In the structure of gynecological morbidity acute inflammation of the uterus appendages occupy the first place. Isolated inflammation of the fallopian tubes is rare in clinical practice. Most often, women have inflammation of the fallopian tubes and ovaries. It can be combined with inflammation of the uterus. Rarely, according to statistics, there are suppurative processes of the uterus and appendages with the possible generalization of the infection.
Salpingo-oophoritis is an infectious-inflammatory process of nonspecific or specific etiology with localization in the fallopian tubes and ovaries. This is the most common inflammatory disease of the pelvic organs.
ICD-10 software code
N70.0 Salpingitis and oophoritis.
N70.1 Chronic salpingitis and oophoritis.
N70.9 Salpingitis and oophoritis, unspecified.
Isolated inflammation of the various divisions of the pelvis is rare, since anatomically and physiologically they are closely related. In this connection, it is difficult to obtain accurate statistical data on the incidence of salpingoophoritis (as well as on the pathologies of other departments of the small pelvis). Nevertheless, about 40% of patients are hospitalized in hospitals for acute processes or exacerbations of chronic diseases of the genital organs. About 60% of patients turn to antenatal clinic for inflammation. Complications after postponed salpingoophoritis are known.
- Every fifth woman transferred salpingoophoritissuffers from infertility.
- An ectopic pregnancy occurs 5–10 times more often.
- In 5–6% of patients there are purulent complications requiring inpatient treatment and surgery (often with removal of the fallopian tubes).
The adhesions process (a consequence of chronic inflammatory diseases) leads to anatomical disorders and pelvic pain, which can affect the sphere of sexual relations.
ANAMNESIS AND PHYSICAL RESEARCH
In acute inflammation, a bimanual examination is always painful (especially the area of the appendages), as this involves the pelvic peritoneum (sometimes with irritation symptoms). In the chronic process, on the contrary, hardening and fibrosis of the fallopian tubes with the formation of adhesions in the small pelvis make the appendages inactive. Often determine their pain.
In the acute process there are no specific changes in the analyzes (moderate leukocytosis with a shift to the left, an increase in the ESR), and in the case of the chronic, only an increase in the ESR is often found. Bacterioscopic and bacteriological studies of material from the cervical canal, vagina and urethra are of primary importance. The goal is to identify pathogens and determine their sensitivity to antibiotics.
The echographic method does not give clear information about acute salpingoophoritis. You can diagnose only the thickening of the fallopian tubes, adhesions in the pelvis. With pelvioperitonite, a small amount of fluid accumulates in the Douglas pocket. You can also determine the tumor form with hydrosalpinx or pyosalpinx.
It is better to use ultrasound with a vaginal sensor. CT or MRI may be used, especially in differential diagnosis with ovarian tumors.
Acute salpingo-oophoritis is often necessary to differentiate from acute surgical pathologies (acute appendicitis, surgical peritonitis, intestinal tumors, intestinal or renal colic). At the same time, the use of laparoscopy allows you to carry out an early topical diagnosis and choose the right treatment strategy.
INDICATIONS TO CONSULTATION OF OTHER SPECIALISTS
Consultations of the surgeon and urologist are often urgently needed, especially in urgent cases of differential diagnosis.
EXAMPLE OF FORMULATION OF DIAGNOSIS
Exacerbation of chronic bilateral salpingoophoritis with the formation of the right-sided hydrosalpinx and adhesions in the pelvis.
TREATMENT OF SALPINGITA, ADNEXIT, SALPINGOOFORITA
AIMS OF TREATMENT
- Relief of acute salpingoophoritis or exacerbation of chronic.
- Clinical and laboratory examination.
INDICATIONS FOR HOSPITALIZATION
Always there in the acute process or exacerbation of the chronic.
NON-MEDICATED TREATMENT OF SALPINGITIS, ADNEXIT, SALPINGOOFORITA
Practice in the chronic process or in the period of post-hospital rehabilitation in the acute process. Physiotherapeutic methods are mainly used: UHF, magnetic therapy, electrophoresis with zinc, magnesium, hyaluronidase, etc., diadynamic currents, spa treatment (radon baths and irrigation, thalassotherapy).
MEDICAL TREATMENT OF SALPINGITIS, ADNEXIT, SALPINGOOFORITA
Fundamental in the treatment is antibiotic therapy, which is appointed empirically, taking into account the most likely pathogens. Modes of PID antibacterial therapy should ensure the elimination of a wide range of pathogens (see the section “The etiology of PID). First-line regimens include a combination of third-generation cephalosporins (cefotaxime, ceftriacon) with metronidazole, prescription of inhibitor-protected aminopenicillins (amoxicillin / clavulanic acid, etc.); as alternative modes, linkosamides can be used in combination with third-generation aminoglycosides, fluorochinones, and others will be used as alternative regimens. with metronidazole, carbapenems. Given the high risk of chlamydial infection, patients are simultaneously indicated the administration of doxycycline or macrolides.
Antibacterial therapy for PID usually begins with the intravenous administration of drugs with the subsequent transition to their oral intake (step therapy). In case of mild forms of PID patients are treated on an outpatient basis, in this case it is preferable to take oral preparations with high bioavailability. Antibiotics are combined with detoxification therapy: saline solutions are injected intravenously, 5% glucose solution ©, reopolyglukine ©, hemodez ©, polydez ©, mafusol, glucose solution, 5% glucose solution, reopolyglukine ©, hemodez ©, polydez ©, mafusol, glucose solution, intravenous fluids, and , protein preparations, etc.
According to the indications prescribed analgesics, local anti-inflammatory drugs in the form of candles, ice on the stomach. When stabilizing the general condition and subsiding of the acute process, phonophoresis with calcium, copper or magnesium is carried out (according to the cycle).
SURGICAL TREATMENT OF SALPINGITIS, ADNEXIT, SALPINGOPHORITIS
At the initial stage, diagnostic laparoscopy is used. In acute inflammatory process, it is advisable to enter into the abdominal cavity a solution of antibiotics (ampicillin 1 g per 20 ml of saline). In the future, surgical treatment is resorted to in the absence of the effect of conservative drug therapy and the formation of purulent tubo-ovarian formations.
INDICATIONS TO CONSULTATION OF OTHER SPECIALISTS
Consultation of specialists (surgeon, urologist) is shown:
- in the first stage - for differential diagnosis,
- in the course of treatment - in the absence of the effect of treatment or the appearance of combined symptoms associated with the pathology of other organs.
The patient must necessarily complete the full course of anti-inflammatory treatment of the acute process or exacerbation of the chronic. It is necessary to conduct courses of anti-relapse treatment, use spa balneotherapy, use methods of contraception. If an STI is found at a partner, treat it and conduct a follow-up examination of the couple.
For life - favorable. Problems usually arise with menstrual, sexual, and reproductive function.
Adnexitis - a gynecological disease in women
Gynecological disease Adnexitis is an inflammation of the uterine appendages caused by various infections, as shown in the photo.
Often the etiology of the disease is the effect of streptococci, staphylococci or Escherichia coli on the female genitals.
More inflammation of the appendages may appear in case of contact with infectious agents. This type of infection is sexually transmitted by species such as gonococci, which causes gonorrheal adnexitis. A rare cause of inflammation can be the tuberculosis process, which spreads through the vessels of a woman’s body.
Most often occurs in women aged 20-45 years. Women's disease Adnexitis is considered dangerous, since the lack of treatment in time, leads to more serious health consequences and eventually provoke infertility or ectopic pregnancy. But even when pregnancy begins, newborns in the first half of the year often suffer from thrush or candidiasis.
What is salpingoophoritis
Inflammation of the appendages is a general term and therefore often in medicine it is referred to as salpingo-oophoritis. The development of the disease is due to the destruction of the epithelium of the fallopian tubes, as a result of which their walls are impregnated with the products of the vital activity of microorganisms, and thereby causing an inflammatory process. What is salpingo-oophoritis in women and what the name of the disease is derived from.
By uterine appendages are meant the fallopian tubes, ovaries and ligaments. Diseases such as Salpingitis and Oophoritis develop. First of all, the pathology covers mucous tubes and walls, as a result of which a characteristic fluid and even pus is formed in them. At this stage of development is called Salpingitis. If inflammation occurs in the ovaries, the disease is called Oophoritis. Then, when both organs are affected, they have the common name Salpingo-oophoritis.
Therefore, when signs of inflammation of the appendages appear in a woman, female diseases Adnexitis, Salpingitis, Oophoritis, which have a common pathogenesis and are, in fact, varieties of one disease, are diagnosed.
Depending on the path of infection in the woman's body, there are:
- the ascending pathway, when the pathogen of pathology penetrates the vagina and cervix,
- the descending path, that is, the infection penetrates through other affected organs,
- lymphogenous way in which the lesion occurs through the lymph nodes,
- hematogenous route when the infection spreads through the blood vessels.
Forms: subacute, acute, chronic
Depending on the clinical course, they are divided into acute, subacute and chronic salpingo-oophoritis, we will understand what this means and what is the difference between them.
- The acute form is expressed in a stormy and painful course with pronounced symptoms with a sharp rise in temperature.
- Subacute Salpingo-oophoritis is accompanied by an erased clinical course without obvious symptoms with a low temperature, characterized by a small amount of vaginal discharge.
- Chronic salpingo-oophoritis is characterized by a sluggish process with clear periods of remission and exacerbation over a long period of time. In this case, the woman is constantly worried about the aching pain in the pelvic area.
Code for ICB 10
Especially for the systematization and analysis of all existing diseases, a special handbook of ICD 10 (International Classification of Diseases 10-Revision) was created, which is a tool for doctors.
It contains information on any pathology and each of them has its own specific code. Inflammation of the appendages is divided into several varieties and, according to the reference book, is included in the category "Inflammatory diseases of the female pelvic organs" with the numbering of codes N70-N77.
The salpingoophoritis code for ICD 10 corresponds to N70, while the category is called “Salpingitis and oophoritis” and includes the following subcategories:
- acute adnexitis code for microcirculation 10 - N70.0,
- chronic adnexitis code according to MKB 10 - N70.1,
- unspecified adnexitis code according to MKB 10 - N70.9.
Under the ICD 10 code N70.1, all varieties of the chronic form of both 2-sided and unilateral salpingo-oophoritis are included. Adnexitis can lead to such a disease as acute cystitis code according to ICD 10 under No. 30.0
Types: left-sided, right-sided, double-sided
Depending on the area of damage, adnexitis can be of several types, and left-sided inflammation is more often diagnosed than right-sided.
The infectious agent enters the right fallopian tube and thereby causes inflammation not only in it, but also in the right ovary and the disease is diagnosed as right-sided salpingo-oophoritis. It is divided into acute form or running chronic.
If the organs on the left side are affected, left-sided adnexitis is distinguished, which, in turn, is divided into categories according to the form of flow:
- chronic left-sided salpingo-oophoritis,
- acute left-sided salpingo-oophoritis.
With the development of pathology from two sides at the same time, the disease is classified as bilateral inflammation of the appendages with subcategories:
- acute bilateral salpingo-oophoritis,
- chronic bilateral salpingo-oophoritis.
Symptoms and causes of Adnexitis in women can be different depending on the infection causing the inflammatory process, as well as the conditions for the development of pathogenic microflora. In medicine, there are several risk factors that can contribute to the development of pathology:
- frequent changes of sexual partner or not using contraceptives during sex,
- hypothermia of the body. Often develops after swimming in the sea or visiting the pool, regardless of the time of year. Hypothermia can be caused by wearing light clothing during cold weather,
- weakened immunity against the background of regular nervous stress,
- hormonal failure and menstrual disorders,
- chronic cystitis,
- neglect of personal hygiene,
- use of intrauterine device for a long time,
- in various medical procedures (childbirth, cleaning after a miscarriage or abortion, a medical examination),
- sexual contact during menstruation.
All these factors contribute to another frequently occurring disease in women: thrush, which can occur on the background of Adnexitis. Treatment of thrush is outpatient, you can choose effective pills from thrush for women, who even in 1 day will be able to cope with the disease.
Often the development of salpingo-oophoritis is associated with attendant problems, such as acute respiratory viral infections, herpes, flu, or appears due to the inordinate use of hormonal drugs.
Not the last role played by psychosomatics, that is, the cause of the development of the disease, experts believe internal psychological factors. A woman in some way feels defective or cannot understand how to behave with a man and thereby realize her feminine qualities. As a result, she herself comes up with a disease on a psychological level. Then chronic adnexitis is treated not only with medication, but also prescribed regular visits to the psychologist.
Symptoms in women
Symptoms and treatment of adnexitis in women can vary depending on the form and type of infection. Signs of inflammation can be felt either on the one hand with left-sided or right-sided disease, or on both sides at the same time, if chronic bilateral adnexitis develops.
In the acute form of salpingoophoritis, the following symptoms appear:
- the lower abdomen hurts a lot, which can give to the lower back,
- frequent urination with a burning sensation when the bladder is empty,
- increased body temperature causing chills,
- complaints about the deterioration of the general condition of the body,
- bleeding between menstrual cycles
- purulent or mucous discharge of brown color, in rare cases bloody.
In the absence of timely and topical treatment, the acute form becomes chronic, but there are already some other symptoms. At the same time, salpingo-oophoritis bilateral chronic is expressed in the same symptoms as the right-sided or left-sided:
- constant dull pain in the lower abdomen, which gives to the leg or thigh,
- monthly delay or cycle failure
- decrease in sexual desire
- frequent manifestations of cystitis
- body temperature fluctuates between 37 and 37.5.
