection 1. Prepare a mixture of marshmallow roots (50 g), oregano herb (200 g) and oak bark (300 g). Boil 200 ml of water, brew 5 tbsp. l. collection Cover the container with a lid and place in a warm place for 30-40 minutes. Then strain the infusion and use it for douching procedures. The course of therapy is 2 weeks.
• Collection 2. Combine St. John's wort, nettle, yarrow, hogweed (50 grams of each plant), thyme, marshmallow root and coltsfoot (100 grams each). Boil 1 liter of water, pour 3 tbsp. l. collection Cover with a lid, wrap in a towel and leave for 2-2.5 hours. Strain. Take half a glass orally three times a day. Duration of treatment – ​​2 months.
• Collection 3. Mix yellow sweet clover flowers, coltsfoot, and centaury in equal quantities. Boil 1 liter of water, pour 5 tbsp. l. collection Cover with a lid and leave for 30-35 minutes. Pass the resulting infusion through cheesecloth. Take 60-70 ml orally up to 5-6 times a day. Duration of treatment – ​​1 month.
• Collection 4. Combine 4 tbsp. l. wintergreen rotundifolia and 2 tbsp. l. St. John's wort. Pour the mixture with a liter of boiling water, wrap it in towels and leave for 2 hours. Strain. Drink 50 ml of infusion at a time, 3 times a day.

Treatment of acute adnexitis at home is possible during the recovery stage. Before using the products, you should consult your doctor.

Treatment of chronic adnexitis

Although the symptoms of chronic adnexitis are mild, its treatment is complicated due to a number of problems:

• Prolonged and mild inflammation leads to the formation of a tissue barrier around the lesion. It prevents the infection from spreading to nearby areas, but also prevents the penetration and accumulation of drugs in the required concentration.
• Due to chronic inflammation, local immunity decreases. The female body cannot cope with the infection and stops fighting.
• Chronic adnexitis can last for years. During this time, the woman manages to get sick from other bacterial infections, for example, sore throat or sinusitis. Periodic delivery of small doses of antibiotics to the source of inflammation in the appendages leads to the development of resistance of pathogenic microflora. As a result, targeted treatment becomes ineffective.

Since it is completely difficult to cure chronic adnexitis, the main efforts are aimed at preventing exacerbations and complications, in particular, infertility. Procedures aimed at restoring local and general immunity and eliminating inflammation are becoming increasingly important.

Drug treatment

Treatment of chronic adnexitis is carried out comprehensively, drugs are prescribed that stimulate the immune system, restore the microflora of the vagina and intestines, and relieve inflammation. Antibiotics may be used in the next step.

As noted above, the chronic course of the disease leads to the formation of a tissue barrier around the lesion and bacterial resistance to drugs, so it is difficult to find out which antibiotics will be effective for this form of adnexitis.

Data from laboratory tests on the sensitivity of bacteria to various groups of drugs do not reflect the characteristics of the flora and tissue structure at the site of inflammation. There is a possibility that the antibiotic selected during the study will not accumulate in the required concentration in the tissues. Such treatment is effective only in 37% of cases.

In order for the treatment of adnexitis with antibiotics to be as successful as possible, it is necessary to prepare the tissues of the source of inflammation and the body as a whole. Drugs are prescribed to restore immunity: Immunal, Cycloferon, Likopid, etc.

Suppositories for chronic adnexitis reduce inflammation and pain. Suppositories Diclofenac, Voltaren, Hexicon, tampons with Vishnevsky ointment can be used. Local treatment increases the permeability of tissue barriers. Thanks to this, antibiotics can accumulate at the site of infection, eliminating it.

Surgery

Surgical treatment of chronic adnexitis can be carried out at any stage. Indications for surgery are severe pain in the lower abdomen, extensive cicatricial adhesions, and the formation of sacs with fluid in the area of ​​the appendages.

During the procedure, the doctor cuts and removes adhesions, restores the patency of the fallopian tubes, and removes purulent and fluid formations. The operation is performed laparoscopically.

Physiotherapy and spa treatment

Since chronic adnexitis needs to be treated comprehensively, physiotherapeutic procedures become more important. During them, the focus of inflammation is affected. As a result, tissue exudation is reduced, their structure and normal functioning are restored. The permeability of the source of infection increases, which makes drug treatment more effective.

A course of physiotherapeutic procedures is a good preventive measure against the formation of adhesions and the development of infertility. Such treatment includes electrophoresis with lidase, potassium, iodine, magnesium and zinc, as well as UHF, ultrasound and vibration massage.

