Ovarian oophoritis. Reasons for the development of the disease. Chronic oophoritis - treatment

Right-sided oophoritis is an inflammatory process in the right ovary. Develops against the background of microbial infection of the organ. Microorganisms enter the ovary from an inflamed appendix or infected intestine. The pathology is characterized by pain on the right side of the lower abdomen, menstrual irregularities and the appearance of specific vaginal discharge.

Right-sided oophoritis is a gynecological pathology, one of the types of ovarian inflammation. Infection of the right ovary is more common than the left one due to the proximity of the appendix, one of the likely sources of infection.

Causes

Let us list the main groups of reasons that can trigger the inflammatory process:

• unhealthy lifestyle: poor diet, stress, lack of exercise and sleep, poor hygiene, unprotected sex;
• foci of infection in the body;
• endocrine abnormalities;
• genital injuries.

The most dangerous form is 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 (lower abdomen on the right) sometimes allows one 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.

Oophoritis is an ovarian disease of an infectious-inflammatory nature. It is the most common among other pathologies of the female reproductive system and, in the absence of qualified treatment, can cause infertility. It mainly affects women of reproductive age, but can occur at an earlier or later age. Next, we will consider the specifics of the disease, treatment of oophoritis, drugs and antibiotics to quickly relieve the inflammatory process.

Occurs when infected with pathogenic microorganisms. These can be pathogens that cause sexually transmitted diseases (syphilis, gonorrhea), intracellular microorganisms (chlamydia, ureplasma, mycoplasma), fungi (candida), opportunistic microorganisms (gardnerella, E. coli). Infection occurs through sexual contact (unprotected contact), during surgical interventions (abdominal surgery, abortion), during installation or removal of the uterine device. The household route of infection is extremely rare, for example, when using someone else's towel or in common areas (bathhouse, swimming pool).

If treatment is untimely or incomplete, an acute disease quickly develops, and then simple hypothermia or even stress is enough to cause an exacerbation.

Symptoms of oophoritis are as follows:

1. Pain in the lower abdomen, where the ovaries are located. The pain can be unilateral or bilateral, depending on the type of inflammation; sometimes discomfort is felt in the lumbar region. The pain is aching in nature and radiates to the leg or thigh.
2. Pathological discharge from the external genital tract not associated with ovulation. They can be of different colors, from milky white to yellowish or greenish, and also have an unpleasant odor (depending on the causative agent of the infection).
3. During an acute inflammatory process, body temperature may rise. With exacerbation of chronic oophoritis, the temperature is rare, the maximum rises to subfebrile values.
4. With inflammation of the ovaries, women experience pain during sexual intercourse.
5. If the disease has become chronic, unpleasant symptoms from the nervous system are possible - depressed mood, irritability, fatigue, decreased libido.

Directions of treatment

When treating oophoritis, it is necessary to adhere to an integrated approach. This is important in order to prevent the disease from becoming chronic, and if it already exists in the patient’s history, to prevent exacerbations.

Antibiotics

The main direction in the treatment of oophoritis is antibiotics. They differ in pharmacological groups, scope of action, side effects and other criteria.

A specific drug is prescribed only after tests have been carried out to determine the type of pathogen (bacterial culture, smears for flora). Despite the fact that most modern antibiotics have a complex effect and several types of microorganisms are sensitive to them, a gynecologist can prescribe two drugs at the same time.

The most effective for oophoritis are cephalosporins and penicillins. Tetracyclines are sometimes used, but they have a lot of side effects and are therefore used extremely rarely, in emergency cases.

Metronidazole is almost always used to eliminate the inflammatory process in the ovaries and/or appendages. It is prescribed simultaneously with drugs such as Clindacin, Gentamicin, Unidox Solutab, Hemomycin, etc. An improved analogue of Metronidazole is Trichopolum. It is easier to tolerate by the body and does not cause nausea or loss of appetite.

Antibacterial drugs are used in the form of tablets, injections, and local drugs are also prescribed - vaginal suppositories. Several forms can be combined at once.

Features of the use of various forms of antibiotics

After treatment with antibiotics, the balance of the natural microflora of the intestine and vagina is disrupted, and this happens not only after vaginal suppositories, but also after other forms of drugs. To restore the microflora, you can use products with lactobacilli - Bifidumbacterin, Bifiform, Linex, Acylact, etc.

