Inflammatory diseases in women. Causes of inflammation of the appendages

Inflammation of the fallopian tubes and ovaries is a fairly common process that requires immediate treatment. Andexitis (inflammation) has two types: it can be unilateral and bilateral. Depending on the name, it is clear in which case and which appendages are inflamed.

Inflammation of the female appendages in 80% of cases is a consequence of the negative impact of viruses and pathogens on the body. The most common causes of andexitis include viruses such as gonococci and chlamydia.

However, inflammation can be caused by a number of other factors. Therefore, before starting treatment, especially with the use of antibiotics, it is necessary to know the true cause of this disease. First of all, you need to seek advice and diagnosis from a specialist who will prescribe a drug that is necessary and effective in each individual case.

Only a doctor prescribes a course of treatment and selects the necessary drug. Therefore, as soon as a woman notices the first signs of inflammation of the appendages, it is necessary to consult a doctor as soon as possible. In some cases, this disease may occur without any symptoms at all, and sometimes signs of the disease appear later and in the following form:

weakness, fatigue, decreased activity
(discharge may be scanty or, on the contrary, abundant)
purulent vaginal discharge
frequent pain in the lower abdomen, which may intensify during sexual intercourse.

Treatment with antibiotics

Antibiotics for inflammation in women are the most effective and common method of treatment. In this situation, only a vitamin complex will not give practically any results.

The main task of the doctor is to select drugs that would cause minimal damage to women’s health, while showing a good effect in the fight against the virus that caused inflammation of the appendages. Microbes quickly become accustomed to drugs, so the choice of antibiotics must be approached with particular care.

All antibiotics that are used for treatment are divided into groups, depending on which virus caused it.

diseases:

macrolides (Azithromycin)
tetracyclines (Doxacycline)
lincosamides (Clindamycin)
penicillins (Ampicillin, Oxacillin)
nitroimidazoles (Metronidazole).

The antibiotic itself, as well as its dosage, amount of administration and course of treatment - all this is prescribed by the attending physician. In a situation where the patient has an acute form of inflammation, the doctor may prescribe several antibiotics at the same time for effective treatment.

Under no circumstances should you choose antibiotics for yourself; with such a choice you can only harm your body.

If the treatment was prescribed incorrectly or untimely, there may be serious complications, including treatment in the future only by surgery.

Consequences of inflammation

Inflammation of the appendages can lead to temporary, and if this disease is left to chance, even to complete loss of a woman’s reproductive function.

In order for a sperm to fertilize an egg, several favorable conditions must coincide. Even if unprotected sexual intercourse has been performed, when sperm enters the woman’s genitals, they encounter a number of obstacles on their way to the cervix, which many are unable to overcome.

If treatment is not started in time, a woman may develop a disease such as endometritis, in which the uterine mucosa becomes inflamed. In this case, there will be acute pain in the lower abdomen, decreased libido, irregular menstruation from the vagina, intoxication, dizziness, chills.

All this in the future leads to the fact that a woman loses the ability to conceive and bear a child, therefore, it is so important to consult a doctor at the first symptoms and signs of illness. Moreover, inflammatory processes in the early stages are treated quite quickly without any unpleasant consequences for the woman’s health.

Sources of infection

Inflammatory processes that occur in the genital organs of both men and women are primarily caused by infection.

Inflammation of the fallopian tubes and ovaries is a fairly common process that requires immediate treatment.

A woman's appendages are affected during the active hematogenous spread of microorganisms from their primary place of formation. In some cases, inflammation of the appendages may be a consequence of appendicitis, tuberculosis or bronchitis. In others, these are viruses that are transmitted only through sexual contact. But in both cases, complex therapy with antibiotics is necessary.

In parallel with taking antibiotics, it is imperative to take. Otherwise, the treatment process will be quite protracted, the woman will always feel tired and lack of strength, nausea, dizziness, and the activity of the kidneys and liver may be impaired due to this.

During treatment with strong antibiotics, almost all normal flora in the body is destroyed, which can lead to rapid adaptation of viral microorganisms to the drug, which will only worsen the situation.

In order to prevent the possibility of inflammation of the female appendages, when treating infectious diseases in the body, it is necessary to take drugs that act as prophylactic drugs against inflammatory processes of the genital organs.

If during the period of current inflammation a woman shows signs of intoxication of the body - nausea, vomiting, acute, heavy menstrual flow, intolerance to light stimuli, etc., then it is necessary to provide the patient with infusion therapy, which can speed up the time for the onset of action of the drugs several times . During treatment, adhesive disease may begin; in this case, in addition to antibiotics, resorption therapy is also used.

Inflammation of the female appendages is a serious disease that requires complex treatment using antibiotics. Only a doctor can prescribe the drug based on tests and the type of viral microorganism that caused the disease.

Treatment must be started as quickly as possible, since at the initial stage of inflammation, this disease can be treated quickly with the use of mild antibiotics.

A specialist will talk about inflammation of the appendages and their treatment in the video:

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Types of inflammation

Gynecological diseases are divided by duration: acute (lasting up to 3 weeks), subacute (lasting up to 1.5 months), chronic (lasting more than sixty days).

According to the type of causative agent of inflammation, there are:

Specific inflammatory diseases - occur under the influence of pathogens such as staphylococcus, streptococcus, E. coli;
Nonspecific - arise from trichomonas, candida, chlamydia, viruses, ureaplasma.

In nature, there are approximately 50 infectious diseases that can be acquired sexually. The most common and famous: AIDS, gonorrhea, syphilis, chlamydia, genital herpes.