During the period of remission of chronic adnexitis, sanatorium-resort treatment is indicated: mud in the form of applications, vaginal baths, balneotherapy, gynecological irrigation and massage. Such procedures are restorative; they normalize women’s well-being and delay the exacerbation of the disease.

Traditional methods

For chronic adnexitis, treatment with folk remedies can be carried out during the period of remission. Thanks to this therapy, inflammation is reduced, pain is relieved, the menstrual cycle is established, and the functioning of the digestive organs is normalized.

The following recipes are effective:

• Infusion . Mix equal quantities of birch and strawberry leaves, corn silk, yarrow grass, and strings. Boil 1.5 liters of water, pour 2 tbsp. l. collection, cover with a lid and put in a cool, dark place for 5 days. Drink half a glass three times a day. The course of treatment is 1 month.
• Mumiyo . Buy a tablet form of mumiyo at the pharmacy. Prepare a solution by stirring 1 pc. in a glass of boiled, but not hot water. Take the entire portion at once 30 minutes before meals. The course of therapy is 1 month.
• Alcohol tincture of propolis . Mix 80 grams of crushed propolis in 300 ml of alcohol. Place in a cool, dark place for a week, shaking the container daily. Drink 4-5 drops twice a day. Duration of treatment is 3-4 weeks.
• Steam baths . Boil a head of cabbage in milk. Take it out and pour the liquid part into a clean bucket. Take off clothes and underwear, sit over the steam. Continue this procedure until the milk cools down. Repeat once a day until the pain goes away.
• Baths with juniper . Boil a bucket of water and pour it over 5 kg of juniper stems. Leave for 2-3 hours, strain and add to a regular bath.
• Tampons with garlic . Grind 2-3 cloves, mix with a small amount of water. Strain and add 1-2 drops of celandine juice. Collect the liquid with a cotton swab and place it in the vagina for 3 hours. Carry out the procedure 2 times a week until the pain in the lower abdomen goes away.

The treatment tactics for adnexitis depend on the nature of its course. In acute infectious-inflammatory processes, the basis of therapy is the use of antibiotics, and in severe cases, surgical intervention.

Chronic adnexitis leads to the fact that antibacterial drugs become less effective. The emphasis is on eliminating inflammation, restoring immunity, preventing exacerbations and complications (adhesions).

I like!

The parts of the pelvis are interconnected, so a disorder affecting one organ gradually spreads to others. Inflammation of the ovaries (oophoritis) is often accompanied by infection of the fallopian tubes (salpingitis). In gynecology, the disease is called salpingoophoritis. If the acute process is not eliminated in time, chronic adnexitis develops. It occurs cyclically, after a period of exacerbation followed by remission.

Collapse

What is chronic adnexitis?

After the acute inflammation of the appendages subsides, several months pass, and the woman notices a deterioration in her health, increased pain, pathological discharge from the vagina, and a delay in menstruation. Exacerbation of chronic salpingoophoritis (adnexitis) may be accompanied by low fever and dysuric symptoms. Sometimes a woman does not suspect that such a disease is the cause of infertility.

Chronic adnexitis refers to inflammatory diseases of the female pelvic organs, subsection - “salpingitis and oophoritis”. ICD 10 code – number 70.1

Chronic salpingoophoritis is caused by microbial damage to the appendages. Pathogens include fungal organisms, viruses, and pathogenic bacteria. Low immunity, hypothermia, constipation, intrauterine operations cause pathogens to penetrate from the vagina into the overlying organs of the reproductive system. Sometimes microbes reach the appendages through the blood and lymph flow from other inflammatory foci.

In rare cases, signs of the disease are detected in a virgin. Not only genital infections cause damage to the appendages, but also other microbes. The most dangerous among them is the tuberculosis bacillus, which affects the genitals. The infection may come from nearby intestinal loops.

Types of pathology

Depending on the location of inflammation, left-sided, right-sided and bilateral adnexitis are distinguished.

The following flow options are distinguished:

• Infectious-toxic, occurring with pain and swelling of the appendages, a blood reaction;
• Neuro-vegetative, when vascular reactions, endocrine changes, depression, and apathy come to the fore.

In contrast to the acute process, the chronic form is distinguished by the paucity of symptoms and a sluggish course. Treatment of pathology is much more difficult and lengthy.