Antibiotics are prescribed without fail; without them, inflammation cannot be stopped. In case of chronic oophoritis, they are used only during periods of exacerbation, and even then not always. Recently, some doctors have been inclined to believe that a long course of oophoritis causes pathogen resistance to antibiotics, therefore it is preferable to treat this disease with other methods.

Other methods

In addition to antibacterial therapy, gynecologists prescribe anti-inflammatory drugs, biogenic stimulants, immunomodulators, as well as drugs to prevent the development of adhesions. Treatment of chronic oophoritis also includes non-traditional methods - physiotherapy and sanatorium-resort treatment.

In the treatment of oophoritis, it is important to consult a doctor in a timely manner and follow an integrated approach to treatment, since this insidious disease can lead to infertility or problems with conception. And in case of inflammation, you cannot do without antibiotics. With a responsible attitude towards your health, oophoritis is completely curable.

The disease is diagnosed when the left ovary is affected. Left-sided oophoritis, causes, signs, treatment of which is the topic of this article, is diagnosed when various microorganisms (chlamydia, staphylococci, etc.) penetrate into it. How to treat left-sided oophoritis? Does it really lead to infertility? In this article we will try to understand all the issues related to the left-handed form.

Left-sided oophoritis: causes of the disease

Why does left-sided oophoritis occur? The main reasons are as follows:

indiscriminate choice of sexual partners;

any gynecological interventions (abortion, childbirth, unprofessional examination, installation of a spiral, etc.) are the cause of left-sided oophoritis;

the presence of other diseases of the genital area and neglect of their treatment;

weakened immunity is also a cause of left-sided oophoritis, hypothermia;

stress, etc.

Left-sided oophoritis: signs of the disease

Typical signs of left-sided oophoritis include:

pain in the lower abdomen (usually on the left side);

high fever that does not go away even after taking antipyretics;

specific leucorrhoea and vaginal discharge, bleeding between menstruation as a sign of left-sided oophoritis;

increased fatigue for no particular reason, irritability;

pale skin, decreased or lack of appetite;

loss of interest in sexual intercourse, lack of orgasm, if it was previously observed, is also a possible sign of left-sided oophoritis.

Of course, based on these signs alone, it will be impossible to speak with 100% probability about the disease with left-sided oophoritis. Only a doctor can make a final diagnosis based on the results of the examination. At the same time, such “signals” from the body cannot be ignored - it is worth visiting a gynecologist. The fact is that the main danger of left-sided oophoritis is the rapid development and occurrence of infertility. In addition, the infection can spread from the affected left tube to the healthy right tube, and the disease will be much more difficult. If oophoritis is treated on time, complications can be avoided, and the patient can count on a successful conception of the baby.

Left-sided oophoritis: treatment of the disease

How is left-sided oophoritis treated?

The doctor prescribes antibiotics for the patient to treat left-sided oophoritis, taking into account the type of infection that provoked the onset of the disease. Many women are afraid to take antibiotics, but they should not refuse them, because infectious infections can only be eliminated in this way.

Physiotherapeutic and balneological procedures, vitamin complexes, and suppositories are also indicated in the treatment of left-sided oophoritis. Patients are often advised to go to a resort.

In the acute form of left-sided oophoritis, bed rest, lack of stress, healthy sleep, and proper nutrition are important.

Left-sided oophoritis can be treated with folk remedies, but you should consult a doctor before using them.

Remember that your health is in your hands!

Oophoritis is an inflammatory process of paired female reproductive glands. It can be either one-sided or two-sided. It often occurs with simultaneous inflammation of the fallopian tubes (salpingitis), in acute or chronic form.

In the first case, intense pain in the lower abdomen, urination disorders, fever, and pathological discharge (leucorrhoea) are noted.

The chronic form is characterized by the presence of pain and metrorrhagia (menstrual irregularities).

The accumulation of pus in the ovaries can lead to the development of pelvioperitonitis, and subsequently to secondary infertility as a result of impaired ovarian function.

Causes of oophoritis and the mechanism of development of pathological changes

If the cause of oophoritis is the causative agents of trichomoniasis, gonorrhea, mycoplasmosis, chlamydia, tuberculosis, then they speak of the specific nature of the inflammation. Conditionally pathogenic microflora (staphylococcus, E. coli, streptococcus, candida) are nonspecific pathogens of this disease.

