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Chronic adnexitis
Last reviewed: 23.04.2024
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Frequently arising or not completely cured inflammatory disease of the uterine appendages may eventually become a more protracted form - chronic adnexitis.
This disease is characterized by a sluggish course and, unlike the acute process, it is much harder to treat.
According to the world medical classification, the pathology code of chronic adnexitis is μB-10:
N70.1 Manifestations of chronic salpingitis and oophoritis.
Causes of chronic adnexitis
Chronic adnexitis is a consequence of acute or subacute adnexitis, which has not been cured in full, or has not been treated at all.
Inflammatory reaction with adnexitis begins with a tubular mucosa: this process is accompanied by all the symptoms of inflammation, which also passes to the muscular tissues of the tubes, causing their edema.
The thickened and elongated tube becomes palpable. An infectious agent with a tubular fluid can penetrate into the serous and peritoneal tissues. As a consequence - the possibility of developing suppuration, peritonitis, the formation of tubo-ovarian neoplasm.
In the appendages there is further inflammation, adherence of the walls of the tubes, exudation and fimbriosis thickening, possibly the development of hydrosalpinx. All this leads to tubal obstruction and a risk of developing an ectopic pregnancy.
Sticking of the walls is the initial stage of the adhesion process, one of the characteristics of chronic inflammatory pathology. Spikes can also affect some areas of the peritoneum, intestine, appendix.
The presence of a constant sluggish foci of infection provokes the appearance of a mild and relatively hidden symptomatology. Clear signs of the disease are visible only during relapses.
Symptoms of chronic adnexitis
Recurrence of chronic adnexitis can begin with soreness of the lower abdomen, chills, urination disorders. With a mirror examination, the phenomena of endocervicitis and the presence of serous or purulent discharge are seen.
Two-hand study does not allow you to clearly feel the appendages, but in the area of their presence, there is a sharp soreness.
The blood test shows an increase in the number of leukocytes and ESR.
The chronic form of the disease can last for more than one year, periodically exacerbating and manifesting itself. Clinical symptoms of the "sleeping" course of the disease can be manifested secretly, in the form of a constant temperature of about 37 C, blunt or pulsating tenderness to the right or left of the navel, especially during the period of PMS or ovulation. There is also soreness on the affected side during sexual contact: often this pain is the reason for the woman's refusal to live sexually. Often patients complain about the inability to conceive a child, and during the examination they have a chronic form of adnexitis.
Pain in chronic adnexitis is "stupid", they tend to increase after considerable physical exertion, before menstruation, during sexual contact, after a stressful situation or hypothermia.
Chronic adnexitis can exist in several variants of the course of the disease:
- bilateral chronic adnexitis - an inflammatory reaction is present in both the left and right tubes and ovaries;
- chronic left-sided adnexitis - the inflammatory process affects only the left uterine tube and the left ovary;
- chronic right-sided adnexitis - inflammatory lesion of the right tube and ovary.
Chronic adnexitis in the stage of remission (in the "dormant" state) may not be accompanied by pain, but there may be irregularities in the menstrual function, a change in the number and duration of secretions expressed by PMS. A woman can experience weakness and headaches associated with a permanent intoxication of the body. Blood tests only confirm the presence of latent inflammation in the body.
Exacerbation of chronic adnexitis on symptoms resembles an acute inflammatory process. Symptoms of inflammation have a pronounced character: it is the abdominal tenderness, general weakness, irritability, temperature 37-37,5 C, it is possible the appearance of vaginal purulent-serous discharge.
Chronic adnexitis and pregnancy
Due to the fact that chronic adnexitis is often the cause of tubal obstruction and the development of ectopic pregnancy, it is necessary to cure this disease before planning a child. After a course of therapeutic procedures and appointments, it is also necessary to make sure that the left and right tubes are passable to assess the chances of pregnancy and prevent ectopic pregnancy. If everything is in order - you can safely make attempts to conceive a baby.
