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

However, inflammation can also 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, it is necessary to seek advice and diagnostics from a specialist who will prescribe the necessary and effective drug in each individual case.

Prescribes a course of treatment and selects the necessary drug - only a doctor. 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 can even proceed without any symptoms, and sometimes the signs of the disease appear later and in the following form:

weakness, fatigue, decreased activity
(allocations can be scarce, or, on the contrary, abundant)
purulent vaginal discharge
frequent pain in the lower abdomen, may increase during sexual intercourse.

Antibiotic treatment

Antibiotics for female inflammation are the most effective and common treatment. In this situation, only the 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 get used to drugs, so the choice of antibiotics must be approached especially carefully.

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

diseases:

macrolides (azithromycin)
tetracyclines (Doxacycline)
lincosamides (clindamycin)
penicillins (Ampicillin, Oxacillin)
nitroimidazoles (Metronidazole).

The antibiotic itself, as well as its dosage, the number of doses and the 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.

In no case should you choose antibiotics on your own, with such a choice you can only harm your body.

In the event that the wrong treatment was prescribed, or untimely, there may be serious complications, up to future treatment only by surgery.

Consequences of inflammation

Inflammation of the appendages can lead to a temporary, and if you let this disease take its course, then even to the loss of a woman's reproductive function.

In order for a spermatozoon to fertilize an egg, several favorable conditions must coincide. Even if unprotected sexual intercourse was performed, when spermatozoa enter the woman's genitals, they encounter a number of obstacles on their way to the cervix that many are unable to overcome.

If treatment is not started in time, then a woman may develop a disease such as endometritis, in which the uterine mucosa is already inflamed. In this case, there will be acute pain in the lower abdomen, decreased sexual desire, 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 malaise. 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 genitals, 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.

The appendages of a woman are affected during the active hematogenous spread of microorganisms from their primary place of formation. In some cases, inflammation of the appendages may be due to appendicitis, tuberculosis, or bronchitis. In others, these are viruses that are only transmitted sexually. But in both cases, complex therapy with the use of antibiotics is necessary.

In parallel with taking antibiotics, be sure to take. Otherwise, the treatment process will be quite protracted, the woman will always feel tired and prone to loss of strength, nausea, dizziness, and the activity of the kidneys and liver may be disturbed in connection with this.

Against the background of treatment with strong antibiotics, almost all normal flora is destroyed in the body, which can lead to rapid addiction of viral microorganisms to the drug, which will only aggravate the situation.

In order to prevent the possibility of inflammation of the female appendages, in the treatment of infectious diseases in the body, it is necessary to take funds that act as prophylactic drugs for 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, strong menstrual flow, intolerance to light irritants, etc., then it is necessary to carry out infusion therapy for the patient, which can several times accelerate the time of onset of the drugs . During treatment, an adhesive disease may begin, in this case, in addition to antibiotics, resolving therapy is also used.

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

Treatment must be started as soon as possible, since at the initial stage of inflammation, this disease is treated quickly with the use of non-potent antibiotics.

The specialist in the video will tell about inflammation of the appendages, their treatment:

Liked? Like and save on your page!

Types of inflammation

Gynecological diseases are divided according to the duration of the course: acute (their duration is up to 3 weeks), subacute (duration up to 1.5 months), chronic (lasting more than sixty days).

By type of causative agent of inflammation are:

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

In nature, there are approximately 50 infectious diseases that can be "earned" 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 disease endometritis, adnexitis, pelvic peritonitis.

Features

The inflammatory disease has not a clear clinical picture. In women, symptoms can be either general, affecting the whole 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 in the lower back and abdomen;
vaginal discharge changes its character, color and smell;
there may be irregularities in the monthly cycle, as well as difficulty urinating.

The disease can be acute, then the symptoms of inflammation in a feminine way acquire the same color: fever, severe abdominal pain, a blood test shows a change in indicators.

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

Treatment

How to treat inflammation? Inflammatory diseases in gynecology are treated with antibiotics. It is by far the most effective treatment for inflammation. Since microorganisms get used to antibiotics very quickly, their choice must be approached with great care. To do this, the doctor during the examination 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 of different groups at once.

Self-selection of antibiotics can irreparably harm the body.

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

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

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

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

In the event that the conservative treatment of inflammation in a feminine way has not brought the desired results, they resort to surgical intervention.