Oophoritis and its exacerbation can be provoked by hypothermia, childbirth, menstruation, the use of intrauterine devices, surgical termination of pregnancy, surgical and diagnostic manipulations on the genitals. Most often, inflammation of the ovaries is secondary, as a result of infection from the uterus, cervical canal, or fallopian tubes. In rare cases, the causative agents of this disease can penetrate the gonads through lymph and blood (in tuberculosis).

With oophoritis, the infectious process gradually spreads from the uterine cavity to the fallopian tubes, affecting at the initial stages only the mucous membrane, then the serous and muscular layers. In this case, the fallopian tube lengthens, thickens, inflammation leads to the formation and secretion of pus with the development of adhesions inside it.

Subsequently, the ovaries are involved in the pathological process; under the influence of pus from the fallopian tubes, their tissues melt. The result of this process is the formation of adhesions between the ovary and the inflammatory-changed fallopian tube, therefore the symptoms of salpingitis and oophoritis are not distinguished separately. In some cases, with inflammation of the ovaries, pathological changes can spread to the surrounding peritoneum.

This process is called periadnexitis. The accumulated inflammatory secretion can be purulent (pyosalpinx) or transparent (hydrosalpinx). The accumulation of pus in the ovary forms pyovar. With further spread of the inflammatory-infectious process, it goes beyond the ovary and pelvioperitonitis develops.

Symptoms and signs - acute, subacute and chronic form

Inflammation of the ovaries can be acute, subacute and chronic. Each of them has its own flow characteristics.

The acute form is characterized by the development of the following symptoms:

• constant intense pain in the lower abdomen, which can be unilateral or bilateral in nature and radiate to the sacrum and lower back;
• frequent urination with sharpness and pain;
• in some cases, abundant serous and purulent discharge from the genital tract;
• fever, fever, general malaise;
• bleeding between periods;
• sharp pain during sexual intercourse.

During a gynecological examination, an enlargement of the ovaries is observed and their pain is noted. With the development of an acute form of the disease, hospitalization is required, followed by treatment in a hospital.

A subacute form of oophoritis is relatively rarely observed; it is usually characteristic of a mycotic or tuberculosis infection.

It is characterized by the same symptoms as with acute inflammation of the ovaries, but they are less severe.

Acute oophoritis, with proper and timely treatment, can result in complete recovery.

Otherwise, the disease takes on a chronic, protracted course, with periods of remissions and exacerbations.

Periods of exacerbation of chronic oophoritis are characterized by:

1. aching, dull pain in the lower abdomen, groin area, in the vagina, which intensifies before menstruation, from hypothermia, against the background of colds;
2. the presence of constant and scanty discharge (leucorrhoea);
3. dysfunction of the ovaries and menstrual cycle;
4. absence of pregnancy, despite normal regular sex life;
5. dysfunction of sexual function, pain during sexual intercourse, decreased sexual desire).

During a gynecological examination, an enlargement of the ovaries is observed, and their sensitivity to palpation is noted. The chronic course of oophoritis is accompanied by a disturbance in the neuropsychological sphere of a woman: poor sleep, irritability, fatigue, decreased performance.

Chronic inflammation of the ovaries can develop without an acute stage. Some sexually transmitted diseases (gonorrhea) are often asymptomatic, and the inflammation of the ovaries caused by them, having a clear latent course, quickly becomes chronic. When the process is prolonged, dangerous changes occur in the fallopian tubes, which lead to the development of obstruction. As a result, adhesions may form around the ovaries, and secondary functional infertility occurs.

Effect on pregnancy

Complications that can develop after oophoritis, in any case, pose a danger to a woman’s reproductive function: dysfunction of the ovaries and the menstrual cycle, obstruction of the tubes and adhesions, spontaneous miscarriage, ectopic pregnancy, sexual dysfunction, infertility, development of inflammatory processes in other organs (colitis , cystitis, pyelonephritis).

That is why timely detection and adequate treatment of this pathological condition is required, after which the ability to perform reproductive function can be restored.

Unilateral oophoritis is diagnosed when one ovary is affected.

Its main causes are gynecological interventions, infectious diseases of the genital organs or other systems, weakened immunity, hypothermia, and stress.

