Adnexitis (oophoritis) - an inflammatory disease of the fallopian tubes and ovaries, which have a similar pathogenesis and clinic. The causative agent can be adnexitises gonococcus, Mycobacterium tuberculosis, staphylococci, streptococci, Escherichia, enterococci, chlamydia, etc. The inflammatory process usually begins in the mucous membrane of the fallopian tube, then passes it to the muscular and serous membranes (endosalpingit, perisalpingit).
Then from the abdominal end of the pipe pours the contents of a pathological environmental pelvic peritoneum and the epithelium of the ovary. Then the infection gets into the follicle (immediately after ovulation) or in the corpus luteum to continue to develop in the ovary itself. Tube and ovary is soldered together to form a single conglomerate, and then the tubo-ovarian inflammatory Education (piosalpinks or piovar), and later developed multiple adhesions that restrict the cross-tubes.
Clinic adneksita
Clinically isolated:
acute
chronic adnexitis.
In acute adnexitis marked rise in temperature, a significant violation of the general condition, severe pain in lower abdomen, dizuricheskie phenomenon. In the early days of sick animals is sensitive to palpation, there may be a protective muscle tension. Pain aggravated by pelvic exam. The contours of the uterus faint, increased, their mobility is limited. In the blood, expressed in neutrophilic leukocytosis with a left shift, increased ESR, observed other nonspecific signs of inflammation (dysproteinemia, C-reactive protein, etc.).
Diagnosis adnexitis
Diagnosis of acute adnexitis (salpingoophoritis) is based on the history and typical clinical, confirmation of the diagnosis may be an ultrasound.
Treatment adnexitis
Treatment of acute adnexitis (salpingoophoritis) is carried out only in a hospital. Patients showed complete rest, bed rest, painkillers, depending on the severity of pain, broad-spectrum antibiotics or antimicrobial fluoroquinolone, antiinflammatory and desensitizing tools. After the acute inflammation subsided shown biostimulants and physiotherapy (electrophoresis with potassium, magnesium, zinc, and ultrasound on the lower abdomen, vibratory).
Chronic adnexitis (oophoritis) is the predominant form of the frequency of the disease. Most often it is the result of untreated or nedolechennogo acute adnexitis. Patients complain of dull, aching pain in lower abdomen, worse before menses, after cooling and in the event of intercurrent disease. The majority of patients noted menstrual dysfunction (poly-, hypo-algomenoreya), which is associated with ovarian dysfunction (hypothyroidism, anovulation, and others). Very often, a chronic inflammation in the tubes and ovaries leading to infertility.
If pregnancy occurs, it occurs negatively, is the localization of ectopic or spontaneous abortion ends. A significant portion of patients suffering from sexual dysfunction (decreased libido, anorgasmia, etc.). The reason for this may be both organic and psychosomatic disorders are often associated with the experiences of women infertility. Very often there are associated abnormalities in the bowel (constipation and chronic colitis), hepatobiliary (biliary dyskinesia, acalculous or calculous cholecystitis), and urinary tract (pyelonephritis).
During a long illness, characterized by periodic exacerbations and remissions. An objective study determined enlarged and painful on palpation appendages located at the back of the uterus, or a dense elastic consistency. Usually the disease is accompanied by vaginitis or endotservitsitah with matching clinical picture.
In the treatment of chronic phase adneksita (salpingoophoritis) dominate physiotherapy and balneotherapy. The use of antibiotic therapy is not indicated, because even when there is no exacerbation or activation of autoinfection reinfection. It is used analgesic, desensitizing, and anti-inflammatory therapy in various combinations depending on the predominant symptoms in a particular patient. Be sure to use a topical treatment in the form of mud and ozokeritnye applications, vaginal baths, pelvic massage. In addition, the patients demonstrated restorative therapy, vitamins, immunostimulants, a good effect as psychotherapy.
