inflammation of the ovaries
inflammation of the ovaries - is pathological changes in the ovaries of infectious and inflammatory nature.Isolated inflammation of the ovaries is uncommon.Like any inflammatory process inflammation in the ovaries can be expressed in the form of an acute or chronic inflammation, have one or dvuhstronnim.Symptoms of subacute inflammation observed in the case of aggravation of chronic inflammation of the ovaries or in the case of subacute.Infrequently occurring joint inflammation of the uterus and ovaries is a serious disease process and lead to the loss of reproductive capacity.
Ovary is an important pair of sexual gland, responsible for women's reproductive function.With the uterus and fallopian tubes is closely linked anatomically and functionally.The average size and shape of the ovary, as well as its structure, with the age.After the completion of puberty the ovaries become "adult" external signs and begin to function fully.After menopause, the hormonal ovari
Externally mature ovary resembles a peach pit no more than 4 cm in length, a width of about 2.5 cm and a thickness of 1-1.5 cm. Outside the ovary is well protected by a thick tunica.It has a pronounced protective effect, however undesirable microorganisms can not penetrate into the ovary.Due to inflammation of the tunica albuginea in the ovary occurs much less frequently than in the uterus or tubes.
Under the tunica is cortex.On its surface is always a large number of unequal maturity of primordial follicles.These follicles are similar to the fluid-filled vesicle, where the egg matures.Structural changes in the ovaries symmetrical cyclical changes in the body and are regulated by sexual hormones.When the process is completed the formation of the egg (mid-cycle), the wall of the follicle is destroyed and mature sex cell leaves the ovary, that is a period of ovulation.If in the next two days, the egg is not fertilized, it dies, and in the case of fertilization it begins to move into the uterus, fallopian tube breaking.Getting out of the fallopian tube into the uterine cavity, the egg is embedded in its thickness, which begins development of pregnancy.
Ovaries are responsible for the formation of estrogen and progesterone, their activities related to the function of other endocrine glands.Due to hormonal ovarian function is the formation of female genitalia and provides the ability to conceive.
ovarian inflammation develops in the presence of the source of infection, which is located nearby, on the background of the deformation mechanisms of immune protection.The most common source of infection is the ovary or fallopian tube gland and inflammation of the right ovary, and may even cause an infected appendix.
Symptoms of inflammation of the ovaries determined the cause of the disease, its stage and the presence of concomitant infection foci in the surrounding structures.In most cases, inflammation of the ovaries is part of a combined inflammation of the uterus (salpingoophoritis), when at the same time affected the fallopian tubes and ovaries.
diagnosis of inflammatory diseases of the uterus, usually does not cause difficulties.The correct diagnosis allows the patient to set specific complaints, the data gynecological examination and laboratory tests.Ultrasound scans helps to localize the inflammatory process and the extent of its spread.
inflammatory disease of the uterus lead to serious complications.Every fifth patient, who has survived salpingo infertile, while 5-6% recover happen suppurative complications requiring major surgery.
Chronic inflammation of the uterus leads to the development of pelvic adhesions.
Therapy involves inflammation of the ovaries an individual treatment program, whose mission is to eliminate the source of infection, correction of associated hormonal and immune changes, as well as the elimination of complications.An important part of the treatment of inflammation of the ovaries in young women is to restore the ability to conceive.
To understand the anatomical and physiological abnormalities in ovarian inflammation, patients should have the right idea about their structure and function.Sometimes patients interpret their diagnosis as an inflammation of the ovaries and as a result of misinterpretation of medical terms.The ovaries and fallopian tubes (tubes of the uterus) are together the uterus, so the diagnosis is interpreted as an inflammation of the ovaries and wrong.To speak correctly, you must use the phrase inflammation of the appendages.
