Salpingitis is an isolated infectious and inflammatory disease of the uterine (fallopian) tube of one or two-sided nature, often leading to its obstruction and, as a result, infertility. As an isolated inflammatory process, salpingitis is rare; in most cases, inflammation is from the area fallopian tubes passes to the ovaries (oophoritis), and acquires the features of combined inflammation of the appendages (salpingoophoritis). Often inflammation of the uterine appendages (ovaries and tubes) is combined with endometritis (inflammation of the uterus).

Fallopian tubes are paired organ, which is an integral part of the uterine appendages. By appearance each fallopian tube resembles a hollow tube 11 cm long, opening into the uterine cavity in the area of ​​its angle from one end and abdominal cavity near the ovary - from the other. The lumen of the fallopian tube is covered with special epithelial cells; on their surface there are formations (cilia) capable of undulating movements(flicker). Beneath the layer of epithelial cells in the wall of the tube is a muscle layer. Thanks to the movements of the ciliated epithelium and contractions of the muscular wall of the fallopian tube, the fertilized egg moves towards the uterus from the abdominal cavity for the subsequent development of pregnancy.

Source inflammatory disease fallopian tubes is an infection. It could be:

— Specific (gonorrheal) flora. The causative agents of gonorrhea (gonococci) have the ability to damage the superficial mucous layer of the external genitalia and penetrate into the underlying layers and tissues. The infection from the vagina quickly rises into the cervical canal (cervical canal), and then into the uterus and appendages. Acute purulent salpingitis caused by gonococci very often leads to infertility and poses a threat to reproductive health female patients.

— Pathogenic nonspecific (nongonorrheal) infection caused by chlamydia, viruses or spirochetes.

— Opportunistic microflora: streptococci, staphylococci, fungi, mycoplasmas, E. coli and others. Representatives of this group of microbes are present in the body of any healthy woman in such quantities that they cannot harm her health. However, if there is favorable conditions they begin to multiply rapidly and become a source of disease.

Salpingitis is extremely rarely caused by a single pathogen. The source of inflammation in the vast majority of cases is a microbial association. By uniting in groups, pathogenic microorganisms develop faster and more efficiently in the tissues of the uterine appendages and spread to surrounding structures.

Since all female genital organs are anatomically and functionally interconnected, infection can enter the fallopian tubes from the vagina, cervix, uterus or ovaries. Cases of infection entering the pipes from distant organs through the hematogenous (through the blood) route are rare.

The presence of infection in the body is not a sufficient condition for the onset of inflammation in the uterine appendages. The disease develops when there is unfavorable factors, reducing the level immune defense body.

Salpingitis can occur in acute or chronic form. The most pronounced clinical picture is acute purulent salpingitis of a specific origin. Exacerbation of chronic salpingitis of a nonspecific nature looks like subacute salpingitis with mild symptoms.

Salpingitis does not have any etiology specific symptoms. As a rule, the disease has signs of acute or chronic inflammation genital organs and requires additional clarification of the localization of the pathological process using two-handed examination and ultrasound.

The diagnosis of salpingitis requires laboratory confirmation. Bacteriological examination identifies the causative agent of infection and helps to choose the right antibiotic for its elimination.

As an isolated infectious-inflammatory process, salpingitis does not exist for long, and then the infection spreads to the ovaries and underlying tissues. Timely diagnosis salpingitis on early stage development can prevent the disease from getting worse and helps avoid complications.

Acute purulent salpingitis can lead to serious complications: the formation of a tubo-ovarian abscess or purulent melting of the wall of the fallopian tube, the development adhesive disease and infertility.

Antibacterial therapy takes the leading place in the treatment of salpingitis. Unfortunately, the presence of a large arsenal antibacterial agents does not always help cure salpingitis. This is possible only at the very beginning of the development of the inflammatory process, and during this period, patients do not often come to the doctor and try to cope with the disease on their own.

