Recently, physiotherapy has been increasingly used in inflammatory diseases of the female genital organs. However, many women are not even aware of the therapeutic effects of physiotherapy in gynecology. Meanwhile, a qualified physiotherapist can successfully treat many diseases of the female genital organs.
More on physiotherapy
Physiotherapy is a field of medicine that studies the therapeutic effects on the human body of artificially created and natural physical factors. By the way, physiotherapy is one of the oldest preventive and therapeutic areas of medicine. It includes: treatment with laser therapy, myostimulation, heat radiation, ultraviolet rays, exposure to current and other methods. The task of physiotherapy is to achieve the best effect in the treatment of diseases with the lowest load on the patient's organs. In some cases, physiotherapeutic methods successfully replace drug therapy, diet, physiotherapy and even surgery.
In gynecology, as in other areas of medicine, physiotherapy can be both an additional treatment method and the main one. And in some diseases - the only way to heal. For example, in case of chronic pelvic pain due to adhesions or neuralgia of the pelvic nerves, when medical treatments are not able to cure the disease at all. Treatment of the disease in some diseases is complicated just because of insufficient blood circulation, and few medicines can solve this problem. But physiotherapy for inflammatory diseases of the female genital organs is precisely aimed at this.
In addition, physiotherapy contributes to the reduction of the postoperative period, prevents the formation of adhesions, helps to restore the damaged uterine mucosa (endometrium). The undoubted advantage of physiotherapy is the absence of side effects and the reduction of drug load. And sometimes completely rejection of drugs. Physiotherapy, like any other treatment, is selected individually.
Objectives of physiotherapy treatment:
• reduction of terms of tissue repair,
• normalization of hormonal metabolism,
• stabilization of the autonomic nervous system,
The effectiveness of physiotherapy is based on the fact that physical (electrical, radiation, magnetic) energy absorbed by the tissues of the body is converted into appropriate biological reactions. Of course, the result of treatment depends on the specific methods, a single dose and the total number of procedures obtained. The most optimal therapeutic effect comes from a complex of procedures, rather than a single exposure.
When physiotherapy is prescribed:
• subacute and chronic diseases of the pelvic organs (chronic inflammation of the uterus),
• infertility due to obstruction of the fallopian tubes,
• postoperative rehabilitation for curettage of the uterus, spontaneous miscarriage, after abortion, after the restoration of the patency of the fallopian tubes,
• preparation of women for pregnancy who have missed pregnancies and spontaneous miscarriages,
• Before the IVF program, it is necessary to prepare the uterine lining (physiotherapy significantly increases the effectiveness of IVF).
What are the treatments?
Which method to prescribe depends on many factors. From diagnosis, age, availability of contraindications to various physical factors, hormonal levels, from individual tolerance of procedures. And in some cases from previously transferred diseases. Today in gynecology, the following methods are used:
• magnetic therapy (has anti-inflammatory effect),
• electrotherapy (electrophoresis, electrostimulation and others). For example, it effectively relieves spasms of smooth muscles and blood vessels with pulsed currents. This procedure improves the blood supply to the tissues and acts as an analgesic,
• ultrasound therapy (improves blood supply to organs and tissues, softens adhesions, provides anesthetic effect, increases the hormonal activity of the ovaries),
• phototherapy and light therapy (using UV, infrared rays) - have a bactericidal effect,
Physiotherapy and pregnancy
It is dangerous for the future mother to take many medications, because they affect not only her body, but also the baby’s body. Therefore, during pregnancy it is very important to use physiotherapy. And although it is sometimes impossible to do without drugs, it is physiotherapy that can achieve a positive effect with lower doses of drugs. Thereby reducing the adverse effects on the fetus.
Physiotherapy is used quite effectively with early toxicosis, with the threat of termination of pregnancy (to reduce the tone of the uterus). Physical therapy is also needed in the postpartum period. It promotes the healing of stitches after cesarean section or stitches on the perineum, is used to treat nipple cracks and prevent mastitis, helps with lactostasis, facilitating the discharge of milk. And darsonvalization is a good remedy for postpartum hemorrhoids.
Physiotherapy for inflammatory diseases of the female genital organs has its own contraindications. True, they are few. Common contraindications are cancer, mental disorders, and uterine bleeding. But methods such as warming, for example, are not recommended for endometriosis, uterine tumors. Although today there are non-thermal factors that can and should be used for endometriosis, myoma and other problems in which overheating is prohibited.
General indications of therapy
With the correct treatment of the inflammatory process in the appendages, the symptoms disappear after a few days. But this is not a reason to stop therapy. It must be completed.
At the initial stage, it is necessary to identify a disease-provoking factor. After that, you can take anti-inflammatory, antimicrobial drugs and carry out procedures to restore the body. The treatment is carried out for a long time.
Therapy in which salpingo-oophoritis is treated includes several points:
- During the period of treatment, complete sexual rest is observed. It is important to pay special attention to the preparation of the diet, rest, psychologically and physically.
- In order to eliminate pain and swelling of tissues, nonsteroidal anti-inflammatory drugs are taken. The effective effect on the body is Ibuprofen, Indomethacin.
- It is necessary to increase the body's immune defense. To do this, the doctor prescribes the intake of multivitamins, which must necessarily contain vitamins B, C, E.
- If an allergic reaction is observed, antihistamine medication is indicated. The doctor may prescribe Suprastin, Cetirizine, Claritin, Zyrtec and others.
- Physiotherapy will be useful for women. To enhance the immune defense, remove toxins from the blood and eliminate the harmful effects of microorganisms is carried out by UV. It is also recommended to undergo a course of ultra-high-frequency therapy in the area of the ovaries and fallopian tubes, electrophoresis.
Chronic stage is characterized by periods of remission and exacerbation. When symptoms increase, the treatment is carried out by analogy with the acute stage.
Therapy includes compulsory hospitalization with the use of:
- antibacterial drugs
- infusion injections,
- of vitamins.
When the period of exacerbation is over, the second stage of treatment of chronic adnexitis begins. It includes:
- aloe shots
- physiotherapy (ultraviolet, electrophoresis with lidazy, potassium, iodine, magnesium, zinc, ultra-high-frequency therapy, vibratory massage, ultrasound).
In addition, the doctor must constantly monitor the clinical indicators.
Physical therapy is aimed at reducing the formation of exudate, resorption of tumors, elimination of pain and adhesions. In addition to the above methods, therapeutic mud, paraffin, baths are used. Women are encouraged to irrigate the vagina with sodium chloride, sulphide waters. When the disease goes into a stable remission, you need a spa treatment.
When the acute stage of adnexitis occurs, therapy is carried out only in the hospital. At the facility, women are at rest, dieting and consuming enough fluids. Doctors monitor the organs of the excretory system.
Acute salpingo-oophoritis is treated with:
- broad spectrum antibiotics
- anti-inflammatory drugs
An important stage of treatment is the intake of antibacterial drugs. They are selected after identifying the pathogen and determining its sensitivity to the antibiotic. The dosage should be prescribed in such a way that the active substance is fully concentrated in the inflammation.
Adnexitis therapy is carried out:
In most cases, the treatment is carried out using those means that have a long half-life and are slowly eliminated from the body. If the course of the disease is complicated, and the risk of sepsis is increased, then a combination of several antibacterial agents is required.
In the presence of anaerobic bacteria, metronidazole is prescribed. It can be taken orally as well as entered into a vein.
In case of intoxication, an infusion is given:
- glucose solution
- dextran solution,
- protein based drugs
- solutions based on water and salt.
Purulent adnexitis is treated surgically.
Doctors try to use minimally invasive methods of operations:
- The acute stage can be eliminated with the help of laparoscopy, during which the pus is pumped out, the use of antiseptics and antibiotics in the inflammatory focus.
- During the puncture of the vaginal fornix, pus can also be removed from a saccular tumor. After that, the patient is given antibiotics.
- If the appendages melt under the influence of pus, the patient has renal failure, the probability of leakage of pus into the cavity or the development of sepsis, the appendages can be removed.
When the acute symptoms are eliminated, physiotherapy is indicated using:
- electrophoresis using magnesium, potassium, zinc,
- vibratory massage
If the acute stage is not cured in time and to the end, a chronic disease appears.