In order to find out which antibiotics to drink for chronic adnexitis, it is imperative to go to a doctor's appointment at the first signs of exacerbation.
Diagnosis and diagnosis
Establishing a diagnosis of Salpingo-oophoritis in some cases can be a very difficult task, since at an early stage of development, the symptoms are the same as that of colpitis, endometriosis, hydrosalpinx or metroendometritis. Therefore, differential diagnosis is used to help identify or eliminate the fear. A complete blood and urine test is performed, and an ultrasound scan is assigned, mr.
A smear of more than 100 leukocytes indicates that the woman has an inflammatory process in the body. To confirm, the doctor with the help of an ultrasound scanner can check for the identification of echo signs of pathology.
Based on the protocol of the examinations, the doctor makes a conclusion and makes a diagnosis.
Treatment (with antibiotics and suppositories)
With the diagnosis of adnexitis, treatment with antibiotics and suppositories takes place in a hospital with bed rest.First of all, treatment is directed to reducing the pain in a woman, and further therapy is carried out to eliminate the cause of the disease.
The scheme and tactics of treatment consists of several stages, which is carried out in accordance with all the recommendations of the doctor. How to treat adnexitis, and which of the drugs are better for stabbing, and which pills can be administered only by a qualified specialist.
The list of drugs used in the treatment of:
Depending on the form of Adnexitis, treatment may vary, so the dosage of drugs and the rehabilitation period are determined by the attending physician.
The acute form of therapy is carried out only in the hospital, includes bed rest and complete rest, if necessary, nursing care is provided. In the first days of hospitalization, a course of treatment with antibiotics and painkillers is prescribed. And also appointed a special diet or fasting, in which you can not eat salty and spicy foods, and minimize the consumption of carbohydrates.
If there is no improvement after 5 days, antibiotics change or prescribe surgery. The operation is called laparoscopy, during which pus is removed from the affected appendages and an antibacterial agent is injected.
Treatment of the subacute form of adnexitis is carried out on an outpatient basis with the help of probiotics, anti-inflammatory and antibacterial drugs. The doctor may prescribe immunotherapy to strengthen the woman’s body as a whole and Remens for the treatment of pathology.
Often, swabs with Levomekol or Vishnevsky ointment, which are injected into the vagina overnight, as well as douching with the help of Miramistin, are used to quickly relieve pain in the pelvic area.
In chronic form, complex therapy is applied, which includes not only drug treatment, but also physical therapy (electrophoresis), in addition, Kombilipen is prescribed to strengthen the body's immunity as a whole. Physiotherapy can be carried out in the form of acupressure, which will help eliminate adhesions in the fallopian tubes.
There are complications in the form of uterine fibroids, then additionally appointed absorbable drugs that help reduce its size. In particularly advanced cases, surgery is performed, which helps to improve the patency of the fallopian tubes or remove the ovaries if they are completely defeated.
Adnexitis can be successfully treated with homeopathy without antibiotics. To do this, you need to consult a homeopath for the selection of individual drugs.
As an addition to the main treatment, you can use herbal remedies for herbs that will help to achieve the maximum result of treatment. If you chose a recipe for yourself. Be sure to consult with the doctor who treats you.
As an anesthetic and anti-inflammatory agent, microclysters of chamomile and hypericum are used. To do this, use the decoction of the plant infused for at least 20 minutes, after which it must be drained and cooled to room temperature. Before the procedure, a cleansing enema is first performed, and then a syringe with chamomile and a hunter is introduced into the anus. A woman should lie on her side until the infusion is fully absorbed. After this procedure, the pain is significantly reduced. The treatment is carried out every evening for 1 week.
Very effective aloe juice with honey to reduce the inflammatory process. Intake is carried out on 1 dessert spoon in the ratio of 1: 1 three times a day before meals. The course of treatment is at least 7 days.
As anti-fever and hemostatic agent can be used infusion of bedstraw. For this you need 2 tsp. crushed plants pour a glass of boiling water and insist 3 hours. Take the tool must be hot for half a glass at a time at least 4 times a day, so before each appointment it is necessary to warm it. The course of therapy is 20 days.
To relieve inflammation spend syringing boron uterus or wormwood. To do this, make an infusion of herbs for 2 hours, then diluted with boiled water 1: 1 and carry out the procedure. Treatment is 7 days.
As a gentle therapy, you can use sea buckthorn oil tampons, which are inserted into the vagina overnight. It helps relieve pain and inflammation. Repeat the procedure is necessary for 1 week. As such, you can apply and propolis with honey.
Adnexitis or thrush is most dangerous in the first weeks of pregnancy, therefore at the first signs of it you should consult a doctor.
Treatment in such cases is carried out in the hospital with antibiotics, which are valid during this period. Lack of timely treatment can have serious consequences for the newborn.
To prevent the reappearance of the disease, you must follow the rules:
• use natural cotton linen,
• be protected during sex,
• avoid accidental connections,
• avoid hypothermia,
• to balance physical activities with rest periods,
• engage in sports to strengthen the immune system.
As a recommendation after discharge, doctors advise to go to a sanatorium and undergo an additional course of rehabilitation. If mud therapy is not contraindicated, it can strengthen the body and increase the periods of remission in chronic form.
It is also necessary for parents to explain to children, especially girls, how important it is to dress according to the weather and not to allow hypothermia, since living healthy is much more exciting. In addition, you need to hold a lecture with the child, which describes the whole danger of the transferred Adnexitis for the female body and how much it costs to make an effort in the end to restore health. If you want to find out if you can get thrush from a man, go here.
Adult women are advised to use Kegel exercises or Norbekov exercises to restore their health.
Watch a video about the pelvic floor muscles - why you need to train:
Adnexitis is now considered the most common female disease. The lack of timely treatment very often causes the development of more serious health complications and eventually leads to: aggravation of the adhesions, formation of uterine fibroids and further increase in its size, as well as premature onset of postmenopausal women, endometritis, dysplasia 1,2,3 degrees, nodular fibromyoma and infertility. You do not need to suffer or search for a solution to the problem on the forums, you need to consult a doctor and undergo a qualitative course of treatment that will help to get rid of the pathology for good.
Adnexitis is a disease that requires mandatory treatment, otherwise very serious consequences may occur.
What is dangerous chronic form of pathology?
The danger of sluggish process lies in its unpredictability. One day, sharp pains can begin, and, as a result, the transition of the chronic to the acute stage. Such an attack ends with the hospital, as this pathology is treated in the hospital.
However, more often chronic adnexitis lasts for years. A woman can plan a pregnancy and not understand why there is no conception. The disease can disappear arbitrarily, if certain factors contribute to this:
- healthy lifestyle
- careful personal hygiene
- light sports
- no messy relationship
- absence of bronchitis, pneumonia
- sex with a clean partner.
Chronic stage development
First, the infection enters the lower part of the genital organs, but in the presence of provoking factors - in the uterus and appendages. Also, bacteria penetrate from the upper respiratory tract, intestines, gall bladder, if they have inflammation. That is why it is necessary to carry out the treatment of chronic adnexitis before the development of complications.
It is easier to control the appendages of the uterus, when the sluggish stage occurs after the untreated acute form, since the woman already knows about her diagnosis. In this case, it is better to undergo a diagnosis at will, rather than wait for a referral from a doctor. It should also be remembered that the chronic stage often develops on its own.
With this disease, conception may occur, but there is a high probability of ectopic pregnancy. The ovum cannot pass through the "corridor" of the fallopian tube into the uterus. On her way there are scars, adhesions, which are formed after the treatment of acute or in the process of complications of the chronic stage.
How does the sluggish process develop?
Chronic adnexitis develops after microbial damage to appendages or nearby organs. The disease may occur after pregnancy, childbirth, if an infection gets into the uterus. In this case, endometriosis is possible, and then, as a result, salpingo-oophoritis. Signs of sluggish adnexitis are almost imperceptible. At the same time, the bilateral process shows more pronounced symptoms, because pathology develops from 2 sides of the uterus:
1. The aching pain in the lower abdomen, from weak to pulsating, noticeable. Almost always pass independently.
2. Pains appear in the middle of the cycle. This distinguishes chronic inflammation of the appendages from many pathologies of the uterus. This symptom has an explanation: adhesions do not allow the egg to exit the fallopian tube in the middle of the cycle.
3. Cycle failure: menstruation goes plentifully, with a significant delay.
4. Pain during sexual intercourse. Manifested not in the place of inflammation, but in the area of the entire small pelvis.
ICD disease classification
According to the International Classification of Diseases ICD 10, chronic adnexitis has a statistical code N70.1. The disease is included in a document entitled: Chronic salpingitis and oophoritis. It explains the essence of the chronic form of the uterus, which combines inflammation of the tubes (salpingitis) and ovaries (oophoritis).
In ICD 10, the disease is listed in the subsection Salpingitis and Oophoritis, which has the code N70. This subsection in ICD 10 is divided into 3 parts according to the forms of this pathology:
Due to the fact that the features of the development of pathology have differences, ICD 10 classifies them as separate diseases in their group. Section N70 is included in the category “Inflammatory diseases of the female pelvic organs”, which includes codes N70-N77. The entire section devoted to these pathologies is included in the rubric “Diseases of the urinogenital system”, which includes codes N00-N99.
The ICD code N70.1 includes all varieties of chronic salpingoophoritis:
- unilateral (left or right)
This classification allows for the ICD 10 code to learn about the diagnosis: chronic salpingo-oophoritis, if it is marked in the medical record. It should be noted that the ICD performs only the analysis, classification, interpretation of diseases, but does not include treatment instructions.
How is the chronic stage treated?
Chronic 1, 2 third-party adnexitis, like other stages of this disease, is treated with antibiotics. They are assigned according to the cause of the infection. This is an important factor, since the doctor prescribes certain antibiotics for a specific type of germs.
When appointing, the following data are taken into account:
- degree of neglect of the process of inflammation
- age, weight of the patient
- place of treatment (outpatient, inpatient).
Antibiotics at the chronic stage
Most often, chronic inflammation of the appendages is a consequence of the penetration of bacteria transmitted from the sexual partner. Then appropriate antibiotics are written out. For example:
- one- or bilateral form caused by chlamydia, mycoplasmas, then erythromycin is prescribed
- cause of inflammation - gonococci, ceftibuten (cedex) antibiotic is prescribed.
More modern drugs: ciprofloxacin, zanocin. These antibiotics make it possible to achieve good results with a decrease in the dose and duration of the course. The preparations are rather effective in the case of stopping the exacerbation of chronic adnexitis and preventing the transition of the disease to the acute stage. These drugs are also used for other forms of adnexitis.
Is pregnancy possible?
If a woman is planning a pregnancy, taking antibiotics should be carried out according to the scheme prescribed by the doctor. Do not exceed the dose, stop treatment early. It should be noted that the chronic stage reduces the chances of getting pregnant, as the process is permanent. Adhesions and scars are characteristic of the sluggish stage, even when symptoms do not appear. However, this only aggravates the situation, because the treatment is not carried out, and sterility develops.
One day, as a result of a long sluggish process, an exacerbation of chronic salpingo-oophoritis may occur, due to which the pathology will pass to other organs of the pelvic peritoneum. That is why pregnancy planning should be carried out with the simultaneous diagnosis of uterine appendages on modern equipment.
Sometimes, laparoscopic surgery is performed to restore the lumen in the tubes. However, the chances of getting pregnant do not increase by 100% even after such an intervention. In this medicine, there are cases when a woman managed to get pregnant after treating this pathology. It is important to complete the entire course of recovery.
Chances and dangers of possible conception
If the form of bilateral adnexitis is diagnosed, the chances are less than that of one third-party. At the same time, much depends on the pipe’s patency, but with exacerbation of chronic adnexitis, the chances fall many times. However, if the egg can pass between scars, it will fall into the uterus and be fertilized by the spermatozoon. The spermatozoon itself can also enter the fallopian tube and fertilize the egg cell in it.
This point is dangerous ectopic pregnancy, which leads to urgent hospitalization and, often, to the loss of the fallopian tube. However, if paired appendages of the uterus remain, the chances of becoming pregnant are very high. It is important to control the state of the appendages, to undergo treatment of chronic 1-sided salpingo-oophoritis.
Until now, the question is: is it possible to cure chronic adnexitis? - there is no single answer. Modern drugs are able to cope with inflammation, but the consequences are largely dependent on the woman. The sooner attention is even paid to mild symptoms, the more likely it is to live with healthy uterine appendages.
Adnexitis: what is it in women
Inflammation of the fallopian tubes and ovaries almost always begins simultaneously. After examination, the doctor can diagnose inflammatory diseases of the uterus. In the predominant majority of cases, salpingitis initially develops, in which the fallopian tubes are affected, the infection quickly spreads to the ovaries, provoking the appearance of oophoritis.
Salpingo-oophoritis is considered one of the most common inflammatory diseases of the female reproductive system. Endometritis, an inflammation of the uterus, is simultaneously found in some patients.
Depending on the nature of the flow, acute or chronic salpingo-oophoritis is isolated. In the acute form of adnexitis, there are pronounced symptoms of increased inflammation of the appendages. In chronic salpingo-oophoritis, the characteristic clinical picture occurs only during exacerbation.
Adnexitis: ICD code 10
According to ICD 10, salpingoophoritis is assigned the code N70:
- N0 - in acute infectious and inflammatory disease,
- N1 - with chronic oophoritis and salpingitis,
- N9 - with unspecified form of salpingoophoritis.
Also, code N70 is assigned for abscesses of the fallopian tubes, ovaries, pyosalpinx, and tubo-ovarian inflammatory process.