Causes inflammation of the ovaries
inflammation of the ovaries has an infectious origin.At the root of the disease is opportunistic (staphylococcus, streptococcus, E. coli, Mycoplasma, etc.) or pathogens (Chlamydia, spirochetes, viruses, etc.) microflora.Specific inflammation provoked by gonococci.Representatives of one species of microorganisms is difficult to overcome the protective barriers of the genital organs, so most of inflammatory diseases of the ovaries and fallopian tubes caused by microbial associations.
inflammation of the ovaries in the absence thereof in the tubes of the uterus is extremely rare.The most common sources of inflammation in the tissues of the ovary is located next to an infected fallopian tube (salpingitis).In inflammation of the ovaries and tubes have a single mechanism for the origin and development.The cavity of the fallopian tubes in a healthy body is sterile.Infection pipe penetrates advantageously ascending path downstream from the vagina, cervix and uterus.Very rarely cause inflammation appendages are available in the body pockets of chronic infection (tonsillitis, pyelonephritis, and so on), in which case the disease-causing microbes to enter appendages downward path through the blood vessels.
To the tubes, and then in the ovaries, began an infectious-inflammatory process, one of infection in these areas is not enough.Healthy appendages in most cases to cope with the infection and prevent it from spreading.Therefore, inflammation of the appendages always develop in immunocompromised patients with an unfavorable background: endocrine and immune diseases, hormonal dysfunction, background gynecological diseases, etc.
inflammatory process in appendages of the uterus begins with infection in the tubes.By the predisposing conditions for the emergence of salpingitis include:
- damaged tissue of external genital tract and the uterine cavity during diagnostic and treatment procedures, abortion or childbirth.Association of opportunistic pathogens to successfully penetrate the mucosal injury in the underlying tissues and begin to multiply, and then climb up to the tubes of the uterus.Pathogens can get into the genital tract and through surgical instruments.
- specific inflammation of the genitals.Gonorrhoea (gonorrhea) can damage the epithelial cells of the outer genital tract and then spread above.Gonorrheal acute inflammation characterized by the rapid spread of genital tract and causes severe septic complications appendages.
- The presence of chronic infectious and inflammatory changes in the uterus.In chronic endometritis pathogens have the opportunity to climb into the fallopian tubes and be a source of inflammation.
- Uterine spiral.As the spiral yarns from the vagina infectious agents can get into the endometrium, and then - in the tubes and ovaries.
- Stress and fatigue.
- Hypothermia, or a sharp change of climatic zones.
Physiological triggers inflammation in the ovaries factors are pregnancy and menstruation.During menstruation, the endometrium is torn away from the uterus, leaving the vast open wound surface blood vessels, and the outer mouth cervical canal reopened.If the vagina is undesirable microorganisms, such conditions favor the spread of infections rising to appendages.
provoke inflammation of the ovaries during pregnancy may be the natural hormonal changes and reduced immune defense.
Features anatomical and physiological structure of ovarian allow them to long and steadfastly resist any infection, but in violation of immune defense mechanisms such capacity is sharply reduced, and infection with inflammation of the tube extends into the tissue of the ovary.
Symptoms and signs of inflammation of the ovaries
85% of patients with inflammation of the ovaries revealed similar processes in the fallopian tubes, which indicates the common mechanisms of disease development.
beginning in the lining of the fallopian tubes (endosalpinkse) infection develops under the influence of inflammation.The wall of the tube increases in volume due to proliferation of the glandular structures and pronounced edema, and it appears the oral inflammatory fluid (exudates), containing a large number of microbes.Over time, the amount of fluid becomes more and more, it has a damaging pressure on the epithelium of the fallopian tube channel.With increasing inflammation in tube process begins sticking its walls.The lumen of the tube is narrowed and then closed altogether.In the fallopian tube vials stored secret sites sticky pipe delimited.Thus formed saccular formation filled with serous contents - hydrosalpinx.In the case of purulent inflammation similar process is accompanied by the formation of piosalpinks - delimited cavity with pus.
with the content of the fallopian tube infection gets beyond it, which also can cause inflammation and adhesions.
inflammation of the ovaries is much rarer than inflammation of the fallopian tubes.This is because the outer shell is able to resist the invasion of ovarian infection.Under certain unfavorable conditions, the protective function of ovarian tissue can be reduced.The most common infection in the thickness of the ovary can penetrate formed during ovulation microtrauma on its outer shell.When the primordial follicle is destroyed, its place formed a "physiological wound", and if at this point is near the source of inflammation, the ovary can become infected.
inflammation of the ovaries increase in size due to pronounced edema.Pathological processes lead to exudation on the surface of the inflamed ovary begins to form multiple small adhesions and adhesions.They appear after exudate becomes thick and viscous, glues and then folds the tunica albuginea to "wall up" infection in one place and not to let it into the pelvic area.In the absence of timely treatment of the ovary can reach large sizes, and infection penetrates into the surrounding structure of the ovary and the subsequent development of inflammation of the pelvic peritoneum and peritonitis.
