Treatment of oophoritis with antibiotics, biogenic stimulants and other drugs. Oophoritis - what is it? Causes and treatment of oophoritis

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The sex glands are a paired organ, they are located in the pelvic area, perform a secretory and reproductive role. Inflammation of the ovaries on both sides is called bilateral oophoritis. The disease affects mainly young women leading a free lifestyle. Absence adequate therapy with oophoritis, it causes adhesions, and this is the main cause of female infertility.

Description of pathology

Inflammation of the ovaries rarely occurs in isolation. More often, the fallopian tubes are involved in the process, then the disease is called salpingo-oophoritis. Pathology is acute and chronic, and with aggressive inflammation can lead to purulent fusion of tissues.

The disease rarely begins as a bilateral process. Usually, the defeat of one ovary creates conditions for the spread of infection in the pelvis. Then pathological changes the other ovary is also exposed.

The inflammatory reaction causes a violation of the structure of the organ, as a result, the function of the sex glands also suffers - menstrual, endocrine, reproductive. Bilateral oophoritis is dangerous pathology which causes severe complications.

Causes

The main cause is infection from fallopian tubes and vagina. The main causative agents of the disease are bacteria transmitted through sexual contact. These include:

In addition to venereal diseases, the cause can be banal microorganisms - pathogenic cocci, coli. The inflammatory process is transmitted to the sex glands from nearby sections - the intestines, Bladder. In addition to bacteria, 2-sided oophoritis is caused by viruses. There are 2 types of sexually transmitted viral agents - cytomegaloviruses and herpes infection.

The disease is the result of medical gynecological interventions. During childbirth, curettage of the uterus, an aggressive effect on the genitals occurs, which leads to their injuries and the development of local inflammation.

Predisposing factors are:

• promiscuity;
• taking antibiotics;
• chronic stress;
• hormonal disruptions;
• vaginal douching;
• chronic inflammatory diseases.

Kinds

The disease occurs in 2 forms:

1. Acute bilateral oophoritis. It begins with pronounced symptoms against the background of high temperature. There is an intense pain syndrome, copious discharge predominantly purulent nature uterine bleeding often occurs.
2. Chronic bilateral oophoritis. It has similar symptoms that are less pronounced, but the disease is dangerous in terms of the development of complications.

Symptoms and signs

suspect acute process possible by the following signs:

• Intense pain in both sides of the abdomen;
• fever;
• Pathological secretions of a mucous, bloody and purulent nature;
• General symptoms of intoxication - chills, weakness, headache;
• Violation of urination;
• Frequent urge to defecate.

On examination, there is tension in the anterior abdominal muscles, so the disease resembles an acute surgical pathology. Appendicitis needs to be ruled out renal colic, peritonitis.

signs chronic oophoritis:

• Weak, non-intense pain in the lower abdomen;
• Violations menstrual cycle – meager discharge, metrorrhagia;
• Endocrine imbalance - a decrease in the synthesis of estrogens and progesterone;
• Pain during sexual intercourse;
• Frigidity;
• Infertility.

signs bilateral oophoritis at chronic course meager. A woman is periodically disturbed by the weak drawing pains in the abdomen, which gain strength before menstruation. Sometimes the disease is detected during the examination of a woman who came to the reception about infertility.

Is it possible to get pregnant and give birth?

Having heard the diagnosis of "inflammation of the appendages", women begin to worry about their ability to conceive a child. Oophoritis and pregnancy are poorly combined with each other.

The disease is really dangerous in terms of the development of infertility, since inflammation of the appendages is accompanied by narrowing of the fallopian tubes. They become impassable for the egg. chronic process leads to the growth of fibrous tissue inside the gonads, as a result, they stop producing eggs. The situation is aggravating hormonal disorders that can cause spontaneous abortion.

It is possible to plan the conception of a child only after a full recovery. If pregnancy occurs against the background of an untreated disease, it may result in an ectopic pregnancy or miscarriage. Since the infection persists in the body, the woman risks the health of the child.

Pathogenic microbes can penetrate the uterus and cause intrauterine infection of the fetus. Ways of infection of a child with chronic oophoritis:

• Hematogenous - with viral infection when pathogens cross the placenta along with the blood;
• Ascending - microorganisms reach the embryo, moving through the female genital tract;
• Descending - with oophoritis, pathogenic organisms pass through the fallopian tubes;
• The child during childbirth is in direct contact with the pathogen, or infection occurs by swallowing amniotic fluid.

