Adnexitis- inflammation of the female internal genital organs ("appendages"). The inflammatory process is associated with the presence of an infection that enters the appendages (ovaries, fallopian tubes), as a rule, from the underlying parts of the genital tract, primarily from the vagina, which normally contains a lot of bacteria, but they do not penetrate further than the vagina.

Inflammatory diseases of the vagina and external genitalia can lead to the penetration of pathogenic microbes inside. Therefore, it is impossible to delay the treatment of even easily occurring vaginitis and vulvitis (infection of the vagina and labia).

Signs of adnexitis can be diagnosed in girls aged 10-12 and in women over 60. Adnexitis and salpingitis occupy a leading position among other pathologies of the female genital area. The nosological classification according to the international classifier of diseases (ICD-10) adnexitis has code 70 and implies not only inflammation of the ovaries, but also of the fallopian tubes.

Causes of adnexitis

The cause of adnexitis is often a sexually transmitted infection, for example, chlamydia, gonococcus, trichomonas, sometimes Staphylococcus aureus, etc. The cause of adnexitis can also be a frequent change of sexual partner, unprotected sex, as well as too rapid resumption of sexual life after childbirth, abortion or gynecological operations.

An important role is played by the state of immunity, because if a woman is constantly under stress, she is more prone to adnexitis. The cause of adnexitis can also be hypothermia due to the fact that a woman does not dress for the weather. The presence of an intrauterine device can also provoke inflammation of the appendages.

Symptoms of adnexitis

Symptoms of acute adnexitis

The main symptom of acute adnexitis is severe pain in the lower abdomen on the right or left. The pain has a pulling or aching character and can radiate to other areas: the lower back, sacrum and rectum. In addition, purulent or serous discharge from the vagina begins. Additional symptoms of acute adnexitis are high body temperature, headache, loss of strength, pain in the joints and muscles.

Symptoms of chronic adnexitis

Sometimes chronic adnexitis occurs immediately, without an acute form, but, as a rule, develops from acute adnexitis in the absence of the necessary treatment. The main symptom of chronic adnexitis is also aching and pulling pains in the lower abdomen, but less intense than in the acute form of adnexitis. Pain occurs periodically, usually before or after menstruation. Another symptom of chronic adnexitis is dyspareunia - pain during intercourse.

In addition, with chronic adnexitis, menstrual irregularities occur: oligomenorrhea, amenorrhea, dysmenorrhea, etc. An exacerbation of chronic adnexitis may appear due to stress, hypothermia, various diseases, and the symptoms are similar to the acute form of adnexitis. A frequent symptom of adnexitis in advanced chronic form is infertility due to obstruction of the fallopian tubes or ovarian dysfunction.

Diagnosis of adnexitis

Diagnosis of adnexitis is difficult, since the symptoms of acute adnexitis are characteristic of various diseases of the pelvic organs, and the symptoms of chronic adnexitis are often not expressed.

To diagnose adnexitis, a gynecological examination is used, which consists of a laboratory analysis of vaginal discharge, as well as a urine and blood test. However, the detection of microorganisms characteristic of adnexitis cannot indicate adnexitis with a sufficient degree of probability, since these signs are not specific.

A more reliable method for diagnosing adnexitis is laparoscopy - an endoscopic examination that makes it possible to examine the ovaries and fallopian tubes and detect such signs of the inflammatory process as accumulations of pus and serous effusion, inflamed mucous membranes, adhesive process with a change in tissue structure.

Treatment of adnexitis

In the treatment of acute adnexitis, hospitalization is necessary, since the acute form of adnexitis can have serious consequences and complications: the formation of purulent cavities in the tubes, purulent fusion of the ovaries, peritonitis, etc.

The patient is prescribed bed rest, drugs are used for pain relief, and broad-spectrum antibiotics and anti-inflammatory drugs are used to eliminate the inflammatory process. In the presence of a purulent process, surgical treatment is used.

In the treatment of chronic adnexitis, the same scheme is used, except that antibacterial drugs are selected taking into account the pathogen, and corticosteroids are used as anti-inflammatory drugs. In addition, immunostimulating and restorative therapy is carried out.

In the treatment of adnexitis, physiotherapeutic methods are also used:

• magnetotherapy,
• microwave and UHF therapy,
• paraffin therapy,
• mud treatment, etc.

Treatment of adnexitis with folk remedies at home

Treatment of adnexitis with folk remedies at home is used for chronic adnexitis. Folk remedies for the treatment of acute adnexitis should not be used, since in the acute form of adnexitis there is a significant risk of developing severe complications, including life-threatening ones.

As a folk remedy for the treatment of adnexitis at home, douching, enemas or baths from infusions and decoctions of medicinal herbs with anti-inflammatory action are used:

• yarrow,
• pharmacy chamomile,
• caragana officinalis,
• hypericum,
• calendula,
• succession,
• sage,
• kalanchoe juice,
• Golden mustache,
• eucalyptus.

In addition, to stimulate the immune system, aloe juice, ginseng infusion, echinacea purpurea infusion, mummy, honey and other bee products are taken orally. It must be remembered that using folk remedies for the treatment of adnexitis at home should only be done after consulting with your doctor.

Prevention of adnexitis

You should follow certain rules for the prevention of adnexitis.

Often this disease becomes a complication of abortion, so it is best to avoid them. If this is not possible, termination of pregnancy should be carried out only in a good clinic, with all precautions, including the rules of personal hygiene after. The same applies to any medical manipulations associated with penetration into the uterine cavity: setting and removing the spiral, childbirth, diagnostic curettage, and so on.

Often the cause of adnexitis is unprotected intercourse, during which infection with sexually transmitted infections occurred. Therefore, casual sexual intercourse and unfamiliar partners should be avoided. If there is at least a minimal lack of confidence in a partner, barrier contraception should be used - condoms.

Even with a regular partner, there is a risk of developing adnexitis if you alternate vaginal intercourse with anal. This can cause the penetration of pathogenic bacteria from the intestines into the vagina and into the uterine cavity.

Sometimes the conditionally pathogenic flora of the vagina becomes the cause of adnexitis. To contain it, good local and general immunity is required. Proper nutrition, periodic intake of vitamins, and in some cases, immunomodulatory drugs help to maintain it.

You should also monitor the cleanliness of the vagina with the help of regular, at least twice a year, gynecological examinations with mandatory bacterioscopy of vaginal discharge.

Like other gynecological inflammatory diseases, adnexitis is often a consequence of hypothermia. Therefore, you should not wear short autumn and winter jackets, short skirts, sit in the cold, allow general hypothermia of the body, as well as wet feet. Even in summer, you can get hypothermia if you sit directly in front of a fan or under a stream of cold air from an air conditioner.

These rules are not only the prevention of adnexitis, but also help prevent many other gynecological diseases.

Adnexitis classification

Adnexitis is classified according to several criteria:

Way of occurrence

• endosalpingoophoritis: the pathogen penetrates through the mucous membrane;
• peresalpingoophoritis: infection begins in the abdominal cavity;
• myosalpingoophoritis: a rare type of disease - the pathogen penetrates from the muscle tissue.

flow type

• chronic: occurs against the background of insufficient effectiveness of treatment;
• acute: characterized by severe conditions with fever;
• subacute: is a transitional stage on the way to recovery or chronic adnexitis;
• purulent inflammation: an extreme type of acute salpingo-oophoritis - cavities filled with pus form in the appendages.

Distribution pattern

• unilateral: only the right or left ovary is affected;
• bilateral: both sides are affected.

Questions and answers on the topic "Adnexitis"

Question:Hello! Is it possible to have sex during the treatment of adnexitis?

Answer: Hello. Sexual contact is allowed under the following conditions: sex with inflammation should be carried out with only one sexual partner; be sure to use a condom. It is not recommended to have sex with this pathology in women if painful sensations and pathogenic secretions are observed during sexual contact. It is important to follow the recommendations of the attending physician regarding sexual activity in case of inflammation of the uterine appendages.

Question:Hello. Can there be wandering pains with adnexitis and thrush, then on the left, then on the right, then in the middle, then subside, then intensify?

