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Ovary inflammation and fallopian tube inflammation

Adnexitis

Ovary and fallopian tube inflammation is a serious gynecological disease. Common features include pain in the lower abdomen, discharge, and fever. Possible triggers are bacteria such as chlamydia. Adnexitis should be treated promptly, as infertility is imminent.

Overview: What is ovarian and fallopian tube inflammation?

Adnexitis is an inflammation of the ovary and fallopian tube. Fallopian tubes and ovaries are grouped under the term adnexa. Adnexe (Latin plural Adnexa) means as much as appendage formation. The term was chosen because both organs appear like an appendage of the uterus. Important terms at a glance:

  • Salpingitis: inflammation of the fallopian tubes
  • Oophoritis: inflammation of the ovaries
  • Adnexitis: combined inflammation of both organs

Chronic adnexitis can damage the fallopian tubes and ovaries to such an extent that affected women become permanently infertile and can no longer have children. Therefore, complaints in the abdomen should always be clarified by the doctor.

Frequency

Predominantly women of reproductive age are affected by inflammation of the fallopian tubes or ovaries, often between the ages of 16 and 24. Girls before puberty and women in menopause very rarely get the disease. The risk of developing adnexitis is particularly high in women with frequently changing sexual partners. The risk of adnexitis can be reduced with the help of so-called barrier contraceptives such as condoms.

Tubal and ovarian inflammation: causes and risk factors

The cause of inflammation of the fallopian tubes and ovaries is often a bacterial infection with gonococci (Neisseria gonorrhoeae) or chlamydia (Chlamydia trachomatis). A mixed infection of both types of bacteria is also possible. More rarely, adnexitis is caused by viruses. Bacteria such as staphylococci, streptococci, enterococci, mycoplasma, and anaerobes (bacteria that survive without oxygen) are also possible triggers or facilitating factors for the development of adnexitis. Adnexitis can also occur in the setting of tuberculosis caused by Mycobacterium tuberculosis.

A particularly high risk for inflammation of the fallopian tubes and ovaries exists for women who:

  • are younger than 25 years
  • have frequently changing sexual partners
  • were very young when they had their first sexual intercourse
  • have a partner with a known sexually transmitted disease

Adnexitis: different routes of infection

Tubal and ovarian inflammation is usually caused by bacteria. The pathogens can reach the ovaries and fallopian tubes (adnexa) via various routes.

Experts distinguish between different infection routes:

  • ascending infection
  • Hematogenous infection.

Ascending infection

In an ascending infection, the pathogens migrate from the outside via the vagina into the uterus and on to the fallopian tubes and ovaries. There are several factors that promote infection:

  • Births and miscarriages
  • Sexual intercourse
  • gynecological procedures, such as the insertion of an IUD or a curettage
  • benign tumors (myomas, polyps) in the area of the cervix and uterus.

Ascending infection occurs almost exclusively in sexually mature, sexually active women.

Hematogenous infection

If the infection reaches the fallopian tubes and ovaries via the bloodstream, experts also speak of a hematogenous infection. One example is adnexitis, which is caused by the tuberculosis pathogen Mycobacterium tuberculosis.

Symptoms: Recognize adnexitis

Depending on whether acute adnexitis or chronic adnexitis is present, different symptoms occur:

Symptoms of acute adnexitis

Acute adnexitis often manifests itself with pain in the abdomen. Pain that begins during or shortly after menstrual bleeding is suggestive of adnexitis. The pain can vary in severity. They are increased by sexual intercourse. In addition, the abdomen is distended and the abdominal wall is tense. In acute adnexitis, the general condition is severely impaired. The affected patients feel ill and fatigued. A mildly elevated temperature or fever is possible with a bacterial infection with gonococci, anaerobes, or chlamydia. In the case of a chlamydial infection, for example, the symptoms can also be very weak or completely absent.

Other symptoms of acute adnexitis:

  • purulent discharge from the vagina
  • Nausea
  • Diarrhea
  • Pain during urination
  • Nausea
  • Constipation
  • Intermittent bleeding
  • enlarged uterus, sensitive to pressure
  • with increasing duration of the disease, pressure-sensitive and swollen fallopian tubes and ovaries (adnexa)

Symptoms chronic adnexitis

If acute adnexitis is not treated successfully, symptoms will persist or may recur. In this case, we speak of chronic adnexitis. Chronic inflammation of the fallopian tubes and ovaries may also be caused by scarring changes in the tissues of the organs left by previous inflammation. If the fallopian tubes and ovaries are scarred or fused in places with neighboring organs, this can cause pain (often after sexual intercourse).

Many women with chronic adnexitis also complain of the following symptoms:

  • Bloating
  • Pain
  • irregular menstrual periods
  • Constipation

Chronic ovarian and fallopian tube inflammation can last for several months to years. Affected women are often less productive during this time and feel restricted in their daily lives.

Ovarian inflammation – diagnosis at the doctor

To clarify whether you are at increased risk for adnexitis, we will ask you several questions before your gynecological exam:

  • What are your symptoms?
  • Are you under 25 years old?
  • Do you have frequently changing sex partners?
  • How do you use contraception?

Physical examination

The anamnesis is followed by the gynecological examination. During this process, we can determine if there are any physical signs that indicate ovarian and fallopian tube inflammation. Possible clues are:

  • Discharge
  • enlarged and pressure painful uterus
  • Pain when moving the cervix (cervical pain)

Further examinations

  • Pregnancy test: Using a pregnancy test, we can check whether the pain in the abdomen is caused by an ectopic pregnancy or other complications of pregnancy.
  • Smear of vaginal secretion: We can examine the smear under the microscope for pathogens and increased white blood cells (leukocytes). In addition, we can send the swab material to a laboratory. There, it can be determined which antibiotics are effective against the pathogen.
  • Smear from the cervix: an infection with chlamydia or gonococci can thus be excluded
  • Urine and blood tests: With the help of these tests, the inflammation levels can be determined.
  • Ultrasound examination: With the help of ultrasound examination we can detect thickened fallopian tubes, pus accumulation on the ovaries or abscesses and fluid in the abdominal cavity behind the uterus.
  • Laparoscopy: A reflection of the abdominal cavity (= laparoscopy) takes place under anesthesia. It allows direct assessment of the ovaries and fallopian tubes as well as adjacent organs.

Ovary and fallopian tube inflammation: prevention, early detection, prognosis

You can prevent adnexitis with these measures:

  • good sexual and personal hygiene
  • Use of condoms during sexual intercourse

Ovarian inflammation: course

Tubal and ovarian inflammation can lead to complications down the road. Thus, the inflammation can spread to neighboring organs such as the peritoneum or appendix and cause an acute abdomen. Prompt initiation of specific therapy is extremely important because it can significantly reduce the risk of late complications such as infertility. A chronic course can lead to protracted symptoms and infertility in affected women.

Treatment details