If you have learned about pregnancy, when the course of chronic adnexitis is in full swing - consult a specialist, he may prescribe a supportive and sparing treatment for you. Antibiotic therapy during pregnancy is not recommended, since antibacterial drugs can adversely affect the development of the embryo. However, the presence of a foci of infection in the reproductive organs can also provoke very serious complications, including fetal fading and spontaneous abortion. Therefore, the child's bearing on the background of a chronic form of adnexitis must be under the mandatory supervision of a specialist.
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Consequences of chronic adnexitis
The most serious consequence of the chronic form of adnexitis may be tubular obstruction, and, consequently, infertility. The walls of the tubes stick together and do not allow the sperm to penetrate and fertilize the egg.
Inflammation also affects the condition and functionality of the ciliary epithelium. Cilia are located in the pipes. Their function is to push a fertilized egg to the uterus. If this ability is broken, the egg can stop somewhere along the tube and begin its development not in the uterus, but inside the tube. This is how ectopic pregnancy develops - the next possible consequence of adnexitis.
Sometimes a chronic inflammatory process can provoke a disruption in the functionality of the ovaries. In this case, the egg loses its ability to ripen and fertilize, which also causes problems with conception. In this case, there may be violations of menstrual function.
Constant soreness in the affected ovary during sexual contact can help reduce libido; may appear irritability, weakness, dissatisfaction, frequent change of mood.
If a woman with a chronic form of adnexitis still succeeds in getting pregnant, the disease can affect the possibility of bearing a baby: with such pathology, fetal infections, spontaneous abortions or premature labor are often the result.
Diagnosis of chronic adnexitis
Diagnosis of inflammation of the appendages is based on an anamnesis of the disease. Incidents of earlier abortions, complicated labor activity, various intrauterine procedures, salpingography, setting of the uterine spiral are taken into account.
Two-handed research almost always determines the soreness and lack of mobility of the appendages on one or both sides.
The chronic process can not impersonate a general blood test: sometimes it only shows an increased ESR. That is why the study of blood is not an informative diagnostic method: much more information can be obtained from bacterioscopic and bacteriological analyzes of smears from the cervical, urethra and vaginal walls. Detected infectious agents are tested for susceptibility to antibiotic therapy.
Among the instrumental methods of examination, one can distinguish echography (shows a thickening of the tubes, adhesions in the pelvic area), hysterosalpingography (shows the patency of the fallopian tubes), vaginal ultrasound, computer or magnetic resonance imaging.
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Treatment of chronic adnexitis
Can I cure chronic adnexitis? It is difficult, but it is possible: the chronic form may require long-term treatment, however, if you have the patience and strictly follow all the prescriptions of the doctor - the result will be.
The treatment regimen for chronic adnexitis is determined by the attending physician individually, proceeding primarily from the sensitivity of the detected microorganisms to antibiotics. Antibiotics for chronic adnexitis are appointed almost always: the exception is, perhaps, only the period of pregnancy.
The disease is best treated during an exacerbation period: it is much easier to attack active bacteria than sleeping.
Treatment of exacerbation of chronic adnexitis can be carried out using an integrated approach, while simultaneously combining medication, physiotherapy and other additional measures.
Treatment of chronic adnexitis with drugs
Treatment of the disease with antibiotics is performed taking into account the possible type of pathogens. Most often, therapies use drugs with a wide range of effects, which have a disastrous effect on the maximum number of bacterial variants.
The main treatment regimen uses a combination of cephalosporin drugs (ceftriaxone, cefotaxime) and metronidazole; often use a group of aminopenicillin antibiotics (amoxicillin, amoksiklav).
Recently, a fluoroquinolone series of drugs (ofloxacin, ciprofloxacin) has been actively used in the treatment of the disease. If found in the analysis of chlamydia can be prescribed doxycycline or macrolide antibiotics (erythromycin, leukomycin, oleandomycin).
Treatment is carried out in a hospital. The introduction of antibacterial agents is first carried out intravenously, gradually switching to internal reception of medicines. Antimicrobials are combined with therapy for the removal of intoxication: isotonic solution, glucose solution, vitamin and protein products.