During acute purulent inflammation may occur to melt the walls of the tube and ovary, followed by the formation of a single delimited cavities (abscess) filled with pus - tubo-ovarian education.
inflammation of the ovaries without proper early treatment leads to the development of adhesions in the pelvic area.As a result of disrupted natural mobility located in the pelvis organs that if "fluster" to each other or to the pelvic peritoneum.The folds formed spikes, is a dormant infection that under adverse conditions, can provoke an aggravation of chronic inflammatory process.
symptom complex with inflammation of tubes and ovaries is determined by the form of the disease and the presence of concomitant genital pathology.In the acute stage of the disease the leading symptom is severe pelvic pain.Pain syndrome depends on which bodies are involved in the inflammatory process.Because adhesions formed pelvic organs change their location and mobility, and this leads to a change in the nature of pain.Typically, the pain in inflammation of the ovaries appear in the groin on the side of the affected ovary and radiating to the lumbar region or rectum, and are similar to the acute surgical pathology.For example, an acute inflammation of the right ovary can mimic appendicitis and acute inflammation of the left ovary can take for left-sided renal colic.Joint inflammation of the uterus and ovaries causes spilled pain without clear localization.
acute infectious inflammation of the uterine appendages accompanied by fever (temperature can reach 40 ° C), malaise, dysuria, purulent or serous-purulent discharge, sometimes accompanied by inflammation of the left ovary defecation disorders.This acute condition is a cause of urgent hospitalization of patients and gynecological hospital.
diagnosis of inflammation of the ovaries no significant difficulties.It noted a sharp pain the lower divisions of the anterior abdominal wall during a general inspection.At gynecological examination on the side of inflammation palpable enlarged and painful uterine appendages.Attempts to offset the uterine cervix appears a sharp pain.
Laboratory diagnosis identifies:
- characteristic of the acute process of increasing the number of leukocytes and the rise of ESR;
- the presence of a large number of smears of white blood cells and pathogens, with specific inflammation - Neisseria gonorrhoeae;
- the source of infection and the appropriate antibiotic to eliminate it (bakposev).
During an ultrasound scan revealed the presence of inflammatory fluid in the posterior fornix, an increase in size of the ovaries, the presence of a fluid piosalpinks.
Acute inflammation of the ovaries during pregnancy is uncommon.Normally, pregnancy is the reason for the worsening of existing chronic inflammation of the ovaries and fallopian tubes.
Chronic inflammation of the ovaries
When untimely begun treatment or in case of inadequacy of six months acute infectious inflammation of the ovaries becomes chronic features.With an active and proper treatment in the majority of cases the inflammation undergoes reverse development, but leaves behind a spike.The spikes delineated spaces remain infectious agents, under favorable conditions, they "wake up" and begin to provoke aggravation.
disease continues for many years and is accompanied by frequent exacerbations and remissions short.
exacerbation of chronic inflammation of the ovaries occurs in subacute form, and does not differ bright clinic.The pain is not acute are strong signs of fever, no blood tests show no abnormalities, and isolation become slimy appearance or disappear altogether.
symptoms of chronic inflammation of the ovaries related to the complications of acute myocardial process - adhesive process and hormonal dysfunction.Typical complaints of patients with chronic inflammation of the ovaries are:
- Persistent aching or pulling, dull pelvic pain without clear localization, sometimes radiating to the lumbosacral region.They relate to the adhesion process, and despite the low intensity, highly nervous about the patient.During menstruation, when supercooling and intimacy pains become stronger.
- Infertility.Diagnosed every third patient with chronic inflammation of appendages.Loss of reproductive functions may be associated with damage to the epithelium of the Fallopian tubes and pathological structural changes in the ovary.Endosalpinksa epithelium during acute inflammation often dies, and the tube can not perform the transport function - to deliver the egg in the uterus.Prevent the movement of the egg can be formed and hydrosalpinx and adhesions in the cavity of the tube.Ovarian infertility due to the effects of an acute infectious tissue damage ovaries and their subsequent inability to "grow" the egg.
- rhythm disorders and the nature of menstruation.