Symptoms and treatment of acute and chronic salpingitis

Salpingitis, what is it? Symptoms, causes and treatment Salpingitis is an inflammation of the fallopian tubes that is caused by bacterial pathogens. This disease is very common and occurs in 30% of women. The course of the disease can have different levels of complications, so there are several forms of salpingitis: latent, acute, chronic.

Acute salpingitis is characterized by piercing pain in the abdomen, mild chills and all the signs of poisoning. Both chronic and acute forms of the disease can lead to reproductive dysfunction and constant pain in the genitals.

This disease usually does not affect the fallopian tube, but immediately becomes bilateral, affecting the muscle tissue of the walls of both tubes.

What it is?

Salpingitis is an isolated infectious and inflammatory disease of the uterine (fallopian) tube of one or two-sided nature, often leading to its obstruction and, as a result, infertility.

As an isolated inflammatory process, salpingitis occurs infrequently; in most cases, inflammation from the area of ​​the fallopian tubes spreads to the ovaries (oophoritis), and acquires the features of a combined inflammation of the appendages (salpingoophoritis). Often inflammation of the uterine appendages (ovaries and tubes) is combined with endometritis (inflammation of the uterus). [adsense1]

Causes of the disease

Salpingitis can be caused by pathogens of various types and classes of pathogenic and opportunistic microorganisms - bacteria, viruses, fungi and protozoa.

Depending on the causative factor, the disease is conventionally divided into:

1. Specific salpingitis - often bilateral, is caused mainly by infectious pathogens that are sexually transmitted. Specific salpingitis is the most common cause of infertility. It is caused by chlamydia, trichomonas, mycoplasma, ureaplasma, gonococcus, cytomegalovirus, herpes simplex virus type II, papillomavirus infection, mycobacterium tuberculosis (very rare).
2. Nonspecific salpingitis, which is caused mainly by epidermal or Staphylococcus aureus, streptococcus, Escherichia coli or enterococcus, gram-positive anaerobic microorganisms that do not form spores (peptococci and peptostreptococci), yeast fungus and some others. As a rule, the damage is unilateral.

An increased risk of inflammation of the fallopian tubes is observed in the following cases:

1. Douching increases the risk of salpingitis, as it promotes the spread of bacteria from the vagina into the uterine cavity and fallopian tubes.
2. Gynecological procedures (endometrial biopsy, curettage, hysteroscopy, abortion, etc.)
3. If a woman has had many sexual partners with whom she has had sex without a condom.
4. If a woman has previously had one of the sexually transmitted diseases (gonorrhea, chlamydia, trichomoniasis, etc.)
5. The presence of an intrauterine device increases the risk of salpingitis in the first 4 months after insertion of the device.

Especially often, inflammatory processes are caused by multiple mixed microbial flora (polymicrobial association), for example, staphylococci with E. coli, gonococci with chlamydia, enterococci with staphylococci and streptococci, clostridia with peptostreptococci, E. coli with enterobacteria and Proteus, etc.

Each type of infection has its own routes of infection and features of the mechanism of development of the inflammatory process. For example, gonococcus is characterized by a purulent nature and bilateral damage.

Salpingitis and oophoritis

Often salpingitis occurs not alone, but together with oophoritis (inflammation of the ovaries). The causative agents of oophoritis include various microorganisms, often found in combination and at the same time quite resistant to antibiotics.

With such a combined disease, the process of soldering the fallopian tube altered due to the inflammatory process with the ovary occurs and a single extensive inflamed formation is formed, which has very serious consequences.

Acute salpingitis

The disease begins with an increase in temperature to high numbers, as well as with general malaise. Heartbeat increases.

Symptoms of acute salpingitis:

• vomit;
• nausea;
• Strong headache;
• pain in the groin area is an important diagnostic symptom. Its localization depends on which of the tubes the inflammatory process has developed;
• pathological discharge. With gonococcal salpingitis, purulent discharge appears, with trichomonas - foamy and abundant. If acute salpingitis is very severe, then the appearance of bloody discharge is noted. It is worth noting that the discharge in this disease is always abundant, and it is accompanied by burning and itching.

Acute salpingitis occurs and progresses due to infection entering the oviduct. The path of entry into the pipes is ascending or from a lesion that already exists in the woman’s body (appendicitis, oophoritis). In most clinical cases, acute salpingitis develops against the background of an ectopic pregnancy. The symptoms of this disease are very pronounced. [adsense2]

Chronic salpingitis

If treatment of acute salpingitis was not carried out or was not started in a timely manner, chronic inflammation begins to form in the fallopian tubes. Chronic salpingitis does not have a pronounced clinical picture; during periods of remission it is asymptomatic, and frequent exacerbations occur in a subacute form.

As a rule, the symptoms of chronic salpingitis are associated with complications that arise after acute inflammation. The most significant symptom of chronic salpingitis is pelvic pain. Their appearance is associated with the adhesive process, and the intensity is directly dependent on the severity of the adhesive process.

Adhesions change the location of organs and affect their mobility. A pronounced adhesive process causes prolonged nagging pain in the lower abdomen, aggravated by physical activity, menstruation or sexual activity.

Exacerbation of chronic salpingitis occurs without severe fever, the temperature does not exceed subfebrile norms, and general health remains normal.

If the infectious-inflammatory process during the acute period of the disease has spread to the ovarian tissue and caused structural disturbances in it, chronic salpingitis may be accompanied by menstrual irregularities.

Menstruation becomes heavier, longer and more frequent.

The most common reason for visiting a doctor by patients with chronic salpingitis is infertility.

Long-term inflammation in the uterine tubes leads to their anatomical and functional deformation: the tubes thicken, their lumen narrows, and the inflammatory exudate glues the walls of the tube together, forming adhesions. Advancement of a fertilized egg into the uterine cavity under such conditions becomes impossible.

