Gonococcus affects tubes mainly by _________

Gonococcus ascends up to the tube mainly mucosal continuity and contiguity, which is facilitated by sexually transmitted vectors such as sperms and Trichomonas. The mucous membrane is first affected and it is edematous, infiltrated with leucocytes and plasma cells. Another route is through reflux of mucosal blood. Mycoplasma spreads across parametrium Lymphatics are involved in spread of secondary organisms and PID following post-aboal and pueperal infection. Organisms from gut affect tubes directly. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 339