Acute adnexitis

In practical gynecology, acute adnexitis occupies one of the leading positions in terms of female morbidity.

Considering the importance of the fallopian tubes and ovaries in the processes of reproduction and women's health, it is necessary to pay attention to this disease in order to have the necessary and adequate understanding of it.

ICD-10 code

• N70.0 Manifestations of acute salpingitis and oophoritis;
• N70.9 Manifestations of salpingitis and oophoritis with unspecified diagnosis.

Causes of acute adnexitis

The infectious agent causing the development of the disease can penetrate into the female genital organs in a variety of ways. The most common way is sexual – directly through the vagina – thus the organs become infected with gonococcus, mycoplasma bacteria, chlamydia, viral microbes and many other microorganisms.

Infection is also possible during surgical interventions in the reproductive organs if medical personnel are negligent in their attitude to the rules of asepsis and antisepsis. This can happen during scraping of the uterine cavity, insertion and removal of a contraceptive IUD, and various diagnostic procedures using contrast agents.

The entry of a foreign infection is not excluded after an artificial abortion or after childbirth. This can happen if a woman already has foci of infection in the body: in the intestines, external genitals, as well as distant foci (inflammation of the middle ear, nasopharynx, tuberculosis).

From distant sites of infection development, microorganisms are carried by the bloodstream and lymph flow, entering the cavity of the fallopian tubes and ovaries, which causes infectious tissue damage and the formation of an inflammatory reaction.

The development of inflammation is facilitated by a decrease in the protective function of the body (immunity), when a weakened body does not have the strength and ability to fight a foreign bacterial agent.

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Symptoms of acute adnexitis

Clinical symptoms of the disease may include local and general manifestations:

• aching or throbbing pain in the lower abdomen, which tends to intensify during menstruation, ovulation, after hypothermia or excessive physical exertion;
• the appearance of uncharacteristic vaginal discharge of a mucous or purulent nature;
• menstrual dysfunction (hyper- and hypomenorrhea, prolongation or shortening of the cycle);
• symptoms of intoxication (feeling of weakness, fatigue, subfebrile temperature, headache);
• digestive disorders, the appearance of cystitis, which is associated with the phenomena of general intoxication.

If signs of acute adnexitis appear, you should immediately visit a gynecologist to prevent the disease from becoming chronic.

The development of acute adnexitis is classified according to the degree of damage to the internal genital organs:

• acute bilateral adnexitis - this course of the disease includes damage to both the left and right fallopian tubes and ovaries. In this case, there is a marked deterioration in the general condition, significant signs of intoxication are detected. Palpation of the lower abdomen determines protective muscle tension and pain on both sides of the navel. Blood analysis indicates pronounced leukocytosis with a shift of neutrophils to the left;
• acute right-sided adnexitis - with this course of the disease, the process affects only the right ovary and fallopian tube. The acute onset of the disease is manifested, first of all, by pain on the right side of the navel and in the lower abdomen, so this condition is often mistakenly diagnosed as acute appendicitis. Therefore, in such cases, a consultation with two specialists at the same time is necessary - a surgeon and a gynecologist;
• acute left-sided adnexitis - the inflammatory reaction affects the ovary and fallopian tube on the left side. With this disease, the patient experiences pulling or pulsating pain to the left and below the navel, often during menstruation or ovulation, as well as during sexual intercourse. Over time, the pain may become constant, pathological vaginal discharge appears, the temperature may rise and cystitis or thrush may develop.

Any manifestations of acute adnexitis require immediate consultation with a gynecologist.

Diagnosis of acute adnexitis

Diagnosis of the acute form of the disease begins with collecting the patient's medical history. The doctor asks questions about sexual development, previous illnesses, childbirth, abortions (both artificial and spontaneous), operations on abdominal organs, and methods of contraception.

To determine the causative agent of the disease, it is possible to conduct a study of the microflora: for this, a smear is taken from the cervical canal, vagina and urethra.

Ultrasound examination is rarely used in such cases, since this procedure does not indicate signs of an inflammatory process.

The bimanual vaginal-abdominal examination procedure allows detection of pain and enlargement of the uterine appendages on the affected side.

A complete blood count reveals an increased number of leukocytes and an increased ESR.

