Acute and chronic salpingitisThere are two types of salpingitis: acute salpingitis and chronic salpingitis.
SymptomsThe symptoms usually appear after a menstrual period. The most common are:
- Abnormal smell and colour of vaginal discharge.
- Pain during ovulation
- Pain during sexual intercourse
- Pain coming and going in periods
- Abdominal pain
- Lower back pain
Causes and pathophysiologyThe infection usually has its origin in the vagina, and ascends to the fallopian tube from there. Because the infection can spread via the lymph vessels, infection in one fallopian tube usually leads to infection of the other.
Risk factorsIt's been theorized that retrograde menstrual flow and the cervix opening during menstruation allows the infection to reach the fallopian tubes.
Other risk factors include surgical procedures which break the cervical barrier, such as:
- antibiotic treatment
- sexually transmitted disease (STD)
- Uterine contractions
- Sperm, carrying organisms upwards.
Bacterial speciesThe bacteria most associated with salpingitis are:
EpidemiologyOver one million cases of acute salpingitis are reported every year in the U.S., but the number of incidents is probably larger, due to incomplete and untimely reporting methods and that many cases are reported first when the illness has gone so far that it has developed chronic complications. For women aged 16–25, salpingitis is the most common serious infection. It affects approximately 11% of the female of reproductive age. Salpingitis has a higher incidence among members of lower socioeconomic classes. However, this is thought of being an effect of earlier sex debut, multiple partners and decreased ability to receive proper health care rather than any independent risk factor for salpingitis. As an effect of an increased risk due to multiple partners, the prevalence of salpingitis is highest for people aged 15–24 years. Decreased awareness of symptoms and less will to use contraceptives are also common in this group, raising the occurrence of salpingitis.
ComplicationsFor the affected, 20% need hospitalization. Regarding patients aged 15–44 years, 0.29 per 100,000 dies from salpingitis.
However, salpingitis can also lead to infertility, because the eggs released in ovulation can't get contact with the sperm. Approximately 75,000-225,000 cases of infertility in the U.S. are caused by salpingitis. The more times one has the infection, the greater the risk of infertility. With one episode of salpingitis, the risk of infertility is 8-17%. With 3 episodes of salpingitis, the risk is 40-60%, although the exact risk depends on the severity of each episode.
In addition, damaged oviducts increase the risk of ectopic pregnancy. Thus, if one has had salpingitis, the risk of a pregnancy to become ectopic is 7 to 10-fold as large. Half of ectopic pregnancies are due to a salpingitis infection.
Other complications are:
- Infection of ovaries and uterus
- Infection of sex partners
- An abscess on the ovary
DiagnosisSalpingitis may be diagnosed by pelvic examination, blood tests, and/or a vaginal or cervical swab.
TreatmentSalpingitis is most commonly treated with antibiotics.
- Salpingitis at eMedicine
- "Salpingitis: treatment, symptoms, cause, prevention, complications, long-term outlook". MamasHealth.com.