Women's diseases are also divided according to the level of infection:

diseases of the lower genital organs. The most common of them vulvitis, vulvar furunculosis, colpitis, bartholinitis, vaginismus, candidiasis, cervical erosion;
diseases of the upper genital organs. These include illness endometritis, adnexitis, pelveo peritonitis.

Distinctive features

The inflammatory disease does not have a clear clinical picture. In women, symptoms can be either general, affecting the entire body, or local, affecting only the affected areas. Diseases have a common symptom, or even several:

itching, redness;
swelling of the vagina and mucous membrane;
pain during sex;
pain is felt in the lower back and abdomen;
vaginal discharge changes its character, color and smell;
There may be disturbances in the monthly cycle, as well as difficulty urinating.

The disease can be acute in nature, then the symptoms of inflammation in a woman take on the same color: increased body temperature, severe abdominal pain, a blood test shows a change in indicators.

The illness may last for a long period of time. Its symptoms lose their sharpness and become less noticeable. But this is also dangerous, since long-term untreated pathology will cause disease in neighboring organs and systems.

Treatment

How to treat inflammation? Inflammatory diseases in gynecology are treated with antibiotics. To date, this is the most effective method of treating inflammation. Since microorganisms very quickly become accustomed to antibiotics, their choice must be approached with special care. To do this, during the examination, the doctor takes a smear for bacterial culture, after which a drug is selected that can cope with the disease.

If a woman has an acute form of the disease, the attending physician may prescribe several antibiotics from different groups at once.

Choosing antibiotics on your own can cause irreparable harm to the body.

The treatment regimen for female inflammation is the same for all types:

The destruction of the pathogen occurs with the help of an antibiotic. It has a bactericidal effect on microorganisms at the stage of their growth;
Taking immunomodulatory drugs is carried out to strengthen the body's defenses. These include thymalin, gammaglobulin, thymosin;
a sick body requires the use of biostimulants. These include aloe extract, plasmol, placenta extract;
At the end of the treatment, physiotherapeutic procedures (electrophoresis, ultrasound, UHF, laser therapy) are used. Mud therapy, exercise therapy, and therapeutic massage are also used.

If a severe form of the disease occurs, additional treatment for inflammatory diseases is included: painkillers, glucose-vitamin solutions, antihistamines, and enzyme preparations are prescribed.

Detoxification medications are used to remove toxins from the body. Their action is also aimed at increasing the volume of circulating blood and stimulating metabolic processes.

If conservative treatment of inflammation in women does not bring the desired results, they resort to surgical intervention.

Complications

If the disease is not treated for a long time, various kinds of complications may arise, including: disturbances begin in metabolic processes, errors in the functioning of the endocrine system, and disruptions in the vegetative-vascular system. Blood circulation in the tissues is disrupted, the egg matures, but with disturbances. Common inflammations in gynecology can cause the formation of adhesions in the tubes, as well as infertility.

Due to past female diseases, the monthly cycle may be disrupted and an ectopic pregnancy may occur.

Despite such significant complications, you just need to remember that every inflammation must be cured, and in a timely manner. And then it will go away, just like a runny nose or a cold, leaving no trace behind.

Prevention

The basis of all preventive measures for inflammatory processes in gynecology was, is and will be regular examination by a gynecologist. Regularity should be twice a year, at least.

In addition, of course, the following factors are important:

Personal hygiene;
A lifestyle that should be healthy;
Use of contraception;
Regular sex life with a meaningful choice of partners.

By taking care of your health and visiting a doctor in a timely manner, you can achieve good results in the timely treatment of all diseases.

Inflammation of the female genital organs accompanied by a vascular-tissue reaction to the influence of pathogens that cause inflammation of a particular organ. The disease is very common and ranks first among gynecological diseases.

Depending on the location of the inflammation, there are:

endometritis (inflammation of the uterus)
cervicitis (inflammation of the cervix)
adnexitis (salpingoophoritis - inflammation of the uterine appendages)
oophoritis (inflammation of the ovaries)
salpingitis (inflammation of the fallopian tubes)
pelvioperitonitis (inflammation of the pelvic peritoneum)

Causes of the disease

A variety of microbes, most often streptococci, staphylococci, gonococci, E. coli, tubercle bacilli, fungi, viruses. They enter the genitals during sexual intercourse and other means.

Symptoms

In acute inflammatory processes, pain is observed in the lower abdomen, often radiating to the lower back, sacrum and hips; increase in temperature; purulent discharge.

Treatment

Treatment of inflammation of the female genital organs begins with eliminating the cause that provoked the development of the inflammatory process. In addition, treatment for possible concomitant diseases may be required. Drugs that can be used during treatment:

Antibacterial/antiviral drugs are selected taking into account the causative agent of the disease.
Immunostimulants: Timalin, Echinacea.
Washing the external genitalia with a warm solution of potassium permanganate, boric acid, and chlorhexidine.
External treatment with antibacterial drugs: Macmiror.
Use of vaginal suppositories: Terzhinan, Polygynax.
The use of vitamin complexes, which include vitamin A and E.
If there are lesions, use the drug Solcoseryl or sea buckthorn oil.
Antihistamines, if there are complaints of itching: Suprastin, Tavegil, Desloratadine.
In some cases, it is advisable to prescribe hormonal drugs both for local treatment and for oral administration. Such treatment may be required during the treatment of patients in older age groups.

The exact treatment regimen is determined individually after a comprehensive examination.

In acute cases of the disease, bed rest and abstinence from sexual activity are required.