The classification of salpingoophoritis
Experts classify adnexitis according to the following parameters:
- nature of the disease (chronic, acute)
- place of origin (left-side, right-side),
- features of flow (serous, purulent).
An accurate diagnosis is established after a survey and examination of the patient.
In uncomplicated conditions, the symptoms of inflammation of the appendages can disappear in 10 days. But improvement does not mean healing. Salpingo-oophoritis becomes subacute. The severity of discomfort gradually decreases, the state of health improves.
But recovery does not occur, inflammation of the appendages becomes chronic. When immunity is weakened, hypothermia, or other provoking factors appear, symptoms of ovarian inflammation in women can regularly appear.
Symptoms in chronic salpingoophoritis are practically absent. The general condition of a woman with sluggish inflammation of the appendages is assessed as satisfactory, only in some patients the temperature stays at 37-37.2 ° C.
Chronic adnexitis provokes menstrual disorders. Most often it leads to algodysmenorrhea or oligomenorrhea. With algomenorrhea menstruation is characterized by increased pain, and with oligomenorrhea, they are characterized by a decrease in the amount of discharge.
Acute inflammation of the uterus on both sides leads to the appearance of severe symptoms of the disease. Pain occurs in both the left and right parts of the abdomen. Bilateral adnexitis develops under the condition that pathogenic microflora has entered both pipes, from which the infection has spread to the ovaries.
Наиболее опасной считается ситуация, при которой развивается двухстронний хронический сальпингоофорит. It provokes the development of infertility, because in this pathological process 2 pipes are impaired and become impassable at the same time.
If inflammation of the appendages is observed on the one hand, the gynecologist diagnoses left-sided or right-sided adnexitis. The causes of salpingoophoritis on the left and on the right are not always the same.
With acute unilateral salpingoophoritis, the prognosis is favorable. If appropriate treatment is prescribed in a timely manner, there will be no negative consequences from the disease.
In right-sided inflammation of the appendages, the process is localized in the right fallopian tube and spreads to the right ovary. The development of salpingoophoritis can provoke intestinal, tubercle bacilli, chlamydia, fungal diseases, appendicitis.
Adnexitis leads to swelling of the fallopian tube and impaired blood circulation. Due to the defeat of the muscle tissues, the appendages begin to thicken, deform, and adhesions form. Right-sided adnexitis can lead to secondary appendicitis.
A common cause of salpingoophoritis on the left side is inflammation of the large intestine located on the left. Infection is also possible with influenza, pneumonia, sore throat.
Inflammation of the appendages on the left side leads to edema of the internal mucous membrane, redness, and ulceration on the surface. The lack of timely treatment can cause a violation of the patency of the left tube.
Inflammation of the ovaries in women: causes
Isolated ovarian oophoritis is rare. Most often, salpingitis provokes the development of oophoritis, as a result, the gynecologist, upon examination, diagnoses salpingo-oophoritis. Among the causes of the development of inflammation of the appendages are called:
- pathogenic organisms - chlamydia, trichomonads, gonococcus, tubercle bacillus, mycoplasma,
- activation of conditionally pathogenic flora - streptococcal, fungal, E. coli, staphylococcal,
- surgical interventions (abortions, medical and diagnostic interventions),
- use of intrauterine devices.
Most often, salpingo-oophoritis develops due to the ingress of pathogenic microorganisms into the cervical canal, uterus. The infection gradually passes from the uterine cavity to the tubes. Initially, the inner mucous layer is affected, then the muscular and serous layers are involved in the process.
Inflammation of the appendages in women: symptoms
Depending on the location of the inflammatory focus, the nature of the course and the individual susceptibility of the woman, the symptoms of adnexitis may vary.
In the chronic form of the pathology, mild persistent abdominal pain is observed. Women describe them as aching. A characteristic sign of salpingoophoritis is the presence of scanty discharge. Patients with diagnosed inflammation of the appendages complain of painful intercourse.
Violations of menstruation are a characteristic feature of chronic salpingoophoritis. Patients complain of increased pain, changes in the amount of discharge and a violation of the regularity of the cycle. Inflammation of the appendages can lead to deterioration of the ovaries. As a result, the process of production of female sex hormones is broken.
Signs of acute inflammation of the appendages and ovaries in women include:
- a sharp deterioration in health with increasing temperature above 38 ° C,
- heart palpitations
- groin pain,
- the appearance of abnormal vaginal discharge,
- increased urination.
Heart palpitations, worsening of well-being are common symptoms characteristic of all inflammatory diseases. A sign of adnexitis is a gradual increase in discomfort in the lower abdomen, the pain begins to give in the anus, coccyx.
Localization of sensations depends on the side of the inflammation. Their appearance is due to the fact that the inflamed fallopian tube swells and begins to irritate the peritoneum, penetrated by many nerve endings. With an increase, it can begin to put pressure on adjacent organs, this provokes increased pain.
With active infectious-inflammatory process appear abundant vaginal discharge. Gonococcal salpingo-oophoritis provokes the appearance of pus, and trichomonas gives rise to frothy discharge. In parallel, there is pain, burning, itching in the genital area, the discomfort increases after urination.
If a woman has chilled the appendages, then there may be abundant mucopurulent discharge. They will consist of mucus, epithelial uterine cells and bacteria.
If an inflammation of the appendages is suspected, a complete diagnosis should be carried out. It includes:
- examination by a gynecologist,
- Ultrasound of the pelvic organs,
- treatment and diagnostic laparoscopy,
- use of radiopaque methods
- examination of cervical smear.
All diagnostic procedures are optional. Tactic examination is chosen by the doctor.
Inflammation of the appendages: treatment
To get rid of adnexitis, the doctor may prescribe special medications, surgery, recommend traditional methods of therapy. Often used drug treatment adnexitis, aimed at getting rid of the infection, reducing the severity of inflammation and improving the performance of the body's defenses.
Antibiotics are prescribed for salpingo-oophoritis. They help to get rid of pathogenic microflora, due to the activation of which developed inflammation of the appendages. For purulent adnexitis, cephalosporins and aminoglycosides are used. For the treatment of diseases caused by chlamydia, use of antibacterial tetracycline and macrolides. In other cases, penicillin antibiotics are prescribed.
In parallel, use of anti-inflammatory drugs: Paracetamol, Nurofen, Butadione. Special attention is paid to vitamin therapy and the use of immunostimulants.
If conservative treatment turned out to be ineffective or pus has accumulated in the area of the appendages, tumors have appeared, prescribe surgery. Surgical intervention allows to remove the formed adhesions, restore the lumen in the fallopian tubes, eliminate purulent foci of inflammation and examine the tumor.
It is impossible to ignore the need to treat appendages when women develop symptoms of inflammation. Treatment is necessary to prevent the development of infertility. Adnexitis can cause:
- impaired patency of pipes
- ectopic implantation of the egg after fertilization,
- sexual dysfunction,
- spontaneous abortion,
- activation of the inflammatory process of other organs - colitis, cystitis, pyelonephritis.
Prevention of inflammation of the appendages
To prevent the development of salpingoophoritis, it is necessary to prevent the possible influence of negative factors. Women are recommended:
- do not supercool
- follow the rules of hygiene genitals,
- avoid sexual intercourse with unverified partners,
- follow all the recommendations of doctors after childbirth, abortion, miscarriage,
- timely treat various inflammatory diseases.
It is important to regularly visit a gynecologist.
Adnexitis can develop at any age, but most often women in their 20–35 years experience inflammation of the appendages. When signs of pathology appear, you should consult a doctor to clarify the diagnosis and prescribe a suitable treatment. Only with timely treatment can the development of complications be prevented. You can understand the cause of the pathology, the symptoms of the disease and find out what tactics of treatment gynecologists use from the video
Causes and types of adnexitis
Adnexitis, as a rule, develops on the background of infection penetration into one of three interconnected organs (uterus, ovaries or fallopian tubes). The cause of infection is pathogenic microorganisms, bacteria, viruses - strepto-staphylo-, gono-and enterococci, chlamydia, ureaplasma, E. coli and others.
Depending on the type of infection, the following types of ovarian adnexitis are distinguished according to ICB 10:
- Nonspecific inflammation of appendages provoked by genital pathogens and opportunistic microflora (various types of cocci). As a rule, such an infection penetrates the fallopian tubes and ovaries in an ascending way from the vagina (for example, during unprotected intercourse).
- Specific adnexitis develops on the background of gonococcal, diphtheria or tuberculosis infection, which penetrates through the circulatory and lymphatic systems.
The inflammatory process can also develop in a downward way, falling into the fallopian tubes and ovaries from distant lesions (for example, tonsillitis, purulent tonsillitis, pulmonary tuberculosis).
The presence of infection in the body does not always lead to the development of adnexitis, the disease provokes a number of predisposing factors:
- weakening of the immune system
- the presence of a secondary infection,
- exacerbation of chronic tonsillitis, tonsillitis,
- abortion, scraping and other operations on the uterus,
- the establishment of the Navy,
- unprotected intercourse,
- stress and overwork.
At risk are women who are sexually active with several partners at the same time, as well as patients after a recent infectious gynecological disease (in particular, chlamydia, trichomoniasis, and others).
Dangers and possible complications
Left-sided and right-sided adnexitis according to MKB 10 can occur with hidden symptoms (subacute form), which makes timely diagnosis and treatment difficult. The neglected form of the disease leads to the formation of adhesions in the fallopian tubes, thereby hindering the successful fertilization.
Purulent inflammation of the appendages is characterized by the formation of specific "pockets" filled with serous fluid. This condition is called Saktosalpinks. The accumulation of pus in the ovaries can lead to their abscess. If the infection spreads to nearby pelvic organs, inflammation may occur in the area of the peritoneum, peritonitis, and so on.
Late and inadequate treatment of right-sided or left-sided adnexitis of the ovary increases the risk of ectopic pregnancy, leads to problems with conception, in some cases even provokes infertility.
Timely treatment of acute and subacute forms of inflammation leads to rapid recovery of the patient with the lowest risk of recurrence. As for chronic adnexitis, it is difficult to treat and often faces serious complications for women's health.
A timely appeal to the gynecologist and an adequately selected treatment allows to cure the right-sided and left-sided adnexitis of the ovaries without complications and consequences. The neglected form of the disease threatens dysfunction of the appendages, problems with the menstrual cycle, disorders of sexual and reproductive function.
Adnexitis: disease code according to ICD 10 1
Among the inflammatory diseases of the female reproductive system, the first place firmly belongs to adnexitis. The disease usually affects not only the fallopian tubes, but also the ovaries. Therefore, the adnexitis code in ICD 10 has No. 70, which includes salpingitis and oophoritis at the same time.
Read in this article.
What happens with the disease?
Under the influence of infection-friendly factors, inflammation captures the mucous coating of the fallopian tube. Gradually, its walls are involved in the process in layers, due to which a serous fluid appears in the lumen. This is salpingitis.
Since the fallopian tubes are connected to the ovaries, inflammation is rapidly spreading to them. The infection is located on the epithelial covering, from which when the germ cell leaves the gland.
Ways of infection
The uterine appendages are a highly vulnerable part of the reproductive system. To get the disease in several ways:
- Infection through blood in genital tuberculosis,
- Leaking agents through the lymphatic system,
- Ascending, that is, the relocation of bacteria from the infected kidneys, lungs, even the throat,
- The spread of the lower parts of the reproductive system.
Adnexit MKB 10 does not divide by this principle. However, the reason for the disease is of decisive importance in the treatment and prevention of relapse. They are distinguished by the type of infectious agents, dividing salpingoophoritis into:
- Specific, that is, caused by the fault of gonokkovye, tuberculosis or diphtheria infections,
- Nonspecific, which are provoked by venereal diseases or opportunistic pathogenic flora present in a healthy body.
Causes of development
Non-specific cases of the disease are more common. But for any of its origin, appropriate conditions are needed under which adnexitis is more likely:
- Ailments that do not affect the reproductive organs (pyelonephritis, often recurring sore throats),
- Psychological shocks that affect the balance of hormones, immunity and vaginal microflora,
- Wrong lifestyle, weakening resistance to infections,
- Ignoring hygiene requirements
- Surgery and other medical manipulations on the uterus (curettage, hysteroscopy, abortion),
- Frequent change of sexual partners.
Salpingoophoritis ICB 10 allocates a special section, if unknown causes of infection in this area of the reproductive system. This is N 70.9, describing the unspecified types of illness.
The disease can settle on one side of the system, in the right or left appendage. When running, it captures both.
Acute course of the disease
No less important, which salpingo-oophoritis code for MKB 10 is due to the duration and symptoms of the disease. These points are reflected in the classification, as they also determine the method of treatment.
When the infection first enters the body, the bacteria develop vigorous activity. The disease has an acute course, that is, clear signs of trouble, forcing to go to a specialist. Moisture is collected in the fallopian tube, causing the appearance of sacs with serous fluid. Sometimes cavities are filled with pus.
Acute adnexitis, code in ICD 10 No. 70.0, lasts up to 7-10 days and has the following manifestations:
- Severe pain in the lower segment of the abdomen, extending into the sacrum and aggravated by pressure. If the inflammation has developed in the right appendage, the sensations are similar to appendicular colic, as radiating to the intestine. When the infection affected the organs on the left, the pain worries from this side, giving to the lower back,
- Vaginal discharge purulent character. If they coincide with menstruation, they change the color of the bloody mucus,
- Increased body temperature, fever, muscle cramps,
- Nausea, repeated vomiting,
- Problems with urination, pain during the process.
