Oophoritis— inflammation in the ovaries, which leads to the defeat of the genitourinary system of the girl / woman. Has a danger to the reproductive system.

Inflammation in the ovary can cause inflammation in the fallopian tubes. The disease appears both in one ovary (then one-sided oophoritis is diagnosed), and in two at once, which is called bilateral oophoritis. If inflammation develops both in the ovaries and in the uterine appendages, they speak of adnexitis or salpingo-oophoritis.

Causes and pathogens

The disease can be triggered by such pathologies:

• chlamydia
• gonorrhea
• T richomoniasis
• tuberculosis
• staphylococci (rare)
• streptococci
• Candida

The following factors influence the development of the disease:

• menstrual cycle
• hypothermia
• surgical procedures on the genitals
• abortions
• installation of an intrauterine device

Inflammation of the ovaries in most cases is a secondary process. This means that the infection first develops in the fallopian tubes, uterus or cervical canal, and then moves upward. In rare cases, pathogens of oophoritis penetrate the gonads through the lymph and blood.

If the disease is not treated, the infection spreads to the fallopian tubes, as a result of which they thicken. Pathological changes in the ovaries negatively affect periadnexitis, and the accumulated inflammatory exudate causes the accumulation of pus and forms a pyovar. Infection in the future may go beyond the ovary and be accompanied by pelpioperitonitis. Oophoritis can also be caused by appendicitis, from which the infection spreads to the ovaries.

Oophoritis develops actively if the following factors are present:

• diseases of the endocrine system
• infections in the body that develop chronically
• stressful situations and overwork
• diseases of the genitourinary system
• no permanent sexual partner
• unprotected intercourse
• smoking
• promiscuity

Symptoms of oophoritis

Manifestations may vary depending on the stage of the pathological process. The stage can be identified by palpation and ultrasound, which makes it possible to determine swelling, tissue changes and soreness of the ovaries. Pathology can be acute, subacute and chronic, depending on which the symptoms differ.

Acute oophoritis is manifested by a number of such signs:

• disruption of the gastrointestinal tract
• general weakness
• high fever, chills
• painful urination
• headaches and muscle pain
• uterine bleeding
• purulent discharge from the vagina
• sharp pain during intercourse
• intense pain in the lower abdomen

In the acute form of the disease, the ovaries are very enlarged due to the inflammatory process and swelling, and pain appears on palpation. It is necessary to hospitalize the patient and treat in a hospital.

For the chronic form of oophoritis, the following symptoms are characteristic:

• lower abdominal pain during intercourse
• menstrual irregularities
• dull and aching pains in the groin and vagina, which become stronger during critical days and with the development of pathologies of various nature
• systematic "awakening" of the disease after remission due to cooling of the body, fatigue and infection in the body
• unproductive attempts at conceiving a child
• leucorrhea (constant scanty discharge)

Chronic oophoritis occurs if the acute form of the disease is not treated. Pathology is diagnosed most often when trying to understand the reason for the impossibility of conception or when contacting a doctor with menstrual irregularities. The ovaries, as found on palpation (palpation by a doctor), are dense in consistency, located behind the uterus.

The chronic form of the disease leads to the following consequences:

• decrease in working capacity
• sleep problems
• fast fatiguability
• irritability
• mood swings

Acute oophoritis

For this form of the disease, symptoms such as pain when you go to the toilet, constant pain in the lower abdomen, spotting and purulent discharge from the vagina, and impaired ovarian function are typical. The temperature may rise. Patients often suffer without sleep, become irritable and lethargic. During intercourse, discomfort and pain arise, therefore, girls with acute oophoritis do not experience any desire for intimacy. The appendages are enlarged, pain is present.

Pathological changes occur in the structure of the fallopian tube. It is soldered to the ovary, forming a single inflamed area. When melting the tissues of the ovary, purulent discharge from the fallopian tube is noted. The body is intoxicated. If acute oophoritis is unilateral, then the disease can quickly spread to a healthy ovary. In this case, we can talk about a bilateral lesion, which is quite difficult to treat. Inflammation leads to the futility of attempts to conceive a child.

Treatment comes only in the hospital. A sick girl/woman is prescribed antibiotic painkillers. In the process of recovery, physiotherapeutic and balneological procedures are prescribed to prevent the disease. Vitamins should also be included in the complex therapy. Vaginal suppositories are also prescribed, which helps to prevent relapses.

Subacute oophoritis

This form is very rare. It occurs due to tuberculosis or mycotic infectious lesions of the body. Symptoms are the same as described above, but less pronounced.

If the subacute form of the pathology is diagnosed in time and correctly treated, then a full recovery occurs. If left untreated, the disease transforms into a chronic form, which is characterized by remissions and periods of exacerbation, which complicates treatment.

Chronic oophoritis

The chronic form of oophoritis is a long-term inflammatory process in the ovaries that occurs if the human body is weakened. For a long time, you may not be aware of the pathology, because there will be no clear symptoms. The consequences are very dangerous: adhesions of the fallopian tubes and infertility.

Typical symptoms of chronic oophoritis:

• aching dull pains in the lower abdomen and in the groin, aggravated before the onset of critical days, with SARS and hypothermia
• irregular cycle
• regular copious leucorrhoea (discharge)
• inability to get pregnant
• feeling tired, irritable, insomnia
• sharp pain during intercourse

Oophoritis can be left-sided, right-sided and bilateral. With bilateral symptoms are blurred, the treatment is difficult. Treatment of the chronic form of the disease is aimed at eliminating the inflammatory process and pain, restoring the protective properties of the immune system and the lost functions of the female reproductive system. The doctor must not only cure the disease itself, but also the nervous and hormonal disorders that affect women's health.

Exacerbations of oophoritis are treated with immunomodulators. A combination of medication and alternative treatment helps. Folk remedies suggest using herbal medicinal decoctions, making baths, douches and tampons out of them. It is also important to eliminate such a symptom as pain, because it affects the state of the cardiovascular and nervous system, provokes nervousness, chronic fatigue and irritability. Antibacterial treatment is indicated in the subacute and acute stages of oophoritis, as well as during exacerbation of the inflammatory process.

Exacerbation of chronic oophoritis

This is a fairly common phenomenon that occurs due to weakened immunity and prolonged inflammation. Treatment is the same as for acute oophoritis. Most often, the disease worsens before the planned menstruation. Complaints of abdominal pain, purulent vaginal discharge, general malaise, etc. are typical. Treatment can be inpatient or outpatient. If a tumor process or a focus of suppuration was detected during oophoritis, then this is an indication for surgery. Methods of physiotherapy and balneotherapy are preventive.

