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Salpingitis
Thefallopiantubesextendfromtheuterus,oneoneachside,andbothopennearanovary.During ovulation,thereleasedegg(ovum)entersafallopiantubeandissweptalongbytinyhairstowards theuterus. Salpingitisisinflammationofthefallopiantubes.Almostallcasesarecausedbybacterialinfection, includingsexuallytransmitteddiseasessuchasgonorrhoeaandchlamydia.Theinflammation promptsextrafluidsecretionorevenpustocollectinsidethefallopiantube.Infectionofonetube normallyleadstoinfectionoftheother,sincethebacteriamigratesviathenearbylymphvessels. Salpingitisisoneofthemostcommoncausesoffemaleinfertility.Withoutprompttreatment,the infectionmaypermanentlydamagethefallopiantubesothattheeggsreleasedeachmenstrual cyclecan'tmeetupwithsperm.Treatmentoptionsincludeantibiotics.Salpingitisissometimes calledpelvicinflammatorydisease(PID).Thisumbrellatermincludesotherinfectionsofthefemale reproductivesystem,includingtheuterusandovaries.

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Symptoms
Inmildercases,salpingitismayhavenosymptoms.Thismeansthefallopiantubesmaybecome damagedwithoutthewomanevenrealisingshehasaninfection.Thesymptomsofsalpingitismay include: Abnormalvaginaldischarge,suchasunusualcolourorsmell Spottingbetweenperiods Dysmenorrhoea(painfulperiods) Painduringovulation Uncomfortableorpainfulsexualintercourse Fever Abdominalpainonbothsides Lowerbackpain Frequenturination Nauseaandvomiting Thesymptomsusuallyappearafterthemenstrualperiod.

Acute and chronic salpingitis

Salpingitisisusuallycategorisedaseitheracuteorchronic.Inacutesalpingitis,thefallopiantubes becomeredandswollen,andsecreteextrafluidsothattheinnerwallsofthetubesoftenstick together.Thetubesmayalsosticktonearbystructuressuchastheintestines.Sometimes,a fallopiantubemayfillandbloatwithpus.Inrarecases,thetuberupturesandcausesadangerous infectionoftheabdominalcavity(peritonitis).Chronicsalpingitisusuallyfollowsanacuteattack. Theinfectionismilder,longerlastingandmaynotproducemanynoticeablesymptoms.

Most cases are caused by bacteria

Innineoutof10casesofsalpingitis,bacteriaarethecause.Someofthemostcommonbacteria responsibleforsalpingitisinclude: Chlamydia Gonococcus(whichcausesgonorrhoea) Mycoplasma Staphylococcus Streptococcus.

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Access to the reproductive system

Thebacteriamustgainaccesstothewoman'sreproductivesystemforinfectiontotakeplace.The bacteriacanbeintroducedinanumberofways,including: Sexualintercourse InsertionofanIUD(intra-uterinedevice) Miscarriage Abortion Childbirth Appendicitis.

Lifestyle risk factors

Lifestylefactorsthatsignificantlyincreaseawoman'sriskofcontractingsalpingitisinclude: Engaginginsexualintercoursewithoutacondom Priorinfectionwithasexuallytransmitteddisease.

Complications of salpingitis
Withouttreatment,salpingitiscancausearangeofcomplications,including: Further infection-theinfectionmayspreadtonearbystructures,suchastheovariesor uterus. Infection of sex partners-thewoman'spartnerorpartnersmaycontractthebacteria andbecomeinfectedtoo. Tubo-ovarian abscess-about15percentofwomenwithsalpingitisdevelopanabscess, whichrequireshospitalisation. Ectopic pregnancy-ablockedfallopiantubepreventsthefertilisedeggfromenteringthe uterus.Theembryothenstartsgrowinginsidetheconfinedspaceofthefallopiantube.The riskofectopicpregnancyforawomanwithpriorsalpingitisorotherformofpelvic inflammatorydisease(PID)isaroundonein20. Infertility-thefallopiantubemaybecomedeformedorscarredtosuchanextentthatthe eggandspermareunabletomeet.AfteroneboutofsalpingitisorotherPID,awoman's riskofinfertilityisabout15percent.Thisrisesto50percentafterthreebouts.

Diagnosis methods
Diagnosingsalpingitisinvolvesanumberoftests,including: General examination-tocheckforlocalisedtendernessandenlargedlymphglands. Pelvic examination-tocheckfortendernessanddischarge. Blood tests-tocheckthewhitebloodcellcountandotherfactorsthatindicateinfection. Mucus swab-asmearistakentobeculturedandexaminedinalaboratorysothatthe typeofbacteriacanbeidentified. Laparoscopy-insomecases,thefallopiantubesmayneedtobeviewedbyaslender instrumentinsertedthroughabdominalincisions.

Treatment options
Treatmentdependsontheseverityofthecondition,butmayinclude: Antibiotics-tokilltheinfection,whichissuccessfulinaround85percentofcases. Hospitalisation-includingintravenousadministrationofantibiotics. Surgery-iftheconditionresistsdrugtreatment.

Where to get help

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Yourdoctor FamilyPlanningVictoriaTel.(03)92570100 Women'shealthcentre Gynaecologist.

Things to remember

Salpingitisisinflammationofthefallopiantubes,causedbybacterialinfection. Commoncausesofsalpingitisincludesexuallytransmitteddiseasessuchasgonorrhoea andchlamydia. Salpingitisisacommoncauseoffemaleinfertilitybecauseitcandamagethefallopian tube. Treatmentoptionsincludeantibiotics.

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