Complications

If the disease is not treated for a long time, various complications may occur, including: metabolic processes begin to have disturbances, errors occur in the endocrine system, malfunctions in the vegetative-vascular system. In the tissues, blood circulation is disturbed, the egg matures, but with disorders. Common inflammation in gynecology can cause the formation of adhesions in the tubes, as well as infertility.

As a result of past female diseases, the monthly cycle may be disrupted, 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 pass, 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 a 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.

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 effects of inflammatory pathogens of a particular organ. The disease is very common and is in first place 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 bacillus, fungi, viruses. They enter the genitals through 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; temperature rise; purulent discharge.

Treatment

Treatment of inflammation of the female genital organs begins with the elimination of the cause that provoked the development of the inflammatory process. In addition, treatment of 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 genital organs with a warm solution of potassium permanganate, boric acid, Chlorhexidine.
External treatment with antibacterial drugs: Macmirror.
Use of vaginal suppositories: Terzhinan, Polygynax.
The use of vitamin complexes, which include vitamin A and E.
In the presence of manifestations, the drug Solcoseryl or sea buckthorn oil is used.
Antihistamines, if there are complaints of itching: Suprastin, Tavegil, Desloratadine.
In some cases, it is advisable to prescribe hormonal drugs for both local treatment and oral administration. Such treatment may be required during the treatment of patients of older age groups.

The exact treatment regimen is determined on an individual basis after a comprehensive examination.

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

Folk remedies

20 g of noble laurel per bucket of water. Use for sitz baths in diseases of the uterus and bladder.
A tablespoon of St. John's wort herb pour 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 chopped walnut leaves with a glass of boiling water. Insist 4 hours. Drink for a day.
Take 1 part sweet clover grass and 10 parts coltsfoot grass. Pour a tablespoon of the mixture with a glass of boiling water. Insist on a water bath for 15 minutes, cool and strain. Drink 1/2 cup 3 times a day for inflammation of the appendages.
The juice of fresh aloe leaves is taken orally in a dessert spoon 2-3 times a day before meals.
From vulvitis there is an effective infusion, which is prepared within an hour. It will relieve both pain and unpleasant tickling. All other remedies for inflammation of the labia are prepared from a week to a month. Grind the root of badan thick-leaved, pour 200 ml of boiling water and cover the vessel with a lid. Leave to stand at room temperature. After an hour, you can make lotions. The more often the procedure is carried out, the faster the itching will pass.
Pass the raw pumpkin through a meat grinder, squeeze the juice from the pulp and consume it in large quantities.
Pour a teaspoon of blueberry leaves with 1 cup of boiling water, leave for 30 minutes, strain. Apply for external treatment of wounds, ulcers, as well as for douching as an astringent, antiseptic and anti-inflammatory agent.
An infusion of small-leaved linden flowers is prepared at the rate of 2-3 tablespoons of raw materials for 2 cups of boiling water. Take inside. For external use, pour 4-5 tablespoons of flowers with 2 cups of boiling water, insist. The infusion is used for inflammation of the female genital organs.
Barberry helps well: pour 1/2 teaspoon of dry roots with 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 grass and pour a glass of boiling water, leave for 1 hour, strain.
Use the flowers and leaves of the mint. Lasnotka is taken both internally and externally - in the form of douching for inflammation of the genital organs. Infusion for internal use: pour 2-3 tablespoons of herbs into 0.5 liters of boiling water in a thermos (daily rate), insist. For external use, double the amount of herb.
Pour a tablespoon of yarrow herb with 1 cup of boiling water, boil for 10 minutes. Drink 1/3 cup 2-3 times a day before meals. Infusions and decoctions of yarrow are used as a means of hemostatic and accelerating blood clotting in external and internal bleeding (uterine bleeding from inflammatory processes and fibromyomas, intestinal, hemorrhoidal).
The flowers of the sweet clover, the herb of the centaury ordinary, the flowers of the common coltsfoot - equally. Pour a tablespoon of the mixture with a glass of water, boil for 15 minutes and strain. Take 1/3 cup 6 times a day for inflammation of the ovaries.
10 g of corn columns with stigmas pour 200 ml of boiling water. Prepare a decoction. Take 1 tablespoon every 3 hours. Use in women's diseases as a hemostatic, sedative, diuretic and choleretic agent.
Pour 10 g of the herb of the tripartite sequence with 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 genital organs.
In inflammatory processes of the female genital organs, a decoction of blackthorn roots is used against whiter. 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 decoction 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 pulling persistent 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 draws 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 results of the studies.