In the treatment of diseases of the female reproductive system an important role is played by the immune defense of the body. You can increase it with the help of a properly formulated diet. So the body can more resist an infectious lesion. In addition, the diet helps to improve metabolic processes in the inflammatory focus.
From the diet during the period of illness it is necessary to exclude allergenic products:
It is also necessary to control the amount of carbohydrates and salt, reducing their consumption.
It is necessary to refuse fried foods. Food should be cooked during boiling, stewing, and steamed. Per day it is necessary to use 2300 kcal.
Diet is needed during remission. Food should contain a rate of vitamins and proteins.
The basis of the treatment of inflammation of the appendages are antibiotics. Therefore, at the initial stage, women are often given injectables three times a day. Further therapy is carried out with antibacterial tablets.
In addition, injections with the use of vitamins, anti-inflammatory drugs, as well as intravenous drip glucose are used.
Injections are not given to all patients. If symptoms are erased, oral medications can be used.
Some women are more prone to the occurrence of adnexitis. This applies to patients with genital infections, intrauterine devices. Also, the negative impact is operations on the organs of the reproductive system, abortions of a spontaneous or medical nature.
To avoid the occurrence of the inflammatory process in the appendages, you must follow the preventive recommendations:
- It is necessary to exclude factors that can lead to the acute stage of the disease and the outbreak of symptoms of chronic adnexitis. Among them, stress situations, hypothermia, unprotected sex, alcohol abuse, and unhealthy diet are distinguished.
- It is important to choose the right contraception so that you do not have to interrupt an unplanned pregnancy.
- If an abortion is required, it is best to have a medical interruption or a mini-abortion.
- Therapy of inflammatory diseases of the pelvic organs and other systems should be timely. It is important to consider the type of pathogen.
- Every six months you need to visit a gynecologist for examination.
Physiotherapy without antibiotics
Many women suffering from adnexitis are prescribed physio. It is shown both in case of exacerbation of the chronic form after stopping the inflammatory process, and when the disease is in remission.
Without antibiotics, it is possible to cope with the symptoms of inflammation in inpatient and outpatient settings. At the initial stage, external exposure is carried out, and then intravaginal treatment is carried out.
In most cases, therapy is carried out in a complex. Each method is needed to influence certain areas.
It is worth remembering that physiotherapy is contraindicated in case of exacerbation of the disease, the presence of cancer, endometriosis, large fibromas, bleeding from the uterus, polycystic ovary.
What physiotherapeutic methods are used in the treatment
Modern physiotherapy is excellent at treating adnexitis and its effects. Among the highly effective methods used:
- low-intensity UHF-effect,
- low intensity UHF therapy,
- infrared laser therapy
- paraffin therapy
- mud treatment
- the use of mineral waters in the form of baths.
Features of therapy
During the exacerbation of adnexitis during the enhancement of the infectious factor, the patient is sent to the hospital for effective treatment, provided in such cases by medical practice. Each patient is treated individually, taking into account the peculiarities of the course of the disease.
During remission or exacerbation, not accompanied by increased inflammation, therapy is carried out in the clinic, where there is the possibility of obtaining physiotherapy procedures. Physical therapy for adnexitis has a good therapeutic effect, it is necessary to use these procedures at the right time, if indicated, and under the supervision of a specialist.
Ultrasound is effective during remission. This procedure has fibrinolytic and analgesic effects. High-frequency diadynamic, sinusoidal, modulated and fluctuating currents have a good effect.
At a certain stage, a magnetic field is recommended for women under 35, applications and vaginal tampons using mud are effective. The use of irrigation with sulfide, sodium chloride water is very effective. Magnetotherapy for adnexitis has become widespread in the treatment of gynecological diseases. This method is based on several principles: improvement of blood circulation, restoration of normal polarity of cells. Treatment of adnexitis with the help of magnetic therapy will help to get rid of pains caused by spikes in the pipes, as well as normalize the menstrual cycle.
A special approach to the appointment of physiotherapy require patients who have chronic adnexitis in combination with impaired ovarian function.
Patients with adnexitis with relative hyperestrogen need electrophoresis with iodine. Useful radon and bromine water. Zinc electrophoresis is effective if there is an insufficiency of the luteal phase of the cycle. Electrophoresis with adnexitis is used both in the period of remission of this disease and in the acute phase. It is necessary to make sure that there are no purulent processes in the appendages of the uterus. In order to cure chronic adnexitis electrophoresis will be used in conjunction with the medicinal substance. At this time, 10% of the drug is ingested.
Particularly effective massage with adnexitis. The point of application is the area of the ovaries, which is projected on the area of the sacroiliac articulation, it is necessary to massage this area smoothly, without causing severe pain. It is enough to do a massage once a week. Some time after the start of the massages, the painful seals under the skin in the area of the sacroiliac joints should disappear, and the course of treatment can be considered complete.
LFK with adnexitis (physical therapy) is aimed at reducing the abdominal muscles, as well as strengthening the pelvic floor muscles and moving organs in the pelvic cavity. This fiz.nagurzka help improve microcirculation in the area of the pelvic organs, thereby preventing the appearance of stagnation.
Аднексит, сопровождающийся гипофункцией яичников и сальпингоофоритом , нуждается в назначении разных физиопроцедур и лечится:
- вибрационным массажем,
- ультразвуковыми процедурами,
- высокочастотными импульсными токами,
- электрофорезом меди,
- mud baths, mineral baths and vaginal irrigation.
Briefly about anatomy and physiology
The fallopian tubes and ovaries are the female genitals located in the pelvis. Their second name is the uterine appendages.
The fallopian tube, the fallopian tube, is a paired hollow organ of tubular form 11-12 cm long. The body cavity of the uterus passes into the cavity of the fallopian tube, the size of which is very small — only 1-2 mm in diameter. At the ends of the pipes there are special villi - fimbriae.
It is in the fallopian tube that the egg meets with the sperm. So if the pipe is broken (for example, due to the inflammatory process), fertilization becomes almost impossible, and if it does, then the risk of ectopic pregnancy is very high.
The ovaries are a paired organ of oval shape with a size of 2 * 3 cm, having a glandular structure. They produce female sex hormones, and also contain eggs. Each month, in the middle of a woman's menstrual cycle, 1 egg leaves the ovary (this phenomenon is called “ovulation”), which is picked up by the uterine tube fimbriae and enters its cavity, where it meets the sperm cell and fertilizes, or passes the whole fallopian tube and enters into the uterine cavity, and then excreted from the body during menstruation.
Isolated inflammation of the fallopian tubes (salpingitis) or ovaries (oophoritis) is extremely rare - as a rule, these 2 organs are affected simultaneously - salpingo-oophoritis, or adnexitis develops.
Causes of chronic adnexitis
The main cause of inflammation in the fallopian tubes and ovaries is infection. In the role of the pathogen can be:
- non-specific microbial flora - staphylo-, strepto-and enterococci, E. coli, mycobacterium tuberculosis,
- pathogens of STDs - Neisseria, chlamydia, ureaplasma, fungi of the genus Candida, mycoplasma and others,
- some pathogenic viruses.
There is also evidence of the allergic component of salpingoophoritis.
The ways of spreading the infection to the tissue of the uterus are the following:
- intracanalicular, or ascending (from the vagina and cervix to the mucosa of her body and fallopian tubes, from there to the ovaries),
- lymphogenous (through the lymphatic pathways of the cervix injured for any reason directly onto the uterine tube tissue),
- hematogenous (with blood from chronic or acute foci of infection of any location - with caries, tonsillitis, pyelonephritis and other diseases),
- contact (from adjacent to the appendages of the uterus organs - appendix, bladder and others).
Risk factors for adnexitis are:
- postpartum period
- abortion (both the manipulation itself and the period after it),
- gynecological examination without asepsis,
- non-compliance with intimate hygiene,
- sexual intercourse without the use of barrier contraception,
- physical overstrain
- psycho-emotional stress
- long sunbathing
- chronic foci of infection of any location,
Mechanism of development of the disease
As a rule, acute or subacute adnexitis first develops, which, if the treatment is inadequate and / or untimely, as well as decreases in the body’s immune reactivity, becomes chronic.