Left-handed

Left-sided adnexitis spreads to the appendages located on the left side of the uterus. The causes of left-sided salpingoophoritis include: sexually transmitted infections, violation of sanitary and hygienic standards during the installation of an IUD, medical manipulations on the reproductive organs. The symptoms of the disease have much in common with left-sided inflammation of the ovary or fallopian tube.

In the absence of proper treatment, chronic left-sided salpingoophoritis occurs in waves. Periods of short-term remission alternate with exacerbation, each of which is accompanied by an increase in painful symptoms.

Right-handed

Right-sided salpingoophoritis is characterized by inflammation of the gonads and tubes on the right side. Symptoms of the pathology are nagging pain in the abdominal area; women also experience a disruption in the menstrual cycle. Unpleasant sensations may intensify during sexual intercourse, as well as during urination. Often the course of the disease is accompanied by an increase in temperature.

In general, the symptoms of right-sided adnexitis are in many ways similar to inflammation of the appendix. That is why, if you have unclear pain in the right side of the abdominal cavity, it is imperative to visit a gynecologist.

Both right-sided and left-sided adnexitis, in the absence of proper therapy, can lead to ovarian dysfunction, as well as the occurrence of adhesive disease.

Double sided

Bilateral adnexitis affects the uterine appendages on both sides. In the early stages of the disease, only the fallopian tubes are damaged, and subsequently the inflammation spreads to the ovaries. Symptoms in women are:

• Feeling unwell, feeling weak;
• Increased body temperature;
• Painful sensations, heavy discharge during the menstrual cycle;
• Irregular onset of menstruation;
• Sexual intercourse causes pain;
• Prolonged unsuccessful attempts to get pregnant;
• Pain in the pelvic and groin area, radiating to the sacrum;
• Pathological discharge from the vagina;
• Long-term depression caused by hormonal imbalances.

Causes

There are a number of reasons that increase the risk of developing chronic adnexitis:

1. Inflammatory processes in the body (including those not affecting the genitals - sore throat, pyelonephritis, etc.)
2. Unhealthy Lifestyle; weakened immunity, low ability of the body to resist infections
3. Systematic neglect of personal hygiene
4. Frequent hypothermia
5. Previous surgical interventions affecting the uterus (in particular, abortions, curettage, hysteroscopy).
6. Frequent change of sexual partners
7. Experienced stress and other psychological shocks that can negatively affect hormonal levels

Symptoms

Sometimes there are no signs of a chronic disease. However, in general, the following clinical manifestations indicate pathology:

1. Painful or unpleasant sensations in the lower abdomen or lower back. The degree of their intensity depends on the severity of the disease
2. Prolonged increase in temperature to subfebrile levels
3. Feeling of general weakness, depression, irritability
4. Various menstrual cycle disorders (delayed onset, decreased or increased duration of discharge).

The reason for the disruption of menstruation is a delay in the maturation of the egg and difficulty in its movement through the pipes.

The duration of clinical manifestations and constant pelvic pain exhaust the woman. Hormonal changes cause her to become nervous and irritable.

Treatment

Is it possible to cure the disease and get rid of the problem forever in the future? Yes, chronic adnexitis is treated long and hard. If you follow all medical recommendations, you will definitely get results. A thorough diagnosis will help answer the question.

There is a standard examination for salpingoophoritis:

• Taking anamnesis (chronological aspects of the disease);
• Gynecological examination;
• Blood and urine tests;
• Bacterial culture from the vagina;
• Biochemical blood test;
• Flora smear examination.

Additionally, hysterosalpingography, CT or MRI are used. Echo diagnostics shows thickening and deformation of the fallopian tubes, adhesions, the presence or absence of fluid in the retrouterine space.

Treatment in hospital

In case of severe exacerbation, there is a need for inpatient medical care; in other cases, therapy is carried out at home. Let's look at how to treat chronic adnexitis with drugs. Depending on the culture results, a combination of several antibiotics is used: tetracyclines, semisynthetic penicillins, cephalosporins. To relieve intoxication, solutions of glucose and sodium chloride are used, administered intravenously.

Physiotherapeutic treatment

Physiotherapy is prescribed after acute manifestations have subsided. Electrophoresis with absorbable agents (lidaza), ultraviolet irradiation, ultrasound, laser treatment, and vibration massage are used.

The use of mud baths and paraffin baths is indicated; vaginal irrigation with mineral water will be beneficial. These activities will be more effective if carried out in a sanatorium setting.

Is chronic adnexitis treated with folk recipes? It will not be possible to cure the disease only with infusions and decoctions, without the use of medications. However, traditional medicine can be an excellent complement to those medications prescribed by a doctor.

