Gynecological disease salpingitis. Salpingitis: signs, diagnosis, treatment. Bacteriological examination of a smear from the cervix

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A common cause of infertility in patients reproductive age considered bilateral salpingitis. There are many reasons for its occurrence. Therefore, women need to know how the pathology manifests itself and what methods are taken to treat the disease.

Salpingitis: what is it?

Salpingitis is an inflammatory process in the uterine tubes. In pathology, the mucous membrane of the appendages is often affected, then the inflammation spreads to the muscles of the fallopian tubes and the outer serous membrane. With bilateral salpingitis, inflammation is observed in both tubes.

As a result of this process, the muscle layer thickens and deforms, which provokes the formation of adhesions. This is fraught with the development of obstruction of the tubes, in which pus (pyosalpinx) or fluid (hydrosalpinx) can accumulate.

Experts say that the disease is found in 30 percent of women aged 20 to 40 years. Pathology usually has the following degrees of progression: acute, chronic or subacute form. The nature inflammatory process There are serous and purulent salpingitis.

Causes

The disease develops when a woman’s reproductive system is infected by pathogenic microorganisms. The most common pathogens are:

• streptococci;
• Koch's wand;
• chlamydia;
• Trichomonas;
• staphylococcus;
• coli;
• fungi.

Most often, bilateral salpingitis occurs with gonococcal infection.

The following factors provoke pathologies:

• abortions;
• miscarriage;
• intrauterine device;
• untreated gynecological diseases;
• childbirth;
• ectopic pregnancy.

The disease often occurs as a complication chronic inflammation appendages. Women who started early are at risk sex life or had many sexual partners. Favorable factors for the development of the disease are alcohol abuse, weakened the immune system, drug addiction, unbalanced diet.

Symptoms

Signs depend on the form of the disease. At acute course There are symptoms that can be confused with appendicitis:

• hyperthermia;
• pain in the lower abdomen (sharp and sharp);
• vaginal discharge mixed with pus;
• pain during sexual intercourse;
• difficulty urinating;
• lower back pain;
• tachycardia.

Subacute and chronic forms are accompanied by the following symptoms:

• aching pain in the lower abdomen;
• itching and burning sensation when urinating;
• elevated temperature;
• general weakness;
• loss of appetite;
• brown discharge, yellow color With unpleasant smell;
• foamy or liquid leucorrhoea;
• pain and bleeding during intercourse.

In case of chronic illness, it is disrupted menstrual cycle: Periods can be heavy or light, irregular and painful. Possible nausea, flatulence and vomiting.

If the above symptoms occur, consultation with an experienced specialist is necessary.

Is it possible to get pregnant and give birth while sick?

Getting pregnant with salpingitis is very problematic. Normal conception is possible only if the disease is treated in a timely manner. When the disease is advanced, obstruction develops, leading to infertility.

Diagnostic methods

The pathology is determined by the gynecologist, who first collects anamnesis and examines the patient. Other methods of examining bilateral salpingitis include:

• ultrasound diagnostics;
• echography;
• gynecological examination (bacterial culture from the cervix, smear for microflora);
• metrosalpingography.

A reliable diagnostic method is laparoscopy (a special device called a salpingoscope is inserted into the tubes through a funnel).

Others are also required laboratory research: urine and blood tests. In some cases, an examination by a urologist or surgeon may be necessary.

Treatment methods

The treatment regimen should be selected by a qualified specialist depending on the severity and form of bilateral salpingitis, individual characteristics body. In any case, therapy should be comprehensive. Drug treatment consists of using the following groups medicines:

• antibiotics;
• anti-inflammatory drugs;
• immunomodulators;
• vitamin complexes.

Appointed symptomatic treatment. For this purpose, antipyretics, antispasmodics or analgesics are used.

Physiotherapeutic procedures are also used: mud therapy, electrophoresis, magnetic therapy.

Antibacterial therapy

In case of pathology, antibacterial drugs are prescribed wide range impact. The choice of remedy depends on the causative agent of the disease. Antibiotics of the following groups can be used:

• Penicillin series. Oxacillin, Ampicillin, Ampiox are usually prescribed.
• Tetracycline group. Tetracycline is used for the inflammatory process.
• Cephalosporins. Effective drugs This group includes Cefotaxime, Cephalexin, Claforan and Ecocephron.
• Macrolide group. Azithromycin, Erythromycin, Sumamed are most often prescribed.

They are used in tablets or injections for intramuscular or intravenous administration.

Metronidazole, Zomax, Kanamycin, Dalatsin, Abactal, and Furazolidone can also be used.

