How to treat bilateral oophoritis. Treatment of acute inflammation of the ovaries. Right-sided oophoritis: causes of the disease

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 intestines and vagina is disrupted, and this happens not only after vaginal suppositories, but also after other forms of drugs. To restore 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 term “oophoritis” is derived from the Greek word oophoron, meaning ovary, and the ending – itis, meaning inflammation. Thus, oophoritis is an ovarian disease of inflammatory nature. Most often, not only the ovary is affected, but also the adjacent fallopian tube. This condition is called “salpingoophoritis” or “adnexitis”. Isolated inflammation of the ovary usually develops against the background of appendicitis.

Causes and mechanism of development

Oophoritis is caused by microorganisms, mainly streptococci, staphylococci, gonococci, E. coli, and mycobacterium tuberculosis, as well as nonspecific anaerobic pathogens. Most often they enter the appendages ascendingly from the vagina through the uterine cavity and tubes. Less common is the spread of infection through the blood and lymphatic vessels from other organs. This path is most typical for tuberculosis pathogens. Microbes enter the vagina and uterine cavity most often during abortion and other manipulations, including when using intrauterine contraception.

It has been proven that the main causes of oophoritis are the pathogens of gonorrhea and chlamydia - sexually transmitted diseases.

Risk factors for this disease are chronic stress, alcoholism, malnutrition, promiscuity, and early onset of sexual activity. Diabetes mellitus, obesity, anemia, and urinary tract infections increase the risk of developing the disease.

Factors in the development of chronic oophoritis are endogenous intoxication and a secondary decrease in the activity of the immune system, which occurs during a prolonged course of acute inflammation. Disorders of microcirculation and rheological properties of blood are important.

Violation of the hormonal function of the ovaries leads to an imbalance in the entire regulatory system of a woman. As a result, hormonal disorders occur, in particular hyperestrogenism.

When acute inflammation transitions to chronic, autoimmune mechanisms become important. The body begins to produce antibodies against ovarian tissue. Such disorders, especially in combination with chlamydia, lead to depletion of the ovarian reserve. At the same time, the prospects as a method of treating infertility sharply decrease.

Clinical picture

Gonococci, chlamydia, and Mycobacterium tuberculosis often cause bilateral oophoritis, while staphylococci, streptococci and Escherichia coli cause a unilateral process.

The clinical course of oophoritis is determined by the causative agent of the disease and the strength of the woman’s immunity, as well as the effectiveness and timeliness of treatment. There are acute and chronic courses of the disease.

Acute oophoritis

It manifests itself as severe pain in the lower abdomen and in the sacral region, often radiating (“giving”) to the rectum. Nausea, vomiting, bloating, and constipation often occur. In many cases, there is an increase in body temperature up to 39˚C, headache, and weakness. Purulent or purulent-purulent discharge appears from the cervical canal.

The examination reveals pain in the lower abdomen. When inflammation spreads to the peritoneum, abdominal muscle tension appears, a positive Shchetkin-Blumberg sign. With a two-handed examination, enlarged, sharply painful appendages can be felt. Nonspecific “inflammatory” changes are observed in the blood - leukocytosis with a shift to the left, an increase in the erythrocyte sedimentation rate.

Such symptoms persist for up to 10 days, after which the process ends with recovery or enters the chronic stage.

Complications of acute oophoritis - pelvioperitonitis, abscess in the rectal-uterine cavity, pyosalpinx. All these conditions cause a sharp deterioration in the patient’s condition and require immediate treatment.

Chronic oophoritis

It can be an acute outcome or have a long course from the very beginning with alternating episodes of remission and exacerbation. The transition of acute inflammation to a chronic form is facilitated by improper treatment, a decrease in the body’s reactivity, and the high pathogenicity of the pathogen. Exacerbations usually occur 3-5 times a year.

Chronization is accompanied by inflammatory infiltration of the ovaries and tubes, the development of connective tissue in them, and the formation of hydrosalpinx (fluid accumulation in the fallopian tube). The blood supply to the ovaries weakens, dystrophic changes develop in them, as a result, the production of estrogen is significantly reduced.

During the period of remission, a woman may not be bothered by anything. Sometimes there is aching pain in the lower abdomen, in the groin area, radiating to the rectum and sacrum. The pain is most often caused by formations around the ovaries and fallopian tubes. The adhesive process is one of the causes of oophoritis. Women are worried about irritability, insomnia, depression, and autonomic disorders. Premenstrual syndrome is characteristic (increased emotional and vegetative disorders, the appearance of pain before the onset of menstruation).