A dangerous situation is when the tube remains partially passable, then the egg stops inside the tube and, mistakenly believing that it has reached the uterus, is implanted into the wall of the tube and begins to develop. Under the influence of a growing pregnancy, the tube stretches and then ruptures. Ectopic pregnancy is a dangerous complication of chronic salpingitis.

Diagnosis of salpingitis

Diagnostics consists of detecting immobile, painful tumors of varying consistency. For the correct diagnosis of salpingitis, determining the probable infectious diseases of a woman is of utmost importance.

So, for example, salpingitis diagnosed in a young girl is most likely of tuberculosis origin, and salpingitis in a married nulliparous woman signals a gonorrheal infection.

The presence of infection is determined by laboratory tests of uterine secretions.

Pain syndrome during salpingitis is often confused with an attack of appendicitis due to the similarity of the nature of the pain. However, salpingitis gives pain located in the deeper parts of the pelvis. The disease is often diagnosed in combination with an ectopic pregnancy. Confirmed diagnosis Salpingitis is a disease unfavorable in terms of cure.

Curing the disease in order to completely functionally restore the patency of the fallopian tubes to achieve the pregnancy desired by the patient occurs in very rare cases. [adsen]

Consequences

Neglected or untreated disease causes serious complications:

• the infectious process spreads to the abdominal organs and pelvic area;
• scars and adhesions form, which can lead to fusion of the fallopian tubes;
• the risk of infertility increases;
• the possibility of an ectopic pregnancy increases significantly.

If a woman contacts a gynecologist in a timely manner and the disease is properly treated, the prognosis, as a rule, is favorable: salpingitis is cured, complications do not develop, and the likelihood of conception increases.

How to treat acute salpingitis?

First of all, acute salpingitis begins to be treated with bed rest and an easily digestible protein diet.

The body's defenses should be supported by a sufficient supply of nutrients, without irritating the intestines with fried or spicy foods.

If you have no appetite, you can abstain from food for several days, but be sure to drink a large amount of warm liquid - tea, fruit juice, compote.

Antibiotics are prescribed based on assumptions about the causative agent of salpingitis and, as a rule, drugs are combined in such a way as to cover the widest range of microorganisms.

For example, 3rd or 4th generation cephalosporins (ceftazidime, ceftriaxone) and metronidazole - this combination is active against aerobes and anaerobes. The course of treatment depends on the type of pathogen; when treating chlamydia, its duration reaches 21 days and can be repeated several times.

Such measures lead to the death of intestinal microflora, therefore, after the end of antibiotic therapy, it is recommended to take preparations of lacto- or bifidobacteria.

To alleviate the woman’s condition, she is given intravenous solutions of glucose, sodium chloride, and polyglucins. Additionally, vitamins, immunomodulators, and desensitizing drugs (diazolin) are prescribed.

Local sitz baths with solutions of chamomile, calendula, and potassium permanganate are shown.

Diet

Diet in the treatment of salpingitis is ineffective and insignificant. However, some recommendations are still given:

1. Drink plenty of fluids;
2. Eat crackers;
3. Consume more vitamins through foods;
4. Periodically consume low-fat dairy products and meat.

There is usually no strict diet here. It is advisable to exclude alcohol as one of the bad habits that suppress the immune system and irritate the gastrointestinal tract.

Is it possible to be treated with folk remedies at home? Nobody cancels folk methods. However, they should not replace drug and surgical treatment, but supplement:

1. Baths with juniper, sage, valerian, rosemary or milk.
2. Douchings from herbal teas.
3. Therapeutic tampons soaked in a decoction of aloe, plantain or cabbage.
4. Herbal tea from various herbal mixtures.

[adsense3]

Surgery

Treatment of salpingitis with surgical intervention is used in both acute and chronic forms of this disease. Indications for surgical treatment are determined by the attending physician.

Indications for surgical treatment of salpingitis are:

• ineffectiveness of conservative treatment;
• tumors in the area of ​​the uterine appendages;
• the formation of purulent formations in the area of ​​the uterine appendages;
• infertility of unknown origin;
• obstruction of one or both pipes as a result of adhesions.

The essence of the operation is to remove part of the fallopian tube, clean it of pus and disinfect it. If it is not possible to eliminate the purulent focus and restore the patency of the fallopian tube, the uterine appendage is removed. In case of chronic salpingitis with pronounced adhesions, adhesions are also removed.

The most effective method of surgical treatment of salpingitis is laparoscopic surgery. It involves removing parts of the tube using special equipment through small holes in the abdominal wall.

If using this method it is not possible to perform a full-fledged operation, then they switch to laparotomy. This operation consists of an incision in the anterior abdominal wall, which is made in order to gain full access to the pelvic organs.

The method is more traumatic and provokes the formation of new adhesions.

The operation is performed in several stages. Initially, the doctor makes three punctures on the abdomen, through which medical instruments and laparoscopic equipment are inserted. Next, using a laparoscope, a special gas (carbon dioxide or nitrous oxide) is pumped into the patient’s abdominal cavity.

This is done to ensure that the organs move away from each other, providing the doctor with good visibility. A laparoscope is a hollow tube with an eyepiece at one end and a video camera at the other. Through the eyepiece, the doctor examines the internal organs, and using a video camera, the image is displayed on the monitor screen.

The remaining incisions are intended for inserting manipulators, with which the doctor carries out the necessary actions.

Laparoscopic treatment allows a woman to go home within three days after surgery, but the recovery process will last up to two weeks. At the same time, doctors advise patients to temporarily refrain from sexual intercourse and visit the gynecological office at least once every 3 months.

Prevention

To prevent infection (remember, the ascending path is the most popular), it is recommended to maintain personal hygiene, use contraception against sexually transmitted infections, maintain immunity and visit a gynecologist at least once every six months.

Forecast

Timely treatment and adequate treatment guarantees complete cure and elimination of the consequences of the disease. The most favorable prognosis is when salpingitis does not cause obstruction of the fallopian tubes. In this case, treatment leads to complete recovery and restoration of reproductive function.