Courses prescribed by doctor antibacterial drugs, they should not be ignored. If there is no positive dynamics and the appendages are enlarged, treatment is carried out surgically. This helps to keep reproductive function and avoid toxicity.

Diagnostics

The doctor will suspect the disease for the following signs:

• Soreness on both sides of the abdomen;
• Pathological discharge from the vagina;
• Swelling in the area of ​​inflamed ovaries;
• Palpation of the ovaries causes pain.

To diagnose oophoritis, you will need additional research– Ultrasound of the pelvis using a vaginal probe. During the examination, enlarged ovaries are found, devoid of the characteristic bumpy surface due to inflammation. Often, obstruction of the tubes, proliferation of fibrous tissue inside the gonads, and inflammation of the body of the uterus are detected.

A complete picture of the disease will give a laparoscopic examination. During the manipulation, you can examine the state of the gonads and other organs, as well as carry out some medical operations.

Be sure to conduct a microbiological analysis of mucus from the vagina and cervical canal. It helps to identify the causative agent of pathology to choose the necessary antibacterial medicines.

Treatment Methods

The acute form of oophoritis requires inpatient treatment. The woman is assigned complete rest, applying cold to the diseased area. A combination of antibiotics is necessarily used, they are used as early as possible - before the results of the tests are obtained.

Chronic bilateral oophoritis can be treated at home. Since the disease is fraught with serious complications, the woman is examined in detail and selected individual plan treatment.

The main groups of drugs:

1. Non-steroidal anti-inflammatory drugs - to eliminate pain and inflammation. Assign Diclofenac, Amethotex, Indomethacin.
2. Metronidazole is widely used in gynecological practice for the treatment of bilateral oophoritis. The drug acts on both bacteria and protozoa, is administered orally or by injection.
3. Painkillers are prescribed if necessary - Aspirin, Spasmalgon.
4. Enzymatic preparations are used in chronic bilateral oophoritis for the prevention and treatment of adhesions - Longidase.
5. Antibiotics to which microorganisms are sensitive - Amoxiclav, Tsiprolet, Doxycycline.
6. Candles with anti-inflammatory action - Hexicon, Terzhinan.

Possible Complications

Consequences acute inflammation appendages:

• Diseases of the intestines and organs of urination;
• Endocrine disorders;
• Purulent fusion of one ovary;
• Irregular or heavy periods;
• development of peritonitis.

With chronic oophoritis:

• Adhesions in the tubes that prevent the advancement of the egg, as a result - the development of infertility;
• chronic pelvic pain;
• Sactosalpinx is a purulent cyst of the uterine appendages. Severe complication requiring immediate surgical intervention.

Some women do not know that oophoritis is a disease during which the ovaries become inflamed. Often inflammatory process passes to the tubes of the uterus. This leads to inflammation of the ovaries. Because of this disease tubes are soldered to the ovaries. After that, a tubo-ovarian formation appears between them.

Exist various classifications this disease. Oophoritis is divided into two types:

1. Specific. The disease appears due to genital infections.
2. Non-specific. Caused by bacteria that are found in the intestines or vagina. This form of the disease may be preceded by an abortion, various gynecological manipulations and a decrease in immunity.

According to the nature of its course, several forms of oophoritis are distinguished:

1. Sharp form. During acute oophoritis there are very severe symptoms, which manifest themselves in the form of muscle and headache, general weakness and fever. All this negatively affects the general condition of the patient.
2. Chronic form. In this case, the symptoms are not very pronounced. Only during exacerbations are there slight pains in the lower abdomen.
3. Subacute form. It develops against the background of mycotic infection or tuberculosis. It occurs quite rarely.

The ovaries are a paired organ, so sometimes not all of the ovaries are affected, but only part of them. On this basis, the following forms of oophoritis are distinguished:

• bilateral;
• left-sided;
• right-sided.

Causes of oophoritis

Such inflammation necessarily appears due to any reasons. The ovaries are located in such a way that the primary penetration of infection into them is impossible. Inflammation of the ovaries appears in the tubes of the uterus. However, this is not the only source of inflammation. The disease can even appear due to appendicitis. In this case, inflammation appears due to staphylococci, streptococci and Escherichia coli.

Oophoritis can occur if a person has infections. Infectious agents include various viruses.

