What is salpingitis?
Salpingitis is the term for inflammation of the fallopian tubes. Most cases are due to an infection. The fallopian tubes are located on either side of the uterus. The hollow cavity of the fallopian tubes allow for an egg cell (ovum) that is released from the ovary to pass into the uterus. Although salpingitis is not often discussed on its own as it is part of the umbrella term pelvic inflammatory disease (PID), it is an important cause of infertility in women.
Sometimes the term salpingitis and pelvic inflammatory disease are used interchangeably but PID can include the inflammation of any part of the female reproductive system including the ovaries, uterus and cervix as well as other structures. It is, however, uncommon for the fallopian tubes to be inflamed on its own without any of the surrounding organs to be affected. This is largely due to the fact that most cases are due to infections that travel up the vaginal tract and it is unlikely that the cervix and uterus are not also infected.
Causes of Salpingitis
Almost all cases of salpingitis are due to an infection. Of the various pathogens, most are due to a bacterial infection. The pathogen typically enters through the vagina and gradually travels upwards towards the fallopian tubes (ascending infection). The pathogens may include those that are transmitted sexually (sexually transmitted infections). The most common bacteria include streptococci, staphylococci, mycoplasma and the bacteria that causes commonly STD’s like gonorrhea and chlamydia. These bacteria cause suppurative salpingitis.
Salpingitis is almost always seen in sexually active women. If it occurs in children, sexual abuse needs to be excluded as a possible cause. However, the pathogens can reach the fallopian tubes through the lymph vessels (lymphatic spread) or even through the bloodstream (hematogenous) from distant sites. Women who recently underwent surgery, including a D&C and those who use vaginal douches are at a greater risk of salpingitis. Another type of fallopian tube infection known as tuberculous salpingitis is rare in developed nations and occurs as a consequence of tuberculosis. However, it is fairly common in countries where tuberculosis is prevalent.
Signs and Symptoms of Salpingitis
Salpingitis may be acute or chronic. Acute salpingitis typically presents with intense symptoms whereas the signs and symptoms may be mild or even barely noticeable in chronic salpingitis. The common clinical features include :
- Abnormal vaginal discharge with foul odor
- Vaginal odor
- Lower back pain
- Lower abdominal pain
- Pain that is periodic and arises more often with ovulation and sexual intercourse
- Frequent urination
- Nausea and vomiting
- Intermenstrual spotting – bleeding between periods
Diagnosis and Treatment
Salpingitis closely resembles urinary tract infections (UTIs) which are common in women. Further tests may therefore be required although the presentation and findings upon clinical examination by a doctor may be sufficient. Women should not assume the symptoms are due to a UTI and therefore attempt to self-medicate. Blood tests, microscopic examination and culture of discharge and the vaginal mucus and sometimes even a laparoscopy may therefore be necessary. If left untreated, the fallopian tubes can be severely damaged and this can lead to abscess formation, increase the chances of ectopic pregnancy or contribute to infertility.
Oral antibiotics are effective most of the time, however, IV administration of antibiotics may be necessary in more severe infections. Surgery is rarely necessary but could be required in untreated and chronic infections. Salpingitis cannot and should not be treated with vaginal douches or topical applications inserted into the vagina.