To prevent antibiotic therapy from leading to dysbiosis, probiotics are prescribed (Linex, Laktovit, Hilak Forte, Vitaflor, Lactobacterin).

Anti-inflammatory drugs

In case of illness, medications are prescribed that effectively relieve inflammation in the fallopian tubes. These include:

• Butadion
• Acetaminophen
• Advil
• Ibuprofen
• Phenylbutazone

Voltaren and Diclofenac are considered effective anti-inflammatory drugs for salpingitis.

Topical agents can be used - anti-inflammatory suppositories (Voltaren, Hexicon, Indomethacin, Movalis, belladonna suppositories).

Droppers

If the tubes are inflamed, droppers with glucose are given. For regulation recovery process ascorbic acid is used.

To prevent intoxication, a dropper is placed with calcium chloride.

If drug treatment is ineffective, then surgery is prescribed.

Possible complications

If treatment of the disease was ineffective or untimely, then this is fraught with the development severe complications. Pus accumulating in the tubes spreads to the pelvic organs, causing dangerous consequences: pelvioperitonitis or perisalpingitis.

The pathology can be complicated by the occurrence of colitis, oophoritis and appendicitis. Chronic illness leads to a disrupted menstrual cycle, manifested by oligomenorrhea (scanty discharge during menstruation) and algomenorrhea (severe cramps during menstruation).

Bilateral salpingitis leads to the development of obstruction of the tubes: their lumen narrows, which complicates the advancement of the egg, so it dies. This state is common reason woman's infertility. Ectopic pregnancy is also considered a common complication.

To avoid serious complications, it is important to diagnose the pathology in time and begin to treat it.

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Chronic bilateral salpingitis leading to tubal obstruction is the cause female infertility. In this regard, it is relevant to know the causes leading to this disease, clinical manifestations diseases so that a woman can promptly pay attention to the existing problem and consult a doctor.

A woman should know that planning a pregnancy before chronic salpingitis and oophoritis is cured is undesirable, since bacterial infection may have a negative effect on the fetus.

What is chronic salpingitis?

Chronic bilateral salpingitis is an inflammatory process of both fallopian tubes. Chronic salpingitis is the outcome of an acute process, the treatment of which at one time was not given due attention or the treatment was insufficient: too short courses of treatment, insufficient doses of antibiotics used, lack of repeat courses consolidation therapy using physiotherapeutic methods.

Causes of chronic salpingitis

In the etiology of chronic bilateral salpingitis, the leading role is played by the microbial factor. Chronic salpingitis can be caused by staphylococci, E. coli, gonococci, streptococci, trichomonas and chlamydia. Microorganisms penetrate the fallopian tubes from the vagina, organs abdominal cavity(appendix, sigmoid colon).

Chronic bilateral salpingitis has a sluggish course with periodic exacerbations. Factors that provoke exacerbation include abortion, intrauterine contraception, overwork, hypothermia, stress and all kinds of gynecological manipulations: hysteroscopy, hysterosalpingography.

Clinical picture of chronic bilateral salpingitis

With chronic salpingitis, the woman’s general condition does not suffer; she is occasionally bothered by mild pain in the lower abdomen. Only during exacerbation does the temperature rise, pain in the lower abdomen intensifies, discharge from the genital tract and frequent urination. The appearance of pain and bleeding during sexual intercourse is typical.

The woman’s general condition suffers: weakness, increased fatigue and irritability. When examining a woman, significant pain is detected in the area of ​​​​both fallopian tubes.

It must be said that salpingitis very rarely occurs in isolation. Most often, the ovaries are also involved in the process. In this case, the woman is diagnosed chronic salpingitis and oophoritis (salpingo-oophoritis), clinical picture which is not much different, can only be accompanied by menstrual irregularities.

Why is chronic bilateral salpingitis dangerous?

During the process of inflammation, which lasts for many years, anatomical changes occur in the fallopian tube, its lumen narrows and is marked partial obstruction, which significantly complicates the process of advancement of the egg into the uterus or causes its death in the fallopian tube.
In the case of fertilization in conditions of impaired peristalsis and function of the epithelium of the fallopian tube, tubal pregnancy develops.

In serious cases, complete obstruction of the tubes with scar tissue is observed with the development of complete bilateral obstruction. Of course, with such changes in the fallopian tube, pregnancy is impossible and a diagnosis of tubal infertility is made.

In chronic salpingitis, the ends of the tubes can close, and the fallopian tube takes on the appearance of a saccular formation (tubo-ovarian formation), inside which a serous or purulent effusion accumulates.

