Diseases of the fallopian tubes. Inflammation of the fallopian tubes
Salpingitis is one of the most common pelvic infections. Isolated inflammation of the fallopian tubes is rare, only in 30 percent of cases. In other cases, inflammation also affects the ovaries with the development of the so-called salpingoophoritis. According to various data, on average, one woman in 10 suffers inflammation of the fallopian tubes. In 20 percent of cases, salpingitis ends in infertility.
Anatomy of the uterus
The uterus is an unpaired muscular organ of the female reproductive system. It has a pear-shaped shape, and the fallopian tubes depart from it on the sides. Normally, the uterus occupies a central position in the small pelvis with a slight forward tilt ( towards the bladder). This position is provided by the ligamentous apparatus of the uterus and its appendages. The uterine appendages are represented by the fallopian tubes and ovaries. The fallopian tubes
The uterine or fallopian tubes are located on both sides of the uterus. They originate in the region of the upper corners of the uterus and go towards the side walls of the small pelvis. On average, the length of one pipe is 10 - 12 centimeters, and the thickness is 0.5 centimeters. Anatomically, several parts are distinguished in the fallopian tube.Parts of the fallopian tube:
- uterine part;
- isthmus;
- ampullary part;
- funnel.
The uterine part of the tube is located in the uterus, connecting the cavity of the fallopian tube with the cavity of the uterus itself. The funnel, opening into the abdominal cavity, communicates the latter with the cavity of the fallopian tube. Thus, at one end the fallopian tube communicates with the abdominal cavity, and at the other - with the uterine cavity. As a result of this anatomical feature, the uterine cavity communicates with the pelvic cavity and the abdominal cavity. This explains the spread of infection through the fallopian tubes. On the one hand, the infectious agent can enter the fallopian tube from the vagina and uterus ( ascending path), and on the other hand, it can penetrate from the abdominal cavity ( descending path).
The walls of the fallopian tubes are somewhat different from the walls of the uterus itself. Unlike the uterus, which has three layers, the walls of the fallopian tubes have four.
The structure of the walls of the fallopian tubes:
- inner mucous layer;
- muscle layer;
- subserous layer;
- serous or connective layer.
With the development of an inflammatory process affecting all layers, the walls of the pipes thicken and deform, and their patency is impaired.
ovaries
The ovaries are female paired sex glands, which are located in the pelvis on the sides of the uterus. The average size of the ovaries ranges from 2 to 5 centimeters in length and 1.5 to 3 centimeters in width. They perform a number of important functions in a woman's body.Functions of the ovaries:
- storage of germ cells;
- monthly maturation of germ cells;
- synthesis of sex hormones estrogen, progestin).
In the ovary, two layers are distinguished - the cortical substance and the stroma. The cortical substance is represented by many vesicles, which are called follicles. These vesicles contain female sex cells or eggs. In the follicles, the eggs are at different stages of maturation. The larger the follicle, the more mature the egg in it. The ovarian stroma is made up of connective tissue.
The ovaries are located in close proximity to the fallopian tubes. One of the longest fringes of the tube approaches the tubal end of the ovary. This explains the fact that isolated inflammation of the fallopian tubes is extremely rare. Most often, salpingitis occurs with the involvement of the ovaries, and in this case it is called salpingo-oophoritis.
The ovaries are mobile organs of the small pelvis. Like the uterus itself, they are fixed in limbo by ligaments.
Causes of inflammation of the fallopian tubes
There are many reasons for inflammation of the fallopian tubes. Basically, these are various microbial associations, as well as viruses. Most often, infection occurs by an ascending route, that is, infection from the genital organs ( vagina) or urinary organs ( urethra) rises to the fallopian tubes. Sexually transmitted infections
Sexually transmitted diseases include bacterial, viral and protozoal infections.The most common sexually transmitted infections are:
- herpes simplex virus type 2.
The mechanism of infection in the fallopian tubes
A feature of most infections is their asymptomatic course. As a result, women do not seek help from a doctor for a long time, and the disease becomes chronic. Prolonged stay of bacteria and viruses in the mucous membrane of the genital organs causes a local decrease in immunity, a violation of circulation in these organs. Further infection under the influence of any factor ( stress, cold) starts to spread upwards. From the vagina or urethra, penetrating through the cervical canal, it first enters the uterine cavity, and then reaches the fallopian tubes.
The mechanism of development of salpingitis
source of infection ( virus or bacterium) having penetrated into the mucous membrane of the fallopian tubes, it begins to actively multiply there. The mucous membrane of the fallopian tubes becomes edematous, and blood circulation in it worsens. The reproduction of a bacterial infection is accompanied by the accumulation of pus in the pipes. Further, the inflammatory process affects all layers of the fallopian tubes, which leads to their thickening and the development of an adhesive process. As a result, tubal obstruction develops, which is one of the most common causes of female infertility. Salpingitis that develops as a result of sexually transmitted infections, as a rule, is bilateral.
Each sexually transmitted infection has its own mechanism of development of the disease and its own characteristics. So, gonococcal infection provokes the development of purulent bilateral salpingitis. Chlamydial salpingitis, which is diagnosed in 30 to 40 percent of cases, is more often than others complicated by an adhesive process. As a rule, chlamydia damages not only the mucous membrane of the tubes, but also the ovaries, disrupting the process of maturation of eggs in them.
Promiscuous sexual intercourse increases the risk of developing salpingitis several times. This is because this increases the risk of infection, as well as the simultaneous development of several infections or the so-called microbial association. At the same time, local immunity decreases, and the genital mucosa becomes less resistant to the penetration of bacteria.
Mechanical damage to the uterine mucosa and fallopian tubes
In addition to the immediate causes that trigger the inflammatory reaction, there are also provoking factors. These factors create conditions for the penetration of bacteria and the development of inflammation. These include various mechanical damage to the mucosa due to abortion and other manipulations.Normally, the penetration and further development of bacteria is prevented by a healthy mucous membrane. The uppermost layer of the mucosa ( epithelium) is one of the protective factors against infections. However, various damage to this epithelial layer becomes the main gateway for infections.
Manipulations leading to damage to the uterine mucosa and fallopian tubes:
- abortions with curettage;
- birth trauma;
- intrauterine devices;
- various intrauterine diagnostic manipulations - salpingoscopy, metrosalpingography.
Abortions and birth injuries violate the integrity of the uterine mucosa and fallopian tubes. Scraping causes the greatest damage, as a result of which not only the mucous layer, but also the muscle layer can be damaged. Those places that were subject to traumatization are later overgrown with connective tissue. They disrupt blood circulation and nutrition. All this makes the mucous membrane of the fallopian tubes less resistant to infections.
Intrauterine devices
But not only mechanical damage can reduce the resistance of the mucous membrane. Intrauterine devices are very often perceived by the female body as a foreign body. As a result, a cascade of inflammatory-allergic reactions is triggered in the uterine mucosa, which also leads to a decrease in local immunity.
The introduction and removal of the intrauterine device itself can also occur with damage to the mucosa. The greatest danger is the removal of a complicated intrauterine device by instrumental means.
Diagnostic manipulations
With metrosalpingography, the patency of the fallopian tubes is visualized by introducing a contrast agent into the uterine cavity. After the contrast agent has been introduced, its distribution is viewed on x-rays. Contraindications to this manipulation are acute infectious processes, but at the same time, the manipulation itself can contribute not only to damage to the mucous membrane, but also to the exacerbation of chronic infections of the genital tract.
Salpingoscopy is performed using a special apparatus ( salpingoscope), which is introduced into the fallopian tube through a funnel. The process of introducing a salpingoscope takes place during laparoscopy. In this case, not only the mucous membrane of the fallopian tube, but also all its layers can be damaged.
Thus, the leading mechanism in the development of salpingitis, on the one hand, is an infection ascending from the genital organs, and on the other, a violation of the integrity of the mucosa and a decrease in immunity.