Drug treatment

For chronic salpingo-oophoritis, rectal or vaginal suppositories with analgesic and antiseptic effects (Genferon, Hexicon) are used. Pathogenetic therapy includes the use of anti-inflammatory drugs in the form of tablets and rectal suppositories (Diclofenac, Movalis). Immunomodulatory agents are indicated. To accelerate tissue regeneration, biogenic stimulants (Humizol) are used.

Possible consequences and complications

The disease primarily affects reproductive function. As a result of morphological and hormonal changes, infertility develops. Chronic inflammation leads to a pathological course of pregnancy (ectopic implantation of the fertilized egg, spontaneous miscarriage).

A constant focus of inflammation provokes sclerosis and infiltrates in the pipes. Adhesions form near the appendages, which cause pain. Inflammation can spread to other internal organs and cause nephritis or colitis.

Pregnancy and chronic adnexitis

Is it possible to get pregnant with this pathology? Doctors do not advise planning conception until the end of therapy, otherwise undesirable outcomes are possible. After completing a course of treatment, it is necessary to re-check the condition of the appendages to assess their functionality. If the result is satisfactory, pregnancy may occur.

Only a qualified specialist can tell you how to treat chronic adnexitis. That is why, if you discover signs of the disease, you should immediately seek help from a gynecologist, without resorting to folk remedies and untested drugs! Advanced stages of the disease are dangerous due to delayed complications.

Adnexitis is a severe, acquired disease of the appendages, disrupting the functions of the reproductive system and nearby tissues, and in the absence of proper therapy, acquiring a hidden course. The patient is tormented by a left- or right-sided inflammatory process in the reproductive organs: ovaries, tubes, uterine body. The development of the disease exhausts the woman with its symptoms, making her infertile.

The disease has a second name - salpingoophoritis. The peak incidence is observed among representatives of the fair sex at the age of 20-30 years, at the most childbearing age. According to the International Classification, the disease code is ICD-10/N00-N99/N70-N77.

Causes

Any representative of the fair sex can suffer from this gynecological disease. There is no specific route of infection by pathogenic microbes. There is no way to insure against the onset of illness. Inflammation of the appendages appears for many reasons:

• Hypothermia. Women should strictly avoid hypothermia in the genital area and lower abdomen. The most common cause of pathology in young girls is wearing inappropriate clothing during the cold season.
• Stress. In severe stressful situations, the immune system loses its ability to maintain the balance of internal microflora. Bacteria present in a woman’s genitals begin to multiply and spread uncontrollably.
• Lymphogenic, hematogenous route. An infection located elsewhere spreads through the lymphatic system or bloodstream. Finding a vulnerable spot in the mucous membrane of the uterus or its appendages, it begins to provoke adnexitis.
• Termination of pregnancy, surgical operations in the abdominal cavity. Any external intervention can cause inflammation. Damaged tissues become more susceptible to microbial attack. The remaining blood begins to decompose already on the second day, causing a severe imbalance of microflora and serious complications.
• Sexually transmitted infections, E. coli, poor personal hygiene.

List of the most common infectious agents, both harmful and opportunistic. Their entry and reproduction into the female reproductive system provokes the appearance of problems with the appendages and the development of associated health problems.

There is no need to torment yourself with an excessive desire for sterility, trying to avoid the appearance of salpingoophoritis. It can appear for no apparent reason. The human internal environment is filled with various types of bacteria. When in balance in the body, they bring benefits to life. But at the slightest malfunction, these bacteria can provoke the appearance of various disorders, including salpingoophoritis.

Symptoms of adnexitis

Inflammation of the appendages is very often not diagnosed due to the absence of obvious signs. Diseases of the reproductive system can masquerade as temporary health conditions associated with a busy work schedule and wearing uncomfortable clothes.

Ailments, the cause of which has been misinterpreted, are suppressed by general medications (antipyretics,). That is why salpingo-oophoritis develops further, sometimes turning into an acute state, sometimes persisting and progressing into a chronic state.

Acute course of the disease

The developing inflammatory process provokes the appearance of symptoms similar to other disorders. But the source of inflammation and its localization can be identified by a combination of signs:

• Temperature increase. For a long time, the indicators remain within 38-38.5 degrees.
• A general malaise appears, a headache, muscles cramp, the body sweats profusely, and the patient feels “freezing.”
• Cutting pain in the lower abdomen. They intensify with a full intestine or bladder, intense sexual intercourse, wearing tight clothing, and sudden movements.
• Piercing pain when suddenly sitting down in a chair or on a chair. It feels like a deep puncture with a knitting needle and goes right to the area where the inflammatory process is taking place.
• The pain spreads to the lumbar and tailbone area even in the absence of pressure on them.
• When palpating the abdomen, the patient has a feeling of tearing of the internal organs (inflamed appendages and ligaments).
• In advanced forms, the disease is possible.
• Urination is impaired.

