Oophoritis remission. Treatment of oophoritis with antibiotics, biogenic stimulants and other drugs

Chronic oophoritis is a dangerous inflammatory process that affects the ovaries. The disease can lead to serious complications. Treatment hr. oophoritis should be carried out in a timely manner. Otherwise, the woman will develop infertility. The disease is difficult to treat, so it should not be allowed to develop.

The defeat of the ovaries can be unilateral or. In the second case, the treatment is long and complicated. The pathological process in this case affects not only the ovaries, but also the fallopian tubes, which reduces the chances of a woman becoming a mother.

Chronic oophoritis is characterized by the presence of mild pain, menstrual disorders. Pathology develops slowly, and its course may be asymptomatic. In this case, the patient does not go to the doctor in a timely manner, which worsens her situation even more.

Chronic oophoritis has its own code in the ICD 10 - 70. Its pathogens are chlamydia, E. coli, streptococcus, and even staphylococcus aureus. The cause of the development of inflammation also becomes tuberculosis, mycoplasmosis, gonorrhea.

The origin mechanism is very simple. First, the pathogen enters the mucous membrane of the vagina and vulva. Further, through the cervical canal, the infection rises into the uterine cavity, and there it is already close to the ovaries.

Reasons for the development of the disease

The disease develops only if the infection can overcome the protective barrier located below the genitals. The following factors can provoke:

• surgical or spontaneous abortion;
• constant overwork or being in a state of stress (it is often these reasons that provoke a disruption in the reproductive female system);
• constant change of sexual partners (increases the risk of infection);
• violations of the functionality of the endocrine system;
• surgical intervention (poorly performed operation provokes infection in the ovaries);
• hysteroscopy, as well as diagnostic or therapeutic curettage of the walls of the uterus;
• complicated childbirth, which are accompanied by ruptures of the birth canal;
• hormonal imbalance;
• tumors localized in the uterus (gradually growing, they also provoke the development of the inflammatory process);
• chronic inflammatory pathologies of the internal or external genital organs of a woman.

It is also important to know why oophoritis becomes chronic. It contributes to:

1. Postponement of treatment due to untimely treatment of the patient to a specialist. If antibiotics are not started at the initial stage of development, then over time the disease will progress, and it will be more difficult to cope with it. Sometimes pathological changes become irreversible.
2. The use of insufficient doses of antimicrobial drugs.
3. Incorrectly prescribed therapy regimen. Here, the treatment of chronic oophoritis causes severe harm.
4. Local or local hypothermia, too heavy physical exertion, nervous shock.
5. Reduced immune defense of a woman.

Chronic oophoritis is difficult to treat, so it is better not to start the disease. In addition, a long-term inflammatory process can provoke serious complications that are not always manageable. Pathology often leads to irreversible consequences - infertility.

Symptoms and signs of pathology

Oophoritis, if it has acquired a chronic form, proceeds in different ways. For example, sometimes it is asymptomatic. Most often, a sluggish character is noted with the periodic appearance of an exacerbation (maximum once a year). In some patients, oophoritis recurs more frequently.

The following symptoms and signs of chronic oophoritis can be distinguished:

• a pronounced violation of the menstrual cycle (between menstrual bleeding there is a large gap or they are absent at all);
• moderate pain in the lower abdomen during sexual intercourse;
• frequent relapses arising from the influence of external factors (hypothermia, overwork);
• no pregnancy, even if the couple is actively trying to conceive;
• weak but constant discharge (leucorrhoea);
• periodic pains of a dull and aching nature in the groin and vagina, which can intensify due to some kind of disease or before the onset of menstruation.

All the insidiousness of chronic oophoritis, the treatment of which almost never begins on time, lies in its latent course. It can develop without an acute period, so the patient does not even suspect the presence of an inflammatory process, and does not receive the necessary treatment when she needs it.

Oophoritis can cause problems with the nervous system and instability of the psychological state of a woman. She becomes irritable, her working capacity decreases, her sleep becomes bad, she gets tired faster. Also, the patient begins to worry that she will not be able to get pregnant. Her emotional state destabilizes, after which her physical health further deteriorates.

If ovarian treatment is not performed, then the patient will experience pathological changes in the fallopian tubes, which will not allow the woman to become a mother. That is, pregnancy can occur, but it will only develop outside the uterus. In the worst case, the patient is diagnosed with secondary functional infertility.

From time to time, a sick woman experiences exacerbations, which are characterized by an increase in the intensity of symptoms. Ignore them and assume that everything will pass by itself, it is not worth it. Also, do not drink anti-inflammatory and painkillers on your own.

Chronic oophoritis on ultrasound

Features of diagnostics

The ineffectiveness of conservative treatment leads to the fact that a woman needs surgery. Which procedure will be applied, the doctor decides, depending on the severity of the woman's condition. Here, the removal of the treated ovary or the affected organ along with the uterus and fallopian tubes can already be carried out.

Chronic oophoritis should be detected correctly and in time. Diagnostics includes the following procedures:

1. Questioning the patient. The doctor must find out if the patient had an abortion, a history of surgery.
2. External examination and palpation by a gynecologist. Here the specialist is able to see the discharge from the cervical canal. In the presence of chronic oophoritis, overhanging and thickening of the vaginal vaults occurs, which can also be detected by palpation. If the doctor pulls on the cervix, the patient gets hurt. The ovaries are enlarged on examination.
3. Smears of the cervix, as well as the walls of the vagina, which should show the cellular composition of the sample, as well as its microflora. For maximum accuracy of the diagnosis, a PCR reaction is performed.
4. Biochemical and general blood test. So you can determine the level of ESR, which in chronic oophoritis is slightly, but increased.
5. Blood test for antibodies to infections: hepatitis, syphilis, HIV.
6. General urine analysis.
7. Ultrasound of the ovaries and uterus with appendages. Here, such signs of chronic oophoritis as enlarged ovaries are found, and fluid collects in the abdominal cavity.

Diagnosis of this disease should be differential, so as not to confuse it with other lesions of the internal organs that require immediate treatment.