Menstrual bleeding may become heavy and prolonged (menorrhagia). Intermenstrual bleeding (metrorrhagia) also appears. Tuberculosis is characterized by scanty menstruation or its absence (amenorrhea).

In half of the patients, sexual function is impaired: sexual desire is lost, anorgasmia develops, and pain appears during sexual intercourse.

Exacerbation is provoked by hypothermia, fatigue, and other nonspecific adverse factors. Signs of oophoritis become more pronounced, the general condition worsens, and fever appears. Mucopurulent discharge from the genital tract often appears. The exacerbation usually lasts several days.

During the period of remission, a gynecological examination reveals a slight increase, moderate pain in the appendages, and limited mobility. During an exacerbation, the appendages are significantly enlarged and painful.

Diagnostics

The diagnosis is made based on the anamnesis (history) and symptoms of the disease. An additional diagnostic method is the pelvic organs and. In doubtful cases, diagnostic laparoscopy is possible - examination of the uterus and appendages using an endoscope through a puncture in the abdominal wall. The latter method is the most informative in the diagnosis of oophoritis and its complications.

The microflora of the cervical canal and vagina is examined. Serological blood tests for chlamydia help in diagnosis. If tuberculosis is suspected, diagnosis is carried out at an anti-tuberculosis dispensary. It includes diagnostic curettage, culture of menstrual blood for mycobacteria, tuberculin tests, metrosalpingography and other methods.

It is necessary to examine the sexual partner, since in most cases the cause of oophoritis is sexually transmitted diseases.

Differential diagnosis is carried out with tubal pregnancy, appendicitis, ovarian apoplexy, rupture of an ovarian cyst. It must be remembered that a combination of appendicitis and right-sided oophoritis is possible. Therefore, when clinical symptoms of the disease appear, the patient should be examined by a surgeon.

Treatment

Treatment goals:

• elimination of the pathogen;
• pain relief and inflammation control;
• prevention of exacerbations and complications;
• restoration of altered function of the genital organs;
• correction of dysfunctions of other organs.

Treatment of oophoritis can be carried out in a hospital or on an outpatient basis, depending on the severity of the disease. Main indications for hospitalization:

• fever above 38˚C;
• inflammatory tubo-ovarian formation;
• pregnancy;
• the presence of an intrauterine device;
• unknown diagnosis;
• no effect within 2 days of outpatient therapy.

In case of acute illness and exacerbation of the chronic process, bed rest, a gentle diet, and ice on the lower abdomen are prescribed.

The main drugs for the treatment of oophoritis are broad-spectrum antibiotics that affect the main possible types of pathogens. The most commonly prescribed inhibitor-protected penicillins, third-generation cephalosporins, fluoroquinolones, aminoglycosides, lincosamides, macrolides, and tetracyclines. Azithromycin in combination with cephalosporins is considered the drug of choice. However, depending on changes in the sensitivity of microbes, the choice of drugs may be different. In many cases, it is advisable to combine the listed drugs with metronidazole, which is effective against anaerobic pathogens.

The duration of antibiotic therapy depends on its effectiveness and usually ranges from 7 to 14 days. The drugs can be prescribed in tablet form or parenterally.

In case of severe fever or deterioration of the general condition, detoxification therapy is carried out. Treatment regimens include nonsteroidal anti-inflammatory drugs, antihistamines, immunomodulators, vitamins, probiotics, and antifungal drugs. In severe cases, it is possible to use extracorporeal detoxification methods (plasmapheresis).

If there is no effect of treatment within 48 hours, the issue of laparoscopy is decided. This intervention allows you to clarify the diagnosis, drain the pelvic cavity, and remove the contents of the tubo-ovarian formation. Severe complications of oophoritis (peritonitis) are an indication for laparotomy.

During the period of remission of chronic oophoritis, antibiotics are not prescribed. The basis of therapy at this time is general strengthening measures and vitamin therapy. Physiotherapy for oophoritis plays an important role in the treatment of the chronic form of this disease. It includes ultrasound, pulsed currents, magnetic field, mud therapy, ozokerite, paraffin. Mineral waters are used in the form of baths or vaginal irrigations. Massage of the abdomen and lower back is used, especially for pain.

Correction of hormonal disorders is carried out using combined oral contraceptives.

For hyperestrogenism, radon baths, zinc or iodine electrophoresis are prescribed. Against the background of hypoestrogenism, copper electrophoresis and high-frequency pulsed currents will help better.

Infertility resulting from chronic oophoritis may be an indication for laparoscopic separation of abdominal adhesions. For women over 35 years of age, the main treatment method is in vitro fertilization. Its capabilities are often limited due to damage to ovarian tissue and depletion of the ovarian reserve.