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, it will be possible to easily get rid of discomfort and irregularities in the menstruation schedule. Factors that cause inflammation can be infectious and non-infectious etiologies..

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

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

In girls and women, inflammation can develop due to:

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

How does the inflammatory process manifest itself?

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

pain in the lower abdomen, different in intensity, can occur during sexual intercourse, physical exertion or at rest, can spread to nearby areas (lower back, hips, and others);
disruptions in the menstrual schedule lead to a delay or early onset of menstruation, while the amount of discharge can be either less than usual or several times greater;
discharge acquire an uncharacteristic texture, color, smell, may be accompanied by vulvitis, burning or itching.

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

weakness and apathy;
disorder of functions of digestion and digestive tract;
dysfunction of the genitourinary system;
pathology 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, an increase in ESR. During a gynecological examination, discomfort or even pain is felt on palpation.

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

What is the risk of not treating

As with any other disease, in the absence of treatment for inflammation of the appendages in women, complications may occur:

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

Therapy for adnexitis should not 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.

folk therapy

Most women are inclined to believe that the 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 with purulent processes, which are accompanied by an increase in temperature, it is better to postpone treatment with folk remedies, turning to specialists for help. 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 with inflammation of the appendages, you must purchase a small syringe with a volume of 200 ml. Before each use and after it should be well washed and poured over with boiling water.

Recipes for internal use

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

Other treatments

There are other ways 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 developing inflammation and do not require any serious effort:

All the rules will help prevent not only "female" diseases, but also improve overall well-being and health, since inflammation should be treated in a complex way - taking medications and observing the right lifestyle. And it is always necessary to remember that it is easier to prevent a disease than to treat 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 a specific etiology of the disease is detected, appropriate drugs are used;
2. Increased immune protection;
3. Increasing the overall resistance of the organism to infections (drugs of the biostimulant group are used);
4. Physiotherapy;
5. In certain cases, in the absence of the effect of conservative therapy, surgical treatment is used.

Pharmacotherapy

In the stage of exacerbation of the inflammatory process, complex treatment begins with antibiotic therapy. More often antibiotics are used. Groups of penicillins, cephalosporins, thienamycins, macrolides, monobactams, chloramphenicol, aminoglycosides, polymyxins, rifamycins and other groups. Preparations of this group are effective in 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 (unazine), amoxicillin, ticarcillin-clavulanic acid (timentin), azlocillin (securopen), carbenicillin (geopen), carfecillin, mezlocillin (baiben), cloxacillin (clobex), flucloxacillin, klonakom-R, piteracillin (psipen, pipraks), bacampicillin (penbak), penamecillin (maripen).

The group of cephalosporins includes drugs such as:

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

Also, for the treatment of inflammatory processes, drugs of the tetracycline group are used: 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, erycycline.

From the group of aminoglycosides, gentamicin, monomycin, kanamycin, amikacin, dibekacin, etc. are used. Polymexin B and polymexin M are drugs from the group of rifamycins. Rifampicin is used from the rifamycin group.

Sulfa drugs are also used to stop the inflammatory process.

Sulfonamides have chemotherapeutic activity in infections caused by gram-positive and gram-negative bacteria, some protozoa chlamydia. Their action is mainly associated with a violation of the formation by microorganisms necessary for their development of growth factors - folic and dihydrofolic acids and other substances, the molecule of which includes para-aminobenzoic acid. Sulfanilamides 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 sulfanilamide drugs, sulfadimethoxin, sulfalene, biseptol, bactrim, sulfatone, groseptol, etc. are more often used.

Biogenic stimulants include preparations of animal and vegetable origin, which, 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 tissues (placental suspension), as well as from firth mud (FIBS) and peat (peat).

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

FiBS for injections- a biogenic stimulant from the distillation of firth mud. Enter under the skin 1 ml once a day, for a course of 30-35 injections.

Peloid distillate- a biogenic stimulator - a product of distillation of firth mud. Enter under the skin 1 ml once a day, for a course of 30-35 injections.