Ultrasound examination of the ovaries affected by chronic oophoritis

Features of treatment

Therapy of oophoritis should be complex and long-term. It is necessary to treat the disease with the help of medications, physiotherapy, folk remedies and other methods. As for conservative therapy, the following drugs are used for its implementation:

• antibacterial and antimicrobial: "Amoxiclav", "Ofloxacin", "Ceftriaxone";
• anti-inflammatory: "Indomethacin", "Ibuprofen";
• fortifying agents and multivitamin complexes;
• light sedatives, as the patient becomes irritable, her emotional and psychological balance is disturbed;
• pills to normalize the menstrual cycle;
• drugs to improve blood circulation in the pelvic organs;
• multivitamins, as well as immunomodulators (the course is held 2 times a year).

Treatment of pathology should be done not only with medications, but also in other ways. Folk remedies can also be useful, but they should be used only after the permission of the doctor.

As for other methods of treatment, the patient is prescribed:

1. Internal administration of tampons soaked in Vishnevsky's ointment or Dimexide. Such therapy allows you to quickly cope with pathogens.
2. Gynecological massage.
3. Plasmapheresis (purification of blood plasma).
4. Physiotherapeutic procedures: ultraviolet irradiation, electrophoresis with the use of anti-inflammatory drugs, UHF. These treatments are in addition to conservative therapy.
5. Physiotherapy. It is necessary to do not only breathing exercises, but also exercises to strengthen the muscles of the pelvic floor. This will improve blood circulation in the muscles and tissue nutrition.
6. Spa treatment. Especially useful is the use of mud baths.

If inflammation occurs during pregnancy, then any antibiotic is not only ineffective for treatment, but can also cause significant harm. Therefore, you should not take any measures arbitrarily.

With the help of folk remedies, chronic oophoritis can also be treated, but before that it is better to consult a doctor. The following recipes will be useful:

1. It is necessary to mix in equal parts the grass of the sweet clover, the centaury, the flowers of the coltsfoot. Further, 1 tbsp. l. the mixture is required to pour a glass of boiling water. After infusion, the remedy should be taken 1/3 cup up to 6 times a day. The course of therapy lasts 1 month.
2. You need to take 50 g of juniper berries and stems and throw them into a bucket of boiling water. It will take 2 hours to infuse. This remedy is used for baths.

To prevent oophoritis from appearing at all, some rules must be observed. For example, you should not have sexual intercourse without barrier protection. You should not change sexual partners frequently. Every year, a woman needs to be examined for the presence of genital infections in the body. At the first symptoms of pathology, you should consult a doctor.

The problem of pregnancy in chronic oophoritis

Many women have one question: if they develop chronic oophoritis, will it be possible for them to become pregnant. It should be noted that any violation of the functionality of the ovaries does not have a very good effect on the possibility of conception. Including chronic oophoritis.

The fact is that the disease can not always be determined in a timely manner. This makes it impossible to treat pathology at an early stage of its development, when pathological changes have not yet affected the fallopian tubes. The long course of oophoritis leads to such complications:

• violations of the functionality of the hormonal system, which can provoke a miscarriage in the early stages;
• inflammation of the fallopian tubes, in which adhesions appear in them, preventing the normal passage of the egg into the uterine cavity (an ectopic pregnancy may occur);
• violation of the full-fledged process of producing female germ cells, the absence of ovulation, which is fraught with infertility;
• intrauterine infection of the fetus.

As you can see, chronic oophoritis should be treated even before pregnancy is planned. Otherwise, the danger may threaten not only the expectant mother, but also her child.

The term oophoritis is derived from the Greek word oophoron, meaning ovary, and the ending -itis, meaning inflammation. Thus, oophoritis is an inflammatory disease of the ovaries. Most often, not only the ovary is affected, but also the fallopian tube adjacent to it. This condition is called "salpingoophoritis", or "adnexitis". Isolated inflammation of the ovary usually develops against the background of appendicitis.

Causes and mechanism of development

Oophoritis is caused by microorganisms, mainly streptococci, staphylococci, gonococci, Escherichia coli, and Mycobacterium tuberculosis, as well as nonspecific anaerobic pathogens. Most often, they enter the appendages ascending from the vagina through the uterine cavity and tubes. Rarely, the spread of infection through the blood and lymphatic vessels from other organs is recorded. This path is most typical for causative agents of tuberculosis. Microbes enter the vagina and uterine cavity most often during abortion and other manipulations, including when using intrauterine contraception.

It has been proven that the main cause of oophoritis are the causative agents of gonorrhea and chlamydia - sexually transmitted diseases.

Risk factors for this disease are chronic stress, alcoholism, malnutrition, promiscuity, early onset of sexual activity. Increase the risk of developing the disease diabetes mellitus, obesity, anemia, urinary tract infections.

Factors in the development of chronic oophoritis are endogenous intoxication and a secondary decrease in the activity of the immune system that occurs during a protracted course of acute inflammation. Violations of microcirculation and rheological properties of blood are important.

Violation of the hormonal function of the ovaries leads to an imbalance of the entire regulatory system of a woman. As a result, hormonal disorders occur, in particular, hyperestrogenism.

When acute inflammation becomes chronic, autoimmune mechanisms become important. The body begins to produce antibodies against ovarian tissue. Such disorders, especially in combination with chlamydia, lead to depletion of the ovarian reserve. At the same time, prospects as a method of infertility treatment are sharply reduced.

Clinical picture

Gonococci, chlamydia, mycobacterium tuberculosis often cause bilateral oophoritis, and staphylococci, streptococci and Escherichia coli cause a unilateral process.

The clinical course of oophoritis is determined by the causative agent of the disease and the strength of the woman's immunity, as well as the effectiveness and timeliness of treatment. Distinguish between acute and chronic course of the disease.

Acute oophoritis

It is manifested by severe pain in the lower abdomen and in the sacral region, often radiating (“giving off”) to the rectum. Nausea, vomiting, bloating, and constipation often occur. In many cases, there is an increase in body temperature up to 39 ° C, headache, weakness. There are purulent or sanious-purulent discharge from the cervical canal.

Examination reveals pain in the lower abdomen. With the spread of inflammation to the peritoneum, tension of the abdominal muscles appears, a positive symptom of Shchetkin-Blumberg. With a two-handed examination, enlarged, sharply painful appendages can be felt. Nonspecific "inflammatory" changes are observed in the blood - leukocytosis with a shift to the left, an increase in the erythrocyte sedimentation rate.