The later a woman comes, the worse the prognosis - the chronic form of salpingitis is difficult to treat. And delaying treatment is fraught with the development of various reproductive dysfunctions. There is a high risk of ectopic pregnancy.

Source: https://p-87.ru/m/salpingit/

Salpingitis: why it occurs and how the disease develops, principles of treatment

Salpingitis is an acute or chronic unilateral or bilateral inflammatory process in the fallopian tubes. According to data from various authors, it is found in approximately 90% of women.

In isolated form, the disease is relatively rare (30%). More often, salpingitis occurs in combination with an inflammatory process in the ovaries (salpingoophoritis or adnexitis). Among all patients with salpingitis, about 70% are women aged 25 years and younger, of which 75% are nulliparous.

Etiology and pathogenesis

Despite the fact that diagnostic and treatment methods are constantly being improved, a trend towards a decrease in the frequency of this pathology in the structure of gynecological diseases has not been observed for many years. Moreover, in women, forms with a subacute, chronic and indolent course are often detected.

Causes of the disease

Salpingitis can be caused by pathogens of various types and classes of pathogenic and opportunistic microorganisms - bacteria, viruses, fungi and protozoa. Depending on the causative factor, the disease is conventionally divided into:

1. Nonspecific salpingitis, which is caused mainly by epidermal or Staphylococcus aureus, streptococcus, Escherichia coli or enterococcus, gram-positive anaerobic microorganisms that do not form spores (peptococci and peptostreptococci), yeast fungus and some others. As a rule, the damage is unilateral.
2. Specific salpingitis - often bilateral, is caused mainly by infectious pathogens that are sexually transmitted. Specific salpingitis is the most common cause of infertility. It is caused by chlamydia, trichomonas, mycoplasma, ureaplasma, gonococcus, cytomegalovirus, herpes simplex virus type II, papillomavirus infection, mycobacterium tuberculosis (very rare).

Especially often, inflammatory processes are caused by multiple mixed microbial flora (polymicrobial association), for example, staphylococci with E. coli, gonococci with chlamydia, enterococci with staphylococci and streptococci, clostridia with peptostreptococci, E. coli with enterobacteria and Proteus, etc.

Each type of infection has its own routes of infection and features of the mechanism of development of the inflammatory process. For example, gonococcus is characterized by a purulent nature and bilateral damage.

Risk factors

Factors contributing to the penetration of infection and the development of the inflammatory process in the pipes are very variable. The main ones:

1. Early sexual activity and the nature of sexual behavior, indicators of which, to a certain extent, are age and marital status. Thus, unmarried women who are sexually active are at significantly greater risk than married women of the same age due to the presence of a large number of sexual partners.
2. Use of intrauterine contraception (risk increases 3-9 times). This risk is explained by the possibility of infection during its administration, bacterial spread along the threads that hang into the vaginal cavity, disruption of the epithelial separation processes during menstruation, suppression of various factors of local immunity (phagocytosis, etc.), the occurrence of microscopic erosive defects of the mucous membranes and the inflammatory reaction of the connective tissue. tissue around the spiral.
3. Traumatic injuries during childbirth and the postpartum period.
4. Surgical interventions, therapeutic and diagnostic manipulations on the cervix, in its cavity or on the pelvic organs - medical or criminal (especially) abortion, diagnostic curettage, vaginal myomectomy, hysteroscopy and hysterosalpingography, etc., cesarean section, diagnostic and therapeutic laparoscopy, surgical surgeries on the abdominal and pelvic organs.
5. Inflammatory processes in the intestines (appendicitis, colitis), long-term chronic inflammatory diseases of the genitourinary tract (oophoritis, endometritis, cystitis, pelvioperitonitis).
6. The presence of chronic foci of infection in the body.

Factors contributing to the activation of the infectious pathogen are:

• a decrease in the body’s overall immune defense as a result of frequent stressful conditions, poor nutrition, neuropsychic fatigue and sleep disturbances;
• the presence of endocrine diseases, especially diabetes mellitus, and metabolic disorders (obesity);
• antisocial lifestyle - alcoholism, drug use, unprotected sexual intercourse;
• sexual intercourse during menstruation;
• poor hygiene of the external genitalia and excessively frequent hygienic douching;
• hypothermia.

Mechanism of disease development

The development of the inflammatory reaction caused by infectious pathogens first occurs in the mucous membrane of the fallopian tube, where they penetrate upward from the vagina through the cervical canal along the surface of its mucous membrane. The movement of most microorganisms occurs mainly with sperm, which help bacteria and viruses overcome the mucus plug. Trichomonas are able to move independently using their flagella.

Other ways of spreading the infection are hematogenous (most typical for mycobacterium tuberculosis), lymphogenous, contact (descending) or mixed.

The contact route of infection occurs in the presence of inflammatory processes in organs located in anatomical proximity to the fallopian tubes (appendicitis, fat necrosis, Crohn's disease, sigmoiditis, diverticulitis or diverticulum perforation, peritonitis, cystitis, etc.).

Microorganisms multiply and, as a result of their vital activity, cause disruption of microcirculation and damage to cells in the surface layer of the mucous membrane, which leads to inflammation, swelling and the formation of adhesions in the lumen of the tube. These factors, as well as the further spread of inflammation to the muscular and serous membranes, determine:

• narrowing of the lumen and deformation of the fallopian tube;
• adhesion in the area of ​​its ampulla as a result of the leakage of inflammatory fluid and the formation of adhesions around it;
• accumulation of serous fluid (hydrosalpinx) with simultaneous stretching of the walls of the pipe and disruption of its peristalsis.

Gradually, the fallopian tube turns into an expanded (sac-like) formation - a sactosalpinx. Subsequently (under certain conditions) suppuration of the serous contents occurs, sometimes very quickly - purulent salpingitis.

Symptoms of salpingitis

Depending on the clinical course, acute and chronic forms of the disease are distinguished.

Acute salpingitis

It most often develops in women aged 20–24 years.