Inflammation of neighboring organs
In the development of salpingitis, an important role is played by the inflammatory processes of neighboring organs ( intestines, bladder). Due to the proximity of the infection from these organs, they can pass to the fallopian tubes. Most often, the infection penetrates through the lymphatic vessels with the lymph flow, but it can also penetrate with the blood flow ( tuberculous salpingitis) or by contact.Pathologies that may be complicated by the development of salpingitis:
- pelvioperitonitis;
In inflammatory bowel disease ( colitis, appendicitis) the inflammatory process is transmitted both by contact and with lymph flow. Appendicitis can be not only the cause of the development of salpingitis, but also its complication.
Pelvioperitonitis is an inflammation of the serous membrane that covers the walls of the pelvic cavity ( in the clinic it is called the peritoneum). Most often it is a complication of any primary infectious process, for example, appendicitis. The peritoneum lines not only the walls of the pelvic cavity, but also the pelvic organs, namely the uterus and fallopian tubes. Therefore, the inflammatory reaction from the peritoneum spreads to the organs that are covered with it.
Types of salpingitis
Salpingitis is classified according to several criteria, namely, according to the location, the nature of the inflammation and the course of the disease. By the nature of the course, acute and chronic salpingitis are distinguished, by localization - right-sided and left-sided, by the nature of inflammation - purulent and serous. Acute salpingitis
Acute salpingitis develops due to the penetration of an infectious agent into the fallopian tubes against the background of a general decrease in immunity. The causative agent can penetrate both by the ascending route ( from the vagina), and descending from any primary focus ( appendicitis). Most often, acute salpingitis develops against the background of inflammation of the ovaries, cysts or ectopic pregnancy. Its feature is pronounced symptoms, as well as the presence of general and local symptoms. Acute salpingitis begins with a sharp deterioration in the condition and an increase in temperature above 38 degrees.General symptoms of acute salpingitis:
- temperature rise;
- weakness, malaise;
- increased heartbeat.
Increased heartbeat
An increased heart rate is also a common symptom in an inflammatory response. It is caused by an increase in body temperature. It is known that heart rate correlates with body temperature. So, with an increase in temperature by one degree, the heart rate increases by 8-10 beats per minute. Accordingly, the higher the temperature, the stronger the heartbeat.
Weakness, malaise
Weakness, malaise, pain in muscles and joints are caused by the action of bacterial toxins on the body. Each type of infection is characterized by its own toxins, which are specific to different tissues. So, some are characterized by tropism for nervous tissue, and at the same time, symptoms such as nausea, vomiting, headache develop, while others = to muscle tissue, which are manifested by severe muscle pain and weakness.
Local symptoms in acute salpingitis:
- pain in the groin;
- pathological discharge from the genitals;
- gastrointestinal and urinary symptoms.
Pain in the groin
The development of pain syndrome is due to inflammatory reactions in the fallopian tube. In this case, mediators of pain sensitivity are released, first of all, these are bradykinins and prostaglandins. As the inflammatory process develops, the pain intensifies. After inflammation has covered all layers of the fallopian tube, it increases in size, swells and begins to compress the surrounding tissues. In this case, the pain begins to give to the coccyx, rectum.
The localization of pain depends on which fallopian tube is inflamed. So, with right-sided salpingitis, pain is localized on the right and can often mimic acute appendicitis; with left-sided salpingitis, pain on the left; with bilateral pain localized on both sides.
Pathological discharge from the genitals
The nature of the discharge in acute salpingitis depends on the type of pathogen. With gonococcal salpingitis, purulent discharge is observed, with trichomonas - abundant, foamy discharge. In extremely severe cases, even spotting can occur.
In acute salpingitis, the discharge is usually always abundant. They may be accompanied by itching, burning, which will increase with urination.
Gastrointestinal and urinary symptoms
As a rule, acute salpingitis is accompanied by disorders from neighboring organs. Most often observed disorders of the urinary system. This is due to the close location of the bladder next to the uterus and fallopian tubes. Therefore, with inflammation of the latter, reflex irritation of the bladder is also observed. This is manifested by painful and scanty, but frequent urination. Very often these symptoms are confused with cystitis.
In addition to the urinary system, the gastrointestinal tract is also irritated. Most often, there is a disorder of the stool, which is manifested by frequent acts of defecation and loose, unformed stools.
Chronic salpingitis
Chronic salpingitis is characterized by very sluggish and poor symptoms. The general condition is satisfactory, the temperature is observed extremely rarely. Even if there is a temperature, it ranges from 37 to 37.2 degrees. Scanty discharge and mild, but constant pain in the lower abdomen are observed. The nature of the pain is not acute, but rather dull or aching. The course of chronic salpingitis is undulating. It can periodically escalate and also periodically fade. Exacerbations can be triggered by stress, hypothermia.In chronic salpingitis, menstrual irregularities are observed. Most often, painful algomenorrhea) and scarce ( oligomenorrhea) menstruation. Bowel or bladder irritation is rare.
Despite the poor clinical picture, chronic salpingitis has an unfavorable prognosis. Most often, it is he who is the cause of infertility. The most unfavorable prognosis concerns chronic bilateral salpingitis, since both fallopian tubes are affected at once.
Left-sided salpingitis
Left-sided salpingitis develops with inflammation of the colon in the sections that are located on the left side of the abdominal cavity. Infection can be introduced with diseases such as pneumonia, tonsillitis, influenza. The process is localized in the left fallopian tube and often accompanies such a disease as inflammation of the ovaries ( adnexitis).The course of left-sided salpingitis
The inflammatory process affects the mucous membrane of the fallopian tube, after which it passes to the muscle and connective tissues. The mucosa swells, redness occurs, the surface layer becomes covered with ulcers. With the further development of the pathological process, the dying layers begin to stick together and form cavities in which blood, mucus and pus accumulate.
Symptoms of left-sided inflammation of the fallopian tubes can be both pronounced and blurred and depend on the form of the disease ( acute, chronic, subacute). Pathology is accompanied by both general manifestations of salpingitis and specific ones.
Forecast of left-sided salpingitis
The prognosis of left-sided salpingitis is favorable in cases where the patient consults a doctor at the first symptoms. With timely treatment, recovery and restoration of uterine functions occurs in a few weeks.
Right-sided salpingitis
With right-sided salpingitis, the inflammatory process is localized in the right fallopian tube. This pathology can be triggered by chlamydia, fungi, Escherichia or tubercle bacillus. The reason for the penetration of pathogens into the vagina may be the lack of proper personal hygiene, unprotected intercourse, negligence during gynecological operations. Also, right-sided inflammation of the fallopian tubes can develop with appendicitis.The course of right-sided salpingitis
The penetration of sources of infection into the fallopian tube causes swelling and impaired blood circulation. The inflammatory process affects the muscle tissue, as a result of which the appendages are deformed and thickened. Further, the thickenings in the tube begin to stick together with the peritoneum, forming an adhesion. The process can affect the appendix and cause secondary appendicitis.
In view of the peculiarities of the anatomical structure, right-sided salpingitis causes difficulties in diagnosis, since its symptoms are similar to a number of diseases. Most often it is confused with appendicitis or ovarian apoplexy.
Forecast of right-sided salpingitis
With the timely detection of right-sided salpingitis and the appointment of appropriate treatment, the prognosis is positive. Complete recovery of the patient and regeneration of all functions of the genital organs is possible in two to three weeks.
Purulent salpingitis
Purulent salpingitis in most cases is the result of a gonorrheal infection. When chlamydia enters the fallopian tubes, the inflammatory process affects the uterus and ovaries. The cause of purulent salpingitis can be abortion, spontaneous miscarriages, expired contraceptive coils.The mechanism of development of purulent salpingitis
This pathology is accompanied by the accumulation of purulent exudate in the cavity of the tube, which is the result of an inflammatory process. When pus enters the abdominal cavity, purulent salpingitis provokes inflammation of the serous cover of the peritoneum ( peritonitis). Also, pus can break into the bladder, rectum, into the vagina. As a rule, purulent salpingitis is unilateral.
Symptoms of purulent salpingitis
In most patients, the manifestation of purulent salpingitis is accompanied by fever, chills, severe and acute pain in the lower abdomen. At the beginning of the disease, the pain is local in nature, its typical localization is the left and right inguinal regions. Subsequently, pain is given to the lumbar region and rectum. With concomitant inflammation of the mucosa and muscles of the uterus ( endometritis) dominated by median pain.