The term "salpingitis" indicates the presence of inflammation in the fallopian tube. It is called right-sided salpingitis if the process develops on the right or left-sided salpingitis when the left tube is affected. Much less common is bilateral salpingitis with the presence of an infectious and inflammatory process in both tubes of the uterus.

Some patients misinterpret the diagnosis as salpingitis of the fallopian tube due to ignorance. The diagnosis of salpingitis of the fallopian tube is similar in meaning to the diagnosis of appendicitis of the appendix, therefore it is incorrect and is not used by specialists.

Causes of salpingitis

The only cause of salpingitis is infection. The disease develops with the participation of opportunistic microbes present in the body or a foreign infection that has entered the body from the outside.

The most common route by which infectious agents enter the fallopian tube and cause inflammation is through the uterus. In a healthy woman, the uterine cavity is sterile. It is protected from infection by the cervical canal, or more precisely, by the cells lining its cavity. Thanks to the cervical glands, the cervix contains large number mucus. It has antibacterial properties and acts as a barrier to the penetration of infection from the vagina into the endometrium. The vaginal environment, in turn, also performs a barrier and protective function. The vaginal microflora contains a large number (98%) of lactobacilli. With their help, a protective layer is formed on the surface of the vagina that does not allow pathogenic microbes to enter the underlying tissue. The lactic acid produced by lactoflora maintains a constant pH of the vaginal environment, at which the infection cannot multiply. The mechanisms of local protection of the genitals from infection are controlled by the hormonal and immune systems.

Thus, in a healthy body, the tissue of the fallopian tubes is protected from infection by an anatomical and physiological barrier. Under certain unfavorable conditions, the protective mechanisms weaken, and the infection penetrates the uterus, and from there into the tubes, where it begins to develop and provokes inflammation.

The risk of developing salpingitis is:

- Promiscuous sexual intercourse. Unprotected contact with a sexual partner suffering venereal disease, leads to a hit specific infection in the vagina. Gonorrheal infection is especially dangerous for the appendages. Gonococci are capable of destroying epithelial cells and causing acute, rapidly developing purulent inflammation. Besides, intimate relationships with numerous partners lead to the fact that a large number of foreign microbial associations constantly enter the vagina. Over time, they lead to disruption of the normal microbial balance of the vaginal environment and provoke inflammation.

— Dysbiotic disorders in the vagina. A long-term imbalance between lactobacilli and opportunistic microorganisms leads to the development of inflammation.

— Infectious and inflammatory diseases of the cervix (endocervicitis). The infection developing in the cervix eventually begins to rise to the uterus, and from there to the tubes.

— Mechanical damage tissues of the genital organs during abortion, diagnostic procedures or during childbirth. The infection penetrates into the thickness of the uterus and appendages through injuries to the mucous membranes or with surgical instruments.

— Intrauterine contraception. The infection enters the endometrium, moving along the spiral threads, and then rises to the tubes.

Severe hypothermia has an indirect effect on the development of salpingitis, stressful situations and severe overwork, which significantly deform the body’s natural immune defense mechanisms.

— Neglect of hygiene standards. This is especially true during menstruation. Some patients do not follow the rules for using vaginal hygienic tampons, changing them too rarely. A blood-soaked tampon left in the vagina for a long time is ideal source for the development of infection.

An unfavorable background for the development of inflammation of the fallopian tubes is serious endocrine and hormonal ailments, especially diseases of the thyroid gland.

So that it appears in the pipes infectious inflammation, the presence of such in the underlying genital organs is not always required. IN in rare cases Salpingitis infection enters the uterine tubes hematogenously (through the blood) from foci of chronic inflammation existing in the body. Salpingitis can develop in patients with tonsillitis, otitis media and other similar ailments.

The origins of inflammation of the fallopian tubes are not always found pathological causes. Significantly facilitates the process of microbial “infection” of the uterus and menstruation. The menstruating uterus from the inside is a large open wound, vulnerable to any infection. If, under the influence of unfavorable factors at this moment, unwanted microflora enters the uterus, it easily causes the development of inflammation and subsequently rises into the uterine tubes.

