Chronic oophoritis on both sides. Oophoritis: how does it manifest itself, why is it dangerous and how to treat? Forms and symptoms

Inflammation of the ovary usually occurs against the background of cervicitis, salpingitis or endometritis, when the infection enters the area of ​​the uterine appendages. Left-sided oophoritis can appear with a disease of the straight or descending part of the large intestine (colitis, proctitis).

Signs of acute inflammatory damage to the left ovary can mimic other diseases, so the doctor must exclude pathology of neighboring organs. Effective treatment without antibiotics and anti-inflammatory drugs is impossible, and self-medication can cause dangerous complications and infertility.

Causes of inflammation of the ovary on the left

Microbial infection through the ascending route is typical for any type of ovarian inflammation. For left-sided oophoritis, a possible variant of penetration of microorganisms may be a descending route, when the infection from the left part of the intestine (colon or rectum) through the lymphatic or blood vessels enters the area of ​​the uterine appendages.

Acute or subacute oophoritis of the left ovary can occur against the background of the following diseases:

• colitis (inflammation in the descending part of the colon);
• proctitis (inflammatory process in the rectum);
• paraproctitis (inflammation in the soft tissues around the anus);
• hemorrhoids complicated by inflammation.

Dysbacteriosis, chronic constipation and any inflammatory process in the gastrointestinal tract are risk factors for the development of acute inflammation in the final intestine. Therefore, timely and complete treatment by a gastroenterologist and proctologist will be an excellent prevention of oophoritis and adnexitis.

Differences between oophoritis on the left and ectopic pregnancy

The main signs of acute oophoritis on the left are pain, vaginal discharge and menstrual irregularities. Similar symptoms occur during ectopic pregnancy, so during the first examination the doctor will definitely check all the symptoms characteristic of this dangerous situation.

Symptoms	Acute inflammation of the left ovary	Ectopic pregnancy on the left
Pain syndrome	Periodic pain of varying degrees of intensity, disappearing with the use of medications	Constant severe or aching pain that does not improve with anti-inflammatory and painkillers
Vaginal discharge	Abundant milky or purulent	Scanty bloody
Body temperature	Rising	Doesn't change
Delayed menstruation	Absent or there are menstrual irregularities (heavy, frequent or unsystematic)	Menstruation does not come on time or there are very scanty periods
Pregnancy test	Negative	Positive
Gynecological examination	On the left, there is pain and heaviness on palpation in the area of ​​the uterine appendages, the presence of a cystic tumor is possible	During examination, the doctor will find a soft, elastic and painful formation in the left uterine appendages; movements behind the cervix will be sharply painful.

In addition to typical symptoms, signs of left-sided oophoritis may be indicated by problems with bowel movements - constipation or diarrhea, unstable bowel movements. After collecting anamnesis and gynecological examination, the doctor will refer you for additional tests.

Necessary diagnostic tests

The diagnostic standard for any type of oophoritis is to identify the main microbial factor. To do this, you need to perform the following tests:

• vaginal smears for infections;
• bacterial culture from the cervical canal with determination of the sensitivity of microbes to antibiotics;
• special tests (PCR) for sexually transmitted infections.

An ultrasound scan should be done to assess the condition of the ovaries, tubes and uterus, identify signs of inflammation and exclude the possibility of ectopic pregnancy. Ultrasound is of great importance in the diagnosis of tubo-ovarian tumors, which are a complicated variant of acute oophoritis or adnexitis.

If there is doubt about the diagnosis and it is impossible to accurately evaluate the left ovary, the doctor will perform a diagnostic laparoscopy. Visual control during endoscopic surgery will allow you to make a diagnosis and perform a treatment procedure with high accuracy and reliability.

Treatment

An important factor in choosing effective therapy is the correct assessment of the variant of the inflammatory process. In case of acute oophoritis, it is necessary to immediately begin antibacterial treatment with a broad-spectrum drug in combination with Metronidazole. After receiving the results of the examination and identifying the causative factor, the specialist will prescribe tablets and medications that will act on the main causative agent of the disease.

The chronic process extremely rarely manifests itself with severe symptoms and does not require emergency treatment measures. The doctor will definitely ask how oophoritis was treated before, what drugs were used and what the effect was.

If there are frequent exacerbations and ineffective therapy, it is necessary to abandon standard regimens: the doctor will select the treatment individually.

