Salpingo-oophoritis, or as it is also called adnexitis, is a common female disease. As a result of infection or under the influence of other unfavorable factors, the appendages begin to develop.

Subsequently, inflammation affects one (unilateral salpingoophoritis) or both ovaries (bilateral adnexitis). Treatment of chronic salpingoophoritis is long and does not always lead to complete recovery. Meanwhile, the pathology is often accompanied by adhesions in the appendages and fallopian tubes, which causes infertility.

The main cause of chronic adnexitis is infection through the genitals, which, combined with low immunity and impaired blood supply to the ovaries and uterus, contributes to the development of inflammation.

Provoking factors are also:

• sexual activity without using condoms;
• sexual contacts during the menstrual cycle;
• sedentary lifestyle;
• hypothermia
• period of pregnancy and childbirth;
• damage to the walls of the uterus by contraception or medical intervention;
• frequent constipation;
• overwork and stress;
• compression of the pelvic organs by tight clothing;
• hormonal imbalance and diseases of the endocrine system;
• infections of the genitourinary system.

Low body resistance and congestion in the pelvis make it difficult to treat the disease, which often leads to the development of a chronic form of the disease.

The disease begins acutely and is accompanied by pronounced symptoms.

If treatment is started in a timely manner, the acute form of salpingoophoritis can be successfully cured.

Otherwise, after a couple of weeks the disease passes into the subacute and then into the chronic stage.

At the beginning of the development of inflammation, the following signs are observed:

• temperature 38-39 degrees;
• pain in the abdominal area of ​​unclear localization and radiating to the anus and lower back;
• purulent discharge appears;
• loss of appetite and bouts of nausea appear;
• headaches and chills are observed;
• flatulence appears.

Symptoms of chronic salpingoophoritis are less intense, and sometimes completely absent.

The following phenomena may be observed:

• pain in the groin and lower abdomen, which intensifies during menstruation and after hypothermia;
• pain during sexual intercourse, which leads to decreased sexual activity;
• purulent leucorrhoea is observed;
• irregular heavy menstrual flow;
• bleeding between menstrual cycles.

Infertility can also be considered a sign of chronic salpingoophoritis, since as a result of inflammation, adhesions form in the fallopian tubes, which makes conception difficult.

What is bilateral chronic salpingoophoritis

With bilateral salpingoophoritis, two uterine appendages and both ovaries are affected. This pathology is much less common than unilateral adnexitis.

In case of inflammation of the fallopian tube and ovary on one side, the other part of the reproductive organs remains healthy and pregnancy may occur.

With bilateral damage, both fallopian tubes are blocked by adhesions and the likelihood of conception is significantly reduced, up to complete infertility.

Treatment

Treatment tactics are selected depending on the form of the disease and the patient’s condition.

Therapy in a hospital setting is carried out for acute forms of salpingoophoritis, during the patient’s pregnancy and for an unconfirmed diagnosis with severe symptoms.

The following medications are used in the treatment of acute adnexitis:

1. Antibacterial drugs of the penicillin, tetracycline, cephalosporin series in the form of tablets or injections. For the treatment of pregnant women, the antibiotic regimen is selected taking into account the period.
2. Antispasmodics and regeneration stimulants.
3. Antifungal agents to restore vaginal microflora.
4. Drugs to enhance immunity and antihistamines.

Local use of antiseptics in the form of douches, suppositories or ointments is used. A laparoscopic examination is performed with simultaneous removal of adhesions and accumulation of pus.

In chronic salpingoophoritis, antibacterial drugs are used only during an exacerbation.

In addition to drug treatment, physiotherapeutic procedures are added:

• electrophoresis
• magnetotherapy
• ultrasound treatment;
• phonophoresis
• hydrogen sulfide and radon baths;

In complicated cases, surgical removal of adhesions and elimination of obstruction of the fallopian tubes using plastic surgery are performed.

Treatment of chronic salpingoophoritis with folk remedies

Inflammation of the ovaries can be treated with douching, medicinal baths and decoctions of medicinal herbs. But given the seriousness of the disease, the duration of treatment and the likelihood of severe complications, the use of traditional medicine should be carried out after the doctor’s approval and combined with prescribed drug therapy.

Infusions and decoctions

In the morning before meals, squeeze the juice from two unpeeled potato tubers and drink. Carry out treatment every day until cure.