Symptomatic therapy includes analgesic and anti-inflammatory drugs that can be prescribed according to individual indications.
Treatment of chronic adnexitis with suppositories
Suppositories for this disease are very effective and are used in complex therapy to relieve inflammation and neutralize bacteria. Vaginal or rectal use of drugs can provide a curative effect in the maximum approach to the focus of infection. Considering the given dosage form, we will stop on the following successfully proved preparations:
- Voltaren. It has a harmful effect on bacteria and produces an anesthetic effect. The maximum daily dose of the drug - up to 150 mg, is used 2 times a day;
- Movalis. A good analgesic, applied within 5-7 days according to indications;
- Hexicon. Antimicrobial and anti-inflammatory drug, used even during pregnancy;
- Fluuomycin. Antibacterial drug, applied once a day before bedtime;
- Indomethacin. Anti-inflammatory and antipyretic rectal;
- Polizhinaks. It is applied within 10-14 days to 1 suppository per day as an anti-inflammatory agent;
- Extract krasavki in candles. Has a good analgesic effect.
Independent use of candles without doctor's appointment is not allowed. Any medicinal product has its own contraindications, and only the specialist can decide whether this treatment is right for you.
Treatment of chronic adnexitis by alternative means
Prescriptions for alternative treatment can only be used in combination with traditional therapy prescribed by a specialist. Doing self-medication is not recommended: it is risky, and for the consequences of such treatment in the answer only you yourself. However, the integrated use of drug and alternative therapies can complement each other, accelerating the onset of recovery:
- mummy. This drug is sold in regular pharmacies. Take it 1 tablet in the morning and for the night on an empty stomach, washed down with milk or juice;
- tea from St. John's wort, chamomile, yarrow, sage and string. On a full teaspoon of each ingredient, brew for 1 liter of boiling water. Insist and drink a glass three times a day;
- sedentary baths from the bark of oak, oregano and althea root. Brew in a liter of boiling water 6 tsp. Oak bark, 4 tsp. Oregano, 1 tsp. Althea, insist half an hour. Pour into the basin (infusion should be 40-45 C) and take a sit-in bath for 15 minutes twice a day;
- raw potato juice. Freshly squeezed juice to drink a third of glass in the morning, up to six months in a row;
- tea made from chamomile. Such tea should be drunk during the day without measure, you can add honey;
- a hog uterus and a red brush. Famous female herbs are brewed for 1 tsp. For a glass of boiling water. Drink before each meal (for half an hour).
Treatment with alternative medications should be coordinated with your doctor, so as not to harm the body. Use of herbs is not recommended during menstruation.
More information of the treatment
Prophylaxis of chronic adnexitis
The main measure for the prevention of chronic adnexitis is the timely treatment of the acute form of the disease. The course of therapy should be completed completely, with the use of all dosages and recommendations of the doctor.
Subsequently, it is possible to periodically conduct courses aimed at the prevention of exacerbations, use sanatorium treatment, mud therapy, and establish a sex life with a regular partner.
Avoid situations that provoke the development of the inflammatory process: stress, hypothermia, infections of the genital organs.
It is necessary to adhere to the rules of intimate hygiene: take a shower every day, wash with warm water, change tampons and gaskets in a timely manner.
It is unacceptable to sit on cold surfaces, swim in cold water. Warm underwear should be worn in winter.
During casual sexual contacts, use condoms; avoid erratic sexual relationships.
For any pain associated with reproductive organs, as well as when uncharacteristic vaginal discharge occurs, it is necessary to visit a doctor without waiting for the progression of the disease.
Prognosis of chronic adnexitis
The prognosis of the chronic form of the disease can be favorable provided timely and qualified treatment with further adherence to all preventive recommendations. Danger to life the disease does not represent. Untreated adnexitis increases the risk of infertility and ectopic pregnancy, disrupts the process of the monthly cycle.
Chronic adnexitis is a serious disease, but you can cope with it by consulting a doctor and strictly following all the recommendations.