A feature of the symptoms of purulent salpingitis are persistent leucorrhoea ( secretions from the genitals) purulent type. The prognosis of purulent salpingitis is favorable with timely surgical treatment. Otherwise, purulent salpingitis is complicated by peritonitis.
Salpingitis with oophoritis
Salpingitis with oophoritis salpingoophoritis) - is an inflammation of the ovaries and fallopian tubes. This form of salpingitis is the most common. Predisposing factors to the occurrence of salpingo-oophoritis are weakening of the immune system, hypothermia, stress.The course of salpingitis with oophoritis
The development of the inflammatory process in salpingitis with oophoritis begins with the ingestion of a pathogenic factor on the mucosa of the fallopian tube. Further, the process passes to the muscle tissue and the serous membrane, then it captures the pelvic peritoneum and the integumentary epithelium of the ovary. After ovulation occurs, the infection enters the ovary, continuing to develop there. With salpingitis with oophoritis, the tube and ovary merge together, forming a common inflammatory conglomerate.
With timely started and properly conducted treatment, the prognosis for restoring reproductive function is favorable, in the opposite case, salpingo-oophoritis is complicated by infertility, ovarian hypofunction.
Symptoms of inflammation of the fallopian tubes
Symptoms of inflammation of the fallopian tubes depend on the nature of the inflammation, the localization of the focus of inflammation, as well as on the individual characteristics of the woman. A woman's concomitant diseases have a great influence on the symptoms of salpingitis. First of all, it concerns sexually transmitted infections. This or that infection in the body of a woman determines the nature of inflammation, the severity of general and local symptoms in salpingitis. Symptoms of inflammation of the fallopian tubes:
- pain in the lower abdomen;
- increase in body temperature;
- discharge;
- violation of the menstrual cycle;
- painful sexual contact;
- female infertility.
Pain in the lower abdomen
Pain syndrome is the main one with salpingitis. Pain is present in both acute and chronic salpingitis. The development of pain symptoms is associated with the development of inflammatory edema in the mucous membrane of the fallopian tubes. In this case, the fallopian tube ( or pipes) swells and increases in size, irritating the serous membrane ( peritoneum), which is riddled with numerous nerve endings. Increasing in size, the fallopian tube begins to compress other nearby organs and nerve endings, causing the spread of pain.In acute salpingitis, the pain is burning, sharp, often radiating to the rectum. With right-sided salpingitis, the pain is located on the right, with left-sided inflammation of the fallopian tube, the pain is localized on the left. In chronic salpingitis, there is a dull, constant pain in the lower abdomen. The pain is aggravated during urination or during sexual intercourse.
Increase in body temperature
Elevated body temperature is a mandatory symptom in purulent and acute salpingitis. The appearance of temperature is due to the vital activity of bacteria in the focus of inflammation. First of all, this is the release of substances by bacteria that cause temperature. These substances are called pyrogens. Pyrogens can be produced not only by bacteria, but also by the body itself in response to the penetration of bacteria into it. In this case, they are called endogenous pyrogens. The temperature in acute salpingitis is due to both body pyrogens and bacterial pyrogens.In acute and purulent salpingitis, a temperature of 38 - 38.5 degrees is observed. It occurs abruptly and is accompanied by chills, increased sweating.
In chronic salpingitis, subfebrile temperature may be observed ( 37 - 37.2 degrees). In this case, fluctuations in temperature during the day can be observed. The temperature may be completely absent, for example, with chlamydial salpingitis. However, the presence or absence of temperature does not always correlate with the prognosis of the disease. So, chlamydial salpingitis, which is characterized by an erased clinical picture and the absence of temperature, is most often complicated by infertility.
Allocations
The nature and intensity of discharge in salpingitis depends on the source of infection. Basically, for inflammation of the fallopian tubes, scanty mucopurulent discharge is characteristic. They are formed due to the intensive multiplication of bacteria in the uterine mucosa and are an accumulation of mucus, uterine epithelial cells and pathogenic bacteria. Propagating in the mucosa of the uterus and fallopian tubes, bacteria stimulate the increased secretion of glands that are located in the mucosa. As a result, more mucus is formed than is normal. Subsequently, cells involved in inflammation join it ( leukocytes) and the bacteria themselves.In chronic forms of salpingitis, discharge may be absent and observed only periodically during exacerbations.
Menstrual irregularities
Violation of the menstrual cycle is an integral symptom in chronic forms of salpingitis. Violations can manifest themselves in the form of heavy or, conversely, scanty menstruation. Most often, menstruation becomes profuse and painful, while the discharge may be with blood clots. But scanty discharge with a pronounced pain syndrome can also be observed.The duration of the entire menstrual cycle may be reduced, and menstruation becomes irregular.
Menstrual disorders occur primarily due to changes in ovarian function. With chronic inflammation of the fallopian tubes, there is a decrease in ovarian function, which leads to a decrease in the level of female hormones. The consequence of this is menstrual irregularities, as well as sexual dysfunction.
Painful sexual contact
Pain during intercourse is a common symptom in subacute and chronic forms of salpingitis. The pains are localized in the lower abdomen and are dull, pulling in nature. The pain syndrome is caused by both inflammation in the mucous membrane and a decrease in ovarian function. In the first case, the pain occurs due to irritation of the inflamed vaginal mucosa. In the second case, the cause of pain is a decrease in estrogen levels. Also, this symptom is accompanied by the absence of the sexual desire itself.female infertility
Female infertility is more a complication of salpingitis than its symptom. It develops due to obstruction of the fallopian tubes. At the heart of the development of obstruction of the fallopian tubes is an adhesive process, which is observed in chronic salpingitis. Due to prolonged inflammation and damage to all layers of the fallopian tube ( or pipes) spikes are formed. Adhesions are connecting strands that form both in the tube itself and between the fallopian tube and other organs. The adhesions themselves form around the inflammatory fluid that accumulates in the tubes. This inflammatory exudate may leak from the fallopian tube through the infundibulum into the pelvic cavity. As a result, adhesions begin to form between the tube and the ovary, thus closing the lumen of the tube.The consequence of an intense adhesive process is the obstruction of the fallopian tubes. If the lumen of the tube closes in the area of the funnel, then the tube becomes completely impassable and therefore the mature egg, after leaving the follicle, cannot penetrate into it and further reach the uterus. But even if the strands formed somewhere in the middle of the fallopian tube, it still prevents the egg from entering the uterus. At the same time, the released egg, although it penetrates the fallopian tube, gets stuck somewhere in the middle, never reaching the bottom of the uterus.
The greatest risk of developing female infertility is observed with bilateral chronic salpingitis, since it affects two fallopian tubes simultaneously. With unilateral salpingitis, even if an adhesive process has developed, one fallopian tube remains functional. The risk of developing infertility in this case is halved.
Diagnosis of inflammation of the fallopian tubes
Methods for diagnosing salpingitis:
- gynecological examination;
- Ultrasound of the pelvic organs;
- laparoscopy;
- radiopaque methods;
- bacteriological examination of a smear from the cervix.
Gynecological examination
Gynecological examination is a method consisting of several stages of examination by a gynecologist. It includes a digital vaginal examination and examination using mirrors. The examination is carried out on a gynecological chair using disposable latex gloves. The patient is lying on her back with legs bent at the knees and ankles on a special stand.Research with mirrors
This study consists in visualizing the walls of the vagina, its vaults and the cervix using vaginal mirrors. There are many models of vaginal mirrors, the choice of which is carried out by a gynecologist. Sims' spoon-shaped mirrors are most commonly used. Initially, the lower mirror is introduced, and then the front one. With salpingitis, mucopurulent mucus is visible on the walls of the vagina and cervix. Also on the mucosa there may be various pathological changes in the form of erosions, dysplasia, tumor-like formations.
Finger vaginal examination
Finger vaginal examination is carried out after the study using mirrors. During this examination, the gynecologist inserts two fingers of one hand into the patient's vagina, and puts the other hand and slightly presses on the lower abdomen. This determines the shape and position of the uterus, the condition of the fallopian tubes and ovaries. With salpingitis, the doctor gropes for a compacted, sharply painful fallopian tube ( one or two) and an ovary. With the development of an adhesive process in the fallopian tubes and ovaries, the gynecologist probes for a tumor-like formation, which consists of adhesions, an ovary and a fallopian tube.
