Updated French guidelines for diagnosis and management of pelvic inflammatory disease

Brun, Jean‐Luc; Graesslin, Olivier; Verdon, Renaud; Agostini, Aubert; Bourret, Antoine; Derniaux, E.; Garbin, O.; Huchon, Cyrille; Lamy, Catherine; Quentin, Roland; Judlin, P

doi:10.1016/j.ijgo.2015.11.028

Cited by 36 publications

(37 citation statements)

References 14 publications

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“…Nowadays, surgery is suggested as the routine treatment for TOA in some guidelines [14], but whether patients benefit from an initial laparoscopic treatment is still debatable. Therefore, the aim of the present study was to retrospectively analyze the patients who were diagnosed with TOA or pelvic abscess in order to examine the benefits and adverse events of early laparoscopic treatment for TOA or pelvic abscess.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Chu

Liang

et al. 2019

Gynecol Obstet Invest

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Background/Aim: We aimed to assess the value of early laparoscopic therapy in management of tubo-ovarian abscess (TOA) or pelvic abscess. Methods: This was a retrospective study of all consecutive patients who were initially diagnosed with TOA or pelvic abscess at the local hospital between January 2010 and December 2014. The risks of operation and recurrence were analyzed using logistic analyses. Results: The durations of body temperature > 38.0°C (p = 0.001) and hospitalization (p < 0.001) were longer in the conventional group versus the early laparoscopy group. In the conventional group, 15 (50%) patients finally underwent laparoscopic exploration. The abscess size in the late laparoscopic group was significantly larger than the successful antibiotic treatment group (6.3 ± 1.5 vs. 4.9 ± 1.2 cm, p = 0.010). Abscess > 5.5 cm was independently associated with antibiotic failure (OR 4.571; 95% CI 1.612–12.962). Compared with late laparoscopy, early laparoscopy was associated with a shorter operation time (p = 0.037), less blood loss (p = 0.035), and shorter durations of body temperature > 38.0°C (p < 0.001) and hospitalization (p < 0.001). The cost was the lowest in the patients successfully treated conservatively. Conclusion: Early laparoscopic treatment is associated with shorter time of fever resolution, shorter hospitalization, and less blood loss compared with conventional treatment for TOA or pelvic abscess.

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Section: Introductionmentioning

confidence: 99%

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Chu

Liang

et al. 2019

Gynecol Obstet Invest

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“…In particular, the development of minimally invasive techniques has greatly advanced the surgical treatment of TOA (11). However, whether patients benefit from early laparoscopic surgery remains controversial (12). The present study aimed to retrospectively analyze patients diagnosed with TOA or pelvic abscess to further explore whether early laparoscopic treatment provides a benefit.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess

Jiang¹,

Shi

Miao³

et al. 2019

Exp Ther Med

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Broad-spectrum antibiotics are the conservative treatment for tubo-ovarian abscess (TOA) or pelvic abscess, but the failure rate of antibiotic therapy remains higher in patients with a larger abscess. The present study aimed to evaluate the clinical value of early laparoscopic therapy in the management of TOA or pelvic abscess. A total of 100 patients were enrolled and their medical records were retrospectively analyzed after excluding 6 patients with malignant diseases. Based on the treatment they had received, the patients were divided into a conservative treatment group (n=41) and an early laparoscopic treatment group (n=53). In the conservative treatment group, 21 patients (51.2%) finally received laparoscopic exploration (late laparoscopic treatment group), and 20 patients (48.8%) achieved a success of antibiotic therapy (successful antibiotic therapy group). The cut-off value of abscess size for predicting antibiotic treatment failure was determined using receiver operating characteristic curve analysis. Multivariate logistic regression analyses were used to explore the association between the clinical variables and antibiotic therapy failure in conservative treatment group. The durations of elevated temperature >38.0°C and hospitalization were significantly longer in the conservative treatment group than those in the early laparoscopic treatment group (all P<0.001). The patients in the late laparoscopic treatment group had a larger abscess size than those in the successful antibiotic therapy group (6.2±1.8 cm vs. 4.8±1.4 cm, P=0.008). An abscess diameter of 5.5 cm was obtained as the cut-off of antibiotic failure, and the sensitivity and specificity were 81.0 and 85.0%, respectively. An abscess diameter of ≥5.5 cm was independently associated with antibiotic failure (odds ratio=5.724; 95%CI: 2.025–16.182; P=0.001). In conclusion, early laparoscopic treatment was associated with a better clinical prognosis than conservative treatment and late laparoscopic therapy for TOA or pelvic abscess patients.

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“…In some cases of PID among virgin female patients, there was a history of abdominopelvic surgery such as for congenital bowel abnormality, fecal incontinence, or appendectomy owing to a perforated appendix. Possible causes of PID include postsurgical complications and congenital defects such as salpinges dysmotility owing to an innervation disorder or damage to ciliated mucosal cells (6,(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Pyosalpinx in a Virgin Female Patient Misdiagnosed with Adnexal Torsion: A Case Report and Narrative Review

Kazemi¹,

Arab²,

Hosseini³

et al. 2019

Iran Red Crescent Med J

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Introduction: Pelvic inflammatory disease (PID) is an infection of the upper genital tract often caused by ascending sexually transmitted infection. However, this condition is very rare in preadolescent and adolescent virgin females who are not sexually active. Pyosalpinx is a complication of PID and a cause of acute abdominal pain misdiagnosed due to similar abdominal emergencies. Case Presentation: A 14-year-old virgin female patient was admitted to the Emergency Department of a secondary care general Hospital in Birjand City, South Khorasan Province, Iran, in 2017. She presented with abdominal pain, nausea, vomiting, and fever started two days earlier. She had no history of vaginal discharge. Ultrasound findings indicated enlargement of the right ovary and a hypo-echogenic mass surrounded by a fluid; adnexal torsion suspected. Another cystic lesion with a thick wall and 14 mm diameter was detected in the left ovary. The patient underwent appendectomy four years earlier. Laparatomy performed due to acute abdomen and pyosalpinx was real diagnosis. The PubMed, Scopus, Clinical Key, and Up To Date were searched for articles published in the English language up to 2017, using various combinations of the following keywords (MeSH terms were not used): pyosalpinx, virgin, intact, entire, virtuous, Vestal, pure, and maiden. Conclusions: Although rare, it is important to keep the pelvic infection in mind in the differential diagnosis of virgin female patients presenting with clinical symptoms of an acute abdomen, especially in the ones with the history of gastrointestinal and urinary tract infection or surgery.

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Updated French guidelines for diagnosis and management of pelvic inflammatory disease

Abstract: Current management of PID requires easily reproducible investigations and treatment, and thus can be applied worldwide.

Cited by 36 publications

References 14 publications

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess

Pyosalpinx in a Virgin Female Patient Misdiagnosed with Adnexal Torsion: A Case Report and Narrative Review

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