Salpingitis is a disease in women caused by inflammation of the fallopian tubes. Salpingitis can be bilateral and unilateral. Most often, the infection penetrates the ascending path into the fallopian tubes from the uterus. Usually, the inflammatory process spreads further, capturing the ovaries. Other methods of infection penetration include descending (from the intestine through the peritoneum), hematogenic (through the blood) and lymphogenic (through the lymph).
The pathogens that cause salpingitis are very diverse. These are microorganisms (staphylococci, streptococci, E. coli, etc.) that cause a non-specific form of the disease (common inflammation) and pathogens of specific salpingitis (tuberculosis, gonorrhea, mycoplasma, chlamydia and other types of salpingitis are distinguished).
With this disease, inflammatory exudate accumulates in the fallopian tubes, leading to obstruction of the fallopian tubes, which can be the cause of infertility in women. In the case of salpingitis during pregnancy, the infection can be transmitted to the fetus, so the occurrence of pregnancy is undesirable until the disease is completely cured.
SYMPTOMS OF SALPINGITIS
Salpingitis can occur in acute or chronic form. Chronic salpingitis, as a rule, occurs with insufficient treatment of the acute form of the disease. But sometimes it occurs primarily, for example, gonorrheal salpingitis initially occurs in a chronic form.
Acute salpingitis immediately makes itself felt by a significant increase in temperature (sometimes up to 40 degrees), as well as sharp pains in the lower abdomen and in the sacrum, dysuric and gastrointestinal disorders. In some cases, there are periodic purulent discharge from the urethra. Although almost immediately you should consult a doctor, it can be difficult to make an unambiguous diagnosis based on the clinical picture.
Chronic salpingitis may manifest itself even slightly. This is a subfebrile temperature and a mild pain syndrome. One of the constant signs of this disease is a violation of the menstrual cycle.
CAUSES OF SALPINGITIS
Salpingitis is often caused by so-called provoking factors – physiological (menstruation, childbirth) or artificial (abortion, hysteroscopy, various operations, etc.). Very often salpingitis occurs when the barrier mechanisms of the cervix are weakened or damaged, including due to the provoking factors listed above.
Factors that reduce the overall immunity of the body can also cause this disease. These include chronic stress, irrational nutrition, drug addiction and chronic alcoholism. In addition, behavioral factors aggravate the picture, among which are the early onset of sexual activity, a large number of sexual partners and an increased frequency of sexual contacts, as well as non-traditional types of sexual contacts and sexual relations during menstruation.
In addition, it is necessary to be attentive to the choice of methods of contraception. The occurrence of the disease is facilitated by the use of hormonal, rather than barrier contraception or douching performed for the purposes of contraception and hygiene.
DIAGNOSIS OF SALPINGITIS
Diagnosis of salpingitis is usually complicated by the similarity of its symptoms with common surgical diseases, such as appendicitis and ectopic (ectopic) pregnancy.
The presence of infection is usually determined by laboratory examination of uterine secretions. In addition, during the examination on the gynecological chair with palpation, soreness of the cervix and high sensitivity of the appendages are observed.
Among the mandatory diagnostic procedures for suspected salpingitis are ultrasound and blood tests. ESR indicators in acute salpingitis are elevated and amount to more than 15 mm /h. There is also a pronounced leukocytosis (above 10.5 thousand). With the help of ultrasound, it is possible to detect directly the presence of inflammation in the fallopian tubes. The specific causative agent of the disease is detected by puncture of the fallopian tube or the posterior arch of the vagina.
In some cases, in the acute form of the disease, a laparoscopic method of material sampling is used. The diagnosis can be made in this way most accurately (approximately 78% of cases). However, due to the increased traumatism of this method, it is not used so often.
TREATMENT OF SALPINGITIS
In the treatment of salpingitis, various antibacterial agents are used (antibiotics: semi-synthetic penicillins, tetracycline preparations, aminoglycoside group antibiotics, levomycetin group drugs and nitrofuran derivatives – furazolidone, furadonin, furazolin, furagin). After the relief of the main symptoms of the disease, antibiotic treatment is recommended to continue for another one to two weeks. In the acute form of the disease, bed rest and taking painkillers and anti-inflammatory drugs are indicated.
With chronic salpingitis, physiotherapy and balneotherapy are indicated. This form of the disease is treated for a long time and in some cases, with relapses of the acute form of the disease, surgical intervention may be the only remedy.
Salpingitis treatment operations are performed in various ways. This may be a puncture of the utero-rectal recess, carried out through the posterior vaginal arch, laparoscopic surgery or adhesiolysis. Sanitation and transvaginal drainage of the pelvis are also often performed.
