Acute adnexitis

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

Given the importance of the fallopian tubes and ovaries in reproductive processes and women's health, attention should be paid to this disease in order to have the necessary and adequate representation about 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

Infectious agent, which causes the development of the disease, can penetrate into the female genital organs in many different ways. The most common sexual path - directly through the vagina - in this way the organs become infected with gonococcus, mycoplasma bacteria, chlamydia, viral microbes and many other microorganisms.

Infection is also possible when performing operative interventions in the reproductive organs with careless attitudes of medical personnel to aseptic and antiseptic rules. This can occur when the uterine cavity is scraped, the contraceptive spiral is installed and removed, and various diagnostic procedures are performed with contrast agents.

The ingress of an alien infection is not excluded after an artificial abortion or after childbirth. This can occur if the woman already has foci of infection in the body: in the intestine, external genital organs, as well as distant foci (inflammation of the middle ear, nasopharynx, tuberculosis).

From distant places of infection, microorganisms are transported with blood and lymph flow, getting into the cavity of the fallopian tubes and ovaries, which causes infection of the tissues and the formation of an inflammatory reaction.

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

[1], [2], [3], [4], [5]

Symptoms of acute adnexitis

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

• aching or throbbing soreness in the lower abdomen, which tends to increase during menstruation, ovulation, after hypothermia, or excessive physical exertion;
• appearance of uncharacteristic vaginal discharge mucous or purulent;
• disorders of menstrual function (hyper- and hypomenorrhea, lengthening 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.

When signs of acute adnexitis should immediately visit a gynecologist to prevent the transition of the disease into a chronic form.

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

• acute bilateral adnexitis - this course of the disease includes the defeat of both left and right tubal ovaries and ovaries. In this case, there is a pronounced deterioration in the general condition, and significant signs of intoxication are found. Palpation of the lower abdomen defines defensive muscle tension and soreness on both sides of the navel. A blood test indicates a marked leukocytosis with a neutrophil shift to the left;
• Acute right-side adnexitis - in this disease, the process affects only the right ovary and the uterine tube. An acute onset of the disease is manifested primarily by pains on the right side of the navel and in the lower abdomen, so this condition is often misdiagnosed as acute appendicitis. Therefore, in such cases it is necessary to consult simultaneously two specialists - a surgeon and a gynecologist;
• acute left-side adnexitis - an inflammatory reaction affects the ovary and the fallopian tube on the left side. With such a disease, the patient finds pulling or pulsing pains on the left and down from the navel, often during menstruation or ovulation, and also during sexual intercourse. Over time, pain can become permanent, pathological vaginal discharge appears, the temperature can rise and cystitis or thrush develop.

Any of the manifestations of the acute form of adnexitis require immediate consultation of a specialist gynecologist.

Diagnosis of acute adnexitis

Diagnosis of the acute form of the disease begins with the collection of anamnesis of the patient. The doctor asks questions about sexual development, past illnesses, childbirth, abortion (both artificial and spontaneous), surgeries on the abdominal organs, methods of contraception.

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

The ultrasonic method of investigation in such cases is rarely used, since this procedure does not indicate signs of an inflammatory process.

The procedure of a two-hand vaginal-abdominal examination allows to detect soreness and an increase in uterine appendages from the affected side.

A general blood test determines the increased number of leukocytes and the acceleration of ESR.

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

[6], [7], [8], [9], [10]

Treatment of acute adnexitis

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

Treatment of acute adnexitis with medicines of a wide range of effects allows to inhibit the growth and development of a wide variety of pathogenic pathogens. For this, penicillin series drugs (ampicillin, oxacillin), tetracycline series (tetracycline, doxycycline), macrolide antibiotics (azithromycin, erythromycin), fluoroquinolone group (ofloxacin), etc. Are used.

Anti-inflammatory therapy is aimed at eliminating signs of an inflammatory reaction. For this purpose, sulfanilamide preparations (biseptol, sulfadimethoxin) are used.

The use of biogenic stimulators is shown, which accelerate the processes of tissue repair and stimulate the protective potential of the organism. Such preparations include aloe extract, vitreous body, plasmin.

Treatment is complemented by the appointment of vitamin products, as well as physiotherapeutic procedures: mud therapy, electrophoresis, magnetotherapy, UHF.

Alternative treatment of acute adnexitis

Alternative methods of treatment - is the use of herbs and fees, which heals the female body, strengthens immune defenses. Alternative recipes are a good addition to the medications of conservative therapy. Such methods will accelerate recovery and enhance the effect of traditional medicines.

• Treatment of St. John's wort and chamomile. It is necessary to pour a glass of boiling water. Dry chamomile grass and as many St. John's wort, cover and leave for 20 minutes. Drink half a glass several times a day.
• Treatment with a hogweed. You should pour a glass of boiling water to 1 full tsp. Dry grass, let stand up to 20 minutes. Take half a cup three times a day before meals.
• Treatment with a red brush. For treatment, prepare the infusion - a glass of boiling water and tsp. Dry raw materials. After 15 minutes, strain and drink after eating a half cup. Therapeutic course - 2-3 months.
• Medical treatment. Mix an equal number of berries of mountain ash, leaves of mint, tansy, licorice, marigold and wild rose berries. Pour boiling water and boil for 20 minutes. Filter and drink in small sips throughout the day.

A good effect in diseases of the genital organs are herbal teas from yarrow, sage, turn, thyme. However, the reception of such beverages should be suspended for a period of a month and renewed upon their completion.

The course of treatment with alternative means can last from one month to six months, then you need to make a month's rest, after which the treatment can be repeated.

[11], [12], [13], [14]

Prevention of acute adnexitis

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

• obligatory daily hygiene of external genital organs;
• the exclusion of casual sexual contacts, the use of condoms;
• Exclusion of sexual contacts during menstruation. Also during this period you should not take a bath, bathe in pools and natural water bodies;
• proper nutrition with an abundance of vitamins, the exclusion of bad habits;
• daily change of linen;
• During menstruation, tampons and pads should be changed every 2-3 hours;
• douching should be done only as directed by the doctor. The water used for this purpose and the tip of the syringe should be boiled.

It is necessary to maintain the immunity of one's body, to avoid hypothermia, overwork, to sleep well, to walk in the fresh air, to engage in active sports.

If any foci of infection are present in the body, they should be treated in a timely manner to prevent the spread of bacteria with blood flow.

When there are suspicious vaginal discharge, pain, cuts, menstruation, you should immediately consult your doctor.

Prognosis of acute adnexitis

Timely cured acute adnexitis does not pose a danger to the body. If the disease is not treated, it can be transformed into a chronic form, provoke the development of a commissural disease. In the future, this threatens with violations of reproductive, sexual, menstrual ability. The development of chronic adnexitis and adhesions can cause ectopic pregnancy, or the inability to become pregnant at all.

Prophylaxis and timely treatment is the guarantee of the woman's future health. Do not be shy and do not be afraid to turn to the doctor, and then acute adnexitis will not have such unpleasant and unfavorable consequences for you.