It is necessary to comply with all the rules prescribed by the doctor. You should continue taking it even if the symptoms have subsided. Untreated salpingoophoritis is dangerous due to its degeneration, transition to a secretive existence.

Symptoms of chronic disease

The lack of adequate therapy provokes the disease to become chronic. It manifests itself with less severe symptoms. But when unfavorable conditions occur, the condition transforms into intense. Signs of hidden salpingoophoritis:

• Increased pain in the lower abdomen. The ailments have a wave-like manifestation.
• Periodic increase in body temperature to subfebrile. It stays within 37.5-38 degrees for five days.
• Vaginal discharge becomes mucous, purulent, and acquires an unpleasant odor.
• : long menstruation with a short cycle; discharge without periodicity; extreme pain during menstruation; scanty menstrual flow with a long cycle.
• Libido decreases, pain appears during sexual intercourse.
• Nearby organs suffer from the proximity of the source of infection. Cystitis and pyelonephritis often manifest in the urinary system. The gastrointestinal tract suffers from colitis and dysbiosis.
• The affected internal secretion organs are not able to fully perform their work. The hormonal balance is disrupted, and the woman’s mental state loses stability.

Getting rid of chronic disease of the appendages is very difficult. It is much easier to eradicate a disease by diagnosing its presence in time. Unscrupulous attitude towards carrying out procedures, failure to complete the course, violation of the regime lead to the development of a more stable form and its severe consequences.

Diagnostics

The primary indicator is complaints of pain in the area of ​​the uterine appendages. A history of sexually transmitted infections, abortions, abdominal surgeries, or childbirth confirms the doctor’s suspicion of salpingoophoritis. Researches are assigned:

• Smears from the vagina and cervix indicate the presence of markers of bacterial and viral infections.
• Ultrasound shows growths, changes in the structure of the inner surface of the uterus and fallopian tubes. But ultrasound research does not give a clear picture of the process.
• General blood test.

The best diagnostic method for identifying adnexitis is laparoscopy. Through small punctures, tracking devices and a manipulator are inserted into the abdominal space to take samples. This reduces trauma and does not require general anesthesia.

Treatment of adnexitis

When turning to professional doctors, even with advanced adnexitis, all patients noticed an improvement in their condition within two months. Neglecting the basic rule of medicine, patients stopped taking medications, allowing the infection to strengthen.

Each form of manifestation of this gynecological disease has its own treatment characteristics. During the acute phase, it is advisable to place the patient in a hospital setting. Getting rid of the chronic type requires consistency, perseverance and strict adherence to the doctor’s instructions.

Measures for acute form

Really effective therapy for salpingoophoritis is carried out in a hospital setting. This way, the patient will be provided with the maximum possible peace, appropriate care, proper nutrition, and monitoring of tests. To stop the destructive process, anti-inflammatory drugs are prescribed:

• Indomethacin;
• Diclofenac;
• Longidaza.

The drugs have a restorative effect on connective tissues damaged by adhesions and inflammation. But the spread of infection will be stopped by antimicrobial drugs and antibiotics that destroy pathogenic microflora:

• Metronidazole;
• Azithromycin;
• Ceftriaxone;
• Tsiprolet;
• Sumamed;
• Amoxiclav;
• Genferon (immunomodulatory effect);
• Digital

At an advanced stage, when suppuration occurs, surgery is prescribed. During this period, the abscess is opened, the internal cavity is washed from residual pus, and sanitation is carried out. Modern clinics use laparoscopy for this purpose.

Measures for chronic form

The primary task in getting rid of salpingo-oophoritis is to relieve the acute period with the help of injections, tablets, and suppositories. The indolent form of the disease of the appendages is subject to less intensive therapy:

• Autohemotherapy. Injection of the patient’s own blood, taken from the venous bed, into the gluteal muscle. Helps to activate the immune system in cases where the disease is sluggish, often recurrent.
• Physiotherapy. Ultraviolet radiation is used to increase general immunity, electrophoresis with iodine, potassium, zinc, magnesium.
• Magnetotherapy. Good results in the treatment of chronic adnexitis can be achieved using the Almag apparatus. It relieves inflammation and eliminates pain.