Answer: Hello. Yes, it happens with adnexitis, you need it.

Question:Good evening, adnexitis was diagnosed, treatment was prescribed, today I’m taking antibiotics for 5 days, for some reason the pain has increased in the evening, it radiates to the leg and makes me feel nauseous, what should I do? Go back to the doctor or it could be from the antibiotics.

Answer: Hello. Treatment of adnexitis should be comprehensive. To reduce pain, suppositories and physiotherapy are used. Report your condition to your doctor.

Question:Hello. I am 27 years old, we are planning a pregnancy. Is conception possible with chronic right-sided adnexitis?

Answer: Hello. Perhaps against the backdrop of a stable remission.

Question:Hello! Here's the question that worries me. I am 22 years old, I gave birth to a daughter two years ago. After childbirth, there was curettage of the placental polyp. Six months later, pains in the lower abdomen began, at first they diagnosed endometritis, then they began to put adnexitis, after treatment the pain does not go away. The doctor prescribed me to drink hormonal, but I'm afraid to drink them. Is it possible to do without hormones? Is it possible to get pregnant with chronic inflammation?

Answer: Good afternoon, I can’t answer without hormones or not, there is not enough information, there may be pregnancy against the background of inflammation, but most likely with problems.

Question:Good afternoon! My sister has recently been ill with adnexitis. The disease is not the most pleasant, and I would very much like to avoid it. Tell us how to protect yourself from it, what kind of prevention of adnexitis is necessary?

Answer: Good afternoon! It is very good that you want to avoid this disease, because it is much easier to prevent than to treat, and the consequences can be very serious, up to infertility, peritonitis, and in rare, most severe cases, even death. Read about the prevention of adnexitis.

Question:Hello, I am 19 years old, exacerbation of chronic adnexitis. Please tell me if the herbs red brush and boron uterus will help me relieve inflammation and get rid of adhesions. These herbs are highly praised. I just can’t inject antibiotics in the near future, because. I'm not sure that I'm not pregnant, I didn't use contraception with my husband. I am waiting for my period, when they come, I will inject antibiotics prescribed by the doctor. So I wanted to heal a little with herbs.

Answer: In our opinion, the medicinal herbs indicated by you will not be able to have a fundamental anti-inflammatory effect, and even more so to eliminate the adhesive process.

Question:I was diagnosed with adnexitis. They removed the ovary and left tube. I passed all the tests and took a course of injections. Now they prescribed regulon, after reading the instructions, it became scary to drink it and, in my opinion, does not apply to my illness at all. Tell me, is the use of this drug necessary or can other, more sparing and safe means be dispensed with?

Answer: Regulon is not a treatment for adnexitis, and can only be prescribed if you need reliable contraception.

Question:Good afternoon! On the last ultrasound of the pelvic organs, my doctor concluded: "Ultrasound signs of chronic adnexitis, adhesive process of the small pelvis (left ovary)". I'm pregnant now, about 5-6 weeks. I feel good, there are no signs of an ectopic, but I do not stop thinking about it. I do not know what to do.

Hello! You need to register for pregnancy and warn the doctor who will manage the pregnancy about the diagnosis, discuss possible risks and follow his recommendations in the future. At the moment, there is no reason to worry - one of the most dangerous complications of adnexitis - infertility - has not affected you, the adhesive process is dangerous, in particular, ectopic pregnancy - this can be excluded using ultrasound (ultrasound will show that the fetal egg is attached in the uterus). As for the chronic inflammatory process, in this case you need to trust the doctor who will observe you, do not miss scheduled visits, and in case of alarming symptoms (unusual discharge, pain, bleeding), come for an urgent consultation.

Question:Hello, 7 months ago, an ultrasound revealed adnexitis, because when I pressed the vaginal probe, I experienced terrible pain in my left ovary. But before the ultrasound, nothing bothered me, and I didn’t know. The truth felt discomfort when having sex with her husband. But no treatment was given. No pregnancy for 9 years. In general, how to find out at what stage I have adnexitis, during the last menstruation I experienced terrible pain (and on the first day of menstruation I was again on ultrasound). Are there any chances for treatment and what form of adnexitis do I have now?

Answer: Hello! You already answered your first question and answered it yourself. Ultrasound showed the presence of chronic inflammation of the appendages. Diagnosis: chronic adnexitis. If adnexitis does not bother, then this does not mean that there is no problem. Infertility (temporary with adnexitis) is one of the possible complications of adnexitis. In the worst case, adhesions and obstruction of the fallopian tubes are formed. Treatment of adnexitis, of course, is carried out by a doctor. It would be nice to know what infections are. But the usual scheme for taking natural remedies for adnexitis is also suitable for you. If there are infections, then the maintenance of immunity will be longer.

Question:Hello! Tell me, please, I had adnexitis, the doctor prescribed Wobenzym and Celebrex after a course of pills, at the end of this course I started having some kind of brown discharge, and menstruation a couple of days later. Tell me, please, because of what it could be? Thank you.

Answer: Hello. This happens while taking antibiotics. But in order to more accurately answer this question, it is better for you to do an ultrasound of the pelvic organs, since such discharge can also occur with other diseases.

Question:Good afternoon! I would like to know what my condition can be connected with, my period ended on the 23rd. Now the lower back is constantly aching and the back hurts, there is bloating, pain in the right side. And such a state, as if menstruation will go again. Could it be something stomach related?

Answer: The symptoms you describe can be observed in a number of diseases (adnexitis, ovarian cyst) and to establish their cause, you need to consult a doctor and undergo an examination. To begin with, you should consult a doctor, take a blood test and do an ultrasound of the internal organs of the small pelvis.

Good day, dear readers!

In today's article, we will consider with you such a female disease as adnexitis, as well as its symptoms, causes, forms, treatment, medicines, folk remedies and other useful information. So…

What is adnexitis?

Adnexitis- an inflammatory disease of the uterine appendages (fallopian tubes and ovaries) of an infectious nature. It is considered the most common gynecological disease among the female population aged 20 to 30 years.

Other names of adnexitis - salpingoophoritis, which consists of the Greek "sálpingos" and novolat. "oophoron" - ovary, salpingitis(inflammation of the fallopian tubes only).

The disease is based on the penetration of infectious agents to the uterine appendages through the vagina (ascending path) or through the blood and lymph (descending path). One way or another, uncontrolled sexual life with several partners, surgical intervention in the pelvic organs, common infectious diseases, and all this, most often, against the background of weakened immunity, usually leads to the development of adnexitis.

Development of adnexitis

The development of adnexitis begins with infection entering the genital appendages, where, after settling on the mucous membrane of the fallopian tubes, an inflammatory process is formed, involving the epithelial (outer) walls of this organ.

Further, as the disease develops, a serous fluid is formed at the site of inflammation, sometimes purulent formations, which moves further along the course - to the ovaries. At the same time, infiltration of the walls of the fallopian tubes and ovaries occurs, after which, these two uterine appendages are soldered, forming a single inflammatory formation.

The onset of the disease is usually acute - accompanied by severe pain in the lower abdomen (palpation in this place is especially painful), fever, general weakness and malaise. If nothing is done at this stage, the disease becomes chronic.

Chronic adnexitis is characterized by periodic exacerbations - attacks of pain in the pelvic area, menstrual irregularities, depression of the psycho-emotional state. Especially exacerbations appear with hypothermia, stress, violation of the diet and work / rest.

Adnexitis - ICD

According to ICD-10, there are:

• N70.0- Acute salpingitis and oophoritis;
• N70.1- Chronic salpingitis and oophoritis;
• N70.9- Salpingitis and oophoritis, unspecified.

Symptoms of adnexitis

Symptoms of acute adnexitis:

• Acute, severe pain in the pelvic region - in the lower abdomen, radiating to the lower back, aggravated by an attempt to palpation, resembling signs of appendicitis;
• Increased body temperature - up to 38-38.5 ° C, chills;
• increased sweating;
• Attacks of headaches and muscle pain;
• Failure in menstruation - menstrual irregularities, painful abundant or scanty discharge, increased duration of the course;
• painful urination;
• Painful sexual intercourse, as well as a feeling of pain after it;
• Purulent discharge from the vagina.