Chronic adnexitis code for ICD 10 received under the number 70.1. Such a course of illness is caused by incorrect or incomplete treatment, as a result of which the disease subsides, but does not go away. Chronic adnexitis occurs when the circumstances provoking it increase.
Identifying this form is more difficult than acute, as there may be no obvious symptoms. And yet they really detect them:
- Periodically disturbing pain in the abdomen, responding to the lower back and hip. Stronger they appear before critical days, under stress,
- Lethargy, general malaise,
- Changes in the passage of menstruation. Allocations become more scarce, the intervals between critical days increase markedly. At the same time, mucus with non-menstrual blood is also noticed.
Disturbance of the menstrual function often becomes an assistant in diagnosing a diagnosis. Long delays mean that the infection impedes the maturation of the egg, therefore making conception impossible. Infertility is not only one of the signs of salpingoophoritis, but also a serious consequence, which is more difficult to eliminate than getting rid of the acute form of the disease.
We recommend reading the article on monthly with adnexitis. You will learn about the effects of the disease on the menstrual cycle and the nature of the discharge, methods of treatment and restoration of the reproductive system.
Ovarian adnexitis - what is it?
Ovarian adnexitis is a disease that affects the body of the fair sex and is associated with the development of the inflammatory process in the tubes of the uterus or ovaries.
According to statistics, the inflammation of the appendages of the ovaries or fallopian tubes is detected by gynecologists in every 4th woman. In addition, the representatives of the weaker sex need to know about the sad statistics. Doctors of gynecological departments call adnexitis in a review of one of the causes of infertility. In 60% of cases, the ailment goes into the chronic stage and practically cannot be treated. To avoid difficulties in conceiving a child, a woman should pay attention to problems with the urogenital system in time.
The diagnosis of adnexitis and what it is for women is established by a gynecologist. Due to the fact that the female body has 2 ovaries and 2 appendages (left and right), there are, respectively, left-sided and right-sided adnexitis.
Infertility and adnexitis - what is it and how are these pathologies related?
A woman should especially carefully monitor the state of her health and not delay with the treatment of adnexitis. Ей стоит помнить о том, что данная болезнь при отсутствии терапии приводит к бесплодию.
Understanding the question of what adnexitis in women, it should be said about the main danger of pathology. The illness is almost asymptomatic, so it is very difficult to identify it and start timely treatment. Adnexitis, if not treated, leads to the development of a variety of complications. These include, for example, adhesions in the fallopian tubes, as well as between them and the neighboring organs (uterus, bladder, intestines, epiploon).
If adnexitis becomes purulent, purulent masses gradually accumulate in the fallopian tubes. Because of them, bags are formed, filled with pus or serous fluid. Sometimes an infection from the ovary or fallopian tubes penetrates the peritoneum, provokes the development of inflammation, the formation of an abscess or peritonitis.
Uterus and adnexitis: before and after treatment
The main task of the doctor is to determine when the disease is adnexitis, from which the pathology originated. Taking into account the causes of the disease specialist develops a treatment regimen. For patients, the question of the state of the uterus with adnexitis before and after therapeutic intervention is the most relevant and important.
The inflammatory process in the uterine appendages is accompanied by vivid clinical manifestations. The pain is localized in the lower abdomen on one or two sides on the sides. From this area, the pain syndrome is projected on the lower back, labia, anus, coccyx, thigh or perineum. The lymph nodes in the groin are often enlarged (they become painful, bulging markedly above the skin). When purulent adnexitis in women, the temperature rises to 38-39 ° C (it normalizes in the morning, and reaches high levels in the late afternoon or at night). Patients with such a diagnosis complain of constant nausea or vomiting, have a strong thirst or dry mouth, they lose their appetite, and if a woman smokes, she has a strong aversion to tobacco products against the background of adnexitis. Localization of pain is observed in the lower abdomen, with body movements, it becomes more pronounced. Women with purulent adnexitis have increased emotionality, they are worried and cry without cause. Consciousness becomes confused, there are headaches, urination - weak and painful, purulent discharge from the genital organs appears.
Chronicity of adnexitis has mild signs or proceeds without any symptoms at all. Sometimes women with this pathology complain of aching pain in the lower abdomen, aggravated before the beginning of menstruation. If the body is turned sharply, the pain in the abdomen becomes acute. Increased pain occurs during sexual intercourse, when a partner makes sudden movements.
Treatment of the acute form of adnexitis is carried out by conservative methods. An experienced doctor knows well where and how adnexitis hurts a woman, and based on the results of the examination, he quickly diagnoses the disease. The course of therapy is carried out with the use of antibiotics. In the formation of tubo-ovarian education, in most cases, patients are recommended to undergo surgery, because conservative treatment is long and may not give a positive result. During surgery, the affected areas of the fallopian tubes are removed.
Adnexitis is among the serious pathologies, and therefore requires an integrated approach for its treatment. Therapy is based on the use of antibiotics, antimicrobial drugs, immunomodulators. The main drug complex complement the course of vitamin therapy. Vitamins are selected by the gynecologist individually. They can be injected into the patient’s body by injection or by taking capsules or tablets.
Diagnosis of adnexitis in patients is carried out in a hospital. Ultrasound is necessarily performed, bakposev is taken from the vagina, a complete blood count is done. During the differential diagnosis of adnexitis, a specialist separates the disease in question from illnesses with similar symptoms (acute appendicitis, endometriosis, diseases of the genital organs, ovarian cyst). In severe cases, consultation with a surgeon is necessary. The international classification of diseases (ICD) helps to differentiate a disease, describe its symptoms and assign the correct treatment to a doctor.
The international classification of diseases was invented to systematize and correctly analyze data on various diseases of human organs and systems. Adnexitis, which gynecologists call the most common inflammatory disease, affects the reproductive system of the female body. The disease violates the integrity of the fallopian tubes and ovaries, therefore, in ICD 10, adnexitis contains information in the form of several different codes.
Causes of adnexitis
The cause of adnexitis is infection in the uterine appendages. This can happen in two ways, ascending and descending. Ascending is the genital route of infection to the appendages when, as a result of penetration into the external genital organs, the infectious agent penetrates the ovaries and fallopian tubes through the vagina and uterus. The descending path is the penetration of infection into the region of the appendages from the primary inflammatory focus present in the body with blood or lymph flow.
The most common causative agent of adnexitis is urogenital infection, or abbreviated IGO. This is a group of microorganisms, united by the primary way of infection, namely sexual. These include gonococci, trichomonads, mycoplasmas, ureaplasmas and some other pathogens. Infection in a descending way is caused, as a rule, by streptococci or E. coli.
The most important condition for the occurrence of adnexitis is the weakening of general and local immunity: an infectious disease that was postponed the day before, hypothermia, failure to follow personal hygiene rules, unprotected sex with doubtful partners, and other manifestations of an unhealthy lifestyle. Psychology of relations between the sexes should exclude such contacts.
Symptoms of adnexitis
Symptoms of adnexitis depend on the acute or chronic form of the disease.
Symptoms of adnexitis in acute form: the appearance of severe pain in the lower abdomen, with the right or left side. The pain is strong, aching and pulling in nature, can give to the sacrum, lower back, rectum. Vaginal secretions of serous (in the form of blood) or purulent character appear. Acute adnexitis is accompanied by a sharp deterioration of the general condition, fever, headaches, muscle and joint pain, and fatigue appear.
In the absence of adequate treatment, adnexitis becomes chronic. Often there is a primary chronic adnexitis, not having a pronounced acute form. Symptoms of adnexitis in chronic form are less pronounced, especially common manifestations. The main symptom of chronic adnexitis is nagging pain in the lower abdomen, less intense than with acute adnexitis. They appear periodically, usually before menstruation or after it. A sign of chronic adnexitis are also painful sensations during intercourse (dyspareunia).
Since adhesions are characteristic of chronic adnexitis and structural disorders in the tissue of the appendages, menstrual irregularities appear: amenorrhea, oligomenorrhea, dysmenorrhea, etc. flow. Sometimes chronic adnexitis can be asymptomatic, and the disease is detected during examination for infertility. Infertility due to impaired ovarian function or obstruction of the fallopian tubes is a frequent symptom of adnexitis in chronic advanced form.
Diagnosis of adnexitis
Establishing the correct diagnosis for adnexitis is quite complicated, since the symptoms of acute abdomen, characteristic of adnexitis in the acute form, are characteristic of many acute diseases of the pelvic organs, and the symptoms of adnexitis in the chronic form are usually not expressed.
As a diagnosis of adnexitis, a gynecological examination is carried out, including laboratory analysis of vaginal secretions, blood and urine tests, including urine counting. Detection of microorganisms typical for adnexitis in the urine and vaginal contents may indicate the presence of adnexitis, but still these signs are not specific, as well as signs of an inflammatory reaction of the body, detected in the blood.
Some symptoms of chronic adnexitis can be detected by ultrasound.
The exact method of diagnosis, eliminating the error, is laparoscopy, which is used in doubtful cases. This endoscopic study allows visualization of the fallopian tubes and ovaries and directly detecting signs of inflammation: accumulations of pus and serous effusion, inflamed mucosa in acute adnexitis, and adhesions with changes in the structure of the appendage tissue in chronic adnexitis.
Treatment of adnexitis in an acute form requires hospitalization, since acute adnexitis is fraught with serious complications: purulent fusion of the ovaries, the formation of purulent cavities in the pipes (piosalpings), peritonitis, etc. Bed rest is prescribed, anesthesia is performed both with the help of medicines and by applying an ice bubble to the area of the affected appendage. Broad-spectrum antibiotics and anti-inflammatory drugs are prescribed to relieve inflammation. When a purulent process is detected, surgical treatment of adnexitis is applied: the accumulation of pus is evacuated by means of laparoscopic access, antibacterial drugs are injected directly into the affected area.
Treatment of chronic adnexitis is carried out according to a similar scheme, but antibacterial drugs are selected based on the sensitivity of the pathogen, corticosteroids are prescribed as anti-inflammatory drugs, general strengthening and immunostimulating therapy is carried out. The physiotherapeutic treatment of adnexitis is indicated: mud therapy, paraffin therapy, magnetic therapy, microwave and UHF therapy, etc.
Folk treatment adnexitis
The folk treatment of adnexitis is used quite widely, especially it is justified in chronic adnexitis. The popular treatment of adnexitis in the acute form is not recommended, as there is a high risk of severe, life-threatening complications or the transition of acute adnexitis to chronic.
As folk treatment of adnexitis, decoctions and extracts of medicinal herbs of anti-inflammatory action are used, which are used for douching, enemas or baths. Pharmaceutical chamomile, St. John's wort, string, sage, calendula, calamus, Kalanchoe juice, eucalyptus, Caragana drug, yarrow, golden mustache and others have such an effect.
As a general tonic and immunostimulating folk treatment of adnexitis, orally ingest aloe juice (pure or 1: 1 with honey), echinacea purpurea infusion, ginseng infusion, mummy, as well as honey and other beekeeping products.
People's treatment of adnexitis, occurring in a chronic form, can be carried out parallel to the drug or during periods of remission, which allows to reduce the drug load on the body.
What is this disease?
Chronic adnexitis according to the ICD 10 code in the International Statistical Classification of Diseases and Problems Related to Health is assigned the number 70.1 (manifestations of chronic salpingitis and oophoritis). The disease develops after penetration into the organs of the reproductive system of pathogenic microorganisms of different origin: bacterial, viral, fungal.
As a result of their growth and active reproduction in the ovaries and fallopian tubes, which form the uterus, an acute inflammatory process occurs. In the absence of qualified medical care, he quickly takes a latent course.
When hypothermia, frequent stressful situations, depressive states, the pathology recurs due to the reactivation of bacteria or viruses. According to the International Classifier, such an exacerbation of chronic adnexitis is assigned a code of ICB 10 No. 70.0, and with an unspecified diagnosis No. 70.9. Infection of a woman with tubercle bacilli or gonococci causes bilateral inflammation of the appendages. In this case, the patient is hospitalized for inpatient therapy. And penetration into the reproductive organs of Escherichia coli and Staphylococcus provokes the development of the most frequently diagnosed disease. This is a chronic left-sided adnexitis, or inflammatory process, occurring in the left appendage.
Important: Streptococci, enterococci, mycobacterium tuberculosis, intestinal sticks are most often the causative agents of pathology. Often, the development of chronic adnexitis is provoked by microbial associations, for example, E. coli and staphylococcus. ”
The beginning of its development is the defeat of the infectious agent of the mucous membrane of the uterus, and then destructive-degenerative changes affect:
- serous layer
- smooth muscle muscles
- epithelium of the ovaries,
- pelvic peritoneum.
After the release of the egg into the fallopian tube as a result of the rupture of the mature follicle, the pathological process rapidly develops in the ovary. Thus, untreated chronic adnexitis in women is inflammation, leading to the formation of numerous adhesions that reduce the functional activity of the fallopian tubes, including the degree of their patency.
Symptoms and treatment of chronic adnexitis are closely interrelated. In case of a sluggish process with a blurred symptom, conservative methods are used to prevent relapse and destroy infectious pathogens. And exacerbations are manifested by a pronounced clinical picture that requires an integrated approach to treatment. Symptoms of chronic adnexitis include:
- frequent occurrence of lower abdominal pain of varying degrees of intensity, which extend to the lumbar and gluteal region, and sometimes the thigh,
- psycho-emotional instability, manifested in excessive irritability, nervousness, insomnia, depressive state,
- autonomic disorders, most often a disorder of the gastrointestinal tract.
