What Is Salpingitis? Causes, Symptoms & Treatment

By MD, PhD, MSc (gynecologist), BSc, MSc (embryologist), BSc, MSc (embryologist), BSc, MSc (embryologist) and (invitra staff).
Last Update: 03/10/2020

Salpingitis is a type of pelvic inflammatory disease (PID) that involves inflammation of the tubes.

It is one of the causes of tubal sterility and increases the chances of ectopic pregnancy.

Symptoms may vary, but most patients report pain in the pelvic area. Patients with salpingitis are treated with antibiotics.

Pelvic inflammatory disease

Pelvic inflammatory disease is inflammation and infection of the upper genital tract. It can affect:

  • Endometrium (endometritis)
  • Myometrium (myometritis)
  • Fallopian tubes (salpingitis)
  • Ovaries (oophoritis)
  • Parametrium (parametritis)
  • Peritoneum (Peritonitis)

It is caused by bacteria from the vagina or cervix that ascend to one of these structures and cause infections. The most common are chlamydia (Chlamydia trachomatis) and gonorrhea (Neisseria gonorrhoeae), which are sexually transmitted diseases (STDs).

Moreover, infection with one of these pathogens increases the transmissibility of HIV and other STDs.

Types of Salpingitis

There are two main types of salpingitis:

Acute Salpingitis
is the one with the worst symptoms (fever, acute pain in the lower part, etc.).
Chronic salpingitis
can go unnoticed (asymptomatic) and mostly occurs after the menstruation.

Depending on whether it affects one or both tubes, a distinction is made between unilateral and bilateral salpingitis, respectively. Approximately 60% of cases are bilateral, i.e. both tubes are affected.

Causes

Salpingitis usually affects women of childbearing age and it occurs in 10-15% of sexually active women, as one of the most common causes of inflammation of the tubes are genital infections, especially sexually transmitted infections.

About 40% of sexually transmitted infections end in salpingitis.

In most cases, salpingitis is caused by a type of chlamydia, the Chlamydia trachomatis. Infection usually begins in the vagina and then moves up to the upper genital tract.

Other possible pathogens that are sexually transmitted and cause this type of inflammation are gonococcus (gonococcal salpingitis) and some types of mycoplasma which occur less frequent.

30-40% of cases of salpingitis are of polymicrobial cause and, among the causative microorganisms, we can find some of the vaginal flora.

Bacteria can also reach the upper genital tract through medical procedures, such as placement of an intrauterine device (IUD) or any invasive test that is capable of dragging microorganisms from the vaginal flora. Examples of these techniques include childbirth, miscarriage, endometrial biopsy, hysterosalpingography, and hysteroscopy.

It may also be a bloodborne infection, as in the case of tuberculosis. If the infection is caused by Mycobacterium tuberculosis, we are talking about tuberculous salpingitis.

Risk Factors

There are some situations or factors that may increase your risk of salpingitis. The most common are the following:

  • Couple with any type of genital infection, especially gonorrhea or chlamydia.
  • Prior pelvic surgery.
  • Use of IUD.
  • History of pelvic inflammatory disease.
  • History of sexually transmitted disease.
  • Multiple sexual partners.
  • Having sexual activity before age 20.

Symptoms

Salpingitis manifests itself over time in a variable way and can go from 2 days to 3 weeks or even months after having had contact with the pathogen.

The fact that there are patients with the infection who have no symptoms makes it easier to become infected and that the chances of complications are higher.

The symptoms of salpingitis may vary depending on the microorganism that acts, but the most characteristic of them is pain in the pelvic area.

Other symptoms that may appear are:

  • Abnormal vaginal discharge with thick discharge
  • Pain during ovulation
  • Unpleasant, uncomfortable, and even painful sexual intercourse (dyspareunia)
  • Fever
  • Nausea and vomiting
  • Irregular menstrual Bleeding
  • Pain when urinating (dysuria), if accompanied by urethritis (inflammation of the urethra)
  • Vaginitis
  • Cramps in the pelvic area

Complications of Salpingitis

Some of the complications that may occur are:

  • Chronic pelvic pain.
  • Tubal factor infertility.
  • Ectopic pregnancy.
  • Recurrent pelvic inflammatory disease.
  • Pelvic abscess.
  • Generalized sepsis or infection
  • Liver and appendix involvement.

Diagnosis and Treatment

To diagnose salpingitis, the patient's symptoms and sexual history are considered, and a physical examination is performed. Only the most serious cases of salpingitis can be detected by ultrasound, though any other pathology can be ruled out.

A microbiological analysis of vaginal secretions can also be performed to detect and identify any pathogen infection.

Generally, if the diagnosis is made early, the inflammation subsides with medication. However, a late diagnosis can lead to more serious complications requiring more invasive treatment and sequels are more likely.

As this is an inflammation normally caused by a bacterial agent, the treatment of choice is the pharmacological one, which consists of antibiotic and anti-inflammatory pain medication.

