Inflammation of the appendages in women, or adnexitis, is an inflammatory process that develops in the ovaries and fallopian tubes.
The ovaries and fallopian tubes are connected anatomically and functionally.
The inflammation that occurs in one of these organs extends to the second. Appendages in women belong to the reproductive system.
At the same time, the ovaries are also an endocrine organ, because it is they that produce sex hormones.
Appendages - paired organs, are located on both sides of the uterus and are attached by ligaments to it and the bones of the pelvis.
The ligaments connecting the fallopian tubes with the uterus also belong anatomically to the appendages.
Adnexitis is the Latin name for appendages. The second name is salpingoophoritis, a Greek term.
Inflammation of the appendages in women - causes
The appendages of a healthy woman do not contain any flora - they are sterile. The ingress of any microorganisms into the ovaries and tubes occurs in an ascending or descending way from adjacent organs.
The cause of inflammation of the appendages in a woman is pathogenic and, under certain conditions, conditionally pathogenic bacteria and viruses.
The most severe and aggressive course of inflammation is caused by pathogenic microbes. Gonococci stand out among them: a specific process in gonorrhea can lead to serious complications.
Other pathogenic microorganisms - chlamydia, mycoplasmas, trichomonads, viruses - are also the cause of severe inflammation of the appendages in women, causing serious consequences with late treatment or inadequate treatment, including infertility.
Conditionally - pathogenic microflora is normally present in small quantities in the vagina and some organs of a healthy woman. These are streptococci, staphylococci, Escherichia coli, etc. Under certain conditions, they become virulent and can cause quite severe inflammation of the appendages.
Microbial associations - infectious agents from various microbial groups - are often the cause of adnexitis.
In order for the sources of infection that fall into the fallopian tubes or ovaries to cause inflammation, exposure to some kind of provoking factor is necessary. There are many such factors that activate the rapid multiplication of microorganisms with the development of subsequent adnexitis. The main and most common of them, which in combination with microbes are the causes of inflammation of the appendages in women, are as follows:
1. Various diagnostic and other medical invasive interventions: abortion, curettage, manipulation during childbirth. They can cause mechanical damage to the mucous membranes, which will become the entrance gate to infection.
2. Means of intrauterine contraception: the spiral, like a foreign body, can cause inflammation, or when it is introduced, there is a violation of the integrity of the mucous membranes, through which the infection can penetrate and spread into the ovaries and tubes. The spiral itself can be a source of infection in violation of the rules of antiseptics.
3. Some endocrinological diseases - diabetes, hypothyroidism, as a result of which the mucous membrane becomes thinner and becomes vulnerable to infection.
4. Pregnancy and menstruation are also predisposing factors, despite the physiological nature of these processes. Certain changes in the mucous membranes occur, as a result of which they are more susceptible to microbes.
In addition to these reasons, there are more general ones that also lead to inflammation:
- stress, overwork, neurosis;
- hypothermia;
- chronic infectious diseases in the acute stage (purulent otitis media, pyelonephritis, tonsillitis, appendicitis, tuberculosis) - the pathogen can enter the appendages by the hematogenous route;
- violation of the balance of microflora and acidity of the environment in the vagina: normally in the vaginal mucosa contains up to 98% of lactobacilli and approximately 2% is conditionally pathogenic flora. Lactobacilli are involved in the synthesis of lactic acid, which, in turn, maintains a constant pH level of 3.8 - 4.5. In such an acidic environment, the propagation of opportunistic microbes is impossible. Deviation in one direction or another of the number of lactobacilli, conditionally pathogenic microbes, pH of the medium leads to increased reproduction of pathogenic microbes and the inflammatory process in the vagina, which can spread to the appendages.
All these causes lead to inflammation of the appendages in women with a compromised immune system. Every person daily encounters a large number of microbes, but inflammation develops only in women with weakened defense mechanisms.
Female appendage inflammation - symptoms
Inflammation of the uterine appendages according to the symptoms that appear during the period of the disease can be confused with the inflammatory process of any pelvic organ.
During this period, concern:
- pains of a different nature in the lower abdomen (acute or aching, drawing) with radiation to the leg or perineum;
- various disorders of the menstrual cycle;
- Signs of intoxication: fever to high numbers, weakness, there may be nausea, vomiting, chills.
Inflammation caused by pathogenic microorganisms is acute, symptoms differ in the severity of their manifestation depending on the pathogen. The most vivid clinical picture is observed if the pathogen is gonococcus. With chlamydia, the inflammation is erased. Gonococci and chlamydia are sown in 60% of all cases of adnexitis.
In chronic inflammation, the period of remission can be determined by infertility, for which a woman is being treated, because there are no clinical symptoms of inflammation without exacerbation.
Inflammation of the appendages in a woman can be either unilateral or bilateral. An isolated inflammatory process in the tubes or separately in the ovaries is extremely rare due to the anatomical proximity of these organs. Inflammation when a pathogenic microbe enters the mucosa begins in the fallopian tubes: local edema and microcirculation disturbance occur at the site of introduction and reproduction, the tube thickens, microbes move toward the abdominal cavity. At this point, abdominal pain may occur. As the edema increases, the lumen of the tube narrows, infertility occurs. According to statistics, every fifth patient suffering from inflammation of the appendages suffers from infertility.
Female appendage inflammation - treatment
Treatment of inflammation of the appendages in women includes a wide range of therapeutic measures. The main method of treatment is antibiotic therapy. An antibiotic is prescribed after receiving the results of bacterial seeding, determining the specific pathogen and its sensitivity to antibiotics. Penicillins, cephalosporins, tetracyclines, aminoglycosides are used.
In parallel with antibiotics, antispasmodics (but - shpa, drotaverin), painkillers (ketans, ketarol), antihistamines, immunomodulators are prescribed. If dysbacteriosis or candidiasis develops during antibiotic treatment due to a violation of the microflora in the vagina, probiotics, eubiotics, antimycotic drugs (ketonazole, diflucan, enterogermina, etc.) are additionally prescribed. To accelerate the healing process, biogenic stimulants, multivitamins are used.
At the same time, drugs for local treatment are used: antiseptics (chlorhexidine, dimexide), anti-inflammatory drugs in the form of vaginal ointments, suppositories, douching.
Physiotherapeutic procedures are effective for inflammation of the appendages. In the acute phase, they are used with caution, in the subacute and chronic use all types of physiotherapy procedures that are intended for anti-inflammatory therapy: ultraviolet radiation, ultrasound, electrophoresis, UHF, laser treatment, etc.
Timely treatment for acute inflammation of the appendages leads to recovery. The chronic process does not always end successfully, but treatment can prolong remission and reduce the symptoms of inflammation.
In severe cases, when the conservative treatment is ineffective, surgical treatment is used when identifying ulcers on the tubes and ovaries. Used in most cases, laparoscopy.
Preventive measures for inflammation of the appendages in a woman - quality of life without a disease
Prevention of inflammation of the uterine appendages is the standard rule, with which you can avoid the disease itself and its complications:
1. Regularly visit a gynecologist for timely detection of the disease, given the often erased symptoms of inflammation.
2. Strictly observe the rules of personal hygiene.
3. Use condoms.
4. Do not self-medicate.
5. Do not abuse alcohol.
6. Eliminate stress, overwork, hypothermia and overheating.
7. Consume lactic acid products containing lactobacilli.
