What is pyosalpinx?

Pyosalpinx is a condition in which the fallopian tube fills up and swells with pus. The fallopian tube is the part of the female anatomy that connects the ovaries to the uterus. Eggs travel from the ovaries through the fallopian tube, and to the uterus.

Pyosalpinx is a complication of pelvic inflammatory disease (PID). PID is an infection of a woman’s reproductive organs. Pyosalpinx happens in about of all PID cases. Pyosalpinx can also be caused by other types of infections, such as gonorrhea or tuberculosis. It’s most common in women ages 20 to 40.

What are the symptoms?

Not every woman has symptoms from pyosalpinx. When symptoms do occur, they can include:

  • pain in the lower belly that is constant, or that comes and goes
  • painful lump in the lower belly
  • pain before your periods
  • fever
  • pain during sex

Infertility may also be a sign of pyosalpinx. That’s because eggs must travel down the fallopian tube to be fertilized and implant in the uterus. If the fallopian tubes are blocked with pus or get damaged by pyosalpinx, you will not be able to get pregnant.

What causes this condition?

You can get pyosalpinx if you have untreated PID. PID is an infection of the female reproductive tract that is caused by sexually transmitted diseases (STDs) like chlamydia and gonorrhea. Other types of infections, including tuberculosis, can also cause this complication.

When there’s an infection in your body, your immune system sends out an army of white blood cells to fight it. These cells can become trapped inside your fallopian tube. A buildup of dead white blood cells is called pus. When the fallopian tube fills with pus, it swells and expands. This causes pyosalpinx.

How is it diagnosed?

Tests that help your doctor diagnose pyosalpinx include:

Pelvic ultrasound

This test uses sound waves to create pictures of your fallopian tubes and other pelvic organs. During the test, the technician puts a special gel on a device called a transducer. The transducer is either placed on your abdomen or inserted into your vagina. The ultrasound creates images of your reproductive organs on a computer screen.

Pelvic MRI

This test uses strong magnets and radio waves to create pictures of your pelvic organs. You might get an injection of a special dye before the test. This dye will make your organs show up more clearly on the pictures.

During the MRI, you will lie on a table, which will slide into a machine. You may hear a thumping noise during the test.


To confirm your diagnosis, your doctor might examine your fallopian tubes with this surgical procedure. You will be asleep during a laparoscopy. The surgeon will first make a small cut near your belly button and fill your abdomen with gas. The gas gives the surgeon a clearer view of your pelvic organs. Surgical instruments are inserted through two other small incisions.

During the test, your doctor will examine your pelvic organs, and may remove a sample of tissue for testing. This is called a biopsy.

How is it treated?

Your doctor will treat PID with antibiotics.

You may also need surgery if pyosalpinx is chronic and you have symptoms. The type of surgery your doctor recommends depends on the severity of your condition.

Surgery options include:

  • Laparoscopy. This procedure can be used to remove the pus without damaging your fallopian tubes or ovaries.
  • Bilateral salpingectomy. This surgery can be used to remove both fallopian tubes.
  • Oophorectomy. This surgery is used to remove one or both ovaries. It may be done together with a salpingectomy.
  • Hysterectomy. This surgical procedure removes part or all of your uterus, possibly along with your cervix. It may be done if you still have an infection.

If your doctor is able to treat pyosalpinx with laparoscopy, you may be able to preserve your fertility. Removing your fallopian tubes, ovaries, or uterus will affect your ability to get pregnant.

Can you prevent pyosalpinx?

Pyosalpinx isn’t always preventable, but you can lower your risk of getting PID by following these tips:

  • use condoms whenever you have sex
  • limit the number of different sex partners you have
  • get tested for STDs like chlamydia and gonorrhea, if you test positive, get treated with antibiotics
  • don’t douche, it increases your risk for infection.


Depending on the severity of your condition, you may be able to preserve and restore fertility following treatment for pyosalpinx. In other cases, you may need surgery that will affect fertility. Let your doctor know if you may consider children in the future before beginning any treatment plans.