The infectious agent enters the ovarian tissue from the fallopian tubes - an inflammatory process develops in them: edema occurs, inflammatory consolidations appear - infiltrates, adhesions form. If both openings of the fallopian tube are closed by adhesions, mucus accumulates in its lumen, the tube increases in size - hydrosalpinx develops.
Chronic inflammation of the tissues of the ovaries causes the development of dystrophic changes in them. The result of violation of microcirculation in them is a decrease in the production of sex hormones, leading to sexual disorders, menstrual disorders and infertility.
The adhesions process develops not only inside the fallopian tube, but also in the small pelvis - adhesions form between the tubes and the ovaries, the walls of the pelvis, the uterus, the bladder, the intestines and the omentum. Gradually, the connective tissue of adhesions becomes more dense and less elastic, firmly connecting the organs with each other.
Symptoms of chronic adnexitis
This pathology proceeds in waves - with periodic alternation of periods of remission and exacerbation.
Women suffering from chronic adnexitis, even in remission, complain of dull, aching, nagging pain, localized in the lower abdomen. The intensity of pain varies from low to severe. In many patients, the pain gives to the rectum, lower back or thigh, and is also accompanied by a violation of the psycho-emotional state (women become irritable, tearful, nervous, some even have depressive disorders).
Pain increases during movement, during menstruation, after hypothermia or psycho-emotional stress.
There are also vegetative disturbances - sweating, palpitations, and others.
Also in chronic adnexitis, patients complain of irregular menstruation. Menstruation becomes profuse and prolonged, premenstrual syndrome is pronounced. During sexual intercourse, women often experience pain, and for some, sexual desire is significantly reduced. Patients with this pathology often cannot conceive, and sometimes they have an ectopic pregnancy.
During the period of exacerbation, there may be an increase in body temperature and basal temperature to subfebrile values.
Principles of diagnosis of chronic adnexitis
Based on the patient's complaints, the history of the disease and life, the gynecologist will suspect the presence of an inflammatory process in the region of the internal genital organs. Palpation of the abdomen in its lower parts can be determined by pain.
During the gynecological examination, the doctor will detect a discharge of serous-purulent or purulent character from the cervical canal, as well as enlarged and painful fallopian tubes and ovaries.
If an abscess or pyosalpinx has formed in the region of these organs, they are defined under the specialist’s fingers as dense formations without clear contours, characterized by marked pain, motionless.
In the peripheral blood (finger test), classic signs of the inflammatory process will be found - increased ESR and leukocyte count, leukocyte shift to the left.
On ultrasound, a specialist will see an increase in the size of the appendages, a thickening of the mucous membrane of these organs, an uneven contour.
Principles of treatment
In the period of exacerbation of the patient can be prescribed antibacterial, anti-inflammatory, painkillers and antihistamines. We will not dwell on drug treatment, but consider in more detail the therapy with physical factors, which in chronic adnexitis turns out to be very effective.
The treatment with physical factors can be carried out both in case of exacerbation of chronic adnexitis (of course, when the main inflammatory process has already been stopped), and in the period of remission, both in inpatient and in antenatal clinics - on an outpatient basis. First, use external techniques, and with minimal manifestations of the inflammatory process replace them with intravaginal.
Rarely prescribed only one method of physiotherapy - as a rule, it is complex, because different methods have on the woman's body as a whole and on the uterus appendages in particular, different effects, the combination of which leads to the desired result.
Contraindications to physiotherapy are:
- acute period of illness
- malignant tumors,
- fibroids of the uterus with a size of more than 6 weeks,
- uterine bleeding,
- polycystic ovary.
Physiotherapy methods aimed at eliminating the inflammatory process
- Drug electrophoresis. With this method, drugs quickly and efficiently penetrate into the affected tissue, where they exert their effects. For this purpose, such agents as antibiotics, sulfonamides and anti-inflammatory drugs can be used. It is important to know that it is impossible to electrophoresis antibiotics directly after taking them in another way - at least one and a half hours should pass from the moment of taking the pill, and after the injection 30 minutes. The current density during medicinal electrophoresis is 0.05 mA / cm 2. Carry out the procedure should be every day for half an hour. The course of treatment is 10 procedures.
- UHF-therapy (low-intensity). UHF-field helps reduce the damaging effect of bacteria on the mucous membrane of the appendages, reduce capillary permeability, inhibit the process of excretion of substances that induce inflammation. During the procedure, a 27.12 MHz UHF field affects the crotch region for 10 minutes. UHF-therapy is carried out daily for 8-10 days.
- Rising shower. During this physiotherapy, microcirculation in the pelvic area and metabolic processes directly in the uterine appendages are improved. Affected tissues recover faster. Rising shower with a temperature of 35-37 ° C and a water pressure of 1-1.5 atm. take within 3 minutes 1 every 1-2 days. The course of treatment is 10 procedures.
- UHF-therapy (low intensity). This physioprocedure stimulates metabolic processes in the uterine appendages and promotes the rapid regeneration of the affected tissues. Use a cylindrical emitter, impose its contact in the area of the projection of the appendages on the anterior abdominal wall (lower abdomen). Radiation power is less than 10 watts. The duration of the procedure is 10 minutes, the frequency is daily, the course of treatment is 10 procedures.
- Infrared laser therapy. The effects of this method of physiotherapy are similar to the effect of UHF-therapy - laser therapy improves the metabolism in the mucous membrane of the affected organs, and also stimulates the regenerative processes in the damaged tissues. In addition, it helps to increase the activity of local immunity, which helps the body more effectively fight infection. The recommended radiation wavelength is 0.89-1.9 microns, power - 100 mW, the mode - pulsed, 50 pulses / s. The duration of the procedure is 10 minutes, the frequency of the procedure is every day, the course of treatment is 10 effects.
- Healing baths. In chronic adnexitis, iodine-bromine and hydrogen sulfide baths are particularly effective. Iodine ions accumulate in the body, improving metabolism, reducing inflammatory processes and stimulating the restoration of damaged tissues. The water temperature is 37 ° C, the content of iodine ions in it is 10 mg / l, bromine is 25 mg / l. Bath should be taken within 10-15 minutes 1 time in 1-2 days. The course of treatment is 10-12 procedures. Hydrogen sulfide baths improve reparative processes in inflammatory tissue. The water temperature is - 35-36 ° C, the content of hydrogen sulfide - 50-100 mg / l. The duration of the bath is 10 minutes. The course of treatment is 10-12 days.
- Paraffin therapy. This thermal physiotherapy helps to improve microcirculation and metabolic processes in the affected tissues. Medical paraffin temperature of 45-50 ° C impose on the perineum or lower back-sacrum. Duration of application - 15-20 minutes. The frequency of procedures is 1 every 1-2 days, the course of treatment is 10 impacts.
- Mud therapy Therapeutic muds reduce the amount of inflammatory secretions secreted by the affected mucosa, stimulate the processes of repair and regeneration. Applications of mud with a thickness of 4-6 cm with a temperature of 40-42 ° C impose on the lower abdomen. The duration of the procedure is up to 20 minutes; it will be moved 10–15 times in a day.
Methods that contribute to the destruction of adhesions in the pelvis
- Ultrasound therapy. A pulsed ultrasound mode with an intensity of 0.4–0.6 W / cm 2 is used. Impact area - the projection of the fallopian tubes and ovaries on the anterior abdominal wall. The duration of the procedure is 10 minutes, the frequency is 1 time in 1-2 days, the course of treatment is 10 exposures.
- Ultrafonoforez iodine or lidz. These drugs contribute to the resorption of scars. The intensity of continuous phonophoresis in the region of the lower abdomen is 0.4 Sun / cm 2, the duration of the procedure is 10 minutes every day for 10-14 days.
Methods that contribute to the restoration of ovarian function
- Mesodiencephalic modulation. This physiotherapy helps to stimulate the pituitary and hypothalamus nuclei, stimulating the production of hormones that activate ovarian function. Impulse currents (60-80 imp / s) affect the brain for 20 minutes 1 time in 2 days. The course of treatment is 10 procedures.
- Transcerebral UHF Therapy. The effects are similar to those of the previous method of physiotherapy. The frequency of the applied oscillations is 27.12 MHz, power - 30 watts. The duration of the procedure is 10 minutes, it is carried out daily, the course of treatment is 10 times.