Acute salpingitis occurs rarely during pregnancy. Usually during pregnancy the existing chronic salpingitis. The appearance of salpingitis in pregnant women is facilitated by a physiological decrease in the level of immune defense and quantitative changes in the composition of the vaginal environment.

Symptoms and signs of salpingitis

The clinical picture of salpingitis depends on the following factors:

- Form of the disease. Acute salpingitis is accompanied by bright inflammatory symptoms and often requires hospitalization of the patient. Chronic inflammation in the uterine tubes during the period of exacerbation looks like subacute salpingitis with a mild clinical picture.

— The nature of the infectious agent. Acute purulent salpingitis has a bright clinical picture and has serious consequences, and the infection caused by chlamydia is asymptomatic.

— Presence of accompanying gynecological pathology. If inflammation of the fallopian tubes occurs against the background of a similar process in other genital organs, the symptoms of salpingitis will be accompanied by signs concomitant diseases, and the course of the disease will be more severe.

- Presence of complications. Acute purulent salpingitis often provokes serious complications requiring immediate intensive hospital treatment or even surgical intervention.

— The state of the patient’s immune system. In weakened patients, the infection is more aggressive and more likely to cause complications.

A typical symptom of salpingitis of any etiology is pain. Intensity pain depends on the stage of the disease. Severe abdominal pain occurs with acute salpingitis. Pain in the left groin area accompanies left-sided salpingitis or, and right-sided inflammation of the appendages is projected onto the right groin area. Often the patient cannot indicate the exact projection of the source of pain, since it is diffuse or radiates to adjacent areas, for example, to the lower back.

Pain in acute salpingitis is sometimes so severe that it makes the disease resemble acute surgical conditions. For example, sometimes acute right-sided salpingitis is difficult to distinguish from acute appendicitis.

In addition to pain, salpingitis may cause an increase in body temperature and a deterioration in general condition. If in inflammatory process the cervix and vaginal mucosa are involved, the patient will complain of pathological discharge () of a serous-purulent or purulent appearance.

A gynecological examination allows you to determine the localization of the inflammatory process and the extent of its spread, as well as detect signs of infection in the vagina and cervical canal, if any.

Getting into the fallopian tube, infectious agents penetrate into the thickness of its wall, as a result it thickens due to inflammatory edema. Serous inflammatory fluid (exudate) begins to accumulate in the lumen of the fallopian tube. During this period, palpation of the uterine appendage area becomes painful.

In the cavity of the fallopian tube, due to inflammation and exudation, the process of wall adhesion quickly develops. The lumen of the tube sharply narrows or closes, and inflammatory exudate continues to accumulate. This is how hydrosalpinx is formed. It can exist in the fallopian tube for a very long time as independent disease. When there is too much secretion, sometimes a so-called ventilated hydrosalpinx is formed: it periodically pours outside the tube into the abdominal cavity, forming adhesions, or into the uterus, causing the appearance of heavy discharge watery appearance.

With purulent salpingitis, an accumulation of purulent exudate, it melts the wall of the tube and the ovary, forming a single cavity (abscess) filled with purulent contents.

Often, patients with salpingitis are concerned about the possibility of pregnancy and its consequences. For most women, bilateral salpingitis significantly reduces the chances of pregnancy.

Obstruction of the uterine tubes due to inflammation and adhesive process lead to infertility. In addition, sometimes the fertilized egg does not have the opportunity to descend into the uterus and is implanted into the wall of the tube with subsequent development.

Pregnancy with salpingitis can occur if there are healthy appendages on one side. Clinically, salpingitis during pregnancy often occurs in the form of a subacute or chronic process.

The primary diagnosis of salpingitis causes certain difficulties due to the close proximity of the ovaries. No additional instrumental methods examinations are not always possible differential diagnosis between salpingitis and salpingoophoritis. For this purpose, it is carried out ultrasound scanning with vaginal sensor.

