Gynecology and Mammology >>>> Salpingo-oophoritis (adnexitis)

Salpingo-oophoritis (adnexitis).

The structural features of the reproductive organs in a woman are such that all the organs involved in this function communicate directly or indirectly with each other, which makes it possible for the inflammatory process, which arises in a certain place of any one of the organs, to spread to the neighboring ones associated with it. organs. This also happens in the case of the inflammatory process that occurs in the fallopian tubes. It spreads very quickly to the ovarian area. When the inflammatory process affects only the fallopian tubes, they speak of salpingitis, if the process affects only the ovarian region, they speak of oophoritis, but if both of these structures are involved in the inflammatory process, then we are talking about salpingo-oophoritis (synonym: adnexitis) or inflammation of the uterine appendages .

The causes of adnexitis (or salpingo-oophoritis) are quite numerous and are associated with the penetration of infectious agents into the above areas, but if we talk about the ways of infection, there are several of them: along the ascending path, the infection spreads from the genitals, through the vagina and uterus; intestinal infection (sigmoid colon, cecum) enters the appendages (fallopian tubes and ovaries); through the bloodstream or with the help of lymph flow (the focus of infection can be in any organ, but it will become the source and cause of inflammation of the uterine appendages ). Among the microorganisms - causative agents of inflammation of the tissues of the appendages, the most common are ureoplasma, mycoplasma, Trichomonas, chlamydia, gonococcus, staphylococcus, streptococcus.

Factors provoking the occurrence of adnexitis (salpingo-oophoritis):

Untreated or chronic urological infections (with urethritis, cystitis, , pyelonephritis);
Violation of the rules of personal hygiene;
Sexual partners who are carriers of the infection;
Vaginal dysbiosis;
Colpitis;
Weakened immune responses of the body;
Surgical interventions that caused the infection;
Injuries during the setting of an intrauterine device, abortion, curettage, difficult childbirth;
Generalized infection that spreads throughout the body;
Hypothermia.

The signs of adnexitis depend on the nature of the course of the disease. In the case of acute inflammation, there is a pulling, aching pain in the lower abdomen. Pain can be bilateral or appear on only one side. Pain can radiate to the lower back, to the pelvic organs. With acute adnexitis, serous or serous - purulent vaginal discharge, chills, general weakness, myalgia are possible . Acute adnexitis can occur together or against the background of acute endometritis. Often the symptoms in acute adnexitis resemble those of appendicitis.

Chronization of the inflammatory process with adnexitis is possible in the case of untreated, untreated or improperly treated acute adnexitis. Relapses are characteristic of chronic adnexitis. The symptoms of chronic adnexitis differ from the symptoms of its acute form:

aching or pulling monotonous pains in the lower abdomen on the right and / or left may periodically appear and disappear,
there may be menstrual irregularities (prolonged bleeding),
soreness during intercourse is possible,
possible disruption of the digestive system, manifested in the form of dyspepsia, colitis,
perhaps general malaise, weakness, fever.

Both acute and chronic adnexitis are dangerous with complications:

The development of adhesions in the ovarian area,
Structural changes in the tissues of the appendages, leading to the formation of fibrous tissue, cysts, fibroids,
Violation of the patency of the fallopian tubes,
Possible more serious consequences in the form of ectopic pregnancy, miscarriage, infertility.

Treatment of salpingo-oophoritis is tied to the form of the course of the disease and consists of a course of antimicrobial drugs to destroy pathogenic microflora (antibiotics are used in various combinations and according to the identified microflora or a wide spectrum of action in an acute process); anti-inflammatory and immunostimulating therapy.

With the development of purulent processes, according to indications, surgical treatment by laparoscopy is used to remove purulent exudate and irrigation with antiseptics the focus of inflammation. The treatment is completed with physiotherapeutic procedures (UHF on the projection of the appendages, electrophoresis, paraffin baths and other procedures), but only after the purulent - inflammatory process has been canceled. It is categorically impossible to use warming procedures in the midst of inflammation, including the use of heating pads, so as not to provoke an abscess, peritonitis.