Mix St. John's wort, nettle and yarrow, a tablespoon each, and thyme, coltsfoot, marshmallow root, 2 tablespoons each. Pour 3 tbsp of boiling water over a liter. l. mixture and leave for a couple of hours. Morning, afternoon and evening, take 100 ml of infusion for 2 months.

2 tbsp. l. Grind and mix strawberry and birch leaves, corn silks, string and yarrow. Pour two tablespoons of the mixture into 1.5 liters of boiling water and leave to infuse for 5-6 days. Drink 100 ml 3 times a day for 30 days.

Take a couple of spoons from a mixture of equal parts of calendula, sweet clover and chamomile flowers, centaury and coltsfoot. Pour two glasses of boiling water and leave for 2 hours. Drink 50 ml 5-6 times a day for 30 days. Avoid sexual activity for the duration of treatment. If nausea occurs, reduce the dose.

According to Art. l. mix thyme, St. John's wort, ginger, valerian roots, calamus, licorice. Add a couple of spoons of knotweed, birch leaves and oregano and three spoons of wormwood. 2 tbsp. l. Boil the mixture in 3 glasses of water for 20 minutes and leave for 2 hours. Drink 3-4 sips several times a day from 1 to 8 months, excluding menstruation.

Make a collection of rowan berries, mint, shepherd's purse, tansy and licorice root, a couple of spoons each. Add a mixture of 4 tablespoons of rosehip, 3 tablespoons of nettle and a spoonful of corn silk and calendula. Boil a couple of tablespoons of the mixture in 2 glasses of water for about 30 minutes, covering with a lid. Pour into a thermos and leave for 8 hours. Drink half a glass several times a day from 1 month to 8. After 30 days of rest, repeat the treatment. The infusion can be sweetened with honey or jam. Do not use the product during menstruation.

Pour a teaspoon of claspberry into a glass of boiling water, cover with a lid and leave for 20 minutes. Drink a couple of large spoons 4-5 times a day, adding a little honey for taste. For the best effect, combine with baths of claspberry infusion.

Baths and douching

2 tbsp. l. linden flowers and 3 tbsp. l. pour oak bark into a thermos and add 1 liter of boiling water. Leave to brew for 30 minutes. Douche with the infusion twice a day.

Chop juniper branches and berries and pour boiling water into a bucket. Leave for 2-3 hours. Strain and pour the infusion into a hot bath. Sit in healing water for 15 minutes.

Grind a couple of large spoons of yarrow and eucalyptus leaves. Infuse 2 tablespoons of the mixture in a liter of boiled water for two hours. Do douching once a day for 14 days.

Make a mixture of 2 spoons of oak bark, 5 spoons of chamomile flowers and 3 spoons of sage. Pour 2 tablespoons of the mixture into a liter of boiling water and leave until cool. Douche with the strained infusion or moisten a gauze swab and insert into the vagina.

Boil 100 g of claspberry for 15 minutes in 2 liters of water. Strain the broth and pour into the bath. Sit in it for 20 minutes.

Vanga recommended this remedy. Pour forest or ordinary hay into a wide container with 5 liters of boiling water, cover with a lid with a hole and sit over the steam. If there is no hay, you can boil fresh cabbage leaves in milk and use them for a steam bath.

Grind a couple of peeled garlic cloves into a paste. Add a teaspoon of water and 5 drops of celandine juice. Moisten a gauze swab in the mixture and insert it into the vagina for three hours. Repeat this procedure twice a week.

1 tsp. Heat propolis and honey for 5 minutes over low heat. Soak a gauze swab in the honey mixture and insert it into the vagina overnight. If there is no propolis, then you can use sea buckthorn oil.

Conclusion

The success of treating any disease directly depends not only on timely and competent therapy, but also on the patient’s attitude towards a successful outcome. For optimists, recovery is always faster and easier and with virtually no complications. And patients who do not expect anything good from treatment and are confident in advance of its ineffectiveness receive the corresponding result.

Chronic salpingoophoritis is a serious disease that, when neglected, deprives a woman of the opportunity to become a mother. If one fallopian tube and ovary are not affected, then pregnancy is quite possible. If bilateral inflammation is detected, then it is too early to despair.

Modern medicine allows surgical intervention to restore patency in the fallopian tubes and increase the chances of successful conception.

The most important thing is not to harm yourself. Self-medication at home for the acute form of salpingo-oophoritis will not eliminate inflammation, but will delay seeking medical help and allow the disease to progress to the chronic stage. Treatment with folk remedies is only possible for the chronic form of the disease during remission and only after consultation with the doctor.