Laboratory diagnostics allows you to determine the nature of the inflammatory process and find out its cause. Laboratory tests for salpingitis include:

- general blood test;

- bacteriological research to identify the causative agent of the disease and determine the antibiotic for its elimination.

- smears of vaginal discharge and cervical canal.

Additional research methods are prescribed according to the clinical situation.

Acute salpingitis

Acute salpingitis begins with the appearance of severe pain. As a rule, pain initially occurs on the side where inflammation develops and can radiate to any area of ​​the abdomen, rectum, thigh or lower back. With bilateral damage to the fallopian tubes, the pain becomes diffuse.

Acute salpingitis always sharply worsens the general condition and is accompanied by symptoms of fever: a significant increase in temperature (above 38°C), chills, rapid heartbeat and severe general weakness. Dysuric disorders, bloating and nausea may occur.

A patient with acute salpingitis is often bothered by copious purulent or serous-purulent discharge, which often has an unpleasant odor.

The clinical picture of acute purulent salpingitis is determined by the form of infectious inflammation. Uncomplicated forms include common acute purulent process in the uterine tube. Complicated purulent salpingitis refers to all delimited purulent processes in the uterine tubes, which are inflammatory abscesses filled with pus. Purulent inflammation fallopian tubes clinical picture resembles symptoms of an acute specific process ().

Carrying out a gynecological examination can be complicated by severe pain when trying to palpate the appendages on the affected side. Sometimes, in the area of ​​diseased appendages, a vaguely expressed painful formation of doughy consistency can be identified.

When examined using mirrors, signs of inflammation of the cervix (endocervicitis) and abundant pus-like leucorrhoea present in the vagina are often revealed.

In acute salpingitis, the infection is not always limited to the fallopian tube; sometimes it spreads to the ovarian tissue with the subsequent development of combined inflammation in the appendages - salpingoophoritis.

Results general analysis blood indicate the presence severe inflammation, an increase in ESR and the number of leukocytes is detected.

Microscopy of a smear of vaginal discharge and the cervical canal confirms the presence of inflammation and the presence of conditionally pathogenic microorganisms. For specific infectious process gonococci are detected in the smear.

Complications of acute purulent salpingitis are:

— Suppuration of the fallopian tube with the formation of a “sac” filled with pus – pyosalpinx.

- Tuboovarian abscess. Pus accumulating in the cavity of the pipe can gradually destroy the surrounding tissue. As a result, the wall of the tube melts, the purulent contents flow to the ovary and damage it. As a result, a single delimited cavity is formed between the tube and the ovary, filled with pus. In fact, the process is limited peritonitis.

— Diffuse pelvioperitonitis against the background of the outpouring of purulent contents of the fallopian tube into the surrounding tissues with an infectious lesion of the pelvic peritoneum.

Salpingitis at the stage acute inflammation requires immediate therapeutic intervention. Only timely treatment can completely eliminate the infection and prevent its consequences. Unfortunately, at the first signs of acute salpingitis, patients do not always rush to seek help and attempt self-medication. At self-treatment using randomly selected antibiotics and symptomatic remedies it is often possible to remove acute symptoms inflammation, which is mistakenly taken for healing. However, in such cases, the infection is not removed from the body, but acquires the features of subacute and then chronic inflammation.

Chronic salpingitis

If treatment for acute salpingitis was not carried out or was not started in a timely manner, chronic inflammation begins to form in the fallopian tubes. Chronic salpingitis does not have a pronounced clinical picture; during periods of remission it is asymptomatic, and frequent exacerbations occur in a subacute form.

