Inflammation of the appendages in women: symptoms, causes and treatment

Inflammation of the appendages of the uterus, or adnexitis, is an inflammatory process that affects both the ovaries and the fallopian tubes.

Very often there is exactly their combined defeat, as the organs are in close proximity to each other.

As a rule, the disease is of an infectious nature, that is, it is associated with infection by pathogenic or conditionally pathogenic microorganisms.

Causes of inflammation of the appendages

The main cause of inflammation of the appendages is infection with microorganisms.

However, in very rare cases, the disease can be caused by autoimmune disorders, when the cells of the immune system begin to damage the fallopian tubes and / or the ovaries. Microorganisms that can cause the development of the inflammatory process in the uterine appendages are divided into two main groups:

1. 1) Conditionally pathogenic, which is activated against a background of decreased immunity
   
2. 2) Pathogenic, which usually come from outside and are not representative of the normal microflora of the genital tract.

It is customary to identify a group of predisposing factors that contribute to the development of the inflammatory process in the uterine appendages. These include the following:

• infringement of the biocenosis in the vagina
  
• the presence of concomitant infectious diseases
  
• diabetes mellitus
  
• administration of immunosuppressants
  
• surgical interventions, etc.

Symptoms of inflammation of the appendages in women

Clinical signs of the disease in women depend on the nature of its course. Acute adnexitis has the same manifestations as exacerbation of chronic adnexitis.

Therefore, the main symptoms of inflammation of the appendages are:

• pains in the lower abdomen, which can give to the lower extremity, the crotch
  
• increase in body temperature
  
• weakness
  
• violation of the ovarian-menstrual cycle( intermenstrual bleeding, profuse and prolonged menstruation).

With vaginal examination, the following signs that confirm the diagnosis can be revealed:

• enlarged appendages
  
• tenderness when they palpate
  
• painful tractions of the cervix.

Chronic adnexitis in the remission phase, as a rule, is asymptomatic. The only manifestation can be infertility, about which women are examined and treated for a long time.

There may also be violations of the ovarian-menstrual cycle according to the type of menstruation delay of different duration. Vaginal examination reveals limited mobility of the uterine appendages and their tightness.

Effect of inflammation of the appendages on pregnancy

Inflammation of the uterine appendages has a very direct effect on the onset of pregnancy, since both the fallopian tubes and the ovaries play an important role in this process.

In the fallopian tube, fertilization takes place, that is, a meeting of the ovum with the sperm. Therefore, in the presence of its obstruction the tubular-peritoneal form of infertility develops.

Normally, the ovaries mature in the ovaries and then enter the abdominal cavity( ovulation).It is the egg that carries the genetic material of the woman, which later combines with the genetic material of the male( spermatozoon).Inflammatory process in the ovaries can lead to the development of anovulatory form of infertility.

Thus, against a background of combined inflammation of the ovaries and fallopian tubes, a combined form of infertility develops. In addition, even against the background of pregnancy, a number of obstetric complications may develop. Most often it is a question of progesterone insufficiency, since progesterone up to 16 weeks is produced by the yellow body of the ovary.

Insufficiency of this hormone can lead to such complications as:

• threat of termination of pregnancy
  
• placental insufficiency
  
• fetal development delay
  
• intrauterine hypoxia.

With diagnosed progesterone deficiency, it is recommended to use its analogs in the form of various dosage forms. It can be vaginal suppositories, tablets for oral administration, as well as injectable forms. These drugs are shown before 16 weeks of pregnancy, then the issue is solved individually

Vaginal dysbacteriosis

Treatment of inflammation of the appendages

Treatment of inflammation of the appendages of the uterus depends on the severity of the inflammatory process. Thus, exacerbation of adnexitis is treated according to the same principles as acute inflammation of the uterine appendages in women.

Conservative therapy is carried out, which includes the following directions:

• antimicrobial therapy
  
• is prescribed non-steroidal anti-inflammatory drugs
  
• vitamins
  
• immunostimulating drugs.

Before the appointment of antimicrobial therapy, it is recommended to carry out a bacteriological study, as well as to identify various urogenital infections that can cause the development of this inflammatory process. This will make it possible to purposefully use this or that antibiotic or antiviral drug.

In the stage of remission of chronic adnexitis treatment is carried out according to slightly different rules:

1. 1) Antibiotic is not prescribed if there are no bright clinical manifestations of the inflammatory process or if
   
2. was not assigned in acute stage 2) Immunostimulating drugs that will allow to normalize the immune function
   
3. systems 3) Vitamins
   
4. 4) Non-steroidal anti-inflammatory agents, with which you can minimize the negative effects of inflammation
   
5. 5) Hormonal prThe drugs that help restore the sensitivity of the ovarian receptors.

Prevention

Preventive measures for inflammation of the uterine appendages are in the following recommendations:

1. 1) Regular visit to the gynecologist, since in some cases the inflammatory process may initially have an erased clinical picture of
   
2. 2) Having one sexual partner
   
3. 3) In case of casual sex,use condom
   
4. 4) Observance of personal hygiene rules
   
5. 5) Regular use of lactic acid products that contain lactobacilli, which arewomen from the normal microflora of the genital tract, protecting them from pathogens.

Complications of

Inflammation of the uterine appendages is a serious pathological process, which in some cases can lead to the development of various complications. It can be such as:

• infertility, which can be associated with obstruction of the fallopian tubes and the development of anovulation
  
• parametritis - inflammation of parametric fiber
  
• abscess of the Douglas space - accumulation of pus in the anterior space
  
• thrombophlebitis of the pelvic veins - thrombosis and venous inflammation
  
• endometritis -inflammation of the inner layer of the uterus and some others.

In conclusion, it should be noted that adnexitis can have either acute or chronic course. Most often, the disease is associated with infection with microorganisms, which can get from outside or be a consequence of the activation of opportunistic microflora.

Clinical manifestations of the disease depends on the severity of the pathological changes that occur. Conducting additional research methods is necessary to select the most rational tactics for treating a woman. However, to achieve the maximum therapeutic result, one should not engage in self-medication.

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