Symptoms of chronic adnexitis:

• Violation of the menstrual cycle associated with hypofunction of the ovaries and a correspondingly reduced level of female sex hormones, which leads to - painful, profuse or scanty, often with clots, increased or reduced duration and irregularity of menstruation;
• Dull pains in the lower abdomen and groin, sometimes aggravated by pathological factors - hypothermia, stress, overwork, the development of secondary diseases;
• Depressed psycho-emotional state;
• Decreased sex drive;
• Sexual dysfunction;
• Pain during and after sexual contact.

Complications of adnexitis

• Adhesion processes in the fallopian tubes;
• Peritonitis;
• anovulation;
• Cholecystitis;
• Colitis;
• Ectopic pregnancy;
• Spontaneous miscarriage;
• Infertility.

Causes of adnexitis

The main cause of adnexitis (salipingoophoritis) is an infection.

The most common causative agents of adnexitis are staphylococci, streptococci, gonococci, chlamydia, Escherichia coli, Mycobacterium tuberculosis and others.

The development of adnexitis occurs especially rapidly against the background of the following adverse factors:

• Violation of the integrity of the mucous or epithelial wall of the pelvic organs (uterus, fallopian tubes, ovaries) due to - endoscopic examination of the uterus, installation of a spiral, having sex immediately after menstruation (or during them) or abortion;
• Inhibition of the activity of the immune system, which usually occurs due to hypothermia, stress, changes in climatic conditions of residence, overwork, malnutrition, hypovitaminosis, the presence of other diseases, especially infectious ones (ARI, influenza, sinusitis and others);
• Complication of diseases such as gonorrhea, chlamydia;
• Unsuccessful abortions.

It should also be noted that various cocci enter the body through the vagina, while Koch's bacillus, E. coli and other internal infections enter the body through the blood and lymph.

Types of adnexitis

The classification of adnexitis is as follows:

By formation:

Primary adnexitis- the development of the disease occurs independently - the infection enters the fallopian tubes and ovaries on its own, or as a result of sexual intercourse, endoscopic examination, etc.

Secondary adnexitis- the development of the disease occurs against the background of other infectious diseases, when pathological microorganisms pass to the uterine appendages from neighboring organs.

By localization:

Unilateral adnexitis- the disease develops on one side of the uterus, so it can be:

• Left-sided salipingoophoritis;
• Right-sided salipingoophoritis.

Bilateral adnexitis- the disease develops simultaneously on two sides of the uterus, left and right.

With the flow:

Acute adnexitis (acute salipingoophoritis)- characterized by the rapid development of the disease with elevated and high body temperature (38-38.5 ° C), severe pain in the pelvic area (especially on palpation), chills, fatigue, general weakness, headaches and muscle pain, painful urination, sometimes purulent vaginal discharge.

Subacute adnexitis- characterized by a decrease in the signs of the disease, incl. a drop in body temperature to 37 ° C, general weakness, pain in the lower abdomen.

Chronic adnexitis (chronic salipingoophoritis)- characterized by some whining in the lower abdomen with periodic bouts of severe but dull pain, menstrual cycle disturbance, decreased libido, and depression of the woman's mental system. An internal examination of the vagina reveals an increase in the uterine appendages.

Diagnosis of adnexitis

Diagnosis of adnexitis includes:

• Anamnesis;
• General blood analysis;
• Blood chemistry;
• General urine analysis;
• Bacteriological examination of a smear from the cervix;
• Ultrasound examination (ultrasound) of the uterine appendages.

Additionally, it can be carried out:

• Hysterosalpingography;
• Tuberculin tests;
• Menstrual blood cultures and others.

Treatment of adnexitis

How to treat adnexitis (salipingoophoritis)? Treatment of adnexitis without fail begins with a thorough diagnosis and identification of the type of pathogen, however, in general, therapy consists of the following points:

1. Hospitalization (with acute adnexitis);
2. Physical rest;
3. Drug treatment;
4. Physiotherapeutic procedures;
5. Diet;
6. Surgical treatment

1. Hospitalization

The need for hospitalization in the acute form of the disease is due to the fact that the pain in acute adnexitis is strong enough to endure them on their own. In addition, this must be done to rule out appendicitis.

Persons who have an exacerbation of the chronic form of the disease are also subject to hospitalization.

2. Physical rest

Physical rest, proper rest are due to the fact that overwork, stress, hypothermia of the body are one of the unfavorable factors, due to which adnexitis could actually form. In addition, during physical rest, the body restores and accumulates the forces necessary for the immune system, and indeed, for the whole body, to fight the disease.

3. Medical treatment

Important! Before using medications, be sure to consult your doctor!

With adnexitis, the following groups of drugs are usually prescribed:

3.1. Antibacterial drugs

Antibiotics for adnexitis are prescribed due to the nature of the disease - the development is due to bacteria entering the fallopian tubes and ovaries, mainly staphylococci and streptococci.

Preference is given to broad-spectrum antibacterial drugs, as well as those with a long half-life.

Among the antibiotics for adnexitis, the following groups and drugs can be distinguished - macrolides ("Azithromycin", "Claritomycin", "Erythromycin"), penicillins ("Amoxicillin", "Ampicillin", "Oxacillin"), tetracyclines ("Tetracycline", "Doxacillin" ), aminoglycoside (Gentamicin, Kanamycin), fluoroquinolone (Ofloxacin), nitroimidazole (Metronidazole), lincosamides (Clindamycin), sulfonamides (Biseptol), cephalosporins (Cefalexin, Ceftriaxone) ), tricyclic glycopeptides ("Vancomycin").

The best effect is achieved with the simultaneous use of several antibiotics from different groups (under one drug from each group).

Antibiotics for salipingoophoritis at the beginning of therapy are usually prescribed intravenously and intramuscularly, after which the patient is transferred to tablets.

Douching and vaginal suppositories are also useful for adnexitis with the addition of antibacterial drugs.

3.2. Painkillers

Painkillers are prescribed to relieve pain in adnexitis and alleviate the course of the disease, since this symptom of the disease is considered one of the most unpleasant.

Among the painkillers for adnexitis, one can distinguish: Paracetamol, Diclofenac, Nimesil, Ibuprofen.

As a first aid, for pain relief, you can apply a cool compress to the suprapubic area, however, still consult a doctor after that.

3.3. Anti-inflammatory drugs

They are prescribed to relieve the inflammatory process directly at the site of the disease. By relieving inflammation, all other signs of salipingoophoritis are also reduced / stopped - fever, pain in the pelvic area, headaches, etc.

Among the anti-inflammatory drugs can be identified - "Wobenzym", "Diclofenac", "Nimesil",

3.4. Body detoxification

During their stay in the body, bacteria poison it with their waste products, which are toxins. In addition, when using antibacterial drugs, the body is also poisoned by dead microorganisms.

To remove toxins from the body, infusion (detoxification) therapy is used, which implies intravenous infusion of glucose solutions, polysaccharides ("dextran"), water-salt solutions.

3.5. Strengthening the immune system

Strengthening immunity is also a very important point in the treatment of this disease, since the development of adnexitis, in addition to infection, is largely due to a weakened immune system, which actually performs the function of protecting the body from adverse factors, incl. bacteria.

Immunostimulants are prescribed as stimulants for the activity of immunity, among which are Immunal, IRS-19, Imudon, Lyzobakt.

A large amount of vitamin C is found in rose hips, dogwood, viburnum, kiwi, currants, cranberries, sea buckthorn, parsley.

3.6. Strengthening the liver

The use of antibacterial drugs contribute to the weakening of the liver, which performs the function of cleansing the body. Also, the load on the liver produces an excess amount of infection and its waste products in the body.

To maintain the functioning of the liver and protect its cells from destruction, hepatoprotectors are used - Hepatosan, Karsil, Ursosan.

3.7. Candles for adnexitis

Candles (suppositories) for adnexitis are a wonderful addition to the general therapy of the disease. By acting on the focus of inflammation locally, various types of suppositories contribute to pain relief, removal of the inflammatory process, relief of infection, improvement of the course of the disease and accelerated recovery. However, suppositories also have a number of contraindications, so they should be used only after consulting a doctor.