The severity of pain increases on the background of hormonal changes, during stressful situations and respiratory pathologies. Symptoms and characteristic signs of chronic adnexitis are also menstrual disorders - menometrorrhagia, hypomenstrual and premenstrual syndromes that accompany anovulation or insufficiency of the corpus luteum. The tubo-peritoneal factor and ovarian steroidogenosis, developed due to the inflammatory process, often provoke problems with conception. And the adhesions formed in the fallopian tubes significantly increase the likelihood of ectopic pregnancy. Neurological disorders and autonomic disorders in combination with frequent relapses cause a decrease in libido.
Exacerbation of chronic adnexitis is complicated by symptoms of general intoxication of the body. When exposed to external or internal negative factors, there is an active reproduction and growth of infectious agents, accompanied by releases into the systemic circulation of their metabolic products. Toxic organic compounds provoke the following symptoms:
- temperature rise above subfebrile values (38.5 ° C),
- fever, chills, profuse sweating,
- weakness, apathy, fatigue,
- headaches, dizziness,
- dyspeptic disorders - nausea, vomiting, motility disorders.
On the background of hyperthermia from the vagina can be mucus with impurities of pus. When an abscess increases the probability of rupture of the fallopian tubes, penetration of purulent mass into the peritoneal cavity.
Note: Chronic adnexitis is often accompanied by a decrease in the body's resistance to infectious agents. Therefore, several months later, a woman develops vaginal and (or) intestinal dysbiosis, manifested in a violation of peristalsis and digestion.
Inflammation of the appendages during pregnancy
In accordance with the code mkb 10 №70.1 chronic adnexitis - a disease for the treatment of which is carried out intensive antibiotic therapy. Therefore, gynecologists strongly recommend that women before the planning of pregnancy to undergo a full examination to identify the pathologies of the reproductive system. This will help avoid a course of taking antibacterial drugs while carrying a child. In addition, the development of chronic disease often causes infertility as a result of obstruction of the fallopian tubes and ectopic pregnancy.
After therapy, the patient is re-examined to establish:
- the absence of pathogenic microbes and viruses in the appendages,
- full restoration of the functional activity of all organs of the reproductive system.
If the exacerbation of left-sided chronic adnexitis occurred during pregnancy, then it is impossible to do without antibiotic therapy. Дело в том, что данная патология может спровоцировать выкидыш и внутриутробную гибель плода. Поэтому врачи незамедлительно приступают к лечению, включая в терапевтические схемы антибактериальные препараты широкого спектра действия.Daily and single dosage, as well as the duration of admission is adjusted taking into account the general state of health of the woman, the presence of pathologies in history, the duration of pregnancy. When choosing antibiotics, preference is given to those for whom teratogenic effects are not characteristic. In chronic adnexitis and pregnancy, continuous laboratory monitoring and monitoring of the patient's well-being is carried out.
Chronic left-sided adnexitis, as well as right-sided, does not require a woman to be hospitalized, provided that there are no symptoms of general intoxication of the body. A necessary condition for rapid recovery is the simultaneous administration of pharmacological preparations and the carrying out of physiotherapeutic procedures:
- magnetic therapy
- ultrasound therapy
- oxygen barotherapy.
In the treatment of all infectious diseases, including chronic adnexitis, in addition to taking medications, patients are prescribed a therapeutic diet. Pathogens grow faster and multiply in a favorable environment for them. It occurs when a woman eats foods high in fat and sugar - sweet and puff pastries, butter or butter cream. The daily menu of a patient with chronic adnexitis should consist of fresh vegetables and fruits, cereal cereals, transparent soups, lean meats and fish.
If the pathology is not accompanied by severe pain and inflammation, gynecologists recommend women to regularly engage in physiotherapy or physical exercise. This will help to normalize blood circulation in the pelvis. Restoration of optimal circulation contributes to the acceleration of metabolism and tissue regeneration. Gynecologists recommend patients with intense pain to increase the effectiveness of treatment to follow the half-bed mode to prevent the development of complications. Removal of pathogenic bacteria and viruses contributes to the daily consumption of 2-2.5 liters of fluid. It may be:
- pure non-carbonated water
- chamomile tea,
- Salted mineral waters - Essentuki №2 and №4, Borjomi, Nagutskaya, Slavyanovskaya, Narzan,
- rosehip infusion,
- fruit drinks, fruit drinks, jellies from fruits and berries.
Drinking plenty of fluids helps prevent symptoms of general intoxication of the body due to the rapid elimination from the infectious foci of the end and intermediate products of the inflammatory process.
Warning: The use of large volumes of fluid is contraindicated in the propensity to edema and the presence of any pathologies of the urinary system.
How to cure chronic adnexitis is known only to doctors of narrow specialization - gynecologists and venereologists (with gonococcal infection). Folk remedies are used in therapy only during the rehabilitation period, after the course of taking antibiotics. Herbal, bee products, vegetable oils are not characterized by antimicrobial, antiviral and antimycotic activity, therefore their use in the treatment of adnexitis is not only impractical, but also dangerous. Weak anti-inflammatory effects of folk remedies distort the clinical picture, will not allow to diagnose pathology in a timely manner.
Antibacterial agents become the drugs of first choice in the treatment of acute or chronic adnexitis. Since the duration of laboratory tests is several days, broad-spectrum antibiotics are prescribed to patients for the relief of the inflammatory process.
As a rule, such activity is characteristic of semi-synthetic penicillins, whose active ingredient is Amoxicillin.
When choosing, preference is given to combination preparations with clavulanic acid. This compound does not have any therapeutic efficacy, but is able to prevent the development of resistance to infectious agents to antibiotics. Clavulanic acid is a part of Amoxiclav, Panclav, Augmentin, Flemoklav. After establishing the species of pathogens of chronic right-sided adnexitis (left-sided, bilateral) therapeutic scheme is corrected. Most often, it includes the following drugs:
- tetracyclines (doxycycline, tetracycline),
- fluoroquinolones (Ofloxacin),
- macrolides (Azithromycin, Erythromycin, Clarithromycin),
- aminoglycosides (Kanamycin, Gentamicin),
- nitroimidazoles (metronidazole),
- lincosamides (Clindamycin).
In case of mixed infections, antibiotics are combined with antimicrobial agents, antimycotic drugs, sulfonamides. Before treating chronic adnexitis, a stage of the pathological process is established. For moderate to high severity, antibacterial agents are immediately used in the form of injection solutions to create the maximum therapeutic concentration in the inflammatory foci. After a few days, they are replaced with tablets, capsules or dragees.
Recommendation: During the reception of antibiotics, patients are prescribed eubiotics for the prevention of dysbiosis. Their use allows you to save in the biocenosis of the vagina and intestines useful lacto-and bifidobacteria.
Chronic adnexitis is considered a cured pathology if the results of laboratory tests have not revealed infectious pathogens. But it is also necessary to conduct pathogenetic and symptomatic therapy to eliminate the developed complications and improve the patient's well-being. For the relief of the inflammatory process and reduce the intensity of the signs of the disease, nonsteroidal anti-inflammatory drugs are used:
These drugs are not prescribed to patients with erosive and hyperacid gastritis, as well as ulcerative lesions of the gastrointestinal tract. To prevent ulceration of the mucous membranes of the digestive system organs, nonsteroidal anti-inflammatory drugs are combined with proton pump inhibitors - Omeprazole, Ultop, Pantoprazole.
NSAIDs are used both in pill form and in rectal suppositories. Used in the treatment of chronic adnexitis drugs in the form of local funds - vaginal suppositories, pills, balls. They have a wide range of clinical activity: antimicrobial, antimycotic, antibacterial. Funds for local use should be used only as prescribed by a physician after establishing the type of infectious agent. For example, Pimafucin is usually prescribed for the treatment of a fungal infection, and Terzhinan for a mixed infection.
Equally important is the increase in the resistance of the body's defenses to prevent painful relapses. For this purpose, immunostimulants (Immunal, Echinacea tincture) and balanced vitamin complexes with trace elements (Supradin, Vitrum, Center) are included in therapeutic schemes. And to eliminate the psychoemotional instability, patients were recommended to use a course of sedatives - Tenoten, Persen, Afobazol.
Acute adnexitis according to ICD 10
Acute adnexitis in the international classification of diseases of the 10th revision has the code N70.0. In accordance with this code, the gynecologist determines the duration of the course of the disease (7-10 days), symptoms (severe pain in the lower abdomen, extending to the sacral region and becoming stronger with strong palpation). In accordance with the classification of adnexitis by mcb, acute adnexitis manifests itself in the form of nausea, frequent vomiting, increased body temperature, muscle spasms, fever, and purulent vaginal discharge. Women with adnexitis often complain of difficult and painful urination. If the etiology of adnexitis is not clarified and the fallopian tube is involved in the process, then the acute adnexitis according to µb has the code N70.9.
Chronic adnexitis and ICD code
If the adnexitis becomes chronic, the code 70.1 is assigned to it in ICD 10. Pathology develops due to improper treatment of the acute form of adnexitis or its complete absence. The disease periodically becomes aggravated and subsides, but it is not completely eliminated. When making a diagnosis, Chronic adnexitis, the code for MKB remains the same, regardless of localization. It is much more difficult to detect the chronic form of the disease than the acute form, since the expressed signs are absent or weakly expressed. The following complaints mainly come from women with chronic adnexitis:
- the time and duration of the menstrual cycle changes (the scarcity of the menstrual flow is observed, the time between two periods increases)
- from time to time there is pain in the abdomen, it is projected onto the thighs and lower back (before the onset of menstruation or at the time of stress there is an increase in pain)
- the patient is worried about lethargy and general malaise.
Correctly diagnose adnexitis by ICD 10 helps the doctor precisely the sign associated with the violation of the menstrual cycle in the patient. If long delays in “critical days” occur, it is likely that the infection does not allow the egg to mature. Consequently, a woman develops problems with the conception of a child. Infertility is a serious complication of inflammation of the ovaries and fallopian tubes, which is much more difficult to eliminate than acute adnexitis. The disease itself does not pose a danger to the life of a woman. However, against its background, complications develop that significantly impair the quality of life and destroy health. Pathology is bad for the reproductive abilities of the female body and sexual functions. The classification of adnexitis in ICD 10 is based on the causes that led to the disease.
Signs and treatment of adnexitis
As shown by statistics, such gynecological disease as adnexitis occupies a leading position in comparison with other diagnoses. It is recognized as dangerous not only because it worsens the quality of life, but also because it can undermine the reproductive function, the restoration of which can take more than one month. An interesting fact is that young women are more susceptible to the occurrence of this disease. More than 70% can completely get rid of the disease, and the rest - are forced to deal with infertility, as the main consequence of adnexitis.
Adnexitis - what is it?
Adnexitis is an inflammation of the uterus, which includes:
There are a huge number of factors that influence the emergence and development of this disease. We list the most common:
- Diseases of the female organs, which, as a rule, occur after complicated labor, improperly performed abortions or established spirals,
- Unprotected sexual intercourse with an infected partner infection,
- The presence of a chronic infection in the body as a whole,
- Severe hypothermia
- Violation of the rules of personal hygiene or, conversely, excessive enthusiasm for her,
- Constipation and hypodynamia,
- Sexual intercourse during menstruation.
Chlamydia, mycoplasma, ureoplasma, gonococcus, staphylococcus and many others similar in type of infection are also the cause of the development of adnexitis.
Chronic bilateral adnexitis
It is also an inflammatory process, but of a more complex form, since the infection affects the appendages on both sides of the uterus. As a rule, the main development of the disease gets in the fallopian tubes. Chronic bilateral adnexitis accompanies such a disease as inflammation of the uterine lining.
The most common infections that become pathogens are:
- symptoms of chronic bilateral adnexitis:
- the appearance of pain, the nature of which is completely similar to the nature of pain in acute and unilateral adnexitis,
- temperature rise,
- common symptoms characteristic of all forms of adnexitis.
Do not let the disease take its course. If you began to notice pain subside, most likely adnexitis has become chronic.
Adnexitis signs and treatment of the disease
The chronic form of the disease requires a long and complex treatment in several stages. As a rule, gynecologists prescribe drugs:
As auxiliary substances, immunity enhancing agents can be prescribed, as a rule, liquid aloe juice is prescribed. In some cases, prescribe physiotherapy (laser, magnet).
The acute form of adnexitis, which is accompanied by high body temperature, abrupt attacks of pain in the abdomen, as well as an increase in appendages during palpation, is carried out only under the supervision of highly qualified in-patient specialists. Assigned compliance with bed rest. As for drugs, gynecologists prescribe the same group of drugs as in the treatment of chronic adnexitis. After eliminating all pain symptoms, the doctor may prescribe a visit to electrophoresis and ultrasound.
In the event that purulent inflammation has been detected, drug treatment becomes insufficient. Drugs begin to enter near the focus of inflammation, and strict bed rest is prescribed. After all the purulent foci disappear and the pain is prescribed, the standard treatment for this type of disease is prescribed.
As prevention and home treatment, you can resort to traditional medicine recipes, namely:
- treatment with mineral waters and mud
- ozokerite compresses,
- Spa treatment,
- paraffin compresses.
We draw your attention to the fact that it is possible to make a complete treatment only under the supervision of a highly qualified doctor. Listen to your body, watch for the slightest changes in the menstrual cycle, the amount and type of discharge. Remember that timely treatment, a gynecologist's visit twice a year, personal hygiene, proper nutrition will not only save your health, but also experience all the joys of motherhood.