The most informative method for diagnosing diseases of the internal genital organs is laparoscopy. However, this method is often combined with therapeutic measures - dissection of adhesions, removal of cysts and neoplasms, etc.

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Treatment of acute adnexitis

The treatment regimen for adnexitis is determined by the doctor based on the results of the studies, as well as tests for the sensitivity of bacterial microflora to the action of antibiotics. The main direction of therapeutic measures is the destruction of foreign bacteria that have penetrated the body, so the main treatment will be antibiotic therapy.

Treatment of acute adnexitis with broad-spectrum medications allows inhibiting the growth and development of a wide variety of pathogenic agents. For this purpose, penicillin series (ampicillin, oxacillin), tetracycline series (tetracycline, doxycycline), macrolide antibiotics (azithromycin, erythromycin), fluoroquinolone group (ofloxacin), etc. are used.

Anti-inflammatory therapy is aimed at eliminating the signs of an inflammatory reaction. Sulfanilamide drugs (biseptol, sulfadimethoxine) are used for this purpose.

The use of biogenic stimulants that accelerate tissue regeneration processes and stimulate the body's defense potential is shown. Such preparations include aloe extract, vitreous body, plasmol.

The treatment is supplemented by the prescription of vitamin supplements, as well as physiotherapeutic procedures: mud therapy, electrophoresis, magnetic therapy, UHF.

Folk treatment of acute adnexitis

Traditional methods of treatment are the use of herbs and infusions that improve the health of the female body and strengthen the immune system. Traditional recipes are a good addition to conservative therapy medications. Such methods will speed up recovery and enhance the effect of traditional medicines.

• Treatment with St. John's wort and chamomile. Pour a glass of boiling water over a teaspoon of dry chamomile and the same amount of St. John's wort, cover and leave for 20 minutes. Drink half a glass several times a day.
• Treatment with orthilia secunda. Pour a glass of boiling water to 1 full teaspoon of dry grass, let it stand for up to 20 minutes. Take half a glass three times a day before meals.
• Treatment with red brush. For treatment, prepare an infusion - a glass of boiling water and a teaspoon of dry raw material. Strain after 15 minutes and drink half a glass after meals. The treatment course is 2-3 months.
• Medicinal collection. Mix equal amounts of rowan berries, mint leaves, tansy, licorice, calendula and rose hips. Pour boiling water over and boil for 20 minutes. Filter and drink in small sips throughout the day.

Herbal teas made from yarrow, sage, string, and thyme have a good effect on diseases of the genitals. However, taking such drinks should be stopped during menstruation and resumed after their end.

A course of treatment with folk remedies can last from one month to six months, then you need to take a month's rest, after which the treatment can be repeated.

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Prevention of acute adnexitis

Prevention of acute adnexitis, and female inflammatory diseases in general, consists of the following measures:

• mandatory daily hygiene of the external genitalia;
• avoid casual sexual contact, use condoms;
• avoiding sexual contact during menstruation. Also, during this period, you should not take a bath, swim in pools and natural bodies of water;
• proper nutrition with plenty of vitamins, elimination of bad habits;
• daily change of linen;
• During menstruation, tampons and pads should be changed every 2-3 hours;
• Douching should only be done as directed by a doctor. The water used for this purpose and the tip of the douche should be boiled.

It is necessary to maintain your body's immunity, avoid hypothermia, overwork, get enough sleep, walk in the fresh air, and engage in active sports.

If there are any foci of infection in the body, they should be treated promptly to prevent the spread of bacteria through the bloodstream.

If you experience suspicious vaginal discharge, pain, cramping, or menstrual irregularities, you should immediately consult your doctor.

Prognosis of acute adnexitis

Acute adnexitis treated in a timely manner does not pose a danger to the body. If the disease is not treated, it can transform into a chronic form, causing the development of adhesive disease. In the future, this threatens reproductive, sexual, and menstrual disorders. The development of chronic adnexitis and adhesions can cause an ectopic pregnancy, or the inability to become pregnant at all.

Prevention and timely treatment are the key to a woman's future health. Do not hesitate or be afraid to see a doctor, and then acute adnexitis will not have such unpleasant and unfavorable consequences for you.