Inflammation of the appendages, as it is also called adnexitis, and in scientific circles - salpingoophoritis - is an acute infectious and inflammatory disease of the reproductive system of the female body. Ignoring this problem, as well as untimely seeking medical help, can be fraught not only with the health of the fair sex, but also with her life. Since such processes also occur in an advanced stage, when the process goes so far that peritonitis is formed, which can ultimately lead to death.
As is already clear, the standards of treatment for salpingoophoritis are based on powerful therapy aimed at combating the pathogen that caused such a serious inflammatory process. The pathogenesis of adnexitis itself affects a large number of processes in the human body, setting it up entirely to fight the pathology that prevents it from functioning in its usual, physiological mode.
That is why there is no single pill that could save a woman from this process. The treatment regimen for salpingoophoritis consists of using a complex of groups of drugs aimed at normalizing all indicators of organs and systems.
Types of disease
There are several types of pathology. Experts classify it depending on the severity of the process, the characteristics of its manifestation, as well as the pathogen that became the provoking factor in the development of the disease.
Classification | Common subspecies |
Depending on the severity of the current | The most popular classification involves dividing adnexitis into acute and chronic. The first develops suddenly, is accompanied by pronounced manifestations and often provokes complications, the second is an advanced form of an acute disease. Chronic adnexitis is accompanied by unexpressed, and relapses are observed 1-3 times a year |
Taking into account the affected side | Depending on the side of the lesion, right-sided and left-sided inflammation, as well as bilateral adnexitis, can be distinguished. The latter type is considered the most severe, often provokes consequences and significantly worsens the woman’s condition |
Depending on the pathogen | In addition, experts divide adnexitis depending on the type of pathogen that led to the development of inflammation. The most common types of pathology are chlamydial and gonococcal, but mycoplasmal and trichomonas are sometimes diagnosed. One of the rare types is considered to be salpingoophoritis caused by microbial association. It is worth noting that the course of pathology of microbial origin does not differ from other varieties, the only exception is the nature of the discharge in the acute period |
The first manifestations of any type are almost the same, which makes diagnosis without laboratory tests impossible.
Prescribing antibiotics for an identified pathogen
The exact type of causative agent of adnexitis can be determined by inoculating smears from the cervix. Also, some types of infection have their own characteristic clinical signs (tuberculosis, diphtheria adnexitis). An anamnesis will help to suggest the type of pathogen, the collection of which may reveal recent STIs.
If the pathogen is identified, then prescribing antibiotics is not difficult.
The drug is selected that is highly effective against the recognized infection, taking into account the individual tolerance and health status of the patient.
Stages and degrees
Adnexitis (treatment with antibiotics and suppositories is considered the most popular) occurs in several stages, regardless of the type of disease. It is only worth noting that with a sudden onset, each degree passes into the next more quickly than with the chronic type of pathology.
Symptoms and treatment of adnexitis in women depend on the stage!
At the initial stage, signs of inflammation are mild.
There may be a slight increase in body temperature, as well as slight discomfort in the lower abdomen.
The patient has no idea about the development of the pathology and considers the symptoms to be the result of overwork or hormonal imbalance.
At a progressive stage, the symptoms worsen, and the woman’s general condition worsens.
Additionally, it is at this stage that complications from the urinary system develop.
It is worth noting that stage 2 is accompanied not only by signs from the reproductive system, but also by general symptoms in the form of pain in the head, severe weakness and other manifestations.
An advanced stage is accompanied by severe pain in the lower abdomen, a critical increase in body temperature, and a deviation in blood pressure in one direction or another. In addition, the inflammatory process spreads to nearby tissues, which aggravates the course of the pathology, and the microorganisms that provoked the disease can penetrate the systemic bloodstream.
In the chronic course of the disease, the symptoms are less pronounced, the transition from a progressive stage to an advanced stage is not so noticeable, and complications develop more often, since the patient does not visit the doctor longer.
Contraindications
Each active ingredient included in rectal and vaginal suppositories used in the treatment of adnexitis has a number of contraindications.
