Salpingitis - Causes, Complications, and Treatment

Introduction:

A part of the female reproductive tract, the fallopian tubes, is situated on each side of the uterus and opens near the ovary. During ovulation, the ovum enters the fallopian tube and is moved along the uterus by tiny hairs inside the fallopian tube. An inflammation that occurs in the fallopian tube is known as salpingitis.

What Is Salpingitis?

Salpingitis is a kind of pelvic inflammatory disease. The word salpingitis arises from the Greek word “salpinx,” meaning trumpet, and “itis,” meaning inflammation. Therefore, it refers to trumpet-like tubes or fallopian tubes. Salpingitis is more commonly caused by sexually transmitted diseases like chlamydia and gonorrhea. After the tube gets infected, inflammation occurs, and pus gets collected inside the fallopian tube. Since bacterial migration happens through the nearby lymph vessels, this infection spreads quickly from one fallopian tube to the other.

Cause of Salpingitis:

Bacteria cause the majority of salpingitis infections. Some common bacteria responsible for causing a salpingitis infection are chlamydia, mycoplasma, streptococcus, staphylococcus, and gonococcus. Before infecting, the bacteria needs to access the reproductive system for the infection to occur. They gain access through miscarriage, abortion, childbirth, or sexual intercourse. Very rarely, abdominal infections like appendicitis cause salpingitis. Salpingitis can also be caused by procedures like insertion of the intrauterine device or internal urine inspection (hysteroscopy), or endometrial biopsy (sampling of the uterine tissue). Procedures like this require instrumentation of the uterus or cervix that can potentially carry the infection-causing bacteria.

What Are the Types of Salpingitis?

Salpingitis can be either acute or chronic.

• Acute Salpingitis - In acute salpingitis, reddish and swollen fallopian tubes are noted, which secrete extra fluid, making the cube’s inner walls stick together. The tubes can also stick to nearby structures like the intestines. At times a fallopian tube fills and bloats up with pus. Very rarely, tubal rupture occurs, leading to peritonitis of the abdominal cavity.

• Chronic Salpingitis - In chronic salpingitis, the infection is mild, lasts longer, and has no noticeable symptoms. They usually follow an acute infection.

What Are the Symptoms of Salpingitis?

Some of the common symptoms of salpingitis include:

• Spotting between periods.

• Pain during the ovulation period, painful periods, or painful sexual intercourse.

• Abnormal vaginal discharge with an unusual smell (foul smell) or color (yellow).

• Fever.

• Lower back pain.

• Vomiting and nausea.

• Abdominal pain on bilateral sides.

• Frequent urination.

• Sometimes the symptoms appear after menstruation.

Risk Factors of Salpingitis

Lifestyle factors that can increase the risk of developing salpingitis include prior STD infection (sexually transmitted disease) and sexual intercourse without adequate protection (condoms).

What Are the Complications of Salpingitis?

Salpingitis can cause various complications even with treatment. Some of them include the following:

• Spread of Infection - Infection can spread to nearby structures like the ovaries or uterus.

• Transmission of Infection to the Sexual Partners - The woman’s partner can contract the bacteria and get infected too.

• Ovarian Abscess - Women with salpingitis can develop abscesses, which may require hospitalization.

• Ectopic Pregnancy - A blocked fallopian tube prevents a fertilized egg from entering the uterine area. This egg then starts growing inside the fallopian tube space.

• Infertility - The fallopian tube can get scarred, and adhesions may form with blockages or get deformed to the extent the sperm and egg cannot meet. After salpingitis, the risk of infertility is almost 15%. After three incidences of infection, the risk increases to about 50%.

Will Salpingitis Affect Fertility?

• If the infection is diagnosed in the early stage and treated, salpingitis does not affect the woman’s fertility. Pregnancy and conceiving will be typically normal.

• But if the treatment is delayed or the infection wasn’t treated entirely previously, salpingitis can cause adhesions, scarring, or blockages in fallopian tubes, leading to infertility. If these obstructions cannot be removed, to conceive, an in vitro fertilization (IVF) treatment will be necessary.

• The chances of ectopic pregnancies are high with salpingitis. An ectopic pregnancy occurs when the fertilized egg implants in an area other than the uterine. They are considered a medical emergency and treated immediately.

How Is Salpingitis Diagnosed?

The doctor first assesses the symptoms and reviews the medical history. A physical examination will then be performed to check for areas of swelling or tenderness. Some other tests that help with diagnosing salpingitis are:

1. General Examination - A general examination checks for localized tenderness or lymph node enlargement.

2. Pelvic Examination - A pelvic examination is done to check for any discharge or tenderness.

3. Blood Test - Blood tests are done to check for markers of infection like WBC (white blood cell count) and other factors that can cause the infection.

4. Mucus Swab Test of Vagina and Cervix - A swab test to identify the infection-causing bacteria. A smear is taken, cultured, and examined in a laboratory.

5. Abdominal or Transvaginal Ultrasound Scan - An imaging technique like ultrasound checks the fallopian tubes and other areas of the reproductive tract.

6. Hysterosalpingogram - Hysterosalpingogram is a type of X-ray where an iodine-based dye is first injected into the cervix. Later an image is taken that highlights the cervix and fallopian tube. This enables the doctor to check for any blockages present in the fallopian tubes.

7. Diagnostic Laparoscopy - In rare cases, the fallopian tube is visualized using a video scope through an incision in the abdomen.

What Is the Treatment for Salpingitis?

The treatment of salpingitis depends on the severity of the infection. Some of the treatment options include:

1. Antibiotics - Antibiotics kill the infection and are successful in almost 80% of cases. The doctor usually prescribes oral or intravenous antibiotics to clear the infection.

2. Hospitalization - In case of an intravenous administration of antibiotics, hospitalization is required.

3. Surgery - Surgical intervention is required only if the condition is drug resistant. Laparoscopic surgeries drain abscesses, and surgery is recommended to remove scars or adhesions formed due to the infection.

How Can Salpingitis Be Prevented?

Sexually active individuals need to check for STIs (sexually transmitted infections) yearly. In addition, ensure that the sexual partner is tested for STDs (sexually transmitted diseases). The other measure is to avoid unprotected sex.

Conclusion:

Salpingitis is inflammation of the fallopian tubes that occurs most commonly through sexually transmitted bacterial infections besides other causes. The infection can be cleared successfully with antibiotics if they are detected early.