Folk remedies

20 g of bay laurel per bucket of water. Use for sitz baths for diseases of the uterus and bladder.
Pour a tablespoon of St. John's wort herb with a glass of boiling water, boil for 15 minutes, strain. Drink 1/4 cup 3 times a day for inflammation of the genital organs.
Pour a tablespoon of dried and crushed walnut leaves into a glass of boiling water. Leave for 4 hours. Drink in a day.
Take 1 part of sweet clover herb and 10 parts of coltsfoot herb. Pour a tablespoon of the mixture into a glass of boiling water. Leave in a water bath for 15 minutes, cool and strain. Drink 1/2 cup 3 times a day for inflammation of the appendages.
Take the juice of fresh aloe leaves orally, a dessert spoon, 2-3 times a day before meals.
There is an effective infusion for vulvitis, which can be prepared within an hour. It will relieve both pain and unpleasant tickling. All other remedies for inflammation of the labia take from a week to a month to prepare. Grind the bergenia root, pour 200 ml of boiling water and cover the vessel with a lid. Leave to sit at room temperature. After an hour, you can make lotions. The more often the procedures are performed, the faster the itching will go away.
Pass the raw pumpkin through a meat grinder, squeeze the juice out of the pulp and consume it in large quantities.
Pour a teaspoon of blueberry leaves into 1 cup of boiling water, leave for 30 minutes, strain. Use for external treatment of wounds, ulcers, and also for douching as an astringent, antiseptic and anti-inflammatory agent.
Prepare an infusion of small-leaved linden flowers at the rate of 2–3 tablespoons of raw material per 2 cups of boiling water. Take orally. For external use, pour 4-5 tablespoons of flowers with 2 cups of boiling water and leave. Use the infusion for inflammation of the female genital organs.
Barberry helps well: pour 1/2 teaspoon of dried roots into a glass of water, boil for 30 minutes, strain and take 1 teaspoon 3 times a day.
We also recommend drinking lemon balm infusion 1/2 cup 3 times a day before meals. To prepare the infusion, take 4 teaspoons of dry herb and pour a glass of boiling water, leave for 1 hour, strain.
Use jasmine flowers and leaves. Take yasnotka both internally and externally - in the form of douching for inflammation of the genital organs. Infusion for internal use: pour 2–3 tablespoons of the herb into 0.5 liters of boiling water in a thermos (daily dose), leave to infuse. For external use, double the amount of herb.
Pour a tablespoon of yarrow herb into 1 cup of boiling water and boil for 10 minutes. Drink 1/3 glass 2-3 times a day before meals. Infusions and decoctions of yarrow are used as a hemostatic agent and accelerate blood clotting during external and internal bleeding (uterine bleeding from inflammatory processes and fibroids, intestinal, hemorrhoidal).
Flowers of sweet clover, herb of centaury, flowers of coltsfoot - equally. Pour a tablespoon of the mixture into a glass of water, boil for 15 minutes and strain. Take 1/3 cup 6 times a day for inflammation of the ovaries.
Pour 10 g of corn stalks with stigmas into 200 ml of boiling water. Prepare a decoction. Take 1 tablespoon every 3 hours. Use for women's diseases as a hemostatic, sedative, diuretic and choleretic agent.
Pour 10 g of herb tripartite into a glass of water at room temperature, boil in a water bath for 15 minutes, strain and cool. Take a tablespoon 3 times a day for uterine bleeding and inflammation of the genitals.
For inflammatory processes of the female genital organs, a decoction of thorn roots is used against leucorrhoea. Pour 5 g of roots or bark of branches with 1 glass of water and boil for 15 minutes. Drink in small sips, like tea. For douching, the broth is diluted with boiled water 1:1.

Every second woman in the world is diagnosed with adnexitis. The reason for contacting a gynecologist, as a rule, is persistent nagging pain in the lower abdomen and interruptions in the menstrual cycle. Adnexitis can be of different types depending on where the inflammatory process is localized. The gynecologist makes conclusions regarding the diagnosis based on the tests performed, the symptoms of inflammation of the appendages in the woman and prescribes treatment according to the research results.

Before starting treatment for inflammation of the uterine appendages, it is necessary to establish the cause of its development. By eliminating the source of the pathological process, you can easily get rid of unpleasant sensations and disturbances in the menstrual schedule. Factors that cause inflammation can be of infectious or non-infectious etiology.

Pathogenic microorganisms disrupt the normal functioning of organs. They enter the microflora in several ways:

from the vagina, passing through the cervix;
from nearby inflamed organs;
through lymph flow;
with the help of blood flow.

In girls and women, inflammation can develop due to:

negligent attitude towards personal hygiene;
inconstancy of sexual partner;
hypothermia, when a woman gets a cold in her appendages due to a draft, sitting on cold objects, etc.;
difficult childbirth;
infectious diseases that suppress the immune status;
inflammation and removal of the appendix;
medical gynecological interventions (abortion, installation and removal of contraceptives in the uterus, etc.).

How does the inflammatory process manifest itself?

If a woman has a cold in her appendages or their inflammation is caused by an infectious process, then the following signs may indicate pathology:

painful sensations in the lower abdomen, varying in intensity, can occur during sexual intercourse, physical activity or at rest, and can spread to nearby areas (lower back, hips, etc.);
disruptions in the menstrual schedule lead to a delay or early onset of menstruation, while the volume of discharge can be either less than usual or several times more;
the discharge acquires an uncharacteristic consistency, color, smell, and may be accompanied by vulvitis, burning or itching.