Humisol- solution of fractions of sea therapeutic mud 0.01%. Apply intramuscularly and by electrophoresis. Intramuscularly injected, starting with 1 ml daily in the first 2-3 days, with good tolerance, continue the introduction of 2 ml 1 time per day for 20-30 days.

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

Enzymes- drugs that have a directed effect on the enzymatic processes of the body. In the treatment of gynecological diseases, proteolytic enzyme preparations (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 tissues and fibrinous formations under local action, to thin viscous secrets, 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 by electrophoresis. The action of another enzymatic preparation is similar to the action of trypsin.

In order to increase specific immune protection, drugs that correct the processes of immunity are used. For this, drugs are used: pyrogenal, prodigiosan, levomisole, glyceram.

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

Vulvitis

Treatment is complex, including the use of local and restorative agents. Treatment of concomitant diseases (diabetes, pustular lesions, helminthiases, cervicitis, etc.) is indicated, in the phase of which vulvitis often develops. In acute vulvitis, two to three times a day, the toilet of the external genital organs is carried out with a warm solution of potassium permanganate (1: 10000), warm infusion of chamomile, 2-3% solution of boric acid, lotions with a solution of furacilin (1: 5000) are used 3-4 times per day, lubrication of the vulva with 5% anesthesin ointment. With vulvitis caused by opportunistic microbes, furazolidone with polymyxin M sulfate in powder is prescribed topically. In subacute course, sitz baths with potassium permanganate or chamomile infusion are recommended 2-3 times a day for 10 minutes.

Bartholinitis

In the acute stage, conservative pharmacotherapy: antibacterial agents (antibiotics, sulfonamides, nitrofurans, biseptol); analgesics (suppositories with belladonna, antipyrine, cefekop); autohemotherapy regional 5-7 ml / m every other day. Local therapy: cryotherapy (30-40 minutes each; lotions with Burov's liquid, lead water, furacilin 1:5000). When the condition improves, physiotherapy is indicated (KUV rays, UHF, microwaves in the centimeter range); in the absence of improvement (after 2-4 days), thermal procedures are shown (heaters, solux, Minin's lamp) in combination with ointment applications (ichthyol, Vishnevsky ointment).

Surgical treatment is performed in the presence of an abscess of the gland. In the chronic stage of the disease, non-drug treatment is carried out in the form of thermal procedures (mud, ozocerite, 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 of a mixture of penicillin 300,000 IU and 5 ml of a 0.25% solution of lysozyme 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). In the form of vaginal sticks, furazolidone is used in combination with polymyxin M.

With 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. Of the local procedures, vaginal irrigation with solutions of potassium permanganate 1:6000, rivanol 0.5-0.1% is used for no more than 3-4 days. With a pronounced process, it is necessary to supplement local treatment with a general one: it is possible to use Biseptol-480 orally, 2 tablets 2 times a day (in the morning and yesterday after meals), tetracycline 0.2 g 5 times a day, erythromycin 0.5 g 4 times a day . Biostimulants are also prescribed (aloe, fibs, vitreous, etc.). For the purpose of immune stimulation - levomisole (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 1% novocaine solution or 10% calcium chloride solution on the vulva area.

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, immunomodulator therapy is carried out (decaris, T-activin, 1 ml of a 0.01% solution subcutaneously). Local treatment is carried out after subsiding of acute inflammatory phenomena: douching or baths with 1-3% protargol solution, 1-2% argentum solution, 3% hydrogen peroxide solution, vagotil, rivanol, furacilin 1:5000; vaginal ointment tampons (with antibiotics, nitrofurans, glucocorticoids, antimycotic drugs); instillation of emulsions into the endocervix of levosin, the course of treatment is 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 antibiotic therapy, immunostimulating and detoxification therapy.

