Second look laparoscopy; evaluation of two different antibiotic regimens after treatment of acute salpingitis

Brihmer, Christina; Kallings, Ingegerd; Nord, Carl Erik; Brundin, Jan

doi:10.1016/0028-2243(89)90011-7

Cited by 15 publications

(3 citation statements)

References 11 publications

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“…A second report found that cervical C. trachomatis isolation was not associated with increased severity of tubal damage in 64 patients with acute PID assessed by laparoscopy. 21 These findings contrast with a Canadian report in which infertility occurred significantly more often with nongonococcal (seven of 13 cases) than gonococcal (zero of 10 cases) PID. 9 Four of the seven infertile patients initially had a tubo-ovarian abscess, and three had culture (one patient) or serologic (two patients) evidence of C. trachomatis infection with the acute episode of PID.…”

Section: Discussioncontrasting

confidence: 78%

Infertility following pelvic inflammatory disease

Pavletic

Wølner‐Hanssen

Hawes

et al. 1999

Infect. Dis. Obstet. Gynecol.

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Objective To assess the frequency of infertility after pelvic inflammatory disease (PID) and factors important in postinfectious tubal damage in an urban population at high risk for sexually transmitted diseases. Methods From a cohort of 213 women with PID documented by laparoscopy and/or endometrial biopsy, 58 women (27% of the initial cohort) were interviewed by phone 2 to 9 years after an index episode of PID. Data regarding the initial history, physical examination, microbiology, laparoscopic, and serologic findings, and data concerning interval contraception, subsequent pregnancy, subsequent infection, and chronic pelvic pain were compared among those with and without infertility at follow up. Results Nineteen (40%) of the 48 women not using contraception were involuntarily infertile after the index episode of PID. Compared with those who had an interval pregnancy, infertile women were older (P = 0.02), more likely to have a history of infertility prior to the index episode of PID (P = 0.001), and were more likely to have occluded or partially occluded fallopian tubes (P = 0.03), peritubal adhesions (P = 0.007), or perihepatic adhesions (P = 0.02) seen by laparoscopy performed during the index episode. Surprisingly, recovery of Chlamydia trachomatis was negatively related to infertility (P = 0.001), although a similar proportion of both groups had chlamydia immunoglobulin M antibody (40% vs. 31%). Chlamydia heat shock protein was weakly related to infertility (P = 0.08). The isolation of Neisseria gonorrhoeae was not significantly different between groups (53% vs. 57%). Conclusions The high rate of postinfection infertility found was probably related to a combination of tubal damage before and during the index episode of PID. Prevention of recurrent PID and better understanding of the pathophysiology of postinfection tubal damage (which may differ between chlamydia and gonorrhea) is needed to develop more effective strategies to reduce permanent tubal damage. Infect. Dis. Obstet. Gynecol. 7:145–152, 1999. © 1999 Wiley‐Liss, Inc.

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Section: Discussioncontrasting

confidence: 78%

Infertility following pelvic inflammatory disease

Pavletic

Wølner‐Hanssen

Hawes

et al. 1999

Infect. Dis. Obstet. Gynecol.

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“…Prospective evidence: following pelvic inflammatory disease forward to tubal factor infertility A number of prospective studies 228,[240][241][242][251][252][253][254] have followed up women with PID to infertility-related outcomes. However, there are major differences in the way that exposures and outcomes have been defined.…”

Section: Outline Of Evidence Sources and Approach To Synthesismentioning

confidence: 99%

The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis

Price

Ades

Soldan

et al. 2016

Health Technol Assess

377

151

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“…Second-look laparoscopy is the fastest and easiest technique to evaluate the effect of treatment of PID on the anatomy and function of the Fallopian tubes (Wølner-Hanssen and Weström., 1983;Teisala et al, 1987;Brihmer et al, 1989). However, thorough epidemiological studies of overall outcomes following PID are extremely difficult.…”

Section: Morbidity Following Pidmentioning

confidence: 99%

Chlamydial pelvic inflammatory disease

Paavonen

Lehtinen²

1996

Human Reproduction Update

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Pelvic inflammatory disease (PID) is the most important complication present in the female lower genital tract, causing major medical, social and economic problems. Although PID can be caused by multiple microorganisms, it results most frequently from the ascent of sexually transmitted Chlamydia.trachomatis or Neisseria gonorrhoeae infections from the cervix to the upper genital tract. The importance of cervical chlamydial infection in the pathogenesis of PID is well recognized. Recent data from many developed countries have shown a striking decrease in the incidence of gonococcal infections, while the rates of chlamydial infections remain high in most countries. Complications of PID are common and usually irreversible. Emerging evidence suggests that universal or selected screening of defined populations for cervical chlamydial infection leads to a dramatic reduction in the incidence of PID. Recent technological advances should further enhance efforts to prevent chlamydial infection and PID. Gene amplification-based diagnostic tests, screening by testing first-void urine, and single dose antimicrobial therapy greatly facilitate chlamydia control programmes. Thus, screening for chlamydia is the key approach in the secondary prevention of PID. The obvious challenge is to make screening for chlamydia the standard for health care for young, sexually active individuals. Since PID is the most important consequence of sexually transmitted bacterial infections, it is also imperative to develop better treatments to prevent the long-term sequelae of this disease. The development and implementation of new and effective intervention programmes for prevention and control of PID is one of the major challenges for the year 2000 and beyond.

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Second look laparoscopy; evaluation of two different antibiotic regimens after treatment of acute salpingitis

Cited by 15 publications

References 11 publications

Infertility following pelvic inflammatory disease

Infertility following pelvic inflammatory disease

The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis

Chlamydial pelvic inflammatory disease

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