- Ascending and circular souls. The water temperature is 37 ° C, the pressure of the jet is 100-150 kPa, the duration of exposure is 3-5 minutes, the frequency is 1 time per day, the course of treatment is 10 showers.
- Bubble baths. The water temperature is 36 ° C, the concentration of air is 50 mg / l, the duration of bathing is 10-15 minutes, the frequency is every day, the course of treatment is 10 procedures.
- Medical back massage. Duration - 20 minutes daily. The course of treatment is 15 procedures.
- Nitrogen baths. The water temperature is 36 ° C, the nitrogen concentration is 20 mg / l, the duration of the bath is 10 minutes every day, the course of treatment is 10 effects.
- Electrosleep. The duration of rectangular pulses is 0.2 ms, their frequency is 5-10 Hz, the current strength is up to 8 mA. The duration of the procedure is 25-40 minutes, the frequency is every day, the course of treatment is 10 effects.
Allowed by patients 2 months after the last exacerbation. Recommended resorts with iodide-bromine, radon, hydrogen sulfide and sodium chloride waters.
As a result, the physiotherapy of chronic adnexitis in the patients correctly and in time is accompanied by pain, the menstrual, sexual and reproductive functions are normalized and, therefore, the quality of life of the woman and her family improves significantly.
Features of the influence of physiotherapy on the body
Such treatment is rarely used by specialists to combat acute pathology. If a woman is diagnosed with severe inflammation, accompanied by high fever, severe pain, and the possible involvement of neighboring abdominal organs, then physiotherapy is recommended only as an auxiliary method.
This method allows you to:
- Significantly strengthen the anti-inflammatory and analgesic effect of conventional drugs.
- Normalize the metabolism not only in the cells and tissues of the affected organ, but also in other body systems of the patient.
- Physiotherapy treatments contribute to the restoration of the immune forces of women who have been squandered in the fight against the disease.
- This therapy is widely used to restore the ovarian and menstrual function of women, which is always important in chronic processes in the ovaries and fallopian tubes.
In addition, most experts note the beneficial effect of physically active factors on the normalization of the hormonal sphere of a woman. Such an effect of the method on the body is an excellent substitute for most hormonal drugs, which are used to treat adhesions and stagnation in the pelvis.
We recommend reading the article on monthly with adnexitis. From it you will learn about the disease and its effects on the menstrual cycle, the causes of pain, treatment and recovery cycle.
And here more about the ovaries during menstruation.
Many gynecologists with great success use physiotherapy to enhance the therapeutic effect of using standard techniques in the treatment of diseases of the female genital organs. Experts identify the following positive results:
- Physiotherapy techniques do not have a sharp effect, so they can be used for a long time. By the way, the result obtained with the combined treatment can be noticeable from 2 to 9 months.
- The time required for a complete victory over chronic diseases, or at least achieving a stable remission, is reduced by approximately 30 - 40%.
- Physiotherapy treatments can be used in combination. They are well combined not only with standard therapy, but also with other techniques, for example, acupuncture.
- The considered method of physical influence on the cells and tissues of the internal genital organs of a woman is often used both as a means of preventing possible repeated inflammations, and as a method of recovery after gynecological operations.
Despite the fact that by its nature this method of treatment is quite aggressive, doctors believe that with skillful use, physiotherapy has a healing, toning, stimulating and regenerating effect on the patient's body. Practically all the techniques included in the complex of active physical factors are widely used in all modern gynecological clinics.
Use for the treatment of special devices
For physiotherapy specialists use:
- Phototherapy or phototherapy.This method allows to achieve good results in diseases of the ovaries, vagina and external genital organs. The most commonly used effects on tissue infrared rays, but to achieve anti-inflammatory and antimicrobial effect, experts prefer a short ultraviolet radiation or KUF. Recently, laser radiation has been increasingly introduced into gynecological practice.
- Magnetic therapy proved to be excellent when removing edema and to reduce the symptoms of chronic inflammation in the pelvis.
- Do not forget about the regular use for the treatment of adhesions in the ovaries and fallopian tubes ultrasound. Under the influence of ultrasonic vibrations, local micromassage of damaged tissues occurs, which enhances their metabolic processes, stimulates the intensity of oxidative mechanisms, and increases the permeability of cell membranes.
In addition, ultrasound exposure contributes to increased secretion of female sex hormones, which can not but have a positive effect on the patient's menstrual function.
The most common method of physiotherapy are various methods of applying electric current. The most famous of these is electrophoresis. With it, you can, for example, enter into the female body medicinal substances that bypass the gastrointestinal tract and enter directly into the bloodstream.
The considered method makes it possible to minimize the concentration of the drug, which reduces the likelihood of various pathological reactions. But in gynecology, other methods of treatment with electricity are widely used.
Such methods include the appointment of patients galvanic and diadynamic currents, high frequency currents Darsonval. These methods of treatment improve blood flow in the pelvic area, enhance tissue metabolism, accelerate the resorption and excretion of exudate.
In addition to these methods of dealing with chronic processes in women, doctors also use ultra-high frequency currents and short-wave diathermy. This use of electricity can significantly increase heat transfer in the affected area, which will lead to a softening of scars and adhesions in the pelvis.
See the adnexitis video:
Other types of physiotherapy
Any external influence on the patient's body in order to rid it of chronic inflammation in the pelvic area can be considered physiotherapy. Specialists refer to such methods gynecological massage, special water procedures, various complexes of physical therapy.
Do not forget about the great benefits of health resorts. For the treatment of such diseases, there is a whole network of sanatoriums where experienced women will help women choose the type of physical effect that is most suitable for treating a particular disease.
Physiotherapy methods for salpingoophoritis
Salpingo-oophoritis or, as most gynecologists say, adnexitis is an inflammatory process in the ovaries and fallopian tubes. The disease is usually protracted and often leads to infertility in women.
If the process is in the acute stage, then the methods of physical exposure are primarily aimed at reducing the inflammation of the tissues, reducing ovarian edema, relieving pain syndrome. When the process goes into the chronic phase, then with the help of physiotherapy, doctors are trying to reduce the number of adhesions and restore the patency of the fallopian tubes.
In order to relieve inflammation and swelling of the tissues, most often women give electrophoresis with specific drugs and UHF-therapy with low intensity. To restore a full-fledged metabolism in the affected organs, first of all, the application of thermal procedures will give the result, most often paraffin and ozocerite are used on the abdomen.
To improve the immune system of a woman, experts recommend sunbathing to the patient, UV radiation in problem areas, bromine and hydrogen sulfide baths. A good result can be obtained by applying diadynamic currents on the region of the appendages and the sacrum. The number of sessions should not be less than 10.
One of the most modern methods of treatment of salpingoophoritis is the use of infrared laser radiation. This method enhances the metabolic processes in the cells of the ovaries and fallopian tubes, helps to restore healthy tissues. The medical procedure itself takes 10 minutes.
Contraindications to physiotherapy for diseases in the pelvis
Despite the seemingly complete safety of using physiotherapeutic methods of treatment in pathology of the pelvic organs in women, these techniques also have quite a few contraindications.
Doctors do not recommend prescribing sessions for the following pathologies:
- First of all, physiotherapeutic methods are not used in the acute period of the disease, or they are used with great limitations.
- Physical effects on the body of a woman are prohibited in the presence of cancer pathology, tuberculosis, problems with blood coagulation.
- Contraindications are acute and chronic renal and hepatic failure, exhaustion of the body, serious diseases of the cardiovascular system.
- Do not recommend such methods of treatment in the presence of the patient diagnosed with endometriosis, uterine bleeding, various benign formations of the external and internal genital organs.
We recommend reading the article about adnexitis: the code for ICD 10. From it you will learn about the disease and the causes of its occurrence, the symptoms of acute and chronic course, methods of treatment.
And here more about the pain in the lower abdomen during menstruation.
Physiotherapy, like any treatment method, can only be carried out under the supervision of specialists. It is they who must determine which method of physical exposure is suitable for a particular patient, and assess the level of its threat to a woman’s health.
Why is physiotherapy important?
