Salpingitis: symptoms, complications, treatment and prognosis

Salpingitis is an inflammation of one or both fallopian tubes.
Women have two fallopian tubes, which are about 10 cm long and carry the eggs from the ovary to the uterus.

The inflammation is caused by germs that usually ascend through the vagina and uterus and enter the fallopian tubes, mainly due to sexual intercourse.
Therefore, salpingitis in virginity also occurs very rarely.

It is very important to diagnose salpingitis as early as possible, before it can cause serious damage to internal organs.

If the inflammation also causes fluid or pus to accumulate in the fallopian tubes, it is called a hydrosalpinx. The fallopian tube infection usually also leads to the infection of other structures, as the bacteria spread through the lymphatic vessels.


Acute and chronic salpingitis

Salpingitis can be acute or chronic.
In acute simple or catarrhal salpingitis, the fallopian tubes turn red, swell and secrete a greater amount of fluid. As a result, the inner walls of the fallopian tubes often come into contact with each other.
The fallopian tubes can also fix themselves on surrounding structures such as the intestines.
Acute purulent salpingitis occurs when a fallopian tube fills with pus, and the swelling is concentrated primarily on the ampoules.
In rare cases, the fallopian tube can rupture and cause a dangerous infection of the abdominal cavity (peritonitis).
Chronic salpingitis is usually the result of a prolonged acute event.
The infection is less severe, takes longer and does not necessarily cause severe symptoms.Types of chronic salpingitis

  • Chronic hypertrophic salpingitis occurs when there is a homogeneous increase in the volume of the fallopian tube.
  • Atrophic salpingitis occurs when the fallopian tube loses volume and becomes rigid.
  • Salpingitis isthmica nodosa forms two nodular enlargements at the level of the isthmuses of both fallopian tubes and often leads to female sterility.

Causes of acute salpingitis

An infection of the vagina or cervix often leads to salpingitis.
When this infection reaches the uterus, it can also affect the fallopian tubes. Infections can be caused by sexually transmitted diseases such as chlamydia or gonorrhea.
A medical or surgical procedure, such as childbirth, a biopsy, or an abortion, can cause acute salpingitis, although it is rare. Salpingitis is more common in young, sexually active women, but can occur at any age.
Salpingitis should not be confused with pelvic inflammatory disease, which affects infections and inflammation of the genital organs in general.

Salpingitis is one of the most common causes of infertility in women.
If not treated immediately, the infection can damage the fallopian tubes forever and the eggs released during each menstrual cycle can no longer meet the sperm.

Possible causes of salpingitis include:

  • Pelvic inflammatory disease
  • Venereal diseases
  • Medical procedures such as laparoscopy, biopsy of the endometrium, or dilation and curettage
  • Abortion or childbirth
  • Bacteria that are naturally present in the vagina

In most cases, it is caused by bacteria, the most common are:

  • Chlamydia
  • Ureaplasma
  • Gonococcus (cause gonorrhea)
  • Mycoplasma
  • Escherichia coli
  • Staph
  • Streptococcus

Symptoms of salpingitis

Symptoms of salpingitis vary depending on the cause and severity.
The following may occur:

  • profuse, foul-smelling vaginal discharge;
  • abdominal pain, which is often dull or mild, but can also become very severe;
  • nausea, vomiting or diarrhea;
  • abnormal menstrual bleeding or bleeding of pinkish or brownish color;
  • urethritis or inflammation of the urethra, which causes pain and burning sensation when urinating;
  • fever and chills;
  • Pain during sexual intercourse.

Symptoms usually appear after menstruation.

Complications and consequences of salpingitis

If left untreated, salpingitis can cause a number of complications, such as:

  • Other infections – The infection can spread to surrounding structures, such as the ovaries and uterus.
  • Infection of the sexual partner.
  • About 15 percent of women with salpingitis develop an abscess that requires hospitalization.
  • Ectopic pregnancy – A blocked fallopian tube prevents the fertilized egg from entering the uterus. The embryo therefore begins to grow within the limited space in the fallopian tube. The risk of ectopic pregnancy for a woman who has suffered from salpingitis or other pelvic inflammatory disease (PID) is about one in twenty.
  • Infertility – The fallopian tubes may become deformed or fibrous (with adhesions) due to previous infections. If the anatomical change is severe, the egg and sperm can no longer meet.
  • After an attack of salpingitis, the risk of infertility in women increases to about 15 percent. This figure rises to 50 percent after three such events.