Common to all are renal-liver failure, ulceration of the rectal mucosa and severe hemorrhoids. Many antibacterial and anti-inflammatory substances are prohibited during gestation, which is necessarily indicated in the instructions.
Symptoms
Externally, the disease manifests itself only in acute cases and at stages 2-3. If inflammation is just beginning to develop, it is impossible to determine it visually. At an advanced and progressive stage, the skin becomes pale, dark circles appear under the eyes, and increased activity of the sweat glands is observed.
As the process lasts for a long time, the patient loses weight, her appetite worsens or is completely absent, and she experiences weakness and drowsiness. Despite this, night sleep is disturbed, nervous tension and sudden mood swings are noted.
Pain with adnexitis varies depending on the stage of the disease. At stage 1, the discomfort is insignificant, has no clear localization, and may disappear and appear under certain circumstances.
As the pathology progresses, the pain may become cutting, dull or aching. Sometimes it is localized only on one side and does not radiate to other parts of the pelvis.
But often the pain occurs suddenly, is constantly present and radiates to the bladder or rectum. If the pain does not have a clear localization, but spreads to the entire lower abdomen and is burning in nature, we can talk about the development of bilateral acute salpingoophoritis.
Typically, dull, nagging and aching pain occurs in patients suffering from a chronic form of inflammation of the uterine appendages. Additionally, the patient’s body temperature rises and for several days it is difficult to reduce it by conventional means. This exhausts the woman, makes her weak, and sometimes there is a persistent fever.
Signs of intoxication are accompanied not only by joint pain, but also by discomfort in the muscles and the whole body; in addition, the patient speaks of nausea, bouts of vomiting and severe headaches.
Intoxication can manifest itself in the form of trembling in the limbs, as well as intestinal dysfunction. In addition, each patient may have other manifestations in the form of frequent urination and pain in the kidney area. It depends on the accompanying disorders and the general state of the immune system.
Classification of adnexitis
According to the nature of the course, salpingo-oophoritis is divided into the following types:
- Spicy. It is characterized by a pronounced clinical picture - increased temperature, pain in the lower abdomen.
- Subacute – symptoms are blurred.
- Chronic – lasts a long time, with remissions and relapses.
According to the location of the source of inflammation:
- Primary - the source of inflammation initially occurs in the appendages.
- Secondary - the inflammatory process spreads to the appendages from other pelvic organs - rectum, bladder, appendix.
According to the location of the disease. One- or two-sided - when the inflammation includes the appendages only on the right or left, or on both sides.
Reasons for appearance
Adnexitis (treatment with antibiotics and suppositories is carried out after the form of inflammation is clarified) is provoked by general or specific causes. General factors include those that lead to the appearance of signs of any form of pathology, and specific factors include special factors leading to the development of a particular type of disease.
Most common common causes:
- Frequent hypothermia of the body.
- Professional activities associated with regular contact with cold water.
- Frequent colds and viral pathologies.
- Weakening of the body's immune defense as a result of insufficient intake of vitamins, minerals or chronic vitamin deficiency.
- Proctitis and paraproctitis of chronic form.
- Colpitis occurring with complications.
- Active sex life and frequent change of partners.
- Ignoring barrier contraceptives.
- Violation of the rules of personal hygiene or technique of washing the external genitalia, which provokes infection from the anus to the vagina.
- Using aggressive douching agents.
- Vaginal dysbiosis.
- Chronic endometritis.
- Surgical interventions on the uterus, causing the spread of infection to the tubes.
- Diagnostic curettage of the uterus.
Chlamydial adnexitis is provoked by chlamydia bacteria, which are present in the vagina, gonococcal adnexitis results from the penetration of gonococci into the tubes and ovaries during infection with gonorrhea.
Trichomonas type of inflammation is a consequence of infection with Trichomonas. If adnexitis, provoked by a microbial association, is diagnosed, then the type of pathogen is quite difficult to determine. Most likely, the cause was several types of microorganisms.
Diagnostics
To identify the exact form of adnexitis and clarify the localization of inflammation, an examination is carried out using several effective methods:
- A general examination and interview of the patient is carried out in each clinic and usually does not require payment. The specialist listens to the patient’s complaints, palpates the area of greatest pain and prescribes additional examination. The method is considered the first step towards clarifying the disease.
- An examination in a gynecological chair and a smear is usually carried out in public clinics, the cost rarely exceeds 200 rubles. During diagnosis, the doctor examines the cervix and mucous membranes, takes a smear from the cervical canal, vaginal wall and urethra to determine the type of pathogen and the degree of purity. This allows inflammation to be diagnosed at an early stage. During the examination, a digital examination of the vagina is required. At this time, the specialist can accurately determine the side of the lesion.
- A general and biochemical blood test does not require payment and is carried out in a public clinic. The result usually shows an inflammatory process, as there is an increase in the number of white blood cells and an increase in the erythrocyte sedimentation rate.
- Ultrasound of the uterus and appendages costs approximately 500-800 rubles. It is carried out in clinics or private offices with appropriate equipment. Diagnostics allows us to detect the source of inflammation, the extent of its spread to surrounding tissues and possible complications.
- Laparoscopy is considered one of the valuable diagnostic methods; it is performed in private and public clinics and costs approximately 700 rubles. During the procedure, a minimal incision is made in the patient's anterior abdominal wall into which a laparoscope is inserted. Thanks to a miniature camera, the specialist assesses the condition of the tissues. Usually on the monitor screen the doctor sees swelling and redness, as well as a fibrous whitish coating covering the fallopian tubes and ovaries, and adhesions.
The most informative method is laparoscopy and ultrasound. They help differentiate pathology from other diseases with the same symptoms. Based on the data obtained, doctors prescribe treatment for the patient.
How drugs are selected
If characteristic symptoms occur, the patient is admitted to a hospital for treatment of adnexitis with antibiotics. This is the first stage of therapy and in case of uncomplicated course of the disease, these drugs help to achieve complete recovery.
Before selecting a treatment regimen for adnexitis, the type of pathogen and its sensitivity to antibacterial drugs are determined. For culture, smears are taken from the cervical canal and puncture from the posterior vaginal fornix. If it is not possible to carry out a culture or the patient is in a serious condition requiring urgent treatment, combinations of antibiotics are prescribed that destroy the most common pathogens of adnexitis.
Prevention
To prevent the development of pathology, the patient should adhere to the principles of a healthy lifestyle, avoid drinking large amounts of alcohol, and also normalize the diet. It is recommended to eat more vegetables, fruits and greens. The diet should contain low-fat dairy products, lean meat and stewed and boiled fish.
Additionally, it is recommended to avoid hypothermia, pay more attention to clothing in winter, and not stay outside for a long time in extremely low temperatures and strong winds.
Experts insist on regular exercise. You shouldn't overload your body with heavy lifting or marathons, but it is recommended to walk more, swim twice a week, or ride a bike. This will avoid blood stagnation, especially in the pelvic organs.
Separately, it is worth paying attention to sex life. It is better to have a permanent partner who regularly visits the doctor for preventive examinations. If a woman does not have one partner, she should definitely use barrier contraceptives, which will minimize the risk of contracting gonorrhea, chlamydia and trichomoniasis.
In addition, you should regularly visit a gynecologist for an examination and a vaginal smear. This will allow you to detect the disease at an early stage, begin treatment and avoid the development of complications.
The effectiveness of suppositories
Suppositories are prescribed for most forms of oophoritis as an additional or primary method of therapy. For local treatment, suppositories based on antimicrobial, anti-inflammatory, enzymatic and biotic agents are used. The effectiveness of suppositories is determined by their local effect, aimed exclusively at the pathological focus.