Left-sided oophoritis

If you have been diagnosed with left-sided oophoritis, this means that the pathological process has affected only the left ovary. The reason lies in gynecological interventions, infectious diseases of the genital organs, stress, weak immunity and cooling (for example, you sat in the cold for a long time).

With left-sided oophoritis, pain is felt only on the left. Typically, an increase in temperature, which does not go away when taking antipyretics. Between periods, bleeding may occur, in which the woman is very tired. Pain in the abdomen is given to the sacrum and lower back. When urinating, there are constant cramps. Purulent and serous discharges are frequent from the genital tract.

For diagnosis, a gynecological examination, laboratory methods and bacteriological examination are needed. With an increase in the ovary and pain during palpation, ultrasound of the pelvic organs, hystersalpingoscopy and laparoscopy with a visual examination of the fallopian tubes, ovaries and uterus are prescribed.

Right-sided oophoritis

Pathology is characterized by an inflammatory process in the right ovary. Often, right-sided inflammation is confused with appendicitis, due to very similar symptoms: sharp girdle pains in the lower abdomen, radiating to the lower back. The causative agents are microorganisms and infection. Without timely medical attention, inflammation can spread to a healthy ovary.

The cause of inflammation of the right ovary can be gynecological manipulations and operations, intrauterine device, abortion. The disease does not develop if you have a strong immune system. Lack of personal hygiene, adherence to strict diets, frequent change of sexual partners and alcohol consumption are disease provoking factors.

Symptoms of right-sided oophoritis:

• pain in the lower abdomen on the right side
• rise in temperature
• weakness and extreme fatigue
• bleeding from the vagina
• abnormal vaginal discharge
• pain during intercourse
• the onset of menstruation at the wrong time (broken cycle)

During treatment, it is important to observe sexual rest and fully follow the recommendations of the attending physician.

Bilateral oophoritis

Bilateral oophoritis is diagnosed if the right and left ovaries are inflamed at the same time. The reasons are the same as with unilateral oophoritis. The main manifestations are intense pain in the groin, lower abdomen and lower back. Pathological discharge from the vagina and other symptoms, which are inherent in the unilateral form of the disease, are also characteristic of bilateral ovarian pathology.

Bilateral oophoritis develops from a unilateral lesion of the ovary. This happens when pathogenic microorganisms pass from the fallopian tubes through the abdominal horses. And salpingo-oophoritis develops if there is a simultaneous infection of the ovaries and the uterine cavity.

The main cause of 2-sided oophoritis: genital infections or microorganisms of normal microflora, which began to multiply under the influence of certain factors. In this case, unprotected sexual intercourse, hypothermia, a decrease in the protective properties of the immune system, infectious processes in the body, emotional and nervous shocks serve as a provoking factor for the exacerbation of the disease.

Diagnosis reveals swelling of the ovaries and the appearance of an abscess, which is palpable as a small seal. It is necessary to carry out a laparoscopy to determine the stage of the disease and the location of the inflammation. If necessary, the doctor may prescribe a puncture and administration of medications.

The goal of treatment is to eliminate the intoxication of the body and reduce the inflammatory process. For the treatment of the acute stage, broad-spectrum antibiotics are used. Treatment also includes anesthetics, immunostimulants, and vitamin complexes to fight infection. In the chronic course of the patient, anti-inflammatory drugs and physiotherapy should be prescribed.

Inflammation prevention is a must. It is necessary to exclude unprotected sexual intercourse, abortion and cooling of the genitourinary system. At the first manifestations of SARS, it is urgent to treat the disease, preventing its development and chronicity.

Salpingitis and oophoritis

As already noted, these two pathologies have similar symptoms. Often, inflammation of the ovaries causes damage to the fallopian tubes, that is, salpingitis. The causative agents are various microorganisms that can be combined, therefore antibiotics may not help in the treatment (one drug acts on a specific pathogen, but it turns out that there are several pathogens). Inflammation leads to changes due to which the fallopian tube is soldered to the ovary. Pus accumulates in the fallopian tube, because the tissues of the ovary are destroyed.

Both considered pathologies are manifested by severe pain in the lower abdomen, in the left or right side. How severe the pain will be depends on the stage of the disease. Pain is described as:

• aching
• acute
• cutting
• pulsating

Oophoritis and salpingitis are diagnosed using a method such as ultrasound, laboratory tests, laparoscopy, etc. are important. Treatment depends on the pathogen identified. In the acute stage, a woman is sent to a hospital for treatment. At the onset of the disease, the patient should be completely at rest, cold compresses and ice are placed on her stomach. This is followed by treatment with antibiotics and pain medications. With the ineffectiveness of treatment with medications, they resort to surgery.

Oophoritis during pregnancy

The disease is dangerous because it has serious consequences that affect a woman's ability to become pregnant. There are violations of the functions of the appendages, obstruction of the tubes, adhesive processes. The regularity of menstruation, sexual function is disturbed. Pathologies such as colitis and cystitis appear in other organs. Chronic inflammation of the ovaries can lead to miscarriages, etc.

For the above reasons, oophoritis is important to detect and treat in time. When planning a pregnancy, it is necessary to undergo a complete examination. With the development of bilateral oophoritis, pregnancy will not occur at all. If there is an infection in the pelvis, the fetus can become infected, then its development is disturbed.

When adnexal function is impaired, the body's production of estrogen and progesterone is also impaired. This explains miscarriages if the woman still managed to get pregnant. Then hormone replacement therapy is performed.

Diagnostics

Diagnosis of oophoritis is considered a complex process. Symptoms that are characteristic of this pathology may be with other diseases. Differential diagnosis is required with such diseases:

• ectopic pregnancy
• cyst, etc.

A gynecological examination and anamnesis are needed at the very beginning when the patient consults a doctor. Examination on the chair and palpation of the ovary / ovaries is carried out. Particular attention is paid to the presence or absence of vaginal discharge and the general condition of the body. The doctor collects an anamnesis, including clarification of complications after childbirth, if any.

They do laboratory diagnostics, that is, a study of blood and urine for the level of leukocytes. Swabs are taken from the urethra and vagina. The doctor also prescribes, as noted above, an ultrasound of the pelvic organs. You may need hysterosalpingoscopy, which allows you to detect pathological changes in the structure of the fallopian tubes, the cause of which is chronic inflammation of the ovaries.