Causes of adnexitis
The etiology of adnexitis, the causes, symptoms and treatment of this pathology are very important for the successful and rapid healing of the disease. In order to develop an effective treatment plan, the doctor, first of all, finds out which factors provoked the development of the disease. If an adnexitis is diagnosed in a patient of the gynecological department, the causes of the disease are ascertained taking into account the results of the diagnostic examination and pronounced external symptoms.
Acute adnexitis: causes and treatment
The causes of the development of acute adnexitis are clarified by a physician during diagnostic activities. The results of the initial examination help to prescribe the correct course of treatment. Diagnostic measures are selected individually. If a woman is in childbearing age and wants to endure and give birth to a healthy child, this fact is taken into account by the doctor when developing a treatment regimen.
The main causes of acute adnexitis:
- promiscuous sex,
- unprotected sex during menstruation,
- previous diseases of the female genitourinary system,
- weakened immunity and hypothermia.
Secondary adnexitis in women develops due to inflammatory diseases of the organs located in the abdominal cavity (colitis, appendicitis). There are cases when the symptoms of adnexitis appear on the background of specific infections (their pathogens can be tuberculosis bacillus, gonococci, syphilis).
Sometimes doctors find a woman with acute adnexitis after laparoscopy (traumatic endoscopic surgery). But mostly for the diagnosis of the disease, more benign methods are used (tomography, transvaginal ultrasound, laboratory tests of vaginal smears, PCR).
If a woman finds symptoms of acute adnexitis (sudden temperature rise up to 39 ° C, chills, sharp pain in the abdomen, extending to the leg, rectum or sacrum area), she needs to consult a doctor to determine the type of the disease. Pain after adnexitis can appear on one side or on both sides. Depending on the location of the pain, doctors diagnose one-sided or double-sided adnexitis. The effectiveness of the treatment of adnexitis in women depends largely on the correct classification of pathology.
The separation of adnexitis in women is carried out on certain grounds. Depending on the method of occurrence of the disease are:
- endosalpingoophoritis (the causative agent of the disease enters the female urinogenital system through mucous membranes),
- myosalpingoophoritis (a rare form of pathology in which the pathogen affects the organs of the reproductive system, namely, its muscular layer),
- resalpingo-oophoritis (infection of the body begins in the abdominal cavity and gradually spreads to the organs in the small pelvis).
Causes of pathology and infection
The main cause of adnexitis is infection. The causative agents of the disease are pathogenic bacteria - streptococci, staphylococcus, enterococci, gonococci, chlamydia, intestinal and tubercle bacilli.
The primary form of adnexitis, which is an independent disease, is usually triggered by opportunistic bacteria that can be activated by weakening the immune system or using an intrauterine contraceptive.
Infection can penetrate the appendages through the blood, lymph, external genital organs, from other organs (lungs, kidneys, throat). Сначала возбудители болезни попадают на слизистую оболочку влагалища, а затем по маточным трубам проникают в яичники.As a result, adhesions form between the fallopian tubes and ovaries. In the absence of timely adequate medical care, the number of adhesions gradually increases, due to which the permeability of the pipes is disturbed, which can lead to infertility.
According to statistics, purulent inflammation in the ovaries and fallopian tubes most often develops in women using the intrauterine device. Infection can also occur during childbirth, during instrumental curettage or abortion.
Increase the risk of developing adnexitis:
- having multiple sexual partners
- intimate contacts during menstruation,
- rejection of barrier contraceptives
- hypothermia, especially if it is accompanied by a weakened immune system,
- any intrauterine intervention, regardless of their purpose (hysteroscopy, abortion, instruments)
- poor hygiene,
- frequent overwork,
- constant stress.
What is chronic adnexitis in women?
The diagnosis of chronic adnexitis and what it is is a pressing issue for gynecology patients who have had to face such a problem. This disease is associated with inflammation of the ovaries and fallopian tubes, against the background of which there is an accumulation of pus in the lumen of the appendages. In chronic adnexitis, pain occurs either on one side or on both sides. Alien microorganisms lead to inflammation of the walls of the uterus and gradually destroy them.
The diagnosis of chronic ovarian adnexitis, the causes of the development of the disease and the features of its treatment
Chronic adnexitis often develops under the influence of adverse factors from the following list.
- Nerve overvoltage, persistent depression and stress.
- Non-compliance by the woman of intimate hygiene requirements.
- Injuries to internal organs.
- Allergic reaction to the materials from which contraceptives are made (condoms).
- Supercooling of the body.
- Non-professional operations on internal organs with gross violations (abortion also applies to them).
- Uncontrolled use of drugs that reduce immunity and disrupt the balance of beneficial microorganisms in the patient's body.
- Complicated childbirth.
- Infectious diseases and promiscuous sex, frequent changes of sexual partners.
Chronic adnexitis in gynecology is diagnosed according to a specific set of features. These include:
- dull pain in the lower abdomen, which increases with hypothermia and excessive stress on a weakened body,
- menstrual disorders (the amount of bleeding decreases)
- a slight but persistent increase in body temperature (fever is maintained for 1 week or more),
- deterioration of sexual functions, reduced sexual desire.
Exacerbation of chronic adnexitis most often occurs on the background of stress, improper lifestyle, poor environmental conditions. This disease is exclusively female, and, according to statistics of recent years, more and more patients of reproductive age are affected.
Treatment of chronic forms of adnexitis is aimed at eliminating infectious foci. The treatment regimen is selected individually by the gynecologist, and antibiotics must be present in it. The doctor recommends that the patient take potent drugs strictly according to the instructions. If you ignore the requirements of a medical specialist, treatment may become ineffective and will be delayed for a long time. Women with chronic inflammation of the fallopian tubes and ovaries are most often recommended to take antibiotics from the list below:
Presented drugs belong to a broad-spectrum drugs, contribute to the effective destruction of pathogenic microorganisms. Due to the use of antibiotics, the external signs of adnexitis are also reduced (high fever, abnormal vaginal discharge, pain in the lower abdomen). To enhance the therapeutic effect, gynecologists recommend using vaginal suppositories with anti-inflammatory and analgesic effects. An example of these candles is diclofenac with adnexitis reviews, this drug is often positive. With caution, it is necessary to use it in women with diseases of the stomach. After eliminating the acute manifestations of the disease, the doctor adds physiotherapeutic methods to the treatment regimen (exposure to variable diadynamic or magnetic currents, massage or ultrasound). The use of these methods helps to prevent the formation of adhesions and scars in the fallopian tubes, improves blood circulation in the organs of the female pelvis.
Chronic adnexitis has nonspecific symptoms, so the disease is very difficult to differentiate from other ailments with similar symptoms. If chronic adnexitis is not cured in time, the patient develops infertility. In the diagnosis of adnexitis one of the most important tasks of a gynecologist is to establish the site of localization of inflammation. According to this criterion distinguish bilateral, right-and left-sided salpingo-oophoritis.
Bilateral adnexitis is among the most common pathologies of the female genitourinary system. Another name for the disease is bilateral salpingo-oophoritis.
A bilateral adnexitis in its initial stage is characterized by the rapid development of inflammation in the cavities of the fallopian tubes (salpingitis). Gradually, the center of inflammation spreads to the ovaries, the second disease, oophoritis, develops. If both pathologies progress further, the disease is aggravated, acquiring a bilateral form. Inflammation that affects both uterine appendages at once, is more severe in comparison with right-sided or left-sided adnexitis.
Right-sided adnexitis in women is a pathological condition associated with inflammation of the appendages or ovaries of the uterus on the right side. The most serious complication of the disease is irreversible infertility.
Factors contributing to the active development of inflammation:
- cholecystitis (acute and chronic forms),
- appendicitis (acute or peritonitis-complicated seizure),
- pyelonephritis (inflammation of the kidney) on the right side
- obstruction of the fallopian tube or its complete absence on the left side,
- reduced immunity, against the background of which often supercooling of the body occurs,
- Poor gynecological examinations, operations in the pelvic organs and uterus,
- varicose veins of the pelvic organs on the right.
The most common cause of adnexitis on the right is infection in a wound after an appendix or gallbladder is removed.
Adnexitis on the left
Adnexitis on the left is characterized by the development of inflammation in the cavities of the fallopian tubes and ovaries located on the corresponding side of the organ. Interestingly, gynecologists are most often diagnosed in patients with left-sided adnexitis.
Symptoms of adnexitis on the left side are expressed quite clearly.
Diagnosis of chronic adnexitis: what it is, why there is and aggravated disease
Chronic adnexitis is characterized by a less pronounced course, therefore, it is much more difficult to diagnose this form of the disease. The formation of a chronic focus of infection with adnexitis occurs when inflammation in the uterine appendages is not treated for a long time. A woman with this problem complains about:
- lower back and stomach pains that have a pressing, aching or pulling character (most often they are localized in the lower, sacral or lumbar region),
- pain increases with hypothermia (for example, after swimming in a cool pond, being outdoors in the fall or in winter in clothes that do not correspond to the season),
- respiratory diseases
- deterioration during menstruation, increased pain during menstruation,
- difficulties in the intimate sphere (a woman loses her sex drive, and during sexual contact she experiences severe pain)
- the duration of critical days and the profusion of blood discharge increase,
- the volume of vaginal secretions increases,
- the inability to perform the childbearing function (the patient has a history of ectopic pregnancy or miscarriage in the early stages of pregnancy, she suffers from infertility).
A gynecologist, when examining a patient with suspected chronic adnexitis, can detect the following signs of illness in her:
- discomfort in the uterine appendages during palpation,
- heaviness in the abdomen (right or left),
- appendages and the uterus themselves become inactive.
The specialist should also differentiate the disease from other ailments with similar symptoms.
What tests for adnexitis need to pass?
Diagnosis of adnexitis involves the use of several methods. One of them is associated with a complex of laboratory studies. The following analyzes are performed in the laboratory:
- general blood analysis,
- study of leukocyte formula (if the number of leukocytes in the blood is increased, this indicates the development of the inflammatory process),
- vaginal adnexitis smear, baccavi, PCR, examination of vaginal and cervical secretions - a set of these tests helps to identify the causative agent of pathology, as well as to find out how resistant it is to certain groups of antibiotics,
- ESR study (erythrocyte sedimentation rate) - with adnexitis, a blood test of this type in almost every 3 cases shows an increase in the erythrocyte sedimentation rate
A popular method for diagnosing adnexitis vaginal smears is the staining of Gram's secretions. For this study, use mucus taken from the surface of the cervix. The technique helps to detect gonococcal pathogens. But in the chronic course of the disease, this method is not effective.
Blood test for adnexitis - an informative method of primary diagnosis, which helps to see an increase in the level of ESR and leukocytes. These parameters signal that an adverse process is developing in the patient's body, acute purulent inflammation. Chronic adnexitis is diagnosed only on the basis of ESR indicators.
Detailed information about adverse processes occurring in the woman’s body is provided by a biochemical blood test. True, the results of biochemical analyzes are important for the diagnosis of acute adnexitis. If the disease becomes chronic, the blood indices listed above return to normal (therefore, pathology cannot be determined from them).
Another blood test option for suspected adnexitis is serological. It is used to identify antibodies to pathogens of sexually transmitted diseases (ureaplasma, chlamydia, mycoplasma).
In addition to laboratory tests, gynecologists also use instrumental methods for detecting adnexitis. Ultrasound examination of the pelvic organs, computed and magnetic resonance imaging gives a good informational result. With an uncertain clinical picture, the gynecologist prescribes laparoscopy. If there is a suspicion of chronic adnexitis, hysterosalpingography is prescribed (the procedure helps to determine the degree of patency of the fallopian tubes if the patient suffers from infertility of unexplained genesis).
To clarify the localization of the inflammatory process in the uterus and to understand the features of the pathology, diagnose using ultrasound.
Ultrasound for adnexitis
Ultrasound with adnexitis - specifying diagnostic technique with high accuracy. If a woman has inflamed appendages, it is difficult to establish this only by external history and laboratory tests. In a situation where the doctor suspects adnexitis in a patient, ultrasound diagnosis is the best way to:
- determine the size and location of internal organs,
- detecting changes characteristic of the inflammatory process in the ovaries or uterus,
- detection of uterine fibroids (or exclusion of this pathology),
- differentiation of adnexitis from other diseases with similar symptoms (for example, appendicitis or tumor neoplasms),
- detection of endometrial and endometriosis pathologies,
- before performing gynecological operations.
Ultrasound is essential for the diagnosis of chronic adnexitis. If the patient develops chronic adnexitis, on the ultrasound sclerotic changes in the uterine appendages are characteristic of this particular disease.
Signs of adnexitis on ultrasound
Answering the question of patients, whether adnexitis is seen on ultrasound, gynecologists note that the fallopian tubes are almost imperceptible in a normal, healthy state. But if a woman has chronic adnexitis, when viewed with an ultrasound machine, the doctor will see in the pictures clear and well-marked outlines of the fallopian tubes. Prolonged inflammation leads to the proliferation of connective tissue, and as a result, the walls of the tubes thicken.
Special attention with ultrasound on adnexitis gynecologist draws on the condition of the ovaries. Normally, these elements of the female reproductive system have well-defined outlines. The follicles make the surface of the ovaries uneven.
An experienced doctor will be able to recognize adnexitis on ultrasound by signs associated with an increased volume of the ovaries. Normally, these elements have the following parameters:
- length - 20-37 mm,
- width - 18-30 mm,
- volume - 10 cm3,
- width - 16-22 mm.