We bring to your attention a video that explains what chronic salpingoophoritis is and the features of its treatment:

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Salpingo-oophoritis is an inflammatory process that progresses in the ovaries and fallopian tubes. It appears due to the entry of the pathogen from the peritoneum, vagina, or appendix. The pathogen can also penetrate the fallopian tubes and ovaries by hematogenous means.

The cause of the development of the disease is, as a rule, gonococcus. The disease can also be caused by streptococcus, enterococcus, chlamydia or. Inflammation in the ovaries and uterine tubes can be observed simultaneously (often the inflammation first affects the ovaries and then spreads to the oviducts). The inflammatory process spreads to the epithelium of the ovaries, fallopian tubes, as well as their muscular layer. After this, pathological formations with pus or serous content begin to develop in the affected areas.

Causes

Among the main reasons that cause bilateral salpingoophoritis are:

• hypothermia (caused, for example, by wearing thin tights in cold weather);
• casual sex. Sexual contact during menstruation can also lead to the development of pathology;
• various stresses.

As a rule, the pathogen penetrates the tissues of the genital organs through:

• lymph (together with lymph flow);
• blood (hematogenous route);
• ascending route (from the vagina through the cervical canal, and then into the uterine cavity and tubes);
• in a descending manner (through the abdominal cavity from the sigmoid or cecum).

After pathogenic microorganisms enter the mucous membrane, inflammation begins there, which spreads to the muscle structures. After some time, the abdominal cavity, the surface of the ovaries and other nearby tissues are involved in the inflammatory process. After ovulation occurs, infectious bacteria enter the corpus luteum and continue to develop in the ovaries. As a result, the affected areas of the tubes and ovaries merge into one tissue.

Stages and types of illness

There are three stages of development of the disease (depending on the nature of the course):

• acute stage. At this stage of the progression of the pathology, the patient feels sharp and severe pain in the lower abdomen, which is accompanied by an increase in temperature and vaginal discharge that has an unpleasant odor. The pain sometimes radiates to the lower back. If acute salpingoophoritis is not treated, it turns into a subacute form;
• subacute stage. Develops in the fallopian tubes or ovaries. The infection can enter the genitals from other organs affected by the pathogen, as well as through lymph or blood. Symptoms of the subacute stage of development of the disease include high temperature, chills, general weakness, and bloating of the lower abdomen. In addition, the patient is bothered by pain in the lower abdomen, especially during sexual intercourse. The subacute period is characterized by long-term remissions;
• chronic stage. It develops if the patient does not consult a doctor in time. Chronic salpingoophoritis is characterized by the presence of symptoms such as pain in the lower abdomen or lumbar region, problems with menstruation. Remission of the disease can take place over several years. An exacerbation of the process can occur at any time, but most often it occurs during the cold season.

Depending on the location, the following types of inflammatory process are distinguished:

• left-handed– occurs when the left fallopian tube is damaged;
• right-sided– occurs when the pathogen damages the right fallopian tube;
• bilateral– develops with simultaneous damage to both fallopian tubes. It is a more severe form of the disease. A characteristic symptom of bilateral salpingoophoritis is an increase in 2 appendages. If a woman progresses with this particular form of the disease, she will not be able to get pregnant until she is completely cured of it. In this case, you should immediately contact a medical facility for diagnosis and treatment. As a rule, this pathology is completely eliminated surgically.

Symptoms of the disease

There are the following main general symptoms of the disease:

• Fatigue sets in quickly;
• temperature rises;
• there is constant weakness;
• disturbances appear in the digestive tract (colitis or enteritis);
• diseases of the urinary system, such as cystitis or pyelonephritis, appear.

Local symptoms of the disease include:

• menstrual irregularities (polymenorrhea or algomenorrhea);
• aching pain in the groin area, which can radiate to the lower back and sacrum;
• discharge that is serous or purulent in nature, as well as an unpleasant odor.

If you do not pay attention to these symptoms and do not undergo adequate treatment in a timely manner, it may develop. Therefore, patients who cannot become pregnant should also be examined by a doctor for the presence of this disease. According to statistics, the symptoms of the disease in about 5% of women are very pronounced. Conservative methods do not always have the desired effect, so they resort to a surgical method - removal of the fallopian tube.