Also, when diagnosing oophoritis, the body is checked for the presence of infectious pathogens by PCR, ELISA, RIF. Additional studies may be prescribed if purulent or tuberculous inflammation is detected. Informative methods for diagnosing the disease in question is laparoscopy. Examine the fallopian tubes, uterus, ovaries; this method is also important for distinguishing diagnostics. The main indication for laparoscopy is chronic pain in the lower abdomen, long-term infertility, inflammation of the ovaries of unknown origin.

Treatment

When the diagnosis is accurately established, the stage of the disease is known, then the treatment is determined. The acute form, as we have already noted, is treated in the hospital. The patient must comply with bed rest, cold compresses are made on her lower abdomen. Prescribe desensitizing and painkillers, antibacterial, restorative drugs.

Treatment of the chronic form of the disease is complex. Make up an individual course of treatment, which includes physiotherapy and medication. Physical therapy may include:

• hirudotherapy
• electrophoresis
• gynecological massage
• magnetotherapy
• laser therapy

Often they resort to a folk method of treatment and herbal medicine, which are also used in the prevention of oophoritis. The therapy is long, but it must be completed. If sexually transmitted infections have become the cause of the disease, then the partner is also treated to avoid prostatitis and re-infection of the partner. For the period of treatment, both are prescribed sexual rest.

In the structure of gynecological diseases, inflammatory processes in the ovaries and fallopian tubes take 1st place. This is the most common infectious pathology in young sexually active women.

Infectious and inflammatory diseases of the ovaries and fallopian tubes in 60% of cases are the reason for the woman's visit to the antenatal clinic, and in 40% of cases - the cause of hospitalization. The most common symptoms of oophoritis and salpingoophoritis are pain in the lower abdomen, pathological discharge from the genital tract, fever.

For the treatment of this pathology, antibacterial drugs, NSAIDs, antispasmodics and surgical methods are used. Now let's talk more about the causes, risk factors, diagnosis and treatment of these diseases.

To understand the severity of this pathology, take a look at the following statistics:

1. 1 20% of infertile women have had salpingo-oophoritis in the past.
2. 2 After the illness, the probability of an ectopic pregnancy increases by 10%.
3. 3 Up to 6% of cases of oophoritis and / or salpingitis end in purulent complications that require emergency surgical intervention.
4. 4 Most often, pathology is diagnosed at the age of 17-28 years. That is, predominantly sexually active young women suffer.

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  1. Basic concepts

  Oophoritis is understood as an infectious and inflammatory process localized in the female genital gonads (ovaries).

  Note that due to the anatomical location, isolated oophoritis is extremely rare. Almost always, the fallopian tube (salpingoophoritis), and sometimes the ligamentous apparatus of the appendages (adnexitis) is also involved in the inflammatory process.

  According to the nature of the course of the infectious process, oophoritis can be:

  1. 1 Sharp;
  2. 2 Subacute;
  3. 3 Chronic;
  4. 4 Exacerbation of chronic salpingo-oophoritis and/or oophoritis.

  According to the etiology, inflammation can be:

  1. 1 Nonspecific. In this case, the cause of inflammation is the representatives of the normal vaginal flora of a woman (conditionally pathogenic microorganisms): E. coli, Proteus, Enterococcus, Peptostreptococcus, Haemophilus influenzae, Gardnerella, etc.
  2. 2 Specific:
     • Chlamydia -.
     • Mycoplasmas -,.
     • Viruses - HSV 2, CMV, HIV.
     • Other bacteria - Mycobacterium tuberculosis, .
     • The simplest -.

  2. Etiology

  As we mentioned earlier, the cause of the disease can be a specific and non-specific infection.

  The most common pathogens are representatives of the normal microflora:

  1. 1 Staphylococci.
  2. 2 streptococci.
  3. 3 Escherichia coli.
  4. 4 Proteus.
  5. 5 and many others.

  In nonspecific inflammation, polymicrobial associations are more often found. In 15-20% of cases of oophoritis and salpingitis, the pathogen cannot be identified at all.

  With specific inflammation, most often detected (30%), (50%), Mycoplasma hominis (in 30% of cases), cytomegalovirus infection (diagnosed in 20.4% of cases).

  3. Risk factors

  There are genital, extragenital and social risk factors for oophoritis / salpingo-oophoritis.

  Genital (that is, associated with the female reproductive system) include:

  1. 1 Infections transmitted through sexual contact (including history).
  2. 3, cervical.
  3. 4 Medical and instrumental abortion.
  4. 5 Interventions involving instrumental expansion of the cervical canal (hysteroscopy, hysterosalpingography, diagnostic and therapeutic curettage of the uterine cavity).
  5. 6 Insertion of an intrauterine device within the last 6 weeks increases the risk of an inflammatory process by 2-9 times.
  6. 7 In vitro fertilization.

  Extragenital risk factors:

  1. 1 Endocrine pathology.
  2. 2 Reception of systemic glucocorticosteroids.
  3. 3 Urinary tract infections.
  4. 4 Immunodeficiency states (taking cytostatics, HIV infection).

  Social factors that increase the incidence of this pathology:

  1. 1 Chaotic sex life.
  2. 2 Change of regular sexual partner (especially during the previous 3 months).
  3. 3 Early onset of sexual life.
  4. 4 Chronic stress.
  5. 5 Non-traditional sexual contacts.
  6. 6 Forced sexual intercourse (including history).

  In pathogenesis, it is possible to note a set of reasons that provide conditions for the onset of an infectious process.

  4. Pathogenesis

  The female urogenital tract is normally protected by several natural barriers that prevent infection from entering the overlying organs. They are:

  1. 1 Closure of the labia.
  2. 2 The acidic environment of the vagina, which is provided by lactobacilli. This requires an optimal level of nutrient substrate (glycogen) and an equilibrium state of the vaginal microflora.
  3. 3 Regular desquamation of the vaginal epithelium. When the epithelium is rejected, pathogenic microorganisms are also removed.
  4. 4 The presence in the cervical canal of cervical mucus (mucus plug), which in its composition contains mucopolysaccharides, lysozyme, immunoglobulins.
  5. 5 Desquamation of the functional endometrium according to the menstrual cycle.
  6. 6 Contraction of the muscular layer of the fallopian tubes (peristalsis) and flickering of the ciliated epithelium towards the uterine cavity also contribute to the elimination of pathogens.

  Under the influence of risk factors, natural barriers are destroyed, which leads to the penetration of infection and the reproduction of microorganisms.

  In the pathogenesis of oophoritis, both the ascending mechanism of the spread of infection and the hematolymphogenic mechanism are important.

  As mentioned above, isolated oophoritis is quite rare. In this case, the infection is most often introduced from nearby organs:

  1. 1 From the rectum and sigmoid colon with the development of left-sided oophoritis, and then salpingitis.
  2. 2 From the appendix with the development of right-sided oophoritis and salpingitis.

