Salpingoophoritis: causes, symptoms and drugs for treatment

Infection can reach the pelvic organs in two ways: hematogenously (with the bloodstream, from organs where there are foci of inflammation) and from the external genital organs, through the uterine cavity.

According to statistics, the pathology occurs in every fourth woman of reproductive age. Of particular danger are complications of salpingoophoritis - disruption of the ovaries, irregular menstrual cycle, adhesions, obstruction of the fallopian tubes, ectopic pregnancy, infertility, the treatment of which takes a longer time. You can be examined and undergo therapy at the AltraVita clinic.

Salpingitis

Oophoritis

Causes of adnexitis

The causative agent of the disease is pathogenic microorganisms - ureaplasma, streptococci, mycoplasma, staphylococcus, chlamydia, gonococcus, etc. Most often, the bacterium enters the body through the ascending route from the external genitalia; sexual contact during menstruation, after childbirth or abortion is especially dangerous.

Less commonly, acute salpingoophoritis develops against the background of another infectious disease. Then the pathogen penetrates the pelvic organs from another source of infection, even from the paranasal sinuses or pharynx.

Risk factors for the development of acute or exacerbation of chronic salpingoophoritis:

poor nutrition;
hypothermia;
frequent stressful situations;
constant overwork;
promiscuity;
use of an intrauterine device;
abortion;
performing manipulations on the pelvic organs;
weak immunity.

Factors of occurrence

The content of the article

The most common cause of the disease is hypothermia. For example, if your lower back is very cold. Wet feet in the autumn or winter season often become a factor leading to salpingo-oophoritis.

Causes:

“Ordinary” bacteria are sources of disease.
Pathogens acquired through sexual intercourse are chlamydia and gonococci. When such bacteria enter the genital tract due to infection, they try to penetrate the uterine tubes. The reason for this lies in the acidity of the mucous membrane. It is most suitable in pipes; in addition, columnar epithelium is located there - the best place for chlamydia to live.

Chlamydia is a pathogenic bactericidal pathogen that has all the necessary means to resist the body's immune system.

Symptoms of salpingoophoritis

Based on the nature of its course, adnexitis is divided into acute, subacute and chronic.

The main signs of acute inflammation:

purulent, mucous or serous discharge from the genitals;
pain in the lumbar region and lower abdomen, aggravated by sexual intercourse;
increase in body temperature up to 39 °C;
chills;
increased sweating;
urinary disturbance;
headache and/or muscle pain;
general malaise.

Subacute salpingoophoritis is a primary inflammation with a mild clinical picture. In this case, the woman feels a dull aching pain without a specific localization, occurring in one or another area of the abdomen.

Chronic salpingoophoritis is manifested by periodically occurring aching pain in the groin area, often in the vagina. This form of the disease is characterized by irregularities in the menstrual cycle, which is caused by changes in ovarian function due to a long-term inflammatory process. Due to ovarian hypofunction, hormone levels decrease. Menstruation is usually heavy, often with blood clots, accompanied by severe pain, and often lasts a long time and is irregular.

Other symptoms of chronic adnexitis:

decreased libido;
pain during sexual intercourse;
mood disorders;
general weakness;
depressed psychological state.

Diagnosis of salpingoophoritis

The doctor makes a preliminary diagnosis based on the patient’s complaints and gynecological examination.

For the final conclusion, a cytological examination of a smear from the cervix, tests for sexually transmitted diseases, and an ultrasound examination of the pelvic organs are performed.

In some cases, diagnostic laparoscopic surgery is required.

The type of pathogen and its sensitivity to antibacterial agents are determined by bacteriological examination.

Differential diagnosis is carried out with ovarian apoplexy, ectopic pregnancy, bacterial vaginosis, colpitis, vulvitis, cervicitis, acute appendicitis, renal and intestinal colic, peritonitis, tumors of the intestine and pelvic organs.

Salpingoophoritis: treatment

If the diagnosis is confirmed, emergency treatment of salpingoophoritis is required - drugs and therapeutic methods are prescribed by the doctor depending on the form of the disease, its cause and the characteristics of the clinical picture of the disease.

Therapy for salpingoophoritis is complex, aimed at eliminating the cause of the disease and stopping the inflammatory process.