Compared to injections and tablets, suppositories have the following advantages:
- candles can be used independently at home;
- unlike injections, the use of suppositories is painless;
- since suppositories act at the local level, they contain less medicine;
- smaller doses of the drug allow you to avoid many complications of general therapy;
- there is no toxic effect on the liver and kidneys;
- there is no risk of injury to the walls of the veins and injection hematoma that occur after injections;
- suppositories have a longer lasting effect due to slow resorption.
Compared to injection and tablet forms, suppositories are more effective for severe manifestations of local inflammation: discharge, spasms, swelling of the mucous membrane and pain.
Treatment methods
Adnexitis (treatment with antibiotics and suppositories should only be prescribed by a doctor) is quite difficult to treat, especially at an advanced stage. Medicines, folk remedies and other methods are used for a complex effect on the body.
Medications
Most often, antibiotics, vaginal suppositories, as well as non-steroidal anti-inflammatory and immunostimulating drugs are used for treatment.
The most popular and effective medications:
- Ceftriaxone is an antibiotic from the cephalosporin group, which is highly effective and helps to quickly destroy pathogenic microorganisms that cause inflammation. It is administered intravenously or intramuscularly, 1 g 2 times a day. The course usually lasts at least 10 days. Before administration, the powder in the vial is diluted with lidocaine or saline. Sometimes the dosage is increased to 4 g per day if the disease is at an advanced stage. The price of the product is from 20 rubles. per bottle.
- Augmentin is an antibiotic from the penicillin group, characterized by its effectiveness and mild effect on the body. The patient is prescribed 2 injections per day, a single dosage is 1.2 g of the drug. The powder is diluted with 10 ml of sodium chloride 0.9% and administered intravenously. The duration of the course is 7-14 days. The price of the drug is from 40 rubles. per bottle.
- Clarithromycin is an antibiotic from the macrolide group, which is considered the most effective in the treatment of acute adnexitis. Due to the high concentration of the active component in the tissues, the maximum effect is achieved after just a few days of use. The patient takes the drug for 7 days, 1 tablet (500 mg) morning and evening. The price of the product is from 150 rubles.
- Nimesil is a non-steroidal anti-inflammatory drug that reduces body temperature and at the same time eliminates pain in the lower abdomen, has a rapid effect and is considered very effective. The powder from 1 sachet should be dissolved in 100-150 ml of warm water, taken orally after meals, but not more than 3 times a day. Course duration is up to 7 days. The price of the medicine is from 30 rubles.
- Prodigiosan is an immunostimulating medication that is considered a good way to strengthen the immune system. Additionally, it prevents the development of intestinal dysbiosis during treatment with antibiotics. The course consists of 5 injections, which are given intramuscularly every 4-5 days. A single dosage is 1 bottle, the price of which starts at 30 rubles.
- Metronidazole is a vaginal suppository used in the treatment of adnexitis provoked by specific pathogens. They are highly effective and quickly destroy pathogenic bacteria. The suppositories should be administered 1 piece in the morning and evening for 10 days. The price of the medicine is from 120 rubles.
- Clotrimazole is a vaginal tablet that is used to treat adnexitis in combination with antibiotics. The product must be administered 1 piece before bedtime for 5 days. The drug is effective and helps to quickly cope with the manifestations of pathology. Price – from 70 rub.
- Reosorbilact is a solution for intravenous infusion using a dropper. Eliminates symptoms of intoxication by purifying the blood. The patient receives from 200 to 400 ml of solution per day, treatment lasts at least 5 days. The price of the product is from 110 rubles.
- Hexicon is a popular drug for destroying pathogenic microflora in the vagina. The candles are very effective and destroy all types of microorganisms. They must be administered before bedtime, 1 piece at a time, for 10 days in a row. The price of the medicine is from 160 rubles.
- Terzhinan – hormonal suppositories with the addition of nystatin. Prescribed for adnexitis, which is provoked by a nonspecific microbial association. They are highly efficient. The course of treatment lasts 10 days, and the patient should be administered 1 suppository before bedtime. Price – from 300 rub.
The patient is usually prescribed several drugs from different groups to quickly eliminate symptoms.
