Tubal Infection (P.I.D.)

Infections of the Fallopian Tubes are called โ€œPelvic Inflammatory Disease,โ€ or โ€œPIDโ€ for short; in medical-speak itโ€™s Salpingitis.ย  The Fallopian Tubes carry the egg from the ovary to the uterus (see Diagram —ย  Female Genital System).ย  Bacteria can move up the vagina, through the uterus, and into the tubes.ย  Tubal infection is serious because 1) there’s always a danger of it spreading into the abdomen and blood (Sepsis), which could be fatal; and 2) it can contribute to infertility (eggs can’t travel down scarred tubes).

The main symptom is pain on the right or left lower abdomen or the pelvic area.  There may be fever or vaginal discharge, but maybe just pain.  Diagnosis is made by physical exam (pelvic exam); through the vagina, the clinician can feel the area with tube and ovary, which would be very tender.  We can also wiggle the cervix (first part of the uterus) which will stretch the tube.  This is normally painless, but causes great pain if the tube is infected.

Antibiotics are usually successful in curing the infection; oftentimes we give them IV for more certainty in order to prevent infertility.  In rare cases, the infection has already begun to form an abscess, which would need surgery.  The bacteria responsible may be STDs, or may be bacteria normally found in the vagina or bowel, especially if infection occurs after a gynecological procedure.

Tubal infections can also be chronic, perhaps with no symptoms at all, but nonetheless major causes of infertility (especially with Chlamydia infections). They can also be a cause of painful menstrual periods; we’d suspect this if painful periods began at a later age, not as a teenager (when pain is common at first). We might be able to diagnose Chronic P.I.D. by an ultrasound, certainly if there’s an Abscess. But sometimes a surgical laparoscopy is necessary to find lower-grade tubal infections.

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