Ultrasound of the pelvic organs
Ultrasound is a non-invasive examination method using ultrasonic waves. Ultrasound of the pelvic organs is performed by a specialist in ultrasound diagnostics.In the study of the pelvic organs, two types of ultrasound are used - transabdominal and transvaginal. In the first case, the sensor is applied to the lower abdomen at the projection points of the fallopian tubes and ovaries, that is, to the right and left inguinal regions. In the second case, the sensor is inserted into the vagina. In both cases, the woman is in the supine position on the couch. Before conducting a transabdominal ultrasound, a woman should fill her bladder as much as possible by drinking 4 to 5 glasses of water beforehand.
Signs of salpingitis on ultrasound:
- thickening of the walls of the fallopian tube;
- expansion of the fallopian tube with hypoechoic contents ( with chronic salpingitis);
- spikes ( with chronic salpingitis);
- accumulation of fluid in the retrouterine space.
- spherical shape of the ovary with a fuzzy contour;
- heterogeneous structure of the ovary, on ultrasound it appears hypoechoic ( dark) and hyperechoic ( light) plots;
- accumulation of fluid in the pelvis;
- blurred visualization of follicles.
Laparoscopy
Laparoscopy is the main method for diagnosing acute salpingitis, its accuracy is 80 - 90 percent. However, this method is associated with numerous risks, including the development of adhesions.Laparoscopy is to visualize the uterine appendages ( fallopian tubes and ovaries) using a laparoscope. This method is a kind of mini-operation, which is performed under local anesthesia. The laparoscope, which is a tube with a lens system, is inserted into the abdominal cavity through small holes. Through an optical cable connected to it, the doctor visualizes the fallopian tubes and ovaries. Thus, tissues are directly visualized and inflammatory processes in them are determined.
With purulent salpingitis, the doctor can visualize the accumulation of pus or even blood in the fallopian tube. The fallopian tube itself looks edematous, enlarged, sharply red.
Radiopaque methods
Radiopaque methods include metrosalpingography, which is used mainly to assess the patency of the fallopian tubes. The method allows you to evaluate the shape, structure, as well as the lumen of the uterus and fallopian tubes.Metrosalpingography
The method consists in the introduction of a contrast agent into the uterine cavity and fallopian tubes, with further tracking of this substance on x-rays. This procedure is carried out in an x-ray room. The woman is in the gynecological chair with legs bent at the knees. The chair is placed under the fluoroscope camera. The doctor inserts a catheter into the cervix, after which contrast is injected into it. Gradually, the contrast agent fills the uterus and fallopian tubes. In this case, delayed pictures are taken. The procedure lasts from 15 to 30 minutes, after which the catheter is removed.
Further, according to the pictures, the doctor evaluates the passage of the substance through the fallopian tubes. If the substance passes completely and evenly through the pipes, then there is no obstruction. If the contrast has ceased to fill the fallopian tube at a certain level, then there is an obstruction of the fallopian tubes.
Most often, obstruction in the fallopian tubes is due to the adhesive process in chronic salpingitis. Spikes deform the fallopian tube, and also fill its lumen. As a result, the lumen of the fallopian tube becomes impassable for the egg, which is the cause of infertility.
Bacteriological examination of a smear from the cervix
Bacteriological examination of a smear from the cervix is one of the mandatory methods in the diagnosis of salpingitis, since most often the cause of salpingitis is sexually transmitted infections ( STI).Infections most often enter the fallopian tube ascending through the vagina, cervix, uterus itself, eventually reaching the fallopian tubes. Therefore, in the treatment of salpingitis, it is necessary to find out which infection persists in the female genital tract. To do this, during a gynecological examination, a smear is taken for bacteriological examination. A smear is taken by a doctor with a special brush from the cervix and urethra. Then it is fixed on a glass slide and sent to the laboratory, where it is studied under a microscope. With salpingitis, an increased number of leukocytes, opportunistic bacteria, a decrease in the number of good bacteria ( lacto- and bifidobacteria)
However, not all infections are detected by this method. Therefore, if there are signs of inflammation in the smear ( increased white blood cell count), but the pathogen is not identified, the doctor may recommend bacteriological culture or PCR smear analysis ( polymerase chain reaction) .
Treatment of inflammation of the fallopian tubes
Medical treatment
Drug treatment of salpingitis includes not only the elimination of infection and anti-inflammatory therapy, but also an increase in the woman's immune system.In the first place in the treatment of salpingitis are antibacterial drugs aimed at eliminating infection from the genitourinary system of a woman. In acute salpingitis, symptomatic treatment is also used, namely antipyretic and anti-inflammatory drugs. The main role in chronic salpingitis is given to immunomodulators.
Antibacterial drugs for salpingitis
| Name of the drug | Mechanism of action | Mode of application |
| Ampicillin | Prevents the development of most bacteria by inhibiting the synthesis of their walls. | Ampoules of 500 mg or 1 g are diluted with saline or novocaine solution. Intramuscularly 500 mg every 6 hours. With purulent salpingitis, 1 gram every 8 hours. The maximum dose is 3-4 grams per day. |
| Ampicillin + Oxacillin
(trade name Ampiox) | It has antibacterial and bactericidal action. | Inside, 500 mg, which is equal to two capsules, every 6 hours. |
| Cefalexin
(trade name Ecocephron) | It inhibits the synthesis of cellular elements of most bacteria, thereby preventing their reproduction. | Inside, one to two capsules ( 250 - 500 mg) 3-4 times a day. Intramuscularly, one ampoule ( 250 mg) every 6 hours. |
| Cefotaxime
(trade name Klaforan) | It inhibits the synthesis of cellular elements of most bacteria, thereby preventing their reproduction. It is a newer drug from the group of cephalosporins. | Intravenously or intramuscularly. With salpingitis of moderate severity, a single dose of the drug is 1 gram, and the daily dose is 3 grams, that is, 1 gram every 8 hours. In severe salpingitis, the dose is doubled. |
| Erythromycin | Prevents the growth of bacteria in the focus of inflammation. | Inside one capsule ( 250 mg) 4 times a day. In severe cases, the dose is doubled to 2 grams ( 8 capsules) per day. |
| Metronidazole
(trade name Klion) | Blocks the reproduction of not only bacteria, but also protozoa ( Trichomonas). | One tablet ( 250 mg) 3-4 times a day. The maximum dose of metronidazole is 1.5 grams. |
| Furazolidone | It has antimicrobial and antiprotozoal activity. | 100 mg ( 2 capsules) 4 times a day, in combination with the main antibiotic. |
| Tetracycline | Stops the growth and reproduction of bacteria in the focus of inflammation. | 250 - 500 mg each ( one or two capsules) 4 times a day after meals. |
| Kanamycin | Violates the synthesis of proteins in bacteria, thereby preventing their reproduction. | The powder is diluted with saline or 0.5 percent solution of novocaine Intramuscularly 1 gram ( one ampoule) twice a day. |
The drugs of choice for salpingitis are antibiotics of the penicillin series, as well as combined penicillins ( for example, ampioks). For purulent salpingitis, drugs of the cephalosporin group are used ( cephalexin and cefotaxime) and aminoglycosides ( kanamycin). Most often, antibiotics are combined with nitrofuran derivatives ( furazolidone), and with salpingitis caused by Trichomonas - with metronidazole. With chlamydial salpingitis, it is advisable to use tetracycline antibiotics ( tetracycline) and macrolides ( erythromycin).
Common symptoms after surgical treatment of salpingitis:
- weakness;
- not severe nausea;
- frequent urge to urinate.
Diet and lifestyle advice after surgery
During the first day after laparoscopy, it is necessary to refrain from eating. The second and third days should be given preference to dairy products
low fat ( kefir, yogurt), breadcrumbs, and lean meats. From the fourth day you need to gradually return to a normal diet. Bed rest should be canceled the day after laparoscopy to prevent the development of thrombosis.