There are factors contributing to the appearance of oophoritis. These include:

• sexual intercourse without protective equipment;
• long-term use intrauterine device;
• non-permanent sexual partners;
• stress, which negatively affects the protective properties of immunity;
• smoking and drinking alcohol, which, when ingested, contributes to a change in the composition of mucus;
• problems with the genitourinary system;
• the presence of chronic infections;
• problems with the endocrine system;
• hypothermia.

In addition, inflammation of the ovaries can be triggered by diseases such as tuberculosis, chlamydia, and trichomoniasis.

The mechanism of the development of the disease

The spread and development of infection in the body is not carried out immediately. First, it enters the uterine cavity and spreads to the tubes. At the very beginning of the development of the disease, the mucous membrane suffers. After that, the muscular and serous layer is affected. The fallopian tube becomes denser and lengthens. Inside, a purulent fluid appears and is released.

Over time, the process passes to the ovaries. Their tissues are damaged under the influence of pus, which is released from the fallopian tubes. This leads to the appearance of adhesions. Sometimes changes can even affect the surrounding peritoneum.

This process is called periadnexitis. The secret that has accumulated as a result of the development of the infection may contain pus or be completely transparent. Pus accumulated in the ovaries leads to the appearance of pyovar. If the infection continues to develop, it will go beyond the ovary, which will lead to the appearance of pelvic peritonitis.

Symptoms of inflammation of the ovaries

The disease has various symptoms. The acute form is expressed by the following symptoms:

• sexual intercourse is accompanied by field sensations;
• bleeding between periods;
• fever and fever;
• often purulent and serous discharge comes out of the genital tract;
• pain when urinating;
• the lower abdomen can be very sore, sometimes the pain goes to the lower back and sacrum.

Symptoms of chronic oophoritis include:

• problems with the menstrual cycle;
• relapses of the disease that appear after severe hypothermia of the body;
• sexual intercourse is accompanied by pain in the lower abdomen.

If the disease is not cured in time, exacerbations may occur. They have the following symptoms:

• the appearance of white discharge;
• decreased libido, problems with sexual function;
• ovarian function is impaired;
• severe pain that may be in the vagina and lower abdomen;
• increased pain before the onset of menstruation.

During an examination by a gynecologist, it may be found that the size of the ovaries has increased. Sometimes the chronic form is the cause of disorders of the neuropsychological sphere of a person. Violations include increased irritability, sleep problems, reduced level performance and fatigue. Sometimes the chronic form has no pronounced symptoms.

If some of the above symptoms were found, it is recommended to consult a gynecologist.

Oophoritis during pregnancy

Violations in the functioning of the ovaries have a bad effect on the course of pregnancy in women. The ovaries are responsible for producing the right amount of sex hormone. They also affect the maturation and release of the egg. All this affects not only the pregnancy itself, but also fertilization. Sometimes the disease leads to infertility in women.

If chronic oophoritis has not led to infertility, then before conception, you must definitely sign up for an examination with a doctor. This will avoid the occurrence of such complications:

1. Hormonal imbalance, which sometimes leads to miscarriage.
2. Infertility. Due to impaired functioning of the ovaries, there may be problems with the production of eggs, which make the process of ovulation impossible.
3. Oophoritis often leads to the appearance of adhesions. Because of them, fertilization can happen in the fallopian tube, and not in the uterus.
4. Fetal infection. It is carried out due to an infection that is present in the body of a woman. In this case, infection occurs not only during pregnancy, but also during childbirth.

It is for these reasons that it is better to visit a doctor before planning a pregnancy.

Diagnosis of the disease

It is difficult to diagnose this disease. The most common symptom of the disease is sharp pain in the abdomen. It can also appear in other diseases. Other signs of oophoritis may appear with various diseases bodies abdominal cavity.

Oophoritis is often diagnosed if a woman complains of problems with the menstrual cycle. To establish the maximum accurate diagnosis the following surveys are carried out:

1. Conducting analyzes in the laboratory. They are done to determine the level of white blood cells in the urine and blood. It rises if there is inflammation of the ovaries.
2. Gynecological history. Determines the location and nature of pain.
3. ultrasound. Performed to examine the pelvic organs.
4. Gynecological examination. Irregularities in the mobility of the uterus and the size of the ovaries are checked.
5. Hysterosalpingoscopy. With its help, you can identify modifications of the tubes of the uterus.

to the most informative and effective ways diagnosis can be attributed to laparoscopy. During which there is a visual examination of the uterus, its tubes and ovaries. It is carried out if the patient has pain in the lower abdomen. During the examination, the doctor can detect adhesions and low level patency of the fallopian tubes.