It is possible to get pregnant while suffering from this disease, but not every woman decides to do this, since the risk of development is very high.

Salpingo-oophoritis and pregnancy can exist together, but getting pregnant in the presence of this pathology is always very difficult. But it’s even harder to bear a child.

Diagnostics

Diagnosis of the disease is carried out on the basis of a study of the woman’s medical history, as well as the disease itself. A specialist can make a preliminary diagnosis of “acute salpingoophoritis” if he finds in the medical history information about previous abortions, difficult births, and the use of an IUD to prevent pregnancy. It is also important to take into account the presence of symptoms characteristic of bilateral salpingoophoritis - pain in the lower abdomen, increased body temperature, etc.

Also, during the diagnosis, research is carried out in the laboratory. They include, with which you can detect an increased amount (this is an indicator of the presence of inflammation in the body). The doctor also takes a swab from the vagina and cervical canal. Such an analysis makes it possible to identify the pathogen, as well as determine which medications it is sensitive to.

During the diagnosis, hysterosalpingography is performed. This technique is very informative. A special contrast agent is injected into the uterine cavity, after which an X-ray is taken.

Such a disease may require additional consultation of the patient with specialists other than the gynecologist (surgeon and urologist).

Treatment of the disease

Treatment of chronic salpingoophoritis, as well as its other varieties, is carried out using several methods. This diagnosis is not a death sentence. As a rule, a woman who is diagnosed with acute or chronic salpingoophoritis will be sent to hospital.

The following methods are now used to treat the disease:

• non-drug treatment. It is carried out if the patient has chronic salpingoophoritis. In this case, UHF therapy, electrophoresis or magnetic therapy are used. Also, as physiotherapeutic methods of treatment, the doctor may prescribe diadynamic currents or treatment in a sanatorium to the patient;
• drug treatment. Prescribed for acute illness. The main group of drugs used to destroy the pathogen are antibiotics. Broad-spectrum antimicrobial drugs are used. There are several treatment regimens: the first involves the use of cefotaxime, ceftriaxone and other antibiotics. The second regimen involves taking lincosamides or fluoroquinolones. Quite often, to prevent the spread of chlamydial disease, the patient is also prescribed a macrolide or doxycycline;
• surgical intervention. Such treatment of salpingoophoritis is used if conservative therapy does not have the desired effect on the patient’s health. The laparoscopy method is used. In this case, the patient is injected into the peritoneal area with a solution of antibiotics.

Inpatient treatment usually takes from one week to 10 days. Afterwards, when the patient’s health improves and the inflammatory process is eliminated, the woman is discharged.

Among the folk remedies, the following are distinguished:

• drinking potato juice on an empty stomach. To get potato juice, you need to grate several potatoes on a fine grater, squeeze, and mix the resulting liquid thoroughly before drinking (the starch contained there can settle to the bottom too quickly). To diversify the taste of this folk remedy, it is recommended to add carrot juice or any other juice. Taking this folk medicine helps eliminate the symptoms of the disease;
• Mix elecampane proportionally with meadowsweet and kermek. Add marin root to the resulting product, and then pink radiola. Infuse for a week in a 50-degree alcohol solution, and then drink the resulting tincture on an empty stomach in the morning and evening;
• meadow cornflower mixed with clematis grass, as well as tenacious. Pour the mixture with one liter of hot water and leave overnight, after boiling for 5 minutes. It is recommended to drink this folk remedy before meals 3 or 4 times a day, 100 grams each time.

It is worth remembering that folk remedies can only alleviate symptoms, and their use must be agreed upon with the attending physician. Otherwise, uncontrolled use of any prescriptions can lead to complications. Under no circumstances should you self-medicate. It is necessary to contact a qualified specialist to carry out a diagnosis, identify the cause of the development of the pathology, and begin treating the disease.

Disease Prevention

To ensure that salpingoophoritis never bothers a woman, she needs to adhere to a few simple rules:

• use contraception during sexual intercourse. This includes barrier type contraception (condoms), as well as local type (ointments, suppositories - popularly called “suppositories”, tablets for vaginal use). They must be used starting from the first sexual intercourse and in any cases when a woman does not plan to conceive a child. You must always remember that the integrity of your partner is not a 100% guarantee that he will not have sexually transmitted infections;
• go with your partner for examination. You can be examined by a urologist before your first intimate relationship takes place. It is worth noting that only one sexual act, during which contraception was not used, can trigger the transmission of the disease;
• avoid genital-anal sexual intercourse if hygienic procedures have not been carried out, as well as in cases where contraception is not used;
• develop a diet for yourself that will include all the necessary vitamins and microelements. This is necessary to maintain proper levels of immunity. You can seek help from a nutritionist. He will help you create a rational menu.