  The ascending route of infection is realized in the presence of risk factors, impaired function of the barriers of the urogenital tract, described above. In such cases, normal elimination of the pathogen from the lower parts of the reproductive system does not occur, so the infection penetrates deeper and deeper.

  Pathogenic microorganisms begin the production of exo- and endotoxins, pathogenicity factors. Inflammation of the ovaries proceeds with five classic, described by Hippocrates, signs: edema, hyperemia (redness), microcirculation disorder, dysfunction and pain syndrome.

  Very quickly, the infectious process from the ovaries passes to the fallopian tubes with the development of an adhesive process in them.

  In the presence of an active immune response to inflammation, adequate antibiotic therapy, the symptoms gradually subside, the infectious agent is eliminated and recovery occurs.

  The pathogenesis of a chronic process is distinguished by the launch of an autoimmune reaction. That is, in response to the primary introduction of the pathogen, the body is not able to provide full protection and respond with a normal immune response.

  5. Main symptoms

  Symptoms of acute oophoritis and salpingitis, as a rule, are pronounced, significantly worsen the patient's condition.

  These include:

  1. 1 Increase in body temperature up to 38C and above, symptoms of general intoxication (chills, weakness, headache).
  2. 2 Intense pain in the lower abdomen. When the right ovary is affected, they speak of right-sided oophoritis. With the localization of pain on the left - about the left side. Pain during oophoritis is quite strong, radiating to the lower back, coccyx, perineum.
  3. 3 In the presence of mucopurulent discharge from the vagina, inflammation of the fallopian tubes (salpingoophoritis) should be suspected. Pathological discharge is observed in 75% of patients with salpingitis and oophoritis.
  4. 4 Pain when urinating.
  5. 5 Expressed, its impossibility.
  6. 6 Abnormal uterine non-cyclic bleeding may be a sign of concomitant endometritis.
  7. 7 Bloating, nausea, vomiting.
  8. 8 Experts believe that acute gonococcal and chlamydial infections have more pronounced symptoms than nonspecific salpingo-oophoritis.

  With an exacerbation of a chronic process, the following symptoms are observed:

  1. 1 Increase in body temperature to subfebrile numbers (37-38 degrees), moderate intoxication (minor headache, malaise, weakness).
  2. 2 Signs of chronic oophoritis and salpingoophoritis include dull or aching pain in the lower lateral abdomen. Their irradiation to the lower back, sacrum is possible.
  3. 3 Violations (damage to the ovarian tissue leads to a violation of the full maturation of the follicle).

  Outside the acute stage, chronic oophoritis and salpingitis are asymptomatic. A woman may be disturbed by mild pains in the lower abdomen, often of a pulling nature. It is difficult for her to indicate the localization of pains, to characterize them.

  The most common complaint in women with long-term chronic bilateral oophoritis / salpingo-oophoritis is the complaint of the impossibility of conception.

  6. Diagnostic measures

  6.1. Anamnesis

  When collecting an anamnesis, it is necessary to clarify the time of onset of symptoms, their connection with any medical intervention, casual sexual contacts. The doctor will definitely ask if this is the first time a woman has experienced such symptoms.

  Information about concomitant extragenital pathology, recent infectious diseases (including ARVI) is of great importance.

  Competent collection of anamnesis, full provision of information by the patient allows narrowing down the range of necessary diagnostic manipulations and prescribing adequate drug therapy.

  6.2. Gynecological examination

  When examining the vagina in the mirrors are observed:

  1. 1 Pathological discharge.
  2. 2 Hyperemia of the mucous membrane, swelling of tissues.
  3. 3 Pain when installing mirrors.

  These signs are associated with concomitant colpitis and / or cervicitis. But this cannot be evidence of damage to the overlying structures of the urogenital tract.

  According to the latest European, American, Russian recommendations, reliable minimum diagnostic criteria for a bimanual examination are:

  1. 1 Pain during palpation of the appendages on the side of the lesion (on the right - with the right-sided, on the left with the left-sided, on both sides - with bilateral oophoritis).
  2. 2 Pain when the cervix is ​​displaced.
  3. 3 In an acute inflammatory process, a bimanual examination is usually difficult due to the sharp pains that occur and the natural resistance of the woman. But if the examination was successful, then the doctor will find edematous, compacted, enlarged ovaries.
  4. 4 In a chronic process, pain on palpation is not so intense, so examination is possible. Adnexa of the uterus are somewhat painful on palpation, taut, dense to the touch. It is possible to identify rounded formations in the area of ​​​​the appendages (hydrosalpinx, tubo-ovarian formations).
  5. 5 One of the signs of the adhesive process is the retroposition of the body of the uterus (Russian national recommendations, 2015).

  6.3. Pregnancy test

  One of the diagnostic methods necessary for adequate differential diagnosis of oophoritis and salpingoophoritis is a pregnancy test. Ectopic (tubal, ovarian, abdominal) pregnancy can occur with similar clinical symptoms. The pregnancy test must be negative.

  6.4. Microscopic smear on flora

  The results may indicate the presence of:

  1. 1 Specific inflammation - if present in a smear or.
  2. 2 Nonspecific inflammation - with an increase in the number of leukocytes in the smear (10 or more) and predominance over rod.
  3. 3 - if there are "key cells" in the smear.

  6.5. Clinical and biochemical blood tests

  The results of the KLA may indicate the presence of an inflammatory process in the body:

  1. 1 increase in the level of leukocytes;
  2. 2 increase in ESR;
  3. 3 increase in the level of C-reactive protein.
  4. 4 violation of protein balance (dysproteinemia) with a predominance of globulins (a sign of acute inflammation).

  6.6. Seeding the contents of the cervical canal

  With bakposev of the contents of the cervical canal, it is possible to detect the causative agent of the infectious process and assess its sensitivity to antibacterial drugs.

  6.7. PCR diagnostics

  The contents of the vagina and cervical canal is the most sensitive and specific method for assessing not only the qualitative, but also the quantitative composition of the flora.

  This diagnostic method is relevant in the presence of latent infections (chlamydia, mycoplasmosis, viral infections). It is these pathogens that are often the cause of chronic oophoritis and salpingo-oophoritis.

  6.8. Ultrasonography of the pelvic organs

  Ultrasound criteria for inflammation in the ovaries and fallopian tubes are:

  1. 1 The presence of fluid in the retrouterine space (with chronic oophoritis, the study is carried out only from 4 to 11 days of the menstrual cycle).
  2. 2 Presence of fluid in the fallopian tubes.
  3. 3 Thickening of the fallopian tubes.
  4. 4 Enlargement of the ovary.
  5. 5 Visualization of tubo-ovarian formation, abscess.