From the above it follows that pregnancy in women suffering from chronic salpingitis, especially bilateral, is problematic. Every fourth woman with chronic salpingitis suffers from infertility.
To reliably determine the possibility of becoming pregnant, a woman must undergo examination and treatment.
To assess the patency of the fallopian tubes, an x-ray method is used - hysterosalpingography using a contrast agent, which is injected into the uterine cavity.

If the tubes are patent, the contrast agent is detected in the abdominal cavity. After treatment, which can last for many years, a woman has a chance to become a mother. If there is an obstruction, a woman can become pregnant only with the use of assisted reproductive technologies, in particular IVF.

Chronic salpingitis. Treatment

Treatment is carried out in a hospital setting. Antibacterial, anti-inflammatory and immunomodulatory therapy is prescribed in combination. Antibacterial therapy is prescribed for a course of at least 10-14 days. In order to prevent dysbiosis and candidiasis, antifungal drugs are simultaneously prescribed.

To stimulate the body's defenses, aloe extract, placenta extract and autohemotherapy are prescribed. In the case of adhesions, enzymes (wobenzym, lidase) are indicated. To resolve adhesions during the period of remission, local physiotherapeutic procedures are prescribed: high-frequency magnetic field, ultrasound. During the period of remission, sanatorium-resort treatment is indicated.

Often when ineffective conservative therapy used for chronic salpingitis surgery. Surgical treatment is resorted to in the event of the formation of tubo-ovarian saccular formations with serous or purulent contents in the area of ​​the fallopian tubes.

In chronic bilateral salpingitis, the surrounding tissues are involved in the inflammatory process with the formation of adhesions between them, the tubes and the ovaries. Therefore, they resort to laparoscopic operations, in which the adhesions are dissected and the patency of the fallopian tubes is assessed.

Reconstructive plastic surgeries are immediately performed - salpingotomy and salpingostomy. IN in this case for chronic salpingitis, treatment is aimed at restoring the patency of the fallopian tube. After such operations, a woman’s chances of becoming pregnant increase.

Specific infectious inflammation of the fallopian tubes, otherwise called salpingitis, is a fairly common disease and, alas, very unpleasant. Even with timely treatment, when a woman immediately consults a doctor when the first symptoms appear, she will have to go through far from painless procedures, which, however, most often ends complete cure. But often ladies prefer to ignore the signals sent by the body (everyone tolerates it - and I will tolerate it). But the “policy of non-interference” will not lead to anything good, and instead of a conservative drug treatment the patient may end up on the operating table.

We would like to immediately reassure especially suspicious ladies: the likelihood that the situation will develop according to the worst-case scenario is quite small, so you should not take the diagnosis of “salpingitis” so seriously. This, let us clarify once again, is exactly the diagnosis! But to think about what you need to pay close attention to when certain symptoms appear, believe me, it makes sense. This will allow you to seek qualified help in time and minimize potential risk. Even in this case, a woman will have to take serious care of her health, but, really, this is much better than memorizing the surgeon’s phone number. This is what we will talk about today.

Scheme of the course of salpingitis

For those who consider themselves “savvy” in medical matters, it will be useful to know that, contrary to popular belief, inflammation of the fallopian tubes in the initial stages can sometimes be practically asymptomatic. And if so, then the absence of a clearly expressed pain syndrome in the presence of several vague manifestations of the disease does not mean that you do not have salpingitis. Only a qualified doctor can confirm or deny the presence of inflammation!

Nonspecific symptoms of salpingitis

1. A sudden and sharp increase in temperature (often up to 40 degrees and above).
2. Severe chills that occur even in the warm season, which, however, are not accompanied by signs of a cold (no cough or runny nose).
3. Problems with urination (frequent urge, pain). They can be easily confused with banal cystitis and you can try to “cure” yourself, significantly complicating the subsequent treatment of salpingitis itself.
4. Unpleasant sensations during sex.
5. Failure of the menstrual cycle (discharge is either too heavy or too scanty).
6. Effects from the outside gastrointestinal tract(almost complete lack of appetite, nausea, vomiting, feeling of heaviness, flatulence, frustration, sometimes heartburn).
7. Grayish-white vaginal discharge without any known issues with the genitourinary area.
8. “Penduldulum” pain in the lower abdomen, which appears and then disappears.
9. Fatigue, decreased performance, depressed mood.

Symptoms of acute salpingitis

Most often, they are clearly expressed and do not present any difficulties for diagnosis. True, upon superficial examination they can be confused with manifestations acute poisoning or the same appendicitis, so when talking with your doctor, try to remember everything that bothers you in one way or another.