If the first symptoms of the disease appear, you should immediately consult a doctor.

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 longer. You can be examined and undergo therapy at the AltraVita clinic.

Causes

The main causes of salpingoophoritis are pathogenic microflora. This can be either a banal coccal flora (streptococci, staphylococci) or sexually transmitted infections - ureaplasma, mycoplasma, chlamydia, gonococci, trichomonas.

Acute salpingoophoritis usually develops against the background of systemic pathology, due to a decrease in the immune function of the body. Provoking factors in this case may be severe stress, hypothermia, failure to comply with the rules of intimate hygiene, unprotected sexual intercourse and a number of other, at first glance, insignificant points.

Chronic salpingoophoritis is, as a rule, a consequence of incomplete or improper treatment of the acute form of the disease or relapses if the above provoking factors are constantly repeated. This form of the disease is especially dangerous due to the sluggish nature of the course and the tendency to develop complications.

From the perineum and vagina, pathogenic microorganisms enter the uterine cavity and fallopian tubes. By intensively multiplying, bacteria and their metabolic products damage the mucous membrane, provoking an inflammatory process. Toxins released into the blood cause intoxication syndrome.

If salpingoophoritis develops as a secondary process, the infection enters the appendages with blood. The further mechanism of development does not differ from that during the ascending process.

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Signs and symptoms

Symptoms of acute and chronic salpingoophoritis are somewhat different, but the general clinical picture of the disease is quite typical and does not cause difficulties in diagnosis.

In the acute form of the disease, the following clinical signs are observed:

• general malaise and weakness;
• cycle failure;
• increased body temperature;
• vaginal discharge;
• itching and burning in the external genitalia;
• severe pain in the lower back and lower third of the abdomen.

The severity of clinical manifestations varies greatly, depending on the form of the disease and the severity of its course.

In severe cases, the body temperature reaches febrile levels, the malaise is very severe, there is no appetite, sweating is bothersome. The pain is localized in the lower abdomen and lower back, with a unilateral process - more on the right or left, constant, acute. In the purulent form, signs of inflammation of the peritoneum are added.

The regularity of menstruation depends on the function of the ovaries. If it is slightly disturbed, the patient maintains a regular cycle, the amount of discharge does not exceed the norm. With a pronounced hormonal imbalance, delays in menstruation, intermenstrual bleeding, an increase in the amount of spotting, and increased pain are possible.

The nature and amount of vaginal discharge are determined by the etiological factor. In most cases, a large amount of mucous or mucopurulent discharge is observed. The gonococcal flora gives the discharge a green tint; with trichomoniasis, it is foamy in nature.

Itching and burning in the external genitalia are observed only with the ascending type of the disease. These signs indicate an infectious lesion of the lower genital tract and the spread of infection upward, into the uterine cavity, fallopian tubes and ovaries.

In the subacute process, clinical manifestations are not so pronounced. Body temperature is low-grade, abdominal pain and general malaise are moderate. Often in such cases, women do not consult a doctor, and after a few days their condition improves. In fact, the disease becomes chronic.

Symptoms of chronic salpingoophoritis:

• irregular pain in the lower third of the abdomen, which intensifies during sexual intercourse or during hypothermia;
• menstrual irregularities;
• development of tubal infertility (due to the appearance of adhesions in the Eustachian tubes).

A characteristic feature of chronic salpingoophoritis is alternating periods of exacerbation and remission. During the remission phase there are no complaints, the patient feels almost healthy. Sometimes there is an irregular menstrual cycle. Periods of exacerbation are characterized by an increase in the severity of symptoms; the patient is forced to consult a doctor to undergo treatment.

The latent form of pathology is especially dangerous. A sluggish inflammatory process can proceed for several years without manifesting itself. They learn about the disease only after the development of complications of salpingoophoritis, in particular, infertility or ectopic pregnancy.

Diagnostics

Diagnosis of salpingoophoritis at the AltraVita clinic begins with a consultation with a gynecologist. At the appointment, the doctor first interviews the patient. The doctor asks whether the woman has chronic diseases, what pathologies of the genitourinary system the patient has had in the past, and so on. This is followed by an examination in a gynecological chair.