The most popular candles for adnexitis: Voltaren, Hexicon, Indomethacin. "Movalis", "Polygynax", "Fluomizin".

Let's look at them briefly:

• Candles "Voltaren"- have antimicrobial and analgesic properties;
• Candles "Hexicon"- have antibacterial and anti-inflammatory properties, have a minimum number of contraindications and are allowed during pregnancy and lactation;
• Candles "Movalis"- has anti-inflammatory and analgesic (anelgesic) properties, belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs);
• Candles "Indomethacin"- have analgesic, anti-inflammatory and antipyretic effects;
• Candles "Polygynax"- have antifungal and antibacterial properties, while having a minimum number of contraindications and side effects, which allows the use of these suppositories for the treatment of many infectious gynecological diseases;
• Candles "Fluomizin"- have an antiseptic (antimicrobial) effect.

4. Physiotherapeutic procedures

Physiotherapy for adnexitis helps to improve the course of the disease, relieve pain, stimulate the body to fight infection and speed up recovery, however, these procedures can only be used in the absence of an acute phase of the disease, i.e. only in the subacute and chronic phases. In addition, some physiotherapy procedures are contraindicated during pregnancy, lactation, and the presence of tumors.

Among the methods of physiotherapy, one can single out: ozokerite, paraffin therapy, electrophoresis (with magnesium, potassium, iodine, zinc and lidase preparations), magnetotherapy, vaginal douching using sulfide and sodium chloride solutions, ultrasound, UV irradiation, vibration massage.

5. Diet for adnexitis

A diet with adnexitis helps to strengthen immunity, improve metabolic processes at the site of the inflammatory process, as well as mobilize all organs and systems to fight the disease.

Compliance with the diet is usually applied in the acute and subacute stages of the disease. A hypoallergic diet is used.

The diet is based on exclusion from the diet - egg whites, nuts, chocolate, mushrooms, lemonade, citrus fruits.

The consumption of table salt and carbohydrates is minimized.

The calorie content of the daily diet is 2300 kcal per day, of which 270-300 g of carbohydrates, 100 g of proteins and 70 g of fats.

Chronic adnexitis without exacerbation is not demanding on a special diet - the emphasis is on a balanced diet containing vitamins, trace elements and proteins.

It is better to use as cooking - steaming, stewing.

6. Surgical treatment of adnexitis

Surgical treatment of adnexitis is used in case of failure to achieve the goals set by conservative methods of treatment, as well as in case of serious complications of the disease - purulent abscesses, severe adhesions and others.

Among the surgical methods for the treatment of adnexitis, there are:

• Laparoscopy, with the help of which purulent formations are removed from the site of inflammation, after which it is treated with antibiotics in this place;
• Surgical removal of the uterine appendages (adnexectomy).

Treatment of adnexitis with folk remedies

Important! Before using folk remedies for the treatment of adnexitis, be sure to consult your doctor!

Honey and propolis. Put honey and propolis in equal proportions in a bowl, then put them in a water bath. Stirring constantly, without overheating, melt these products to a liquid mixture. After wetting a tampon in this remedy, wait until the liquid has cooled, and put the tampon as deep as possible into the vagina, overnight. The course of treatment is - until the symptoms of the disease pass.

Sagebrush. This method has long been considered effective for the treatment of diseases of the uterine appendages at home. It is necessary to pour 2 liters of water into a bucket and bring to a boil, after which a handful of wormwood is thrown into the boiling water. The bucket is removed from the stove, placed on the floor and it is necessary to sit down above it so that the vapors enter the vagina. A positive effect will begin to be felt after 5-6 procedures.

Thigh. Collect thigh grass during flowering, chop it, and 1 tbsp. add a spoonful of raw materials to 1 liter of boiling water in a saucepan. Boil this folk remedy for adnexitis for about 10 more minutes, leave to cool and infuse. You need to drink the remedy in a warm form, with the addition of honey, during the day. The sediment from this decoction can be used as an internal douching. The course of treatment is about 3-4 weeks. This tool helps with almost all female diseases - mastopathy, fibroids, cysts, uterine cancer, obstruction of the fallopian tubes, menstrual irregularities.

Badan. Put 50 g of crushed bergenia root in an enamel pan and pour 300 ml of boiling water over it, cover the product and let it brew for 8 hours. In this extract, you can moisten a tampon and lay it overnight in the vagina. To use bergenia as a douche, which will also help in the fight against the disease, you need 2 tbsp. Spoons of the extract diluted in 2 liters of boiled water. Badan is especially effective in discharges.

Badan extract can also be taken orally - drink 1 teaspoon 3 times a day, an hour before meals, for 3 days, then take a break and the course can be repeated.

Herbal collection 1. Make a mixture of equal parts winterweed, hogweed and wintergreen. 1 st. pour 500 ml of boiling water over a collection spoon and cover the container with a lid, set aside the infusion agent overnight. In the morning, strain and drink half a glass 4 times a day.

Herbal collection 2. Make a collection of carefully crushed the following plants - 4 teaspoons of buckthorn, peony and mugwort roots, as well as 3 teaspoons of elecampane and bloodworm roots. Further, 2 tbsp. add spoons of the collection to a saucepan with 500 ml of boiling water, reduce the heat and boil the product for another 30 minutes. Next, leave the remedy for infusion and cooling for 30-40 minutes, strain it, add a little honey and take half a glass, 3-4 times a day.

Prevention of adnexitis

Prevention of adnexitis includes:

• Avoid hypothermia;
• Avoid stress;
• Avoid casual sex;
• Avoid abortion;
• Refusal to take alcoholic beverages, spicy food;
• Eating foods enriched with vitamins and trace elements;
• Compliance with the rules of personal hygiene, especially during menstruation;
• Regular visits to the gynecologist for the timely detection and treatment of diseases of the genitourinary system, to prevent their development and transition to a chronic form;
• Contacting a gynecologist with incomprehensible discharge (especially with an unpleasant odor), discomfort, burning and pain in the genitourinary system;
• Wearing underwear made from natural fabrics;
• Follow the work/rest/sleep schedule, get enough sleep.

Adnexitis (salpingoophoritis) is an inflammatory process of a unilateral or bilateral nature, which involves the ovaries and fallopian tubes in the lesion at the same time. Such a pathology has quite serious consequences, because in addition to a negative impact on the quality of life, it often causes a violation of reproductive functions. The causative agents of adnexitis are staphylococci, streptococci, gonococci and some other pathogens. How to treat adnexitis in order to avoid negative consequences, more details in the article.

Features of treatment

Treatment of the disease begins only after confirmation of the diagnosis. Its main goals are:

• getting rid of the inflammatory process;
• elimination of pain syndrome;
• improving the state of the immune system;
• restoration of the normal functioning of the organs of the reproductive system;
• restoration of the normal functioning of the endocrine, nervous and other systems.

Acute adnexitis can be cured only in stationary conditions, because illiterate and inadequate treatment at home often leads to complications: the formation of purulent cavities in the tubes, purulent fusion of the ovaries, peritonitis.

The patient must comply with bed rest. To eliminate pain, pain medications are prescribed, inflammation - antibacterial agents and anti-inflammatory drugs. Supplement medical treatment with physiotherapy with folk remedies.

Medicines

In the process of treating adnexitis, antibacterial drugs (primarily), anti-inflammatory drugs and other symptomatic drugs are used to help eliminate unpleasant clinical manifestations.

Antibiotics

To cure the disease, it is necessary to choose the right antibiotic. When choosing, they take into account which pathogen caused the development of pathology (gonococcus, chlamydia, mycoplasma, enterobacteria, etc.), as well as the level of its sensitivity to a particular drug.

Acute adnexitis should be treated with drugs from the following groups:

• penicillins (for example, Amoxicillin, Ampicillin);
• cephalosporins (eg, ceftriaxone, cefotaxime);
• tetracyclines (eg doxycycline);
• fluoroquinolones (eg Ofloxacin, Ciprofloxacin);
• macrolides (eg Azithromycin, Erythromycin);
• aminoglycosides (eg, gentamicin);
• nitromidazoles (eg Metronidazole, Ornidazole).