Traditional methods
Adnexitis (treatment with antibiotics and suppositories can be supplemented with other means) in the acute stage cannot be cured using alternative medicine recipes. However, the patient's condition can be alleviated.
Tampons with garlic juice help destroy germs in the vagina. It is necessary to squeeze out the juice of several cloves of garlic and soak a small cotton swab in it, insert it into the vagina overnight. The manipulation must be repeated for at least 7 days in a row.
Douching with chamomile solution is considered a good additional treatment. To obtain an infusion, pour 500 ml of boiling water over 20 g of dry raw materials and leave for 1 hour to infuse. After this, you should filter the infusion and collect it in a small rubber bulb. Douching is carried out before bedtime and after hygiene of the external genitalia for 10 days.
It is recommended to make compresses based on a decoction of cinquefoil for at least 2 weeks in a row to eliminate pain. You can prepare a decoction from 1 liter of water and 50 g of dry herbs, cook for 5 minutes, leave for 2 hours. Soak a piece of gauze or cloth in the broth and apply to the lower abdomen for 1 hour. Repeat daily for 2 weeks.
Any prescription can cause complications; consultation with a doctor is required.
Other methods
Additional methods include ultrasound treatment and surgery.
The operation is performed according to strict indications, for example, in case of formation of an abscess in the uterine area, persistent infertility and multiple adhesions. In addition, if the pathology is regularly and very often complicated, surgical intervention is indicated. The operation is performed under general anesthesia and involves removal of adhesions or the entire tube in case of massive damage and neglect of the process.
Ultrasound treatment is considered a good way to alleviate the patient’s condition in the chronic course of the disease. The procedures are carried out once every 3 days in a medical institution and last no more than 30 minutes. and help relieve inflammation, pain, and stimulate tissue repair. The course consists of 10-15 sessions.
Special recommendations for the use of candles
To ensure that treatment of adnexitis with suppositories does not cause inconvenience, you must adhere to several recommendations:
- During treatment, use daily sanitary pads. Suppositories, when melted inside the body, greatly stain laundry. Their oily base can leave untidy, difficult-to-clean stains. Therefore, while using suppositories, it is worth protecting your underwear with daily clothes.
- Wet the candle. Vaginal and rectal suppositories, capsules and tablets will be easier to administer if they are first moistened with warm water.
- Follow the instructions. Suppositories used in the treatment of adnexitis contain serious medicinal substances that have a whole list of contraindications and side effects. They should be used only as prescribed by a doctor and strictly according to the prescribed regimen.
- Do not use suppositories if side effects occur. If they appear, treatment should be stopped and seek help from a doctor.
Possible complications
If left untreated, the pathology will certainly provoke complications. Most often, adhesions appear that disrupt the functioning of the organs of the reproductive system. In addition, blood poisoning and inflammation can spread to the uterus and intestines.
Adnexitis can also provoke infertility, leading to the loss of not only the fallopian tubes, but also the uterus. The most common complication is the transition of an acute disease to a chronic form.
Adnexitis is an inflammatory disease of the uterine appendages, which quite often affects women of all ages. Treatment of the disease is long-term and involves eliminating symptoms with antibiotics and suppositories. If carried out correctly, complications can be avoided.
Article design: Vladimir the Great
Anti-inflammatory drugs
One of the basic principles of counteracting adnexitis is considered to be the use of focal anti-inflammatory drugs. The most effective in this situation will be Voltaren - a non-steroidal, anti-inflammatory, antipyretic and analgesic drug that is a cyclooxygenase inhibitor. Its closest analogue is considered to be diclofenac - both of the above-mentioned systemic drugs contain an active substance that reduces the level of prostaglandins in the hypothalamus and the site of inflammation. This eliminates not only pain, but also reduces possible blood loss.
Diclofenac and Voltaren tablets are enteric-coated and begin to act a few hours after administration. The initial daily dose for adults is 150 milligrams per day, divided into 2-3 doses, then the concentration can be reduced to 100 mg per day.