After completing the examination, the following procedures are performed to confirm the diagnosis:

• Ultrasound of the pelvic organs;
• taking gynecological smears for flora, the presence of infections;
• general blood analysis;
• biochemical screening.

Ultrasound examination allows you to examine the internal genital organs, identify signs of acute or chronic inflammatory process, and assess the condition of the fallopian tubes and ovaries.

At the AltraVita clinic, ultrasound is performed transabdominal and transvaginally. In the first case, the examination is carried out through the lower part of the anterior abdominal wall. To ensure that the internal genital organs are clearly visible on the screen, a woman should drink several glasses of water an hour before the procedure. A filled bladder will serve as a kind of acoustic window, conducting ultrasonic waves deep into the pelvis.

During a transvaginal examination, a sensor is inserted into the vagina. This technique is more informative and does not require preparation. To prevent the spread of infection, a condom is placed over the sensor.

Microscopic and bacteriological examination of discharge allows us to identify the true causes of salpingoophoritis, determine the sensitivity of bacteria to antibacterial agents and select treatment with the most effective drugs.

A general and biochemical blood test allows you to assess the general condition of the patient’s body who has been diagnosed with this disease, identify concomitant diseases, abnormalities in the functioning of internal organs and systems.

According to the patient’s indications, the level of hormones in the blood is determined, CT and MRI, and hysteroscopy are performed. A comprehensive diagnosis of salpingoophoritis allows you to accurately determine the form and nature of the disease, significantly increasing the chances of a good clinical outcome.

Therapy

Treatment of acute salpingoophoritis or during exacerbations is carried out in a specialized hospital. Therapy includes the prescription of antibacterial drugs, which is carried out taking into account the sensitivity of the flora to them and the type of causative agent of the disease.

Simultaneously with antibacterial therapy, detoxification therapy is prescribed, during which special anti-inflammatory suppositories are used, which reduce temperature, relieve inflammation and have an analgesic effect on the affected pelvic organs.

After the inflammatory process is relieved, the patient is prescribed absorbable medications and physiotherapeutic procedures. They will prevent the appearance of adhesions in the fallopian tubes, reducing the risk of infertility and ectopic pregnancy in the future.

If conservative treatment does not produce results, then surgery is indicated, usually laparoscopy. The scope of the operation is determined individually. If an abscess forms, the fallopian tube is removed as a source of infection. To restore the patency of the appendages, adhesions are cut and rough scars are removed.

Chronic salpingoophoritis during periods of exacerbation is treated similarly to acute. During the remission phase, the use of physiotherapy is indicated. The appropriateness of prescribing a particular technique is determined by the attending physician, depending on the severity of menstrual irregularities, the presence of adhesions, and the symptoms of the disease.

Treatment includes techniques such as ultrasound, magnetic fields, pulsed currents, reflexology, mineral waters, mud in the form of applications, irrigations, baths. These procedures have a beneficial effect on general and local immunity, improve blood supply to the pelvic organs, enhance regenerative processes, and restore hormonal balance.

If pathology has become the cause of infertility, an IVF procedure is indicated. This technique allows you to give birth to a child even for those women who have a history of hormonal or tubal infertility.

Pregnancy after IVF usually proceeds normally. Hormonal support is rarely necessary to prevent spontaneous miscarriage.

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The most common cause of infertility is long-term inflammation in the uterine appendages. Chronic bilateral salpingoophoritis negatively affects the patency of the fallopian tubes and the hormonal function of the ovaries, sharply reducing a woman’s reproductive ability. In addition to infection, predisposing factors are of great importance in the occurrence of pathology.

The symptoms of the disease are scant, and the optimal diagnostic test would be laparoscopy, which allows assessing the area of ​​the uterine appendages and the patency of the fallopian tubes. Chronic bilateral adnexitis requires complex therapy using medications and physiotherapeutic techniques. The criterion for cure is the onset of pregnancy, but in case of irreversible blockage of the tubes, in vitro fertilization (IVF) cannot be avoided.

Inflammation on both sides: causative factors

An acute inflammatory process that occurs during a primary infection almost always precedes chronic adnexitis. Microbes through the vagina and cervical canal first enter the uterus and tubes, causing endometritis and salpingitis, and then spread to the appendage area.