  With ultrasonography, an assessment of the blood supply to the ovaries and fallopian tubes is also carried out using dopplerometry. The presence of pathology is indicated by an increase in their blood supply due to vasodilation against the background of an inflammatory reaction.

  6.9. Laparoscopy

  Diagnostic laparoscopy is the most informative, but at the same time the most invasive and expensive method for verifying oophoritis and salpingitis. When it is carried out under general anesthesia, a laparoscope is inserted into the abdominal cavity, which allows visualization and assessment of the state of the pelvic organs.

  With laparoscopy, it is possible to remove tubo-ovarian formations, chromohydrotubation (assessment of the viability of the fallopian tubes with a liquid), assessment of the condition of the ovaries, detection and, if possible, dissection of adhesions.

  As already mentioned, this procedure is a full-fledged operation and is more often performed either in inflammatory processes that do not respond to long-term conservative therapy, or if there are indications for emergency surgical intervention.

  7. Treatment tactics

  The main goals of oophoritis treatment are:

  1. 1 Complete elimination of the pathogen.
  2. 2 Prevention of process chronization (with acute oophoritis).
  3. 3 Elimination of pain syndrome.
  4. 4 In case of exacerbation of a chronic process - its relief and achievement of remission.
  5. 5 In chronic asymptomatic course - prevention of complications.

  The severe course of the disease with severe intoxication, the lack of effect of outpatient treatment are indications for hospitalization (CDC Sexually Transmitted Diseases Treatment Guidelines, 2015).

  The ineffectiveness of conservative therapy in the hospital after 72 hours is an indication for surgical intervention (level of evidence - IIC).

  At the moment, the following regimens for the use of antibacterial drugs are recommended for the treatment of oophoritis and salpingo-oophoritis (see Table 1).

  

  Table 1 - Schemes for the use of antibiotics for oophoritis and salpingo-oophoritis according to Russian clinical protocols and CDC recommendations. Expand the table to view

  The main principles that any of the above treatment regimens must meet are:

  1. 1 Assigned empirically combinations of antibacterial drugs should have a wide spectrum of action and be active against all possible pathogens.
  2. 2 Empiric antibiotic therapy is prescribed only for acute inflammatory process, for chronic oophoritis, treatment is prescribed only according to the results of bacteriological examination and PCR.
  3. 3 Exacerbation of chronic oophoritis is treated according to the same principles as the acute process, with the appointment of empirical antibiotic therapy.
  4. 4 All patients should be screened for sexually transmitted infections, including HIV (LE-IVC).
  5. 5 Patients with mild and moderate forms of the course of the disease can be treated on an outpatient basis, subject to strict adherence to all doctor's recommendations.
  6. 6 In the treatment of oophoritis, the use of local forms of drugs (suppositories, vaginal tablets) is ineffective. Vaginal suppositories and ovules are used only in the presence of concomitant colpitis, cervicitis or bacterial vaginosis.
  7. 7 If allergic reactions occur to injectable drugs, they should be discontinued immediately and the regimen changed to one of the alternatives (Evidence level Ib, A).
  8. 8 In the absence of positive dynamics against the background of ongoing therapy within 72 hours, the treatment regimen should be changed.

  Evaluation of the effectiveness of the therapy for acute oophoritis is performed 72 hours after the start of treatment. By this time, the results of bacteriological examination, the sensitivity of the identified microorganisms to the prescribed antibacterial drugs are retrospectively evaluated.

  It must be remembered that with oophoritis, treatment at home with folk remedies and non-traditional methods is unacceptable!

  Without etiotropic treatment, the disease can be complicated by tubo-ovarian abscess, pelvioperitonitis, and infertility. Other complications, including chronic pelvic pain, ectopic pregnancy, tubal infertility (TFI), and IVF failure, may occur in up to 25% of patients with salpingitis and oophoritis.

  8. Oophoritis and pregnancy

  The most common question in women suffering from the disease concerns the possibility of becoming pregnant. The onset of pregnancy is quite possible with any form of inflammation.

  However, oophoritis reduces the likelihood of natural fertilization of the egg. We wrote above that the altered ovary is not able to ensure the full maturation of the follicles and effective ovulation.

  At the stage of pregnancy planning in women with chronic oophoritis, it is important:

  1. 1 Determine the likely causative agent of the disease and achieve its elimination with antibiotics.
  2. 2 Eliminate concomitant extragenital pathology.
  3. 3 Examined for sexually transmitted infections (both the woman and her partner). If an STI is detected, both partners are treated.
  4. 4 Make sure the normal patency of the fallopian tubes, normal ovulation.

  9. Prevention

  According to European, American and Russian recommendations, one of the main links in the prevention of pathology is the protection of women from genital infections. It implies:

  1. 1 use of condoms;
  2. 2 having a permanent sexual partner;
  3. 3 trusting, close relationship with a partner;
  4. 4 examination for sexually transmitted infections at least once a year.

  In addition, it is necessary:

  1. 1 follow the rules of personal hygiene;
  2. 2 use individual underwear, especially in crowded places (saunas, swimming pools, water parks, etc.);
  3. 3 wear comfortable underwear made from natural fabrics;
  4. 4 immediately contact a specialist if any pathological discharge from the genital tract, pain in the lower abdomen and other signs of PID appear.

Oophoritis is called inflammation of the ovary - a paired organ of the female reproductive system, the uterine (fallopian) tube connecting to the uterus. The ovaries are responsible for the maturation of eggs and the production of female sex hormones, so inflammation of the ovary, especially chronic oophoritis, can have the most adverse effects on a woman's health, including causing infertility.

Causes of oophoritis

Oophoritis is almost never an independent disease. The ovaries are located so that the primary infection cannot penetrate them. Most often, inflammation is transmitted to the ovary through the fallopian tube, in this case, oophoritis is accompanied by salpingitis (inflammation of the fallopian tube), this condition is called salpingo-oophoritis, or adnexitis (inflammation of the uterine appendages). The causative agents of oophoritis are sexually transmitted infections (STIs): chlamydia, gonococci, Trichomonas, etc. Less often, inflammation is transmitted to the ovary from another source located in the abdominal cavity, for example, with appendicitis. In this case, the pathogens are streptococci, staphylococci, Escherichia coli.