Associated methods of recovery are: vitaminization, introduction of a proper diet, and strengthening physical exercises. To establish reproductive function, hormonal therapy is used in some cases.

Folk remedies

Treatment of salpingoophoritis at home is effective only in cases of using medications prescribed by a doctor. But folk remedies can also alleviate a woman’s condition, relieve exacerbation, and slow down the development of the disease.

• Douching with a decoction of chamomile, sweet clover, sage, and horsetail. These herbs have a local antiseptic and anti-inflammatory effect. Decoctions can be made from individual items or as a collection. Consumption of dry material: 1 tablespoon per glass of water.
• Borovaya uterus inside. A wild herb that has a beneficial effect on a woman’s reproductive function. Anti-inflammatory, immunomodulatory, antimicrobial effects support the body.

The herb is always brewed in boiling water and simmered over low heat for 15 minutes. Cools naturally. Strained. For douching for adnexitis, “hot” douching is used. The temperature of the liquid in them is higher than body temperature, but should not exceed 42 degrees.

Diet for adnexitis

Nutrition for an inflammatory disease should place minimal stress on the digestive tract. A correct diet is one in which the following rules are followed:

• It is not allowed to consume alcohol or other drugs during treatment with medications prescribed by a doctor.
• You should avoid fried and salty foods.
• Fatty dishes and foods rich in seasonings negatively affect blood composition and make recovery difficult.
• Drinking plenty of fluids is necessary. This speeds up metabolism and promotes rapid removal of toxins and drugs from the body.
• The basis of the diet should be lean meats, steamed or boiled, greens, and cereals.
• Fruits and vegetables rich in vitamin C strengthen the immune system. Rose hips, sweet peppers, kiwi, sea buckthorn, citrus fruits, and rowan are consumed fresh. Ascorbic acid does not withstand high temperatures and disintegrates when boiled.
• To quickly restore normal microflora destroyed by antibiotic therapy, it is recommended to consume fermented milk products.

Proper nutrition will help not only get rid of the disease, but also prevent its occurrence. The introduction of healthy lifestyle habits has a preventive value; it will protect against many problems and deviations in the future.

Consequences of the disease

Adnexitis is a general name that includes a wide variety of additional diagnoses. Depending on the location of the disease process, the degree of its development, and the damage it causes to the woman’s health, the following are distinguished:

• Apoplexy of the ovary. Damage to the ovarian wall. The infection “corrodes” the thin shell, threatening to rupture at the slightest strain.
• Pelvioperitonitis. Damage to the peritoneum. This condition is life-threatening, since its development poses a risk of extensive infection and sepsis.
• Endometritis. Inflammation of the internal cavity of the uterus.
• Adenomyosis. Benign growth of the walls of the uterus. The endometrial mucosa begins to thicken and grow into the deeper layers of the muscle walls. This makes conception impossible and increases pain during menstruation.
• . Vaginal infection.
• Oophoritis. Inflammation of the ovaries, disrupting their functionality and structure. The condition threatens to rupture the membranes.
• Parametritis. Disorders that occur in connective tissue. Indicates the spread of infection.
• Salpingitis. The pathological process occurs directly in the pipes. Threatens obstruction, secondary infertility.
• Endometriosis. Proliferation of mucous membranes.
• Spikes. Violations of tissue integrity shrink, heal, and scar.

Each diagnosis has a detrimental effect on the patient’s future health. The mucous membranes of the reproductive system acquire an uneven structure and an uneven surface. The lumens of the pipes narrow and become unable to perform their functions.

Prevention

It is always easier to protect yourself than to cure any serious disease. This disease poisons the lives of women at their most beautiful, childbearing age. In order to avoid the onset of salpingoophoritis, it is necessary:

• Avoid hypothermia from childhood. Don't sit in the cold. Wear clothes appropriate for the weather.
• Observe personal hygiene rules.
• Pay attention to your health. Periodic visits to the gynecologist with tests and examinations in the chair.
• Exclusion of casual sexual relations.
• If an unwanted pregnancy occurs, do not waste time. It is better to have a medical abortion or vacuum aspiration. During these manipulations, no injury is caused to the internal tissues of the uterus.

The best way to get rid of painful diseases is to prevent their occurrence. Preventing the onset of adnexitis will protect you from pain, inconvenience, problems with conceiving and bearing a desired child, and damage caused by antibiotic treatment.