1. An unprovoked increase in temperature to 37.5–39 degrees, accompanied by weakness, chills, malaise and increased heartbeat. By the way, it is believed that each “additional” degree increases the heart rate (heart rate) by 7-10 beats per minute.
2. Severe pain in the groin area.
3. Obvious signs of damage to the gastrointestinal tract and genitourinary system. The reason for this “promiscuity” of salpingitis is that the development of the inflammatory process leads to enlargement and swelling of the fallopian tubes, which because of this begin to put pressure on the surrounding tissues, and the resulting pain begins to radiate to the rectum and tailbone.
4. Abnormal vaginal discharge (purulent, foamy, or even bloody, depending on the type of pathogen).

Symptoms of chronic (sluggish) salpingitis

Manifestations are often blurred and implicit, and the patient’s general condition is satisfactory or even good. The most important diagnostic criterion - temperature - in this case turns out to be uninformative, and 36.9–37.2 degrees (that is, the low-grade threshold) is considered by few doctors general practice considers it a sufficient basis for an additional in-depth examination.

One of the few visible manifestations of chronic salpingitis is certain menstrual irregularities. Painful or scanty periods (in other words, algomenorrhea and menstruation) are unlikely to add Have a good mood, and in the absence of adequate therapy) may well lead to infertility.

Symptoms of left-sided salpingitis

The external manifestations of this subtype are not much different from the classic ones (we talked about them earlier), therefore only a doctor can determine the presence of the disease during a qualified gynecological examination. Characteristic signs of left-sided salpingitis are swelling of the mucous membrane of the fallopian tube, ulceration of their surface layer, the formation of a cavity filled with mucus, pus and/or blood.

Symptoms of right-sided salpingitis

Due to some features anatomical structure In women, it can easily be confused with appendicitis, and the existing signs of the disease are associated with the lesion muscle tissue, swelling and formation. In other words, to determine the presence of right-sided salpingitis based only on external manifestations, almost impossible.

Acute or chronic salpingitis (oophoritis) is a gynecological disease caused by bacteria that provokes inflammation in the fallopian tube. The mucous and muscle tissues of both tubes are usually affected.

Inflammation affects the muscles of the visceral peritoneum. Approximately 30% of patients who applied for examination women's doctor, receive a diagnosis of oophoritis.

Reasons for the development of salpingitis

There are two main reasons why acute salpingitis develops:

1. Mechanical impact.
2. Introduction of bacteria.

Signs of inflammation of the ovary and fallopian tube are usually observed in women and girls of puberty who are sexually active.

The mechanical causes that cause this disease are injuries to the mucous and muscle tissue associated with the following phenomena and procedures:

• abortion;
• difficult labor;
• injections medicines into the uterine cavity or puncture in case of rupture of an ovarian cyst and internal bleeding;
• endometritis;
• examination of the uterus using various instruments.

Oophoritis also develops if staphylococcus, gonococcus, and streptococcus bacteria enter the internal genital organs.

Adnexitis (salpingitis) can be provoked by common E. coli, Frenkel diplococci, influenza bacillus, syphilis or actinomycosis. Treatment will then be aimed at eliminating the root cause.

The nature of the inflammation is:

1. spicy,
2. chronic;
3. hidden.

Important information: it was noted that 12% of patients diagnosed with inflammation of the ovaries and fallopian tubes had a history of tubercle bacilli in the body, although a direct connection between salpingitis and tuberculosis has not been confirmed.

The reasons often depend on the location of the patient.

For example, if in locality An unfavorable situation was noted regarding the frequency of sexually transmitted diseases; in half of the patients diagnosed with acute or chronic salpingitis, the causative agent of the disease will be a gonorrheal or syphilis infection.

Help to establish the cause during diagnosis will help correct definition method of penetration of bacteria into the cavity of the fallopian tube.

Most often, they pass ascendingly through the genital tract, enter the uterus, and then rise through the endometrial mucosa into the fallopian tubes.

But if the pathogen is tuberculosis bacillus, bacteria can enter the pipes from the lymph nodes of the abdominal cavity, intestines or through the blood in a hematogenous form of penetration

Signs of salpingitis (inflammation of the ovary and fallopian tube)

The symptoms of salpingitis are very similar to the symptoms of other gynecological diseases (adnexitis, oophoritis, even endometritis), so diagnosis is often difficult.

Most characteristic feature– a strong increase in body temperature, sometimes up to 40 degrees, chills, fever.

In addition, the following additional symptoms are observed:

• sharp pain in the lower abdomen;
• if the causative agent is a tuberculosis bacillus, the pain is localized in the inguinal and sacral regions;
• painful urination and defecation;
• pain during sexual intercourse.

If acute salpingitis is not treated and the disease is allowed to transform into a chronic form, pain may disappear and only bother you from time to time, for example, after physical work.