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

Factors contributing to the occurrence of oophoritis are:

• hypothermia;
• Diseases of the genitourinary system;
• Foci of chronic infection in the body;
• Endocrinological diseases;
• Tobacco smoking. Under the influence of tobacco smoke products entering the body, the composition of the mucus that forms the cervical plug changes, resulting in a decrease in its barrier properties, which leads to the penetration of infection from the external genital tract;
• Wrong lifestyle, overwork, stress as a factor that reduces the protective properties of the immune system;
• Promiscuous sex life, especially without the use of barrier contraceptives.

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

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

Chronic oophoritis often has a latent onset, that is, to be primary chronic, or develop as a result of untreated acute oophoritis. The only sign of chronic oophoritis for a long time is an unexpressed pain syndrome. The pain, as a rule, is unstable, has a dull, aching character, appears with overwork, hypothermia, stress, during intercourse. Most often, such signs of oophoritis in its chronic form appear on the eve of menstruation. Another sign of oophoritis in an advanced chronic form is menstrual irregularities due to impaired estrogen production by the affected ovary.

In some cases, chronic oophoritis proceeds so implicitly that it is detected only during examination for menstrual irregularities or infertility.

Diagnosis of oophoritis

Diagnosis of oophoritis is considered a difficult task, since pain, which is the main symptom of oophoritis, can accompany any disease of the abdominal organs. If oophoritis is suspected, a gynecological examination is performed, with a mandatory study of the vaginal microflora. Ultrasound of the ovaries can show the changes that have occurred as a result of chronic oophoritis; for an acute disease, this method is not informative.

The main method for diagnosing oophoritis is laparoscopy. This is a study using an endoscope that allows you to visualize the tissues of the ovary and detect signs of an inflammatory process. To determine the degree of ovarian dysfunction in chronic oophoritis, an endocrinological examination is performed, with the compilation of an ovulation diary.

Treatment of oophoritis

Treatment of chronic oophoritis and acute oophoritis is different.

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

Treatment of chronic oophoritis must be carried out consistently and persistently, otherwise it may threaten the loss of ovarian function. For the treatment of chronic oophoritis, antibiotic therapy is also used, taking into account the identified microflora. Anti-inflammatory steroid drugs are prescribed. The main efforts are aimed at eliminating the infection and combating the adhesive process, for which injections and electrophoresis of absorbable drugs are prescribed. Physiotherapy and balneotherapy are the main methods in the treatment of chronic oophoritis.

It must be understood that the treatment of chronic oophoritis will require a change in the habitual lifestyle to a healthier one. General strengthening procedures are needed that stimulate the body's own defenses, the transition to a healthy diet, the rejection of bad habits and an increase in physical activity to eliminate congestion in the small pelvis. Only under all these conditions can we talk about the possibility of a complete cure.

Complications of oophoritis

A complication of acute and aggravated oophoritis may be suppuration of the ovary. This is an acute inflammatory process, as a result of which purulent fusion of the ovary occurs, and it turns into a thin-walled spherical formation filled with pus. This condition requires urgent surgical intervention, since rupture of the ovary leads to peritonitis.

Chronic oophoritis, which is severe, with frequent relapses, in combination with chronic salpingitis, can lead to sactosalpinx, a purulent tumor of the uterine appendages. This condition also requires surgery. The ovary and fallopian tube are removed.

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

Therefore, the treatment of oophoritis must be started as early as possible, and be sure to complete.

Video from YouTube on the topic of the article:

What is oophoritis? Long-term chronic inflammatory processes occurring in the pelvic area can lead to the development oophoritis - inflammation of the ovaries.

Among older women, there is an opinion that such problems can happen due to hypothermia (for example, sitting on something cold). However, in itself, hypothermia will not lead to oophoritis; for it to start, a rapid multiplication of pathogenic bacteria is necessary: ​​streptococci, gonococci, Trichomonas.

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The mechanism of development of oophoritis

Inflammation of the ovaries is almost never an independent disease and does not occur instantly. Its development is preceded by certain stages:

1. Reproduction of bacteria in the body of the uterus, cervix, in the fallopian tubes or in the vagina.
2. In order for the infection to go beyond a specific organ of the reproductive system, it is necessary to leave the disease without treatment for a rather long period. Therefore, inaction provokes the spread of infection to neighboring organs.
3. In most cases, the fallopian tube becomes the conductor of pathogenic microbes to the ovary. Therefore, endometritis, and various diseases related to the flora of the vagina and cervical canal gradually rise up the oviduct.
4. If the changes taking place in the body are still ignored, then the infection first covers one ovary, and then the other, even though they are located quite far from each other.

In more rare cases, it happens that oophoritis occurs due to or a common serious infectious disease.

Signs of acute oophoritis

Acute oophoritis cannot go unnoticed, so a woman is forced to go to the doctor a few days after it starts. This form of the disease is characterized by the following symptoms:

• The presence of a high temperature, above 38.5 degrees. Moreover, it either cannot be brought down, or already 30-40 minutes after the decrease, the temperature quickly rises again.
• Sharp pains in the lower abdomen. If the oophoritis is one-sided, then pain and backache are noted only from the side of the inflamed ovary. But often pain is noted in the lower back or in the sacrum, as well as in the thigh.
• General weakness, dizziness, chills, pallor of the skin are concomitant symptoms of oophoritis.
• Frequent urination. If oophoritis was the result of an inflammatory process in the vagina or urethra, then going to the toilet may be accompanied by pain.
• Diarrhea, frequent urge to defecate.

This condition requires immediate hospitalization. In addition, there is also a subacute form of the disease in which all the symptoms of acute oophoritis are observed, only not so pronounced.

Symptoms of chronic oophoritis

If the acute form of the disease was treated incorrectly or not sufficiently, then it turns into chronic oophoritis. It is much more difficult to treat it, and due to the fact that at times the pain subsides and the disease is latent, a woman can postpone a visit to the doctor for years.

The following symptoms are characteristic of this form of the disease:

• Aching pain in the lower abdomen. It is often impossible to determine its specific localization. Pain sensations are not permanent - they subside after taking analgesics, and the woman feels quite healthy until the next attack.
• Discharge from the vagina has an unpleasant odor, all the time go in large quantities.
• Menstrual irregularity
• Constant detection of fluid in the retrouterine space on ultrasound (on different days and phases of the cycle).

Left-sided and right-sided oophoritis - features

If the root cause of the disease is endometritis or vaginitis, then the inflammatory process, as a rule, rises up both fallopian tubes.

Thus, not one, but two ovaries are often affected, therefore, the diagnosis is “bilateral oophoritis”. But in milder cases, the inflammatory process is localized only on one side.