In addition to general antimicrobial therapy, the specialist will recommend the following drugs:

• anti-inflammatory rectal suppositories;
• hormonal agents to restore the menstrual cycle;
• local administration of suppositories to remove infection from the vagina;
• pills or herbal remedies to boost immune defense.

Usually, during the treatment process, supervision by a gynecologist and consultation with a proctologist are necessary. At the recovery stage, you can add physiotherapeutic treatment and rehabilitation in sanatorium conditions to the course of therapy.

Both unilateral and bilateral inflammatory processes in the ovaries can cause dangerous and irreversible complications. Timely treatment and strict adherence to the doctor’s recommendations will be the best prevention of infertility and hormonal imbalance, which is especially important for women who dream of motherhood.

Acute oophoritis (inflammation of the ovaries) is on the list of the most common gynecological diseases, but only a few women know what it is and how the pathology manifests itself. Meanwhile, timely diagnosis and treatment of oophoritis can protect a woman from many serious complications.

Causes of acute inflammation of the ovaries

The main cause of acute ovarian inflammation is a bacterial infection. Inflammation can be provoked by both pathogens of sexually transmitted diseases (Trichomonas, gonococci, mycoplasma, chlamydia, etc.) and microorganisms belonging to opportunistic microflora and activated when conditions favorable to them arise (staphylococci, streptococci). Subacute oophoritis occurs due to fungal or tuberculous infection of the body.

Acute inflammation of the ovaries is rarely primary; most often it develops as a complication of other gynecological pathologies. In most cases, the infection enters the appendages through the fallopian tubes. Pathogenic flora can be introduced into the ovaries during the birth process, abortion and surgical interventions.

Oophoritis often develops under the influence of such predisposing factors as decreased immunity, frequent changes of sexual partners, the presence of foci of chronic infection in the body and hormonal imbalances.

Symptoms of acute oophoritis

The acute stage of development of oophoritis is characterized by the following symptoms:

• intense pain in the lower abdomen, which can radiate to the lower back or sacrum;
• purulent vaginal discharge;
• sharp pain during sexual intercourse;
• minor uterine bleeding between menstruation;
• fever, chills, weakness;
• frequent and painful urination.

At the onset of the disease, inflammation often affects only one ovary, in this case we are talking about left-sided or right-sided acute oophoritis. At the same time, the pathological process can quickly “move” to the second appendage, causing bilateral oophoritis. In the subacute form of the disease, all of the above symptoms may be present, but in most cases they are not as pronounced as in acute inflammation.

Diagnostics

To establish an accurate diagnosis if oophoritis is suspected, the doctor interviews the patient and conducts an examination in a gynecological chair. Palpation of the internal genital organs reveals enlargement and tenderness of the ovaries on one or both sides. In addition, the specialist visually assesses the nature of vaginal leucorrhoea.

When diagnosing oophoritis, they must take a smear from the vagina and urethra, and also conduct blood and urine tests to detect the presence of a bacterial infection in the body. The development of the inflammatory process will be indicated by an increase in the number of leukocytes. To establish the source of infection, some women are additionally prescribed a test for sexually transmitted diseases.

The inflammatory process in the ovaries is easily traced using ultrasound, so ultrasound diagnostics is also included in the list of mandatory studies if oophoritis is suspected.

Treatment of acute ovarian inflammation

Oophoritis, accompanied by severe symptoms, requires hospitalization and strict bed rest. The disease is treated with the mandatory use of antibiotics:

• Ceftriaxone;
• Amoxiclav;
• Ofloxacin;
• Doxycycline.

When sexually transmitted infections are detected, antibacterial treatment is required not only for the woman herself, but also for her partner, otherwise the patient faces re-infection and relapse of oophoritis.

It is prohibited to independently treat oophoritis with antibiotics, since only a doctor can determine the appropriate remedy and develop the necessary regimen for taking antibacterial drugs, based on laboratory and functional diagnostic data.

If it has been determined that oophoritis is caused by fungal microflora, the woman needs to take antifungal medications.

For symptomatic therapy, vaginal suppositories with antibacterial and anti-inflammatory effects are used:

• Betadine;
• Hexicon.

The duration of treatment is from 7 to 14 days. Since oophoritis is accompanied by severe pain, the patient may be prescribed antispasmodics and analgesics:

• No-Shpa;
• Spasmalgon;
• Baralgin.

With severe fever and signs of severe intoxication of the body, a woman diagnosed with oophoritis needs to take antipyretics and detoxification therapy. To improve the condition and speed up the healing process, immunomodulators are used.