It manifests itself as acute, but more often pressing or dull, gradually increasing throbbing pain in the lower abdomen on one or both sides, depending on the location of the process.

The pain radiates to the lumbar, sacral, coccygeal areas, and also radiates to the groin (or inguinal) region, the upper parts of the inner thigh, and the rectum.

The acute course of the disease is accompanied by dyspareunia, dysuria, symptoms of general intoxication - general malaise and weakness, chills, fever up to 38-38.5 ° C, headache, gastrointestinal disorders (nausea, possible vomiting, discomfort in the stomach and intestines, bloating, urge to defecate, loose stools).

Diagnosis is made based on clinical symptoms. Vaginal examination reveals discharge and enlargement (to varying degrees) of the fallopian tube. The latter is sharply painful, has a “doughy” consistency, and its boundaries are unclear.

If inflammation of the fallopian tube is accompanied by the initial development of pelvioperitonitis, moderate muscle tension in the lower abdominal wall, symptoms of peritoneal irritation, and vaginally detectable bulging of the wall of the pouch of Douglas (with the appearance of an inflammatory effusion in the pelvis) are possible. An ultrasound examination reveals thickening of the walls of the appendages, the presence of fluid in their lumen and in the space behind the uterus.

Additional are a clinical analysis of blood and urine, clinical and microbiological examination of a smear from the cervical canal, as well as medical history data - previous abortions, childbirth, sexual intercourse during menstruation, diagnostic and therapeutic manipulations, etc.

If there are difficulties in making a diagnosis, diagnostic laparoscopy is performed.

Chronic salpingitis

It manifests itself as persistent, low-intensity, but almost constant aching and dull pain in the lower abdomen, as well as pelvic pain.

Pain intensifies during sexual intercourse, as well as before, during or at the end of menstruation and is often accompanied by irradiation to the lumbosacral and groin areas.

The intensity of pelvic pain depends on the severity and nature of the adhesive process. Very often the intensity of pain does not correspond to the degree of pathological changes.

Menstruation is usually heavy and clotted, but can sometimes be scanty. The general condition is satisfactory, sometimes a slight increase in temperature of no more than 37-37.2 ° C is possible.

Discharge is most often absent or scanty of a mucopurulent nature.

In addition, many women experience a lack of libido, orgasm, dyspareunia, and sometimes pain during urination, itching in the perineum and increased frequency of bowel movements.

Vaginal examination reveals scant discharge, slight pain when attempting to displace the cervix, and a moderately painful thickened fallopian tube (or tubes) with relatively clear boundaries and limited mobility. There are no changes in clinical blood test parameters; sometimes a slight acceleration of ESR is possible.

The chronic process usually develops after suffering untreated or untreated acute salpingitis or as a result of superinfection. But in recent years, due to the development of forms of microorganisms resistant to antibiotics, inflammation often occurs in an erased form or immediately becomes chronic with relapses and remissions.

An exacerbation may be due to additional invasion of microorganisms or activation of an existing infection, provoked by the above contributing factors or concomitant infectious diseases.

An exacerbation is manifested by the same symptoms as an acute process, but their severity is much less: discharge increases slightly, the frequency, duration and intensity of pain increases, there are no chills, the temperature does not exceed 37.5-38oC, long-lasting irritability, increased fatigue, etc. d.

A complication in the form of purulent salpingitis develops most often after gonorrhea.

Its signs are high fever, chills, copious discharge of a purulent nature, an increase in pain in the abdomen with a gradual spread to the bladder area, lumbar region, and rectum.

In rare cases, a purulent inflammatory process in the fallopian tubes develops gradually without symptoms of intoxication and with low-intensity pain.

Consequences

Left-sided salpingitis can cause acute appendicitis, inflammation of the intestine in the area of ​​the ileocecal angle, pelvioperitonitis and diffuse purulent peritonitis, the formation of adhesions and acute or chronic intestinal obstruction. Right-sided salpingitis also sometimes contributes to dysfunction of the large intestine, the development of adhesions and intestinal obstruction, and inflammation in the sigmoid colon (sigmoiditis).

Pregnancy with salpingitis is associated with a high probability of its pathological course and complications during childbirth, infection of the fetus and child, and chronic and erased forms of the disease are the most common cause of spontaneous abortions, miscarriage, tubal pregnancy, and bilateral salpingitis in 20% or more leads to complete infertility.

In addition, chronic salpingitis often causes physical and psychological discomfort, adnexitis and menstrual irregularities, purulent complications in the tubes and ovaries, pelvioperitonitis and diffuse purulent peritonitis.

How to treat salpingitis?

In acute and subacute cases, as well as during relapse, during pregnancy, and in the absence of the effect of outpatient therapy, the disease is treated in a hospital setting. It can be conservative or surgical.

The main principle of conservative therapy is the use of antibacterial agents, taking into account the results of culture of smears from the vagina and cervix for microflora and its sensitivity to antibiotics.

Treatment with antibiotics is carried out according to certain regimens and in dosages that depend on the severity of the inflammatory process.

For these purposes, for example, the following combinations of drugs are used: Ofloxacin with Metronidazole; Ciprofloxacin with Doxycycline and Metranidazole; Ceftriaxone with Sumamed or Azithromycin; Cefoxitin with Doxycycline; Amoxicillin or Amoxiclav with Ofloxacin or Doxycycline as monotherapy.

If there is an inflammatory process in the vaginal mucosa and cervix, suppositories with antibacterial and anti-inflammatory components (indomethacin) are prescribed. In severe conditions caused by intoxication, detoxification therapy is carried out intravenously.

• How to relieve pain from salpingitis?
• For severe pain, vaginal or rectal suppositories are used, as well as tablets containing non-steroidal anti-inflammatory drugs.
• Is it possible to take duphaston for salpingitis?
• The disease, especially during remission, is not a contraindication for its use.

In the chronic course of the disease during the period of remission, treatment with folk remedies is possible in the form of warm sitz baths with infusions of sage, calendula, rosemary, juniper, and a decoction of valerian root. They have anti-inflammatory and sedative effects.