Features of right-sided oophoritis

Sharp pains on the right side of the patient are often confused with signs of appendicitis. Similarly, the abdomen is tender on palpation. However, in acute appendicitis, when the appendix is ​​pressed and the pressure is suddenly released, the patient feels a shooting pain.

Whereas in acute right-sided oophoritis, with the weakening of pressure, a decrease in pain will be felt.

Features of left-sided oophoritis

Pain on the left side can be given to the kidney, to the lower intestines. Therefore, at first, without having the results of an ultrasound scan, a sharp deterioration in well-being can be associated with renal colic.

But the results of the study of the pelvic organs will give an unequivocal answer: if the diagnostician determines a significant increase in the size of the ovary, then the gynecologist will diagnose "left-sided oophoritis".

Treatment of oophoritis - drugs and methods

Oophoritis is treated both medically and with the help of surgery. Physiotherapy is actively used as auxiliary methods.

Antibacterial therapy

The course of treatment for ovarian oophoritis should include antibiotics and anti-inflammatory drugs, with which it is necessary to stop the inflammatory process.

Azithromycin is an antibiotic that is prescribed for infections caused by streptococci, staphylococci, chlamydia, ureaplasma, mycoplasma.

However, its prolonged use causes the body to get used to the active substances of the drug. In addition, the appointment of Azithromycin should be done with caution if the patient has renal or hepatic insufficiency.

Gentamicin is an antibiotic often prescribed to treat oophoritis. It is effective specifically for purulent inflammation and actively suppresses the reproduction of staphylococci.

However, the drug does not fight well with streptococci and treponema, so before starting treatment, the doctor must find out what was the causative agent of inflammation.

Trichopol is an antimicrobial drug often prescribed for infections of the reproductive system. A side effect is nausea, which occurs 20-30 minutes after taking the pill, especially if the woman drank it on an empty stomach.

Since acute oophoritis is accompanied by severe pain, the doctor prescribes analgesics to eliminate discomfort.

Surgical treatment

If the inflammatory process has entered an advanced stage, then the patient often finds herself filled with pus of the fallopian tubes and the uterine cavity.

In this case, surgical intervention is performed using laparoscopy, during which the exudate is removed, and the ovary is cleared of purulent neoplasms.

If the inflammatory process is serious and threatens the life and health of the patient, and it is not possible to stop it surgically, then an ovarian resection is performed, or the complete removal of the ovary and fallopian tube.

Physiotherapy

In the treatment of oophoritis with antimicrobial drugs, the doctor will prescribe physiotherapy, which will speed up the recovery process of the body.

• Electrophoresis - in case of inflammation and the presence of purulent exudate, the procedure is carried out using absorbable preparations: aloe, lidase.
• Autohemotherapy - involves the introduction of the patient's own venous blood. The method was developed at the beginning of the last century and was used for infectious diseases.

Treatment prognosis and complications

With timely detection of oophoritis and proper treatment, a woman in the future can plan a pregnancy and carry it quite successfully. The longer the visit to the doctor is delayed, the more serious the consequences will be:

• A running inflammatory process can be cured on the ovary, but it is much more difficult to get rid of it from the fallopian tubes. Therefore, when planning a conception in the future, a woman will have an increased risk of ectopic pregnancy.
• The lack of correct and timely treatment of acute oophoritis will provoke its transition into a chronic form. This will entail ovarian dysfunction, which will certainly affect the possibility of conception and the hormonal background in general.
• Oophoritis, brought to an extremely serious stage, will cause the removal of the ovary, fallopian tube, and in some cases even the uterus.

With inflammation of the ovaries, it is important to respond to a deterioration in well-being in the very first days - this is the key to successful treatment of oophoritis and the absence of negative consequences in the future.

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Chronic oophoritis is a dangerous inflammatory process that affects the ovaries. The disease can lead to serious complications. Treatment hr. oophoritis should be carried out in a timely manner. Otherwise, the woman will develop infertility. The disease is difficult to treat, so it should not be allowed to develop.

The defeat of the ovaries can be unilateral or. In the second case, the treatment is long and complicated. In this case, the pathological process affects not only the ovaries, but also the fallopian tubes, which reduces the chances of a woman becoming a mother.

Chronic oophoritis is characterized by the presence of mild pain, menstrual disorders. Pathology develops slowly, and its course may be asymptomatic. In this case, the patient does not go to the doctor in a timely manner, which worsens her situation even more.

Chronic oophoritis has its own code in the ICD 10 - 70. Its pathogens are chlamydia, E. coli, streptococcus, and even staphylococcus aureus. The cause of the development of inflammation also becomes tuberculosis, mycoplasmosis, gonorrhea.

The origin mechanism is very simple. First, the pathogen enters the mucous membrane of the vagina and vulva. Further, through the cervical canal, the infection rises into the uterine cavity, and there it is already close to the ovaries.

Reasons for the development of the disease

The disease develops only if the infection can overcome the protective barrier located below the genitals. The following factors can provoke:

• surgical or spontaneous abortion;
• constant overwork or being in a state of stress (it is often these reasons that provoke a disruption in the reproductive female system);
• constant change of sexual partners (increases the risk of infection);
• violations of the functionality of the endocrine system;
• surgical intervention (poorly performed operation provokes infection in the ovaries);
• hysteroscopy, as well as diagnostic or therapeutic curettage of the walls of the uterus;
• complicated childbirth, which are accompanied by ruptures of the birth canal;
• hormonal imbalance;
• tumors localized in the uterus (gradually growing, they also provoke the development of the inflammatory process);
• chronic inflammatory pathologies of the internal or external genital organs of a woman.

It is also important to know why oophoritis becomes chronic. It contributes to:

1. Postponement of treatment due to untimely treatment of the patient to a specialist. If antibiotics are not started at the initial stage of development, then over time the disease will progress, and it will be more difficult to cope with it. Sometimes pathological changes become irreversible.
2. The use of insufficient doses of antimicrobial drugs.
3. Incorrectly prescribed therapy regimen. Here, the treatment of chronic oophoritis causes severe harm.
4. Local or local hypothermia, too heavy physical exertion, nervous shock.
5. Reduced immune defense of a woman.

Chronic oophoritis is difficult to treat, so it is better not to start the disease. In addition, a long-term inflammatory process can provoke serious complications that are not always manageable. Pathology often leads to irreversible consequences - infertility.

Symptoms and signs of pathology

Oophoritis, if it has acquired a chronic form, proceeds in different ways. For example, sometimes it is asymptomatic. Most often, a sluggish character is noted with the periodic appearance of an exacerbation (maximum once a year). In some patients, oophoritis recurs more frequently.