After acute symptoms are relieved, the woman is recommended to undergo a course of physical treatment to restore the functioning of the reproductive system and reduce the risk of complications.

If the patient’s well-being does not improve within 4 days after the start of therapy, specialists decide to perform laparoscopic surgery, which will determine why the oophoritis is not amenable to conservative treatment. If necessary, drainage of the pelvic cavity is performed during the intervention.

Possible complications

Acute oophoritis, left without treatment, quickly becomes chronic, accompanied by frequent exacerbations. This leads to the formation of adhesions, which impair the patency of the fallopian tubes, increase the risk of ectopic pregnancy, and provoke partial or complete infertility. causes various menstrual cycle disorders and increases the risk of developing concomitant gynecological diseases, in particular salpingitis (inflammation of the fallopian tubes).

In severe cases, oophoritis can lead to the formation of abscesses in the abdominal cavity and peritonitis.

Prevention

To prevent the development of oophoritis, a woman needs to avoid frequent changes of sexual partners, practice protected sex and be regularly checked for the presence of sexually transmitted infections, and if they are detected, immediately begin appropriate treatment.

You should visit a gynecologist at least twice a year for a preventive examination. Infectious foci in other areas of the body should also be eliminated in a timely manner.

Constantly taking care of your own immunity will help reduce the risk of an inflammatory process in the ovaries - giving up bad habits, eating healthy, playing sports, taking vitamin complexes. In addition, it is important for women to protect themselves from hypothermia and psycho-emotional stress.

Oophoritis is an inflammation of the ovaries that can affect either one or two ovaries. The disease rarely occurs in isolation. In most cases, it is provoked by salpingitis - inflammation of the adjacent fallopian tubes. The fact is that the organ in which the eggs mature is connected to the uterus precisely through the fallopian (uterine) tubes. Then experts prefer to use the term salpingoophoritis.

Oophoritis manifests itself as cutting or aching pain in the lower abdomen, purulent vaginal discharge, increased body temperature, fever, and bloating. At the first signs, you must immediately consult a gynecologist for an accurate diagnosis and treatment. Timely seeking medical help will help cure the disease and prevent the development of a chronic disease.

Types of oophoritis

Oophoritis, like other inflammatory diseases, has several forms - this determines the methods of treating the disease. Depending on the course, acute oophoritis is distinguished, as well as subacute and chronic forms. According to location, the diseases are one or two-sided. Due to inflammation, viral, fungal or bacterial etiology of the disease can be distinguished.

In any case, if signs of ovarian inflammation are detected, you must urgently visit a gynecologist. Due to the similarity of the disease with diseases of the genitourinary system and abdominal cavity, the help of specialized specialists will also be required: a urologist, a surgeon, a gastroenterologist.

You should not delay receiving qualified medical care, much less self-medicate for oophoritis. This very often leads to complications, purulent inflammation and the transition of ovarian disease to the chronic stage. These organs play a huge role in the female body - they carry out reproductive and hormonal functions. In the case of chronic oophoritis, the structure of these paired organs changes radically, which can further lead to infertility.

Causes of the disease

Ovarian tissue can be affected due to a number of factors. There are several protective barriers that prevent infectious agents from entering. These are the microflora of the vagina, mucus in the cervix, as well as the natural peristalsis of the fallopian tubes. The pelvic bones reliably protect these reproductive organs from mechanical stress. Therefore, inflammation of the ovaries mainly occurs in patients with weakened immune systems, or those who have undergone surgical and diagnostic interventions. The latter include abortions, curettage and invasive diagnostics. Having miscarriages is another risk factor. Unprotected promiscuity, smoking, stress and hypothermia also play a large role in the development of the disease. Internal causes can also provoke oophoritis:

• hormonal imbalances and endocrine disorders;
• chronic diseases of the genitourinary system and genital organs;
• malignant formations in the pelvic area;
• infections in the abdominal area, inflammation of the appendix.

The result is a weakening of the protective functions in the body, and as a result, the penetration of the infectious agent. The main ones are: Escherichia coli, staphylococci, streptococci, enterococci and Klebsiella. The inflammatory process is also provoked by pathogens of sexually transmitted infections, chlamydia, trichomonas, gonococci, ureaplasma and anaerobic bacteria. There are common cases in which oophoritis in patients with tuberculosis was caused by Koch's bacillus. The mechanism of inflammation is as follows: the pathogen that has entered the ovarian zone attaches itself outside, then, during ovulation, the infection penetrates inside, where it begins to multiply and destroy healthy cells.