Infusions and decoctions from collections of plant parts for douching can also be used: black elderberry flowers with flax seeds and chamomile flowers; knotweed with nettle leaves, oak bark and cinquefoil root; leaves of the herb melilot officinalis with flowers of chamomile, speedwell and wormwood.

In the acute period, treatment with folk remedies is not used. In the absence of effect from conservative therapy and with purulent salpingitis, surgical removal of the fallopian tube is indicated.

Source: https://ginekolog-i-ya.ru/salpingit.html

Salpingitis - causes, signs, symptoms and treatment

Salpingitis is an infectious disease accompanied by unilateral or bilateral inflammation of the fallopian tubes (oviducts). In this case, at first only the mucous membrane of the fallopian tubes is affected, but as the disease develops, other layers are also affected with a violation of their peristalsis.

Etiology

There are a huge number of reasons that can cause inflammation of the oviducts. Clinicians identify three significant causes of the development of salpingitis - STIs, mechanical damage to the epithelium of the oviducts and uterus, and inflammation of nearby organs.

STI

The most common sexually transmitted infections are cytomegalovirus infection, chlamydia, herpes simplex virus (type 2), trichomoniasis, and gonorrhea.

All these infections can cause inflammation not only of the genital organs, but also of the urinary organs. Their peculiarity is that they can be completely asymptomatic.

If bacteria or viruses remain in the vaginal mucosa for a long time, this will lead to a weakening of the (local) immune system. Under the influence of unfavorable factors (stress), it rises and affects the cervix, uterus and, ultimately, the fallopian tubes.

Mechanical damage to the epithelium

The spread of pathogenic microorganisms is prevented by a completely healthy and undamaged mucous membrane of the uterus and oviducts. If it is damaged, it will turn into a gateway for pathogenic microorganisms.

Medical procedures leading to disruption of the integrity of the epithelium:

• salpingoscopy;
• abortions;
• installation of spirals.

Inflammation of organs located close to the oviducts

In the progression of salpingitis, inflammatory processes that can develop in neighboring organs play an important role. Due to their anatomically close location, infection from them can enter the oviducts.

Manifestation of salpingitis

Kinds

According to the location they are distinguished:

• bilateral salpingitis;
• left-handed;
• right-sided

According to the nature of the flow:

• subacute salpingitis;
• spicy;
• chronic.

Acute salpingitis

Acute salpingitis occurs and progresses due to infection entering the oviduct. The path of entry into the pipes is ascending or from a lesion that already exists in the woman’s body (appendicitis, oophoritis). In most clinical cases, acute salpingitis develops against the background of an ectopic pregnancy. The symptoms of this disease are very pronounced.

The disease begins with an increase in temperature to high numbers, as well as with general malaise. Heartbeat increases.

Symptoms:

• vomit;
• nausea;
• Strong headache;
• pain in the groin area is an important diagnostic symptom. Its localization depends on which of the tubes the inflammatory process has developed;
• pathological discharge. With gonococcal salpingitis, purulent discharge appears, with trichomonas - foamy and abundant. If acute salpingitis is very severe, then the appearance of bloody discharge is noted. It is worth noting that the discharge in this disease is always abundant, and it is accompanied by burning and itching.

Chronic salpingitis

Chronic salpingitis has very scant and unexpressed symptoms. The patient's condition is usually satisfactory. Body temperature rises in extremely rare cases. The only symptom important for diagnosis is abdominal pain, dull or aching. The disease progresses in waves. From time to time it can worsen (due to stress or hypothermia) or subside.

A characteristic symptom for chronic salpingitis is NMC. Menstruation is usually heavy and very painful. Despite the fact that all the clinical symptoms of chronic salpingitis are very mild and do not cause the woman significant discomfort, the prognosis will be unfavorable - infertility develops.

Left-sided salpingitis

Left-sided salpingitis develops as a result of inflammation of the colon (that part of it that is located on the left side). The inflammatory process first attacks the mucous membrane of the oviduct and then spreads to the muscle tissue. Because of this, the mucous membrane turns red, swells, and its epithelium becomes covered with ulcers.

If the process continues to progress, the necrotic tissues will begin to stick together and form cavities of various sizes, in which blood, pus or mucus will concentrate.

Symptoms of left-sided salpingitis can be either pronounced or vague.

The prognosis of the disease will be positive if a woman, as soon as she discovers signs of salpingitis, immediately visits a qualified doctor.

Right-sided salpingitis

Right-sided salpingitis is characterized by the occurrence of an inflammatory process in the right tube. The progression of the pathology can be caused by chlamydia and other pathogenic microorganisms.

Causes of infection in the vagina:

• unprotected sexual intercourse;
• failure to comply with personal hygiene rules;
• mechanical damage during gynecological operations.

If the infection has penetrated the oviduct, it immediately swells and the blood flow in it is disrupted. First, inflammation covers the muscle tissue and because of this, the appendages thicken significantly. After some time, the thickenings stick to the peritoneum and form a pathological adhesion.

If you diagnose right-sided salpingitis in time and prescribe treatment, the prognosis will be positive. All symptoms will disappear after 3 weeks and the woman will fully recover.

Purulent salpingitis

Purulent salpingitis most often occurs and progresses due to gonorrheal infection. The cause of the development of this disease can also be a miscarriage, criminal abortion, or the installation of uterine devices with an expired expiration date.

With this disease, a large amount of pus accumulates in the cavity of the tube. If it penetrates the abdominal cavity, the course of the disease will be complicated by peritonitis.

The symptoms of purulent salpingitis are very pronounced. The patient's temperature rises and pain appears in the lower abdomen. Vaginal discharge is purulent. The only correct method of treating purulent salpingitis is surgery. Conservative methods are not used as they are ineffective.