In antibacterial therapy, broad-spectrum antibiotics are used; 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 semi-synthetic penicillins (6.0 g per day), tseporin, kefzol, cefamisin (6.0 g per day), kanamycin (2 g per day), gentamicin (160 mg per day), while combinations of tseporin are the most effective. 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 after 12 hours), nitrofurans (inside - 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. Also, drugs of the tetracycline group are prescribed at a dose of 0.75 g per day intravenously after 8 hours. For the prevention of candidiasis, nystatin is prescribed 2 million units per day, levorin 1 million units per day. In the treatment of endometritis, the administration of antibiotics in a daily dose into the uterine muscle through the posterior fornix or under the endometrium is used.
The following are used as immunostimulants: thymolin - 10 mg intramuscularly 1 time per day for 7 days; T-activin - 1 ml of a 0.01% solution i / m 1 time per day for 5 days; thymogen - 100 mcg intramuscularly for 5-7 days; immunoglobulin - 5 ml intramuscularly or intravenously every other day, 5 doses.
Anti-inflammatory therapy includes derivatives of salicylic acid (aspirin), pyrazolone (analgin, butadione), para-aminophenol (paracetamol), indolacetic (indomethacin, metindol), proteonic (ibuprofen) acids. Assigned in therapeutic doses of 1 tablet 3 times a day.
Detoxification therapy. The total infusion volume is 1250 ml per day: rheopolyglucin 400 ml, blood plasma, 10% glucose solution 400 ml, Ringer's solution 250 ml. The therapy also includes vitamins and antihistamines. Local treatment includes vacuum aspiration of the uterine cavity, gentle curettage of the uterus, and long-term intrauterine dialysis. Irrigation of the uterine cavity is carried out with solutions of antiseptics and antibiotics (solutions of furacilin, hydrogen peroxide, dimexide, chlorophyllipt). Physiotherapy - pulsed ultrasound, electrophoresis of copper, zinc, laser therapy, vibration massage.

Chronic endometritis

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

Salpingoophoritis

Acute salpingo-oophoritis provides for complex therapy:

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

1. In antibacterial therapy, treatment is carried out simultaneously with two or more antibiotics: a combination of semi-synthetic penicillins (ampicillin, oxacillin, methicillin, ampiox) - 3.5 g / day, probenecid - 1 g orally, tetracycline - 0.5 g 4 times per day for 7 days. Perhaps a combination of cephalosporins - 2.0 g / day, intramuscularly, then tetracycline inside - 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. in / m, in / in; claferan - 2.0 g / day. in / m .;

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

The main antibiotics used in the treatment of acute salpingo-oophoritis 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% solution in / in with 100.0 ml of 5% glucose solution, chlorophyllipt - 0.25% solution - 2-4 ml in / in jet 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 total infusion calculation is 40 ml per 1 kg of body weight.

3. Desensitizing therapy. Apply antihistamines - diphenhydramine, pipolfen, suprastin, tavegil; preparations of calcium chloride, gluconate - 3% solution in / in drip of 200 ml; autohemotherapy 5-7 ml / m according to the scheme; histaglobulin is injected s / c 2 ml every 3-4 days.

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

4. Immunotherapy. Timalin is used intramuscularly at 10-20 mg for 5-10 days, taktivin - s / c 1 ml for 5-10 days, thymosin - s / c 1 mcg / kg of body weight for 20-30 days , thymogen - 100 mcg intramuscularly for 5-7 days, gamma globulin 12-15 ml 10% solution intramuscularly 1 time in 20 days 3-4 injections; pyrogenal and prodigiosan are prescribed after the acute process subsides.

5. Enzyme therapy. Lysozyme is used topically in a 0.5% emulsion, as well as in / m; trasilol - in/in drip up to 50,000 units per day for 3 days.

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

In the event of complications of acute salpingo-oophoritis, 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. Widely prescribed painkillers (paracetamol, indomethacin, etc.); 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).

From physiotherapy, ultrasound, phonophoresis, drug electrophoresis, UHF, microwave, magnetic fields are used; laser therapy, therapeutic exercises, therapeutic massage and psychotherapy.

Pelvioperitonitis

It is accepted to allocate general and local therapy of peritonitis. Surgery is central to the treatment of peritonitis. Treatment of peritonitis is staged and includes preoperative preparation, surgical intervention, intensive in the postoperative period.

Pharmacotherapy of pelvioperitonitis corresponds to the treatment regimen for acute salpingo-oophoritis. With timely started and properly conducted treatment, it is often possible to avoid surgical intervention.

Parametritis

Treatment of parametritis, as well as pelvioperitonitis, provides for complex therapy, including antibacterial therapy, desensitizing, detoxification therapy, symptomatic treatment, and physiotherapy. In the absence of the effect of conservative therapy, surgical treatment is performed.