Symptoms

In the acute form of the disease, symptoms appear quite suddenly. The temperature rises sharply (up to 39C). Patients note a sharp deterioration in their general condition, chills, dizziness and weakness, which sometimes leads to fainting. Subsequently, a sharp cutting pain appears in the lower abdomen. With a bilateral course of the disease, it can cover the entire groin area. When one ovary is affected, the patient experiences pain on the affected side. Over time, they intensify, especially with sudden movements and turns of the body. Pain is also felt in the area of ​​the coccyx, anus and lower back, and genitals. Additional signs can be identified for a more accurate diagnosis. These are stool disorders, discharge of pus from the vagina, decreased daily diuresis (outflow of urine), and bloating in the abdominal area.

In subacute inflammation of the ovaries, the above signs of oophoritis are less pronounced. There is no fever, the temperature rarely rises above 38 degrees. The pain in the abdominal area is rather aching, it is very difficult to determine its localization. This fact makes it difficult to make a diagnosis, due to the similarity with the symptoms characteristic of infections of the genitourinary system. Clear clinical signs of this stage include discharge of blood and pus from the vagina. The natural course of the menstrual cycle is disrupted, up to complete cessation. Less pronounced symptoms of the subacute course of the disease are dangerous because in these cases women are in no hurry to consult specialists. Counting on treatment at home and a natural favorable outcome. This approach is fundamentally incorrect; oophoritis in this case is also fraught with serious complications.

The chronic course of the disease is characterized by relapses. The impetus for their development is stress loads, physical fatigue, hypothermia, viral and bacterial infections. The rest of the time, the ovarian disease passes without obvious symptoms. The main ones are disruption of the menstrual cycle and pain during sexual intercourse. Another criterion is the duration of the main signs of oophoritis. It should be more than six months. Very often, a chronic disease is determined during the diagnosis of infertility. Chronicization of the process occurs as a result of improper or insufficient treatment for oophoritis, in the acute or subacute phase.

Diagnostic tools

Modern medicine has a wide range of capabilities for identifying and treating ovarian diseases at the earliest stages. Although, just a few decades ago, the diagnosis of oophoritis was less effective. The fact is that the main signs of the disease are very similar to the manifestations of appendicitis, peritonitis, cystic formations and ectopic pregnancy. Therefore, an experienced doctor prescribes a series of examinations and consults with other specialized specialists.

First of all, a detailed gynecological and general medical history is compiled. The full picture is revealed: unsuccessful pregnancies, the presence of abortions, chronic diseases of the genitourinary system, diseases of the abdominal cavity. A visual examination is carried out in a gynecological chair to determine the condition of the reproductive system and the presence of discharge. Using the palpation technique, pain in the area of ​​the fallopian tubes and ovaries is determined. Blood and urine tests are examined, including for the presence of bacterial infections. Bacterial culture of a vaginal smear is intended to help determine the causative agent of inflammation.

A fairly informative method for diagnosing oophoritis is ultrasound examination of the pelvic organs. During it, the diagnostician can determine the focus of the disease directly in the ovary, as well as identify the spread of infection to the fallopian tubes.

Modern laboratory equipment makes it possible to use enzyme immunoassay and polymerase chain reaction. These methods guarantee fairly high results in determining the cause of the disease. A very effective method for determining oophoritis is diagnostic laparoscopy (introduction of optical instruments into the ovaries through small punctures in the abdominal cavity). This allows the doctor to obtain the most complete research results, to identify the presence of adhesions and obstruction of the fallopian tubes in the chronic form of the disease.

Therapeutic measures

Treatment and its duration are prescribed depending on the form of oophoritis. In acute cases, the patient must be hospitalized in a hospital. The main goal is to suppress the action of the causative agent of ovarian inflammation. Therefore, antibacterial therapy is prescribed. Painkillers are used to reduce pain. Patients with oophoritis are advised to eat a diet without spicy, smoked, or canned foods, drink plenty of fluids, and undergo strict bed rest. Desensitization (measures to eliminate the body's increased sensitivity to foreign substances) is designed to prevent the disease from passing into the chronic stage. Non-steroidal anti-inflammatory drugs are also used to eliminate inflammation. The prognosis for treatment with timely treatment is usually favorable.