Diagnosis of salpingitis

Physical examination: The examination can determine the location and nature of the pain.
Although a vaginal exam can be very painful, it can reveal the appearance of abnormal vaginal or cervical discharge or signs of cervical infection.
Fever does not always have to occur.
The minimum criteria set by the Centers for Disease Control and Prevention (CDC) in the U.S. are: abdominal pain, adnexal pain (ovaries, fallopian tubes, and ligaments of the fallopian tubes), and pain when moving the cervix.

Other criteria of the CDC include fever above 38.3°, abnormal vaginal and cervical discharge, elevated levels of C-reactive protein in the blood and elevated UCS, positive cultures for gonorrhea or chlamydia.
Tests: Cultures are used to identify the microorganisms responsible for the infection.
The infection can be confirmed by a complete blood count, which has an increased number of white blood cells (leukocytes). Erythrocyte sedimentation rate (UCS) and C-reactive protein are supportive laboratory tests.
The RPR (Rapid Plasma Reagin) test is used to rule out syphilis. The urine culture can also be applied to rule out a urinary tract infection (for example, cystitis).
A pregnancy test may be needed to rule out an ectopic pregnancy.
With an ultrasound examination, a tuboovarial abscess can be ruled out.
Ultrasound can help rule out other causes of bilateral pelvic pain.
CT and magnetic resonance imaging may be helpful if the ultrasound scan has not yielded any results.
A laparoscopy can be performed to confirm the diagnosis or to rule out diseases with similar symptoms, such as ectopic pregnancy or appendicitis.

Laparoscopy is a surgical procedure in which a small light-bearing endoscope is inserted through a small incision in the abdominal wall. This allows the doctor to visually examine the fallopian tubes and their immediate surroundings.
For the diagnosis of salpingitis, endometrial biopsy has an accuracy of 90%.

Differential diagnosis of salpingitis To diagnose salpingitis
, the doctor must exclude the following diseases:

  • Appendicitis
  • Ectopic pregnancy
  • Pelvic inflammatory disease
  • Oophoritis (inflammation of the ovaries)
  • Septic abortion
  • Rupture of an ovarian cyst (ovarian cyst)
  • Ovarian torsion (ovarian peduncle torsion)
  • Tuboovarial abscess
  • Degenerate leiomyoma
  • Diverticulitis
  • Cystitis
  • Tuberculous salpingitis

Treatment of salpingitis

Treatment of salpingitis is based on the administration of antibiotics (often for several weeks). The chosen antibiotics specifically attack the organisms that caused the disease.
They often cover a wide range and include as many microbes as possible.
The sexual partner should also be examined and, if necessary, treated. He must take all the necessary medications and abstain from sexual intercourse during the treatment period in order to prevent re-infection.

Treatment depends on the severity of salpingitis and consists of:

  • Antibiotic therapy – To fight the infection, which occurs in about 85 percent of cases.
  • Hospitalization – Here, the antibiotics can be administered intravenously.
  • Surgery – When salpingitis does not respond to drug therapy.

Natural remedies for salpingitis

Traditional medicine recommends medication to treat the condition, but hygienists believe that the best therapy is a healthy diet and lifestyle (sufficient exercise and no vices).
In this way, the body should be able to recover because the immune system is strong and can defeat the bacteria.

One can take baths in thermal springs with healing water to promote the healing process.

Prognosis of salpingitis

A good result is directly dependent on the speed of treatment.
The infections can persist despite the treatment and cause the following symptoms:

  • Persistent lumbar pain
  • Abdominal pain or abdominal pain
  • Pelvic pain
  • Frequent menstrual cycle and heavy menstrual bleeding
  • Pain during sexual intercourse

Patients usually experience pain relief within 48 to 72 hours of taking the antibiotics.
If symptoms persist for more than 3 days, salpingitis becomes subacute.

60-80% of patients with a tuboovarial abscess experience improvement with antibiotics alone; another 20-40% require surgical drainage or needle aspiration of the abscess, about 20% of women with infected fallopian tubes need to be hospitalized.

25% of patients with salpingitis experience long-term complications, such as ectopic pregnancy, chronic pelvic pain, and infertility.

Read more: