Adnexitis – Inflammation of the appendages of the uterus

Adnexitis is an inflammation of the fallopian tubes and ovaries of the uterine appendages.
It is also called salpingo-oophoritis. The disease is dangerous in the so-called. Due to the development of healing in the fallopian tubes, as the latter cause ectopic pregnancy and infertility.

Adnexitis can be acute or chronic, unilateral or bilateral, serous or purulent, predominantly with tubal damage (salpingitis) or aggravated ovarian inflammation (oophoritis). Separately isolated pyosalpinx – purulent discharge from the fallopian tubes. According to the causative agents are distinguished nonspecific (caused by coccal flora, for example, staphylococcus, streptococcus, gonococcus) and specific (tuberculous, chlamydial, diphtheria and other etiologies) adnexitis.

Among the provocative factors of adnexitis are:

• Sexual contact during menstruation;
• Abortion (the main cause of adnexitis, the infection may spread not only during abortion, but also after a woman does not abstain from sexual intercourse for 2-3 weeks after surgery);
• Untreated diseases of the genitals (vaginitis, vulvitis);
• Transmitted infections (influenza, pneumonia, tuberculosis);
• Venereal diseases;
• IUD insertion;
• Chronic stress, fatigue, nervous tension and all the factors that lower immunity.

Acute adnexitis

Acute inflammation of the uterine appendages usually develops against the background of the ongoing inflammatory process in the body. Due to the weakening of the body’s immune system, the causative agents of the infection also reach the uterine appendages from certain foci and cause damage to them (for example, during angina, hemorrhoids, etc.). The infection spreads both lymphatically and ascendingly.

Infection is possible after surgery, abortion, sexual intercourse, menstruation and more. Characteristic symptoms are fever, head and muscle pain, sometimes urinary incontinence, lumbar and abdominal pain, enlargement of the uterine appendages, discharge in case of involvement of the uterus in the inflammatory process. Acute adnexitis is sometimes accompanied by bloating, nausea and vomiting.

Chronic adnexitis

Salpingo-oophoritis becomes chronic due to improper treatment of acute disease. Its exacerbation develops sexual dysfunction, deterioration of self-esteem, temperature reaction, sometimes urinary excretion and indigestion. Chronic adnexitis is characterized by deafness in the abdomen, which intensifies during menstruation and sexual intercourse, after physical exertion, and other, short and scanty menstruation, or vice versa – intense bleeding during menstruation. It is chronic salpingo-oophoritis that causes obstruction of the fallopian tubes (as a result of the development of healing processes), which causes infertility.

Purulent adnexitis

This form of the disease is often a complication of gonorrhea. It can be of specific or polymicrobial etiology. Purulent adnexitis may be caused by abortion, stress, childbirth, intrauterine operations, intimate intercourse during menstruation, and more. Symptoms of the disease include abdominal pain, sharp pain when urinating, fever, discharge. The disease is accompanied by increased palpitations, dry mouth, general weakness, dizziness, pain in the rectum and lower abdomen.

Treatment

In the treatment of inflammation of the uterine appendages, the main focus is on inhibiting and eliminating the infection, preventing complications, and maintaining and restoring a woman’s reproductive function.

The main thing is to start the appropriate therapy in time, to carry out the complex treatment step by step. Chronic adnexitis is relatively difficult to cure because the cause of the pathological process is often unknown. In severe cases, adnexitis is treated inpatiently.

Hospitalization of the patient is required in the following cases:

• The patient is under 20 years of age;
• Adnexitis developed after intrauterine intervention;
• In conditions of immunodeficiency;
• When a purulent complication is suspected;
• When prolonged outpatient treatment does not work;
• During adnexitis during pregnancy (because of increased risk of fetal infection, complications of childbirth and other).

In addition to drug therapy (antibiotics, anti-inflammatory and immunomodulatory drugs) in the treatment of adnexitis, surgical intervention is sometimes required (especially in purulent complications).

What are the complications of untreated adnexitis:

• Formation of a purulent discharge in the rectum, abdomen, or bladder;
• Small cystic degeneration of the ovaries;
• Ectopic pregnancy;
• Endocervicitis and cervicitis (spread of infection to the genitals);
• Infertility.