The main clinical symptoms are pain in the lower abdomen (for left-sided oophoritis - on the left, for right-sided oophoritis - on the right), high temperature, which does not decrease when taking antipyretics, specific vaginal discharge, bleeding between menstruation, increased fatigue.

Irritability, pale skin, loss of interest in sexual intercourse. A feature of this disease is that the inflammatory process from the left tube can move to the right tube and vice versa. In addition, right-sided oophoritis is sometimes confused with appendicitis, so careful examination by a qualified specialist is necessary.

Bilateral oophoritis

With bilateral oophoritis, both ovaries are affected at once. The causes of this pathological condition are no different from those observed with unilateral damage to the gonads.

The main symptoms of bilateral oophoritis are pain in the lower abdomen, groin, lower back, which are intense, vaginal discharge, uterine bleeding noted between menstruation, urination problems, and insomnia.

There are acute, subacute and chronic forms of the disease. Their difference lies in the severity of the clinical picture, sometimes in the cause of its occurrence, which determines the need for an individual approach to treatment.

Diagnostics

Symptoms of ovarian inflammation are quite vague, in the acute form they are difficult to distinguish from manifestations of an acute abdomen: ectopic pregnancy, appendicitis, cyst, endometriosis, ovarian cystoma, peritonitis.

A correct diagnosis of ovarian inflammation can be made based on gynecological history (identification of associated factors, causes of the disease and characteristics of the genital area), laboratory tests (increased levels of leukocytes in urine, blood tests, smears from the urethra and vagina).

In addition, important information is provided by a gynecological examination (enlarged and painful ovaries, impaired mobility of the appendages), ultrasound diagnostics of the pelvic organs, bacteriological examination, PCR diagnostics, ELISA, RIF (detect hidden infections, the causative agent of the disease).

The most informative diagnostic method for ovarian inflammation is laparoscopy. It makes it possible to directly examine the uterus, fallopian tubes, and ovaries. Indications for this manipulation are long-term pain in the lower abdomen of a chronic nature, which is of unknown origin, prolonged infertility, inflammation of the ovaries, which cannot be treated comprehensively.

In case of chronic oophoritis, during laparoscopy, there is a violation of the patency of the fallopian tubes, their infection, the presence of adhesions, formations in the ovaries and fallopian tubes, and adhesions in the pelvis. The severity of changes is determined by the duration of the chronic disease and the frequency of relapses.

Treatment

Treatment of ovarian inflammation begins only after a final diagnosis has been established.

Therapy for the disease is determined by the stage of its development, the causes that caused it and the nature of the symptoms.

Acute oophoritis can only be treated in a hospital. Bed rest is prescribed, in the first days cold is applied to the lower abdomen, desensitizing (eliminating symptoms of inflammation) and painkillers, sulfonamides, antibacterial and restorative agents, calcium chloride.

In the subacute stage, physiotherapeutic procedures are added to the main therapy. Chronic inflammation of the ovaries requires physiotherapy and balneotherapy.

Advanced and chronic forms of oophoritis are more difficult to treat and take longer, compared to cases of timely treatment of patients, and can lead to serious complications requiring surgical intervention.

A pressing issue is the rational use of antibacterial agents. Drugs of this group are indicated in cases of relapse of chronic oophoritis, if the increase in inflammatory phenomena is pronounced. Antibiotics are also used for exacerbations of the disease during general strengthening therapy and physical treatment.

If treatment with these drugs and sulfonamides was not carried out in the subacute and acute stages of ovarian inflammation, then the use of such drugs is also completely justified.

The goal of treatment of chronic oophoritis is to provide an antimicrobial, anti-inflammatory effect, increase the body's immune reactivity, pain relief, restore impaired functions of the genital organs, as well as abnormalities in the nervous, vascular, and hormonal systems of the body that have developed against this background.

A traditional method of treating ovarian inflammation includes herbal medicine, which is used as a preventive measure or an addition to the main therapy.

To prevent oophoritis, women should avoid overwork, hypothermia, stress, and observe all rules of personal hygiene. It is also important to consult a gynecologist at least twice a year. Proper nutrition, a healthy lifestyle, avoiding abortions and casual sex will prevent the development of ovarian inflammation and its complications.

