Salpingitis

Definition - What is Salpingitis?

Salpingitis is a medical condition, in which the fallopian tubes become infected and inflamed. This condition is also known as the pelvic inflammatory disease, even though this might encompass not only the symptoms of salpingitis but also the ones of endometriosis or oophoritis. As you will have the opportunity to read below, salpingitis is often triggered by a bacterial infection and, in severe cases, it can cause severe damage to the fallopian tubes, leading to infertility in women.

Types of Salpingitis

Salpingitis can be diagnosed as an acute or chronic condition.

Acute

In the patients who are diagnosed with acute salpingitis, the fallopian tubes are inflamed and red in color. Moreover, they secrete excessive quantities of fluid, which can lead to their interior walls sticking together. In more severe cases, the fallopian tubes might also stick to the nearby structures, such as the intestines. It is also possible that the fallopian tube might be inflamed due to the collection of pus. If the infected fallopian tube will rupture, the infection can reach the abdominal cavity and lead to the appearance of peritonitis.In acute salpingitis, the patients present pain in the lower abdomen (the pain can be unilateral or bilateral, depending on the involvement of the tubes). The pain can radiate to the upper abdomen, especially in the more severe cases. Nausea and vomiting can be present, as well as fever or irregular bleeding (if the patient also presents endometriosis). At the start of the condition, the patient might be asymptomatic or present only mild symptoms.

Chronic

The diagnosis of chronic salpingitis means that the problem has existed for some time now, even though it has not caused any obvious symptoms. The infection exists in the body, at the level of the fallopian tube, being mild in intensity. The chronic salpingitis is characterized by periods of exacerbations and remissions, leading to complications, such as the tubo-ovarian abscess.

Symptoms

These are the most common symptoms that appear in patients suffering from salpingitis:

• Vaginal discharge (the color and smell are abnormal)
• Pain – this can appear during ovulation and sexual intercourse
• The pain can also come and go (periods of remission and exacerbation)
• The patients can present pain at the level of the lower back or abdominal pain
• System symptoms are present as well, such as nausea, vomiting or fever
• Bloating is often a symptom of this condition
• Spotting between the menstrual periods
• The menstrual period is painful (dysmenorrhea)
• Frequent urination

Causes

These are the most common causes that can lead to the appearance of salpingitis:Bacterial infection at the level of the vagina (infection spreads from one fallopian tube to the other through the lymph nodes)

• Most commonly – N. gonorrhea, chlamydia, mycoplasma, staphylococcus and streptococcus
• Other bacteria – ureaplasma urealyticum, anaerobic and aerobic bacteria

Diagnosis

These are the most common methods used for the diagnosis of salpingitis:

• General examination – allows the doctor to identify the areas with tenderness and also if there are any swollen lymph nodes
• Examination of the pelvis – the pelvic examination is essential, so as to identify the tenderness/pain in the pelvic area or to verify the vaginal discharge
• Blood testing – in case of an infection, the white blood count is going to be increased beyond the normal levels
• Vaginal or cervical swab – a small sample is taken in order to perform a smear culture, this will allow for the exact identification of the bacteria that has caused the infection in the first place
• Laparoscopy – making a small incision, the doctor will use a camera in order to explore the abdomen and visualize the fallopian tubes (recommended for the more severe cases)

Treatment

These are the most common methods used for the treatment of salpingitis:

• Antibiotics
• These are prescribed in order to eliminate the bacterial infection
• They should be taken for as long as they are prescribed, otherwise the bacteria will develop resistance to the treatment
• During the treatment with antibiotics, you will also be prescribed probiotics (so as to protect the healthy intestinal flora)
• Intravenous antibiotics are administered in more severe cases (hospitalization)
• Surgical intervention
• Recommended in the patients who have failed to respond to the treatment with antibiotics
• Patient education (reduce the risk of recurrence) – the patients are informed about the importance of having protected sexual intercourse.

Risk factors

These are the risk factors for salpingitis:

• Menstruation – during menstruation, the risk of bacterial infection is increased, due to the cervix being opened (it is easier for the bacteria to reach the fallopian tubes)
• Endometrial biopsy
• Curettage – medical procedure, in which a curette is used in order to remove tissue, through scraping (method of abortion as well)
• Hysteroscopy – medical procedure, in which the uterine cavity is inspected with the help of an endoscope (the access is through the cervix)
• A change in the vaginal or cervical medium (allows the bacteria to proliferate, reaching the fallopian tubes) – this change might be due to: treatment with antibiotics, ovulation, menstrual cycle and sexually transmitted diseases
• Sexual intercourse (facilitates the proliferation of the bacterial infection from the vagina to the fallopian tubes) – the risk factors associated with sexual intercourse include the contractions of the uterus and the sperm (as it can carry the bacteria)
• Insertion of an intra-uterine device
• Miscarriage or abortion
• Childbirth
• Inflammation of the appendix.

Complications

These are the complications that can occur in patients diagnosed with salpingitis:

• The spreading of the infection to the ovaries or the uterus
• Tubo-ovarian abscess – this is a serious complication of salpingitis, which can occur in approximately 15% of the patients and requires hospitalization
• Ectopic pregnancy – even though the egg is fertilized, it cannot enter the uterus, due to the fallopian tubes being blocked
• Infertility – the infection or inflammation of the fallopian tubes can lead to scarring or permanent damage (the risk of infertility increases with each episode of salpingitis)
• The infection of the sex partners is also possible, especially if one has unprotected sexual intercourse.

In conclusion, salpingitis is a serious condition and it should be treated as such. If no medical intervention is pursued, salpingitis can lead to infertility and ectopic pregnancies. The sooner the treatment is started, the more reduced the risk of complications is going to be.