Inflammatory diseases of the genital organs

Inflammatory diseases in the structure of gynecological morbidity make up about 60% of outpatients and 30% of inpatients. The anatomical and physiological characteristics of the female body, as well as social and living conditions, determine the presence of risk factors for the development of inflammatory diseases of the genitals, as well as natural biological barriers.

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Risk factors

Factors that promote and hinder the development of inflammatory diseases of the lower female genital organs

Factors that contribute to inflammation

Natural barriers that prevent the development of inflammatory diseases

Failure to observe personal hygiene rules Proximity of the excretory organs (external opening of the urethra and rectum) Urinary incontinence Hypofunction of the ovaries (childhood and old age) Frequent vaginal douching (disruption of its microecology) Uncontrolled use of antibiotics, hormonal contraceptives Pathology of the adrenal glands and other endocrine glands Trauma during childbirth, abortions

Closed state of the labia, tone of the perineal muscles Adequate hormonal supply Presence of lactobacilli Acidic environment of the vagina The presence of a mucous plug in the cervical canal

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Pathogenesis

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

The main disorders of specific functions of women in inflammatory diseases of the lower part of the female genital organs

Function	Nature of the violation
Menstrual	Hypomenorrhea, algomenorrhea
Sexual	Dysparusia, decreased libido
Secretory	Pathological discharge (leucorrhoea) from the genital tract
Reproductive	Infertility
Pregnancy	Miscarriage, chorioamnionitis, intrauterine infection of the fetus
Childbirth	Untimely rupture of amniotic fluid, increased incidence of pathological bleeding in the placental and early postpartum period
Postpartum period	Development of localized and generalized forms of postpartum diseases

The ascending path of spreading contributes to rapid generalization and multilevel nature of the lesion. Outcomes of inflammatory diseases - transition to chronic forms, formation of persistent pain syndrome. High level of work losses, social maladjustment of the sick woman, necessity of rendering emergency medical care in some cases determine increased attention to treatment and prevention of this group of diseases of the female genital tract.

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Forms

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

Nosological forms of purulent-inflammatory diseases of female genital organs

Nosological forms	Anatomical localization
External genitalia
External genitalia	Vulvitis, vulvar furuncle, vulvar abscess, bartholinitis, abscess of the large gland of the vestibule of the vagina
Internal genital organs
Vagina	Vaginitis (colpitis), vaginosis, vulvovaginitis, urethritis, paraurethritis
Uterus	Cervicitis, endocervicitis, endometritis, endomyometritis (panmetritis), perimetritis, uterine abscess (pyometra)
Uterine appendages	Salpingitis, perisalpingitis, oophoritis, perioophoritis. salpingo-oophoritis (adnexitis, adnextumor), fallopian tube abscess, ovarian abscess, tubo-ovarian abscess
Parauterine space, pelvic tissue, peritoneum	Parametritis, pelvic cellulitis, pelvic phlegmon, small gas abscesses (excluding abscesses of the uterine appendages), pelvic peritonitis (pelvioperitonitis), peritonitis
Soft tissues
Soft tissues	Cellulitis, fasciitis, myositis, phlegmon
Mammary glands
Breast	Mastitis, breast abscess
Generalized infection
Sepsis	Septicemia, septicopyemia, infectious-toxic (septic) shock

Inflammatory diseases of the lower genital tract

The lower part of the female genital organs includes the vulva, external genitalia and vagina.

Inflammatory diseases of the lower genital organs are most typical for the reproductive period of a woman's life, but they also occur in young and old age. Vulvitis and vulvovaginitis account for about 65% of all diseases of the reproductive system in childhood and prepuberty.

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Diagnostics genital inflammatory disease

When collecting the anamnesis of the disease, the time of appearance of the signs of the disease, their nature and degree of severity, previously carried out treatment measures and their effectiveness are noted.

By studying the gynecological anamnesis, the connection of the disease with the time of the onset of menstruation, the change in symptoms depending on the phase of the menstrual cycle are revealed. If the patient is sexually active, the number of sexual partners, the frequency of sexual contacts, the presence of signs of an infectious process of the external birth organs in the partner, the use of barrier methods of contraception are determined.

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

The condition of the vaginal mucosa is assessed in the mirrors: hyperemia, edema, ulceration, degree of hormonal saturation of the mucosa; features of the condition of the cervix, condition of the external os and visible part of the cervical canal. Smears are taken for microbiological examination from the vagina, urethra, cervical canal, washing from the vagina, as well as smears from the surface of the cervix for oncocytology.

A bimanual (rectovaginal) examination is performed to assess the condition of the internal genital organs, which allows one to suspect the ascending spread of the inflammatory process.

Laboratory tests (blood, urine, feces) allow us to determine the form of the disease: acute, chronic; the degree of prevalence of the process; the involvement of adjacent organs.

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