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

There are different classifications of this disease. Oophoritis is divided into two types:

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

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

1. Acute form. During acute oophoritis, there are very pronounced 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 minor pains in the lower abdomen observed.
3. Subacute form. Develops against the background of mycotic infection or tuberculosis. It is quite rare.

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

• double-sided;
• left-handed;
• right-sided

Causes of oophoritis

Such inflammation necessarily appears due to some reason. 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 uterine tubes. 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 E. coli.

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

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

• sexual contacts without protection;
• long-term use of an intrauterine device;
• non-regular sexual partners;
• stress, which negatively affects the protective properties of the immune system;
• smoking and drinking alcohol, which, when ingested, contributes to changes in the composition of mucus;
• problems with the genitourinary system;
• presence of chronic infections;
• problems with the endocrine system;
• hypothermia.

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

Mechanism of disease development

The spread and development of infection in the body does not occur 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 this, the muscular and serous layers are affected. The fallopian tube becomes denser and lengthens. Inside, purulent fluid appears and is secreted.

Over time, the process moves to the ovaries. Their tissues are damaged by the pus that 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 secretion that has accumulated as a result of the development of 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 spread beyond the ovary, which will lead to the appearance of pelvioperitonitis.

Symptoms of ovarian inflammation

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 painful, sometimes the pain extends 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;
• 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 discovered that the size of the ovaries has increased. Sometimes the chronic form is the cause of disturbances in the neuropsychological sphere of a person. Disorders include increased irritability, sleep problems, decreased levels of performance, and fatigue. Sometimes the chronic form does not have pronounced symptoms.

If some of the above symptoms are detected, it is recommended to consult a gynecologist.

Oophoritis during pregnancy

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

If chronic oophoritis does not lead to infertility, then before conception you must make an appointment with a doctor for examination. This will avoid the following complications:

1. Hormonal imbalance, which sometimes leads to miscarriage.
2. Infertility. Due to impaired functioning of the ovaries, problems with the production of eggs may occur, which make the process of ovulation impossible.
3. Oophoritis often leads to the appearance of adhesions. Because of them, fertilization can occur in the fallopian tube rather than in the uterus.
4. Fetal infection. It is carried out due to an infection that is present in the woman’s body. 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

Diagnosing this disease is difficult. The most common symptom of the disease is acute pain in the abdominal area. It can also appear in other diseases. Other signs of oophoritis can appear in various diseases of the abdominal organs.

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

1. Carrying out analyzes in the laboratory. They are done to determine the level of white blood cells in the urine and blood. It increases if there is inflammation of the ovaries.
2. Gynecological history. Determines the location and nature of pain.
3. Ultrasound. It is carried out to examine the pelvic organs.
4. Gynecological examination. Abnormalities in uterine mobility and ovarian size are checked.
5. Hysterosalpingoscopy. With its help, you can identify modifications of the uterine tubes.

The most informative and effective diagnostic methods include laparoscopy. During which a visual examination of the uterus, its tubes and ovaries takes place. It is performed if the patient has pain in the lower abdomen. During the examination, the doctor may identify adhesions and low 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.

Antimicrobial agents are also used during treatment. They are very effective in treating the chronic form of the disease. Medicines such as Tinidazole and Metromindazole are often used.

Oophoritis is accompanied by severe pain. To relieve them, drugs related to anti-inflammatory non-steroidal drugs are used. This group includes Ibuprofen, Indometac and Diclofenac. In gynecology, suppositories or tablets with indomethacin are often used.

Treatment of the disease must be carried out comprehensively. The bulk of treatment is aimed at treating the infection, with additional measures aimed at supporting the body's immune system. To increase the effectiveness of the immune system, immunomodulating agents and vitamins are prescribed. Many gynecologists use the drug Vagilac, which places lactobacilli in the vagina. This allows the natural acidic environment to be restored.

Care should be taken to ensure that the ovaries are completely “rested” from the resulting inflammatory shock. In this case, combined oral contraceptives will help. With their help, the menstrual cycle is regulated, which allows you to preserve the required number of eggs.

Prevention of oophoritis

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

• you should lead an active lifestyle;
• avoid hypothermia;
• do not forget about personal hygiene;
• use different methods of contraception;
• be regularly examined by a gynecologist.

The above rules must be followed from 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 diseases such as oophoritis.