With cold appendages, symptoms are often accompanied by an increase in temperature up to 40°C. In addition, regardless of whether women have a cold or not, inflammation can cause other problems with the body:

weakness and apathy;
disorders of the digestive and gastrointestinal tract functions;
dysfunction of the genitourinary system;
pathologies of the endocrine system, in particular the thyroid gland;
nervousness and psycho-emotional disorders.

Clinically, a woman has an increased volume of leukocytes in the blood and an increase in ESR. During a gynecological examination, discomfort or even pain is felt upon palpation.

If the disease becomes chronic, then all the symptoms become less intense, but accompany the woman constantly.

What are the consequences of lack of treatment?

As with any other disease, if inflammation of the appendages is left untreated, women may experience complications:

infertility;
increased likelihood of ectopic pregnancy;
soldering in pipes;
purulent processes that require surgical intervention and sometimes removal of the uterine tubes.

Therapy for adnexitis cannot be delayed. It is better to go to a gynecologist who will tell you what and how inflammation of the appendages is treated in each individual case.

Traditional therapy

Most women are inclined to believe that treatment of adnexitis with folk remedies is in no way inferior to drug therapy. In many cases, indeed, home remedies help get rid of pathologies quite effectively. But in case of purulent processes, which are accompanied by an increase in temperature, it is better to postpone treatment with folk remedies and seek help from specialists. If the pathology is not so acute or has already become chronic, then alternative medicine recipes are quite suitable for therapy.

Medicines for douching

For treatment of inflammation of the appendages, you need to purchase a small syringe with a volume of 200 ml. Before each use and after, it should be rinsed well and doused with boiling water.

Recipes for internal use

In combination with douching, you can take any of the folk remedies for inflammation of the appendages given below:

Other treatments

There are other options to treat inflammation:

Preventive actions

In order not to treat inflammation of the appendages in the future, women are advised to follow the rules of prevention. They significantly reduce the likelihood of inflammation and do not require any serious effort:

All the rules will help prevent not only “women’s” diseases, but also improve overall well-being and health, since inflammation must be treated comprehensively - by taking medications and following a correct lifestyle. And it is always necessary to remember that preventing a disease is easier than treating it later.

Treatment of inflammatory diseases should be comprehensive and include:

1. Etiotropic treatment aimed at eliminating the pathogen. For this purpose, antibacterial drugs, sulfonamides are used, and when the specific etiology of the disease is identified, appropriate drugs are used;
2. Increased immune defense;
3. Increasing the body’s overall resistance to infections (using biostimulant drugs);
4. Physiotherapy;
5. In certain cases, in the absence of effect from conservative therapy, surgical treatment is used.

Pharmacotherapy

In the stage of exacerbation of the inflammatory process, complex treatment begins with antibacterial therapy. Antibiotics are used more often. Groups of penicillins, cephalosporins, thienamycins, macrolides, monobactams, chloramphenicol, aminoglycosides, polymyxins, rifamycins and other groups. Drugs in this group are effective against infections caused by gram-positive bacteria (streptococci, staphylococci, pneumococci, etc.), spirochetes and other pathogenic microorganisms. They have a bactericidal effect on microorganisms in the growth phase.

The antibacterial effect is associated with the specific ability of penicillins to inhibit the biosynthesis of the cell wall of microorganisms. This group includes drugs such as: benzylpenicillin sodium salt, phenoxymethylpenicillin, oxacillin sodium salt, methicillin sodium, ampicillin, ampiox sodium, sultamicillin (unasin), amoxicillin, ticarcillin-clavulanic acid (timentin), azlocillin (Securopen), carbenicillin (geopen), carfecillin, mezlocillin (baiben), cloxacillin (clobex), flucloxacillin, clonacom-R, piteracillin (psipen, piprax), bacampicillin (penbak), penamecillin (maripen).

The group of cephalosporins includes drugs such as:

cephalexin,
cefadroxil,
cefazolin,
cefapirin,
cefuroxine,
cefradine and others.

Also, drugs from the tetracycline group are used to treat inflammatory processes: tetracycline hydrochloride, doxycycline, monocycline and others. From the group of macrolides, oleandomycin, erythromycin, midecamycin (macropen), clarithromycin (clacid) are used. Complex preparations containing macrolides and tetracyclines are used: oletethrin, tetraolean, ericycline.

From the group of aminoglycosides, gentamicin, monomycin, kanamycin, amikacin, dibekacin, etc. are used. The group of polymexins is represented by the drugs polymexin B and polymexin M. From the group of rifamycins, rifampicin is used.

Sulfonamide drugs are also used to relieve the inflammatory process.

Sulfonamides have chemotherapeutic activity against infections caused by gram-positive and gram-negative bacteria, some protozoan chlamydia. Their action is associated mainly with the disruption of the formation by microorganisms of growth factors necessary for their development - folic and dihydrofolic acids and other substances, the molecule of which includes para-aminobenzoic acid. Sulfonamides are captured by the microbial cell instead of para-aminobenzoic acid and thereby disrupt the course of metabolic processes in it. From the group of sulfonamide drugs, sulfadimethoxine, sulfalene, biseptol, bactrim, sulfatone, groseptol, etc. are most often used.

Biogenic stimulants include preparations of animal and plant origin that, when introduced into the body, can have a stimulating effect and accelerate regeneration processes. Biostimulants used in medical practice include preparations from plants (aloe extract), animal and human tissue (placenta suspension), as well as from estuary mud (PhiBS) and peat (peat).

Aloe extract liquid for injection- a preparation made from canned, fresh or dried aloe leaves. 1 ml is injected under the skin daily (maximum daily dose 3-4 ml), for a course of 30-50 injections.