As a rule, the symptoms of chronic salpingitis are associated with complications that arise after acute inflammation. The most significant symptom of chronic salpingitis is pelvic pain. Their appearance is associated with the adhesive process, and the intensity is directly dependent on the severity of the adhesive process. Adhesions change the location of organs and affect their mobility. A pronounced adhesive process causes prolonged nagging pain lower abdomen, worsening with physical activity, menstruation or sexual activity. If, as a result of acute inflammation, the genital organs are slightly damaged, pain appears only during an exacerbation.

Exacerbation of chronic salpingitis occurs without severe fever, the temperature does not exceed subfebrile norms, and general health remains normal.

If the infectious-inflammatory process in acute period the disease has spread to the ovarian tissue and caused it structural damage, chronic salpingitis may be accompanied by disorders menstrual cycle. Menstruation becomes heavier, longer and more frequent.

The most common reason for visiting a doctor by patients with chronic salpingitis is. Long-term existing inflammation in the uterine tubes lead to their anatomical and functional deformation: the tubes thicken, their lumen narrows, and the inflammatory exudate glues the walls of the tube together, forming adhesions. Advancement of a fertilized egg into the uterine cavity under such conditions becomes impossible.

A dangerous situation is when the tube remains partially passable, then the egg stops inside the tube and, mistakenly believing that it has reached the uterus, is implanted into the wall of the tube and begins to develop. Under the influence of a growing pregnancy, the tube stretches and then ruptures. Ectopic pregnancy – dangerous complication chronic salpingitis.

At gynecological examination patients with chronic salpingitis may experience limited mobility of the uterine appendages. Usually, with pronounced post-infectious changes, it is possible to palpate a thickened tube and/or an enlarged ovary. Attempts to displace the cervix in the case of severe adhesions are accompanied by pain.

Transvaginal ultrasound examination allows you to determine the location of the uterine appendages and the presence of adhesions in the pelvic area.

Additional examination methods are carried out according to the clinical situation. In difficult cases, laparoscopy helps to make the correct diagnosis.

Treatment of salpingitis

It is possible to completely eliminate salpingitis only at the stage of acute inflammation, if treatment is started when the first signs of the disease appear, and the treatment regimen was chosen correctly. The uterus and appendages are connected anatomically and functionally, and also have a common extensive circulatory system. All this contributes rapid spread infections from the fallopian tubes to adjacent structures with the subsequent development of general inflammation and complications.

The main therapeutic goals for salpingitis are the timely elimination of the source of infection and the elimination of its consequences.

Treatment of acute inflammation of the appendages requires hospitalization of the patient. Patients with severe symptoms of exacerbation of chronic salpingitis are also admitted to the hospital.

Treatment of acute salpingitis begins with antibacterial therapy. Antibiotics are selected individually after laboratory (bacteriological) confirmation. Antibacterial therapy should be prescribed as early as possible, but laboratory results may have to wait several days. As a rule, antibiotics are initially prescribed wide range(penicillins, cephalosporins, tetracyclines, etc.), since they can affect most infectious agents. After receiving the test result, the antibiotic is continued (if appropriate) or changed.

Chronic salpingitis without exacerbation usually does not require antibiotics.

In a hospital setting, antibiotics can be administered intravenously (drip) or intramuscularly. If the patient’s condition is not severe, they are limited to tablet medications.

In parallel with antibacterial therapy, painkillers, antihistamines, immunostimulants and vitamins are prescribed. To prevent the development of dysbacteriosis while taking antibiotics, antifungal agents.

Sometimes patients ask which suppositories for salpingitis help cure inflammation. Antibacterial suppositories for salpingitis are not prescribed to treat infection in the fallopian tube, they are intended to eliminate infectious and inflammatory phenomena in the vagina and cervical canal. If examination reveals no signs of vaginal infection, local therapy is not required.

After a course of antibiotics, they begin to eliminate the consequences of the infection. To improve the regeneration of damaged tissues, they are used biogenic stimulants(Humisol, Aloe Extract and the like). Physiotherapy helps eliminate adhesions and improve blood supply to the pelvic organs.

During the treatment of salpingitis, a method is individually selected for patients reliable contraception to avoid an ectopic pregnancy.