Within two to three weeks after the operation, heavy physical exertion and sports should be abandoned. Avoid sudden movements, heavy lifting, long flights and trips. When taking a shower, you can not rub the seams with a washcloth, and after water procedures, the surface of the wounds should be treated with antiseptics ( solutions of brilliant green or potassium permanganate). For two weeks, you should not take a bath, go to saunas, swim in pools, lakes and other bodies of water. Clothing should be chosen loose, which does not put pressure on the seams.
You should return to sexual activity, depending on the recommendations given by your doctor.
Planning for pregnancy after surgery
Elimination of obstruction of the fallopian tubes increases the patient's chances of becoming pregnant. Over time, the likelihood of conception decreases, since after a year or two, a new adhesive process may occur. For those women who want to become pregnant, after the operation, it is necessary to start taking hormonal drugs for several months. Next, you should start planning pregnancy. The chances of restoring fertility depend on the location of the adhesive process. If it was around the fallopian tube, more than half of the patients can get pregnant naturally ( 60 percent). In the case of the formation of adhesions inside, the probability of pregnancy is reduced to 10 percent.
Folk methods of treatment
Treatment of salpingitis with traditional medicine includes the following procedures:- baths;
- douching;
- medical tampons;
- infusions and decoctions.
Baths
With inflammation of the fallopian tubes, baths have a tonic and cleansing effect, help reduce pain during exacerbations of the disease. Baths also help to strengthen the immune system. According to the method of carrying out the procedure, they are divided into water and steam.Juniper baths
These water procedures are recommended for patients with bilateral salpingitis. To prepare such a bath, you should take 50 grams of common juniper ( veres) and fill with a liter ( four glasses) boiling water. The berries and stems of the plant can be used as raw materials. After the juniper is infused ( two to three hours), add the infusion to the bath water. Water temperature should be 35 - 37 degrees. The duration of the bath should not exceed half an hour ( thirty minutes).
Baths with sage
Baths with sage infusion are recommended for women with chronic salpingitis. Add an infusion of clary sage to a bathtub filled two-thirds with fresh water, the temperature of which does not exceed 35 degrees. To prepare a decoction, you need one hundred grams of dry sage. Fill the raw material with one liter of water ( four glasses) and put on a slow fire for an hour and a half.
Baths with valerian
Baths with valerian extract have a relaxing and restorative effect on the body. Fill the bath with water so that the water level in a sitting position does not exceed the line of the chest. The water temperature should not exceed forty degrees. Add fifty milliliters to the bath ( three and a half tablespoons) valerian extract. The duration of the procedure is twenty to thirty minutes.
Rosemary baths
To prepare a rosemary bath, you will need thirty milliliters ( two tablespoons) extract of this plant, which must be purchased at the pharmacy. Pharmaceutical agent can be replaced with home-made infusion. To do this, pour three hundred grams of rosemary leaves with three liters of water ( twelve glasses) and, bringing to a boil, hold on low heat for thirty to forty minutes.
Milk steam bath
A milk bath will help relieve pain during inflammation of the tubes. To comfortably and effectively carry out this procedure, you need to purchase a stool or chair, in the seat of which a hole has been made. To prepare a steam milk bath, boil three liters of fresh cow's milk. Cool the milk slightly and pour it into a basin or other container, the volume of which does not exceed ten liters. Place a stool over the container, and sit on it, giving steam access to the genitals. In the absence of a chair with a hole, you can do without it by squatting over the steam. The lower part of the body must be wrapped in a warm blanket. It is necessary to carry out the procedure until the milk has cooled down. Systematic - once a day at bedtime for three to four weeks.
douching
The principle of douching is to wash the vagina with herbal decoctions. For the procedure, a gynecological syringe is required, which must first be disinfected. Douching can be done in the supine position. The procedure in a horizontal position is more convenient to do in the bath. Dial a pre-prepared decoction into the syringe. Treat the vestibule with sterile petroleum jelly or baby cream. Lie down on the bottom of the bathtub, and throw your legs on its sides. Relax the muscles and insert the tip of the syringe into the vagina, releasing air from it. Pour the solution inside the vagina. The duration of the procedure should not exceed fifteen minutes. The temperature of the broth during the first procedure should be thirty-seven - thirty-eight degrees. When carrying out subsequent procedures, the temperature of the liquid must be gradually increased to forty-five - forty-eight degrees. If during douching the body temperature rises or pain increases, the temperature of the infusion should be reduced. To increase the effect, after douching on the lower abdomen, you need to put a heating pad or make a warm compress.Douching affects the natural microflora of the internal genital organs, so the procedures should be carried out in a course that does not exceed two weeks.
Infusions and decoctions for douching
Plants for the preparation of solutions that are used for douching:
- calendula;
- sage;
- Oak bark;
- Linden;
- upland uterus;
- badan.
Collection Components #1:
- knotweed ( highlander bird) - fifty grams;
- nettle ( leaves) - thirty grams;
- oak bark - ten grams;
- Potentilla root - ten grams.
- black elder ( flowers) - two tablespoons;
- chamomile ( flowers) - two tablespoons;
- flax seeds - two tablespoons.
- Chernobyl ( wormwood) - twenty grams;
- veronica oak ( flowers and leaves) - twenty grams;
- chamomile ( flowers) - twenty grams;
- sweet clover - five grams.
Medical tampons
In the treatment of salpingitis with folk methods, therapeutic tampons are widely used, which are a female hygiene tampon soaked in a decoction or juice of a medicinal plant. The procedure is carried out in the evening. A medical tampon is inserted into the vagina and left overnight. For the preparation of therapeutic tampons, natural cotton tampons should be used.Tampons with bergenia decoction
Badan has an anti-inflammatory effect, promotes the resorption of the adhesive process. To prepare the infusion, take one hundred grams of dry bergenia root and grind it in a coffee grinder. Fill the raw material with two glasses ( 500 milliliters) boiling water, wrap the container with a towel and leave to infuse for six to eight hours. After that, strain the broth and soak the swab. The course of treatment with bergenia should not exceed twenty days.
Aloe tampons
Aloe has a strong antimicrobial effect and is widely used in folk medicine in the treatment of inflammation of the fallopian tubes.
Rules for using aloe:
- use only the lowest leaves, the length of which does not exceed fifteen to eighteen centimeters;
- aloe must be more than two years old;
- to increase the concentration of nutrients, do not water the plant with water for several days before use.
Recipes for solutions for tampons based on aloe:
- With plantain. Bring one hundred milliliters of water to a boil, add one tablespoon of crushed plantain and keep on fire for two to three minutes. Strain the broth and add fifteen drops to it ( tablespoon) aloe juice;
- With cabbage. Grind fresh cabbage leaf, wring out. Mix a tablespoon of cabbage juice with the same amount of aloe juice;
- With honey. Take one tablespoon of natural liquid honey and mix with a tablespoon of aloe juice.
Means for ingestion
Means based on medicinal plants are used to reduce inflammation and improve immunity. For the preparation of drugs according to folk recipes, you should use fresh ingredients, and buy herbs only in pharmacies.Herbal collection with absorbable action
The herbs included in the collection contribute to the resorption of adhesive processes. Also, the use of a decoction helps to restore the hormonal background of the body and reduce pain.
Infusion components:
- peony evasive ( Maryin root) - twenty grams ( one and a half tablespoons with top);
- celandine ( nipplewort) - twenty grams;
- calendula flowers ( marigold) - twenty grams;
- common nettle - twenty grams;
- field yarutka - ten grams ( tablespoon without top);
- sweet clover - ten grams.
An anti-inflammatory agent
The composition of this folk remedy includes marshmallow root ( 50 grams) and rendered lard or lard ( two tablespoons).
Pour dry marshmallow root with water in a glass or ceramic bowl and leave for twenty-four hours in a dark place. After that, place the container on low heat, bring to a boil and leave to simmer for several hours until the root becomes soft. Cool the plant and grind it in a meat grinder or blender. Combine lard and marshmallow gruel and put to languish on fire for two to three hours in a bowl with thick walls. Remove from heat, stir and place in a container with a lid, easy to store in the refrigerator. You need to take the remedy in three tablespoons at the same time as eating.
