Tratamentul laparoscopic al bolilor pelvine inflamatorii şi implicaţiile infertilităţii

Introduction. Genital infections, in both men and women, may cause permanent functional damage to the reproductive tract, resulting in infertility. In men, post-infection infertility is uncommon, whereas in women sequelae after pelvic inflammatory disease (PID) are the most common cause of acquired infertility. The objective was to assess if laparoscopy can improve the outcome in term of infertility in patients with pelvic inflammatory disease. Materials and method. We conducted a descriptive retrospective cohort study in our clinic (Bucur Maternity from Bucharest) between 2016 and 2018 among patients who were admitted for PID. Patient’s age, parity, the anatomoclinical form of the disease, the presence of infertility before and after treatment, the type of surgery and the outcome were assessed. Results. 267 patients with PID were admitted in the three years of the study. Forty-three underwent surgery, of which 18 were laparoscopic. Five patients (28%) suffered from primary or secondary infertility prior to surgery. Almost half of the laparoscopies were performed for unilateral or bilateral sactosalpinx; there were two cases of both endometriosis and PID, two cases of adnexal tumors, one case of bilateral pyosalpinx, and one case of haematosalpinx. The evolution was uneventful in all cases. The patients were followed for a mean period of 12 months after surgery, and hysterosalpingography was performed in order to assess tubal patency. We encountered tubal obstruction in 60% of the cases where tubes were preserved. Conclusions. Minimally invasive surgery is justified in order to diagnose, treat and prevent further fertility implications in patients with PID.