If oophoritis is a sign of gonorrhea or chlamydia, it is imperative to treat the woman’s sexual partner.

Prognosis and prevention

In an acute uncomplicated process, the prognosis is usually favorable, the disease ends in recovery. The most common complication is pyovar, or ovarian abscess. This condition requires surgical treatment.

Patients are often interested in the question of whether it is possible to become pregnant with chronic oophoritis. This disease can cause infertility due to the formation of adhesions in the pelvic cavity, as well as due to a decrease in the ovarian reserve - healthy ovarian tissue containing eggs. In addition, the risk increases. According to some sources, the incidence of infertility reaches 18% even after a single acute salpingoophoritis. With a chronic disease, infertility is found in 70% of patients.

Persistent infertility is most often caused by tuberculous oophoritis.

Prevention of the disease includes the prevention of abortions, the correct implementation of intrauterine interventions. To avoid exacerbation of oophoritis, a woman should avoid overwork, hypothermia, and heavy physical exertion.

Oophoritis is called inflammation of the ovary - a paired organ of the female reproductive system, the 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 consequences for 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 commonly, 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, and E. coli.

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

Factors contributing to the occurrence of oophoritis are:

• Hypothermia;
• Diseases of the genitourinary system;
• Foci of chronic infection in the body;
• Endocrinological diseases;
• Tobacco smoking. Under the influence of tobacco smoke products 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;
• Poor lifestyle, overwork, stress as a factor that reduces the protective properties of the immune system;
• Promiscuous sex life, especially without the use of barrier contraception.

In clinical practice, acute, subacute and chronic oophoritis are distinguished; the process can be unilateral or bilateral.

Acute oophoritis begins suddenly, with sharp pain in the lower abdomen, which can radiate to the groin and lumbosacral region. Urination becomes difficult, sometimes painful, and purulent discharge from the vagina appears. Signs of oophoritis are accompanied by a general deterioration of the condition: high temperature, fever, headaches and muscle-joint pain.

Chronic oophoritis often has a hidden onset, that is, it can be primary chronic, or develop as a result of untreated acute oophoritis. The only sign of chronic oophoritis for a long time is unexpressed pain. The pain, as a rule, is not constant, is dull, aching in nature, and appears during overwork, hypothermia, stress, or during sexual 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 is so subtle 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 carried out, with a mandatory examination of the vaginal microflora. Ultrasound of the ovaries can show changes that have occurred as a result of chronic oophoritis; for an acute form of the disease, 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 ovarian tissue and detect signs of an inflammatory process. To determine the degree of ovarian dysfunction in chronic oophoritis, an endocrinological examination is carried out, with the compilation of an ovulation diary.

Treatment of oophoritis

Treatment of chronic and acute oophoritis differs.

In case of acute oophoritis, a course of antibacterial therapy is prescribed using broad-spectrum antibiotics, often in combination with sulfonamide drugs. Painkillers and anti-inflammatory drugs are used, bed rest is advisable, and an ice pack is applied to the area of ​​the affected ovary to relieve pain. When the signs of acute inflammation subside, they resort to physiotherapeutic procedures: electrophoresis, laser therapy, magnetic therapy, UHF and microwave therapy, etc. Treatment of oophoritis in acute form is carried out in a hospital setting.

Treatment of chronic oophoritis must be carried out consistently and persistently, otherwise it may result in loss of ovarian function. Antibacterial therapy is also used to treat chronic oophoritis, 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 is necessary to understand that treatment of chronic oophoritis will require changing your usual lifestyle to a healthier one. General strengthening procedures are needed that stimulate the body's own defenses, switch to a healthy diet, give up bad habits and increase physical activity to eliminate congestion in the pelvis. Only if all these conditions are met can we talk about the possibility of a complete cure.

Complications of oophoritis

A complication of acute and aggravated oophoritis can be suppuration of the ovary. This is an acute inflammatory process, as a result of which purulent melting of the ovary occurs, and it turns into a thin-walled spherical formation filled with pus. This condition requires emergency surgery, as ovarian rupture 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.

The most common complication of chronic oophoritis is the development of adhesions, which disrupts the patency of the fallopian tubes, and sclerosis of the ovary, in which its tissue is replaced by fibrous tissue, which leads to loss of function. Since the ovary is an endocrine gland, its improper functioning affects the woman’s hormonal background, which can cause various disorders - from anorgasmia to infertility.

Therefore, treatment of oophoritis must begin as early as possible, and be sure to be completed.

Video from YouTube on the topic of the article:

Ovarian oophoritis, i.e. their inflammation is not very common in gynecology in its pure form. This disease is usually accompanied by an inflammatory process in the fallopian tubes and is then called salpingoophoritis. Also, this pathology can be combined with endometritis or adnexitis.