Decoctions that eliminate inflammation
Recipes that reduce the inflammatory process in salpingitis:
- With viburnum. Pour fifty grams ( three heaping tablespoons) dry flowers with one liter of boiling water and soak for thirty minutes ( half an hour) in a water bath. Strain the broth, add natural linden honey to taste. You need to drink a drink one hundred grams three times a day;
- With birch bark. Put one liter of water on fire in enameled or glassware. After the water boils, add two tablespoons of chopped dry birch bark. After twenty minutes of slow boiling, remove from heat, strain, add a tablespoon of natural honey and five drops of iodine. You need to drink a decoction in a heated form before going to bed, half a glass each;
- With mother and stepmother. Combine two tablespoons of chopped herbs of sweet clover and centaury. Add three tablespoons of coltsfoot flowers and pour a liter of boiling water over. Place the container with the drink in a dark place for two to three hours to infuse. You need to take a decoction of 80 milliliters ( one third of a glass) five to six times a day.
Prevention of inflammation of the fallopian tubes
Prevention of salpingitis is the timely and proper treatment of infections of the genital organs. For this, it is recommended to undergo preventive gynecological examinations with a bacteriological analysis once a year. Identified infections should be completely cured. To prevent the infection from becoming chronic, it is necessary to complete the course of treatment, even if there are no visible symptoms of the disease. Another important point is the treatment of the sexual partner. Because, even after successful treatment, the infection can again enter the genital tract.
It is also recommended to avoid casual sex and unprotected sex. The immune system of a woman should be maintained at a high level, since a weak immune system provokes the development of infections. The entrance gate for bacteria is the injured mucous membrane of the genital tract, so the use of intrauterine contraceptives should preferably be avoided.
Inflammatory diseases of the fallopian tubes (salpingitis) can be caused by a variety of flora, mainly bacterial. Usually, the spread of pathogens occurs in an ascending way from the uterus, hematogenous and lymphogenous infection is much less common.
Acute serous salpingitis usually does not cause severe clinical symptoms. Macroscopically marked edema and hyperemia of the tube wall. On microscopic examination, edema, plethora, and moderate leukocyte infiltration are usually limited to the mucosa.
In acute purulent salpingitis, the fallopian tube is thickened, with a dull surface, covered with fibrinous-purulent exudate. Pus is released from the lumen of the tube. Microscopically, there is a sharp hyperemia, edema and infiltration of the tube wall with polymorphonuclear leukocytes. Characterized by severe damage to the epithelium of the tube, its degeneration, necrosis, desquamation.
Chronic salpingitis often develops after suffering acute salpingitis. The formation of adhesions on the outer surface of the fallopian tube and between the folds of the endosalpinx is determined; microscopically in all layers of the tube - lymphomacrophage infiltration and sclerosis of varying severity, atrophy of the muscle layer and epithelium gradually progresses.
When the lumen of the tube is obliterated, an accumulation of purulent exudate (pyosalpinx) or transudate (hydrosalpinx) can be observed in it, which is accompanied by an expansion of the lumen, first by hypertrophy, and later by atrophy of the muscular and mucous membranes.
Tuberculosis of the fallopian tubes develops with the hematogenous spread of Mycobacterium tuberculosis. A productive reaction with the formation of granulomas is characteristic. Inflammation is accompanied by a pronounced adhesive process with the formation of obstruction of the tubes.
Tumors of the fallopian tubes are relatively rare. Among benign tumors, leiomyoma and mesothelioma are described; morphologically, these tumors have the same structure as in the uterus. Malignant tumors (adenocarcinoma, sarcomas, carcinosarcoma) are even more rare. In the fallopian tubes, the formation of metastases of cancer of the ovaries, body and cervix, breast, stomach is possible.
More on the topic Fallopian tube diseases.:
- DISEASES OF THE FEMALE GENITAL ORGANS AND BREAST GLANDS. DISEASES OF THE CERVIC. DISEASES OF THE BODY OF THE UTERUS. DISEASES OF THE UTERINE TUBES. DISEASES OF THE OVARIAN. BREAST DISEASES
Salpingitis is a female disease in which the reproductive system suffers, and in 20% of cases leads to infertility. Pathology is manifested by inflammation of the fallopian tubes, it occurs as a result of infection in the body that affects the ovaries, uterus and its appendages.
Causes of inflammation of the fallopian tubes
According to the variety of microorganisms that caused the pathology, salpingitis can be specific and nonspecific.
The first occurs when infected with chlamydia, Trichomonas, gonococci, Mycobacterium tuberculosis. The second can be caused by Staphylococcus aureus, streptococcus, Escherichia coli, fungi.
Factors that increase the risk of inflammation include:
Diseases of neighboring organs can provoke salpingitis:
- acute appendicitis;
- oophoritis;
- colitis.
Symptoms of the disease
Inflammation occurs in acute, subacute and chronic forms.
The acute form is characterized by the following symptoms:
- body temperature rises to 38 ºC;
- there is a sharp pain in the lower abdomen, which gives to the sacrum;
- with salpingitis, the amount of vaginal discharge increases, serous-purulent, bloody, foamy leucorrhoea can be observed, their number and type depend on the pathogen that caused the pathology;
- nausea, sometimes vomiting and diarrhea;
- the woman feels weakness, dizziness, tachycardia;
- urination disorders occur: urine becomes less, and the urge is frequent and painful.
In the subacute form of salpingitis, the symptoms may be the same, but the pain is not so sharp and the body temperature does not rise above 37.3 ºC.
The chronic form of the disease often proceeds without any special symptoms. A woman may feel mild aching pain during the day. The number of withdrawals is increasing. Body temperature remains within normal limits. A woman with a chronic form of salpingitis has menstrual irregularities. Menses are often scanty and painful. A woman may experience pain during intercourse, irritation in the vagina and a decrease in libido. This form of the disease is the most difficult to identify and cure.
The localization of pain in pathology depends on how widespread the inflammation is. Salpingitis can be:
- left-sided;
- right-handed;
- bilateral.
Diagnostics
It is important to diagnose pathology in time. For this, women should not neglect preventive examinations by a gynecologist. This is the only way to identify the chronic form.
In the acute stage, in order to correctly diagnose, the doctor performs:
- seat inspection;
- palpation examination of the patient's abdomen;
- ultrasound examination of the pelvic organs;
- transvaginal ultrasound.
With salpingitis, the following are prescribed:
- a general blood test, which, with inflammation, will show a high level of ESR and leukocytes;
- PCR analysis to exclude the presence of trichomonas, gonococcus or chlamydia;
- smear from the vagina and urethra to determine the causative agent of the disease.
To assess the patency of the fallopian tubes, metrosalpingography (radiocontrast method) is done. A contrast agent is injected into the uterus and fallopian tubes, then the condition of the tubes is assessed using x-rays.
The laparoscopy method is now carried out in rare cases when salpingitis is in advanced form. This procedure is traumatic. Holes are made in the abdominal cavity, through which a laparoscope is inserted. With this method, you can examine the condition of the fallopian tubes, take a smear, see the prevalence of the disease and the presence of adhesions.
Treatment of salpingitis
Women with acute inflammation are treated in a hospital, other forms can be eliminated on an outpatient basis.
With salpingitis, the patient is prescribed bed rest, cold on the stomach, and a sparing diet.
Medical treatment includes:
- antibiotics;
- anti-inflammatory and analgesic drugs;
- if necessary, antipyretics;
- immunomodulators;
- vitamins and minerals.
Antibacterial therapy for inflammation of the fallopian tubes is carried out after the result of sowing and determining the causative agent of the disease. Then the doctor should check the sensitivity of bacteria to antibiotics. With this in mind, antimicrobial agents of the following classes can be prescribed:
- penicillins;
- cephalosporins;
- macrolides;
- tetracyclines, etc.
In order to neutralize the pathogen, salpingitis is used:
In order to relieve the symptoms of inflammation, lower body temperature and relieve the patient of pain, the doctor may prescribe tablets, injections or suppositories:
- Butadion;
- ibuprofen;
- Advil;
- Nurofen;
- Nimesil;
- Acetaminophen;
- MIG 400.