Another common route of infection is through the blood or lymphatic vessels from any source of inflammation. For the occurrence of 2-sided salpingoophoritis, predisposing factors are of great importance:

• improper or incomplete treatment of acute inflammation in the female genital organs;
• frequent medical abortions;
• failure to comply with the rules of sexual hygiene;
• diagnostic or therapeutic interventions that disrupt local defense mechanisms;
• decreased or absent immune defense;
• long-term wearing of an intrauterine contraceptive device;
• impaired blood supply to the pelvic organs due to varicose veins;
• chronic diseases of the intestines and urinary system;
• environmental factors (frequent hypothermia, physical labor, sedentary lifestyle, poor nutrition).

An important factor in the prevention of salpingoophoritis on both sides is the maintenance of general and local immunity. In women who often suffer from respiratory infections with colpitis or chronic cervicitis, a chronic version of bilateral salpingoophoritis may appear after an uncomplicated abortion.

In this case, there will be no signs of acute inflammation: the weakened body will not be able to cope with the infection, and the manifestations of inflammation will be so minimal that the woman will not notice signs of acute salpingoophoritis.

Complications: possible outcomes

Of the most unpleasant and dangerous consequences of chronic adnexitis, it is necessary to highlight from 2 sides:

• hydrosalpinx (accumulation of inflammatory fluid in the pipes);
• tubovar, pyovar (formation of a purulent focus);
• tubo-ovarian tumor (a conglomerate of ulcers in the female genital area);
• infertility (every 5th woman with adnexitis);
• endocrine disorders associated with changes in ovarian function;
• adhesions in the abdomen;
• gynecological diseases (uterine leiomyoma, endometriosis, ovarian cysts, endometrial hyperplastic processes).

Long-term chronic bilateral damage to the uterine appendages without treatment leaves a woman no chance: blockage of the fallopian tubes and hormonal problems form a persistent and irreversible version of infertility.

The formation of a purulent tumor is rare, but is the main indication for surgery for salpingoophoritis.

Phases of the inflammatory process

The following phases of chronic salpingoophoritis are characteristic of the uterine appendages:

• catarrhal;
• infiltrative;
• sclerotic.

It is optimal to identify and treat the first 2 stages, when the inflammatory process affects the surface layers of tissue. In the absence of timely treatment, sclerotic processes occur in the uterine appendages, which are the basis of adhesive disease and total obstruction of the fallopian tubes. Sclerosis can be divided into 3 phases:

• involutional (reversible);
• stabilized;
• progressive (irreversible)
.

It is possible that if therapy is started in time, then even in the sclerotic phase of inflammation it is possible to create conditions for restoring a woman’s reproductive function.

Manifestations of pathology

The following symptoms are characteristic of chronic inflammation in the uterine appendages on both sides:

• pain in the abdomen and lower back, nagging or aching, periodic or constant, but with the obligatory condition - the pain syndrome is always bilateral;
• copious vaginal discharge of a mucous-milky or purulent nature;
• hypermenstrual syndrome (increased frequency and duration of menstruation);
• fertility problems (from a high risk of ectopic pregnancy to persistent infertility).

Against the background of bilateral adnexitis, concomitant diseases often occur:

• metabolic syndrome (weight gain, arterial hypertension);
• problems with the thyroid gland (hypothyroidism);
• liver and intestinal diseases;
• inflammatory processes in the kidneys and bladder.

The correctness of the diagnosis depends on the quality of the diagnosis, so it is necessary to follow the doctor’s prescriptions and complete all studies.

Principles of examination for 2-sided lesions

The main stages of the diagnostic process include:

• taking an anamnesis (the doctor will be interested in the characteristics of menstrual and reproductive function, previous abortions and medical interventions, gynecological problems and complaints);
• tests for infections (it is important to accurately identify the causative agent of the disease, although this cannot always be done with chronic adnexitis);
• hormonal studies (to assess the degree of ovarian damage and identify common endocrine diseases);
• ultrasound, tomography and endoscopic examination (ultrasound will not always be able to identify serious problems in the uterine appendages, tomography will help to detect tumors in the pelvis, and laparoscopy is an operation that is used at the last stage of diagnosis).

Therapy for chronic inflammation

Exacerbation of chronic 2-sided adnexitis and detection of infection are indications for antibiotic therapy. In all other cases, there is no point in using antimicrobial drugs: against the background of chronic inflammation, the best therapeutic effect will be provided by drugs with the following effect: