About the disease
Chronic parametritis is an inflammatory process of the parametrium. The parametrium is the connective tissue that separates the cervix from the bladder. A woman suffering from chronic parametritis may experience problems with bladder function and pain in the area of the cervix.
In most cases, inflammation of the parametrium is caused by the bacteria Staphylococcus aureus. Other common causes of chronic parametritis are cervical rupture due to an abortion or previous injury of the uterus. Surgery on the uterus, which affects the parametrium, can also cause chronic parametritis in the longer term.
Chronic parametritis develops when the stage of infiltration of the tissue begins, when a woman develops perivascular edema or the purulent process begins. Inflammation usually starts to manifest itself 7-10 days after the bacteria have infected the connective tissue. The acute form of parametritis can also develop 7-10 after an abortion or other trauma to the uterus. Chronic parametritis may develop if the inflammation has not subsided several days after its onset.
Symptoms
- Fever reaching 38-39°C
- Acute pain in the abdomen radiating to the lower back or sacrum
- Chills
- Headache
- Excessive thirst
- Cystitis in some cases
- Pain during urination
- Pain in the cervical muscles
- Pain intensifies during sexual intercourse
- Menstrual cycle can be disrupted
Diagnosis
- During a general examination, the gynecologist will determine whether or not there are signs of infiltration of the uterus. This can be detected if the vaginal walls are smooth and painful upon contact. In progressed forms of chronic parametritis, accumulated pus can trigger the development of fistulas that can open into the bladder or rectum and can be visible to the gynecologist.
- A blood test can find out if bacteria have made their way into the blood stream, which could have caused parametritis.
- Analysis of a smear test from the urethra and vagina can establish whether there is any inflammation of the connective tissue near the uterus.
- During an ultrasound, the gynecologist will examine the walls of the uterus and bladder, to determine whether parametritis has affected any other organs of the reproductive system.
Treatment
- Conservative treatment, such as antibiotics, may be sufficient to fight the infection if bacteria caused the parametritis. Such treatment usually lasts five to seven days. Also, calcium chloride can be injected intravenously to reduce the pain and fever.
- A laparoscopic resection and parametrial tissue removal is a minimally invasive surgical procedure. The inflamed parametrial tissue is removed using a laparoscope. Removal of this tissue will prevent the inflammation from spreading to other tissue and will alleviate the pain.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