Similar symptoms persist for up to 10 days, after which the process ends with recovery or passes into the chronic stage.

Complications of acute oophoritis - pelvioperitonitis, abscess in the recto-uterine cavity, pyosalpinx. All these conditions cause a sharp deterioration in the patient's condition and require immediate treatment.

Chronic oophoritis

It can be an acute outcome or from the very beginning have a long course with alternating episodes of remission and exacerbation. The transition of acute inflammation to the chronic form is facilitated by improper treatment, a decrease in the reactivity of the body, and the high pathogenicity of the pathogen. Exacerbation usually occurs 3-5 times a year.

Chronicization is accompanied by inflammatory infiltration of the ovaries and tubes, the development of connective tissue in them, the formation of hydrosalpinx (accumulation of fluid in the fallopian tube). The blood supply to the ovaries weakens, dystrophic changes develop in them, as a result, estrogen production is significantly reduced.

During the period of remission, a woman may not be bothered by anything. Sometimes there are aching pains in the lower abdomen, in the inguinal region, radiating to the rectum and sacrum. The pain syndrome is most often caused by the formation around the ovaries and fallopian tubes. The adhesive process is one of the causes of oophoritis. Women are concerned about irritability, insomnia, depression, autonomic disorders. Premenstrual syndrome is characteristic (intensification of emotional and autonomic disorders, the appearance of pain before the onset of menstruation).

Menstrual bleeding may become heavy and prolonged (menorrhagia). There are also intermenstrual bleeding (metrorrhagia). Tuberculous lesions are characterized by scanty or absent periods (amenorrhea).

In half of the patients, sexual function is disturbed: sexual desire is lost, anorgasmia develops, and pain occurs during intercourse.

The exacerbation is provoked by hypothermia, overwork, and other non-specific adverse factors. Signs of oophoritis become more pronounced, the general condition worsens, fever appears. Often there are mucopurulent discharge from the genital tract. The exacerbation usually lasts for several days.

During the period of remission, a gynecological examination determines a slight increase, moderate soreness of the appendages, and limitation of their mobility. During an exacerbation, the appendages are greatly enlarged and painful.

Diagnostics

The diagnosis is made on the basis of the anamnesis (history) and symptoms of the disease. An additional diagnostic method is the pelvic organs and. In doubtful cases, diagnostic laparoscopy is possible - examination of the uterus and appendages using an endoscope through a puncture in the abdominal wall. The latter method is the most informative in the diagnosis of oophoritis and its complications.

Examine the microflora of the cervical canal and vagina. Help in the diagnosis of serological blood tests for chlamydia. If a tuberculous lesion is suspected, the diagnosis is carried out in an anti-tuberculosis dispensary. It includes diagnostic curettage, menstrual blood cultures for mycobacteria, tuberculin tests, metrosalpingography and other methods.

It is necessary to examine the sexual partner, since in most cases the cause of oophoritis is a sexually transmitted disease.

Differential diagnosis is carried out with tubal pregnancy, appendicitis, ovarian apoplexy, ovarian cyst rupture. It must be remembered that a combination of appendicitis and right-sided oophoritis is possible. Therefore, when clinical symptoms of the disease appear, the patient should be examined by a surgeon.

Treatment

Treatment goals:

• elimination of the pathogen;
• pain relief and inflammation control;
• prevention of exacerbations and complications;
• restoration of the altered function of the genital organs;
• correction of violations of the work of other organs.

Treatment of oophoritis can be carried out in a hospital or on an outpatient basis, depending on the severity of the disease. The main indications for hospitalization:

• fever above 38˚C;
• inflammatory tubo-ovarian formation;
• pregnancy;
• the presence of an intrauterine device;
• unidentified diagnosis;
• no effect within 2 days of outpatient therapy.

In acute illness and exacerbation of the chronic process, bed rest, a sparing diet, and ice on the lower abdomen are prescribed.

The main drugs for the treatment of oophoritis are broad-spectrum antibiotics that affect the main possible types of pathogens. The most commonly prescribed inhibitor-protected penicillins, III generation cephalosporins, fluoroquinolones, aminoglycosides, lincosamides, macrolides, tetracyclines. The drug of choice is azithromycin in combination with a cephalosporin. However, depending on the change in the sensitivity of microbes, the choice of drugs may be different. In many cases, it is advisable to combine the listed drugs with metronidazole, which is effective against anaerobic pathogens.

The duration of antibiotic therapy depends on its effectiveness and usually ranges from 7 to 14 days. The drugs can be administered in the form of tablets or parenterally.

With severe fever, deterioration of the general condition, detoxification therapy is carried out. The treatment regimens include non-steroidal anti-inflammatory drugs, antihistamines, immunomodulators, vitamins, probiotics, antifungal drugs. In severe cases, it is possible to use extracorporeal detoxification methods (plasmapheresis).

If there is no effect of treatment within 48 hours, the issue of laparoscopy is decided. This intervention allows you to clarify the diagnosis, drain the pelvic cavity, remove the contents of the tubo-ovarian formation. Severe complications of oophoritis (peritonitis) serve as an indication for laparotomy.

During the period of remission of chronic oophoritis, antibiotics are not prescribed. The basis of therapy at this time are restorative measures and vitamin therapy. Physiotherapy for oophoritis occupies an important place in the treatment of the chronic form of this disease. It includes ultrasound, impulse currents, magnetic field, mud therapy, ozocerite, paraffin. Mineral waters are used in the form of baths or vaginal irrigations. Massage of the abdomen and lower back is used, especially with pain syndrome.

Hormonal disorders are corrected with the help of combined oral contraceptives.

With hyperestrogenism, radon baths, electrophoresis of zinc or iodine are prescribed. Against the background of hypoestrogenism, copper electrophoresis and high-frequency pulsed currents will help better.

Infertility resulting from chronic oophoritis may be an indication for laparoscopic separation of adhesions in the abdominal cavity. In women over 35, the main treatment is in vitro fertilization. Its capabilities are often limited due to damage to the ovarian tissue and depletion of the ovarian reserve.

If oophoritis is a sign of gonorrhea or chlamydia, it is imperative to treat the woman's sexual partner.

Forecast and prevention

In an acute uncomplicated process, the prognosis is usually favorable, the disease ends in recovery. The most common complication is pioovar, or ovarian abscess. This condition requires surgical treatment.

