salpingo - a joint disease process in the tubes of the uterus and ovaries infectious and inflammatory origin.Most cases salpingoophoritis is one-sided.
isolated infectious process only in pipes or just ovaries are extremely rare.Typically, the infection spreads rapidly to the fallopian tubes (salpingitis) on the ovaries (oophoritis), causing general inflammation, so salpingoophoritis various etiologies (specific or nonspecific) prevail in the structure of infectious and inflammatory diseases of female pelvic organs.Sometimes salpingo combined with inflammation of the uterus (endometritis).
Ovary is a steam iron, is responsible for producing hormones.His "feminine" appearance and the ability to reproduce a woman is obliged to ovarian hormone, namely estrogen and corpus luteum hormone - progesterone.Their size, weight, structure and functioning are determined by the nature of a woman's age.After the completion of puberty (puberty), the ovaries begin to complete hormonal activity, w
hormonal ovarian function is closely related to the endocrine, nervous and exchange systems.The set of functions of these systems provides the conditions for normal ovaries.
outside the ovary is covered by a thick and dense capsule (tunica), its uneven surface gives ovaries resemblance with a stone peach.Within the tunica is a continuous maturation of follicles - small "bubbles" surrounded by a protective capsule.Within each follicle is a female sex cell (ovum).The degree of maturity of the follicle corresponds to the degree of maturation of the egg.After the process of follicle maturation, its outer shell is broken and the egg leaves the ovary adult (ovulation period).In the ovaries of healthy women over the life of the follicles are always present, are at different stages of maturity.Usually their presence and structural features indicate the physician ultrasound diagnosis during the study.
If the ovaries become infected, it causes structural changes in its tissues and hormonal dysfunction.As a result, due process of oocyte maturation is disturbed, there are disturbances of the menstrual cycle and infertility.
Fallopian tube - this body doubles as a tube, on the one hand in the opening angle of the uterus cavity, and the other - the peritoneal cavity near the ovary.They function as a sort of tunnel, in which the fertilized egg moves from the abdominal cavity into the uterine cavity for the onset of pregnancy.The mucous lining the cavity of the fallopian tube, forming many small folds, ensuring its mobility.
To the egg moved in the right direction, fallopian tube performs undulating toward the uterus.The epithelial layer of the fallopian tubes contain special "ciliary" cells.On the surface there is a "cilia", they oscillate (flicker) and help to promote the egg in the right direction.
If you get an infection in the fallopian tube develops edema, narrowing the lumen of the tube until the full adhesion of the walls, broken or stops the process of the wave-like motion.
complex system of ligaments holding the uterus, ovaries and uterine tubes in position and ensures their permanent anatomical and physiological connection.This explains the rapid spread of any infection in the uterus - fallopian tubes - ovaries.
source of infection when the pathogens are salpingoophoritis specific infections (gonorrhea) and representatives of non-specific (opportunistic) microorganisms.Specific inflammation always begins in the acute form, and proceeds with severe clinical signs and subacute nonspecific salpingo origin may show small signs.
inflammatory disease of the ovaries and uterine tubes always develop on the background of immune disorders.A healthy immune system is able to withstand most infectious agents, so when ingested pathogenic bacteria develops the disease is not always and not at all.The risk of developing salpingoophoritis found women with chronic neginekologicheskimi infectious, immune and endocrine disorders.
Usually, diagnosis salpingoophoritis in the stage of acute inflammation in the right of the survey does not cause difficulties.Specific symptoms salpingo not.Manifestations of the disease may be similar to infectious-inflammatory process any location in the pelvis, and sometimes beyond, organ.Therefore, the initial diagnosis requires salpingo simple laboratory and instrumental confirmation.
forecast primarily depends on when he was diagnosed with salpingo and the timeliness of the beginning of his treatment.Pelvic cavity contains a well-developed network of blood, so any infection quickly spread to other organs and tissues.If a woman is trying to treat yourself or ask for help out of time, salpingo becomes chronic with alternating periods of exacerbation and remission.
to choose the right medical tactic at salpingo necessary to establish the cause of infection and to evaluate its effects.The leading role in the treatment of acute or exacerbated chronic inflammatory processes owned by antibiotics.The desired drug is selected individually according to the bacteriological conclusion.
If chronic inflammation is in remission, treatment is carried out without the participation of antibiotics.Therapeutic measures are aimed at eliminating the consequences of the infection and restore the normal functioning of the immune system.
a long-term infection of the fallopian tubes and ovaries provoke serious consequences: ectopic pregnancy, menstrual disorders and infertility.Some salpingoophoritis septic complications (purulent salpingitis and suppurative tubo-ovarian abscess) require surgery, which does not always manage to save the affected organ infection.
only reason salpingoophoritis development is the penetration of infection in the tissue of the uterus and ovaries pipe on the background of a sharp decline in the level of immune protection.
source of infectious inflammation may be causative agents of sexually transmitted diseases (gonorrhea), pathogenic or opportunistic bacteria: staphylococcus, streptococcus, E. coli, chlamydia, mycoplasma, and so on.The vast majority of salpingoophoritis not caused by one pathogen, and mixed microbial association.We can say that every patient with salpingo A personal "set" of pathogens.
presence of pathogenic microflora does not always lead to the development of the disease.Generally, salpingo develops in the presence of unfavorable background.Inflammation of the ovaries and uterine tubes provoke:
- Severe hypothermia (especially during menstruation), which are reduced by the action of mechanisms of immune protection, and pathogenic microbes begin to proliferate.
- Abortion, scraping the uterus, hysteroscopy and similar surgical manipulation of the genitals.The infection gets to the injury of the uterus through the mucous membranes or entered from outside the body using the tools.During childbirth or postpartum infection enters the damaged surface of the birth canal and into tissues and organs.
- Intrauterine contraception.During long-term presence of uterine spiral in the uterus, around the image of a local inflammation and microtrauma appear.Furthermore, intrauterine over time loses antiseptic properties and become unsterile.Infection of the uterus can get outside for violations of the rules of the introduction of an intrauterine device.Once in the uterus, infection with time and gets in the pipe, causing inflammation.
- Sexual contact with a source of venereal (specific) infection.The most common acute purulent salpingo called the agent of gonorrhea (gonococcus).Promiscuity also predispose to the development of infectious-inflammatory process in the uterus, as they violate the constancy of the composition of the microflora of the vagina and deplete local immunity.
- The presence of an infectious inflammation of the uterus (endometritis).
- The presence of chronic foci of infection in the body when tonsillitis, pyelonephritis, otitis media, and so on.During their acute infectious agents can get to the uterine appendages through the blood or lymphatic vessels.
- Heavy hormonal and endocrine diseases (hypothyroidism often and diabetes).
- stress, neurosis and frequent fatigue.
salpingo can trigger physiological reasons, these include pregnancy and menstruation.In the body of pregnant women going on physiological changes in the composition of the vaginal microflora and reduced immune defense.Acute salpingo pregnancy occurs much less frequently available exacerbation of chronic inflammation.
During menstruation uterus is converted into extensive wound surface, and a change occurs in the vagina microbial composition.In such circumstances, the infectious agent is easier to overcome the local anatomical and physiological barriers and penetrate into the uterus, and then - in the tubes and ovaries.
Pathological changes in the composition of the normal vaginal microflora significantly facilitate the process of infection of the uterus and appendages.In healthy women, the vagina is prevalent lactic microflora - lactobacilli (98%).It provides a constant pH of the medium and inhibiting the growth of opportunistic pathogens.Reducing the number of lactobacilli causes a change in the microbial composition of the vaginal environment, unwanted microflora begins to vegetate vigorously and provokes a local inflammatory process.The infection then enters the cervix the cervical canal causes inflammation and rise above - in the uterus and tubes.
Symptoms and signs salpingoophoritis
ovaries and uterine tubes are closely related anatomically, they have a common circulatory and lymphatic system, so the infection rarely develops in isolation.Infrequently salpingo occurs only on one side due to ascending infection when the germ enters the Association of the uterus from the underlying structures - the vagina, cervix or uterine body.Much less infection gets to the appendages by descending from upstream organs and tissues through the blood vessels.It is noted that the right-left-hand salpingo detected more frequently.
inflammation initially begins to develop in the canal of the fallopian tube (salpingitis).The infection damages the surface epithelium and be embedded in the layers.As a result, the tube wall becomes edematous and thickened.In the cavity of the tube is released inflammatory secret.At this stage of the disease palpation of the area becomes painful appendages.
When the inflammatory secretions become much he and pathogens falls from the chimney of the uterus into the abdominal cavity.As a result, infected ovary surrounding the peritoneum and the outer shell of the fallopian tube (periadneksit).Since inflammation becomes diffuse in nature, grow and inflammatory symptoms of infection - pain intensified, there are signs of intoxication.
shell of the ovary is able to resist infection with a powerful protective layer embryonic epithelial cells.Therefore, the ovaries are affected only in the presence of an infection of structural defects, such as cysts.In place of formation of ovarian cysts shell thinned and could miss the infection into the underlying tissue.If the ovaries are unable to resist infection, inflammation and limited signs periadneksita not develop further.However, in this case, without the timely elimination of the disease becomes chronic inflammation and can get into the ovarian tissue when a provocative situations.
ovulation period is also favorable for infection of the ovaries.After the rupture of the follicle on the surface is formed microtrauma through her infection penetrates into the tissue of the ovary, and the symptoms of disease associated signs of inflammation of the ovary (oophoritis).
in the fallopian tube during salpingitis due to swelling and development of inflammatory secretion (exudate) sticking occurs between the walls is followed by the closing of the lumen of the tube.Secret code becomes much ampullar Front pipe uterus turns into saccular formation with serous contents - hydrosalpinx, some of the patients, he exists as an independent chronic disease.
If the contents of the tube is filled with pus, formed piosalpinks.
inflammation of the uterus in the surrounding area is also accompanied by a process of exudation.First, inflammatory fluid has a low density, but with time it becomes more viscous and viscous, forms a specific bands (adhesions), which are bonded to each other surrounding tissues and organs.In chronic adhesive process is disturbed mobility of the uterus and its appendages, there are constant aching pain in the abdomen.
clinical picture and symptoms of the disease are largely determined by the nature of the pathogen, inflammation of the form I and the individual body's ability to resist infection.Gonorrheal and septic salpingoophoritis caused by staphylococcal and streptococcal infection, most often occur in the form of acute purulent inflammation.
Lesser symptoms limited aggravation salpingoophoritis or subacute salpingo when infected with chlamydia.
The first symptom salpingoophoritis any cause - pain in the abdomen.Character of pain depends on the location and the stage of inflammation.When unilateral pain inflammation appendages appear on the affected side and more pronounced in the acute stage of inflammation.The intensity of pain increases with the spread of the infection, then it could join the symptoms of fever, leucorrhoea and menstrual disorders.With involvement of inflammation of the tissues surrounding the ovary, pain become diffuse nature, which makes it difficult to primary diagnosis.Often, patients with acute inflammation in the uterine appendages fall into the hospital with suspected acute surgical pathology.For example, a sharp right-salpingo often diagnosed as appendicitis.
Beli when salpingo may be purulent or seropurulent.The source of the abnormal discharge is inflammation of the vagina and cervix (cervicitis).
Menstrual irregularities at salpingo associated with tissue damage and ovarian hormonal imbalance and most often appear heavy menstruation or intermenstrual bleeding.
Every fifth patient with salpingo complains of infertility.It is associated with hormonal disorders, with blocked fallopian tubes inflammatory exudate and adhesions in the pelvic cavity.
Clinic salpingoophoritis can be very diverse.If the patient has a concomitant gynecological and extragenital pathology, to a small set of symptoms of inflammation and join other nonspecific symptoms: impaired bowel and bladder, bowel disorders, etc.In such a situation, one has to resort to the help of related professionals.
primary diagnosis salpingoophoritis includes the study of patient complaints and gynecological examination.To confirm the diagnosis it is necessary to carry out laboratory tests: complete blood count, strokes separated the vagina and cervix to help determine the degree of inflammation and the bacteriological examination identifies the pathogen.Ultrasound examination is conducted to clarify the localization of the disease process and the nature of structural damage.