Treatment of oophoritis

Oophoritis is an inflammatory process occurring in the ovaries. Now this is a fairly common disease, so alternative treatment for oophoritis is widely practiced. Its diagnosis and treatment are often difficult, since it is often accompanied by concomitant inflammatory processes developing in neighboring organs. In the absence of proper treatment, this situation can lead to serious disruptions in the functioning of the digestive, endocrine, and nervous systems.

Traditional treatment of oophoritis

Experts believe that traditional treatment for oophoritis should be used only in the chronic stage of the disease. Its main recipes include the following:

To treat oophoritis, mix dried linden and chamomile flowers in a 3:2 ratio. After this, to treat oophoritis, take five to six spoons of the resulting mixture, add 1 liter of water, boil and let the broth brew for half an hour. When it has cooled to body temperature (36.6 degrees), strain it through double cheesecloth. The resulting infusion can be used for baths or for vaginal douching. Sometimes you can add the herb cinquefoil to the collection for traditional treatment;

Prepare a mixture of the following medicinal herbs for treatment: take sandy immortelle flowers, birch leaves, wild strawberries, yarrow, mint herb, nettle leaves, string, rose hips and rowan berries in the ratio 2:2:2:2:2:3:3:3 :1. All ingredients for the traditional treatment of oophoritis should first be cut into medium-sized pieces. Place 2-3 tablespoons of the resulting mixture in 0.5 liters of boiling water and leave the mixture for 10 hours, then strain the solution. The infusion should be taken for oophoritis, 0.5 cups three times a day.

Try using the above folk methods for treating oophoritis, and you will soon feel relief.

Causes of oophoritis

One of the most common causes of oophoritis is an infection of the fallopian tubes, which spread to the ovaries along the ascending path. The inflammatory process can be caused by both viruses and microorganisms that the body cannot cope with on its own due to reduced immunity. Those who practice frequent changes of sexual partners without using protective equipment are also at risk of contracting oophoritis, because in this case it is very easy to contract any sexually transmitted infection. Factors that provoke oophoritis can also include abortion, childbirth, and surgical intrauterine intervention.

Many factors can lead to the development of ovarian oophoritis:

Infections that are transmitted through sexual contact. The most common are Trichomonas, chlamydia, mycoplasma, gonococcus, ureaplasma;

Infectious processes of an inflammatory nature affecting internal organs: pathogens include representatives of opportunistic microflora - streptococci and staphylococci, E. coli, etc. ;

Abortions, especially if they were performed late in pregnancy;

Difficult labor and birth by cesarean section provoke ovarian oophoritis;

Hypothermia leads to oophoritis;

Severe stress, constant depression;

Hormonal disorders;

The use of intrauterine devices.

In the vast majority of cases, ovarian oophoritis is of a secondary nature: the infection spreads from the fallopian tubes, the inflammatory process in which can affect the nearby genital organs.

Symptoms of oophoritis

Inflammation of the ovaries is characterized by the following symptoms:

Throbbing or aching pain in the lower abdomen or in the area of ​​the ovaries;

Frequent urination, often painful and accompanied by a burning sensation - symptoms of oophoritis;

Specific abundant, sometimes mixed with pus, discharge from the genital tract;

Bleeding between menstruation with oophoritis of the ovaries.

The acute course of the disease is accompanied by symptoms of intoxication: headaches, loss of appetite, high fever, weakness, joint pain. In the chronic form of ovarian oophoritis, the symptoms are less pronounced; patients usually complain of periodic pain and discomfort in the lower abdomen, irregular menstrual cycle, and pain during sexual intercourse.

To accurately diagnose oophoritis, palpation, ultrasound using a transvaginal sensor are used, laboratory tests of urine and blood are done, and a smear is taken to determine the causative agent of the disease. Treatment of ovarian oophoritis mainly involves taking antibiotics, anti-inflammatory drugs, and anesthetics to relieve pain. To consolidate the effect, general strengthening drugs and physiotherapy are prescribed.

Acute oophoritis - treatment and causes

Acute oophoritis is a severe inflammation of the ovary, which connects to the uterus via the fallopian tube. The ovaries are responsible for the maturation of the egg and the production of female sex hormones, so their damage can have very serious consequences for the female body.

Diagnosis of acute oophoritis

Diagnosis of acute oophoritis is a non-trivial task, since severe pain, which is the main sign of the disease in its acute form, can relate to almost all diseases of organs located in the abdominal cavity. If oophoritis is suspected, laboratory tests of blood, urine, and vaginal smear are required to identify the causative agent of the infection.

