woman's health

adnexitis

Definition of adnexitis

Annexed is any inflammatory process that affects the appendages of the uterus, or ovaries and tubes (hence the name "annexed"); in the medical language, one speaks more precisely of salpingovaritis, which can manifest itself in a chronic, subacute or acute form.

When phlogosis only affects salpingis, we speak of salpingitis (a phenomenon that is also very frequent), while the term "pelvic inflammatory disease" is suitable for expressing inflammation extended also to the peritoneum.

Incidence

Adnexa is estimated to be a very frequent phenomenon: statistics record about a million cases a year in the US. In general, the annexes mainly involve young women, aged between 20 and 25, with intense sexual activity; it also seems that the annexes affect one woman per 100. In other words and in other numbers, the annexes represent 30% of gynecological disorders.

Annexitis can also occur in the puerperal period, and in this case it is an inflammation that generally afflicts some women a few weeks after giving birth.

Causes

The factors that cause the annexes are almost the same as those we have analyzed in the article "the salpingites", so much so that, often times, the terms are used without distinction as synonyms (even if it is not entirely correct, since they involve adjacent areas but different).

The most important causative factors predisposing annomenite are represented by microorganisms such as: Staphylococci, streptococci (pyogenic microorganisms, which cause inflammation ), gonococci (germs responsible for blenorragia), tubercular bacilli (sporadic cases) and Chlamydia. Bacteria generally spread by blood or lymphatic, but can reach the ovary (and generate infection) also through the uterine mucosa and sexual intercourse. As already mentioned in the previous paragraph, the annexes can also be favored by childbirth or abortion.

Obviously, the cooperation of the bacteria aggravates the pathology: for example, the gonococcus, a proponent of blenorragia, can cause a noticeable and excessive exudation inside the lumen of the tube which, in turn, favors the invasion of other bacteria in the tuba itself.

Symptoms of acute annexe

Annessaitis can be acute, subacute or chronic.

In acute annomise, inflammation causes strong and sudden pains, similar to colic, in the area between the lower abdomen and the lumbo-sacral region; in addition, acute annexitis causes a typical sensation of tension in the abdominal muscles, resulting in menstrual irregularities, dyspareunia (pain during intercourse) and possible fever. Acute adnexa may be the cause or consequence of cervicitis and endometritis, three closely related pathological phenomena: the simultaneous presence of adnexa, cervicitis / endometritis causes a copious loss of mucus from the genitals and fever.

Acute annexitis is usually caused by puerperal bacterial infections (after birth, or following an abortion) and blenorrhagic infections (favored by the gonococcus).

More often than not, acute annexe affects only one tuba, but both can be infected: due to the inflammatory process, the structure of the tube undergoes considerable alterations, which consist in the increase in volume, in the congestion and in the production of a purulent or serous exudation. The infection thus spreads to the ovary and to the peritoneum.

As for the subacute annomenite, the disorder is generally accompanied by tuberculous foci that evolve into chronic forms in most cases.

Symptoms of chronic annexitis

Acute annexitis, if not promptly cured, can also evolve in the chronic form, thus lasting over time with sometimes very painful episodes: chronic annessitis, generally, does not cause a real fever, but rather a low-grade fever (slight thermal bodily alteration), often accompanied by asthenia, vaginal discharge, loss of appetite and malaise in general.

From a morphological point of view, chronic salpingitis causes deformation and swelling of the tuba, with consequent formation of adhesions that favor further bacterial infections.

In a general sense, the typical symptomatological picture of chronic annexitis does not differ much from the acute form, except for the intermittency of pain and the tightening of the same, especially following physical exercises of consistent size and efforts. It has been estimated that the aggravation of symptoms often coincides with the period preceding the menstrual flow.

The most unpleasant consequence of chronic adnexal is sterility, a condition given by the adhesions formed in the ovary, in the uterus and in the peritoneum, which in the long run may occlude the lumen of the tube.

Diagnosis and treatment

The gynecologist certainly represents the medical figure to whom the woman should address already from the earliest manifestations of the symptoms listed above: the timely accurate examination is essential to identify the inflammation of the uterus and the infection caused by the bacteria.

The therapy to treat annomyitis is aimed, first of all, at the destruction of the pathogenic bacteria that caused the damage, and secondly, to make the patient recover from inflammation.

When it comes to chronic adnexal disease, the doctor may recommend the administration of targeted antibiotics for that particular pathogen. The correction of intimate hygiene is indispensable, which must be even more scrupulous in the case of annexes.

The gynecologist must prepare the patient for a treatment that may take a long time and the woman must not become discouraged if the disorder persists even after a few months. In this regard, it is also advisable to take spa treatments which, in addition to determining a positive outcome against annomnite, promote a woman's relaxation, which is absolutely essential. It has been in fact assessed that many women affected by adnexa are considerably stressed: in this regard, thermal treatments induce relaxation and are simultaneously beneficial for combating the disorder.

In the most serious cases of adnexa, the woman should undergo surgery for excision of diseased tissues and the preservation of productive capacity.