FiBS for injections- a biogenic stimulant from distilled estuary mud. 1 ml is injected under the skin once a day, for a course of 30-35 injections.

Peloid distillate- biogenic stimulant - a product of distillation of estuary mud. 1 ml is injected under the skin once a day, for a course of 30-35 injections.

Humisol— solution of sea healing mud fractions 0.01%. Used intramuscularly and by electrophoresis. It is administered intramuscularly, starting with 1 ml daily in the first 2-3 days; if well tolerated, continue administering 2 ml 1 time per day for 20-30 days.

Placenta extract for injection- aqueous extract from cold-preserved human placenta. Inject 1 ml under the skin daily or every other day.

Enzymes- drugs that have a targeted effect on the enzymatic processes of the body. In the treatment of gynecological diseases, enzyme preparations with proteolytic action (trypsin, chymotrypsin) are used. Trypsin is an endogenous enzyme that breaks peptide bonds in a protein molecule. The use of trypsin is based on its ability to break down necrotic tissue and fibrinous formations under local influence, to liquefy viscous secretions, exudates, and blood clots. Crystalline trypsin is administered intramuscularly at 5-10 mg 1-2 times a day for a course of 6-15 injections. Trypsin is also used using electrophoresis. The action of another enzyme preparation is similar to the action of trypsin.

In order to increase specific immune protection, drugs that correct immune processes are used. For this purpose, the following drugs are used: pyrogenal, prodigiosan, levomisol, glyceram.

Pyrogenal is a lipopolysaccharide formed during the life of microorganisms Pseudomonas aeruginosa and others; has a pyrogenic effect.

Vulvitis

Treatment is complex and includes the use of local and general restoratives. Treatment of concomitant diseases (diabetes, pustular lesions, helminthiasis, cervicitis, etc.) is indicated, during which vulvitis often develops. In case of acute vulvitis, two to three times a day, toilet the external genitalia with a warm solution of potassium permanganate (1:10000), warm infusion of chamomile, 2-3% boric acid solution, apply lotions with a solution of furatsilin (1:5000) 3-4 times per day, lubricating the vulva with 5% anesthetic ointment. For vulvitis caused by opportunistic microbes, furazolidone with polymyxin M sulfate in powder is prescribed locally. For subacute cases, sitz baths with potassium permanganate or chamomile infusion 2-3 times a day for 10 minutes are recommended.

Bartholinitis

In the acute stage, conservative pharmacotherapy: antibacterial agents (antibiotics, sulfonamides, nitrofurans, biseptol); analgesics (suppositories with belladonna, antipyrine, cefekop); Regional autohemotherapy 5-7 ml IM every other day. Local therapy: cryotherapy (30-40 minutes each; lotions with Burov’s liquid, lead water, furatsilin 1:5000). If the condition improves, physical therapy (UV rays, UHF, centimeter wave microwaves) is indicated; if there is no improvement (after 2-4 days), thermal procedures (heating pads, Sollux, Minin lamp) in combination with ointment applications (ichthyol, Vishnevsky ointment) are indicated.

Surgical treatment is performed in the presence of a gland abscess. In the chronic stage of the disease, non-drug treatment is carried out in the form of thermal procedures (mud, ozokerite, paraffin); laser therapy.

Colpitis

Pharmacotherapy. Etiotropic treatment is carried out with antibiotics and antibacterial agents after determining the sensitivity of the pathogen to them. The main method of application is local. Antibiotics are used in the form of irrigation with a mixture of penicillin 300,000 units and 5 ml of 0.25% lysozyme solution for 8 days; antibiotics are also used in the form of vaginal suppositories (penicillin or neomycin up to 100,000 units, furazolidone 0.05 g). Furazolidone is used in the form of vaginal sticks in combination with polymyxin M.

For colpitis, the use of locally estrogen-containing drugs is indicated: ointment (folliculin - 500 units, lapolin - 30 g); vaginal suppositories (folliculin - 500 units, boric acid - 0.1 g, cocoa butter - 1.5 g), or 3-5 drops of folliculin solution (1000 units) are instilled into the vagina, the course of treatment is 10-15 days. Local procedures include vaginal irrigation with solutions of potassium permanganate 1:6000, rivanol 0.5-0.1% for no more than 3-4 days. In case of a pronounced process, it is necessary to supplement local treatment with general treatment: it is possible to use Biseptol-480 orally, 2 tablets 2 times a day (morning and yesterday after meals), tetracycline 0.2 g 5 times a day, erythromycin 0.5 g 4 times a day . Biostimulants (aloe, fibs, vitreous, etc.) are also prescribed. For the purpose of immune stimulation - levamisole (Decaris) orally at the rate of 0.0025 g/kg for 3 days.

Non-drug treatment. Physiotherapy is used in the form of general ultraviolet irradiation, electrophoresis with a 1% solution of novocaine or a 10% solution of calcium chloride on the area of the external genitalia.

Endocervicitis

In the acute stage of the disease, etiotropic treatment is carried out (antibacterial, taking into account the sensitivity of microorganisms to antibiotics, sulfonamides). In the chronic form, therapy is carried out with immunomodulators (decaris, T-activin, 1 ml 0.01% solution subcutaneously). Local treatment is carried out after acute inflammatory phenomena have subsided: douching or baths with a 1-3% solution of protargol, 1-2% solution of argentum, 3% solution of hydrogen peroxide, vagotil, rivanol, furatsilin 1:5000; vaginal ointment tampons (with antibiotics, nitrofurans, glucocorticoids, antimycotic drugs); instillation of emulsions into the endocervix of levosin, course of treatment for 7 days.