Ultrasound is not very informative when determining acute oophoritis by method, since it can show the dynamics of the development of the process over time, i.e. more applicable in the case of chronic inflammation of the ovaries.

In complicated cases of acute oophoritis, a diagnostic method such as laparoscopy is used. An experienced doctor, having studied the results of all the above studies for acute oophoritis, can easily select an individual treatment regimen for acute oophoritis for each patient.

Causes of acute oophoritis

Acute oophoritis is very rarely diagnosed without accompanying diseases of the female genital area, since the ovaries are located in such a way that the primary infection cannot enter them. Most often, infection occurs through the fallopian tube, which is the first to be affected. In this case, we can talk about salpingoophoritis. The causative agents of the disease include bacteria and viruses that cause sexually transmitted infections: gonococci, Trichomonas, chlamydia, etc. Sometimes the ovary in acute oophoritis can become inflamed due to the fact that in the abdominal cavity there is a source of nonspecific infection caused by E. coli, streptococci and staphylococci.

Sometimes the cause of acute oophoritis can be a general infectious disease of the body of a general nature, most often of a viral nature.

Factors contributing to the development of ovarian inflammation in acute oophoritis are:

Endocrinological diseases;

Hypothermia with oophoritis;

Promiscuous sexual intercourse, especially if partners do not use barrier contraception;

Diseases of the urinary system;

Stress, overwork, poor lifestyle as factors that reduce immunity;

Foci of untreated chronic infections in the body during oophoritis.

Left-sided oophoritis - treatment and symptoms

Oophoritis is an inflammatory process that develops in the female paired sex glands - the ovaries. It can be unilateral or bilateral, with left-sided oophoritis being more common.

Left-sided oophoritis - treatment

An accurate diagnosis of “inflammation of the appendages” can be established based on the results of the following examinations:

Gynecological examination for oophoritis;

Laboratory tests, bacteriological examination, ELISA and PCR diagnostics;

Ultrasound examination of the pelvic organs;

Hystersalpingoscopy;

Laparoscopy, through which you can conduct a visual examination of the fallopian tubes, uterus and ovaries.

It is very important to identify and begin treatment of left-sided oophoritis on time so that it does not lead to the development of serious complications, so do not delay your visit to the doctor.

Inflammation of the ovaries can have acute and chronic forms, each of which has its own characteristics.

Signs of acute left-sided oophoritis

The following symptoms are characteristic of the acute form of left-sided oophoritis:

Constant severe pain with left-sided oophoritis in the lower abdomen, which radiates to the lower back and sacrum. If they are localized on the left side, this means left-sided oophoritis, on the right - right-sided;

Frequent urination, accompanied by pain and stinging with left-sided oophoritis;

In some cases, abundant serous and purulent discharge from the genital tract;

Fever, increased temperature, general intoxication are signs of left-sided oophoritis;

Bleeding between periods;

Sharp pain during sexual intercourse with left-sided oophoritis.

A gynecological examination reveals enlargement of the ovaries and their sharp pain. Acute oophoritis requires urgent hospitalization in a hospital.

Signs of chronic left-sided oophoritis

Chronic inflammation of the ovaries has the following symptoms:

Aching, dull pain in the vagina, lower groin and abdomen, which intensifies with hypothermia, acute respiratory infections, and the onset of menstruation;

Menstrual irregularities;

Scanty but constant discharge (leucorrhoea) with left-sided oophoritis;

Decreased sexual desire, pain during sexual intercourse;

Absence of pregnancy in the presence of regular sexual activity with oophoritis.

Causes of left-sided oophoritis

Inflammation of the ovaries in left-sided oophoritis often has a specific nature if it is caused by pathogens of tuberculosis, gonorrhea, mycoplasmosis, chlamydia, trichomoniasis, but it can also be nonspecific if it is caused by microorganisms belonging to opportunistic microflora (staphylo- and streptococci, candida, E. coli, etc.).

Right-sided oophoritis - treatment and causes

Oophoritis refers to an inflammatory process occurring in the ovaries. In severe cases, it can be bilateral, but more often it is either left-sided or right-sided oophoritis, which differ in the location of pain. It is often accompanied by inflammation of the fallopian tubes – salpingitis.