For the speedy recovery of the body after salpingitis, you need to take vitamins. The most necessary for women's health are vitamins C, E, B12, B6, cocarboxylase.
Immunomodulators that a patient needs to take for a speedy recovery include:
- Imunofan;
- Groprinosin;
- Polyoxidonium.
In severe forms of the disease can not do without surgery. Indications for surgery may be the following cases:
- when the therapy does not help;
- when tumors are found on the appendages;
- when salpingitis leads to purulent formations;
- adhesive processes of one or two fallopian tubes.
In the chronic form, physiotherapy methods are effective. These procedures include:
For the treatment of salpingitis, you can use folk remedies, but only after consulting a doctor. Effective are:
- Baths with juniper, sage, rosemary, with the addition of milk. Such procedures have anti-inflammatory, analgesic, sedative effects. Baths increase a woman's immunity and contribute to a quick recovery. The water temperature must not exceed 38 ºC. The procedure should last 20-25 minutes.
- Douching with infusions and decoctions of herbs: linden, chamomile, calendula, sage, etc. Such manipulations that help with salpingitis should be carried out in courses of 7 to 14 days. When douching, you must adhere to all standards of disinfection and hygiene.
- Aloe tampons. Therapeutic tampons relieve inflammation well, because aloe juice is an antimicrobial agent.
- Anti-inflammatory teas with viburnum, coltsfoot, calendula, birch bark.
Complications
The most dangerous complication of salpingitis is purulent damage to the fallopian tubes, their perforation and blood poisoning. This condition can lead to death.
Other consequences of inflammation are the formation of adhesions and scarring on the fallopian tubes. A woman may not know about them for many years. Such formations lead to the fact that a fertilized egg cannot enter the uterus. A woman for no apparent reason does not become pregnant for many years. And when this happens, there is an ectopic pregnancy, which often leads to the fact that the fallopian tube has to be removed.
Prevention
To reduce the risk of salpingitis, you need to:
- timely undergo preventive examinations at the gynecologist;
- consult a doctor in time if symptoms of pathology of the female genital organs occur;
- always undergo treatment to the end, and not quit after the condition improves;
- protect yourself from sexually transmitted diseases by using barrier methods of contraception;
- follow the rules of personal hygiene.
In order not to get sick with salpingitis, a woman must maintain her immune system at a high level, not overwork, play sports, and eat right.
is the fallopian tubes
In the female body there is a very important organresponsible for the ability of a woman to give birth to children - this is the uterus. This organ is connected to the abdominal cavity through tubular formations called fallopian tubes. It is through these pipes fertilized the egg descends from the ovary into the uterus in order to gain a foothold there and further develop. If the patency of the fallopian tubes is not all right, then the egg will not be able to reach the uterus, which can lead to an ectopic pregnancy.
Usually in this case, the diagnosis is " obstruction of the fallopian tubes".
This disease is considered one of the main causes of female infertility.
In the presence of this disease, the lumen of the fallopian tubes is closed in a woman due to the occurrence of adhesions, and the shape of the tubes may also change, which will also interfere with the advancement of eggs into the uterus. With inflammation of the fallopian tube, its lumen narrows due to swelling of its inner surface, and the ability to contract decreases, without which the egg simply will not move through the tube. And the consequence of the transferred inflammation is adhesions in the fallopian tubes, blocking their lumen.
Symptoms of diseases of the fallopian tubes
Pain when probing the pipes indicates a problem
The main symptom, which suggests that the patient has obstruction of the fallopian tubes, is infertility. Of course, it can be caused by a host of other reasons, but first of all, there is a diagnosis of the condition of the fallopian tubes.
Obstruction of the fallopian tubes can be complete when both tubes are closed by adhesions, or partial, when only one tube is in a normal state, and also when inflammatory processes develop around both tubes.
As other symptoms of obstruction of the fallopian tubes, one can single out the fact of having an ectopic pregnancy, when it is normal fertilized the egg, unable to reach the uterus, tries to attach itself to the walls of the fallopian tube. In this case, the so-called tubal miscarriage usually occurs, which can be complicated by rupture of the fallopian tube.
Causes of diseases of the fallopian tubes
The underlying causes may be hormonal or infectious.
As the causes of obstruction of the fallopian tubes, doctors call a variety of inflammatory processes in the fallopian tubes caused by exposure to sexually transmitted infections, as well as the presence of endometriosis and tumors of the tubes of various etiologies. The infection enters the fallopian tube from the vagina or by the lymphogenous route, for example, if the patient has tuberculosis of the fallopian tube.
Tumors in the tubes are quite rare and are removed by surgery.
In addition, adhesions in the fallopian tubes may begin in response to artificial termination of pregnancy.
In rare cases, women have a congenital pathology of the fallopian tubes, which is expressed in their underdevelopment, but such deviations are usually detected even before the onset of puberty, and may not be clinically manifested at all.
Quite often, the processes leading to the occurrence of adhesions in the fallopian tubes can take place secretly and in no way affect the woman's well-being. It's just that she can't get pregnant.
Diagnosis of diseases of the fallopian tubes
Ultrasound and laparoscopy are considered the most informative diagnostic tools.
Naturally, at first they use gynecological examination with palpation of the uterus, then other methods of checking the fallopian tubes are already prescribed. The main and, perhaps, the most effective method for diagnosing obstruction of the fallopian tubes is hysterosalpingography. This method is based on the introduction of special contrast agents into the uterus and fallopian tubes for their subsequent X-ray imaging. The results of x-ray imaging will determine the patency of the fallopian tubes in the patient and, with a high degree of probability, determine the causes of the abnormal processes of fluid movement inside them.
There is another method called echohysterosalpingoscopy- the patient is introduced into the uterine cavity physiological solution and then, using methods ultrasonic research, the movement of fluid through the fallopian tubes is monitored.
Recently it has been widely used laparoscopic a method for studying the processes taking place inside the tubes - optical tubes are inserted through a pair of small holes in the abdominal cavity, with which you can examine in detail the mucous membrane of the inner surface of the uterus, as well as assess its condition, and, if necessary, immediately excise the adhesions. Laparoscopy of the tubes is carried out with sparing methods, and the patient can return to normal life after a while.
Treatment of diseases of the fallopian tubes
Treatment of diseases of the fallopian tubes directly depends on the nature of the disease and symptoms.
Treatment of obstruction of the fallopian tubes is mainly aimed at eliminating adhesions that interfere with the normal advancement of eggs into the uterus. At the initial stage, it can be assigned physiotherapeutic treatment, which is aimed at softening the adhesions existing in the pipes against the background ongoing inflammatory process in pipes. This method will give results only if no more than six months have passed from the onset of inflammation in the tubes and the formation of adhesions.
Laparoscopy is the best method for diagnosis and treatment
Basically, in the presence of adhesions in the pipes, surgical methods such as hysteroscopy are used - surgical dissection of adhesions is performed to restore the patency of the pipes, and also performed restorative plastic of the walls of the fallopian tubes.
The methods of blowing pipes with air or liquid are no longer used due to the large percentage of complications that arise after them.
Treatment of diseases of the fallopian tubes folk remedies
You can use ortilia and a red brush for folk treatment of diseases of the fallopian tubes
Although you can find many traditional medicine recipes on the Internet aimed at treating tubal obstruction, you should not rely solely on these methods.
Taking medicines such as boron uterus, milk thistle and marsh cinquefoil should act as maintenance therapy aimed at treating the ongoing inflammatory process in the uterus and its tubes.
If adhesions have already formed in the pipes, and for a long time, then the effect of the use of folk remedies will not come. In this case, you should not rely on herbs, but it is better to go to the hospital for an operative intervention such as HSG of the fallopian tubes, especially since it is carried out in modern conditions with sparing methods.
Inflammation of the fallopian tubes is an infectious disease that develops on the uterine appendages on one or both sides and can capture the ovaries, ligaments, and spread to the pelvic organs.
The fallopian tubes start from the corners of the uterus, end with a funnel that communicates with the abdominal cavity. Therefore, infectious processes from them can spread further into the abdominal cavity.
Pathology may differ in localization in the pipes, the nature of the course and etiology.
By localization, inflammation of the tubes can be:
- left-sided;
- right-sided;
- bilateral.
