Inflammatory diseases of genital organs

Inflammatory diseases in the structure of gynecological morbidity account for about 60% of outpatient and 30% of inpatients. Anatomical and physiological features of the female body, as well as social conditions determine the presence of risk factors for the development of inflammatory diseases of the genitals, as well as natural biological barriers.

[1], [2]

Risk factors

Factors contributing to and impeding the development of inflammatory diseases of the lower section of female genital organs

Factors contributing to the occurrence of inflammation

Natural barriers to the development of inflammatory diseases

Non-compliance with personal hygiene The proximity of the excretory organs (the external opening of the urethra and rectum) Urinary incontinence Ovarian hypofunction (children and senile age) Frequent douching of the vagina (violation of its microecology) Uncontrolled use of antibiotics, hormonal contraceptives Pathology of the adrenal glands and other endocrine glands Trauma in childbirth, with abortion

The closed state of the labia, the muscle tone of the perineum Adequate hormonal supply Presence of lactobacilli Acidic environment of the vagina Presence in the cervical canal of the mucous plug

[3], [4], [5], [6]

Pathogenesis

Inflammatory diseases of the genital organs violate all the specific functions of the female body.

The main violations of women's specific functions in inflammatory diseases of the lower part of the female genital organs

Function	The nature of the violation
Menstrual	Hypomenorrhoea, algodismenorea
Sexual	Dysparsunia, decreased libido
Secretory	Pathological discharge (whites) from the genital tract
Reproductive	Infertility
Pregnancy	Noninvasiveness, chorioamnionitis, intrauterine infection of the fetus
Childbirth	Untimely outflow of amniotic fluid, an increase in the frequency of pathological hemorrhage in the consecutive and early postpartum period
Postpartum period	Development of localized and generalized forms of postpartum diseases

The ascending path of propagation promotes rapid generalization and the multilevel nature of the lesion. Outcomes of inflammatory diseases - transition to chronic forms, the formation of persistent pain syndrome. The high level of labor losses, social disadaptation of a sick woman, the need to provide emergency medical care in a number of cases, cause increased attention to the treatment and prevention of this group of diseases of the female sexual sphere.

[7], [8], [9], [10]

Forms

The course of inflammatory diseases of female genital organs can take place in acute, subacute and chronic forms.

Nosological forms of purulent-inflammatory diseases of female genital organs

Nosological forms	Anatomical localization
External genitals
External genitals	Vulvit, vulvar furuncle, vulvar abscess, bartholinitis, abscess of large gland of vestibule vestibule
Internal genitals
Vagina	Vaginitis (colpitis), vaginosis, vulvovaginitis, urethritis, paraurethritis
Uterus	Cervicitis, endocervicitis, endometritis, endomyometritis (panmetritis), perimetritis, abscess of the uterus (pyometra)
Uterus	Salpingitis, perisalpingitis, oophoritis, periophoritis. Salpingoophoritis (adnexitis, adnecstumor), abscess of the fallopian tube, ovarian abscess, tubo-ovarian abscess
Perimatum space, pelvic cellulose, peritoneum	Parametritis, pelvic cellulite, pelvic phlegmon, abscesses of small gas (excluding abscesses of the uterine appendages), pelvic peritonitis (pelvioperitonitis), peritonitis
Soft fabrics
Soft fabrics	Cellulite, fasciitis, myositis, phlegmon
Mammary gland
Breast	Mastitis, breast abscess
Generalized infection
Sepsis	Septicemia, septicopyemia, infectious-toxic (septic) shock

Inflammatory diseases of the lower genital tract

The lower section of the female genitalia includes: the vulva, the external genitalia and the vagina.

Inflammatory diseases of the lower genital area are most typical for the reproductive period of a woman's life, but are found in young and old age. Vulvit and vulvovaginitis account for about 65% of all diseases of the reproductive system in childhood and prepubescent.

[11], [12], [13], [14], [15], [16], [17]

Diagnostics of the inflammatory diseases of genital organs

When collecting an anamnesis of the disease, the time of appearance of the signs of the disease, their nature and degree of severity, previous medical measures and their effectiveness are noted.

Studying the gynecological anamnesis reveal the relationship of the disease with the time of the onset of menstruation, the change in symptoms depending on the phase of the menstrual cycle. If the patient is sexually active, find out the number of sexual partners, the frequency of sexual intercourse, the presence of signs of an infectious process of external generic organs in the partner, the use of barrier methods of contraception.

When examining the external genitalia pay attention to the signs of the inflammatory process - hyperemia, edema, rashes in the vulva, urethra, large glands of the vestibule, their excretory ducts.

In the mirrors, the state of the mucous membrane of the vagina is assessed: hyperemia, edema, ulceration, the degree of hormonal saturation of the mucosa; features of the cervix, the condition of the external throat and the visible part of the cervical canal. Make smear extraction for microbiological examination from the vagina, urethra, cervical canal, flushing from the vagina, and smears from the surface of the cervix to oncocytology.

Bimanual (rectovaginal) research is performed to assess the state of internal genital organs, which allows one to suspect an upward spread of the inflammatory process.

Laboratory tests (blood, urine, feces) can determine the form of the disease: acute, chronic; degree of prevalence of the process; interest of related bodies.

[18], [19], [20]