Video

Treatment of inflammatory processes of nonspecific etiology of the upper genital organs

Acute endometritis

Pharmacotherapy includes general and local treatment. General treatment includes antibacterial therapy, immunostimulating and detoxification therapy.

Antibacterial therapy uses broad-spectrum antibiotics; It is advisable to simultaneously prescribe a combination of at least 2 antibiotics in maximum doses, taking into account the sensitivity of the microflora. The combinations include semisynthetic penicillins (6.0 g per day), zeporin, kefzol, cefamizin (6.0 g per day), kanamycin (2 g per day), gentamicin (160 mg per day), with the most effective combinations being ceporin and oxacillin, ampicillin and gentamicin, chloramphenicol and limcomycin. Antibiotics are supplemented with sulfonamides (etazol IV in the form of a 10% solution of 10.0 ml every 12 hours), nitrofurans (orally - 0.8 g per day, IV - 0.1% solution of furagin drip 400-800 ml), metronidazole (Klion) IV 100 ml every 8 hours at a rate of 5 ml per minute for 7 days. Tetracycline group drugs are also prescribed at a dose of 0.75 g per day intravenously every 8 hours. To prevent candidiasis, nystatin is prescribed 2 million units per day, levorin 1 million units per day. When treating endometritis, antibiotics are administered in a daily dose into the uterine muscle through the posterior fornix or under the endometrium.
The following are used as immunostimulants: timolin - 10 mg IM once a day for 7 days; T-activin - 1 ml of 0.01% solution IM once a day for 5 days; thymogen - 100 mcg intramuscularly for 5-7 days; immunoglobulin - 5 ml IM or IV every other day, 5 doses.
Anti-inflammatory therapy includes derivatives of salicylic acid (aspirin), pyrazolone (analgin, butadione), paraaminophenol (paracetamol), indoleacetic (indomethacin, methindol), proteonic (ibuprofen) acids. Prescribed in therapeutic doses, 1 tablet 3 times a day.
Detoxification therapy. The total volume of infusion is 1250 ml per day: rheopolyglucin 400 ml, blood plasma, 10% glucose solution 400 ml, Ringer's solution 250 ml. Therapy also includes vitamins and antihistamines. Local treatment includes vacuum aspiration of the uterine cavity, gentle uterine curettage and long-term intrauterine dialysis. Irrigation of the uterine cavity is carried out with solutions of antiseptics and antibiotics (solutions of furatsilin, hydrogen peroxide, dimexide, chlorophyllipt). Physiotherapy - pulsed ultrasound, electrophoresis of copper, zinc, laser therapy, vibration massage.

Chronic endometritis

The main therapeutic factors are physiobalneotherapy. The most commonly used magnetic fields are UHF, centimeter-wave microwaves, pulsed ultrasound, electrophoresis of copper and zinc. Therapeutic mud, ozokerite, paraffin, sulfide and radon waters (baths, irrigation) are effective. Desensitizing therapy is also prescribed - diphenhydramine, suprastin, pipolfen. During menstruation, broad-spectrum antibiotics are indicated.

Salpingo-oophoritis

Acute salpingoophoritis requires complex therapy:

antibacterial;
detoxification;
desensitizing;
immunotherapy;
enzyme therapy;
non-drug treatment.

1. During antibacterial therapy, treatment is carried out simultaneously with two or more antibiotics: a combination of semisynthetic penicillins (ampicillin, oxacillin, methicillin, ampiox) - 3.5 g / day, probenecid - 1 g orally, tetracycline - 0.5 g 4 times per day for 7 days. A combination of cephalosporins is possible - 2.0 g/day, intramuscularly, then tetracycline orally - 0.5 g 4 times a day for 7 days.

The following therapeutic combinations are considered the most effective:

a) doxycycline - 0.1-0.2 g/day orally for 7 days and cephalosporins (cephaloridine) 4.0 g/day. i/m; cephaliuin - 2.0-3.0 g/day. i/m, i/v; claferan - 2.0 g/day. i/m;

b) dalacin C - 300-600 mg IV, IM after 8-12 hours, then 900-1200 mg IV after 12 hours and gentamicin - daily dose 2.4-3.2 mg/kg body weight after 6-8 hours for 6-8 days; Brulamycin - daily dose 2-3 mg/kg body weight IM, IV after 6-8 hours; kanamycin - 1.5-2 g/day. in 8-12 hours.

The main antibiotics used in the treatment of acute salpingoophoritis belong to the group of penicillins, cephalosporins, aminoglycosides, macrolides, tetracyclines, chloramphenicol and antibiotics of different groups. In complex treatment, nitrofurans are also used - 0.3 g/day, metronidazole - 0.5-1.5 g/day; biseptol - 1.92 g/day, dimexide 20% IV solution with 100.0 ml of 5% glucose solution, chlorophyllipt - 0.25% solution - 2-4 ml IV in a stream 2-4 times a day - within 5-10 days.

2. Detoxification therapy includes infusion therapy: hemodez IV drip 100 ml once every 3-4 days, glucose-vitamin solutions - 1000-1500 ml with a complex of vitamins IV drip. The general infusion calculation is 40 ml per 1 kg of body weight.

3. Desensitizing therapy. Antihistamines are used - diphenhydramine, pipolfen, suprastin, tavegil; calcium chloride preparations, gluconate - 3% solution IV drip, 200 ml; autohemotherapy 5-7 ml IM according to the schedule; histaglobulin is administered subcutaneously, 2 ml every 3-4 days.