Treatment Methods

Most often, the course of treatment consists of antibiotics. Many of them are in the group of penicillins and cephalosporins. The most popular drugs include Cefatoxime, Timentin and Amoxiclav.

During treatment, apply antimicrobials. They are very effective in treating the chronic form of the disease. Often used drugs such as Tinidazole and Metromindazole.

Oophoritis is accompanied severe pain. Anti-inflammatory drugs are used to relieve them. nonsteroidal drugs. This group includes Ibuprofen, Indomethacin and Diclofenac. In gynecology, suppositories or tablets with indomethacin are often used.

Treatment of the disease should be carried out comprehensively. The main part of the treatment is aimed at treating the infection, and additional measures- for support immune system organism. To increase the efficiency of the immune system, immunomodulating agents and vitamins are prescribed. Many gynecologists use the drug "Vagilak", which places lactobacilli in the vagina. This allows you to restore the natural acidic environment.

Care should be taken to ensure that the ovaries completely "rest" from the resulting inflammatory shock. In this case, combined oral contraceptives. With their help, the regulation of the menstrual cycle is carried out, which allows you to save the right number of eggs.

Prevention of oophoritis

To avoid the occurrence of this pathology, you need to follow some rules. These include the following items:

• should be active image life;
• avoid hypothermia;
• do not forget about personal hygiene;
• enjoy different methods contraception;
• regularly examined by a gynecologist.

The above rules must be followed adolescence. It is very important that parents explain to teenage girls how to prevent the occurrence of inflammatory processes. This will help in the future to avoid the occurrence of a disease such as oophoritis.

Oophoritis is called inflammation of the ovary - a paired organ of the female reproductive system, the uterine (fallopian) tube connecting to the uterus. The ovaries are responsible for the maturation of eggs and the production of female sex hormones, so inflammation of the ovary, especially chronic oophoritis, can have the most adverse effects on a woman's health, including causing infertility.

Causes of oophoritis

Oophoritis is almost never an independent disease. The ovaries are located so that the primary infection cannot penetrate them. Most often, inflammation is transmitted to the ovary through the fallopian tube, in this case, oophoritis is accompanied by salpingitis (inflammation of the fallopian tube), this condition is called salpingo-oophoritis, or adnexitis (inflammation of the uterine appendages). The causative agents of oophoritis are sexually transmitted infections (STIs): chlamydia, gonococci, Trichomonas, etc. Less often, inflammation is transmitted to the ovary from another source located in the abdominal cavity, for example, with appendicitis. In this case, the pathogens are streptococci, staphylococci, Escherichia coli.

In some cases, oophoritis can be caused by a general infectious disease organisms, most often of viral origin.

Factors contributing to the occurrence of oophoritis are:

• hypothermia;
• Diseases genitourinary system;
• Foci chronic infection in organism;
• Endocrinological diseases;
• Tobacco smoking. Influenced by products tobacco smoke entering the body, the composition of the mucus that forms the cervical plug changes, resulting in a decrease in its barrier properties, which leads to the penetration of infection from the external genital tract;
• Wrong lifestyle, overwork, stress as a factor that reduces protective properties immune system;
• Promiscuous sex life, especially without the use of barrier contraceptives.

IN clinical practice There are acute, subacute and chronic oophoritis, the process can be unilateral or bilateral.

Acute oophoritis begins suddenly, with sharp pains in the lower abdomen, which can give into the groin, lumbosacral region. Urination becomes difficult, sometimes painful, appear purulent discharge from the vagina. Signs of oophoritis are accompanied by a general deterioration in the condition: high temperature, fever, headaches and musculoskeletal pains.

Chronic oophoritis often has a latent onset, that is, to be primary chronic, or develop as a result of untreated acute oophoritis. The only sign of chronic oophoritis long time is an unexpressed pain syndrome. The pain is usually intermittent, dull, aching character, appears with overwork, hypothermia, stress, during intercourse. Most often, such signs of oophoritis in its chronic form appear on the eve of menstruation. Another sign of oophoritis in an advanced chronic form is menstrual irregularities due to impaired estrogen production by the affected ovary.