In this case, the patient should pay attention to symptoms such as purulent discharge from the vagina (purulent salpingitis), irregular menstruation, difficulty conceiving a child.

The disease and its clinical picture

Chronic salpingitis can be quite difficult to diagnose: symptoms are usually absent or smoothed out, and the causative bacteria have already died.

Instead, it may increase the number of streptococci or staphylococci, which in this case are the causes of secondary infection.

Treatment requires complex treatment; it is important to choose the right combination of drugs with different effects.

How acute salpingitis will develop and proceed, and what treatment will be required, largely depends on the type of pathogen and the woman’s immunity.

On initial stage changes in the body are almost invisible.

Tumors may develop in the future of different nature. Often inflammation affects neighboring organs.

During exacerbation, symptoms such as swelling of the external and internal genital organs, copious discharge, sharp pain.

Bilateral purulent salpingitis is diagnosed with gonorrheal infection.

Infiltrates with purulent filling are formed; with syphilis or actinomycosis, numerous granulomas appear - all these are typical symptoms of sexually transmitted diseases, which are accompanied by severe inflammation.

Complications and consequences of salpingitis

E If the inflammation is not treated, the vaginal folds hypertrophy, they coalesce and form cystic cavities with purulent secretory contents.

The fimbrial ends of the fallopian tube become overgrown, the remains of decomposed epithelium accumulate in the tubes, and saccular tumors form.

When the tubes contract, their contents can spill into the uterine cavity and cause endometritis.

If treatment has not yet been carried out at this stage, the inflammatory process affects neighboring organs.

Hypertrophied tubes can adhere to the ovaries and uterus, sometimes to adjacent areas of the intestine.

Most often, the affected fallopian tube fusions with the ovary and the formation of one large tumor. In medicine, this complication is called salpino-oophoritis, oophoritis or.

If the tube becomes fused with the uterus, a diagnosis of perimerosalpingitis is made. If the tube has fused with the intestines and other organs, we are talking about perisalpingitis.

Untimely or poor-quality treatment of the disease leads to persistent obstruction in the fallopian tube or both at once (bilateral salpingitis, oophoritis), and this in turn becomes the cause of difficult-to-treat infertility. In other words, salpingitis will not allow pregnancy.

It is no less dangerous if oophoritis provokes partial closure of the fallopian tubes. In this case, conception is possible, but the risk of developing an ectopic pregnancy with salpingitis is very high.

In rare cases, hemorrhages into the uterine cavity are observed.

Oophoritis - diagnosis and treatment

Treatment will depend on the type of pathogen. For gonorrheal infection, a gonococcal vaccine is administered, then a course of protein therapy is prescribed.

If the causative agent is a tuberculosis bacillus, oophoritis or acute salpingitis must be treated using radiotherapy. Various procedures are prescribed to promote the resorption of cysts and adhesions:

1. Hot compresses with medications.
2. Hot water bottles.
3. Warm enemas and douching with solutions medical supplies or decoctions of medicinal herbs.
4. Diathermy.
5. Solar electric baths.
6. Warming up with a quartz lamp.

In case of exacerbation of salpingitis, treatment is carried out on an outpatient basis. Complete rest and bed rest are required.

Strong pain syndrome eliminated with the help of painkillers, ice is applied to the lower abdomen, ointments and gels are used externally, and suppositories are used intravaginally.

If treatment conservative methods turned out to be ineffective, surgical treatment of salpingitis is carried out. But first the doctor must determine the location of the inflammation:

• bilateral salpingitis;
• right-sided oophoritis;
• left-sided salpingitis.

Surgical treatment is carried out in two ways: conservative and radical.

If the situation allows, the woman’s internal genital organs are preserved after conservative surgery. If the situation is critical, sections of the fallopian tube, ovaries, and sometimes the body of the uterus are removed - this is a radical operation.

A woman should remember that until she cures salpingitis, pregnancy may not occur.

And if the inflammation reaches the uterine cavity, the patient may develop endometritis - a very dangerous disease.

Endometritis and its symptoms

It's called endometritis pathological changes in the mucous epithelium of the uterus, which can provoke:

1. untreated inflammation of the ovary and fallopian tubes (bilateral salpingitis, purulent salpingitis, right-sided or left-sided salpingitis);
2. exposure to a septic pathogen;
3. improper douching;
4. intrauterine examinations;
5. childbirth;
6. abortions and other manipulations with curettage.

However, there are other reasons that provoke endometritis:

• poor immunity;
• frequent stress and overwork;
• vitamin deficiency;
• non-compliance with genital hygiene;
• having sex during menstruation;
• diseases of other internal organs.

Endometritis can develop acutely, but a latent course of the disease is also possible, which is even more dangerous, since the diagnosis is often made very late.