Mild disease is recommended to be treated with a drug such as Azithromycin with a gradual transition to the drug Clindamycin. Often, an inhibitor-protected penicillin is prescribed, for example, Amoxicillin, Amoxiclav, Augmentin in combination with Doxycycline.

Adnexitis in women caused by chlamydia is often treated with doxycycline. As an alternative, macrolides are used - Azithromycin, Erythromycin or others. The gonococcal nature of the disease is eliminated by Ceftriaxone, Azithromycin or any fluoroquinolone. Mycoplasmas are treated with Azithromycin, Doxycycline, Ofloxacin.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs with focal effects are used as basic therapy. One of the most effective drugs is Voltaren, which has anti-inflammatory, antipyretic, analgesic effects.

Interesting! The closest analogue of the drug Voltaren is Diclofenac, the active component of which helps to reduce the level of prostaglandins in the hypothalamus and in the focus with an inflammatory process. This eliminates pain and reduces the risk of blood loss.

Diclofenac is used in the form of tablets, which are coated on top with an enteric coating. Their action begins only a few hours after the use of the drug. The initial daily dosage is considered to be 150 mg, divided into several doses.

Local treatment

At home, local treatment can be carried out. This, of course, will not help eliminate the root cause of the disease, that is, the infection, but it can save a woman from many unpleasant symptoms. For example, suppositories will be effective, most of which have anti-inflammatory, analgesic, antipyretic effects: Indomethacin, Movalis, Longidase, etc.

You can carry out local therapy, which consists in taking local baths and douching with disinfectant solutions: Dimexide, Chlorophyllipt, Furacilin, etc. For such purposes, decoctions of medicinal herbs are also used: celandine, chamomile, calendula, sage, yarrow, etc.

For douching, an infusion of oak bark, nettle, sage, chamomile, horsetail, thyme is prepared: all ingredients are mixed in equal volume, 30 g of the mixture is taken, 1 liter of boiling water is poured and infused for 30 minutes. The finished infusion is filtered and used for its intended purpose, douching before going to bed.

An infusion of thyme is added to the baths: 200 g of raw materials per 3 liters of hot water. The bath is taken for 15-20 minutes. Many female diseases, including adnexitis, are treated with milk baths: boil 3 liters of milk and add to bathing water.

Tampons that can be prepared from therapeutic mud or blue clay will be effective: mix the ingredient with water until a creamy mass is formed, put on a slow fire and simmer for 1 hour. After cooling in the resulting product, moisten a gauze swab, then insert it into the vagina, keeping for 20 minutes. Instead of mud and clay, you can take honey.

You can put compresses using an ordinary bottle filled with warm water. It can also be a mud cake placed in a gauze napkin. Compresses are applied to the area of ​​the ovaries, covering from above with a warm scarf or lying down under a warm blanket.

You can eliminate the pain syndrome in chronic adnexitis with the help of microclysters with a warm solution of Novocain, with a 5% solution of potassium iodide, as well as with the help of presacral novocaine blockade.

Other drugs

To rid the body of the waste products of harmful microorganisms, detoxification therapy is carried out, which is expressed in the use of low-molecular plasma substitutes: Reopoliglyukin, Neogemodez, Neocompensan. The total volume of injected fluid is determined taking into account the severity of the disease and body weight.

The drug Ovariamin helps to normalize ovarian function, but is not a medicine, but a dietary supplement

To normalize blood circulation in small vessels, prescribe medications that improve the rheological properties of blood. For example, it can be Fraxiparine or Heparin. In severe cases of adnexitis, immunoglobulins are used, which include antibodies against the pathogen.

After all the symptoms of the acute stage have been eliminated, in chronic adnexitis, biostimulants are prescribed, which include Ovariamin and others. In addition, stimulation of ovulatory function is often prescribed with the help of Clofit medicine.

Physiotherapy

After the chronization of the inflammatory process, physiotherapy procedures are periodically required, which have anti-inflammatory, analgesic, anti-adhesion, immunomodulatory, and calming effects. In addition, this method of therapy helps to restore the endocrine function of the ovaries.

Physiotherapy for adnexitis is divided into 2 groups: extracavitary, which includes techniques that affect the pelvic organs through the front wall of the abdomen, and intracavitary: rectal, vaginal, endocervical. With adnexitis, magnetotherapy, electrophoresis with medicinal substances, phonophoresis, laser therapy, hydrotherapy, mud and light therapy are most often performed.

Direct indications for physiotherapy:

• acute inflammatory process with moderately severe symptoms;
• subacute stage of adnexitis;
• stage of exacerbation of the chronic form of the disease;
• chronic form of pathology, stage of pregravid preparation;
• pain syndrome with minimal severity of the inflammatory process.

Direct contraindications to physiotherapy:

• inflammatory process with suppuration;
• concomitant precancerous gynecological disease;
• a benign tumor in the organ of the reproductive system (in the uterus, ovary);
• pathologies and tumor-like neoplasms requiring surgery.

Sometimes hormonal correction is required. This is achieved with the help of electrical stimulation of the cervix, electrophoresis with vitamin B1, laser stimulation.

Diet

It is possible to permanently eliminate acute adnexitis only by a complex method. So, along with taking medications, a special diet is required. The daily diet should include foods that contain vitamin C. Such a microelement will help increase the protective function of the body and thereby speed up recovery. Products containing ascorbic acid are citrus fruits, sweet peppers, currants, cranberries, pomegranates, etc.

Important! During the treatment of adnexitis, it is required to normalize the activity of the intestine, since stagnation of feces is a direct path to inflammatory processes. To do this, it is necessary to include fiber in the diet: boiled and stewed vegetables (cabbage, potatoes, zucchini, eggplant, broccoli, cauliflower, beets, etc.).

To restore the beneficial microflora of the intestines and vagina after taking antibacterial drugs, daily consumption of fermented milk products containing bifidus and lactobacilli (kefir, sour cream, fermented baked milk, yogurt, etc.) is required.

In addition, it is necessary to normalize the drinking regimen: drink at least 2 liters of liquid per day. It can be non-carbonated mineral water, fruit drink, freshly squeezed juices, compotes, weak green tea.

To maintain a normal balance of proteins, the consumption of lean meat and fish (beef, turkey, pollock, blue whiting, hake, etc.) is required. Dishes are prepared with herbs: spinach, parsley, basil, cilantro, onions, leeks, etc.

Other therapeutic measures

You can supplement the main treatment by visiting balneological resorts, where they use not only local methods of treating adnexitis, but also those that contribute to general calm. Spa treatment includes:

• sanatorium mode (elimination of any physical work, peace of mind, proper nutrition);
• correct and healthy climatic conditions;
• sunbathing (heliotherapy);
• mud therapy with a thermal factor;
• mineral baths using carbon dioxide, sodium chloride.

Multivitamin preparations, for example, Complivit, will help to increase the protective function of the body.

An obligatory component of the treatment of chronic adnexitis is vitamin therapy. By taking vitamin complexes, you can increase the state of immunity, prevent the recurrence of the disease. Vitamins useful for women's disease:

• vitamin E: helps dissolve adhesions, reduce inflammation, activate tissue regeneration and restore the natural functioning of the ovaries;
• vitamin B2: helps to accelerate tissue healing, normalize the production of hormones that are involved in stimulating the activity of the uterine appendages;
• vitamin B6: involved in the production of antibodies that activate the fight against infections;
• vitamin B9: helps to normalize the menstrual cycle, accelerate the process of cell division and the healing of affected tissues;
• vitamin B12: helps to strengthen the immune system, improve metabolic processes and normalize the reproductive system.

Operation

In most cases, the disease in a chronic form proceeds with a purulent process. Running abscesses in the appendages can no longer be eliminated with pills and injections. For this reason, surgical intervention is prescribed, which consists in opening and washing the abscesses.

Modern medicine offers a minimally invasive way to perform such operations - laparoscopy. In this case, large incisions are not required, but only tiny holes in the anterior abdominal wall, through which all abdominal manipulations are carried out.