Glucocorticoids are indicated in the acute, subacute stage - prednisolone - 5 mg / day for 5 days, then according to a scheme of increasing doses for 25 days, then the dose is adequately reduced to the original one.

4. Immunotherapy. Thymalin is used intramuscularly at 10-20 mg for 5-10 days, tactivin - subcutaneously at 1 ml for 5-10 days, thymosin - subcutaneous at 1 mcg/kg body weight for 20-30 days. , thymogen - 100 mcg intramuscularly for 5-7 days, gamma globulin 12-15 ml of 10% solution intramuscularly once every 20 days for 3-4 injections; pyrogenal and prodigiosan are prescribed after the acute process has subsided.

5. Enzyme therapy. Lysozyme is used topically 0.5% emulsion, as well as intramuscularly; Trasylol - IV drip up to 50,000 units per day for 3 days.

6. Non-drug treatment. Cryotherapy - vaginal and external abdominal hypotherampia - up to 2-3.5 hours per day. Hyperbaric oxygenation - pressure 1.5-3 atm. - for 1-1.5 hours a day, course of treatment is 6-7 procedures. Also used are exchange plasmaphoresis, ultraviolet irradiation of blood, extracorporeal hemosorption, laser therapy, reflexology.

If complications of acute salpingoophoritis occur, the formation of saccular formations of the uterine appendages (pyosalpinx, ovarian abscess, tubo-ovarian formations), surgical treatment is indicated for patients.

Chronic salpingoophoritis

Treatment with antibiotics is indicated in cases of exacerbation of the process. Painkillers (paracetamol, indomethacin, etc.) are widely prescribed; sedatives and neurotropic drugs (nozepam, phenazepam); desensitizing agents (diphenhydramine, pipolfen); tonics (eleutherococcus, pantocrine, leuzea); hormonal correction of secondary ovarian hypofunction in accordance with functional diagnostic tests; enzymes (ronidase, lidase, trypsin, chymotrypsin, caripazim).

Physiotherapy uses ultrasound, phonophoresis, medicinal electrophoresis, UHF, microwave, magnetic fields; laser therapy, therapeutic exercises, therapeutic massage and psychotherapy.

Pelvioperitonitis

It is customary to distinguish between general and local therapy for peritonitis. Surgery is the mainstay in the treatment of peritonitis. Treatment of peritonitis is staged and includes preoperative preparation, surgical intervention, and intensive postoperative intervention.

Pharmacotherapy of pelvioperitonitis corresponds to the treatment regimen for acute salpingoophoritis. With timely initiation and proper treatment, it is often possible to avoid surgical intervention.

Parametritis

Treatment of parametritis, as well as pelvioperitonitis, involves complex therapy, including antibacterial therapy, desensitizing, detoxification therapy, symptomatic treatment, and physiotherapeutic treatment. If there is no effect from conservative therapy, surgical treatment is performed.

Treatment of inflammatory processes of the genital organs of specific etiology

Trichomoniasis

Treatment of trichomoniasis should be comprehensive and include specific therapy (antitrichomoniasis drugs) in combination with broad-spectrum antibiotics, immunostimulants, biostimulants, and vitamins. Treatment should be carried out both general and local.

For specific therapy, drugs of the imidazoles group (metronidazole, flagyl, trichopolum) are used according to the scheme.

Scheme No. 1
Day 1 - 1.5 g/day in 3 divided doses every 8 hours; Day 2 - 1.25 g/day in 3 divided doses every 8 hours; 3rd day 1.0 g/day; 4th day - 0.75 g/day; Day 5 - 0.5 g/day in 2 divided doses.

Scheme No. 2
1st day 0.5 g 2 times a day; 2nd day 0.25 g 3 times a day; then 4 days in a row, 0.25 g 2 times a day

Scheme No. 3
0.25 g 2 times a day (0.5 g/day); b) nitazol (alienitrazole, tricholaval) - 0.1 g 3 times a day; c) tinidazole (fasigin, triconidazole) - 2.0 g/day once (4 tablets with meals), or 0.5 g (1 tablet) every 15 minutes for an hour (2 g/day) - for 1 day.

The treatment regimen also includes nitrofurans (furagin 0.1-0.15 g 3 times a day, furadonin 0.1-0.15 g 4 times a day - 7 days), antibiotics (tetracycline 0.3 g 5 times a day , then 0.2 g 5 times a day - up to a course dose of 10.0 g, lithacycline 0.3 g 2-3 times a day, doxycycline - 0.3 g first dose, then 0.1 g 4 times a day ).

Locally prescribed: trichopolum 0.5 g/day (in tablets, suppositories), clotrimazole (1 vaginal suppository per day - 6 days), Klion-D (vaginal tablets: 500 mg metronidazole and 150 mg miconazole - 1 tablet in the vagina - 10 days), nitazol (in suppositories, suspensions - 15 days), irrigation with antibiotic solutions (gramicidin); pimafucin (1 tablet in the vagina - 20 days), powders from drugs of the nitrofuran group.

Immunotherapy includes drugs - pyrogenal, autohemotherapy, T-activin, thymalin. Biostimulants and vitamin therapy are carried out according to the generally accepted scheme.