When an adnexitis is diagnosed by ultrasound, an increase in the size of the appendages is a sign of inflammation (salpingoophoritis, adnexitis) or polycystic. All the above characteristics of the disease, which can be seen with ultrasound, are more characteristic of chronic adnexitis. If the female body develops acute inflammation of the fallopian tubes or ovaries, the ultrasound images show accumulation of pus or inflammatory fluid in them (with the formation of pyosalpinx). The inflammatory process on ultrasound is manifested in the form of an increase in density, the appearance of puffiness and thickening of the fallopian tubes. The appendages are deformed, their outlines become uneven. In the latter, pus can accumulate, and in this situation, an ultrasound examines a cavity with a dense purulent capsule.
If adnexitis is suspected, ultrasound examinations are performed at least 2 times, choosing different phases of the menstruation cycle. This approach is necessary to properly assess changes in the structure of the endometrium. Transvaginal examination gives the best information, therefore gynecologists choose it more often than abdominal. If the first ultrasound shows the expansion of the fallopian tubes, the study is repeated immediately after the completion of menstruation. Repeated ultrasound analysis helps the specialist to understand whether menstrual blood is thrown into the fallopian tubes.
The doctor makes a diagnosis based on the following indirect manifestations:
- fallopian tubes thickened and filled with inflammatory fluid,
- deformations of the myometrium and endometrium are observed,
- spikes appear in the pelvis,
- there are tubo-ovarian abscesses, in which the ovaries and fallopian tubes melt under the influence of purulent masses, and capsules filled with pus are formed in them.
To obtain a more accurate clinical picture, the gynecologist recommends that a woman with suspected adnexitis supplement the ultrasound diagnosis with the following procedures:
- tests of secretions from the uterine cervix for microscopy, PCR, bacposa (this complex helps to identify infectious pathogens that are sexually transmitted),
- external examination in the gynecological chair with palpation of the internal organs with two hands (using this procedure, the medical specialist determines the mobility of the pelvic organs, their volume, the degree of sensitivity of the appendages and the uterine cervix),
- pregnancy test.
Adnexitis and laparoscopy
Laparoscopy with adnexitis is used in conjunction with ultrasound diagnosis or as an independent procedure. If you compare laparoscopy with ultrasound, it is the most informative. The technique involves the diagnosis of inflammation in the uterus, appendages, ovaries or tubes with the help of surgical procedures. Laparoscopy is performed using a special medical instrument - a laparoscope. It is inserted into small incisions formed by the surgeon on the anterior wall of the peritoneum. During laparoscopy, the doctor may see changes in the fallopian tubes and ovaries, provoked by inflammation.
The clinical picture with laparoscopy can correspond to 5 stages.
- The first stage - there is a small edema of the fallopian tube.
- The second stage - the size of the fallopian tubes is slightly increased.
- The third stage - the surface of the tubes of the uterus is covered with a touch of pus.
- The fourth stage - purulent tumors appear in the uterine appendages.
- The fifth stage - a strong pressure of purulent contents leads to rupture of the fallopian tube, peritonitis develops (pus enters the abdominal cavity and provokes inflammation of the walls of the peritoneum).
Ultrasound and laparoscopy are the main instrumental methods of diagnosis of women with complaints characteristic of adnexitis. The doctor, prescribing an ultrasound examination, relies on the pronounced symptoms of the disease, which the patient describes during the initial examination.
Symptoms of adnexitis
Complaints to adnexitis and all symptoms can be completely different and depend on the individual characteristics of the female body, as well as the form of the disease. Единственный общий признак для всех типов аднексита связан с локализацией боли. Дискомфортные ощущения возникают в нижних боковых частях живота (если развивается двусторонний аднексит) или смещаются влево либо вправо (если сальпингоофорит — односторонний).
Основные симптомы аднексита у женщин (фото)
Symptoms of adnexitis are almost always associated with painful sensations. The pain, starting in the stomach, gives in:
- lower back
Inflammation of the uterine appendages and ovaries is accompanied by soreness and swelling of the lymph nodes located in the groin (they become well visible, protrude from under the skin).
Pain syndrome with adnexitis is directly related to the ingress of an infectious pathogen into the human body. Against the background of the infection, the uterine appendages swell strongly, a purulent or serous inflammatory fluid appears (sometimes there are blood impurities in it). The first signs of developing adnexitis:
- high temperature
- stomach ache,
- nausea, retching and vomiting, abdominal distension,
- urinary disorders (bladder emptying becomes painful and difficult)
- there is a strong tension in the abdominal wall,
- there are sharp pains
- the patient complains of a deterioration in general well-being,
- temperature rise to high elevations (38-39 ° C),
- pains in muscles and head (a characteristic sign of intoxication),
- with pressure on the abdomen, pain syndrome appears.
Symptoms of adnexitis in women are expressed in varying degrees. The intensity of their manifestation depends on what type of pathogen provoked the disease, how strong the patient’s immunity is, what the extent of the inflammatory process is.
Unilateral adnexitis: symptoms, reviews, features of the manifestation of the disease
Why adnexitis occurs, what it is in women, the symptoms and characteristic manifestations of inflammatory disease - all these nuances interest patients who first heard this diagnosis in the gynecologist's office. Acute and chronic adnexitis are one-sided and two-sided.
Common symptoms characteristic of unilateral adnexitis are as follows:
- pain syndrome of a different nature, appearing in the lower abdomen and projected on the lumbar region or thigh,
- purulent, mucous or serous discharge from the vagina, sometimes with blood inclusions,
- a strong decrease in sexual desire, discomfort in the process of sexual intercourse (occurs on the right or on the left, depending on the location of inflammation).
Characteristic signs of unilateral purulent adnexitis are also intoxication and well-marked fever. This combination of symptoms creates certain difficulties in the primary diagnosis of inflammation of the ovaries and fallopian tubes. The listed signs of unilateral adnexitis are similar to other acute inflammatory abnormalities of the abdominal cavity. In this regard, the external symptoms of the disease can not be taken as a basis for the diagnosis. The task of the gynecologist at this stage is to differentiate adnexitis with other diseases of the abdominal cavity. For example, if a specialist suspects a patient with inflammation of the ovaries or uterine appendages on the right, he should exclude right-sided renal colic or appendicitis (signs of “acute abdomen” are also characteristic of such pathologies).
Unilateral adnexitis is localized on the right or on the left. Right-sided inflammation of the appendages is accompanied by such external manifestations:
- acute pain in the right side, often imitating appendicitis,
- pain sensations of a burning or pulling nature, which are projected onto the region of the sacrum or rectum.
The characteristic symptoms of left adnexitis:
Compared with unilateral salpingo-oophoritis, bilateral inflammation of the appendages in women is much more acute. A description of the symptoms of adnexitis on the forums for bilateral inflammation includes the following unpleasant manifestations. The patient is experiencing acute abdominal pain, her peritoneum is irritated, there is a strong tension of the abdominal muscles (anterior abdominal wall). Bilateral adnexitis is characterized by the clinical picture of "acute abdomen" and severe intoxication of the body.
Chronic adnexitis: symptoms in women
Being in search of an answer to the question “adnexitis - what is it, symptoms, signs and manifestations of the disease”, a woman should understand that such a disease in the absence of timely treatment can become chronic. Signs of chronic inflammation of the uterus:
- pains of dull or aching nature in the lower abdomen, sometimes projected on the sacrum,
- menstruation cycle disorders
- development of dysmenorrhea (the strongest pain syndrome during menstruation),
- pain at the time of bowel movements or during sexual intercourse,
- the appearance of mucopurulent vaginal discharge,
- increase in body temperature to the level of + 38 ° C during periods of exacerbation of chronic adnexitis.
Against the background of chronic inflammation, a woman may develop ovarian adnexitis, the symptoms of which are similar to those described above. The problem manifests itself in the absence of proper and timely treatment of acute inflammation in the uterine appendages. The functions of the ovaries are violated, they form adhesions. The only way to avoid chronic inflammation is that at the first warning signs a woman should seek help from her gynecologist. He will conduct an examination and on the basis of his results he will make a preliminary diagnosis. In order to clarify the nature and form of the disease, the specialist will prescribe a complex of tests to the woman, including a study of vaginal secretions on the microflora, hidden infections, bacposa.
The inflammatory process in the appendages of the uterus is almost always accompanied by the appearance of secretions of various colors, exuding an unpleasant odor. In women with adnexitis, the discharge provokes itching, burning and irritation of the vagina. Discomfort in the genital area becomes the first "alarm bell" and the reason for contacting a specialist.
Is there any excretion with adnexitis? Useful information from experts
Gynecologists draw women's attention to the fact that with inflammation of the uterine appendages, secretions always appear. They may differ in their consistency, profusion, color, smell. In general, vaginal discharges are present even in the normal state of microflora. In healthy women, they do not cause any discomfort, do not have a pronounced unpleasant odor, in color - transparent. However, the clinical picture changes when a gynecological disease “matures” in the female body.
What secretions with adnexitis are there?
When a woman develops adnexitis, what secretions can appear from the vagina? Such a question can often be found in medical forums. Responding to it, doctors emphasize that the pathological secret from the vagina is very different from healthy lubrication. Inflammation of the appendages is accompanied by the formation of mucus with an unpleasant odor, causing burning and itching in the vagina. Discharge with this disease can be:
The color of the discharge is important in the diagnosis of adnexitis. Focusing on the shade of white from the vagina, the doctor determines the approximate type of pathogen that provoked the disease.
Adnexitis and brown discharge
Vaginal brown secretions with adnexitis indicate acute inflammation. Often brown leucorrhea with inflammation of the uterine appendages exudes an unpleasant smell, contains purulent inclusions. A characteristic symptom of the disease is the acyclicity of the appearance of a brown vaginal secretion. Many patients with this symptom of adnexitis suffer from severe pain during menstruation. Against the background of inflammation of the appendages, the periods become abundant. Highlight brown color appear regardless of the phase of the menstrual cycle, are smearing and scanty.
Adnexitis and yellow discharge
Adnexitis in women also provokes the appearance of yellow or green discharge with an unpleasant odor. If the inflammatory process is caused by a gonococcal pathogen, the vaginal mucus will be yellow, sometimes with an admixture of pus. Trichomonas parasitizing in the appendages of the uterus, contribute to the formation of bubbling greenish-yellow secretions. If the disease is in the acute stage, the discharge has a bright yellow color.
The gynecologist, when examining the patient and analyzing the results of laboratory tests, should find out the factors that provoked adnexitis, whether there is a discharge of a pathological nature, pain and discomfort in the abdomen. The specialist should pay attention to the nature of menstruation (abundant, painful, or, conversely, scanty).
Treatment of vaginal discharge with adnexitis is carried out in a conservative manner, using traditional medications. Most often, the doctor prescribes medication for treating infection and antibiotics. In individual cases, it is advisable to use special gels or ointments (for example, Candibene), vaginal suppositories (Bifidobacterin, Lactobacterin). These drugs compensate for the lack of beneficial lactic acid bacteria in the vagina and help fight against pathological microorganisms. Simultaneously with medical appointments, it is allowed to use folk remedies to eliminate pathological secretions. A good effect on the inflammation of appendages is given by warm baths with the addition of twigs or pine extract. Quickly get rid of whites help douching with the use of decoction of Hypericum or grass collection (yarrow, rosemary, sage, oak bark). All components are taken in equal quantities and poured boiling water (3 l). The prepared composition is cooked on low heat for 5 minutes, then cooled, filtered and used for medicinal purposes.
If adnexitis color discharge is less dangerous and easier to treat, then bleeding is one of the more serious complications of the inflammatory process.
Adnexitis and bleeding
Adnexitis and bleeding are dangerous and pathological conditions interrelated with each other. The onset of inflammation is associated with ingestion of an infectious pathogen, and when the problem worsens, adhesions form, ulcers form in the fallopian tubes, menstrual disturbances are observed, and severe uterine bleeding occurs.
Adnexitis with bleeding: how dangerous is it?
Adnexitis is a gynecological disease in which ovarian dysfunction often develops. Because of this, the woman's cycle of menstruation is disturbed, the number of female sex hormones decreases, and on this background, sexual desire drops. A characteristic sign of acute adnexitis is profuse and painful menstruation. Blood discharge comes with clots, the duration of menstruation increases. But depending on the individual characteristics of the female body, the situation may be reversed. Menstruation is characterized by scarcity of discharge, and its duration is only 2-3 days.
During the entire menstrual cycle (between menstruation), many women with adnexitis experience severe and prolonged bleeding. This symptom is also associated with disorders of the menstrual cycle.
Adnexitis with blood in women is a dangerous condition that requires qualified medical assistance for its elimination. Uterine bleeding on the background of inflamed appendages are spontaneous and unexpected. Provocative factors for their appearance are strong stresses and a woman lifting heavy objects. Chronic adnexitis is accompanied by bloody vaginal discharge. If the inflammatory process has become chronic, the woman’s menstruation may stop altogether and be absent for several months in a row. The main recommendation for patients in whom adnexitis is complicated by bleeding and an impaired menstruation cycle is dieting.
Adnexitis during pregnancy
Against the background of a natural decrease in immunity, the pregnant woman may aggravate the chronic form of adnexitis, or infection from the lower genital organs may occur. This condition can be divided into 2 types of risk: the risk of complications for the mother and the risk of complications for the fetus.
For mothers, adnexitis during pregnancy is fraught with inflammation of neighboring organs and general intoxication of the body. For the fetus, adnexitis during the gestational period threatens abortion, as well as the risk of intrauterine infection. It is also possible infection of the fetus during childbirth.
Consequences of adnexitis during pregnancy
In case of delayed treatment, refusal of hospitalization or self-treatment, there are possible risks of infection of the fetus, spontaneous abortion in the early stages, premature birth at a later and stillbirth.