Treatment for subacute and chronic forms of the disease is characterized by the presence of physiotherapeutic procedures. Electrophoresis, exposure to electric and magnetic fields, UHF therapy, and quartz radiation are used. If tumors with purulent contents, as well as serous and bloody fluids at the site of inflammation are detected, the surgeon performs punctures to puncture the formations and pump out the exudate.

For chronic oophoritis, massage and sanatorium-resort activities, including treatment with mineral waters, are effective. The patient should reconsider her lifestyle, diet, and rest regimen. Moderate physical activity and regular courses of vitamin therapy are required. Planned pregnancy should be postponed until the period of remission, and sexual contact should be limited. In the absence of positive dynamics, surgical removal of part of the affected ovaries is possible. Therefore, the main task for doctors and patients is to prevent inflammation from becoming chronic.

Oophoritis is a long-term inflammation that affects the female paired sex glands - the ovaries. In women of fertile age, oophoritis contributes to the development of various hormonal imbalances, menstruation and phases leading to infertility.

The gradual development of chronic bilateral oophoritis, accompanied by can be fatal. Diseases associated with oophoritis are much more common: endometritis, adnexitis , myometritis, etc.

Read more about what it is and how to cure oophoritis later in the article.

Causes of oophoritis

Typically, the onset of the inflammatory process appears due to the action of infectious antigens on the ovaries. The main causative agents of inflammation are:

• Mycobacterium tuberculosis. According to statistics, in 32% of cases in women, a specific oophoritis with one or two-sided inflammation is detected. Characteristic features are tuberculous tubercles, homogeneous or layered caseomas;
• sexually transmitted infections. The presence of various harmful microorganisms affects both glands simultaneously;
• pathogenic bacteria contribute to the activation of inflammation.

The ovaries are protected from harmful microorganisms by the dense outer capsule and the physiological characteristics of the location. Therefore, to activate inflammation, the following can help:

• pathological diseases of the female reproductive system. Oophoritis is found in women with secondary manifestations of endometritis, cervicitis, etc.;
• inflammation of the pelvic organs. Acute limited and diffuse inflammation of the peritoneum, ascites (abdominal edema), peritoneal cancer, etc. can contribute to the occurrence of chronic bilateral oophoritis;
• tumor-like formations of the ovaries. Tumors are divided into:
  • epithelial. The main components are the cells lining the outside of the ovaries;
  • germinogenic. Consist of cells that produce eggs;
  • stromal. Tumors are formed from ovarian cells responsible for the production of female sex hormones - progesterone and estrogen.

Provoking factors for the development of the disease

In addition to the reasons, there are some factors that can contribute to the development of oophoritis. Provoking factors are:

• The active spread of harmful pathogens is caused by:
  • complicated childbirth;
  • abortions performed;
  • abrasion, etc.;
• promiscuity (promiscuous and frequent sexual intercourse). Constantly changing sexual partners and unprotected sexual intercourse significantly increase the likelihood of ovarian infection;
• secondary pathologies and low immunity. The risk of symptoms of oophoritis is much higher in women suffering from various chronic diseases and obesity. Also, any stressful situations adversely affect a woman’s health;
• long-term use of immunosuppressive drugs;
• injury to the uterus;
• lack of personal hygiene.

Symptoms of oophoritis

All symptoms and signs of oophoritis completely depend on the stage, nature of the inflammation and location of the pathology. Initially, the disease has mild symptoms or no symptoms at all.

A woman begins to be disturbed by aching or cramping pain in the lower abdomen, discharge mixed with pus, which has a characteristic odor and hue. Such symptoms appear in most infectious diseases of the reproductive system.

At the acute stage A woman may experience an increase in temperature to high levels and the appearance of sharp pain in the iliac region on the left or right.

At the subacute stage the condition improves slightly, the temperature drops, but such an improvement cannot be considered a complete cure for the disease. On the contrary, the process itself is at an active stage, and if medical care is not received in a timely manner, the disease will progress to the stage of chronic oophoritis.

Upon palpation, small compactions filled with purulent masses are felt. In this case, an increase in the uterine appendages is observed.

A distinctive feature for left-sided inflammation is its localization, which extends to the entire lower back. Right-sided oophoritis manifests itself in the form of pain on the right side, requiring careful diagnosis.

Ovarian inflammation is characterized by the following symptoms:

• menstrual irregularities:
  • (absence of menstruation)
  • menorrhagia (heavy periods)
  • too frequent menstruation, etc.;
• involuntary metrorrhagia () with manifestations of algodismenorrhea (increased pain during menstruation);
• general condition worsens;
• dyspareunia – sharp pain during sexual intercourse.