The following symptoms and signs of chronic oophoritis can be distinguished:

• a pronounced violation of the menstrual cycle (between menstrual bleeding there is a large gap or they are absent at all);
• moderate pain in the lower abdomen during sexual intercourse;
• frequent relapses arising from the influence of external factors (hypothermia, overwork);
• no pregnancy, even if the couple is actively trying to conceive;
• weak but constant discharge (leucorrhoea);
• periodic pains of a dull and aching nature in the groin and vagina, which can intensify due to some kind of disease or before the onset of menstruation.

All the insidiousness of chronic oophoritis, the treatment of which almost never begins on time, lies in its latent course. It can develop without an acute period, so the patient does not even suspect the presence of an inflammatory process, and does not receive the necessary treatment when she needs it.

Oophoritis can cause problems with the nervous system and instability of the psychological state of a woman. She becomes irritable, her working capacity decreases, her sleep becomes bad, she gets tired faster. Also, the patient begins to worry that she will not be able to get pregnant. Her emotional state destabilizes, after which her physical health further deteriorates.

If ovarian treatment is not performed, then the patient will experience pathological changes in the fallopian tubes, which will not allow the woman to become a mother. That is, pregnancy can occur, but it will only develop outside the uterus. In the worst case, the patient is diagnosed with secondary functional infertility.

From time to time, a sick woman experiences exacerbations, which are characterized by an increase in the intensity of symptoms. Ignore them and assume that everything will pass by itself, it is not worth it. Also, do not drink anti-inflammatory and painkillers on your own.

Chronic oophoritis on ultrasound

Features of diagnostics

The ineffectiveness of conservative treatment leads to the fact that a woman needs surgery. Which procedure will be applied, the doctor decides, depending on the severity of the woman's condition. Here, the removal of the treated ovary or the affected organ along with the uterus and fallopian tubes can already be carried out.

Chronic oophoritis should be detected correctly and in time. Diagnostics includes the following procedures:

1. Questioning the patient. The doctor must find out if the patient had an abortion, a history of surgery.
2. External examination and palpation by a gynecologist. Here the specialist is able to see the discharge from the cervical canal. In the presence of chronic oophoritis, overhanging and thickening of the vaginal vaults occurs, which can also be detected by palpation. If the doctor pulls on the cervix, the patient gets hurt. The ovaries are enlarged on examination.
3. Smears of the cervix, as well as the walls of the vagina, which should show the cellular composition of the sample, as well as its microflora. For maximum accuracy of the diagnosis, a PCR reaction is performed.
4. Biochemical and general blood test. So you can determine the level of ESR, which in chronic oophoritis is slightly, but increased.
5. Blood test for antibodies to infections: hepatitis, syphilis, HIV.
6. General urine analysis.
7. Ultrasound of the ovaries and uterus with appendages. Here, such signs of chronic oophoritis as enlarged ovaries are found, and fluid collects in the abdominal cavity.

Diagnosis of this disease should be differential, so as not to confuse it with other lesions of the internal organs that require immediate treatment.

Ultrasound examination of the ovaries affected by chronic oophoritis

Features of treatment

Therapy of oophoritis should be complex and long-term. It is necessary to treat the disease with the help of medications, physiotherapy, folk remedies and other methods. As for conservative therapy, the following drugs are used for its implementation:

• antibacterial and antimicrobial: "Amoxiclav", "Ofloxacin", "Ceftriaxone";
• anti-inflammatory: "Indomethacin", "Ibuprofen";
• fortifying agents and multivitamin complexes;
• light sedatives, as the patient becomes irritable, her emotional and psychological balance is disturbed;
• pills to normalize the menstrual cycle;
• drugs to improve blood circulation in the pelvic organs;
• multivitamins, as well as immunomodulators (the course is held 2 times a year).

Treatment of pathology should be done not only with medications, but also in other ways. Folk remedies can also be useful, but they should be used only after the permission of the doctor.

As for other methods of treatment, the patient is prescribed:

1. Internal administration of tampons soaked in Vishnevsky's ointment or Dimexide. Such therapy allows you to quickly cope with pathogens.
2. Gynecological massage.
3. Plasmapheresis (purification of blood plasma).
4. Physiotherapeutic procedures: ultraviolet irradiation, electrophoresis with the use of anti-inflammatory drugs, UHF. These treatments are in addition to conservative therapy.
5. Physiotherapy. It is necessary to do not only breathing exercises, but also exercises to strengthen the muscles of the pelvic floor. This will improve blood circulation in the muscles and tissue nutrition.
6. Spa treatment. Especially useful is the use of mud baths.

If inflammation occurs during pregnancy, then any antibiotic is not only ineffective for treatment, but can also cause significant harm. Therefore, you should not take any measures arbitrarily.

With the help of folk remedies, chronic oophoritis can also be treated, but before that it is better to consult a doctor. The following recipes will be useful:

1. It is necessary to mix in equal parts the grass of the sweet clover, the centaury, the flowers of the coltsfoot. Further, 1 tbsp. l. the mixture is required to pour a glass of boiling water. After infusion, the remedy should be taken 1/3 cup up to 6 times a day. The course of therapy lasts 1 month.
2. You need to take 50 g of juniper berries and stems and throw them into a bucket of boiling water. It will take 2 hours to infuse. This remedy is used for baths.

To prevent oophoritis from appearing at all, some rules must be observed. For example, you should not have sexual intercourse without barrier protection. You should not change sexual partners frequently. Every year, a woman needs to be examined for the presence of genital infections in the body. At the first symptoms of pathology, you should consult a doctor.

The problem of pregnancy in chronic oophoritis

Many women have one question: if they develop chronic oophoritis, will it be possible for them to become pregnant. It should be noted that any violation of the functionality of the ovaries does not have a very good effect on the possibility of conception. Including chronic oophoritis.

The fact is that the disease can not always be determined in a timely manner. This makes it impossible to treat pathology at an early stage of its development, when pathological changes have not yet affected the fallopian tubes. The long course of oophoritis leads to such complications:

• violations of the functionality of the hormonal system, which can provoke a miscarriage in the early stages;
• inflammation of the fallopian tubes, in which adhesions appear in them, preventing the normal passage of the egg into the uterine cavity (an ectopic pregnancy may occur);
• violation of the full-fledged process of producing female germ cells, the absence of ovulation, which is fraught with infertility;
• intrauterine infection of the fetus.

As you can see, chronic oophoritis should be treated even before pregnancy is planned. Otherwise, the danger may threaten not only the expectant mother, but also her child.