If a pregnant woman regularly visits the antenatal clinic and passes tests, then the sad consequences can be avoided. The earlier it is possible to diagnose adnexitis and prescribe treatment, the greater the chance that the disease will not have complications during the course of pregnancy.
It is known that the disease is easier to prevent than to cure, so gynecologists recommend every woman to follow a number of simple rules:
- Do not lead promiscuous
- Visiting a gynecologist every six months
- Avoid abortion
- Keep personal hygiene
- Dress for the weather
- Do not self-medicate, and at the first symptoms of the disease contact a doctor.
Baths and douching in adnexitis therapy
- Good results in the treatment of adnexitis can be achieved by making steam baths 1 time per day (preferably in the evening). The course of treatment is carried out until the symptoms disappear. To do this, it is best to use grass nettle. In order to prepare such a bath you need 1 cup of dry grass of a plant, pour 1.5-2 liters of water heated to 90 degrees and cook for 15-20 minutes. After cooking, the broth is filtered and poured into a container suitable for sitting.
- For the preparation of the next medication, you need 80 g of grass with a goose foot, pour 4 cups of hot water and insist near the stove during the day. This broth is recommended to wash the vagina 2 times a day (morning and evening) for 15 days.
- To prepare another decoction for douching, you need 20 g of oak bark, 30 g of sage grass and 50 g of chamomile flowers. All this must be thrown into a container with 1.5 liters of boiling water and allowed to brew for 4 hours. Ready decoction need to perform douching 1 time per day during the month.
- For the manufacture of another medicinal product you need 40 g of Oregano grass, 60 g of oak bark and 20 g of Althea pharmaceutical herb, pour 400 ml of water heated to 80-90 degrees. Boil this broth for 15-20 minutes and leave to infuse overnight. This broth needs to be washed in the vagina in the morning and evening until full recovery.
- 10 g of dried linden flowers and 20 g of chamomile flowers should be filled with 350 ml of water. Broth put on low heat for 5 minutes. Let it stand for 30-40 minutes. Strain the prepared medicine. Conducts douching this tool need several times a day during the week.
Folk remedies for oral adnexitis
- For cooking means you need to throw 10 g of white ashberry white into a container of 250 ml of boiling water and boil over low heat for 5 minutes. Insist 10 minutes in a thermos. This medicine should be consumed 25 ml 4 times a day 30 minutes before meals.
- For quick elimination of the inflammatory process, you can also make a turn of tea. To do this, 10g of plant bark should be thrown into a container with 250 ml of water and boiled for half an hour. This medicine should be drunk 1 glass every evening for 3-5 weeks.
Тампоны для лечения аднексита
- Another effective folk remedy in the treatment of many women's diseases, including adnexitis - medicinal clay tampons. To prepare a medicinal tampon, a woman needs to purchase blue or green clay at a pharmacy. Note! Clay for the manufacture of tampons should be cleaned. Not bad if it will contain any additives with useful trace elements. Before use, the clay must be sifted. After that, it is mixed with water and put in a water bath. As a result, the clay should be quite warm, but not hot. From such clay to mold a tampon and put for 30 minutes in the vagina. This medicine can be used no more than 3 times a week. Remove the remnants of the tampon by douching from the decoction of therapeutic anti-inflammatory herbs. Also, to overcome adnexitis, dimexide can be administered in the form of tampons, with other medicinal preparations, for example, Vishnevsky ointment for adnexitis can also be used in a single drug mixture.
- A remedy based on bee propolis (bee glue) also has a good efficacy in the treatment of female inflammatory diseases. It enhances local immunity in the vagina, eliminates inflammatory processes, promotes tissue regeneration and has a negative effect on many types of viruses, bacteria and fungi. The greatest results in the treatment of adnexitis can be achieved if you combine folk remedies from propolis with antibiotics. It is necessary to make such tampons at the rate of 50 g of propolis, 50 g of honey and 100 g of sea buckthorn oil. It is necessary to use such tampons in the evenings for 15 days.
In addition to douches, baths and tampons, a woman can also use special therapeutic applications. They are also made from cosmetic clay. Such applications can be done within 3-4 days after the first signs of the development of adnexitis. Any kind of clay can be used for making applications; however, the best results can be achieved by using pink or yellow clay.
To prepare the application, the clay is diluted with water to obtain the consistency of liquid sour cream. After that, the clay is heated. It should be warm enough, but not hot.
This clay woman should coat the lower abdomen and lower back. After that, the place on which the clay was applied is wrapped with cling film, wrapped in a warm towel and left for 1.5-2 hours.
At the end of the procedure, the clay is washed off under the shower with warm water. The duration of treatment is 3-4 procedures.
Note! Before you treat adnexitis folk remedies, even the most, at first glance, harmless, you need to consult with your doctor.
What should be the diet for adnexitis?
Treatment of diagnosed adnexitis should be comprehensive and immediate. Dietary nutrition is an integral part of drug therapy. Recommended products for adnexitis:
- black and red currants
- Bell pepper,
In the daily diet must be present steamed or boiled vegetables (they contain a lot of fiber, necessary for the proper operation of the intestine). You need to diversify your menu with cabbage, zucchini, potatoes, onions, eggplants, cauliflower, broccoli, beets, carrots, etc.). In vegetable dishes you can add a little vegetable oil (sunflower, olive, flax).
If a woman has been undergoing antibiotic treatment for adnexitis, she should take care of the restoration of the vaginal and intestinal microflora. Fermented milk products saturated with lactic and bifidobacteria contribute to this. There are many such substances in kefir, koumiss, yogurt, ryazhenka, sour cream. Throughout the treatment, you need to drink at least 1.5 liters of any liquid per day (mineral water without gas, fruit drinks, fresh juices, fruit stewed fruit without added sugar, weak green tea).
Lean fish and meat will help restore and maintain the balance of proteins in the body. It is recommended to eat rabbit, turkey, beef, putas, hake, and pollock meat. In the daily menu of patients with adnexitis must be present a variety of greens (basil, parsley, spinach, cilantro, leek, onion bulb feathers).
Adnexitis diet - what kind of food is prohibited?
In acute and chronic adnexitis (in the acute stage), the amount of salt in the diet should be reduced, the amount of food with large amounts of carbohydrates should be reduced, and sugar should be discarded. It is recommended to completely remove such products from your menu:
- bean food
- chicken eggs,
- canned fish, smoked products,
- sweet drinks with gas, prefabricated juices,
- pastries, coffee drinks, cocoa, chocolate,
- spicy marinades and sauces, pepper, mustard.
Using a diet to fight adnexitis helps increase the chances of a woman getting pregnant and carrying a healthy baby.
Pregnancy and conception
Is there a chance that a woman with inflamed uterine appendages will conceive with adnexitis? This question is often heard in the walls of gynecological clinics and offices. Doctors give different answers to it. The development of the situation in each particular case will depend on the patient's state of health, the individual characteristics of her body, and age.
Is it possible to get pregnant with adnexitis?
Inflammatory processes occurring in the organs of the female reproductive system, always interfere with the successful conception of the child. Directly adverse processes do not affect conception, but there are some nuances.
- If the fallopian tubes become inflamed and swell, the lumen in them too narrows. As a result, the likelihood of an ectopic pregnancy increases.
- Salpingo-oophoritis (adnexitis) becomes an unfavorable factor provoking circulatory disorders in the pelvic organs (including the uterus). The embryo does not receive the necessary nutrition, so there are serious problems with the bearing of the fetus. In patients with this problem, spontaneous miscarriages constantly occur or missed abortion occurs.
- Deformities and pathological changes in the internal mucous membranes of the uterus against the background of severe inflammation are another reason that a woman cannot conceive a child. The embryo simply does not have the ability to fix on the inflamed endometrium.
The likelihood of pregnancy with unilateral inflammation of the appendages is higher. The fallopian tube, unaffected by the inflammatory process, remains passable and therefore the woman has chances to conceive naturally.
Conception and chronic adnexitis: when can you get pregnant?
We should also consider the question of the probability of conception with chronic adnexitis. With this form of the disease, the probability of pregnancy is the highest. The severity of pathological abnormalities in the uterus with chronic inflammation is less, therefore there are no interferences for conception and gestation. However, the expectant mother should be careful, because during pregnancy the immune system weakens. Because of this, the chronic pathology of the fallopian tubes can aggravate and lead to abnormalities in the development of the fetus, provoke a fading of pregnancy.
Obstruction of the fallopian tubes against the background of bilateral adnexitis is an indication for artificial insemination (IVF procedures).
Tubal-peritoneal infertility in women, triggered by inflammatory processes in the uterus and its appendages, is a serious problem that prevents conceiving a child. A woman with this ailment is unable to get pregnant naturally, so doctors offer her the best option - in vitro fertilization (IVF). The main indications for IVF are chronic adnexitis, chronic salpingitis or oophoritis. The IVF program demonstrates high efficiency and gives positive results in chronic adnexitis. Such factors as the patency of the fallopian tubes or their functionality are insignificant and do not interfere with conceiving a baby by artificial means.
Will adnexitis with eco interfere with successful conception?
Despite the many obstacles that inflammation creates in the uterine appendages on the way to the desired conception, the IVF procedure with this disease is successful in many cases.
Chronic adnexitis and IVF can be called compatible with each other. Even if the disease is not eliminated, the ability to perform in vitro fertilization is preserved. This adnexitis procedure has several advantages:
- the degree of patency of the fallopian tubes does not affect the success of IVF,
- the conception of the child, performed by IVF against the background of chronic adnexitis, completely eliminates the likelihood of developing congenital anomalies of the fetus (the ready embryo is carefully examined by qualified specialists of the Reproductive Clinic before it is placed in the mother of the future mother)
- Despite the fact that fertilization occurs artificially, and the uterine appendages in a woman are affected by chronic inflammation, the conceived child is born healthy, does not differ at all in its level of development from children born of natural fertilization.
Eco and adnexitis: new opportunities to get pregnant
Adnexitis is characterized by many dangerous complications (especially its acute form), so a woman should undergo special treatment before IVF and eliminate the illness. To eliminate the side effects of adnexitis after IVF, surgical removal of the affected fallopian tubes is performed, and only then an in-vitro fertilization program is performed. Such radical measures contribute to the creation of favorable conditions necessary for the formation and development of embryonic cells.
Late treatment of adnexitis leads to serious health problems. Sometimes the effects of the disease are so adverse that even conception with IVF becomes impossible. In this regard, a woman should know the danger of inflammation of the uterus, and avoid complications of the disease.
Adnexitis and its consequences for the female reproductive system
The consequences of adnexitis are always very unpleasant and insidious. These include:
- obstruction of the fallopian tubes due to adhesions,
- ectopic pregnancy,
- discomfort during sexual intercourse (abdominal pain),
- reduced sex drive.
Prolonged inflammation of the fallopian tubes and ovaries provokes the rapid proliferation of connective tissue in the membranes of the ovary. The result is a thickening of the ovarian capsule, and its surface is covered with a large number of adhesions. With excessive compaction of the capsule during ovulation is not broken, therefore, the egg is not possible to go outside and connect with sperm. In connection with the adverse course of adnexitis, infertility is diagnosed in a woman. The same problem occurs with hormonal ovarian dysfunction. Infertility is often diagnosed against the background of chronic adnexitis. It can only be prevented by performing prevention of inflammation of the appendages and the uterus.
Useful tips on the treatment of adnexitis in medical forums
What is adnexitis and how to treat - on the medical-oriented forums you can find all the information about this disease, how to eliminate it and prevent it. Women who have long and unsuccessfully struggle with chronic adnexitis, visit online forums to get effective advice from the same patients or an experienced doctor. The age of visitors to medical forums is significantly different. At such resources come and young girls 18-20 years old, and mature women who are already fortunate enough to become mothers. The symptoms of the inflammatory process are different for each of them. Some patients complain of persistent pulling back pains, others are tormented by weakness, nausea, fatigue, vomiting. Launched ailment leads to problems with conception and birth of children. Unfortunately, doctors in polyclinics do not always use an individual approach in the treatment of inflammation of the fallopian tubes and ovaries. In this regard, the effectiveness of the prescribed treatment is low, so the patient has to visit the forums on the network and select a complex of medicines for themselves.
Topical questions about adnexitis and home treatment in the forums
Medical forums and websites where young mothers communicate with each other contain a large number of different questions about adnexitis. Mostly women are interested in the causes of the disease, preventive measures and features of treatment. Visitors to online resources share their experience in treating chronic forms of adnexitis with folk remedies and at home. You can also read about the treatment of adnexitis reviews on the forum. They help to understand which drugs contribute to recovery, and which are ineffective and harmful.
Many women note on the forums that only an integrated approach helps to cope with adnexitis (especially long-standing, chronic). The chances of successful treatment of inflammation increase, if the patient takes antibiotics, attends physiotherapy, makes douching using herbal remedies. When antibiotic therapy, it is advisable to take medications for the prevention of the restoration of normal microflora. Vaginal suppositories with indomethacin, Ginalgin provide an excellent therapeutic effect. Also recommended for use are swabs soaked in aloe juice mixed with honey. Many patients say that with adnexitis, the warm climate of the sea, regular bathing in salt water, gynecological massages, special Kegel and Norbekov exercises help a lot.
Acute adnexitis should be treated only in a hospital setting. The forums often have a question on the home treatment of acute inflammations of the uterus. Experts do not recommend women to self-medicate, since acute adnexitis can transform into chronic inflammation, which will be much more difficult to cure.