Since the symptoms of oophoritis are quite painful, a woman may experience nervous system disorders, disturbed sleep, and a decrease in female libido (sexual desire).

Classification

The development of oophoritis is divided into three stages: acute, subacute and chronic. There is also right-sided, left-sided and bilateral oophoritis. Each stage of the disease has its own symptoms and severity:

• acute stage– a woman experiences cutting pain when urinating, prolonged cramping pain in the abdominal area, daily vaginal purulent discharge appears, and a possible increase in temperature. Sleep is often disturbed and manifests itself as insomnia. The uterine appendages increase in size. The ovaries adhere to the fallopian tubes, after which the fused area becomes inflamed and intoxication begins;
• subacute stage– This stage is rare. The cause of development is tuberculosis or mycotic infection of the entire body. Symptoms are similar to those of the acute stage, but less pronounced;
• chronic stage– at the third stage, the inflammatory process has a long course, appearing if the woman’s body is severely weakened. A woman may not even be aware of the presence of pathology, since chronic oophoritis is practically asymptomatic. Irreversible consequences include infertility.

Oophoritis occurs:

• left-handed– causes include various gynecological interventions, infection of the genital organs, stress, weakened immunity or hypothermia. A high temperature is possible, which cannot be relieved with antipyretic drugs. Pain appears only on the left side, gradually moving to the sacral area, urination is painful, serous discharge is observed;
• right-handed– right-sided oophoritis is mistakenly compared with appendicitis, since some symptoms are quite similar. The causes are harmful bacteria or infections. If left untreated, inflammation may spread to other healthy pelvic organs;
• two-way– two ovaries are inflamed at the same time. Inflammation manifests itself as intense pain, uncharacteristic discharge, etc. Chronic bilateral oophoritis can occur due to unprotected sexual intercourse, low protective function of the body, hypothermia or constant emotional stress.

Diagnostics

To make a correct diagnosis, characteristic nonspecific symptoms are taken into account, which indicate the presence of other gynecological diseases. Therefore, diagnostics involves the use of methods that will give the most informative results. These include:

• gynecological examination. Bimanual examination helps to identify pasty or compacted appendages. When palpated, pain and limited mobility are observed;
• transvaginal ultrasound examination. Thanks to ultrasound, you can find out the size of the glands and the smoothness of their surface. With inflammation, an increase in echogenic structure is observed due to the presence of fibrous areas. There may be signs of inflammation of the endometrium and fallopian tubes;
• laparoscopy. This endoscopic manipulation is one of the best methods for diagnosing various inflammations of the pelvic organs. The procedure helps confirm the inflammatory process itself and, if necessary, biological material is taken for histology analysis;
• laboratory tests to identify the main causative agent of oophoritis include:
  • microscopy - studying small objects using a microscope;
  • bacterial culture of vaginal discharge - study of the physicochemical and biological characteristics of a large number of microorganisms;
  • (PCR) – a method of molecular biology aimed at identifying microorganisms that cause various infectious diseases;
  • immunofluorescence reaction (RIF) - a method of immunological blood analysis;
  • enzyme-linked immunosorbent assay (ELISA) is a diagnostic method aimed at identifying antigens that lead to the development of infectious diseases;
    • tuberculin test is a method showing the body’s response to the main causative agent of tuberculosis. It is carried out only in case of extensive inflammation with mild clinical symptoms.

Differential diagnosis is indicated only in the presence of other inflammatory and extensive pathological processes in the pelvic region.

Treatment of oophoritis

The selection of treatment depends on the severity of the stage of the disease and the presence of complications. If the cause of the inflammatory process is determined, it is recommended to take certain medications, balneotherapy, etc. Surgical treatment is not excluded.

Drug therapy (drugs)

Drug therapy is most common for the prevention and treatment of oophoritis.

Medicines are prescribed exclusively by the attending physician. Essential medications include:

• antibiotics – Tetracycline, Levofloxacin, Augmentin, Streptomycin, . The selection of drugs takes into account the susceptibility of opportunistic flora;
• – Meloxicam, Xefocam, Nimesil, Celebrex. Non-steroidal drugs help reduce pain and the specificity of inflammatory changes;
• enzyme preparations - Creon, Normoenzyme, Ermital, Pancreatin, Gastenorm forte, Pankurmen;
• immunostimulants - Interferon, Dekaris, Arbidol, Likopid, Viferon, Derinat. The main task of immunostimulants is to strengthen the body's protective functions.

