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INFECTIONS OF THE TUBES - SALPINGITIS

What are Infections of the Tubes ?

Salpingitis is an inflammation of the Fallopian tubes or oviducts. There are two tubes, one on each side of the womb. They are about 10 cm (4 inches) long, and at the inner end they connect with the inside of the womb. The outer end is free, but very close to the ovary on each side. The outer end actually looks very much like an open sea anemone, with fine tentacles, whose job it is to pick up the egg. These tentacles are called fimbriae. The tube gets narrower, the closer it gets to the womb. The widest part is about the width of a pencil, while the narrowest is almost as small as a pencil point. The sperms swim up through the womb and along the tube. One of the them fertilizes the egg ant the outer end. The fertilized egg then travels back down the tube and into the womb. The tube is lined by cells, which help the egg on this journey. Salpingitis nearly always affects both tubes. The symptoms of salpingitis and their severity can vary a great deal. An acute and bad infection causes severe lower abdominal pain. There may be peritonitis (inflammation of the lining of the abdomen). There is a high fever, the patient may vomit and be unable to keep down food and fluids. The symptoms are due to the presence of pus in the tubes, like a large abscess. Hospital treatment is then essential. However, many cases are not as severe as this, and do not justify hospital admission. There is lower abdominal pain, particularly during intercourse. There may be a vaginal discharge, and in chronic cases, the periods become heavy and more painful.

How do Infections of the Tubes occur ?

The bacteria can get to the tubes in different ways. The infection may start in the vagina and go up through the womb into the tubes. This is usually a sexually transmitted infection such as gonorrhoea or chlamydia. Very occasionally salpingitis may follow an operation such as a termination of pregnancy. It may also follow natural pregnancy or miscarriage. It is possible for salpingitis to be spread from appendicitis. It can be quite difficult to tell which infection a patient has. Salpingitis may be brought in the bloodstream from an area of infection elsewhere. Tuberculosis can do this but it is very rare.

Why do Infections of the Tubes occur ?

Sexually transmitted infections are the most important cause of salpingitis. The more sexual partners, the greater the risk of infection. The intrauterine contraceptive device (coil) increases the risk. Barrier methods of contraception, especially the condom, reduce the risk. A woman is at greater risk of infection at the time of a period. A suspected appendicitis in a young woman should be treated quickly. This reduces the risk of the infection damaging the tubes. Any abnormal bleeding after any sort of pregnancy should be checked. If part of the pregnancy or afterbirth has not come away, it causes bleeding and may become infected. A D & C may need to be done.

Treatment Involved for Infections of the Tubes

The acute, severe case needs to be treated in hospital. Antibiotics are given in an intravenous drip. It may be necessary to do a laparoscopy to make sure of the diagnosis. Occasionally an operation may be needed to drain the abscess. Less severe cases may still need hospital treatment. Antibiotics and painkillers will be given. You will be discharged when the pain and temperature have subsided. If an abscess forms in one tube and the other is normal, the infected tube may be removed. Sometimes episodes of pain keep recurring. If the woman wants no more children, a hysterectomy may be done and both tubes removed.

After Treatment for Infections of the Tubes

Unfortunately salpingitis often recurs and may become quite a chronic condition. The risks of recurrence can be reduced by using barrier contraception and having one sexual partner. The coil and unwanted pregnancies should be avoided. There is a risk of ectopic pregnancy and infertility in the future.

If Infections of the Tubes ar Left Untreated

The longer the infection is neglected, the greater the risk of permanent damage to the tubes. The infection could spread outside the tubes and cause adhesions of the bowel. Prompt treatment of the acute infection reduces the risk of infertility.

Effects on Family of Infections of the Tubes

Salpingitis can be very distressing if it becomes a chronic problem. A marriage needs to be very strong if intercourse is often painful and if fertility is reduced. It helps if a wife and husband can see the doctor together to discuss the problems.