The antibiotic used will depend on the microorganism that causes the infection. Some of those used are doxycycline, azithromycin, erythromycin or levofloxacin.

The patient's partner should also be treated with antibiotics and it is advisable to avoid sexual intercourse until one week after the end of the treatment.

In the most severe cases, if outpatient treatment is not effective, hospitalization of the patient may be necessary.

If the infection of the fallopian tubes becomes complicated, surgical treatment will be undertaken. If a pelvic abscess develops with a collection of pus, drainage surgery may be necessary. In more severe cases, salpingectomy (removal of the tubes) may also be required.

Salpingitis, sterility and infertility

The fact that a large percentage of patients have subclinical (symptomless) chlamydial infection means that it remains untreated and spreads to the upper genital tract. These subclinical cases are the origin of most cases of sterility (difficulty in conceiving) due to tubal factor.

The inflammation of the structures of the fallopian tubes causes the permeability of the tubes to be altered. This causes a mechanical obstacle in the path of the egg to the uterus, making it difficult for it to meet the sperm. Therefore, it prevents fertilization from happening.

Furthermore, in 50% of ectopic pregnancies this clinical background exists. It has also been shown that approximately 20% of abortion patients are infected with chlamydia. Therefore, it is also a cause of infertility (difficulty in carrying a pregnancy to term).

If you want to know more about the difference between sterility and infertility, you can visit the following link: Is infertility the same as sterility?

If after the treatment the tubes are still altered and there the patient wants to get pregnant, the indication will be an in vitro fertilization (IVF) treatment, since due to this alteration, pregnancy with artificial insemination would not be possible.

If a woman gets pregnant without having treated her chlamydia infection, she may havec premature delivery and infections in the newborn that can cause conjunctivitis and pneumonia.

FAQs from users

Can salpingitis become really serious?

By Blanca Paraíso MD, PhD, MSc (gynecologist).

Only in a minority of cases of salpingitis does peritonitis or pelvic abscess develop, manifesting itself with more intense pain and general symptoms such as fever. If this degree is reached, surgery is sometimes necessary to cure the disease, and the tubes and even the ovaries have to be removed.

In the most severe cases, the process can extend to other abdominal organs such as the liver or even pass into the blood (sepsis), posing a risk to the woman's life.
Read more

Is there a natural treatment for salpingitis?

By Rebeca Reus BSc, MSc (embryologist).

In the treatment of salpingitis, absolute rest and a mild nutrition are recommended, but it is also essential to follow an antibiotic treatment, since the complications of this pathology can be very serious.

Do contraceptives protect against salpingitis?

By Rebeca Reus BSc, MSc (embryologist).

Only barrier contraceptives, such as condoms, can protect against sexually transmitted diseases, which are the main cause of salpingitis.

However, oral contraceptives have been shown to reduce the incidence of these: they cause an increase in the viscosity of cervical mucus, which makes it difficult for microorganisms to enter.

On the other hand, as already mentioned in the article, the IUD is a risk factor for this pathology.

I'm a virgin. Can I still get salpingitis?

By Rebeca Reus BSc, MSc (embryologist).

It is very rare for these infections to occur without sexual intercourse, but they can also be caused by some medical procedures, such as hysteroscopy.

What is salpingitis isthmica nosoda?

By Zaira Salvador BSc, MSc (embryologist).

Salpingitis isthmica nosoda, also known as diverticulosis of the Fallopian tube, consists of a nodular thickening of the isthmic portion of the fallopian tubes, although it can also affect their entirety.

It is a progressive and irreversible process that causes infertility and an increased risk of ectopic pregnancy.

The exact cause of this alteration is unknown, although it is most likely to be of an inflammatory origin.

Suggested for you

We've discussed STDs as the most common cause of salpingitis. If you want to know more about the types of sexual infections that exist, you can read more here: Sexually transmitted diseases (STDs) in men and women.

You want to learn more about disorders in the fallopian tube? Read more about those disorders as a cause for sterility here: Female tubal factor infertility.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Authors and contributors

 Blanca Paraíso
Blanca Paraíso
MD, PhD, MSc
Gynecologist
Bachelor's Degree in Medicine and Ph.D from the Complutense University of Madrid (UCM). Postgraduate Course in Statistics of Health Sciences. Doctor specialized in Obstetrics & Gynecology, and Assisted Procreation. More information about Blanca Paraíso
License: 454505579
 Rebeca Reus
Rebeca Reus
BSc, MSc
Embryologist
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information about Rebeca Reus
 Teresa Rubio Asensio
Teresa Rubio Asensio
BSc, MSc
Embryologist
Master's Degree in Medicine and Reproductive Genetics from the Miguel Hernández University of Elche (UHM). Teacher of different Clinical Embryology courses at the UHM. Member and writer of scientific contents at ASEBIR and ASPROIN. Embryologist specializing in Assisted Procreation at UR Virgen de la Vega. More information about Teresa Rubio Asensio
 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Romina Packan
Romina Packan
inviTRA Staff
Editor and translator for the English and German edition of inviTRA. More information about Romina Packan

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