Symptom of purulent salpingitis - pain in the lower abdomen

Salpingitis and oophoritis

Salpingitis and oophoritis are simultaneous inflammation of the oviducts and ovaries. This form of the disease occurs most often. The lesion is usually unilateral, rarely bilateral. Chronic salpingitis and oophoritis occur after microorganisms enter the oviduct mucosa.

The inflammation first affects the mucous membrane and muscle tissue, and then moves to the epithelium of the ovary. As a result, the ovary and oviduct are combined into one pathological element - a conglomerate.

Treatment of salpingitis should be carried out immediately to avoid the development of complications and completely restore reproductive function.

Many are sure that salpingitis and pregnancy are incompatible, and that if the disease develops, a woman will no longer be able to get pregnant. It's a delusion. Infertility occurs only if salpingitis is not diagnosed and treated in a timely manner.

Diagnostics

• inspection;
• laparoscopy;
• Ultrasound;
• x-ray using contrast agents;
• LHC examination of a smear taken from the cervix.

Treatment

Treatment of salpingitis is aimed at eliminating infection, inflammation, and increasing immunity. For this purpose, the following groups of drugs are prescribed:

• antibacterial;
• antifungal;
• probiotics;
• NPP;
• vitamins;
• antioxidants;
• immunomodulators.

Salpingitis is treated with surgery in the following cases:

• the presence of purulent formations;
• conservative treatment was ineffective;
• infertility;
• tumors.

The operation is not performed in the presence of acute infectious diseases or poor blood clotting. Its essence is to restore the patency of the fallopian tube and cleanse it of purulent contents. If this is not possible, then part of the pipe is removed. Now this surgical intervention is performed laparoscopically.

Source: https://SimptoMer.ru/bolezni/zhenskie-zabolevaniya/889-salpingit-simptomy

Salpingitis - treatment, symptoms, causes, diagnosis - Doctor Nearby Clinic

If you have more than 80% of the listed symptoms, we strongly recommend that you consult a doctor for advice.

Acute and chronic salpingitis can affect reproductive function in women and cause spontaneous miscarriages, inability to become pregnant, and constant pain in the lower abdomen. As an isolated inflammation, salpingitis appears quite rarely; most often it occurs against the background of an inflammatory process of the ovaries - oophoritis and the uterus - endometritis.

Causes of the disease

Fallopian salpingitis appears as a result of viral or microbial infection, which can occur in three ways:

1. With the ascending transmission of infection from neighboring organs - the uterus (with a cyst, endometritis), vagina (with vulvovaginitis, vaginitis), urinary ducts.

2. By contact, when infection occurs through organs of other systems that have become infected - for example, due to appendicitis.

3. Hematogenously, when the infection is transmitted through the blood.

Factors that provoke the appearance of salpingitis may be:

• sexually transmitted diseases - trichomoniasis, gonorrhea, herpes, chlamydia;
•  performing abortions with curettage;
• use of intrauterine devices;
• the occurrence of injuries during labor;
• carrying out metrosalpingography, salpingoscopy;
• inflammatory diseases of nearby organs – appendicitis, oophoritis, colitis, pelvioperitonitis

Causes and symptoms of acute salpingitis

Acute salpingitis occurs as a result of infection in the fallopian tubes along the ascending path or through an already existing focus - oophoritis, appendicitis. Very often, the development of this disease occurs against the background of an ectopic pregnancy and is accompanied by pronounced symptoms:

• increased body temperature;
• increased heart rate;
• general malaise, weakness;
• nausea and vomiting;
• headache;
• pain in the genital area - their localization is determined by the development of the inflammatory process in one of the fallopian tubes;
• specific discharge from the genitals - purulent, foamy, bloody, can be very copious and accompanied by itching and burning;
• disorders of stool and urinary function.

Symptoms of chronic salpingitis

In most cases, chronic salpingitis does not have severe symptoms and does not cause the patient much discomfort. The woman feels well, the temperature is usually normal. Dull or aching pain in the abdomen and minor discharge may occur.

Symptoms are wave-like, can subside and intensify as a result of stress and hypothermia. A characteristic sign of chronic salpingitis is disruption of the menstrual cycle, discharge during menstruation is profuse and accompanied by pain.

A common prognosis for the development of this disease is the impossibility of pregnancy.

Causes and symptoms of left-sided salpingitis

The development of left-sided salpingitis occurs as a result of the inflammatory process of the left side of the colon. Swelling and redness of the mucous membrane of the fallopian tube occurs, and ulcers form on the epithelium.

As the disease progresses, necrotic tissues will stick together and cavities with pus, mucus and blood will form. Symptoms can be pronounced or expressed rather weakly.

The patient feels abdominal pain and fever.

Causes and symptoms of right-sided salpingitis

Right-sided salpingitis is characterized by inflammation in the right fallopian tube, caused by the activity of various pathogens - for example, chlamydia. The causes of infection can be sexual activity without using condoms, poor personal hygiene, and traumatic injuries as a result of gynecological surgical interventions.

When infection penetrates the fallopian tube, swelling and disruption of blood outflow occur, severe thickening of the appendages and the formation of adhesions. A woman may have a fever, pain in the pelvic organs, and discharge. If right-sided salpingitis is diagnosed and treated in a timely manner, the consequences can be avoided and a complete recovery will occur.

 

Causes and symptoms of purulent salpingitis

Purulent salpingitis usually occurs as a result of infection with gonorrhea. It can also be triggered by a miscarriage, an abortion performed outside the walls of a medical institution, or the use of expired uterine devices.

A large amount of pus forms in the cavity of the fallopian tube, and when it penetrates into the abdominal cavity, peritonitis develops. The symptoms of purulent salpingitis are very noticeable.

Body temperature rises, severe pain occurs in the lower abdomen, which can radiate to the lower back and rectum, purulent vaginal discharge, chills, and fever. This disease must be treated surgically; conservative methods are ineffective.

Salpingitis along with oophoritis

The most common form of the pathological process is simultaneous inflammation of the fallopian tube and ovaries. Most often, the lesion occurs unilaterally, bilaterally occurs much less frequently.