According to the nature of the course, it is divided into acute, subacute and chronic.
Etiology, or cause, is the pathogen that caused the inflammatory response.
They can be:
- specific (gonorrhea, chlamydia, trichomonas, syphilis, HIV, herpes simplex virus or human papillomavirus);
- nonspecific (staphylococci, streptococci, Pseudomonas aeruginosa, Proteus), these are microorganisms that are normally found in the genital tract.
In 60% of cases, inflammation of the ovaries and fallopian tubes is caused by chlamydial infection. Sometimes it is not a single microorganism, but a microbial association. The disease acquires an acute course when the infection enters the fallopian tubes, lasts up to 2 months.
This may happen:
- sexually;
- ascending - through the cervical canal, the uterine cavity into the tubes;
- hematogenous - from foci of infection located elsewhere in the body;
- lymphogenous - through the lymphatic vessels;
- along the length - from nearby foci of infection, for example, from appendicitis directly into the tube on the right.
If inflammation of the fallopian tubes lasts up to 6 months, then this is a subacute process. A chronic disease develops after an acute one, and can bother for years. In this case, periods of remission alternate with periodic exacerbations.
Symptoms
If this is an acute inflammation of the fallopian tubes, the symptoms are pronounced. The body temperature rises to 38-39 degrees. The pain in the lower abdomen is sharp. Left-sided salpingitis is accompanied by pain on the left, right-sided - on the right, bilateral - on both sides. The severity of the syndrome depends on the involvement in - the more its irritation, the more painful.
In 2/3 of patients, inflammation of the fallopian tube passes to the ovary. The appendages swell, increase in size. There is irritation of neighboring organs, urination disorder is observed, pain in the lower back appears. In some cases, fluid accumulates in the appendages, which is formed during inflammation. It expands them, does not pour into the abdominal cavity, hydrosalpinx develops. A purulent infection translates this condition into pyosalpinx, it is able to leave behind a large number of adhesions, which leads to infertility.
Uncontrolled intake of antibiotics and a decrease in the reactivity of the body makes the course of an acute process erased, increases the likelihood of its transition to a protracted one. If it has developed, the symptoms will appear with an exacerbation of the process. The temperature will rise, chills will appear, pain in the lower abdomen, radiating to the lower back.
Disorders of the genitourinary system consist in painful intercourse, impaired urination. There may be violations of the digestive, cardiovascular and endocrine systems. The discharge may acquire a purulent tint, which is more often observed with gonorrheal infection, cause irritation and itching in the perineum.
Inflammation of the fallopian tubes and ovaries causes a change in their function, which is manifested by menstrual irregularities. Menstruation becomes plentiful or, on the contrary, scanty, painful, the duration and regularity may change.
Chronic inflammation of the fallopian tubes causes infertility in women.
Causes of inflammation
Risk factors for salpingitis are exogenous influences:
- abortion;
- the behavior of intrauterine manipulations (probing, installing a spiral);
- operations.
Endogenous causes:
- weakened immunity;
- hormonal changes;
- chronic diseases;
- anomalies in the development of the genital organs.
Features of behavior that cause inflammation of the fallopian tubes:
- frequent change of sexual partners;
- sexual intercourse during menstruation;
- early onset of sexual relations;
- non-traditional ways of intercourse.
In the development of pathology, social factors play a certain role - the standard of living, stress, alcohol consumption and smoking.
Consequences of the disease
Acute or chronic inflammation of the tube can cause ectopic pregnancy, infertility, miscarriage, or pregnancy complications. The adhesive process leads to chronic pelvic pain and painful intercourse. For a pregnant woman, pathology of the placenta, infection of the fetus, stillbirth, complicated pregnancy and childbirth are possible.
Diagnostics
The first stage of the examination is a gynecological examination. Inspection in the mirrors allows you to identify changes in the mucous membrane of the vagina, erosion on the cervix, the nature of the discharge from it. With the help of a digital examination, a sign of inflammation of the appendages is detected - their compaction, pain during displacement, limitation of mobility. The uterus is not involved in the process, therefore it has the usual size.
During the examination, smears are taken from the vagina to determine the flora. Depending on the number and type of bacteria, the presence of leukocytes, the degree of purity of the vagina and the presence of an inflammatory process are determined. The causative agents of STIs are diagnosed using the polymerase chain reaction (PCR).
Pelvic ultrasound is a non-invasive and safe method of examination. Can be performed through the abdominal wall or with a vaginal probe. Salpingitis on ultrasound is defined as thickened walls of the tubes and expansion of their lumen, the presence of fluid in them and in the retrouterine space, adhesions. Accession by enlargement of the ovaries and fuzziness of their contours, the structure of the organ is heterogeneous with hyper and hypoechoic areas, the follicles are not visualized enough.
Metrosalpingography is an X-ray method for determining the patency of the pipes. A contrast agent is injected into the uterine cavity, and with the help of an x-ray, its distribution through the tubes is clarified. Places of narrowing become noticeable, and fluid does not enter the abdominal cavity. The obstruction is usually caused by adhesions.
Laparoscopy is a medical and diagnostic procedure. A special instrument and a video camera are inserted into the abdominal cavity through small punctures. The affected tube appears red and edematous, and may be dilated with hydrosalpinx or pus accumulation. In chronic inflammation, a large number of adhesions are found.
At the same time, treatment is carried out - adhesions are dissected, the patency of the pipes is restored with the help of plastic surgery. If this is not possible, they are simply removed. Pipes with hydrosalpinx are a source of infection for the whole organism.
Treatment
Indications for hospitalization are the following:
- ineffectiveness of home treatment;
- the serious condition of the woman;
- pregnancy;
- tubo-ovarian abscess;
If inflammation of the fallopian tubes occurs, treatment should be prescribed by a doctor. Self-medication is fraught with the development of complications or the transition to a chronic form.
Conservative therapy
Antibacterial drugs form the basis of treatment. Broad-spectrum antibiotics are used: Ampicillin, Cefalexin, Cefotaxime, Erythromycin, Metronidazole, Furazolidone. The attending physician selects the optimal dosage and course of medication. The drug is selected based on the type of pathogen and its sensitivity to antibiotics.
After treatment with antibacterial drugs, the fungal flora can be activated and thrush can develop. For the purpose of prevention, fluconazole is used. Dysbacteriosis is prevented by taking probiotics (Linex, Bioflor). Paracetamol, Ibuprofen, Butadione will help relieve inflammation and eliminate pain.
Immunomodulators increase the body's resistance to infection, have antioxidant activity, and reduce the risk of adhesions. Representatives of this group are Polyoxidonium, Imunofan, Groprinosin. Be sure to use vitamin complexes. Chronic salpingitis is recommended to be treated with physiotherapy - electrophoresis, ultrasound, reflexology.
ethnoscience
When the symptoms are correctly identified and the treatment is aimed at eliminating the cause of salpingo-oophoritis, folk remedies can be used as an adjunct to.
Baths have a tonic effect, relieve pain. The optimum temperature is 35-37 degrees. For preparation use infusion of juniper, sage, rosemary, valerian extract.
Douching is carried out with herbal decoctions. They are prepared from plant collections, 2-3 tablespoons per 0.5 liter of boiling water. The following combinations are recommended:
- In a 1:1 ratio of flax seeds, elder flowers and chamomile.
- 2 tablespoons of chamomile inflorescences, oak veronica and wormwood grass, a teaspoon of sweet clover.
- 10 g of oak bark and cinquefoil root, 30 g of nettle and 50 g of knotweed.
For the preparation of therapeutic tampons, a hygienic tampon, or independently twisted from a bandage, is impregnated with a decoction of bergenia, plantain and aloe juice. Douches and tampons affect the microflora of the vagina. They are given in small courses.
To reduce inflammation, decoctions of birch bark, viburnum flowers, coltsfoot herbs are used inside. They are prepared from 1 tablespoon of dry raw materials and 200-300 ml of boiling water. Bring to a boil and leave to cool. Honey is added to the decoction.
If timely treatment is started, then acute inflammation in the fallopian tubes is less likely to turn into chronic, the risk of complications is reduced.