When the remission period begins, therapy is prescribed that strengthens the immune system and restores the functions of the reproductive and endocrine systems.

Surgical intervention

Surgical treatment is required only if severe complications are present. If a woman is diagnosed with purulent-inflammatory diseases (purulent endomyometritis, adnextumor, pyovar, etc.) or adhesive diseases leading to tubo-peritoneal infertility, surgical intervention is necessary.

Additional treatments at home

As alternative and additional methods of treating oophoritis at home, some folk remedies are not prohibited. But turning to traditional medicine for oophoritis should be agreed with a doctor, since self-medication can provoke the development of serious consequences.

Nutrition

Comprehensive treatment of oophoritis involves complete and proper nutrition, containing all the necessary microelements and vitamins. Products that should be present in a woman’s diet are:

• chicken eggs. They contain a high level of lecithin, which is involved in the production of sex hormones and the normal absorption of vitamins;
• fatty fish. Fish is high in fatty acids, which have an anti-inflammatory effect. Omega-3 also helps normalize hormonal balance;
• Olive oil contains vitamin E, which has a beneficial effect on the production of hormones and the regulation of the hormonal cycle;
• citrus. The vitamin C it contains has long been considered the best antioxidant that protects, restores and improves women's health;
• Fermented milk products contain calcium, protein and vitamins, which stimulate the immune system.

The diet for oophoritis should be prepared individually by a nutritionist.

Folk remedies

Treatment of oophoritis using various folk recipes can be used. However, you shouldn't get too carried away.

The use of herbs and various infusions should be carried out after a previously prescribed course of medication or surgical intervention.

The safest recipes for ovarian inflammation include:

• Infusion of chamomile and linden flowers. Mix dried flowers, you should get 6 tablespoons in total, add two glasses of water, boil for 25 minutes over medium heat, leave for 30 minutes. Cool, strain well and do microenemas in the vagina in the evening for two weeks;
• Decoction of oak and linden. Take 2 tablespoons of crushed bark and a spoon of linden blossom, add 1.5 liters of water, place in a water bath and cook for 35 minutes. The decoction is best used as a douche twice a day (morning and evening);
• Kalanchoe juice. The juice should only be freshly squeezed. Take the leaves, wash well and grind to a paste, then squeeze through cheesecloth and store the resulting juice at a temperature of up to 9 °C. Take a teaspoon once a day in the morning or use for tampons. In this case, it is necessary to dilute the juice with boiled water. The course of treatment is 15 days.

Prevention

To prevent chronic oophoritis, a woman needs to be examined by a gynecologist every six months, undergo invasive procedures if necessary, refuse abortions and promptly contact specialists to receive qualified assistance.

It is necessary to exclude promiscuity, use contraceptives, maintain proper hygiene, and stop smoking and drinking alcohol. A woman should avoid strong physical and psycho-emotional stress.

Prognosis for patients

If the course of oophoritis passed without complications and the treatment was correct, then the prognosis in most cases is favorable. If a woman seeks medical help late, the treatment can be severe and prolonged. If there is insufficient or no treatment, severe exacerbations and irreversible consequences (infertility) may develop.

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- a long-term inflammatory process that affects the ovaries. An exacerbation of the disease is characterized by dull or aching pain in the lower abdomen and groin area, mucous and mucopurulent leucorrhoea. In the remission phase, disorders of the ovarian-menstrual cycle, dyshormonal disorders, and infertility are observed. To diagnose the disease, bimanual examination, ultrasound of the pelvic organs, laparoscopy, and laboratory diagnostic methods are used. The treatment regimen includes etiotropic antibacterial drugs, anti-inflammatory, immunocorrective and enzyme agents.

General information

The disease occurs cyclically: a period of exacerbation with clinical symptoms, expressed to varying degrees, is replaced by remission. Exacerbation of the process is usually facilitated by hypothermia, stress, hormonal changes during pregnancy or before menstruation, colds, and decreased immunity.

Symptoms of chronic oophoritis

The clinical picture of the disease depends on its phase. During an exacerbation, the patient is bothered by a dull or aching pain in the lower abdomen and groin area. Possible irradiation to the sacrum, increased pain during physical exertion and sexual intercourse. If other genital organs are involved in the inflammation, the amount of vaginal discharge increases, usually mucous, less often mucopurulent. General symptoms, as a rule, are mild; in rare cases, they manifest as fever up to low-grade levels, nausea, and sometimes vomiting.

In remission there is usually no pain. A woman’s sleep may deteriorate, performance may decrease, fatigue and irritability may occur, the menstrual cycle, sexual and reproductive functions may be disrupted. With chronic oophoritis, periods become irregular, while the menstrual cycle usually lengthens, intermenstrual bleeding, pain and heavy menstrual flow may occur. Some patients experience severe PMS. In 50-70% of women, libido decreases, which is often associated with dyspareunia (painful sensations during sex). In some cases, the only sign of chronic inflammation is the inability to become pregnant with regular sexual activity.

Complications

Since in a chronic course oophoritis is usually combined with salpingitis, the most serious complication of the disease is adhesive disease. It is plastic pelvioperitonitis and disruption of the endocrine function of the ovaries that usually lead to tuboperitoneal infertility. In addition, such patients have a significantly increased risk of ectopic pregnancy and miscarriage. With exacerbation, oophoritis can be complicated by purulent-inflammatory processes, from purulent melting of the ovaries (pyoovar) to the formation of a tubo-ovarian abscess and the development of peritonitis.

Diagnostics

When making a diagnosis, it is necessary to take into account that the symptoms characteristic of chronic oophoritis are quite nonspecific and may indicate other gynecological diseases. Therefore, the examination plan includes methods that reliably confirm the localization of inflammation and allow identifying the pathogen:

• Examination on the chair. On bimanual examination, the appendages are pasty, compacted or stringy. On palpation, pain and limited mobility are noted.
• Transvaginal ultrasound. The ovaries are enlarged, their surface is smoothed. The echogenic structure is enhanced due to the presence of areas of fibrosis. Echo signs of inflammation of the fallopian tubes and endometrium may be present.
• Laparoscopy. The endoscopic method is considered the gold standard for diagnosing inflammation in the ovaries. During the procedure, you can not only confirm the inflammatory process, but also, if necessary, take biomaterial for histological examination.
• Laboratory diagnostics. Microscopy, culture of vaginal discharge, PCR, RIF, ELISA and other tests can determine the causative agent of oophoritis.
• Tuberculin test. Indicated in the presence of an extensive inflammatory process in the pelvic area with scant clinical symptoms.

Differential diagnosis is carried out with other inflammatory gynecological diseases and volumetric processes in the pelvic cavity. According to indications, the patient is referred for consultation to a gynecologist-reproductologist, oncogynecologist, or phthisiatrician.

Treatment of chronic oophoritis

The choice of therapeutic regimen depends on the phase of the process. In case of exacerbation and the identified causative agent of inflammation, the following are indicated:

• Etiotropic antibacterial therapy. Medicines are selected taking into account the sensitivity of pathogenic flora. If necessary, broad-spectrum antibiotics are prescribed until culture results are obtained.
• Anti-inflammatory drugs. Non-steroidal drugs can reduce pain and the severity of inflammatory changes.
• Enzyme therapy. The use of enzyme preparations is aimed at preventing adhesive disease and resolving existing adhesions.
• Immunocorrection. To strengthen the body's own defenses, immunostimulants, interferonogens, and vitamin and mineral complexes are recommended.

During the period of remission, therapy aimed at strengthening the immune system and restoring reproductive and endocrine functions plays a leading role. At this stage, immunoregulators, enzymes, eubiotics, biogenic stimulants, and hormonal drugs are prescribed. A combination of drug treatment with physiotherapy and balneotherapy is effective. Surgical techniques are used in the presence of complications. Operations are indicated when severe purulent-inflammatory diseases (pyoovar, tubo-ovarian abscess, peritonitis, etc.) and adhesive disease leading to tubo-peritoneal infertility are detected.

Prognosis and prevention

With an uncomplicated course and proper treatment, the prognosis is favorable. To prevent chronic oophoritis, it is recommended to visit a gynecologist every 6 months, carry out invasive procedures reasonably, refuse abortions, and promptly and sufficiently treat infectious and inflammatory diseases of the reproductive sphere. It is important to exclude casual sex, use barrier contraceptives, maintain personal hygiene, lead a healthy lifestyle with sufficient physical activity, and quit smoking and alcohol abuse. It is necessary to avoid hypothermia, significant psycho-emotional and physical stress.