The inflammatory process originates on the mucous membrane of the fallopian tube and is then transmitted to the epithelium of the ovary. As a result, a pathological conglomerate is formed.

It is necessary to begin treating salpingitis and oophoritis as quickly as possible in order to preserve the possibility of pregnancy in the patient. 

Diagnosis of salpingitis

Diagnostic methods include:

• conducting a gynecological examination;
• Ultrasound of the pelvic organs (ultrasound examination is performed transvaginally and transabdominally);
• bacteriological examination of a smear taken from the cervix, bacterial culture, smear analysis using the PCR method - one of the mandatory methods aimed at identifying sexually transmitted infections;
• performing laparoscopy;
• carrying out metrosalpingography.

During a gynecological examination, a vaginal examination using fingers and a speculum examination are performed. This ensures visualization of the vaginal walls and fornix, and the cervix.

The presence of salpingitis is characterized by purulent mucus on the walls of the vagina and uterine cervix, as well as possible erosions, dysplasias, and neoplasms on the mucosa. During a digital examination, the gynecologist evaluates the shape and position of the uterus, fallopian tubes and ovaries.

With salpingitis, soreness of the fallopian tubes and adhesive formations are detected.

To identify acute salpingitis, laparoscopy is one of the main diagnostic techniques, the accuracy of which is approximately 80-90%.

You can also see purulent and blood accumulations in the oviducts.

Metrosalpingography is one of the radiopaque methods aimed at assessing the patency of the fallopian tubes.

A contrast agent is injected into the uterine cavity and tubes, which is subsequently monitored on x-rays. Photos are taken with a delay.

In the presence of obstruction, the contrast does not fill the fallopian tube at a certain level, which is most often caused by adhesions against the background of chronic salpingitis.

Treatment of salpingitis

Treatment of salpingitis in Moscow clinics is carried out using medicinal and surgical methods.

The following are prescribed as therapy:

• antibiotics – Ceftriaxone, Azithromycin, Doxycyline, Cefotaxime, Ampicillin, Metronidazole;
• anti-inflammatory drugs - Ibuprofen, Acetaminophen, Butadione, Paracetamol, Terzhinan suppositories, Hexicon;
• immunomodulatory agents – Imunofan, Polyoxidonium, Groprinosin, Humisol;
• antipyretics and antihistamines;
• vitamin complexes containing cocarboxylase, vitamins E, C;
• probiotics, antioxidants.

It is also possible to carry out physiotherapeutic procedures - electrophoresis with lidase, treatment with pulsed low-frequency ultrasound, reflexology, infusion therapy, heat therapy, diadynamic therapy, autohemotherapy. During treatment, it is advisable to adhere to a healthy diet and avoid the consumption of alcoholic beverages, which leads to a deterioration of the immune system and the functioning of the gastrointestinal tract.

It is possible to add traditional methods to drug therapy - taking baths with valerian, sage, juniper, rosemary, milk, douching with a herbal solution, using tampons with a decoction of plantain, aloe, cabbage, and consuming various herbal teas.

In cases of ineffectiveness of drug and physiotherapeutic treatment, as well as in the presence of tumor formations in the uterine appendages, adhesions causing obstruction of the fallopian tubes, accumulation of pus, and infertility, the patient is prescribed surgical intervention.

First of all, adhesions and neoplasms are eliminated and normal patency of the fallopian tubes is restored.

Surgical intervention is carried out by laparoscopy (the surgeon makes a small incision through which a miniature camera is inserted and the affected areas of the tubes are excised and their patency is restored) or laparotomy (the abdominal cavity in the area of ​​​​the projection of the affected fallopian tube is dissected, the infected areas are eliminated, sanitation, dissection of adhesions is carried out formations). 

Complications caused by salpingitis

Complications of salpingitis include:

• onset of infertility;
• increased risk of ectopic pregnancy by up to fifty percent;
• the occurrence of an adhesive process, leading to surgical intervention and, if the outcome is unfavorable, removal of the fallopian tubes;
• infection of the peritoneal and pelvic organs.

Salpingitis and the possibility of getting pregnant

If the patient suffers from unilateral salpingitis and treatment was started in a timely manner, her chances of becoming pregnant on her own without undergoing additional medical procedures and manipulations are very high. If the inflammatory process is traced in both uterine appendages, the probability of spontaneous pregnancy is one in ten.

About twenty-five percent of women suffering from a chronic form of salpingitis receive a conclusion about the occurrence of infertility. Through the use of laparoscopic surgery, complete elimination of intrauterine adhesions is possible; competent drug therapy helps eliminate the inflammatory process.

After long-term treatment, spontaneous pregnancy may occur.

In case of obstruction of the fallopian tubes, which cannot be restored, or in the case of removal of the oviducts, a woman’s opportunity to become a mother is realized using the IVF technique.

Disease prevention

Prevention of salpingitis is quite simple.

A woman is required to observe the rules of personal hygiene, use barrier methods of contraception (condoms) during casual sexual intercourse, undergo regular examinations by a gynecologist (at least once a year), and immediately contact a specialist if symptoms of the disease or other discomfort occur. It must be remembered that timely treatment is the key to the absence or minimum number of further complications.

Source: https://www.drclinics.ru/bolezni/salpingit/

How is chronic salpingitis manifested and treated?

Chronic salpingitis is an infectious-inflammatory disease in which bilateral fallopian tubes are damaged. The disease is quite widespread, since, according to statistics, up to 30% of the fair sex faces this problem.

What causes pathology?