– infectious inflammation of the fallopian (fallopian) tubes. Acute salpingitis occurs with severe pain in the abdomen, fever, chills, intoxication. In subacute and chronic forms of salpingitis, the clinical picture is erased, but dyspaurenia and infertility are often observed. Diagnosis of salpingitis includes bimanual examination, bacterioscopic and bacteriological research smears, echography. Treatment of salpingitis is carried out using antibacterial therapy and physiotherapeutic methods. When purulent tubo-ovarian tumors form, laparoscopy is indicated.

Symptoms of salpingitis

Start clinical manifestations salpingitis is usually associated with the end of menstruation. Acute salpingitis manifests with sharp deterioration well-being, accompanied by fever, chills, and pain in the lower abdomen radiating to the sacrum and rectum. Gastroenteral disorders (nausea, flatulence, vomiting), intoxication (weakness, myalgia, tachycardia), functional and emotional-neurotic disorders appear.

The pathognomonic symptom of salpingitis is serous-purulent leucorrhoea from the genital tract and urethra. Dysuric disorders are characterized by frequent urge to urinate, cramps, and the release of urine in small portions. Intestinal disorders manifested by irritable bowel syndrome - frequent loose stools. Often with salpingitis there is severe pain during sexual intercourse.

With subacute salpingitis, health improves, pain decreases, and body temperature becomes low-grade. Chronic salpingitis can occur against the background of satisfactory general condition, normal temperature body, but with persistent pain. Exacerbations of chronic salpingitis are provoked by overwork, hypothermia, stress, and intercurrent infections. If salpingitis is complicated by pyosalpinx, hectic fever develops, chills develop, intoxication increases, and severe symptoms peritoneal irritation. Rupture of the pyosalpinx and discharge of pus into the abdominal cavity can lead to diffuse peritonitis.

Gonorrheal salpingitis differs little in course from the septic form of inflammation, however, with gonorrhea, in addition to the fallopian tubes, the urethra, cervical canal, paraurethral ducts, Bartholin's glands, and rectum are affected. Chlamydial salpingitis occurs more gradually, with symptoms of urethritis, cervicitis, endometritis, and destructive damage to the fallopian tubes. After suffering chlamydial salpingitis, ectopic pregnancy and infertility often develop. Salpingitis of tuberculous etiology has a chronic course; exacerbations are observed in the caseous form of the process.

Diagnosis of salpingitis

Finding out the medical history allows the gynecologist to associate the disease with complicated childbirth, surgical termination of pregnancy, gynecological manipulations, change of sexual partner, etc. When diagnosing salpingitis, they rely on a set of data from physical, laboratory, and instrumental examinations.

Treatment of salpingitis

Acute salpingitis and severe exacerbation of the chronic form require hospital treatment. Important components therapy for salpingitis bed rest, cold on the hypogastric area, gentle diet. Prescription of antimicrobial therapy is based on results bacteriological culture and elucidation of the etiology of salpingitis. Treatment can be carried out with semisynthetic penicillins, cephalosporins, fluoroquinolones, aminoglycosides, macrolides, tetracyclines for 10-14 days. At the same time, nitrofuran derivatives, antifungal agents, NSAIDs, infusion therapy, autohemotherapy. Stimulation of metabolic and microcirculatory processes is carried out by the introduction of vitamins, thiamine pyrophosphate, aloe extract, hyaluronidase.

Salpingitis caused by anaerobic flora and Trichomonas is treated with metronidazole; Treatment of tuberculous and gonorrheal salpingitis is carried out according to the principles of treatment of tuberculosis and gonorrhea. For chronic salpingitis and during the recovery period after an acute process, physiotherapy is widely used -

Preventive measures against salpingitis require gentle implementation of any gynecological interventions, promotion of barrier contraception and safe sex, timely elimination of foci of extragenital and genital infection, and proper hygienic education of girls.

