How to judge whether it is adnexitis

Adnexitis usually refers to inflammation of the fallopian tubes and ovaries, which can be diagnosed comprehensively through clinical symptoms, physical examination, laboratory tests and imaging tests. Main symptoms include lower abdominal pain, abnormal vaginal secretions, fever, frequent urination, painful urination, and abnormal menstruation.

1. Lower abdominal pain

Patients with adnexitis often present with persistent lower abdominal pain, which worsens after activity or sexual intercourse. Pain may radiate to the lumbosacral area or inner thigh. Tenderness in the adnexal area can be found during gynecological examination, and some patients have rebound tenderness. The pain is severe during the acute attack, and is mostly dull pain or swelling in the chronic phase. The degree of pain is related to the extent of inflammation, and symptoms are more obvious when bilateral adnexa are involved.

2. Abnormal vaginal discharge

About 80% of patients develop purulent or purulent leucorrhea, which is significantly increased in amount and accompanied by a peculiar smell. Examination of secretions revealed a large number of white blood cells and pathogenic bacteria. Neisseria gonorrhoeae infection has yellow-green discharge, while chlamydial infection is mostly mucopurulent. Chronic patients may have thin yellowish discharge, which needs to be differentiated from vaginitis.

3. Fever

Acute adnexitis is common with fever above 38°C, accompanied by systemic symptoms such as chills and headache. The degree of increase in body temperature is related to the severity of the infection, and hyperthermia may occur in purulent inflammation. Routine blood tests showed a significant increase in white blood cell count and neutrophil ratio. Chronic patients may have low-grade fever or normal body temperature.

4. Frequent urination and painful urination

When inflammation involves the tissues around the bladder, it can irritate the bladder and cause symptoms of discomfort during urination. Routine urine examination may reveal leukocyturia but urine culture is negative, which is called urethral syndrome. It needs to be differentiated from urinary tract infection, which usually has positive urine culture. Severe symptoms may cause difficulty urinating or tenesmus.

5. Abnormal menstruation

It may manifest as increased menstrual flow, prolonged menstruation, or non-menstrual bleeding. Inflammation can lead to menstrual disorders when it affects ovarian function, and long-term chronic inflammation may cause amenorrhea. Dysmenorrhea may worsen when the endometrium is involved, and it needs to be differentiated from endometriosis. Some patients experience sexual intercourse pain or infertility.

If adnexitis is suspected, seek medical advice as soon as possible and avoid strenuous exercise and sexual intercourse. Keep your vulva clean and dry and choose breathable cotton underwear. The diet should be light and supplement with appropriate amounts of high-quality protein and vitamin C. Bed rest is required in the acute phase, and moderate aerobic exercise can be performed in the chronic phase. Regular gynecological examinations can help detect lesions early, which may develop into pelvic abscess or infertility without standardized treatment.