Patients are often interested in the question of whether it is possible to become pregnant with chronic oophoritis. This disease can cause infertility due to the formation of adhesions in the pelvic cavity, as well as due to a decrease in ovarian reserve - healthy ovarian tissue that contains eggs. In addition, the risk increases. According to some data, the frequency of infertility reaches 18% even after a single acute salpingo-oophoritis. In a chronic disease, infertility is already found in 70% of patients.

Persistent infertility is most often caused by tuberculous oophoritis.

Prevention of the disease includes the prevention of abortion, the correct conduct of intrauterine interventions. To avoid exacerbation of oophoritis, a woman should avoid overwork, hypothermia, heavy physical exertion.

Women who are worried about menstrual irregularities and a long absence of pregnancy often turn to the gynecological department. Having carried out all the necessary diagnostic measures, the doctor determines the cause of such failures. Often it becomes oophoritis. What it is? Symptoms and treatment of the disease.

What is oophoritis? And why does it occur in women? This disease is an inflammatory process that occurs in the ovaries and is accompanied by unpleasant sensations.

The most basic reason why bilateral oophoritis is formed in women is the penetration of the infectious agent into the fallopian tubes, through which it then entered the ovaries in an ascending way.

More susceptible to oophoritis are those women who often change sexual partners and do not use contraceptives. Also, the disease can cause complications after caesarean section, inflammation of the uterus after childbirth, abortion, surgery in the uterus.

Bilateral oophoritis can cause the following reasons:

• Infectious diseases, sexually transmitted.
• Inflammations that occur in the body, for example, inflammation of the seam after a cesarean.
• Abortions carried out in late pregnancy.
• The appearance of complications after childbirth in women, childbirth by caesarean section, as a result of which the seam may become inflamed.
• Hypothermia of the body.
• Stressful situations, depression.
• Failure of the hormonal background.
• Use of coils to prevent pregnancy.

In most cases, bilateral ovarian oophoritis in women can affect nearby genitals. To prevent this from happening, timely treatment is necessary.

Clinical picture of the disease

Signs of oophoritis appear depending on the stage at which the pathology develops and how it proceeds. Therefore, experts distinguish several varieties of ovarian inflammation in women.

Acute form of pathology

The manifestation of acute oophoritis in a woman is pronounced. Signs of pathology greatly torment patients, require urgent intervention by doctors. This stage causes the following symptoms of oophoritis:

• High body temperature.
• The occurrence of chills, weakness throughout the body, a decrease in efficiency.
• Failure in the functioning of the digestive system.
• Soreness in the lower abdomen, in the head, muscle tissues, and also during urination.
• Vaginal discharge that contains pus.
• Bleeding from the uterus caused by a malfunction of the gonad.
• Pain during sexual intercourse.

Acute bilateral ovarian oophoritis is diagnosed by a gynecologist when examining a patient on a chair. He notices a strong increase in the ovaries due to swelling and inflammation. When you press on the affected area, the woman feels pain.

Chronic stage of the disease

Chronic oophoritis develops slowly, does not have such clear signs of bilateral oophoritis as in the acute form. This stage is characterized by the following manifestations:

1. Failure of the menstrual cycle in women, lengthening or shortening of menstruation, profusion or scarcity of bleeding.
2. Soreness in the groin area of ​​a aching nature, as well as during sexual intercourse.
3. Scanty discharge, having a white color and going regularly.

Chronic ovarian oophoritis is of little concern to the patient, so it is rarely possible to identify it in a timely manner. Usually, ovarian pathology is discovered when trying to establish why a woman cannot conceive a child or she has menstrual irregularities. When the gynecologist feels the area of ​​​​the appendages, the patient feels pain, and the doctor feels an increase in the woman's ovaries.

The manifestation of signs of chronic oophoritis also affects the nervous system, for example, the ability to work decreases, nervousness appears, there is no desire to sleep and eat, and constant fatigue is felt. In some cases, chronic oophoritis in women occurs not as a result of undertreated acute oophoritis, but as an independent pathology of the ovaries.

Subacute form of the disease

Subacute oophoritis of the ovaries in women is diagnosed quite rarely. It occurs when a woman's body develops fungal or tuberculosis bacteria. The signs of this stage are also manifested as in acute oophoritis, but they are less pronounced.

Thanks to modern methods of treatment, this stage of ovarian inflammation can be successfully treated. And if you do not fight it, then the disease will flow into a chronic type, then the therapy will last long and difficult.

Inflammation on the left and right side of the uterus

Since the uterine inflammatory process in women can affect not only two ovaries at once, but only one, left-sided and right-sided oophoritis are isolated. Their symptoms disturb patients in almost the same way, however, there are some differences.

For example, right-sided oophoritis causes a woman severe pain of a sharp nature on the right side. This symptom is very similar to the symptom of appendicitis. In this regard, the doctor needs to exclude the presence of pathology of the appendix during the examination.

Left-sided oophoritis of the ovaries in women leads to pain in the left side. Basically, the infection passes from one ovary to another, so most often bilateral inflammation still develops. Right-sided and left-sided oophoritis together cause pain not in a specific side, but in the lower abdomen, lumbar and sacral.

Inflammation in pregnancy

The combination of chronic bilateral oophoritis of the ovaries and the conception of a child is considered unsuccessful. After all, the activity of the ovaries is disrupted, which has a negative effect on conception, the normal course of pregnancy and the birth of a baby. This is due to the fact that these organs are responsible for the full maturation of the egg and its release from the follicle.

Even if there is a chance to become pregnant with inflammation of the ovaries, then before that you should undergo a thorough examination and treat perioophoritis. If this is not done, then there may be negative consequences:

• Failure of the hormonal background in a woman, which can lead to a miscarriage.
• Development of an ectopic pregnancy. It happens that the occurrence of right-sided or left-sided oophoritis of the ovaries is combined with inflammation of the uterine tubes. As a result, adhesions are formed, which can interfere with the normal fertilization of the egg.
• Inability to conceive a child. Disrupted ovarian function adversely affects the formation of a mature egg, as a result of which ovulation does not occur.
• Transmission of the infection to the baby. This can happen both in utero and when a woman is already giving birth.

Identification of the disease

Bilateral oophoritis of the ovaries in women is found with difficulty. After all, the symptoms of the disease are very similar to other diseases of the abdominal organs. In most cases, the detection of pathology occurs when a woman goes to the doctor with a complaint about changes in the menstrual cycle or a long absence of pregnancy.

Therefore, it is very important to make an accurate diagnosis. In order to carry out the following diagnostic measures for inflammation of the ovaries in women:

• The study of the patient's symptoms and information about past abortions, difficult childbirth, the use of spirals to prevent unwanted pregnancy, the presence of diseases of the genital organs and inflammation of the sutures after labor.
• Inspection in the chair, in which the specialist feels an increase in the ovaries and the mobility of the uterus.
• Laboratory studies of blood, urine and smear. With the development of inflammation, an increased content of leukocytes is observed. With the help of a smear, the pathogen and its sensitivity to antibacterial drugs are determined.
• Ultrasound examination of the pelvic organs, with the help of which it is possible to see inflammation, its localization.
• Analysis for ovarian oophoritis for the presence in the body of an infection that caused the development of the disease. If there is a gonorrheal or tuberculous inflammatory process, then additional diagnostic measures are prescribed.
• Hysterosalpingoscopy, which allows to detect severe violations of the structure of the uterine tubes, the cause, the ovaries began to become inflamed.
• Laparoscopy, which is the most effective method of examination for inflammation of the ovaries of women. It gives the doctor more information about the condition of the uterus. This method is used when there are constant pains in the lower abdomen, there is inflammation of the ovaries, for a long time it is not possible to conceive a child, there is an ineffectiveness of the drug treatment of oophoritis. The diagnostic measure allows you to establish violations of the patency of the fallopian tubes in a woman, the formation of adhesions and the penetration of infection.

How to get rid of the disease?

Treatment of oophoritis is prescribed from the moment an accurate diagnosis is made. The doctor draws up a treatment plan depending on the stage of the disease and what symptoms it causes.

If a woman suffers from acute oophoritis of the ovaries, then treatment in a hospital is necessary under the constant supervision of specialists. Patients must observe strict bed rest, they are allowed to apply something cold to the affected area of ​​\u200b\u200bthe body. The doctor necessarily prescribes antibiotics for inflammation of the ovaries.

It is also recommended to use drugs that have desensitizing, analgesic properties. In addition, it is required to maintain the state of the immune system, strengthen the body. The subacute type of pathology is also treated, but physiotherapy procedures are also added.

Treatment of chronic ovarian oophoritis in women is carried out for a rather long period of time and is complex. After all, this stage often leads to the development of various severe complications, which can often be treated only with surgical intervention. Each patient is assigned individual therapy. Treatment for chronic ovarian oophoritis consists of taking medications and performing physiotherapy procedures.

A procedure such as electrophoresis, laser therapy, massage, and magnet treatment is widely used for inflammation of the ovaries in women. These techniques help reduce the risk of obstruction in the fallopian tubes and the formation of adhesions. Also, acupuncture is used to eliminate pain.

The most basic task of the treatment plan for oophoritis is the suppression of the inflammatory process. In addition, it is necessary to restore the activity of the reproductive system, activate the immune system, normalize the hormonal background, get rid of disorders of the vascular and nervous systems.

When prescribing antibiotics, the sensitivity of the pathogen to a particular drug is first determined. Otherwise, the recommended drug for oophoritis in women may be ineffective. Be sure to take vitamins to strengthen the body, painkillers to eliminate discomfort,

Many doctors prefer drugs in the form of rectal suppositories. They are quickly absorbed into the blood and within a few minutes begin to act. It is recommended to use Betadine. Such suppositories with oophoritis are able to destroy the infection, eliminate pain, and suppress inflammation.

Disease Prevention

In order to prevent the development of inflammation of the ovaries in women, it is necessary to regularly undergo examinations by a gynecologist. After all, the disease can proceed without manifestations, which makes it difficult to detect it in time. It is necessary to get rid of any inflammation that develops in the pelvic organs in a timely manner.

It is necessary to refuse to conduct a promiscuous sexual life in order to avoid sexually transmitted infections, use contraceptives, prevent abortions, and treat stitches after childbirth.

It is important to lead a healthy lifestyle, eat right, exercise, have a good rest. You should also know what oophoritis is in order to recognize changes in the body and contact a gynecologist in time.

Thus, ovarian perioophoritis in women is a serious disease that can occur for various reasons, for example, act as a complication after a cesarean section, abortion, wearing a spiral to prevent conception, and other factors. If the first symptoms of inflammation are detected, you should immediately visit a doctor, otherwise there is a high risk of not conceiving a child.

Today, many women are faced with a diagnosis of "oophoritis". What it is? What are the reasons for the development of this disease? How dangerous can the disease be? Are there effective treatments? What should be feared? The answers to these questions will be useful and interesting to every woman.

Oophoritis: what is it?

Oophoritis is an inflammatory disease of the ovaries. In fact, this disease is often diagnosed in young women of reproductive age. It should be noted that the inflammatory process can be localized both in one and in two ovaries at once. Oophoritis is accompanied by pain, discomfort and disturbances in work.

In the absence of timely and proper treatment, the inflammatory process becomes chronic. By the way, quite often the disease also affects the fallopian tubes (acute or chronic salpingitis and oophoritis).

The main causes of the disease

The cause in most cases is a bacterial infection. Moreover, in modern medicine, specific and nonspecific oophoritis are distinguished. The causes of specific inflammation are the causative agents of various sexually transmitted diseases. For example, it can develop against the background of chlamydia, gonorrhea, trichomoniasis, tuberculosis, mycoplasmosis, etc.

Nonspecific inflammation is associated with the activation of opportunistic microflora. Against the background of a decrease in immune defense, the inflammatory process can be caused by the rapid multiplication of staphylococci, Escherichia coli, streptococci, and even fungi of the genus Candida.

Are there risk factors?

Of course, some women are more susceptible to such a disease. Why? First of all, the risk group includes patients who are sexually promiscuous, since the frequent change of partners and the refusal of appropriate protection increases the likelihood of developing sexually transmitted diseases.

