The effectiveness of nonsteroidal anti-inflammatory agents in the treatment of pelvic inflammatory disease: a systematic review

Abstract

BackgroundPelvic inflammatory disease (PID) is the result of infection ascending through the endocervix to the uterus and fallopian tubes. Inflammation driven by infected host cells appears to be central to the development of tissue damage and associated reproductive complications. Nonsteroidal anti-inflammatory agents (NSAIDs) therefore have the potential to reduce the sequelae associated with pelvic infection.MethodsA search of four electronic reference databases, an internet search for relevant grey literature and a review of the bibliographies of identified publications was used to identify studies evaluating NSAIDs in the management of PID. A predefined search strategy was used to identify studies that included women with PID aged over 16 and diagnosed after 1980. Randomized controlled trials, nonrandomized controlled trials, and cohort studies with comparison group data were included without language restriction. Two reviewers independently assessed the studies against agreed criteria and extracted relevant data using a standardized pro forma. A meta-analysis to calculate the relative risk associated with NSAID use was planned if appropriate.ResultsForty-three studies were identified. After reviewing abstracts or full texts, two randomized controlled trials were found to meet the selection criteria for inclusion. The use of NSAIDs was reported to improve tubal patency, reduce pelvic adhesions and reduce suprapubic pain but the studies were of poor quality with a high risk of bias. Meta-analysis of the data was not performed.ConclusionsInsufficient data is available to support or refute the efficacy of NSAIDs in the prevention of short or long-term complications of PID.

Deep functional synthesis: a machine learning approach to gene functional enrichment

“…For example, the query "inflammatory" is expanded to add inflammatory myopathy, immune reconstitution inflammatory syndrome, and pelvic inflammatory disease ( Figure 1C ). Functions associated with more than one inflammatory diseases are in the answer graph, for example the top-ranked gene PTGS2 regulates the inflammatory response by generating prostaglandins (Hata and Breyer, 2004) and plays a key role in both the treatment of pelvic inflammatory disease (Dhasmana et al, 2014) and immune reconstitution inflammatory syndrome (Shankar et al, 2007) .…”

Nonsteroidal anti-inflammatory drugs for management of pelvic pain in women

“…Избыточная экспрессия ЦОГ-2 также связана с повышенным риском онкологических заболеваний женских половых органов, и это является дополнительным основанием для подавления ее активности [6]. Исследований, посвященных проблеме терапии ВЗОМТ с помощью НПВП, мало, и особенности их дизайна затрудняют выполнение метаанализа [7], однако систематизация полученных в этих работах данных позволяет утверждать, что включение НПВП в схемы комплексной терапии острых ВЗОМТ улучшает исходы лечения и долгосрочный прогноз.…”

Pelvic inflammatory disease in the adolescent

“…Inadequate diagnosis and treatment of PID complicated by subclinical PID is an important factor in the development of infertility in adolescent and adult women [28]. Nonsteroidal anti-inflammatory drugs have not been proven to be useful in the prevention of acute or chronic sequelae of PID [58]. The impact of unnecessary surgery with potential negative effects including infertility must be factored into the consequences of PID as well [59].…”