Physiotherapy is often and very unfairly ignored by both patients and doctors. The visual and instant effect of it is not visible, and it is too laborious to walk to the clinic in 10–15 days for procedures in the clinic. Hand on heart, people often just too lazy to attend the procedure and spend precious time on them, which can be spent at home watching TV or a computer.
I would like to refute this prejudice, since physiotherapy in gynecology is indispensable, its results can cope with those problems that are not amenable to expensive medicines.
For all its apparent simplicity, physiotherapy is able to cure deeply hidden pathologies, such as extensive adhesions in the pelvic organs, amenorrhea, anovulation, or advanced chronic inflammation of the appendages.
In gynecology, physiotherapeutic procedures can in some cases completely replace surgical interventions, drug therapy, therapeutic exercises or massage.
Even if the procedures cannot be used to replace the appointment of one of the above-mentioned methods of treatment, they can significantly complement and enhance the effect.
When is physiotherapy needed?
Let's start with a rather impressive list of conditions in which such procedures are assigned to gynecology:
- Menstrual disorders,
- Lack of ovulation or its irregularity,
- Chronic inflammation of the uterus or its appendages,
- Adhesions, obstruction of pipes,
- Pain syndrome,
- Mastopathy and some other problems with the mammary glands,
- Preparing for the IVF protocol and for normal pregnancy,
- Diseases and inflammations of the nerves in the pelvic region,
- Hypoplasia of the uterus, disorders of the development of the genital organs,
- Urological diseases
- After any genital surgery,
Let us dwell on the last paragraph. Absolutely every surgery on the genitals, even the smallest (like cleaning or abortion) can lead to the formation of adhesions.
Appointment of physiotherapy after surgery is absolutely necessary, as they not only accelerate the process of healing and recovery, but also reduce the risk of unpleasant consequences and infertility in the future.
What are the procedures?
In the treatment of gynecological diseases, physiotherapy methods are divided into three general groups:
- Artificial or hardware method. This includes procedures using various instruments and devices. The following physical factors are used as means of influence:
- electric current of different voltage (UHF, electrophoresis, etc.),
- a magnetic field,
- light (ultraviolet radiation),
- laser radiation
- ozone therapy
- vacuum (vacuum massage),
- Natural (natural) factors - mud, water treatments.
Invaluable benefits in the fight against adhesions, inflammation of the pelvic organs and other pathologies have therapeutic mud. In physiotherapy, they are used both in conjunction with the hardware method (for example, electrophoresis with mud) and in the form of wraps, mud baths, and tampons with medical mud. Curative water in the treatment of gynecological problems is used from the point of view of its chemical composition (bath, douching, ingestion). They also exploit the mechanical properties of water in the procedures of hydromassage, Charcot's douche, and fan douche. Thermal properties of water are used in contrasting or warming showers and baths, which activate the work of internal organs.
- Gynecological massage and special exercises also apply to physiotherapy. Massage is indicated for extensive adhesions, obstruction of the tubes, and pathologies of the uterus. Massage is done only by the gynecologist, the number of procedures is assigned based on the patient’s diagnosis. Exercises are made by the patient independently, this section of exercise therapy is usually indicated after surgical interventions as a method of preventing adhesions or to improve blood circulation in the small pelvis.
Advantages and disadvantages
The advantages of physiotherapy include the following points:
- Low cost. Most procedures are available even in the most ordinary clinic and cost mere pennies. With the direction of the attending physician, the procedures are most often completely free. You may need to buy active ingredients that are introduced into the body with the help of physiotherapy (gels, ointments, therapeutic mud, ampoules). But all these tools are cheap.
- No side effects. Procedures using a current or a magnetic field may and may have little effect on adjacent organs, but it is likely to be positive. And if you compare with drugs that affect not only the gynecology field, but also put the liver, kidneys, gastrointestinal tract and God knows what else, the physical procedures are absolutely harmless.
- High efficiency and general benefits for the body. The benefits of physiotherapy have been repeatedly proven in all countries of the world. You may feel that after lying for 15 minutes on the couch with plates on the stomach, you do not feel any changes in the body.
But believe thousands of research and reviews of satisfied patients - the effect of the procedures is, and very significant. It just manifests itself after a full course of treatment and can be noticed after repeated examination by a doctor, and not “by eye”.
- Physical therapy reduces the duration of treatment of the disease, enhances the therapeutic effect of any medication and reduces their dosage, accelerates the healing process and tissue regeneration after surgery, prevents the transition from an acute condition of the disease to a chronic one, which is much harder to treat. You can be cured without attending the procedures, but with them the treatment will be much faster, more effective and with minimal consequences.
- In gynecology, physiotherapy is absolutely indispensable. Chronic chronic inflammations, disorders of the reproductive organs, ovarian dysfunction, chronic pelvic pain syndrome, damage to the tubes and other organs by adhesions do not respond well to drug therapy. But the procedures, especially in combination with drugs, work wonders in this area.
The disadvantages of physiotherapy are so few that it is even difficult to find them. The only thing that can be considered a disadvantage is the need to visit a clinic or hospital to undergo procedures. It is one thing if a woman is prescribed physiotherapy after the operation and she can attend the procedure while in the hospital or on the hospital. But working women may seem difficult to find the time and desire to go to the clinic. After most procedures, it is recommended to sit or lie on the couch for 15–20 minutes before going out. This recommendation is especially important during the cold season.
However, gynecologists most often prescribe physiotherapy to patients with chronic inflammation,
leading to adhesions in the pelvis or those who have already been diagnosed with adhesive disease. It is worth remembering that adhesions in the fallopian tubes - one of the most common causes of infertility in our time. In the majority of patients, they appear just as a result of undertreated inflammations, while physiotherapy during inflammation can minimize the risk of adhesions.
Therefore, it is worth thinking about the future and decide: is it worth sacrificing an hour of your time for some 10 days for the sake of being able to conceive and bear a child without any problems?
Treatment of chronic adnexitis
The treatment of adnexitis in the chronic form is rather difficult, primarily because chronic inflammation proceeds sluggishly. In periods of remission to continue therapy with antibacterial drugs is not justified.
If chronic adnexitis caused infertility, then surgery is used.
Treatment of exacerbation of chronic adnexitis
The treatment of adnexitis, which has acquired a chronic form, is complicated, primarily because the cause of the disease (which can be different) is rather difficult to identify and does not always work.
In chronic inflammation in the appendages, drug therapy, physiotherapeutic procedures, treatment in sanatorium-resort conditions, special physiotherapy exercises, etc. are used.
Light gymnastics helps to strengthen the immune system, walks in the fresh air, healthy nutrition also contribute to the body's defense.
When exacerbation of chronic adnexitis (pain, feeling unwell, etc.), you should consult a specialist and begin treatment.
During the exacerbation of the process, antibiotics, anti-inflammatory drugs, sedatives, vitamins are used. During periods of remission, physiotherapy treatment is indicated - acupuncture, electrophoresis, mud therapy.
Women with chronic adnexitis are recommended therapy in sanatoriums, therapeutic exercises, psychotherapy, etc.
During exacerbations, fried, fatty, smoked products are excluded from the diet, salt consumption is reduced as much as possible.
With frequent exacerbations of chronic adnexitis, irreversible health consequences can occur, therefore it is recommended not to provoke the disease: avoid hypothermia, heavy loads (physical and emotional).
Treatment of acute adnexitis
Treatment of adnexitis in the acute form usually takes place in a hospital, otherwise, possible serious complications (pus formation, peritonitis, etc.). During therapy it is important to comply with bed rest.
First of all, in case of acute adnexitis, painkillers, anti-inflammatory (antibacterial, antimicrobial, if necessary) drugs are prescribed.
When prescribing antibiotics, the sensitivity of the pathogen to the drug must be taken into account. Most often in acute adnexitis appointed apmicillin, tetracycline, ofloxacin, erythromycin, gentamicin, metronidazole, clindamycin.
In acute inflammation, doctors prefer antibacterial drugs with a long half-life. In case of a severe process or suspicion of a purulent complication, antibacterial drugs of different groups are prescribed, for example, aminoglycosides and penicillins (oxacillin and kanamycin). Drugs can be administered both intravenously and orally, as a rule, at the beginning of treatment, intravenous administration of antibiotics is used, followed by replacement with tablets.
Acute adnexitis often leads to intoxication of the body. In this case, intravenous glucose, protein drugs, reopiglugine, etc. are added to the therapy.
When a purulent process begins, an operation is obligatory - laparoscopy, during which pus is removed from the appendages and an antibacterial agent is injected into the affected area. This method is less traumatic and quite effective.
If you do not carry out the treatment of acute adnexitis, it gradually becomes chronic, with periodic exacerbations.
Treatment of subacute adnexitis
Treatment of adnexitis in a subacute form, after the removal of acute symptoms, consists in physiotherapeutic procedures (ultrasound, mud therapy, etc.).
It is worth noting that early detection of the cause of inflammation allows the doctor to prescribe an effective therapy. The earlier the treatment of adnexitis is initiated, the less likely there is a scarring in the appendages of the uterus. As a rule, subacute adnexitis occurs as a result of mycosis or tuberculosis infection (it is extremely rare). Главным принципом лечения подострой формы аднексита является устранение основного заболевания и симптоматическое лечение.
Лечение двухстороннего аднексита
Лечение аднексита обычно проводится в условиях стационара. Bilateral inflammation requires an integrated approach. In the acute course of the disease, antibacterial drugs are prescribed (ampicillin, amoxiccycline) or a combination of several groups of antibiotics (usually in especially severe cases). If chlamydia has become the causative agent of inflammation, then tetracycline antibiotics are prescribed, anaerobic bacteria - metronidazole. The course of treatment and dosage is prescribed by the attending physician, usually the course of therapy lasts up to 10 days.
In addition to antibiotic therapy, sedatives, anti-inflammatory, and anesthetics are prescribed. Woman during this period is attributed to bed rest, diet food.
In chronic bilateral inflammation, physiotherapeutic methods are used, in some cases it is impossible to do without surgical intervention, in particular, it may be necessary to remove the fallopian tubes or ovaries.
Treatment of right adnexitis
Right-sided adnexitis in its symptoms resembles appendicitis and it is impossible to do without professional advice in this case. The doctor after examination, examination and ultrasound data can determine the diagnosis, but in some cases all data may indicate both adnexitis and appendicitis.
If the data obtained is not sufficient for diagnosis, it is necessary to determine the localization of pain - when appendicitis pains the iliac region, with adnexitis - pain is concentrated in the lower abdomen and gives the lower back. Also, one should not completely exclude the possibility of exacerbation of these two diseases, in this case the exact cause can be established only after surgery.
Treatment of left adnexitis
Left-sided adnexitis usually occurs for the same reasons as other inflammation in the appendages, so the principle of treatment in this case does not change drastically.
Often, adnexitis leads to infertility, so treatment of adnexitis cannot be performed independently. In addition, it is impossible to diagnose only on the basis of sensations, it is necessary to conduct a number of additional studies to determine the causative agent of inflammation and prescribe an effective therapy. With adnexitis, warming of the abdomen is contraindicated in order not to provoke an even greater inflammatory process and severe pain (in some cases, an ice compress is recommended).
In left-sided inflammation, painkillers, antibacterial and other drugs are prescribed. After reducing the acute symptoms, they begin treatment with the help of physiotherapeutic procedures - electrophoresis, ultrasound, paraffin applications.
Adnexitis treatment during pregnancy
Inflammation of the appendages in pregnant women is treated only in the hospital. First of all, the treatment of adnexitis during pregnancy is not only aimed at suppressing infection and the inflammatory process in the body, it is very important to prevent the spread of infection through the placental barrier, and this is the greatest difficulty in treating pregnant women. However, if the treatment of adnexitis is started in a timely manner, then the woman's probability of normally carrying out and giving birth to a healthy child increases.
For the treatment of adnexitis, antibacterial drugs are prescribed that can be used during pregnancy (it is important to test the sensitivity of microorganisms before using the drug). Also effective therapy includes fortifying, anti-inflammatory drugs.
Adnexitis treatment methods
The treatment of adnexitis contains several basic principles:
- Treatment of adnexitis with antibiotics, anti-inflammatory, etc. therapy
- Endoscopy, through which the welded fallopian tubes are dissected
- Treatment in sanatorium conditions
Also, along with the general treatment is widely used topical: ointments, tampons with anti-inflammatory solutions, baths.
Depending on the causative agent of inflammation, antibiotic therapy can be prescribed to the sexual partner.
Inflammation of the appendages may be associated with concomitant gynecological diseases (uterine fibroids, endometritis, etc.).
In parallel with antibiotic therapy, immunostimulating, analgesic and anti-inflammatory therapy is prescribed. To reduce the inflammatory process in the appendages, as a rule, rectal suppositories are included, which include diclofenac.
After removing the acute symptoms of the disease and going into remission, physiotherapy is prescribed: mud therapy, electrophoresis on the lower abdomen, lower back, tampons with medical herbs, ultrasound treatment and n. Recently, hirudotherapy has become increasingly popular, which shows quite good results.
Treatment of adnexitis is based on antibiotic therapy. At the beginning of the disease, the doctor may prescribe a course of antibiotics as injections 3 times a day, then pills with antibiotics are prescribed. In addition, the woman is prescribed a course of vitamins, glucose, anti-inflammatory drugs.
When inflammation of the appendages injections are not assigned in each case. For example, if the course of the disease is erased, then it is possible to use antibiotics in the form of tablets.
Treatment of adnexitis, as already mentioned, should be comprehensive. As an adjuvant therapy for drug treatment, you can use douching decoctions of some herbs that have anti-inflammatory, anti-edema, healing, etc. action. For douching it is recommended to use chamomile, oak bark, linden, yarrow, eucalyptus extracts.
Treatment of adnexitis with homeopathy
An experienced homeopath will help to cope with almost any disease without the use of chemistry. Quite often, chronic adnexitis torments women for a long time, occasionally becoming aggravated and delivering a lot of inconvenience and disturbing the quality of life.
The homeopathic treatment of adnexitis is sometimes much more effective than the traditional one, since it affects the whole body and does not have side effects.
However, the appointment of homeopathic medicines should be done only by an experienced doctor, taking into account the individual characteristics of the woman's body.
Adnexitis treatment regimen
For effective therapy, complete diagnosis is necessary in order to identify the cause of inflammation and the degree of organ involvement in the inflammatory process.
Treatment for adnexitis usually includes:
- broad spectrum antibiotics (mainly with a long period of action)
- enemas with drugs
- candles (rectal, vaginal)
- immunostimulating, anesthetics, anti-inflammatory drugs
After the acute inflammatory process has passed, physiotherapeutic procedures are prescribed. With the formation of adhesions, surgical treatment is recommended.
Preparations for the treatment of adnexitis
Treatment of adnexitis is possible with various antibacterial drugs. For more effective treatment, before the appointment of the drug is a test to determine the susceptibility of microorganisms that caused inflammation in the appendages. Also, the doctor prescribes painkillers and anti-inflammatory drugs, physiotherapy. In case of acute illness, the doctor may refer for compulsory hospitalization.
The most well-known antibacterial drugs for the treatment of inflammatory processes in the appendages are as follows:
- Erythromycin - the most effective drug that destroys chlamydia and mycoplasmosis. The duration of the dose and the dose determined by the doctor, given the severity of the disease and the patient's condition. In some cases, erythromycin is replaced by ofloxacin, azithromycin, dioxycilin.
- metronidazole - used for trichomoniasis (as well as for all sexually transmitted diseases). Based on the diagnostic data, the doctor determines the course duration and dosage (the drug is available in the form of tablets).
- ceftibuten - an antibiotic that is active against a large number of microorganisms, is available in capsules. This drug may be replaced by similar ones: cefaclor, cefuroxime.
- Azithromycin (Zamax) - is prescribed for diseases of the genitourinary system, for urethritis (gonorrheal and non-gonorrhea), cervicitis, etc.
Vaginal suppositories with antibiotics (fluomizin, movalis, etc.) can be used for topical treatment. In combination with general treatment, drugs speed up the healing process and reduce pain.