Diagnosis of right-sided oophoritis

A reliable diagnosis of “oophoritis” can be made based on the following data:

Gynecological history (presence of sexually transmitted infections, abortions, previous inflammatory diseases of the uterine appendages, intrauterine surgical interventions, complications after childbirth) and signs of the current disease (localization and nature of pain, presence of discharge, general well-being);

Laboratory tests for oophoritis (inflammation of the ovaries is accompanied by an increase in the number of leukocytes in urine and blood tests, smears from the urethra and vagina);

Gynecological examination for oophoritis (this reveals enlargement of the ovaries and their soreness, decreased mobility of the uterine appendages);

Ultrasound diagnostics;

Bacteriological examination using PIF, ELISA, PCR diagnostics, which help to detect hidden infections and determine the causative agent of the inflammatory process;

Hysterosalpingography (it is used to determine changes in the fallopian tubes associated with inflammation of the ovaries):

Laparoscopy, which allows you to directly examine the uterus, fallopian tubes and ovaries, and identify right-sided oophoritis.

The combination of the above methods for diagnosing oophoritis will allow timely identification of the disease, prescribing treatment for right-sided oophoritis and avoiding serious complications.

Right-sided oophoritis - causes

The cause of oophoritis is various infections, often transmitted through sexual contact - gonorrhea, chlamydia, mycoplasmosis, etc. Abortion, menstruation or childbirth can also provoke the development of the inflammatory process in right-sided oophoritis. In most cases, ovarian inflammation is the result of secondary infection due to complications of salpingitis.

Right-sided oophoritis - signs

The main signs that may indicate that you are experiencing oophoritis are the following:

Urinary disorders are a sign of right-sided oophoritis;

Severe pain with right-sided oophoritis, appearing in the lower abdomen: they are localized on the right if it is a right-sided oophoritis, and on the left if it is left-sided;

Abundant leucorrhoea of ​​a purulent nature is a sign of right-sided oophoritis;

Sharp acute pain during sexual intercourse with oophoritis.

Bilateral oophoritis - treatment and symptoms

The diagnosis of “bilateral oophoritis” means inflammation of both ovaries, which, as a rule, is combined with an inflammatory process in the fallopian tubes. The most common cause of signs of bilateral oophoritis is the ascending route of infection from the vagina and tubes.

Bilateral oophoritis - treatment

To treat acute bilateral oophoritis, a woman must be hospitalized and prescribed bed rest, as well as taking antibiotics, painkillers, and applying ice to the lower abdomen. You should also not neglect vitamins and restorative procedures for bilateral oophoritis. To prevent the adhesive process, absorbable medications, gynecological massage, physiotherapy and mud therapy are prescribed. All procedures for the treatment of bilateral oophoritis in this case are aimed at preventing severe complications, such as infertility.

Signs of acute bilateral oophoritis

Bilateral oophoritis has both acute and chronic stages of the disease. The onset of the disease or its relapse is usually associated with the arrival of menstruation. Signs of an acute inflammatory process in the ovaries include the following:

Severe pain in the lower abdomen and lumbar region;

High body temperature accompanied by chills during oophoritis;

Urinary disorders;

Profuse leucorrhoea, sometimes mixed with pus during oophoritis;

Uterine bleeding between menstruation.

Signs of chronic bilateral oophoritis

If oophoritis is not treated in time, it enters the chronic stage. In this case, the signs of the disease are less pronounced, but it is more likely to lead to ovarian dysfunction and further infertility. Its characteristic symptoms are:

Irregular menstrual cycle with bilateral oophoritis;

Aching weak pain in the lower abdomen;

Pain during sexual intercourse.

Inflammation of the ovaries can lead to changes in the neuropsychic state of the patient: irritability, poor sleep, fatigue, decreased performance, etc. Also, bilateral oophoritis can be accompanied by sexual dysfunction: absence or change in sexual desire, vaginismus, lack of orgasm, which is also associated with disorders in the functioning of the ovaries.

Causes of bilateral oophoritis

Factors predisposing to the occurrence of bilateral oophoritis are the presence of foci of infection in the body, frequent changes of sexual partners, hypothermia and fatigue. Menstrual bleeding, abortion and childbirth can also contribute to the development of bilateral oophoritis.

Chronic oophoritis - treatment and signs

As practice shows, chronic oophoritis, the treatment of which can take a very long time and is not always highly effective, is a disease that must be eliminated at the acute stage.

Oophoritis is an inflammation of the most important female genital organs – the ovaries. It is most often combined with salpingitis. If this disease is not detected and treated on time, it can lead to infertility and other unpleasant complications. Chronic oophoritis can be a consequence of infection of the female genital organs with sexually transmitted infections, staphylococci and streptococci, tuberculous mycobacteria, etc.

Chronic oophoritis - treatment

The diagnosis of “chronic oophoritis” is made on the basis of a gynecological examination, ultrasound examination, blood and urine tests, which in this case indicate an increased number of leukocytes, smear tests, including bacterial cultures and PCR diagnostics, which allow determining the pathogen and its sensitivity to antibacterial drugs. Hysterosalpingography and laparoscopy are also used before treating chronic oophoritis for diagnosis.