Gonorrhea

Treatment of gonorrhea begins with antibacterial therapy - broad-spectrum antibiotics are used: benzylpenicillin - intramuscularly at 60,000 - 400,000 units every 3 hours (per course - 4.2-6.8 million units), bicillin 1, 3, 5 - intravenously /m 600,000 units after 24 hours (per course - 3.6 million units), ampicillin 0.5 g intramuscularly after 4 hours (per course - 8.0 g), ampiox - intramuscularly - 2.0 g/ day (course 15.0-21.0 g), oxacillin - orally 0.5 g 5 times a day (course - 10.0 - 14.0), caffecillin - orally 0.5 g 3 times a day ( course 5.0-8.0 g), chloramphenicol - orally 0.5 g 4 times a day (course 6.0-10.0 g), tetracycline - orally 0.3 g 5 times a day (course 5 .0-10.0 g), doxycycline - orally 0.1 g 2 times a day (course 1.0-1.5 g), rifampicin - orally 0.3-0.6 g 1-2 times a day day (course 1.5 g-6.0 g). Sulfonamides - biseptol 2 tablets 2 times (course 16-20 tablets), sulfatone - 2 tablets 2 times a day (course - 4.2 g - 7.0 g).

Immunotherapy

There are specific and nonspecific immunotherapy for gonorrhea. Specific immunotherapy involves the use of gonovaccine. The initial dose IM is 200-400 million microbial bodies after 1-2 days, then the dose is increased by 150-300 million and brought to 2 billion microbial bodies (6-8 injections). Nonspecific immunotherapy - pyrogenal (initial dose 25-50 MTD IM, increase by 25-50-100 MTD to the maximum dose (not higher than 1000 MTD) depending on the body's response, course - 10-15 injections; prodigiosan, autohemotherapy, levamisole , methyluracil.

To accelerate the regression of inflammatory infiltrates in the affected organs, biostimulants are prescribed, the course of treatment is from 15 to 25-30 days.

Candidiasis

Treatment of patients with genital candidiasis is carried out with antifungal antibiotics and synthetic drugs: amphotericin B - 50,000 units intravenously in 500.0 ml of 5% glucose solution - daily, course - 4-8 weeks (with breaks), total dose - 1.5 - 2 million units; amphoglucamine (in tablets) - 200,000 units 2 times a day for 10-14 days; mycoheptin - orally, 200,000-250,000 units 2 times a day, for 10-14 days; nystatin - orally, 500,000 units up to 1,000,000 units, per day up to 6,000,000-8,000,000 units, course - 14 days; levorin - 400,000 units orally 2-3 times a day for 10-12 days.

Vaginal suppositories of clotrimazole, polygynax, pimafucin, vaginal tablets of terzhinan, Klion-D, vaginal cream of batrafen are used locally. For prophylactic purposes, use nizoral at a dose of 200 mg/day for a long time (2-5 months).

Non-drug therapy includes physical therapy (ultrasound, diathermy, microwave, UHF, microwaves), balneotherapy, exercise therapy, and sanatorium-resort treatment.

Mycoplasmosis (ureaplasmosis)

Treatment begins with antibiotics active against mycoplasmas: doxycycline (vibramycin) - 100 mg 2 times a day for 10 days; course - 20 g; erythromycin - 500 mg 4 times a day for 14 days; tetracycline - 0.5 g 4 times a day for 1-2 weeks, course - up to 27.0 g. Gentamicin is administered intramuscularly at 40 mg every 8 hours for 5-7 days, course 600-840 mg.

In a hospital setting, you can use intravenous morphocycline with 5% glucose solution. Locally indicated are ointment tampons with 1-3% tetracycline ointment, 1% erythromycin ointment, vaginal tablets, cream, clotrimazole suppositories, Klion-D.

Of the non-drug treatments, the most indicated are physiotherapy - inductotherapy, UHF, electrophoresis, ultrasound, phonophoresis through tetracycline, erythromycin ointment, low-frequency pulsed currents, ozokerite, paraffin.

Tuberculosis of female genital organs

Treatment includes specific and nonspecific therapy.

Specific treatment involves the use of etiotropic chemotherapy, which has a bacteriostatic effect on mycobacteria. These are first-line drugs - derivatives of GINK: tubazid (single dose 0.3-0.6 g, daily 0.6-0.9 g), ftivazid (single dose 0.5-1.0 g, daily 1.0- 2.0 g), saluzide (single dose 0.5-1.5 g, daily dose -2.0 g), PAX - (single dose 4.0-5.0 g, daily dose 9.0-15.0) ;

Second-line drugs: ethionamide (single dose 0.25-0.5 g, daily dose 0.75-1.0 g); tibon, thioacetazone (single dose 0.03-0.005 g, daily dose - 0.06-0.1 g).

The most effective combinations of chemotherapy drugs are: GINK + kanamycin + PAS (Tibon - for intolerance); GINK+PASK; GINK + rifampicin + ethambutol; GINK + rifampicin + PAS; ethambutol + rifampicin, etc. In case of significant changes in the appendages, treatment is carried out with a triple combination of drugs (isoniazid, benemecin, ethambutol). Duration of treatment is 12-18 months.

Nonspecific therapy includes enzyme therapy (lidase 64 units intramuscularly for 30-40 days, or use suppositories with ronidase). Among the antioxidants, use a 30% solution of alpha-tocopherol acetate - 1 ml IM daily, course of 50-60 injections; 30% sodium thiosulfate solution - 10 ml IV every 1-2 days (course of 40-50 injections). Hydrotubation is carried out with a solution containing 30% sodium thiosulfate solution - 10 ml, lidase - 64 units, penicillin 1 million units, novocaine 0.25% solution.

Non-drug treatment includes physiotherapy. SMT electrophoresis, phonophoresis with hydrocortisone, mud therapy, balneotherapy.

If there is no effect from conservative therapy and there are indications, surgical treatment is performed.