Treatment of inflammatory processes of the genital organs of a specific etiology

Trichomoniasis

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

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

Scheme No. 1
1st day - 1.5 g / day in 3 doses after 8 hours; 2nd day - 1.25 g / day in 3 doses after 8 hours; 3rd day 1.0 g/day; 4th day - 0.75 g / day .; 5th day - 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, litacycline 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 of metranidazole and 150 mg of 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 antibiotic therapy - broad-spectrum antibiotics are used: benzylpenicillin - intramuscularly at 60,000 - 400,000 IU after 3 hours (per course - 4.2-6.8 million IU), bicillin 1, 3, 5 - in / m 600000 IU after 24 hours (for the course - 3.6 million IU), ampicillin 0.5 g / m after 4 hours (for the course - 8.0 g), ampioks - in / m - 2.0 g / days (course 15.0-21.0 g), oxacillin - inside 0.5 g 5 times a day (course - 10.0 - 14.0), coffecillin - inside 0.5 g 3 times a day ( course 5.0-8.0 g), levomycetin - inside 0.5 g 4 times a day (course 6.0-10.0 g), tetracycline - inside 0.3 g 5 times a day (course 5 0-10.0 g), doxycycline - inside 0.1 g 2 times a day (course 1.0-1.5 g), rifampicin - inside 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), sulfaton - 2 tablets 2 times a day (course - 4.2 g - 7.0 g).

Immunotherapy

Allocate specific and nonspecific immunotherapy for gonorrhea. Specific immunotherapy involves the use of gonovaccine. The initial dose of IM is 200-400 million microbial bodies in 1-2 days, then the dose is increased by 150-300 million and adjusted to 2 billion microbial bodies (6-8 injections). Nonspecific immunotherapy - pyrogenal (initial dose 25-50 MPD IM, increased by 25-50-100 MPD to the maximum dose (not higher than 1000 MPD) 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 - intravenously 50,000 IU in 500.0 ml of 5% glucose solution - daily, course - 4-8 weeks (with interruptions), total dose - 1.5 - 2 million units; amphoglucamine (tablets) - 200,000 IU 2 times a day for 10-14 days; mycoheptin - inside 200,000-250,000 IU 2 times a day, for 10-14 days; nystatin - orally, 500,000 IU up to 1,000,000 IU, up to 6,000,000-8,000,000 IU per day, course - 14 days; levorin - inside 400,000 IU 2-3 times a day for 10-12 days.

Locally apply vaginal suppositories of clotrimazole, polygynax, pimafucin, vaginal tablets of terzhinan, Klion-D, vaginal batrafen cream. For prophylactic purposes, Nizoral is used at a dose of 200 mg / day for a long time (2-5 months).

From non-drug therapy, it is necessary to carry out physiotherapy (ultrasound, diathermy, microwave, UHF, microwaves), balneotherapy, exercise therapy, spa treatment.

Mycoplasmosis (ureaplasmosis)

Treatment begins with antibiotics that are 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, the course is up to 27.0 g. Gentamicin is administered intramuscularly at 40 mg every 8 hours for 5-7 days, the course is 600-840 mg.

In a hospital setting, you can use morphocycline IV with 5% glucose solution. Ointment swabs with 1-3% tetracycline ointment, 1% erythromycin ointment, vaginal tablets, cream, clotrimazole suppositories, Klion-D are shown locally.

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

Tuberculosis of the female genital organs

Treatment includes specific and non-specific therapies.

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

Second-line drugs: ethionamide (single dose 0.25-0.5 g, daily 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 - with intolerance); GINK+PASK; GINK + rifampicin + ethambutol; GINK + rifampicin + PAS; ethambutol + rifampicin, etc. With significant changes in the appendages, treatment is carried out with a triple combination of drugs (isoniazid, benemycin, ethambutol). The duration of treatment is 12-18 months.

Nonspecific therapy includes enzyme therapy (lidase 64 IU IM for 30-40 days, or suppositories with Ronidase are used). Of the antioxidants, a 30% solution of alpha-tocopherol acetate is used - 1 ml intramuscularly daily, a course of 50-60 injections; 30% sodium thiosulfate solution - 10 ml IV every 1-2 days (course 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.

From non-drug treatment, physiotherapy is used. SMT electrophoresis, phonophoresis with hydrocortisone, mud therapy, balneotherapy.

In the absence of the effect of conservative therapy and the presence of indications, surgical treatment is performed.