Adnexitis is one of the most common inflammatory diseases of the female genital tract. With adnexitis, the inflammatory process affects the appendages – the ovaries and fallopian tubes. It is very important to treat this disease in time, otherwise adnexitis can acquire a chronic course or lead to the development of severe complications.
Causes of adnexitis
The pathogenic microorganisms — streptococci, staphylococcus, mycobacteria, E. coli, etc. — are directly responsible for the inflammation of the appendages. Bacteria can get into the tubes and ovaries in two ways, for example, in the lungs, maxillary sinus, tonsils).
In the development of adnexitis, risk factors that reduce the body’s immune defenses or are of infectious nature are of great importance:
stress (psychological and physical);
debilitating severe common diseases;
frequent change of sexual partners;
STDs (sexually transmitted diseases);
insufficient or improper hygiene of the genitals.
Quite often, adnexitis becomes a complication of bacterial vaginosis, vaginitis and vulvaginitis. In terms of the occurrence of adnexitis, sexual contact can be dangerous in the coming days after an abortion or miscarriage, as well as during menstrual bleeding, when the cervix is ajar and can become a gateway for infection to enter the uterine cavity and higher in the tubes and ovaries.
Acute adnexitis is characterized by a pronounced clinical picture:
general body temperature rises: this indicates a general intoxication of the body;
there are pains in the lower abdomen, which often give to the rectum and the sacrum;
may disturb urination, headaches, back pain;
abnormal vaginal discharge: may be signs of concomitant vaginitis or endometritis.
All the above symptoms should be a reason for urgent consultation with a gynecologist. Without treatment, acute adnexitis can be complicated by the formation of an abscess (tubo-ovarian abscess), peritonitis, and other life-threatening diseases.
Acute adnexitis ends with recovery or chronic process. The risk factors for the formation of chronic inflammation of the appendages include the late start of treatment, the aggressiveness of the causative agent of inflammation, the presence of moments that support inflammation (weak immunity, general weakness of the body, etc.).
The course of chronic adnexitis is usually recurrent: periods of exacerbation alternate with periods of improvement — remission. In the acute phase, the symptoms are similar to manifestations of acute inflammation of the appendages, but their intensity is often milder. During remission, a woman may notice the following unpleasant symptoms:
dull, aching unstable pains – are the result of the formation in the pelvic cavity adhesions;
tendency to frequent vaginitis;
violation of the menstrual cycle associated with proliferation of connective tissue in the ovary – the main endocrine organ that forms the hormones of a woman. Violation of the cycle is usually manifested abundant or, conversely, scanty, menstruation;
depression of sexual desire;
pain during intercourse.
The prolonged course of chronic adnexitis leads to the proliferation of connective tissue with the formation of infertility and adhesions in the pelvis. A long-standing source of infection in the body can cause other infectious and inflammatory processes – chronic colitis, chronic pyelonephritis, etc. In women with chronic adnexitis, ectopic pregnancy is more common – this is due to impaired tubal patency.
The gynecologist should deal with the treatment of inflammation of the appendages. Depending on the severity of the process, the treatment of the acute process may require hospitalization or take place on an outpatient basis – in a polyclinic setting.
Surgical treatment: it is necessary for the purulent complications of adnexitis.
Antibiotics: prescribed for acute adnexitis and exacerbation of the chronic process. Often, antibiotics are administered in the form of injections, but in some cases it is possible to use tablets.
Antihistamines: reduce the swelling of the inflamed ovaries, thereby relieving pain.
Vitamins: aimed at improving the body’s resistance and the speedy healing of damaged tissues.
Physical therapy: ultrasound treatment, mud therapy, diametria, etc.
Immunomodulators: increase the body’s defenses, promote rapid healing, prevent frequent exacerbations of the chronic inflammatory process.
In the treatment of chronic adnexitis, experts sometimes use long-term use of hormonal contraceptives.