Typically, latent endometritis is detected when a woman is examined for other diseases.

Acute endometritis has clear symptoms, but sometimes it is confused with the malaise that occurs in a woman before her period begins.

How does a patient diagnosed with endometritis feel?

1. The woman feels excruciating pain in the lower abdomen.
2. There is copious discharge from the vagina, which has a very unpleasant odor.
3. Urination becomes painful.
4. Body temperature rises to 38 and above.

The first thing a woman should pay attention to is an increase in body temperature in the absence of any other symptoms.

If this condition lasts more than two days, you should immediately be examined by a gynecologist.

Most often, at the initial stage, endometritis is manifested by spotting brown or red discharge, which can turn purulent after a few days.

If endometritis is not treated, it can cause serious complications, including uterine cancer.

The name of the disease comes from the Greek “salpingos” - trumpet. With this pathology, inflammation occurs in the fallopian tubes, which connect the body of the uterus to the ovaries. Most often the infection occurs upward path- pathogenic microorganisms spread from the uterus to the tubes, involving them in the inflammatory process.

Less commonly, downward spread occurs - in this case, pathogenic agents enter the fallopian tube from nearby parts of the intestine. It is also possible for the infection to move through the bloodstream from another source of infection in the patient’s body. Pathogens can be different - tubercle bacilli, cocci, chlamydial pathogens, intestinal flora and others.

Initially, the inflammation process affects the mucous surface of the fallopian tube and if treatment is not started, the disease penetrates into the deeper layers of tissue. In advanced cases, adhesions of the fallopian tube will occur and obstruction will occur. This leads to serious complications, making treatment and restoration of the patient’s fertility extremely difficult.

Classification of salpingitis in women

Chronic salpingitis. In some cases, it may not give external manifestations. But more often, with this type of salpingitis, patients primarily note aching and nagging pain in the lower third of the abdomen. Decreased appetite, severe fatigue, difficulty urinating, low-grade fever bodies with chills. Often, adhesions begin in the fallopian tubes and an ectopic pregnancy may occur.

Acute salpingitis. When it occurs, fluid collects in the fallopian tube and the tissue becomes inflamed. Always expressed by characteristic pain in the abdomen and back (lower back), vaginal discharge. Body temperature is increased.

When urinating, the patient experiences cutting and stitching pain, and during sexual intercourse – discomfort and pain. Menstruation is also painful. When purulent discharge forms and accumulates in the fallopian tubes, acute purulent salpingitis is diagnosed.

Purulent salpingitis. This form of the disease is characterized by a sharp increase in temperature, severe abdominal pain, fever, severe weakness and malaise. Purulent discharge is observed from the vagina. Menstruation is scanty or, on the contrary, too abundant, urination is difficult, sexual intercourse causes severe pain. The patient should urgently seek medical help.

Bilateral salpingitis. Since both tubes are involved in the process, the risk of infertility is very high if you are late with proper treatment. In some cases, the fallopian tubes have to be removed. With this type of salpingitis, patients note constant pain, severe weakness, intimate contacts are painful, and bleeding is also possible. Nausea and poor appetite, unusual vaginal discharge, problems with urination, fever and fever may also occur.

Causes of manifestation

Almost always, salpingitis begins when pathological microflora from the body of the uterus penetrates the fallopian tube. The infection subsequently spreads to the ovary or nearby tissues (for example, ligaments).

As the inflammatory process develops, liquid discharge (exudate) accumulates in the tube, its presence provokes a cicatricial and adhesive process.

In an acute process, cavities with purulent contents or serous fluid may form in the tubes. Such cavities can form an abscess affecting the ovary, and the infection can spread into the abdominal cavity, involving other pelvic organs.

The main pathogens that cause salpingitis:

• causative agent of chlamydial infection;
• gram-negative diplococcus (the causative agent of gonorrhea);
• intestinal flora;
• causative agent of trichomoniasis;
• mycoplasma;
• ureaplasma;
• staphylococci and streptococci;
• various viruses (herpes, cytomegalovirus);
• fungi.

Symptoms and signs

Usually the disease begins to manifest itself after menstruation. There is a sharp deterioration in the woman’s condition; against the background of elevated temperature, a febrile state and abdominal pain are observed. Pain may radiate to the sacrum and perineum.

Enteral manifestations are also possible in the form of excessive accumulation of gases, nausea, and vomiting. Everything is complicated by severe weakness, rapid heartbeat, severe pain in the muscles.

The vaginal discharge is characterized by a serous-purulent discharge with an unpleasant odor. When urinating, the patient notes pain and frequent urges.

Diarrhea is possible.