Only a doctor can determine what treatment is needed. The severity of the disease and the characteristic features of its development are taken into account. In any case, the earlier adnexitis was detected and appropriate therapy started, the more favorable the prognosis.

Adnexitis - inflammation of the appendages (ovaries, fallopian tubes and their surrounding structures). It can occur in acute, subacute and chronic forms. This largely determines the symptoms of pathology, the timeliness and effectiveness of treatment, as well as the likelihood of complications. How to choose the right therapy regimen? What method of treatment is preferable for different forms of adnexitis?

Read in this article

What is dangerous adnexitis

Inflammation almost never goes unnoticed in the body, especially when it affects such delicate, delicate and small structures as the ovaries, fallopian tubes and everything that connects them. Therefore, any adnexitis should be taken very seriously, following all the recommendations and treatment regimens. Otherwise, you may face a number of complications.

Formation of adhesions in the pelvis

This has to be faced in all cases of chronic adnexitis, as well as in the untimely treatment of other forms. cause pain, the intensity of which depends on the severity of the process and concomitant diseases.

Pain can disturb constantly throughout the entire cycle or appear only during menstruation. They can be mild and sometimes unbearable.

Adhesions may involve the fallopian tubes and ovaries, increasing the risk of ectopic pregnancy. They also present great difficulties in IVF. Sometimes the process of egg collection is technically impossible due to a pronounced adhesive process.

Fallopian tube obstruction

It is formed both due to adhesions and due to inflammation of the inner lining of the fallopian tubes. And their clearance is normal - only a few millimeters, so even a slight inflammation can lead to impaired patency and infertility.

Autoimmune disorders

Chronic salpingo-oophoritis can lead to the destruction of part of the ovarian cells. After that, the body begins to "attack" them as foreign objects. As a result, the woman has the following:

• problems with ovulation;
• due to ovarian failure.

Formation of cysts

Inflammation of the ovaries is one of the reasons for the formation of functional cysts. And they affect the overall hormonal status of a woman, the quality of intimate relationships and many other processes.

Formation of abscesses, pyosalpinx

The most formidable complication of inflammation of the appendages is the formation of ovarian abscesses, as well as the accumulation of pus in the fallopian tubes. Without treatment, pelvioperitonitis develops. All these are acute surgical conditions that require urgent surgical treatment, often with the removal of the uterus and appendages.

Diagnosis of adnexitis in women

The assumption about the disease is established based on the complaints of the woman. In the chronic form, symptoms will be minimal.

In order to confirm adnexitis, a routine gynecological examination is sufficient. At the same time, painful areas of the appendages are determined, the ovaries are enlarged and may contain a cyst. A number of other symptoms are also found, for example, pain when moving the cervix and many others.

For the subsequent choice of treatment, examination is not enough; a complex of diagnostic measures is needed. Namely:

• (free fluid is determined, enlarged ovaries, etc.);
• from the vagina and cervical canal (because often the infection is ascending);
• PCR of vaginal and cervical secretion for the main pathogens (chlamydia, myco-, ureplasma, Trichomonas, gonococci and others);
• bacteriological culture of the vaginal flora, including sensitivity to antibiotics.

Watch the video about adnexitis:

Primary treatment of bilateral adnexitis

In most cases, the first episode of adnexitis occurs in an acute form. Therefore, the chances of curing the disease with a minimum number of consequences are higher. The main directions are as follows:

Method	Features of therapy
Antibacterial therapy	It is optimal if drugs are selected taking into account the sensitivity of pathogens. Doxycycline, Clarithromycin, Azithromycin, Cephalorosporins are the most commonly used drugs. Sometimes a combination is prescribed, especially if the infection is combined, or the pathogen has not been identified. These can be intramuscular or even intravenous injections, followed by the transition to oral forms.
vitamin therapy	It helps to increase immunity, relieve inflammation faster and with minimal consequences for the body. A, E, C, group B are used.
Desensitizing therapy	It is used to relieve pain, swelling of tissues. Usually these are intramuscular injections of Diphenhydramine or oral antihistamines (Loratadin, Ketotifen and others).
Local treatment	Increases the effectiveness of the general course. Most often, complex candles are used, for example, Polizhinas, Terzhinan. If the pathogen is installed, it is better to use more narrowly targeted suppositories, for example, for trichomoniasis - Trichopolum, etc.
Immunostimulating agents	Needed to increase the body's resistance. Autotransfusion is often used. At the same time, the venous blood taken from the girl is immediately injected into her intramuscularly.
Physiotherapy	It is a good addition to the main therapy. But it is better to start it not in the acute period, but when the main symptoms subside. It will help to fix the effect. Most often used medicinal on the lower abdomen, UHF, ultrasound and others at the discretion of the doctor.
Oral contraceptives	Appointed by the course for 3 - 6 months after basic therapy. While taking hormonal drugs, ovarian function subsides, which gives them time to recover.
Analgesics, antispasmodics, anti-inflammatory drugs	They are prescribed for severe pain syndrome.

Treatment regimen for chronic adnexitis: drugs, suppositories

Chronic adnexitis is often associated with formation against the background of constant inflammation, which must be taken into account when examining and prescribing treatment. The following is also characteristic of chronic adnexitis:

• moderate pain syndrome;
• adhesive process;
• dysfunction;
• latent course, pathogens are not always immediately detectable.

The severity of certain signs should be taken into account when prescribing treatment regimens. Tactics are as follows:

• It is useful to prescribe, first of all, methods of physiotherapy that will cause an exacerbation of the pathology. And after that, use all other drugs. This way you can achieve the most effective treatment.
• Antibacterial drugs, taking into account crops and sensitivity.
• It is recommended to use absorbable preparations, for example, Wobenzym, Longidaza in the form of suppositories, Lidaza (including physiotherapy with it), Trypsin, Streptokinase and others. They can somewhat reduce the severity of the adhesive process and thereby reduce the pain syndrome.
• Antispasmodic, anti-inflammatory drugs (No-shpa, Ketanov and others).
• Against the background of chronic adnexitis, inflammation often develops in the vagina, so suppositories are used topically. They can be either monocomponent or contain several active substances. These are Hexicon, Clotrimazole, Ginocaps, Terzhinan, Polygynax and others at the discretion of the doctor.
• To restore menstrual function, as well as to normalize the functioning of the ovaries, vitamin complexes, dietary supplements, homeopathic remedies or oral contraceptives are prescribed. Cyclodinone, Time factor, Cyclovita and others are effective.

Method of treatment for exacerbation of adnexitis: antibiotics as an emergency measure

The reappearance of symptoms of the disease against the background of chronic adnexitis is fundamentally no different from the acute form of the disease. Therefore, the principles of therapy are the same.

But chronic forms of adnexitis often occur against the background of resistant flora. This means that previously used treatment regimens, in particular, antibacterial drugs, may be of little or no effect. Therefore, the administration of antimicrobials should be approached with particular vigilance after culture and sensitivity results.

Exacerbation of adnexitis is often accompanied by the formation of ovarian abscesses, accumulation of pus or other fluid in the fallopian tubes. Treatment in these situations is only operational, often with the removal of the uterus and appendages.

Treatment of adnexitis during pregnancy

Often women believe that pain in the lower abdomen during pregnancy is associated with adnexitis. In fact, everything is completely different. The pains are very similar, in the same places, they can even match in intensity. But this is not adnexitis, but a threat of interruption, possibly due to infection.

The hormonal background of a woman during pregnancy, as well as all the structural changes that occur at this moment, exclude the appearance of adnexitis.

If there is inflammation of the appendages, either fertilization will not occur, or the fetal egg will not be fixed in the uterine cavity. In the case when pregnancy occurs, the inflammation is in remission or absent.

During gestation, any infection is concentrated in the vagina, cervix, in extreme cases - in the endometrium, which has adverse consequences.

Features of treatment with folk methods

Adnexitis should not be treated only by alternative methods. Alone, they are ineffective. But if combined with drug treatment, you can get a more significant result.

With adnexitis, it is effective to use tampons with healing solutions, baths, and it is also recommended to take the formulations inside.

Recipe 1. You should take aloe juice or fresh leaves mixed with liquid honey and let it brew for 10-14 days. Apply to gauze swabs and lay overnight for 7-10 days.

