Salpingitis: Causes, Risk Factors, Pathophysiology, Signs, Symptoms, Treatment-Antibiotics
What is Salpingitis?
Infection and inflammation in the fallopian tubes is known as salpingitis. The term pelvic inflammatory disease (PID) is also used to describe salpingitis; however, PID has a broader definition and is referred to various medical conditions and diseases of the female upper genital tract, such as endometritis, oophoritis, parametritis, myometritis etc., whereas salpingitis is specifically referred to the infection and inflammation in the fallopian tubes. There are two types of salpingitis: acute and chronic salpingitis. Antibiotics are given for treating salpingitis.
Causes, Risk Factors and Pathophysiology of Salpingitis
The infection often starts in the vagina and spreads upwards to the fallopian tube. As the infection may spread through the lymph vessels, infection in one fallopian tube may also cause infection in the other fallopian tube. It has been speculated that the infection reaches the fallopian tubes during retrograde menstrual flow and during the opening of cervix during menstruation. Risk factors include surgical procedures which disturb the cervical barrier, such as endometrial biopsy, curettage and hysteroscopy.
Factors which alter the microenvironment in the vagina and cervix and encourage the infecting organisms to multiply and subsequently ascend to the fallopian tube also increase the risk of salpingitis. These factors include: treatment with antibiotics, ovulation, menstruation, and sexually transmitted disease (STD).
Other than this, sexual intercourse may also enable the infection to spread from vagina to the fallopian tube. Coital risk factors include uterine contractions and sperm transmitting the organisms upwards.
The common bacteria which causes salpingitis are: N. gonorrhoeae, chlamydia trachomatis, mycoplasma, staphylococcus and streptococcus. However, salpingitis is often polymicrobial and involves different types of organisms such as ureaplasma urealyticum, anaerobic, and aerobic bacteria.
Complications for Salpingitis Include:
- Increased risk of ectopic pregnancy due to damaged oviducts.
- Infection of uterus and ovaries.
- Infection of sexual partner.
- Ovarian abscess.
- Scarring of fallopian tubes.
Signs and Symptoms of Salpingitis
The Symptoms Commonly Appear After a Menstrual Period and Include:
- Abnormally colored vaginal discharge.
- Foul smelling vaginal discharge.
- Pain felt during ovulation.
- Pain felt during sexual intercourse.
- Pain occurring and subsiding during periods.
- Pain in the abdomen.
- Pain in the lower back.
Investigations for Salpingitis
- Pelvic examination.
- Blood tests
- Vaginal or cervical swab.
- Culture of the vaginal discharge.
Treatment for Salpingitis
Antibiotics are the common choice of treatment of salpingitis. Patients should abstain from the sex during the treatment, otherwise the infection may persist. Both the sexual partners should be tested for STD. In serious cases where the antibiotics don't work and the infection persists, fallopian tubes, ovaries and/or the uterus may need to be removed surgically; but this happens in extreme cases and the best way to avoid this situation is to get prompt treatment as soon as the symptoms appear.