Sexual intercourse is difficult due to severe pain.

If pathological process is under acute form, then the pain is not pronounced, the temperature is low, subfebrile. The condition of the patients is satisfactory.

The chronic form of the process can occur against the background of standard body temperature. But at the same time, there is persistence of pain in the abdomen.

The process can worsen under the influence of severe stress, increased load, low temperatures(hypothermia).

If the process is purulent, then not only the body of the uterus, but also the cervical canal, ureters and urethra, and rectum may be involved.

If the cause of salpingitis is chlamydia, then the symptoms are more subdued. But at the same time, salpingitis is complicated by inflammation of the endometrium and urethra, and destructive lesions of the tubes are observed. The result is the development of ectopic pregnancy and irreversible infertility.

Course of the disease

The process of development of salpingitis can be unilateral, or it can affect both tubes (bilateral).

First of all, inflammation affects the epithelium of the fallopian tube (the upper layer of the mucous membrane of the inner surface of the fallopian tube). The next stage is inflammation of the muscle fibers of the tube and the serous layer.

During the inflammatory process, discharge, serous or purulent form. These abnormal accumulations of infected fluid provoke the formation of adhesions and scars, both inside and outside the tubes. The presence of these symptoms indicates that the disease is progressing to a chronic stage.

If treatment is not started on time, the pathological process leads to the patient completely blocking the lumen of the fallopian tubes, causing their obstruction. This causes infertility.

Features of manifestations during pregnancy

Pregnancy and salpingitis are often incompatible. If a woman is diagnosed with “salpingitis,” this means, at the very least, the need for serious and thoughtful treatment in order to make pregnancy possible in the future.

In most cases, if the diagnosis is made correctly and the correct treatment regimen is prescribed, the process can be stopped and eradicated. A woman can conceive and carry to term normally healthy child. The earlier the disease is detected and therapy is started, the greater the chances of successful recovery.

Salpingitis can be unilateral or bilateral. Complete infertility will occur only when both fallopian tubes are affected by inflammation. If, as a result of pathology, one pipe is impassable, the second will remain active. But it should be borne in mind that if the one-sided process is missed, then the infection can quickly spread its influence to the second pipe.

With the onset of pregnancy, it is better to wait until treatment and make sure that the tests are in order. This is necessary so that the infectious agent cannot infect the fetus and harm it.

Many experts are of the opinion that salpingitis and pregnancy are incompatible. But with timely and correct treatment, conception is quite likely.

In that case. If salpingitis has developed during pregnancy, it is necessary urgent treatment. Therapy should be prescribed in a more gentle form. In the absence of treatment measures, everything can end in an infected abortion or the death of the child.

If the cause of salpingitis is chlamydia or gonococcal infection, high danger transmission of infection to the child during childbirth.

Diagnostics and examinations

A manual examination for salpingitis will be very painful. The specialist will note the presence of liquid contents on the left or right, depending on the location of the process. The tissues will be swollen, so the infiltrate will not have clearly defined boundaries. If the process has reached a chronic form, then the appendages will be inactive due to the fact that fibrous and sclerotic processes take place in them.

The blood test will show an increased ESR and an increase in the content of leukocytes.

A specialist will definitely take a smear test in order to conduct a microbiological analysis and determine the causative agent of the infectious process. In order to identify certain types of pathogens, the polymerase method is used chain reaction and enzyme immunoassay method.

To visualize the process and determine the extent of its spread, ultrasound is used, both externally and through the vagina. The image shows thickening of the fallopian tubes, adhesions and scar formations, effusion, accumulations of serous fluid and pus, and tumor-like thickenings in places of its accumulation.

In very severe cases of salpingitis can be used diagnostic laparoscopy. In this case, the patient is under anesthesia through small incisions in the abdominal wall a laparoscope is inserted and the area of ​​the fallopian tubes is examined, while it is possible to immediately take a smear directly in the area of ​​the infectious focus.

Danger and aggravation

The most common complication of salpingitis is inflammation of the ovary. The ovary is the area closest to the inflamed tube and the infection penetrates into it quickly and without difficulty. The symptoms of oophoritis are no different from salpingitis, the menstrual cycle is disrupted, painful stomach, fever, vaginal discharge.

It is often combined with inflammation of the uterine epithelium -.

Another complication is the accumulation of purulent discharge in the fallopian tube - pyosalpinx. With absence timely treatment there is a danger of pipe rupture and infection of the abdominal cavity - peritonitis, sepsis. If the treatment has been carried out and completed, then in this case a complication is possible in the form of disruption of the patency of the fallopian tube due to the adhesive process. In the future, this complication can cause ectopic pregnancy and infertility.