Recipe 2. In equal quantities, you need to take nettle and dandelion root, calendula and cinquefoil flowers, mistletoe and horsetail leaves. Pour all this with hot water, let it brew for several hours, and then use it to warm up in a hot bathroom.

Recipe 3. It is useful to take an infusion of a boron uterus and a red brush. For this, plants should be poured in equal proportions with alcohol or vodka, let it brew in a dark place for two weeks. Take 5-10 drops 3-4 times a day for 10-14 days.

Adnexitis after treatment

Not always adnexitis is easily and smoothly treated, complications are possible, the consequences of non-compliance with the course of taking medications, and much more.

Possible Complications

Adnexitis often requires the appointment of serious medications. Therefore, in some cases, thrush may develop if prophylaxis with antifungal agents is not carried out in time.

Also, various kinds of allergic reactions are not excluded. The presence of hypersensitivity to drugs should warn the doctor in advance.

If there are any problems with the liver or kidneys, it is better to carefully monitor the function of these organs. Antibiotics and other drugs put a significant burden on them.

When can you get pregnant

After suffering acute adnexitis (or activation of a chronic infection), it is recommended to refrain from pregnancy for 2-3 months. Do not forget to treat the sexual partner. It is useful during this period to take contraceptives.

This tactic is due to the following:

• the ovaries and the reproductive system as a whole need time to recover in order for the pregnancy to proceed successfully;
• during this period of time it will become clear whether the infection has completely cured, it will already be possible to pass control tests, including PCR.

Is it possible to relapse

Adnexitis often occurs repeatedly in one girl and can subsequently turn into a chronic form with periodic exacerbations. This can be caused by the following:

• all doctor's recommendations for treatment have not been fulfilled;
• pathogens have already developed resistance to the antibiotics used;
• the sexual partner has not been treated, has not made a recovery control.

Prevention of adnexitis

Prevention of adnexitis primarily includes sexual education. This means that all questionable intimate relationships must be protected.

You should also be regularly examined by a doctor, undergo all the treatment prescribed, if necessary, and follow the recommendations.

Adnexitis is an inflammation of the appendages, which often occurs in a chronic form. Consequently, it entails infertility, menstrual irregularities and many other gynecological diseases. Only timely detection and competent full treatment will avoid all the troubles if the disease could not be avoided.

Similar articles

Adnexitis or salpingo-oophoritis is caused by the activity of bacteria that have entered through the genital tract or with the bloodstream.

The appendages of a woman are called the uterine (fallopian) tubes and ovaries. They are located in the pubic area, above the pubic bone. These organs are responsible for the growth and development of the egg, as well as for its release into the uterine cavity.

The maturation of female germ cells occurs inside the ovary. In the middle of the cycle, a mature egg leaves it in the cavity of the fallopian tube, goes to the uterus. At this point, the egg can be fertilized by the male germ cell (sperm). Then, when it hits the uterine mucosa, it will attach to its surface, pregnancy will begin. If the egg remains unfertilized, then it leaves the uterine cavity along with the mucous epithelium. This is how menstrual bleeding occurs.

All the internal hollow organs of a person are lined with mucous epithelium. Inflammation of the appendages is expressed in redness and swelling of their mucous surface. More often, inflammation affects the fallopian tubes, but it can also spread to the ovarian mucosa.

The action of the inflammatory response is aimed at limiting the spread of infection. With redness and swelling, a number of biochemical processes are triggered that stop the further spread of the pathogen and cause its death. Thus, inflammation of the uterine appendages is a response to the penetration of bacteria or viruses inside.

Local inflammation of the ovaries and appendages in women in medical terminology is called adnexitis.

Factors and causes of adnexitis

The cause of adnexitis is an infection. Inflammation is caused by pathogenic organisms (so-called bacteria) or pathogenic particles (viruses). At the same time, they can get into the appendages in different ways, during intercourse or during medical procedures (installation of a spiral, curettage of the uterus during an abortion). Internal infection is also possible - with blood flow from another inflamed organ. More often than others (in 80% of cases), the causative agents of inflammation are cocci, chlamydia.

In order for pathogens to enter the appendages from the outside, they must overcome the protective barrier of the vaginal mucosa. Healthy vaginal flora protects the appendages from pathogens. If the microflora of the vagina is disturbed for some reason, then infection becomes possible.

The following factors lead to a decrease in immunity, a violation of the vaginal flora, and the appearance of inflammation:

• hypothermia- banal situations such as “got a cold”, “badly dressed”, “wet her feet”, “sat in the cold”.
• Stress- forms a general muscle and vascular spasm, disrupts blood circulation, becomes the cause of congestion. Therefore, against the background of constant stress, various infections often appear.
• Unsatisfied sexuality(forms stagnant processes).
• Hormonal disorders- more often hormonal imbalance is formed against the background of taking contraceptives.
• Sexual life with multiple sexual partners- often causes the transmission of sexual infections to each other, the appearance of acute and chronic inflammation.

Note: the human bacterial flora contains pathogens in certain quantities. At the same time, their vital activity is controlled by immunity. With a persistent decrease in defense reactions (against the background of private psychoses, stress, with poor nutrition, for other reasons), inflammation of the internal organs can form on its own, without the presence of a source of infection.

How to determine the presence of inflammation in the accessory organs? What are the signs of inflammation of the appendages in women if the process has acquired a sluggish chronic form?

Symptoms of inflammation of the appendages in women

The main symptom of inflammation is pain. With adnexitis, it occurs in the lower abdomen, lower back and may be accompanied by additional symptoms - unpleasant mucous secretions (leucorrhoea), failure in menstruation.

In acute adnexitis - severe pain. They are accompanied by painful urination and pain. And they can also give in the leg. Acute adnexitis is often accompanied by fever. Possible indigestion.

Chronic form, sluggish inflammation of the appendages in women does not cause fever. Pain is felt as mild, moderate or may be absent altogether. The appearance of mild pain in chronic adnexitis can be felt against the background of an increase in temperature during a cold infection. Pain during intercourse is also possible, especially with deep penetration.

Note: often pain during intercourse is the only sign of sluggish chronic adnexitis.

Mucous discharge from the vagina (leucorrhoea) during an acute process may have a sharp unpleasant odor, yellow or green hues. They can also be plentiful, create some discomfort throughout the day for a woman. In chronic adnexitis, the discharge is weak or absent altogether.

Also, the presence of chronic inflammation in the appendages may be accompanied by menstrual irregularities. The reason for this is that the ovaries perform the function of producing sex hormones - estrogens, progestins. In inflamed tissues, hormonal synthesis is disrupted, which causes deviations in the timing of menstruation, their abundance, duration, and other cycle disorders.

Often chronic adnexitis occurs imperceptibly. However, it needs to be treated. A long chronic process is dangerous with complications.

Consequences of inflammation of the appendages: adhesions and infertility

What threatens adnexitis to a woman? Why is a sluggish inflammatory process harmful if it does not create pain, is not a source of discomfort? Why is it important to know about the presence of inflammation?

We list what processes occur in the appendages during a long-term sluggish inflammatory process:

1. The mucous membrane of the fallopian tubes swells, increases in size, the lumen in the tubes narrows, they become impassable for the eggs. This condition is called "tubal" infertility.
2. Adhesions are the result of a long-term inflammatory disease. They are bundle-like growths of connective tissue on the inflamed mucosa. This is a kind of "bridge" that separates the area of ​​inflammation from healthy cells. In the future, the presence of adhesions may cause the fertilized egg to stop as it moves towards the uterus. And that means - to cause infertility, the inability of a woman to become pregnant. The use of antibiotics can also be the cause of adhesions.
3. With a difficult or impossible passage of the egg through the fallopian tube, the fertilized zygote may linger in it or go the other way - to the abdominal cavity. This is how an ectopic pregnancy is formed.
4. The process of synthesis of female sex hormones is disrupted. Which leads to menstrual irregularities, unstable egg maturation.

Conclusion: chronic inflammation of the appendages often causes a violation of the reproductive function of a woman, a violation of the reproductive processes, which can be defined in a more understandable word - infertility.