In some cases, chronic oophoritis proceeds so implicitly that it is detected only during examination for menstrual irregularities or infertility.

Diagnosis of oophoritis

Diagnosis of oophoritis is considered a difficult task, since pain, which is the main symptom of oophoritis, can accompany any disease of the abdominal organs. If oophoritis is suspected, a gynecological examination is performed, with a mandatory study of the vaginal microflora. Ultrasound of the ovaries can show changes that have occurred as a result of chronic oophoritis for disease in acute form this method is not informative.

The main method for diagnosing oophoritis is laparoscopy. This is a study using an endoscope that allows you to visualize the tissues of the ovary and detect signs of an inflammatory process. To determine the degree of ovarian dysfunction in chronic oophoritis, an endocrinological examination is performed, with the compilation of an ovulation diary.

Treatment of oophoritis

Treatment of chronic oophoritis and acute oophoritis is different.

In acute oophoritis, a course of antibiotic therapy with antibiotics is prescribed. a wide range actions, often combined with sulfa drugs. Use painkillers and anti-inflammatory drugs, preferably bed rest, an ice pack is applied to the area of ​​\u200b\u200bthe affected ovary in order to remove pain syndrome. When the signs of acute inflammation subside, they resort to physiotherapeutic procedures: electrophoresis, laser therapy, magnetotherapy, UHF and microwave therapy, etc. Treatment of acute oophoritis is carried out in a hospital.

Treatment of chronic oophoritis must be carried out consistently and persistently, otherwise it may threaten the loss of ovarian function. Also used in the treatment of chronic oophoritis. antibiotic therapy, taking into account the identified microflora. Anti-inflammatory steroid drugs are prescribed. The main efforts are aimed at eliminating the infection and combating the adhesive process, for which injections and electrophoresis of absorbable drugs are prescribed. Physiotherapy and balneotherapy are the main methods in the treatment of chronic oophoritis.

It must be understood that the treatment of chronic oophoritis will require a change familiar image life to a healthier one. General strengthening procedures are needed that stimulate the body's own defenses, the transition to healthy eating, rejection bad habits and increase physical activity to eliminate congestion in the pelvis. Only under all these conditions can we talk about the possibility of a complete cure.

Complications of oophoritis

A complication of acute and aggravated oophoritis may be suppuration of the ovary. This is an acute inflammatory process, as a result of which purulent fusion of the ovary occurs, and it turns into a thin-walled spherical formation filled with pus. This condition requires urgent surgical intervention, since rupture of the ovary leads to peritonitis.

Chronic oophoritis, which is severe, with frequent relapses, in combination with chronic salpingitis, can lead to sactosalpinx, a purulent tumor of the uterine appendages. This condition also requires surgery. The ovary and fallopian tube are removed.

Most frequent complication chronic oophoritis is more developed adhesive process, which violates the patency of the fallopian tubes, and sclerosis of the ovary, in which its tissues are replaced fibrous tissue leading to loss of function. Because the ovary is a gland internal secretion, then its improper functioning is reflected in hormonal background women, which can cause various disorders - from anorgasmia to infertility.

Therefore, the treatment of oophoritis must be started as early as possible, and be sure to complete.

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Right-sided oophoritis is an inflammatory process in the right ovary. It develops against the background of microbial infection of the organ. Microorganisms enter the ovary from an inflamed appendix or an infected intestine. Pathology is characterized by pain on the right in the lower abdomen, menstrual irregularities and the appearance of specific secretions from the vagina.

Right-sided oophoritis - gynecological pathology, one of the varieties of inflammation of the ovaries. Damage to the right ovary is more common than the left due to the proximity of the appendix, one of the likely sources of infection.

Causes

We list the main groups of causes that can trigger the inflammatory process:

• Not healthy lifestyle life: malnutrition, stress, lack of movement and sleep, poor hygiene, unprotected sex;
• foci of infection in the body;
• endocrine abnormalities;
• genital trauma.

Most dangerous form is a chronic right-sided oophoritis - a long-term inflammatory process with periodic exacerbations.

Signs of right-sided oophoritis

The nature of the sudden onset of pain syndrome (in the lower abdomen on the right) sometimes makes it possible to mistakenly suspect an attack of appendicitis in a patient. However, there are other symptoms that indicate a gynecological problem:

• menstrual dysfunction;
• abnormal discharge between periods;
• sexual dysfunction;
• emotional tension, anxiety.