Collapse

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 serosa. 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. Based on the nature of the inflammatory process, serous and purulent salpingitis are distinguished.

Reasons

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.

Often the disease occurs as a complication of chronic inflammation of the 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 immune system, drug addiction, unbalanced diet.

Symptoms

Signs depend on the form of the disease. In acute cases, symptoms are observed that can be confused with appendicitis:

• hyperthermia;
• pain in lower section 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 with an unpleasant odor;
• foamy or liquid leucorrhoea;
• pain and bleeding during intercourse.

With chronic illness, the menstrual cycle is disrupted: periods can be heavy or scanty, 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 tests: 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 of drugs:

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

Symptomatic treatment is prescribed. 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, they are prescribed antibacterial drugs wide spectrum of influence. 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.

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

Droppers

If the tubes are inflamed, droppers with glucose are given. Ascorbic acid is used to regulate the recovery process.

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 disrupted menstrual cycle, manifested by oligomenorrhea ( scanty discharge during menstruation) and algodismenorrhea ( 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. A common complication An ectopic pregnancy is also considered.

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

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When microbes enter the uterine appendages, in most cases an inflammatory process develops on both sides. Bilateral salpingitis, as the first stage of ascending adnexitis, occurs in 70% of women with acute infection vagina and uterus. Quite quickly, the bright manifestations of the disease subside: if treatment is not carried out, then there is a high probability of inflammation turning into chronic form. Sometimes the acute process develops into a complicated form: purulent salpingitis can become the basis for infertility and ectopic pregnancy.

Causes of bilateral pipe damage

All variants of tubal-uterine inflammation can be divided into 2 groups:

• gonorrheal (infection with gonococci always causes damage to the fallopian tubes on both sides);
• non-gonorrheal (chlamydia, Escherichia, staphylococci, streptococci, enterococci), which can be either bilateral or unilateral.

Factors contributing to the spread of infection:

• intrauterine contraceptive;
• performing a medical abortion;
• diagnostic procedures.

First, infection of the inner lining of the fallopian tube occurs with the development of endosalpingitis. Then the inflammation spreads to the muscle layer, which causes swelling, an increase in the size of the fallopian tubes and a pronounced accumulation of inflammatory fluid. Exudate along with microbes enters the stomach, creating conditions for salpingoophoritis. Spontaneously or in the background improper treatment chronic bilateral salpingitis develops, which subsequently manifests itself typical symptoms adnexitis.

Symptoms of the disease

An acute inflammatory process in the fallopian tubes will manifest itself with the following symptoms:

• pain in the lower abdomen on both sides (from dull and aching to strong and cutting);
• vaginal leucorrhoea (from profuse mucous to milky and purulent);
• increased body temperature with chills (if purulent salpingitis occurs).

Possible signs of inflammation in reproductive organs are problems associated with urination (pain, pain, increased frequency, decreased amount of urine). If such complaints arise, you must contact medical assistance to prevent the development of complications.

Methods for detecting bilateral inflammation

Great value for production correct diagnosis has a woman's early visit to the doctor. In the first stages of the disease, when an acute inflammatory process occurs, it is much easier to detect the microbial factor of bilateral salpingitis. Standard studies:

• taking smears from the vaginal wall, cervical canal and urethra;
• bacterial culture from the endocervix to detect gonorrhea;
• definition chronic types infections using a special laboratory diagnostics(PCR).

An ultrasound scan helps the doctor see bilateral changes in the fallopian tubes and the presence of complications associated with inflammation inside the uterus in the ovarian area. If there is a suspicion of a purulent process in the area of ​​the uterine appendages, then laparoscopy (visual examination of the abdominal cavity) will be required to confirm the diagnosis and perform therapeutic procedures.

Treatment

The most significant therapeutic factors for bilateral salpingitis include:

• course of antibacterial therapy using strong drugs and compliance with the optimal duration of medication;
• anti-inflammatory drugs that will help relieve pain and eliminate inflammation in the fallopian tubes;
• droppers with solutions to improve the general condition, reduce temperature and remove toxic substances from blood.

In addition, the doctor will use medicines to increase immune defense, remove vaginal leucorrhoea and correct urinary problems.

Purulent bilateral salpingitis, as a factor of dangerous complications, is an indication for laparoscopic surgery. It is necessary not only to put accurate diagnosis during a visual inspection of the fallopian tubes, but also to create conditions for removing pus and preventing dangerous changes in reproductive system women.

Complications

Two-way inflammatory lesion Fallopian tubes can cause the following dangerous situations:

• repeated ectopic pregnancies;
• infertility;
• the appearance of a purulent tumor in the uterine appendages;
• formation chronic endometritis with menstrual irregularities;
• complications in the 1st trimester of pregnancy (embryo death, spontaneous miscarriage).

Development of bilateral inflammatory changes in the tubes - this is an extremely unpleasant situation that threatens a woman with tubal infertility and high risk surgical interventions. At the first signs of inflammation in the appendages, you should consult a doctor in order to make a timely diagnosis and start treatment as early as possible.

Causes

The most common route of occurrence of salpingitis is ascending, that is, through the vagina; Then the microorganisms move along the cervical canal, enter the uterus itself and come to their final destination - the fallopian tubes. The second path is descending: from sigmoid colon or vermiform appendix. Another way pathogenic microorganisms penetrate the fallopian tubes is through the blood and lymph from any source of infection in the body. The development of the disease through surgical intervention is possible, and most often it is provoked by criminal abortions and operations on the uterus with poorly sterilized instruments. Surgical interventions produced on the uterus and fallopian tubes, leave extensive wound. Damaged epithelium becomes a field for the development of infection after curettage, hysteroscopy and other surgical procedures.

Symptoms of chronic salpingitis

• Pain in the lower abdomen
• Increased body temperature
• Discharge
• Menstrual irregularities
• Painful sexual intercourse
• Female infertility

Diagnostics

In case of chronic salpingitis, hysterosalpingography is used to determine the patency of the fallopian tubes.

Using ultrasound to diagnose salpingitis is ineffective.

Differential diagnosis is often made with impaired tubal pregnancy, acute appendicitis, and ovarian apoplexy.

Types of disease

Types of salpingitis:

• Acute salpingitis
• Chronic salpingitis
• Left-sided salpingitis
• Right-sided salpingitis
• Purulent salpingitis
• Salpingitis with oophoritis

Patient Actions

In case of chronic salpingitis, cooling and overwork should be avoided.

Treatment of chronic salpingitis

At chronic course salpingitis during remission antibacterial therapy(Terzhinan and other drugs) are prescribed only in cases where it has not been done before. To stimulate the body's protective functions, FiBS, aloe extract, placenta extract are used, and autohemotherapy is performed. In case of pronounced adhesive changes in the pelvis, enzyme preparations are prescribed. It is also effective to use rectal suppositories containing lidase, amidopyrine and sodium salicylate.

To enhance nonspecific immunological reactions, as well as increase the body's resistance during persistent remission of the disease, bacterial polysaccharides - pyrogenal and prodigiosan - are used in the protection of antibiotics.

To dissolve adhesions, as well as for pain relief during remission, pulsed ultrasound is used, impulse currents low frequency, as well as a high or ultra-high frequency magnetic field. For chronic salpingitis, acupuncture is also used, which has an analgesic effect, eliminates functional disorders and promotes regression pathological changes. In cases of sactosalpinx or tubo-ovarian formation and in case of ineffectiveness conservative therapy surgical treatment is prescribed.

Complications

Ectopic pregnancy is a dangerous complication of chronic salpingitis.

Prevention of chronic salpingitis

Preventive measures against salpingitis require gentle implementation of any gynecological interventions, propaganda barrier contraception and safe sex, timely elimination of foci of extragenital and genital infections, proper hygienic education of girls.