The chronic form develops against the background of an advanced stage of acute salpingitis. In most cases, this occurs as a result of untimely, incorrect or insufficient treatment, in the absence of courses of restorative therapy. Often the disease is caused by pathogenic organisms. The most common pathogens include:

1. Escherichia coli.
2. Gonococci.
3. Chlamydia.
4. Staphylococci.
5. Trichomonas.
6. Streptococci.

These bacteria and microorganisms penetrate directly into the fallopian tubes through the appendix, abdominal organs and vagina. Experts also identify the following causes of pathology:

1. Long-term and uncontrolled use of hormonal contraceptives.
2. Early onset of sexual activity.
3. Sexual contacts during menstruation.
4. Promiscuous sex life.
5. Age factor (women under the age of 35 are most susceptible to this disease).
6. Abortion.
7. C-section.
8. The presence of untreated gynecological diseases in an advanced stage.
9. Previous traumatic injuries and surgical interventions in the uterine area.
10. Pregnancy.
11. Climax.
12. Presence of an intrauterine device.
13. Weakened immunity.
14. Frequent stress.
15. Chronic fatigue.
16. Poor nutrition.
17. General hypothermia of the body.
18. Hysteroscopy.
19. Hysterosalpingography.
20. Acute inflammatory processes in the uterus and its appendages.
21. Douching.

All these factors contribute to the emergence and development of chronic salpingitis and cause exacerbations and complications.

Depending on the location, pathology is divided into several types:

1. Right-sided - occurs when the right fallopian tube is inflamed.
2. Left-sided - formed on the basis of damage to the left fallopian tube.
3. Bilateral - observed with an inflammatory process affecting both sides of the uterus.

Signs of the disease

Very often, chronic salpingitis occurs for a long time without pronounced symptoms. Characteristic signs may appear only during periods of exacerbation.

This significantly complicates the diagnosis of the disease, and significantly increases the risk of developing associated complications and the transition of the pathology to a severe, advanced stage.

Chronic salpingitis has the following symptoms:

1. Pain in the lower abdomen with a tendency to intensify during menstruation.
2. Disruptions in the menstrual cycle.
3. Associated oophoritis.
4. Possible discharge from the genital tract.
5. Increased body temperature.
6. Frequent urge to urinate.
7. Painful sensations accompanied by bleeding during sexual intercourse.
8. Increased fatigue.
9. General weakening of the body.
10. Drowsiness.
11. Unreasonable, increased irritability.
12. Intestinal irritation.

In the advanced stage, the following manifestations may be observed:

1. Fever.
2. Nausea, attacks of vomiting.
3. Painful sensations in the lumbar region and lower extremities.
4. Purulent discharge with a specific, unpleasant odor.
5. Bloating.
6. Permanent lack of appetite.
7. Difficulty in defecation.

Chronic bilateral salpingitis in an advanced state is fraught with the development of a number of severe complications, including damage to nearby organs and infertility.

Therefore, if you detect at least a few of the above signs, it is recommended to immediately consult a doctor and undergo the necessary examination.

How dangerous is the pathology?

Bilateral salpingitis in chronic form is dangerous due to its complications.

These include:

1. Oophoritis is an inflammatory process that affects the ovaries. Manifested by pain in the side and lower abdomen, vaginal discharge. The disease occurs when infection penetrates from the fallopian tubes to the ovarian area.
2. A tubo-ovarian abscess is a purulent inflammation that occurs in the ovaries and fallopian tubes. Its main symptoms are pronounced pain in the abdominal area and high temperature, sometimes reaching critical levels. In the absence of timely treatment, inflammation spreads to the peritoneal area and becomes the cause of the development of sepsis or peritonitis.
3. Chronic pelvic pain is considered one of the most common consequences of salpingitis. According to statistics, this phenomenon is observed in every 4 patients who encounter this problem. Pain may spread to the abdominal area and tends to intensify with physical exertion, hypothermia, or during menstruation.
4. Infertility is one of the most serious complications that salpingitis can lead to. Due to the active spread of the inflammatory process in the fallopian tubes, obstruction develops, which reduces the chances of successful conception by exactly half.
5. An ectopic pregnancy is the result of a tubular obstruction. Among the fair sex, the risk of this pathological phenomenon increases by 20-50%.

Salpingitis that develops during pregnancy poses a serious threat to both the mother and the fetus.

This combination is extremely unfavorable and can lead to the following consequences:

1. Miscarriage.
2. Premature birth.
3. Death of the fetus.
4. Complicated birth process.

In order to avoid such unfavorable consequences, reducing the likelihood of their manifestation to minimal indications, a pregnant woman diagnosed with “salpingitis” is subject to immediate hospitalization and careful medical supervision.

Diagnostic methods

Salpingitis in chronic form is diagnosed by a gynecologist during the study of the clinical picture, the results of the anamnesis, and through a gynecological examination. However, given the fact that the pathology often occurs without pronounced symptoms, to clarify the diagnosis and determine the severity of the disease, the following studies are prescribed to the patient:

1. General blood analysis.
2. An ultrasound examination is necessary to confirm the presence of inflammation and to study the general condition of the fallopian tubes.
3. A puncture of the fallopian tubes is taken for further analysis in order to determine the causative agent of the disease.
4. Laparoscopy is one of the most informative types of diagnostic procedures used for chronic salpingitis. The accuracy of its results is equal to 80%.
5. Microbiological analysis of vaginal and urethral discharge.
6. PCR diagnostics.
7. Analysis of urine.
8. ELISA diagnostics.

How to treat the disease?

Therapy for chronic salpingitis largely depends on the stage of development of the disease, its severity, and the presence or absence of possible complications.

To combat it, two types of treatment are used: conservative and surgical.

Conservative treatment consists of taking antibiotics. The drugs are selected by the doctor individually depending on the type of pathogen.

In addition, patients are prescribed anti-inflammatory and painkillers. Vitamin therapy and physiotherapy are actively used. In some cases, detoxification therapy is indicated.

During the operation, the pus is removed and the patency of the fallopian tubes is restored. In particularly critical situations, the fallopian tubes themselves are removed.

• Chronic salpingitis is considered a serious gynecological disease that requires adequate and timely treatment.
• Only a well-chosen course of therapy and strict adherence to medical recommendations will avoid a number of complications.

Source: https://upraznenia.ru/xronicheskij-salpingit.html