Inflammation of the ovaries and fallopian tubes.

Adnexitis (salpingitis, salpingoophoritis) is an inflammation of the uterine appendages (fallopian tubes and ovaries). Etiology. Most often, the inflammatory process begins with fallopian tubes. The disease, as a rule, has an acute course – acute salpingitis. Infection can enter the fallopian tubes both ascending (from the genital tract) and descending (with blood flow). The reason may be a variety of microorganisms – staphylococci, streptococci, esherechia. Adnexitis is a frequent complication of sexually transmitted infections ( gonorrhea, ureaplasma, trichomonas, chlamydia , etc.).    
Salpingoophoritis can also begin after childbirth, as a result of abortion and other gynecological interventions (biopsies, installation of an intrauterine device). The inflammatory process can go from the appendages to the uterus.

The most common causes of exacerbation of inflammatory diseases of the uterus and appendages are non-specific factors, such as overwork, hypothermia, stressful situations, negative emotions, extragenital diseases.

Symptoms

Adnexitis most often begins acutely, with a rise in temperature to 39ºС. The most constant and characteristic manifestation of adnexitis is pain. Pain, as a rule, is localized in the lower abdomen and can radiate to the lumbar or sacral spine. Most often, pain occurs periodically, less often – they are constantly disturbed. Sometimes the symptoms resemble acute appendicitis. Pain often continues to exist after the disappearance of signs of an inflammatory reaction and may intensify with cooling, various diseases, physical and emotional overloads, etc. The menstrual cycle is disturbed, menstruation becomes painful and longer, intermenstrual bleeding is possible. Patients complain of pain during urination, as well as characteristic watery and sometimes purulent discharge (white). Abdominal pain also occurs during intercourse and persists for some time after it. Without timely treatment of adnexitis, the disease becomes chronic, which is characterized by constant periods of exacerbation. One of the main manifestations of chronic inflammation of the appendages is a menstrual cycle disorder that occurs in more than half of patients with this diagnosis. There is an increase in temperature to 37-38C during periods of exacerbation. Menses become painful, discharge can be either scarce or abundant, postmenstrual or premenstrual discharge is possible. As a rule, pain is accompanied by changes in the neuropsychic state of patients (poor sleep, irritability, reduced ability to work, fatigue, etc.). The frequency of infertility in patients with adnexitis can reach 60 – 70%.

TREATMENT OF ADNEXITIS.

Adnexitis treatment is a set of measures aimed at identifying and suppressing the causative agent of the disease. Only a doctor, after taking a smear and determining the sensitivity of the pathogen to antibiotics, can choose the necessary drug.

Treatment of adnexitis (especially acute) includes: 

• Broad-spectrum antibiotics (preferably after bacteriological culture of vaginal secretions to determine sensitivity to antibiotics); 
• In some cases, along with antibiotics, Metronidazole is prescribed , in / drip; 
• Anti- inflammatory and analgesic drugs (NSAIDs) — diclofenac sodium, indomethacin , ibuprofen, nimesulide , etc., for 10 days. The most effective drugs are rectal suppositories;   
• Desensitizing agents – e.g. diazolin .  

With purulent forms of inflammation of the appendages, laparoscopy is used, during which pus is removed and antibacterial drugs are injected directly into the focus of inflammation.
Patients need bed rest. When acute inflammation is relieved, physiotherapy and biostimulants are used.

If the disease is not treated, then it becomes chronic. During exacerbations, women complain of severe pain in the lower abdomen, menstruation becomes painful and prolonged.

Treatment of adnexitis (chronic) is:  

• Anti-inflammatory therapy – NSAIDs (diclofenac sodium , etc. );   
• Desensitizing therapy (e.g. diazolin );  
• Painkillers ;
• Reception of vitamins and immunostimulants; 
• Physiotherapy – balneotherapy – the use of mud and ozokerite applications, electrophoresis with zinc, iodine. The course of vaginal baths and gynecological massage.   

Chronic inflammation of the appendages without appropriate treatment leads to adhesions, impaired patency of the fallopian tubes, ectopic pregnancy, infertility