The disease carries with it various consequences for the patient’s reproductive system - difficulties with conception, ectopic pregnancy. Even after complete recovery, they may still long time painful sensations may be observed in the pelvic area, since the adhesive process affects not only the tubes themselves, but also the surrounding organs. As a result, sexual function is complicated. Full recovery fallopian tubes affected by salpingitis is impossible.

If salpingitis is in chronic form, then when exposed to certain factors, exacerbations are possible. They are caused by stressful situations, sudden heavy loads, exposure to cold, and so on.

Treatment of salpingitis

In acute forms of salpingitis, as well as chronic ones in the acute stage and various complications of the disease, it is carried out only in a hospital hospital setting. Outpatient treatment of salpingitis is possible only in remission.

The use of medications and treatment methods largely depend on the extent of the process and the presence of complicating factors.

This disease is characterized by the fact that the pathogens that cause it are highly resistant to most antibacterial drugs wide spectrum. Therefore, such antibiotics are used only at the onset of the disease, if antibacterial treatment has not yet been used.

In order to prescribe an effective antibiotic, an analysis is carried out to determine the sensitivity of microorganisms to a particular drug.

If the disease is chronic, immunostimulating drugs are mandatory. Also, to achieve the desired effect, they use stimulation of their own immunity by introducing their own blood and placental preparations.

If the disease was not diagnosed in time, the process is started, adhesions and scars may be detected. In these cases, medications are prescribed that soften adhesions and scars, relieve swelling, and improve the movement of fluids in tissues.

Widely used in the treatment of salpingitis medicines in the form of candles. Suppositories are used rectally. This helps to hit quickly active substance to the source of infection. In addition, various painkillers and anti-inflammatory agents are often used in suppositories to improve general condition patients, pain relief.

After the patient is treated with antibiotics, various methods of physical therapy are successfully used. They are effective for removing painful sensations, softening and resorption of adhesive formations.

The main method is electrophoresis of various drugs. Experts recommend combining dimethyl sulfoxide and iodine.

If salpingitis is combined with fibroids or endometritis, magnetic therapy is recommended.

Hydrotherapy, especially radon baths, has a good effect.

Acupuncture helps relieve pain and activates protective organisms patients.

Microwave irradiation with decimeter and centimeter waves helps localize the process, prevents its spread and accelerates recovery.

In extremely advanced cases, if all other methods have failed, and also if there is a threat to the patient’s life, surgical treatment has to be used. This can be an operation with preservation of the fallopian tubes (conservative), or their complete removal (radical).

Folk remedies

Complete cure of salpingitis with folk remedies impossible. These methods can be used as a complement to the main therapy and only after consultation with a specialist.

• Grind 100 grams of anise seeds and mix with 0.5 kg of honey. Use this mixture for oral administration, a small spoon before meals, in the morning, afternoon and evening;

• herbal mixture - chamomile flowers, anise seeds and elderberry in equal proportions, mix and chop. Fill hot water and boil over low heat for 2 - 3 minutes. Take 0.5 cups orally in the morning, afternoon and evening before meals;

• Grind the juniper berries and branches and add hot water, bring to a boil and leave for two hours. Use the resulting product in an amount of 50 grams for a bath. Take a bath for half an hour.

Treatment practice

The patient needs strict medical supervision, so she will need to be in inpatient conditions. Bed rest and a quiet environment are recommended. You need to follow a gentle diet.

Based on the tests performed, correct antibiotic therapy is prescribed. The duration of therapy will be from 10 days to two weeks.

Antibiotic therapy is supplemented with the use of vitamin supplements and physiotherapeutic procedures. Acupuncture is used to relieve pain.

Prevention

First of all, to prevent the disease, it is necessary to detect and treat it in a timely manner. infectious diseases genital area. To do this, you need to regularly go to the doctor for examination and get tested. All identified infections must be cured completely, preventing them from becoming chronic.

It is important to provide treatment to your partner as well to avoid re-infection.

It is necessary to avoid casual connections and avoid unprotected contacts.

It is imperative to maintain high immune status to resist infections.

Pathogenic agents can enter the body when the mucous membranes are injured, so it is undesirable to use intrauterine devices.

Forecast

In the chronic form of salpingitis, the prognosis is unfavorable. It often causes infertility. Most of all, this concerns a bilateral process, since both fallopian tubes are affected.

For left-sided salpingitis, the prognosis is favorable if the woman consulted a specialist in a timely manner and the correct treatment was carried out. After a few weeks, normal functioning of the organs can be resumed.

With right-sided salpingitis, the prognosis is also favorable if it is diagnosed in a timely and correct manner. After a few weeks, the normal functioning of the reproductive organs is restored.