Chronic oophoritis, the treatment of which usually involves the use of balneotherapy (adding essential oils, sea salt, medicinal algae, mud to baths) and physiotherapeutic procedures (electrophoresis, UHF therapy, etc.), often requires the use of antibiotics. At the same time, antibiotics are prescribed only for exacerbations. The treatment regimen for the disease also includes taking vitamins and anti-inflammatory drugs.

Remember that it is better to prevent the occurrence of chronic oophoritis than to treat it later.

Chronic oophoritis - signs

The following symptoms are characteristic of the acute stage of oophoritis:

Swelling and tenderness of the ovaries upon palpation;

High temperature with oophoritis;

Painful sensations during sexual intercourse;

Severe pain in the lower abdomen and lumbar region;

Urinary disorders in chronic oophoritis;

Manifestations of ovarian dysfunction (intermenstrual uterine bleeding, etc.)

Chronic oophoritis has the following symptoms:

Aching, periodically appearing pain in the abdomen;

Painful and enlarged ovaries;

Menstrual irregularities with oophoritis;

Infertility;

Sexual dysfunctions (lack of sexual desire or orgasm, discomfort during sexual intercourse);

Fatigue and drowsiness;

Irritability with oophoritis;

Light but constant vaginal discharge.

Chronic oophoritis during pregnancy

Unfortunately, a successful combination of chronic oophoritis and pregnancy is unlikely, because the proper functioning of the ovaries is very important for planning pregnancy, its normal course and successful childbirth. It is the ovaries that determine the production of the necessary sex hormones, the maturation and release of a full-fledged egg from the follicle, which makes fertilization possible.

Chronic oophoritis – is pregnancy possible?

Changes in the functioning of the ovaries, caused by the presence of pathogens of sexually transmitted infections or microorganisms that “dormant” in the female body and manifest themselves only against the background of reduced immunity, can be practically asymptomatic. However, carrying a child with oophoritis is an additional burden on the female body, so all the unpleasant symptoms associated with oophoritis will come to the fore.

Planning pregnancy with chronic oophoritis

So that chronic oophoritis, during which pregnancy is still possible, does not prevent you from giving birth to a healthy baby, it is recommended, even if you consider yourself healthy, to visit a doctor before planning a conception and undergo an examination to identify the latent (hidden) form of this disease. If you don't do this, you may experience the following complications:

Ectopic pregnancy with chronic oophoritis. Since inflammation of the ovaries is usually combined with inflammation of the tubes, adhesions can form in the pelvis, which contribute to the fact that fertilization will occur not in the uterus, but in the tube, which will cause this threatening condition;

Infertility with chronic oophoritis. Ovarian dysfunction leads to the fact that the production of a full-fledged egg, and therefore ovulation, becomes impossible, so pregnancy will not occur.

Chronic oophoritis during pregnancy - complications

If you become pregnant while having chronic oophoritis, this is fraught with serious complications. This means that there is a permanent focus of infection in the mother’s body, which means that infection of the fetus is also very possible. Even if this does not happen during pregnancy, the baby can become infected while passing through the birth canal. In addition, inflammatory processes in the ovaries during chronic oophoritis can lead to hormonal disorders during pregnancy, and this, in turn, to miscarriage. Also, antibiotic therapy in case of a sharp exacerbation of chronic oophoritis is practically impossible. Therefore, it is best to try to get rid of oophoritis before pregnancy.

Oophoritis is inflammation of the ovaries. It can be unilateral and bilateral, acute and chronic. In women of reproductive age, prolonged oophoritis can cause infertility and disharmony in sexual life. If acute inflammation of the ovaries with purulent complications develops, life may be threatened.

Isolated oophoritis is rare. In most cases, there is either inflammation of both the ovaries and fallopian tubes (these reproductive organs are called the uterine appendages).

Causes of oophoritis

An inflammatory reaction in the ovaries can develop in various pathological situations. Among them, the main place, of course, is occupied by infections. But they can also play their etiological role pelvic area injuries, inflammatory diseases of organs adjacent to the ovaries, as well as changes in the structure of the ovary that are observed for cysts and neoplasms(inflammation occurs as a protective mechanism).

Infectious agents can reach the internal reproductive organs both from the outside (through the vagina) and through the blood and lymph flow. The following infectious agents are of greatest importance in the development of oophoritis::

• mycobacteria;

Factors that provoke the penetration of these pathogens into the ovaries:

In addition, the infection can penetrate from anatomical structures adjacent to the ovaries. This is possible with other diseases.