As for nonspecific inflammatory processes, there are risk factors here too. In most cases, the activation of opportunistic bacteria occurs against the background of a local or systemic decrease in the level of immune defense. Therefore, women with various chronic inflammatory diseases are more prone to such a disease.

Hormonal imbalance also negatively affects the state of the immune system. Therefore, risk factors include diseases of the endocrine system, uncontrolled use of hormonal contraceptives, as well as artificial termination of pregnancy.

The disease can be the result of inflammation of the organs of the genitourinary system. Right-sided oophoritis often develops against the background of intestinal infection, in particular, the blind process (appendix).

On the other hand, the state of the immune system is affected by malnutrition, constant stress, emotional and mental overstrain, and the negative impact of smoking has also been proven, since substances that enter the body along with cigarette smoke change the chemical composition of the mucous plug of the cervical canal, thereby reducing the resistance of the reproductive system.

What are the symptoms of acute inflammation?

Acute oophoritis is accompanied by severe symptoms. There is a sharp increase in body temperature. Along with fever, other signs of intoxication appear - general malaise, weakness, drowsiness, dizziness, chills, body aches.

A very characteristic symptom is a strong, sharp pain in the lower abdomen, which often radiates to the lower back or sacrum. The pain can be very intense. Signs also include frequent urination, accompanied by cutting pain in the urethra. Naturally, sexual intercourse is also accompanied by severe discomfort.

In addition, with oophoritis, abundant serous or from the vagina may appear. Some women also complain of mild bleeding that has nothing to do with menstruation.

Sometimes the infection passes to the organs of the digestive system - in such cases, violations of the intestinal function are possible.

In any case, the acute form of the disease requires urgent hospitalization. Treatment is usually carried out in a hospital setting.

Subacute form of the disease and its features

Subacute oophoritis is a rare occurrence. In most cases, the cause of this form of the disease is the causative agent of tuberculosis or mycotic infection.

The clinical picture in this type of disease resembles acute oophoritis. But here symptoms, as a rule, are expressed not so distinctly.

Left- and right-sided inflammation: features of the clinical picture

As already mentioned, inflammation can affect either one or both ovaries. Depending on the location of the inflammatory process, left-sided oophoritis, right-sided and bilateral inflammation are distinguished. The overall clinical picture looks about the same, but there are still some differences.

For example, right-sided oophoritis is accompanied by sharp pains on the right side, which resembles the clinical picture of appendicitis. Therefore, in the process of differential diagnosis, the doctor must necessarily exclude the possibility of inflammation of the appendix.

In turn, left-sided oophoritis is accompanied by pain on the left side. But quite often, the infection from the affected ovary quickly spreads to the tissues of the fallopian tube, and from there to the other ovary. Inflammation of two appendages at once is a bilateral oophoritis. Pain in this form of the disease is localized in the lower abdomen, lower back and often radiates to the sacrum.

Chronic oophoritis: what is it?

The chronic form of the disease, as a rule, develops in the absence of proper treatment. It is characterized by periodic exacerbations, which are replaced by periods of relative well-being of the body.

In the acute phase, women, as a rule, complain of aching and dull pains in the lower abdomen. Soreness can spread to the groin and vagina and increase with hypothermia. In addition, chronic bilateral oophoritis (most often inflammation covers two ovaries at once) is accompanied by a violation of the normal menstrual cycle. There is also a decrease in sexual desire.

Moreover, constant, albeit mild, discomfort affects the psycho-emotional state of the patient. Women tend to suffer from increased fatigue and sleep problems. Against the background of a chronic illness, mental and physical performance also decreases, causeless irritability appears.

Are complications possible?

There are many complications that - in the absence of correct and timely treatment - leads to oophoritis. What it is? What are the consequences of the disease? First of all, it is worth noting that inflammation of the appendages quite often affects the functioning of the reproductive system.

As already mentioned, chronic often lead to the formation of adhesions in the fallopian tubes. In turn, the violation of patency is reflected in the menstrual cycle and often becomes the cause of infertility. The consequences of inflammation can also include menstrual disorders, including heavy bleeding, the appearance of uncharacteristic discharge, pain during menstruation. Other disorders are possible, including anorgasmia, a violation of the normal synthesis of hormones in the ovaries. It also increases the chance of an ectopic pregnancy.

In addition, oophoritis of the ovary can affect the work of other organ systems. In particular, the infection can easily pass to the organs of the genitourinary system, which leads to the development of cystitis, pyelonephritis, etc. The development of infectious diseases of the intestine is not excluded. On the other hand, inflammation of the uterine appendages affects the hormonal background, which, in turn, leads to malfunctions of the nervous and endocrine systems.

Chronic bilateral oophoritis can also provoke the formation of a purulent tumor of the uterine appendages. Such a complication often leads to the complete removal of the fallopian tubes and ovaries and, accordingly, infertility.

Modern diagnostic methods

This disease has a similar picture with different diseases. That is why a thorough diagnosis in this case is extremely important. First of all, a gynecological examination is performed, during which the doctor can determine an increase in the ovaries, a violation of their mobility, as well as pain. In addition, the gynecologist collects a complete medical history, including information about symptoms, previous infectious and inflammatory diseases, abortions, etc.

Standard tests also include urine and blood tests, as well as vaginal tests. With inflammation, an increased number of white blood cells can be seen. Examination of samples taken from the vagina helps determine the type of infection. In some cases, additional PCR diagnostics are performed.

Oophoritis of the ovary can also be determined during an ultrasound examination of the pelvic organs. If chronic inflammation is suspected, patients are prescribed hysterosalpingoscopy. However, the most informative diagnostic method is laparoscopy, in which the doctor has the opportunity to carefully examine the fallopian tubes, ovaries and uterus. Such an examination is prescribed in controversial cases, as well as in the absence of the effect of treatment or prolonged, chronic inflammation.

Medical treatment of salpingo-oophoritis

It is immediately worth noting that only a doctor knows how to treat oophoritis. The issue of hospitalization of the patient is decided on an individual basis - acute inflammation is best treated in a hospital setting. The patient is shown strict bed rest and good nutrition.

In the first few days, ice is applied to the lower abdomen. Antibacterial therapy is mandatory - antibiotics are also selected individually, depending on the nature of the pathogen and its sensitivity to certain drugs. Painkillers and sometimes sleeping pills are used to relieve pain. Taking multivitamin complexes and immunomodulators helps to increase the body's resistance, which speeds up the healing process.

Other treatments

Of course, for the treatment of oophoritis, especially when it comes to its chronic form, various physiotherapy procedures are also used. In particular, therapy may include electrophoresis with amidopyrine, salicylic acid and other drugs. UHF and magnetotherapy, UV irradiation, inductotherapy, treatment with low-frequency pulsed currents are also widely used.

If there is an accumulation of pus or exudate in the pelvic area, a puncture is performed, during which the doctor removes the fluid. To consolidate the result, patients are recommended spa treatment, in particular, therapy using medicinal mud, mineral waters, etc.

Are there effective methods of prevention?

Preventive measures include timely diagnosis and treatment of sexually transmitted infections. Women are recommended to undergo a scheduled gynecological examination and take tests at least once every six months. Naturally, casual sexual contact should be avoided.

Also, do not forget about the state of the immune system. Proper nutrition, hardening, the absence of bad habits, regular physical activity - all this will positively affect the state of the whole organism. For any infectious or inflammatory diseases, the patient should undergo appropriate therapy.

Women who have already suffered some inflammatory diseases of the pelvic organs are recommended spa treatment.

Folk methods of treatment

Of course, alternative medicine offers a lot of tools that can cope with inflammation. In particular, decoctions of sage, chamomile, linden and oak are widely used for douching. To prepare a home remedy, you need to mix two parts of linden flowers and three parts of chamomile flowers. Pour six tablespoons of the mixture of herbs with a liter of water and bring to a boil over low heat. After the broth has cooled, strain the liquid. You can use the medicine for both douching and warm baths. The procedure is repeated daily for two weeks.

However, in no case should you refuse conservative treatment. Medicinal herbs can only be used as an aid. Acute oophoritis is an extremely dangerous disease, so you should not risk your health.

The ovaries are the storage of eggs and the source of sex hormones in a woman's body. Any failure in their work leads to a violation of the reproductive function: there are difficulties with conceiving and bearing a child.

One of the diseases of the female gonads is oophoritis - an inflammatory process that often develops against the background of STIs and leads to infertility, hormonal imbalance and early menopause.

The mechanism of the development of the disease

The ovaries are the innermost section of the female reproductive system. They are securely hidden in a strong bone container - the small pelvis, which protects them from any mechanical impact and injury. Gonads (ovaries) partially communicate with the abdominal cavity, but most of them lie retroperitoneally. They are movably connected by ligaments to the uterus and pelvic walls, closely communicate with the end sections of the fallopian tubes. Behind them are the ureters, the upper third of the rectum, large arterial vessels. Inflammation of the ovaries is an infectious process of a specific and nonspecific nature. Most often, the pathogen enters them from the underlying parts of the reproductive system: it penetrates into the mucous membrane of the vulva and vagina, penetrates through the cervical canal into the uterine cavity, from where it reaches the end point through the fallopian tubes - the female gonads. Extremely rarely, the inflammatory process is represented exclusively by oophoritis. Usually women develop inflammation of the uterine appendages: fallopian tubes and ovaries.

Normally, the reproductive system of a woman is well protected from the invasion of pathogens: the vulva and vagina have the ability to self-cleanse, the cervical canal is blocked by dense mucus. The uterine epithelium (endometrium) is shed monthly during menstruation, taking pathogenic bacteria with it, and the tubes make peristaltic movements (shrink) in the opposite direction from the ovaries.

The infection is able to penetrate the ovaries only if the barrier function of the underlying genital tract is impaired. The following factors provoke inflammation of the ovaries:

• Artificial and spontaneous abortion;
• Therapeutic and diagnostic curettage of the uterine cavity;
• Hysteroscopy;
• Childbirth, especially complicated by rupture of the genital organs;
• Hormonal imbalance;
• Chronic inflammatory diseases of the female reproductive system;
• Tumors of the cervix and body of the uterus.

Separately, oophoritis occurs when the infection penetrates downward through the lymphatic or blood vessels from other organs. Most often, its source is the rectum and sigmoid colon - the final sections of the large intestine. In addition, the infection can go down the peritoneum, for example, with appendicitis. In such situations, salpingitis joins a second time when the inflammatory process spreads to the fallopian tube.

Initially, the pathogen is introduced into the outer shell of the ovary and causes an inflammatory process in it. Once a month, ovulation occurs - a mature follicle bursts into the abdominal cavity, releasing an egg into it. In its place, an unprotected surface remains, which becomes the entrance gate for infection. The causative agent penetrates deep into the ovarian tissue, damages it and triggers an inflammatory reaction.

pathogens

As already mentioned, oophoritis can be specific and nonspecific, which is determined by the type of microorganism:

1. Nonspecific - it is caused by opportunistic bacteria:

• Escherichia;
• Klebsiella;
• Proteus;
• Staphylococci;
• Streptococci;
• Enterococci.

2. Specific - due to STIs and other pathogenic agents:

• Anaerobes;
• Mycobacterium tuberculosis.

Classification and symptoms

Symptoms of inflammation of the ovaries are differently expressed at different stages of the course of the process. According to the duration of the disease, there are:

1. Acute inflammatory process- develops suddenly and a woman can tell when the first signs appeared. The disease begins with chills, after which the body temperature rises to 38-39 degrees C. The patient is worried about the growing pain in the lower abdomen, which is cutting in nature and intensifies when moving or turning the body. Pain sensations are localized from the side of the inflamed ovary and gradually capture an increasing area. They give to the perineum, coccyx, rectum. Perhaps the appearance of purulent discharge from the genital tract when attached. Often there is a violation of the stool, bloating, the amount of urine excreted decreases. Without emergency treatment, a fatal outcome is possible, as a result of peritonitis, a common inflammation of the peritoneum.
2. subacute- the severity of the symptoms subsides, the body temperature returns to normal or does not exceed 38 degrees C. The nature of the pain changes from cutting to dull aching, the localization is unclear: it seems that the entire half of the abdomen hurts from below. Stool and urination are restored, but mucous and mucopurulent discharge from the genital tract persists. The menstrual cycle is disturbed: from the complete cessation of menstruation to heavy and prolonged bleeding.
3. Chronic oophoritis- this is the name of a disease that lasts more than six months. Symptoms of inflammation occur during an exacerbation of the process: the body temperature rises slightly, the pain becomes cutting. In the calm stage, a woman is disturbed by dull aching pains in the lower abdomen on one or both sides, menstrual irregularities and infertility. Discharges from the genital tract are absent or have a mucous character.

Signs of ovarian inflammation also depend on the localization of the pathological process:

• Right handed oophoritis most often leads to constipation, since the right ovary is in close proximity to the final section of the colon;
• left hand rather lead to liquefaction of the stool, because the pathological process is localized near the junction of the small and large intestines - the caecum. The feces in it are liquid, and irritation of the intestinal wall leads to their rapid transit, due to which the water does not have time to be absorbed.

Accordingly, pain sensations are localized in the area of ​​oophoritis: inflammation of the right ovary leads to pain on the right, and left - on the left. The causative agents of genital infections often affect both gonads with the development of bilateral oophoritis.

Diagnostics

The diagnosis is established by a gynecologist based on the results:

1. Questioning a patient- often the disease is associated with abortion, childbirth, STIs and interventions in the female genital organs.
2. Inspection and palpation- during the examination on the chair, the doctor sees a thickening and overhanging of the vaginal vaults, purulent discharge from the cervical canal. Stretching the cervix increases pain in the patient. On palpation, the gynecologist determines enlarged and painful uterine appendages. With a long-term inflammatory process, their mobility is reduced, numerous adhesions appear in the pelvic cavity.
3. from the cervix and vaginal walls on microflora and cellular composition. The resulting material is inoculated on nutrient media to determine the type of pathogen and its sensitivity to antibiotics. Additionally, the main STIs are carried out: chlamydia, mycoplasmosis, ureaplasmosis, and.
4. General and biochemical blood test- during acute oophoritis, signs of inflammation are revealed in them: an increase in the number of leukocytes, a change in their qualitative composition with a predominance of young forms, an increase in ESR, C-reactive protein, gamma globulins. A sign of chronic inflammation in the inactive phase is a slight but persistent increase in ESR.
5. Blood tests for to , C and B, .
6. Urinalysis- in an acute inflammatory reaction, a protein is found in it.
7. Ultrasound of the pelvic organs- the inflamed ovary is enlarged in size, a small amount of inflammatory fluid is determined in the abdominal cavity.

If the doctor detects an extensive inflammatory process in the small pelvis with an increase in lymph nodes, but the patient complains little and feels satisfactory, he prescribes a tuberculin test. Such a clinical picture of the character for tuberculous oophoritis. In case of a delay in menstruation, it is necessary to conduct a pregnancy test - a growing fetal egg in the abdominal cavity or fallopian tube gives a similar clinic with inflammation of the ovaries.

Treatment

To avoid chronic process and infertility, the treatment of ovarian inflammation must be carried out on time and in full. For the period of acute manifestations of the disease, the patient is hospitalized in a gynecological hospital, she is shown bed rest and diet.

The main goal of therapy is to eliminate the pathogen with antimicrobial drugs. Chronic oophoritis is treated on an outpatient basis, in this case, immunocorrection and normalization of local blood circulation come first.

Acute stage of the disease

During acute manifestations of oophoritis, food should be easily digestible, contain a lot of protein, dietary fiber and vitamins. It should be abandoned for a while from marinades, smoked meats, fatty meats and fish. During the period of fever, a woman should consume a large amount of warm liquid: compote, fruit drink from berries, non-carbonated mineral water.

Applying ice to the lower abdomen for 10-15 minutes every hour will help reduce the severity of pain and reduce inflammatory damage to the ovarian tissue. After the acute symptoms subside, a warm heating pad can be used - it promotes the resorption of the infiltrate and healing.

Before determining the type of pathogen for treatment, use broad spectrum antibiotics:

• Ampicillin;
• Oxacillin;
• Ampiox;
• Doxycycline (Unidox);
• Cefazolin.

From 3-5 days of antibiotic therapy connect antifungal drugs for the prevention of genital:

1. Ketoconazole 0.4 g per day for 5 days;
2. Miconazole 0.25 g 4 times a day for up to two weeks.

pathogenetic(affecting the links of the pathological process) treatment of oophoritis includes:

• Desensitization- to prevent autoimmune processes and chronic disease. For this purpose, calcium chloride is administered intravenously or antihistamines (zodak, tavegil, diazolin) are taken orally.
• Anti-inflammatory drugs- to reduce the area of ​​inflammatory damage to the ovarian tissue. The most effective for this are glucocorticoids, which are taken orally 2-5 tablets per day (celeston, triamcinolone). Widely used non-steroidal anti-inflammatory drugs (NSAIDs) - diclofenac, naproxen, nimesulide.
• vitamins- have a general strengthening effect, accelerate the healing process of tissues. With oophoritis, vitamins A, E, C are prescribed inside, intramuscularly - B 1.

• Absorbable preparations- prevent the formation of adhesions in the pelvis and fallopian tubes. In gynecology, Wobenzym, Serta, lidase, crystalline trypsin and magnesium sulfate are used.
• Stimulants of the immune response- improve the protection of tissues from the pathogen, contribute to its elimination (excretion from the body). They are represented by preparations of animal (polybiolin, plasmol, placenta extract) and vegetable (aloe extract, peat, fibs) origin.

Local treatment oophoritis includes irrigation of the vagina with an antiseptic solution (weak solution of manganese, chamomile decoction), after which the following is administered:

1. A swab soaked in diluted Dimexide and Vishnevsky's ointment;
2. Anti-inflammatory suppositories with indomethacin.

chronic stage

Oophoritis should be treated after its chronicity by general strengthening methods:

Twice a year, a woman should take multivitamin preparations, in addition, the doctor prescribes immunomodulators (licopid).

Alternative treatment

Folk remedies have an anti-inflammatory effect and can be used at any stage of the disease. Some recipes:

Acute oophoritis and each exacerbation of chronic oophoritis lead to irreversible damage to ovarian tissue. Infertility can develop after the first episode of the disease, so it is extremely important to immediately consult a doctor and begin treatment.

Barrier contraception, a regular sexual partner, and annual screening for sexually transmitted infections are the main methods for preventing STD-related oophoritis.

Video: oophorit in the program “Live healthy”