Antibiotics that act on the infectious agent are selected depending on its sensitivity. Usually aminopenicillins, fluoroquinolones, aminoglycosides, and cephalosporins are prescribed. In case of acute adnexitis, treatment is carried out in a hospital setting, and antibacterial agents are administered intramuscularly or intravenously.

Typically, systemic antibiotic treatment is combined with local antibiotic treatment in the form of vaginal suppositories.

If intoxication develops, appropriate infusion therapy is carried out; if neoplasms are detected in the fallopian tubes or ovaries, surgical intervention is performed.

To more quickly eliminate inflammation, anti-inflammatory drugs are also used. If necessary, immunostimulating and desensitizing therapy is carried out.

After acute inflammation subsides, drugs are prescribed that restore the vaginal biocenosis. Physiotherapeutic measures are recommended.

Salpingo-oophoritis - inflammation of the uterine appendages

Salpingo-oophoritis, or inflammation of the uterine appendages, is one of the causes of infertility: every fifth woman who experiences it cannot have children. And the danger of salpingoophoritis lies not in the seriousness of the very nature of the disease and treatment, but in the asymptomatic course. We asked Professor, Doctor of Medical Sciences, leading specialist of the gynecology department of City Clinical Hospital No. 79 Armen Eduardovich Ter-Hovakimyan to talk about the causes of development, treatment methods, and possible consequences.

— Armen Eduardovich, before talking about the disease itself, let’s touch on the anatomy of the uterine appendages...

A.E.: The uterine appendages are the fallopian tubes and ovaries. That is, when we talk about inflammation of the uterine appendages, we mean inflammation of these organs not individually (inflammation of the fallopian tube is called salpingitis, and inflammation of the ovaries is called oophoritis), but collectively. And it is called salpingoophoritis, as well as adnexitis. Salpingitis and oophoritis are rare; most often, of course, this is a simultaneous inflammation of both the fallopian tubes and the ovaries, which can also be supplemented by inflammation of the uterus itself (endometritis).

— What are the causes of inflammation of the uterine appendages?

A.E.: Salpingoophoritis refers to inflammatory diseases of the pelvic organs. This is an ascending infection. The causative agents of PID are various pathogenic microorganisms that infect the columnar epithelium of the cervical canal. This is often facilitated by bacterial vaginosis, in which the protective properties of the cervical mucus deteriorate, and this facilitates the spread of an ascending infection.

The ascending route of penetration of pathogenic microorganisms is the most common. Less commonly, the inflammatory process begins with the peritoneum. In isolated cases, pathogenic microorganisms may penetrate directly into the muscle membrane.

One of the main causes of inflammation of the pelvic genital organs is intrauterine interventions, and, first of all, intrauterine contraceptives. This may also be a consequence of non-radical surgical operations for purulent diseases of the uterine appendages and spontaneous miscarriages.

— What are the symptoms of inflammation of the uterine appendages?

A.E.: This is fever, pelvic pain and pain in the upper parts of the vagina during sexual intercourse, pain on palpation of the uterine appendages. But more often than not, symptoms are either mild or absent. Because of this, complications occur, since the diagnosis is made late.

With chronic salpingoophoritis, menstrual dysfunction occurs; they are observed in 40-55% of patients.

- But pain sensations can be deceptive, for example, they can have a different source of origin. Does it happen that other diseases “replace” inflammation of the uterine appendages?

A.E.: Indeed, there are a number of diseases with which a differential diagnosis has to be made: appendicitis, endometriosis (a benign disease in which cells of the uterine mucosa can be found in other organs/tissues), bleeding corpus luteum, ectopic pregnancy.

Under the “mask” of chronic salpingoophoritis, diseases such as external genital endometriosis, uterine fibroids with inflammatory changes, varicose veins of the small pelvis, cysts, ovarian cystomas, etc. occur and are not diagnosed in a timely manner.

— How is inflammation of the uterine appendages diagnosed?

A.E.: A clear sign of inflammation is an increased number of leukocytes detected by microscopy of discharge from the vagina and cervical canal.

To determine inflammation of the uterine appendages, pelvic ultrasound and diagnostic laparoscopy are also performed. Echoscopy (ultrasound) is not a sufficiently informative method; rather, it is additional. But laparoscopy helped reduce both false-positive and false-negative diagnoses. This is perhaps the only method for the fastest and most accurate diagnosis, as well as the use of therapeutic intracavitary procedures.

— How dangerous is inflammation of the uterine appendages?

A.E.: Even an acute inflammatory process can result in complete recovery with timely and adequate treatment. The danger lies precisely in not starting the diagnosis of the disease. After all, it passes and is asymptomatic. Acute salpingitis (inflammation of the fallopian tubes) can become a chronic process that continues for a long time (months, years).

— What could be the consequences of inflammation of the uterine appendages?

A.E.: 20% of women who have had the disease suffer from infertility. Pathological outcomes of pregnancy (spontaneous miscarriages, ectopic pregnancy) are also observed.

When the disease passes into the chronic stage, disorders of the woman’s sexual and menstrual function may occur; premature birth; fetoplacental insufficiency (impaired placental function); intrauterine infection of the fetus; various prenatal pathologies; disability of women due to pain.

— How is inflammation of the uterine appendages treated?

A.E.: If the inflammation is not severe, then it can be treated on an outpatient basis with antibiotics. If the general condition worsens or if an abscess is suspected, antibiotics are administered intravenously.

In folk medicine there is a remedy that has an analgesic and anti-inflammatory effect: cold is applied to the suprapubic part. After 2 hours of use, take a break for half an hour.

If salpingoophoritis has reached an acute stage, treatment with antibiotics is carried out only in a hospital, where certain conditions are created. Laparoscopy is also used: the fallopian tubes are irrigated with an isotonic solution that contains antiseptics and antibiotics. Autohemotherapy (subcutaneous and intramuscular injection of the patient's own blood taken from a vein), aloe injections, physiotherapy: UV irradiation, electrophoresis of drugs (potassium, magnesium, zinc), vibration massage, UHF therapy are also recommended. Physiotherapeutic procedures are carried out against the background of antibacterial therapy, under the control of clinical and laboratory parameters. Rational use of these funds helps the success of treatment, preventing the transition of the inflammatory process to the chronic stage, when irreversible changes may occur (sclerosis, scars, adhesions).

Sometimes there is a need for surgical intervention to remove purulent formations.

In the treatment of the chronic form of the disease, immunomodulators and interferon inducers are used.

— Is it possible to have sexual activity if inflammation of the uterine appendages is diagnosed?

A.E.: It’s possible, but for the duration of treatment, sexual activity is completely excluded. Before resuming sexual relations, sexual partners must be tested for chlamydia and gonorrhea and, if necessary, given antibiotic therapy. After receiving negative tests, it can be resumed.

Complications

In the absence of treatment, the inflammatory process most often becomes chronic. Women complain of constant pelvic pain. They often experience menstrual irregularities, develop chronic cystitis, hydrosalpinx (the so-called dropsy of the fallopian tubes).

Adnexitis is dangerous due to the development of purulent complications (peritonitis). Adhesions can form in the fallopian tubes, which can lead to ectopic pregnancies and infertility. If pregnancy occurs, there is a high probability of fetoplacental insufficiency.

Doctors do not exclude the risk of formation of adnexal tumors.

How will you be treated for adnexitis?

When choosing treatment tactics, our doctors take into account indications, contraindications, course of the disease and accurate diagnosis. The main method of treating appendages is antibacterial therapy. However, a sustainable therapeutic effect can only be achieved with an integrated approach. Your doctor may prescribe for you:

detoxification therapy;
drug therapy with antihistamines;
enzyme therapy;
physiotherapy.

If complications of inflammation of the appendages occur, surgical intervention may be required.

Prevention

To prevent the development of adnexitis, doctors recommend:

observe the rules of personal hygiene;
wear high-quality underwear made from natural fabrics;
avoid hypothermia, including avoiding getting your feet wet, not swimming in cold water, and not sitting on cold surfaces;
increase immunity - exercise, exercise, eat right;
use contraceptives during occasional sexual intercourse;
be regularly examined by a gynecologist.

Diet

During the acute and subacute stages of adnexitis, patients should follow a hypoallergenic diet. It is advisable to exclude from the diet:

mushrooms;
chicken egg whites;
chocolate;
baked goods, sweets;
citrus fruits, etc.

Limit the amount of table salt. Food must be processed by boiling or stewing.

If salpingoophoritis does not have pronounced symptoms, it is not necessary to adhere to a diet. But nutrition should always be complete, with sufficient vitamins and proteins.