The cause of chronic oophoritis is most often untreated acute oophoritis. Exacerbation of chronic oophoritis can be provoked by hypothermia, strong, therapeutic and diagnostic manipulations on the genitals.

Symptoms of oophoritis

Acute oophoritis is characterized by a pronounced clinical picture. Patients are usually concerned about:

Chronic oophoritis, in turn, occurs more covertly– no severe pain, discharge, fever, etc. However, the pathology makes itself felt through various hormonal disorders and discomfort during sexual intercourse. Some patients experience pain during ovulation, when a mature egg leaves the ovary, which is accompanied by a violation of its integrity.

The development of chronic inflammation of the ovaries is associated both with hormonal imbalance (it is the ovaries that synthesize the bulk of female sex hormones) and with a violation of egg production.

Diagnostics

Women with suspected ovarian inflammation should undergo a comprehensive examination, since the clinical picture of this disease is very similar to a lot of other gynecological (and not only) diseases.

The patient's examination plan usually includes:

• gynecological examination;
• pelvic organs;
• infection testing;
• blood and urine tests.

In some cases, they resort to diagnostic laparoscopy, during which therapeutic measures can be immediately carried out.

It is imperative to visit a gynecologist and undergo an examination to identify possible chronic inflammation of the ovaries for women who suffer from infertility, have various problems with menstruation (delays, severe pain, heavy or, on the contrary, scanty bleeding), and cannot fully live an intimate life due to pain and discomfort.

Treatment of oophoritis

Treatment tactics for oophoritis depend on the clinical picture of the disease. In most cases, it is possible to eliminate inflammation using conservative methods. If a purulent process develops, doctors have to resort to surgical intervention.

Conservative methods of treating oophoritis include:

• drug therapy;
• physiotherapy;
• gynecological massage;
• herbal medicine (exclusively as an auxiliary method).

The goal of drug treatment of ovarian inflammation is to eliminate infectious agents, reduce the severity of the inflammatory reaction and increase immune defense, and normalize the functioning of the ovaries. For this, gynecologists prescribe to patients:

• (one or more - it all depends on the pathogens isolated during the analysis). Preference is given to broad-spectrum drugs that penetrate well into the ovarian tissue.
• Anti-inflammatory drugs. They relieve inflammation and reduce the severity of pain. They are used orally or rectally (in the form of suppositories).
• Immunomodulators(most often interferon-based agents).
• Combined oral contraceptives(normalize the secretory activity of the ovaries).
• Vitamin complexes.

Among the wide range of physiotherapeutic procedures, preference is given to the following:

• electrophoresis;
• laser therapy;
• magnetic therapy.

The use of physiotherapeutic methods is possible only after the acute symptoms of the disease have been eliminated. Thanks to physiotherapeutic effects, it is possible to achieve complete cessation of the inflammatory process and prevent the occurrence of adhesions (inflamed ovaries can “stick together” into a conglomerate with surrounding organs).

When is surgical treatment indicated?

Surgical treatment is resorted to in the event of the development of purulent complications - tubo-ovarian abscess and pelvioperitonitis. To prevent these complications, it is necessary to consult a doctor immediately and not self-medicate.

If pus has accumulated in the area of ​​the ovaries and fallopian tubes, laparoscopic surgery. It is low-traumatic because it does not require extensive access to the organ being operated on. All surgical procedures are performed through small incisions under the control of optical technology.

If the inflammatory process spreads to the peritoneum surrounding the reproductive organs (this pathology is called pelvioperitonitis), abdominal surgery, allowing for better sanitization of the abdominal and pelvic cavity. If the inflammatory process is started, it may be necessary radical removal the affected ovary along with the fallopian tube.

Prevention

Prevention of oophoritis includes:

• Regular gynecological examinations. Every woman should visit a gynecologist at least once a year for preventive purposes, since many female diseases can be asymptomatic.
• Timely detection of inflammatory processes in the reproductive organs (any harmless vaginitis or cervicitis can become a source of infection for the uterus and its appendages).
• Protection against sexually transmitted infections.
• Diagnosis and treatment of inflammatory diseases of organs located near the ovaries.
• Healthy lifestyle. Proper nutrition, giving up bad habits, physical activity, adequate sleep and rest - all these factors increase the female body’s ability to resist infections.

It is important to remember that the ovary is an organ on the condition of which a woman’s ability to have children depends. Therefore, any pathological changes in it affect reproductive function. Chronic inflammatory processes are especially dangerous. Against the background of chronic oophoritis, problems with conception arise, and in the event of a long-awaited pregnancy, various pregnancy complications arise.

Zubkova Olga Sergeevna, medical observer, epidemiologist