The active ingredient of Trichopolum is mitranidazole, which has an antimicrobial and antiprotozoal effect. Adnexitis treatment with trichopolis occurs when anaerobic bacteria are detected. The drug is not used for serious violations of renal and hepatic function, bone marrow, nervous system. The course of drug therapy usually lasts no longer than 10 days, if the doctor decides to continue treatment with Trichopol, then liver function and peripheral blood should be monitored.
Dimexide refers to anti-inflammatory drugs, also has a local anesthetic effect.
The drug penetrates well through the mucous membranes, increases the sensitivity of bacteria to antibacterial drugs. Dimexide has a low toxicity.
Comprehensive treatment of adnexitis along with antibiotics, anti-inflammatory and other means includes tampons with dimexidum and novocaine (1: 4).
Biseptol is a combination bactericidal agent, produced in the form of tablets or intravenous injections. Treatment of adnexitis must necessarily include an antibacterial drug that suppresses and destroys pathogenic microflora. Biseptol is indicated for anaerobic gram-positive and gram-negative microorganisms, chlamydia, etc.
Wobenzym has a general effect on the body: reduces inflammation, swelling, improves immunity and improves blood circulation. All this makes the drug in demand in the treatment of many gynecological diseases. Wobenzym is often included in the complex treatment of adnexitis. One distinctive feature of vobenzyme is that the drug has the ability to inhibit the growth of connective tissue (prevents the formation of adhesions).
In viral infection, Viferon is prescribed, which in the complex therapy blocks the growth and reproduction of viruses. Treatment of adnexitis caused by the herpes simplex virus, papilloma often occurs with wiferon, which has shown good efficacy. One of the benefits of the drug is that it makes healthy cells immune to viruses.
Treatment of adnexitis caused by anaerobic microorganisms is carried out with the help of nitroimidazoles. Metronidazole is a drug of this group, and has the ability to destroy most anaerobic bacteria. The drug is well established in the treatment of the genitourinary system. Metronidazole is available in pill form, the course of treatment is determined by the attending physician.
Candles hexicon are often used in inflammatory diseases in the appendages. The drug has a minimal amount of adverse reactions, and the components of the drugs are not absorbed into the blood. Treatment of adnexitis with hexicon is usually carried out by a ten-day course, in some cases the drug can provoke itching and severe allergies.
When do I need to prescribe physiotherapy?
The spectrum of gynecological pathology requiring a course of physiotherapy is very large. Traditionally, physical factors have been used in the treatment of subacute and chronic diseases of the pelvic organs (chronic inflammation of the uterus) and infertility. With the introduction of operations for the restoration of the tubal patency into general practice, physiotherapy has not lost its relevance as a method of postoperative rehabilitation treatment. The use of anti-inflammatory factors in the first stage immediately after surgery improves the postoperative period and prevents the formation of adhesions.
At the second stage in the next menstrual cycle, it is desirable to conduct a full-fledged course using factors that restore the functional usefulness of the fallopian tubes. Of great importance is the rehabilitation of women after artificial abortion, spontaneous miscarriage, or curettage of the uterus for non-developing pregnancy. The inevitable trauma of the uterine lining under these conditions may have different effects on their reproductive function in the future.
Numerous studies have shown that in the overwhelming majority of women who have undergone an artificial or spontaneous abortion, menstrual disorders and other problems in the sexual sphere do not develop immediately, but several years after the intervention. Therefore, it becomes clear why rehabilitation treatment aimed at the future is so important. This is more promising than a long and hard struggle with the old, neglected chronic inflammation of the genital organs and adhesions.
Recently, much attention has been paid to the treatment of uterine factors of infertility. The uterus mucous membranes (endometritis) that were transferred in the past can lead to its functional inferiority. A fertilized egg or cannot penetrate into the endometrium, or pregnancy "freezes" in the early stages of development, because there is no complete blood supply and nutrition of the developing embryo. A miscarriage occurs spontaneously or missed abortion is diagnosed. These conditions require subsequent curettage of the uterus, which in itself is an additional trauma to the mucosa.
Therefore, after the intervention, the important point of the rehabilitation course is therapy with the help of physical factors. At the same time, antibiotics and hormones are treated according to indications, incl. the appointment of short courses of hormonal contraceptives. This contributes to the structural and functional restoration of the endometrium and the favorable course of subsequent pregnancies.
When diagnosing a pathology leading to infertility or miscarriage, the inclusion of non-drug therapy by physical factors in the treatment complex can significantly increase the number of pregnancies obtained and reduce reproductive losses. In recent years, so-called. assisted reproductive technology-in vitro fertilization programs (IVF) or "test tube babies". Under this program, the fertilized egg is transferred directly to the uterus of the woman. And here the uterine factors of infertility and miscarriage (for example, chronic endometritis) are even more, if not crucial.
Therefore, in many medical centers, the impact of physical factors on the uterine mucosa is an important step in preparing a woman for the upcoming attempt of in vitro fertilization and embryo transfer. This is especially important for patients having failed IVF attempts in the past.
Thus, physiotherapy is indicated in the following conditions:
- rehabilitation treatment after gynecological operations
- rehabilitation after abortion and curettage of the uterine lining
- preparation for pregnancy of women with spontaneous miscarriages and missed abortions in the past
- preparation of the uterine lining before the IVF program
- traditional indications for the use of physical factors - chronic inflammation of the uterine appendages
- sterility due to obstruction of the fallopian tubes
What to choose?
The choice of the active principle, as in the prescription of drug therapy, is made on the basis of diagnosis, age, hormonal background, the presence of contraindications to certain physical factors, individual tolerance of the procedures and the specific tasks that the doctor is facing regarding the preservation and restoration of the reproductive function of this woman in the future. Of course, a program of treatment for a patient of late reproductive age who is not planning a pregnancy, and receiving a procedure after abortion of a young woman will differ significantly.
The following physical apparatus factors are most often used today in gynecology:
- electric and magnetic fields. The current factor of the electromagnetic field can be mainly its electric or magnetic component. Magnetotherapy is mainly characterized by an anti-inflammatory effect, which is associated with the anti-edema effect of the factor. This allows you to widely use the magnetic field in gynecology in the early postoperative period after surgical interventions.
- electrotherapy (use of electric current). It is possible to use direct current (galvanization, medicinal electrophoresis), pulsed currents (interference therapy, electrical stimulation, etc.). Лечение импульсными токами снимает спазм сосудов и гладкой мускулатуры, что способствует улучшению кровоснабжения тканей, оказывает обезболивающий эффект.
- действие факторов механической природы (ультразвуковая терапия). Ultrasound (US) effects provide a kind of micro-massage of cells and tissues, accompanied by the appearance of heat, and provide anesthetic effect, “softening adhesions”, improve the blood supply to tissues and increase the hormonal activity of the ovaries.
- phototherapy. Light treatment - the use of ultraviolet (UV) rays, infrared and visible rays. Shortwave UV rays, for example, when directly exposed to pathogenic microorganisms that are directly on the skin or mucous membrane, cause a pronounced bactericidal effect and are used in the treatment of inflammation of the mucosa of the external genital organs and the vagina. Phototherapy also includes the use of laser radiation. Low-intensity laser radiation includes the complex treatment of endocervicitis (inflammation of the cervical canal), colpitis (inflammation of the vaginal mucosa) and inflammatory diseases of the pelvic organs.
Separately, it is necessary to highlight the issue of contraindications to physiotherapy to gynecology. Many women, given the long history of the disease and age, burdened by comorbidities. Heat-forming procedures, in particular, are contraindicated in endometriosis and uterine myoma. Today, there are factors and there is a great many years of experience in their use for the treatment of women with such comorbidities (for example, interferential currents). An important postulate for each doctor is the saying “do no harm”, therefore the selection of an individual treatment program for such patients requires special care.
Existing techniques in physiotherapy
After the examination and diagnosis of the disease, the treatment of which requires the appointment of physiotherapy, it is necessary to individually select the procedure procedure. Numerous techniques can be out of the cavity, i.e. external with localization effects on certain areas of the skin of a woman, intracavitary (rectal, vaginal), and their combination. Intracavitary techniques in gynecology, as a rule, are more effective than extracavitary procedures. In gynecological diseases, the choice of the day of the menstrual cycle to begin a course of physiotherapy plays an important role. The coincidence in the time of the start of procedures with the preovulatory period or ovulation, the second phase of the menstrual cycle is often accompanied by various local and general undesirable reactions (pain, disruption of the rhythm of menstruation, etc.). Thus, in the absence of urgent indications, the optimal time for starting a course of physiotherapy for gynecological diseases is 5-7 days of the menstrual cycle, i.e. immediately after the end of menstruation. And on the days of ovulation and at the end of the cycle, the intensity and duration of the action of the factor must be reduced due to increased sensitivity to stimuli on these days.
It is possible to conduct an intensive course of treatment consisting in carrying out 3 procedures per day on the basis of specialized departments where physiotherapists and obstetricians-gynecologists work together, which allows direct dynamic monitoring of the condition of each specific patient not only by the physiotherapist, but also by the obstetrician-gynecologist . The introduction of patient feedback channels into the physiotherapeutic equipment also allows the power characteristics to be automatically corrected during procedures to increase the clinical effectiveness of the treatment.
What is the role of physiotherapy in gynecology with infertility? Physiotherapy is an integral component of the treatment and prevention of gynecological diseases. Physiotherapeutic procedures are highly effective and safe. Today, widely used: electrophoresis, magnetic therapy, phototherapy, massage, laser therapy and ultrasound.
When is physiotherapy given?
The main indications for the application of the technique are:
- gynecological surgical interventions,
- abnormal development of the genitals,
- hypoplasia of the uterus,
- inflammation of the nerves in the hip area,
- preparation for pregnancy or in vitro fertilization protocol,
- breast diseases,
- obstruction of pipes
- inflammatory processes in the uterus,
- lack of ovulation
- cleaning the uterus,
- hormonal disbalance.
When tubal infertility disrupts the work and the structure of the appendages. The causes of pathology are: infectious and inflammatory processes, endometriosis, surgery on the pelvic organs. Obstruction of the pipes is most often associated with the presence of infections. So, chlamydia, causing inflammation, leads to the destruction of fimbriae and the formation of hydrosalpinx. Mycoplasmas, settling on the cells, attach to the sperm and slow it down. Ureaplasma with the help of sperm penetrates the tubes, causing them obliteration. Also, the pathogens of this disease have a toxic effect on the ciliated epithelium, which leads to a significant decrease in the rate of passage of the egg into the uterus. In addition, viruses lead to a decrease in the immune system.
Peritoneal infertility occurs in 39% of women with pathology. The disease is caused by adhesions occurring in the appendages. The causes of development are surgical interventions, endometriosis, inflammatory processes.
Any surgical procedure carried out in gynecology, can provoke the occurrence of adhesions. Physical therapy in the postoperative period accelerates tissue regeneration, promotes recovery, reduces the risk of adverse effects.
Technique and the positive aspects of physiotherapy
Most of the gynecological diseases associated with stagnant processes in the pelvic area. Similar pathology interferes with the treatment of other diseases in women. The use of only tablets in this case is ineffective. To avoid surgery, doctors prescribe physiotherapy.
Physiotherapy has several advantages:
- eliminate pain symptoms,
- regenerate affected tissue
- remove inflammation
- normalize metabolism
- improve blood circulation
- allow you to recover faster after surgical interventions,
- reduce the likelihood of complications or relapse
- they can be administered simultaneously with antibiotic treatment,
- reduce the load on the body while taking medication.
There are certain methods of conducting procedures:
- The therapy is carried out by treating the skin, as well as rectally or vaginally. Intracavitary procedures are more effective because they directly affect the site of the disease.
- If there are no urgent indications for the use of therapy, the course is carried out starting from the 6th day of the cycle. If the beginning of the procedure coincides with ovulation, then the likelihood of side effects increases significantly. Treatment during critical days leads to increased bleeding.
- procedures are performed only on the empty bladder. Upon completion of treatment should not immediately leave. It takes some time to stay indoors. Any hypothermia during treatment can lead to exacerbation of the disease.
Many women, faced with infertility, are on a long difficult path to combat this disease. In some cases, conventional medication treatment helps, in others it is necessary to combine various means. Electrophoresis and other methods, together with medical treatment, can restore women's health, help get rid of infertility and gynecological diseases. The doctor, after examining and examining the tests, prescribes a procedure that best suits the specific case. Only compliance with the appointment of a specialist will provide an opportunity to restore health.
Painkillers are prescribed for severe pain. Local anesthetics (suppositories, ointments) have a good effect. Rectal suppositories diclofenac will help reduce inflammation and pain, the absorption of which after the injection occurs rather quickly. When injected into the blood, diclofenac has a general effect on the body, relieves pain, reduces inflammation, and reduces fever.
Indomethacin with adnexitis
Indomethacin is a nonsteroidal anti-inflammatory drug that is well established therapy of gynecological diseases.
The drug is available in the form of rectal suppositories.
Indomethacin relieves and relieves inflammation, has antipyretic effect. Indomethacin is contraindicated in case of ulcer, abnormal liver function, kidney function, during pregnancy.
Comprehensive treatment of adnexitis includes the use of anti-inflammatory suppositories, in particular, indomethacin.
Adnexitis treatment at home
Treatment of adnexitis, more precisely, prevention of the chronic form can be carried out with the help of traditional medicine.
Aloe and cabbage juice is considered effective in this case. A tampon is impregnated with the juice of plants and placed in the vagina overnight, the course of therapy is two weeks. It also helps to avoid exacerbations of tampons with Vishnevsky ointment (a two-week course of treatment).
Treatment of adnexitis, provided that the disease is detected at an early stage, is not difficult. In this case, it is important to undergo a diagnosis and determine the cause of the disease and not abandon treatment after the acute manifestations of the disease subside. Otherwise, adnexitis can become chronic, which can lead to serious health problems.
With the development of the chronic form of adnexitis, various physiotherapy procedures are recommended (UHF, ultrasound, electrophoresis, etc.).
With frequent exacerbations, spa treatment is recommended (mineral baths, mud therapy, etc.).
In addition to prevention, it is important to eat properly and fully, to keep an active lifestyle, not to freeze.
During electrophoresis under the influence of direct current a specific drug substance is injected under the skin. Up to 10% of the drug (depending on age, current density, solvent used, etc.) enters the body through a pad soaked in solution.
Treatment of adnexitis by electrophoresis is recommended after the abatement of the acute process of inflammation. The procedure has absorbable, analgesic and anti-edematous properties.
Magnetotherapy for adnexitis
Magnetotherapy is widely used in the treatment of gynecological diseases. This method is based on several principles: improvement of blood circulation, restoration of normal polarity of cells.
Treatment of adnexitis with the help of magnetic therapy will help to get rid of pains caused by spikes in the pipes, as well as normalize the menstrual cycle.
Physical factors and pregnancy
Healing physical factors may also be used during pregnancy. Drugs can penetrate to the developing fetus and not always have a positive effect on it. Without drugs, it is often necessary. Physical therapy also allows you to achieve the same effect with lower doses of drugs and reduce the adverse effect on the fetus.
Physical factors are used in early toxemia of pregnant women, having a positive effect on the emetic vegetative center in the brain. With the threat of abortion, it is possible to reduce the tone of the uterus, for example, using magnesium electrophoresis with a gestation period of more than 8 weeks, since magnesium reduces the sensitivity of the uterus to oxytocin (a hormone that causes uterine muscle contraction).
In the postpartum period, physiotherapy is simply indispensable:
- better postoperative period after cesarean section, healing of the suture
- healing of the seams on the perineum,
- nipple cracking treatment and mastitis prophylaxis (inflammation of the mammary gland)
- physiotherapy perfectly helps with lactostasis, facilitating the discharge of milk and preventing the inflammatory process from developing. In the postpartum ward it is a very useful thing that can ease the hard physical labor of manual breaking through :)
- physiotherapy (darsonvalization) is an excellent remedy for postpartum hemorrhoids.
- impulse currents improve intestinal peristalsis and uterine contractions - they can solve the problem of its poor contraction, delay of blood clots in the cavity, especially with neck spasm, postpartum intestinal paresis
- The use of physiotherapy in the postpartum period dramatically reduces the likelihood of developing postpartum endometritis. (Mmm)