How to treat inflammation of the appendages

Treatment of inflammation of the appendages in women depends on the strength of the inflammatory process and the nature of the infection. If the cause of the disease is a pathogenic microorganism (bacterium), then antibacterial drugs (antibiotics) are needed. If a virus has become the cause of the infection, then antiviral measures and means are needed - specific antiviral drugs and immunomodulators.

Acute stage: we treat the pathogen infection

More often, the causative agent of the inflammatory process in the female genital organs are pathogenic bacteria (anaerobes), the reproduction and vital activity of which occurs in an oxygen-free environment. Antibacterial drugs are prescribed for their treatment. The choice of antibiotic is determined by the type of pathogen. Antibacterial agents have a wide spectrum of action, but are unable to equally counteract all pathogens. Therefore, for effective treatment, the pathogen is determined - a swab is taken from the vaginal flora.

If it is impossible to sow the pathogen, then antibiotics of the widest and most general spectrum of action are prescribed. These are drugs of the cephalosporin and penicillin groups (Ceftriaxone, Amoxiclav). They can also prescribe milder antibacterial agents - Erythromycin, Metronidazole. With non-extensive inflammation, they are prescribed in the form of tablets. With severe adnexitis - in the form of injections (shots), which are done under the supervision of a doctor in a hospital.

What antibiotics for inflammation of the appendages and ovaries are prescribed for home treatment:

• Macrolides- Azithromycins (Summamed), Erythromycins (international version - Clindamycins). These pills for inflammation of the appendages are most often prescribed in the treatment of adnexitis. They are considered the least toxic antibacterial drugs with a minimum of side effects and contraindications.
• Fluoroquinalines- Norfloxacin, Ofloxocin, Lomefloxacin. They represent one of the latest generations of antibacterial drugs, they are almost not addictive.
• Nitromidazoles- Metronidazole, Ornidazole, Ternidazole. This group acts against pathogens of the nitro group.

Note: often for the treatment of genitourinary diseases, two types of antibiotics are prescribed simultaneously. One is against anaerobic bacteria (those that breed in an oxygen-free environment). And the second - against aerobes (reproducing in the presence of oxygen).

Remission stage: we treat the remnants of the inflammatory process

After limiting the growth and development of the pathogen, a period of remission begins. It is characterized by the presence of residual signs of inflammation in the cells of the mucous epithelium. That is, there is still inflammation, but the cause-causative agent is no longer there.

Often, many women end treatment at this stage, believing that the residual effects will pass on their own. This is indeed possible, but only in a healthy female body with strong immunity. Often the opposite happens. Residual inflammation becomes the basis for re-infection and relapse (return) of the disease. Therefore, treatment must be completed. What is prescribed in the remission stage?

For the final recovery, measures are prescribed to resolve the focus of inflammation. They speed up the elimination of toxins. As a rule, those means are used that stimulate blood circulation inside the abdominal cavity, accelerate local blood flow in the area where the ovaries and fallopian tubes (appendages) are located.

These include:

• Physiotherapy (magnetotherapy, electrophoresis).
• Warm-ups and compresses.
• Paraffin treatment.
• Mud cure.
• Massage - special gynecological, on the lower back and lower abdomen.

They also prescribe treatment with mineral waters at a balneological resort.

Means for raising immunity

In addition to "direct-acting" drugs, which are directed directly against the causative agent of infection, the treatment of adnexitis uses drugs and drugs to increase immunity. They are also necessarily used in the treatment of viral inflammation caused by foreign particles (for example, in the treatment of genital herpes). Immunity boosters include:

• Vitamin and mineral complexes- necessary to ensure active protective reactions. They are prescribed for any diseases, infections, inflammations.
• Prebiotics- preparations for the normalization of the bacterial flora, provide the action of local immunity of the internal cavity of the vagina, intestines. Be sure to be prescribed in the treatment of antibacterial substances.
• Specific drugs to stimulate the immune system- antiviral drugs, immunomodulators. They must be prescribed for a viral infection. For example, against herpes - tablets and ointments with acyclovir, famvir, panavir. And for any viral infections - suppositories with interferon.

Often, treatment with absorbable drugs, taking funds for immunity is prescribed from the first days of the disease. If the inflammation is caused by a bacterial pathogen, then immunity agents are an additional treatment that shortens the duration of antibiotic therapy. With a viral pathogen, immunostimulants provide the main treatment for the disease.

The duration of antibiotic treatment takes from 7 to 10 days. The duration of treatment with vitamins, prebiotics, as well as the use of physiotherapy is 3-4 weeks (almost a month).

Note: also with severe pain, analgesics are prescribed.

Treatment of chronic inflammation of the appendages differs in duration and uses various drugs - tablets, injections, vaginal suppositories, as well as physiotherapy. The most convenient for home treatment and very effective vaginal suppositories.

Anti-inflammatory suppositories for inflammation of the appendages

The introduction of drugs into the vaginal cavity ensures the rapid penetration of the drug into the inflammation zone, a high therapeutic effect of its use. What anti-inflammatory suppositories are used in gynecology for inflammation of the appendages?

Candles with NSAIDs

NSAIDs or nonsteroidal suppositories for inflammation of the appendages with anti-inflammatory action:

• Indomethacin.
• Diclofenac.
• Voltaren.

Also, with adnexitis, hemorrhoidal suppositories with belladonna are prescribed. They are anti-inflammatory and analgesic at the same time.

These drugs are referred to as drugs for the treatment of joint diseases and inflammation. They are also successfully used in the treatment of any internal inflammatory processes.

Suppositories with absorbable action

These drugs prevent the formation of adhesions. They stop adhesions during inflammation, dissolve adhesions after treatment of adnexitis.

• Terrilithin candles- dilute blood clots and pus, break down necrotic (dead) tissues.
• Longidaza- also promotes the resorption of adhesions, stops the adhesive process.

Vaginal suppositories with antiseptics of antifungal and antibacterial action for the treatment of appendages are ineffective. They are prescribed if, in addition to adnexal inflammation, there is inflammation of the vaginal cavity (colpitis).

Candles with antifungal action:

• Gynomax.
• Myconalosis.
• Guino-Pevaril.
• Nystatin.
• Primafungin.
• Terzhinan.

Candles with antibacterial action:

• Dalacin.
• Clindamycin.
• Metrovagin.
• Betadine.
• Hexicon.
• Iodoxide.
• Fluomizin.
• Terzhinan (complex preparation with antibacterial and antifungal action and hormonal prednisolone).

Treatment with candles, the introduction of medicinal substances into the cavity of the vagina or rectum is indicated for various diseases. Medicinal substances enter the bloodstream, bypassing the digestive tract, without partial destruction in the liver. Which reduces the frequency of allergic reactions, increases the effectiveness of treatment.

Rectal suppositories with immunomodulating action

Preparations with interferon exhibit antiviral action. They are broad-spectrum immunomodulators. The most famous of them are Viferon, Genferon, Kipferon.

Note: the listed drugs are rectal suppositories, that is, they are injected into the rectum through the anus.

Candles to normalize the microflora of the vagina

Also during and after the treatment of andexide, suppositories are used to normalize the vaginal flora - Acylact, Lactobacterin. They are essential for antibiotic treatment. Desirable - in the treatment of viral forms of infections.

Treatment of inflammation of the appendages with folk remedies

How to treat inflammation of the appendages without pharmaceutical drugs? Traditional medicine offers a number of measures that are aimed at limiting the development of inflammation and the spread of infection.

To stimulate the immune system is taken orally:

• Onion garlic- sources of sulfur and popular natural immunomodulators.
• citrus juices- sources of vitamin C.
• Vegetable fresh juices sources of digestible vitamins.

For local antiseptic therapy - they do vaginal douching, put tampons with natural antibiotics and antiseptics.

In doing so, they use:

• aloe;
• warm infusions of antiseptic herbs;
• tampons with ichthyol ointment.

As well as warm baths with essential oils, steaming with wormwood, salt, salt compresses on the lower abdomen.

Traditional medicine does not always cure inflammation to the end. In order to prevent its transition into a chronic form, after treatment it is necessary to take tests and check that there are no foci of inflammation left.