A study of second-look laparoscopy after acute salpingitis

B. Gerber, A. Krause
In: Archives of Gynecology and Obstetrics · 1996 · vol. 258(4) , pp. 193–200 · doi:10.1007/s004040050123 · PMID:8844136 · W2015672862
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This study assessed second-look laparoscopy after acute salpingitis and found it accurately predicted reproductive function, with bilateral tubal occlusion strongly correlating with infertility and pelvic adhesions.

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This retrospective study evaluated whether second-look laparoscopy with tubal dye insufflation could predict later reproductive function in women previously treated for laparoscopically proven acute salpingitis, analyzing 69/158 women with at least two years of involuntary infertility and mean follow-up of 76 months. Bilateral tubal occlusion was present in 21.7% overall and increased with AS severity, while infertility during follow-up varied by stage (9.5%, 35%, and 39.9% for stages I–III). Among women with proven bilateral tubal occlusion, 80% had involuntary infertility, and test performance metrics for predicting subsequent infertility were reported as specificity 85.2%, sensitivity 80%, and positive predictive value 84.1%, with pelvic adhesions correlated with tubal occlusion and chronic pelvic pain. The paper’s main caveat is that it relies on a selected subgroup of women with prolonged infertility rather than all women treated for acute salpingitis. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract. Acute salpingitis (AS) has a major impact on the reproductive health of women. In this study second-look laparoscopy was assessed for its ability to predict reproductive function after AS. We questioned 158 women who had had a second-look laparoscopy with tubal dye insufflation after laparoscopically proven AS between September 1984 and August 1989. The answers of 69 women with at least two years of involuntary infertility were analyzed. The mean follow-up period was 76 months (range 53–108 months). Second-look laparoscopy revealed bilateral tubal occlusion in 21.7% (15/69). Bilateral tubal occlusion was found in 9.5% (2/21) after mild stage, 20% (4/20) after moderate stage and 32.1% (9/28) after severe stage AS. The rate of infertility during follow-up was 9.5% (stage I), 35% (stage II) and 39.9% (stage III). Eighty per cent (12/15) of women with proven bilateral tubal occlusion after treated AS had involuntary infertility, and 14.8% (8/54; P=0.000001) of women with one or both tubes patent also had infertility. Specificity, sensitivity and positive predictive value for subsequent infertility were 85.2%, 80% and 84.1%, respectively. Pelvic adhesions (21/69) were strongly correlated with bilateral tubal occlusion (8/21; 38.1%; P=0.029), a history of chronic pelvic pain (14/21; 66.7%; P=0.00024), as well as failure to achieve an intrauterine pregnancy (10/21; 47.6%; P=0.024). Recurrent pelvic infections occurred in 16% (12/69) and ectopic pregnancies in 7.3% (5/69). Operations for infertility and pelvic pain (excluding ectopic pregnancy), were carried out in 11.6% (8/69). We conclude that second-look laparoscopy after treated AS have accurate evaluation of reproductive function. Similar content being viewed by others Author information Authors and Affiliations Additional information Received: 10 January 1996 / Accepted: 29 April 1996 Rights and permissions About this article Cite this article Gerber, B., Krause, A. A study of second-look laparoscopy after acute salpingitis. Arch Gynecol Obstet 258, 193–200 (1996). https://doi.org/10.1007/s004040050123 Issue date: DOI: https://doi.org/10.1007/s004040050123

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