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Query: UMLS:C0003615 (appendicitis)
 4,439 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a retrospective study the frequency of infertility was estimated in women operated for perforated or non-perforated appendicitis before the age of 25. Of the 48 patients with simple perforation 19% were infertile, while this frequency was 31% in 16 patients with Douglas abscess. In the control group of 58 patients 12% could not have children. It is concluded that it is unlikely that appendicitis with perforation will cause infertility unless there is a Douglas abscess.
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PMID:Infertility as a complication of perforated appendicitis. Late follow-up of a clinical series. 52 87

In September-December 1988 in Australia, at least 1495 couples in metropolitan Perth completed a questionnaire as a part of a study to measure the extent of infertility (inability to conceive after 12 months on unprotected intercourse) and sterility (surgical procedure responsible for end of reproductive function) and to examine their characteristics and associations. 22.6% of all couples had no children. 53 couples (3.5%) suffered from current infertility. It was highest among 30-34 year old women (4.2%). 285 women (19.1%) had experienced infertility at some time in their lives. Lifetime cumulative incidence of ever having been infertile was 22.8%. Lifetime infertility was significantly associated with multiple sexual partners (p = .04), pelvic inflammatory disease (p = .0001), and appendicitis with rupture (p .0001). Tubal pathology and male problems were the leading causes of infertility. 555 couples (37.1%) experienced surgical sterility. Just 2% of these 555 couples had an associated reproductive disability (inability to achieve desired level of reproductive function). Sterility prevalence was greatest among 40-44 year old women (72.2%). Contraceptive sterilization was the major reason for surgical sterility. 47 couples (3.1%) had reproductive disability. They comprised 36 infertile couples and 11 surgically sterile couples. 10 of the surgically sterile couples regretted their decision to undergo sterilization. 48.9% of all reproductive disabled couples had at least 1 child. 23 of the 47 couples sought medical treatment for reproductive disability. Reproductive disability peaked at 30-34 years old (female partner's age). Medical intervention allowed .9% of all women (14 women) in the survey to conceive. These results indicated a need to develop a strategy to prevent reproductive disability, especially infertility.
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PMID:A survey of infertility, surgical sterility and associated reproductive disability in Perth, Western Australia. 129 86

Infertility is secondary to pelvic adhesions in 15-20% of cases. Pelvic adhesions result from pelvic inflammatory disease, previous pelvic surgery, foreign bodies and previous appendicitis with pelvic abscess. As a result of the insult to the peritoneal surfaces of the pelvic organs, the concentrations of peritoneal fluid leukotriene, B4 and prostaglandin E2 are increased. Also, there is a decrease in plasminogen activity. The end result will be the formation of fibrin deposits, which will end in the formation of pelvic adhesions. The diagnosis of adhesions can be achieved by a high index of suspicion in patients with a history of pelvic infections or surgery. A pelvic examination with fixation of the uterus and/or adnexa is also highly suggestive. A hysterosalpingogram might lead to a suspicion of the presence of pelvic adhesions; however, there is some degree of false-positive and -negative results. The definitive diagnosis depends on laparoscopy. The use of an internationally accepted classification, such as that of the American Fertility Society, allows investigators to compare the results of treatment. Various adjuvants have been used following lysis of adhesions to prevent their recurrence; they yield various results. The most significant recommendation is to prevent the occurrence of adhesions by following the principles of microsurgical technique during every surgical procedure.
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PMID:Pathophysiology of pelvic adhesions. Modern trends in preventing infertility. 137 47

A study was undertaken to determine fertility status in a group of adult females who as children had been operated on for perforated appendicitis between 1957 to 1975. The 389 girls operated on for perforated appendicitis were reviewed. Their ages ranged from 10 months to 13 years at the time of appendicectomy. Of these girls, 276 were now 20 to 43 years old, and they were contacted by means of a mail questionnaire, and personal interview wherever necessary. It proved possible to contact 181 women; 102 of them were married and 79 were unmarried. Eight-four of the married women (82%) had one or more children. Nine unmarried women also had one or more children. Eighteen married women who have no children were studied in detail. Five women were on contraceptives, two desired pregnancy but had not conceived, and one patient was separated from her husband. Two patients had conceived and aborted, and two were married to infertile men. Of the remaining six patients who had been investigated for infertility, no demonstrable cause of infertility was found in three. Of the other three patients, one showed evidence of bilateral tubal occlusion secondary to pelvic inflammatory disease, one has had a right ectopic pregnancy followed by two abortions, and the third patient was found to have a pituitary adenoma. Our data show that perforated appendicitis before puberty has little if any role in the aetiology of tubal infertility.
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PMID:Fertility following perforated appendicitis in girls. 273 21

A case of fistula between the right salpinx and appendix, most probably caused by untreated appendicitis, is presented. The patient was admitted to hospital because of involuntary infertility.
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PMID:[Salpingo-enteric fistula demonstrated by hysterosalpingography (HSG)]. 278 68

In a retrospective study the frequency of infertility was estimated in 41 women operated for perforated appendicitis from the catchment area of Huddinge University Hospital. As a control group we selected an identical number of females of the same age, social and national background. About 85% of the subjects in both groups answered the questionary. Excluding a large number of voluntarily childless women, there were 5 instances out of 20 (25%) in the patient group and 1 out of 24 (4.2%) in the control group of unvoluntary childlessness. We found the incidence of 25% of unvoluntary infertility in the perforation group noticeable, although statistically not significant.
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PMID:Infertility in young women due to perforated appendicitis? 346 Feb 92

We studied the importance of a history of appendectomy for appendicitis in 279 women with laparoscopically or surgically diagnosed tubal infertility and a control group of 957 fertile women. After controlling for the effects of age, use of an intrauterine device for contraception, a history of pelvic inflammatory disease, and other potential confounding variables, we found that no excess risk of tubal infertility was associated with a simple appendectomy without rupture. However, when the operation was reportedly for a ruptured appendix, the relative risk of tubal infertility was 4.8 (95 percent confidence interval, 1.5 to 14.9) for women who had never been pregnant and 3.2 (95 percent confidence interval, 1.1 to 9.6) for women with one or more previous pregnancies. We conclude that the early diagnosis and treatment of suspected appendicitis in girls and women of reproductive age may reduce the incidence of tubal infertility resulting from the sequelae of a ruptured appendix.
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PMID:Appendectomy and the risk of tubal infertility. 378 7

An analysis was made of the history of 302 patients who underwent laparotomy for tubal infertility. The following potential risk factors and their relationship to the pregnancy rate and outcome of pregnancy were studied: various groups of gynecological laparotomy, salpingitis, gonorrhoea, complicated and uncomplicated appendicitis, induced and spontaneous abortion and IUD-usage. 234 of the 302 patients (77.5 per cent) had one or more of the potential risk factors in their history. Salpingitis was the most frequent risk factor (36.1 per cent). Regarding pregnancy rate after tubal surgery the most serious risk factor was a previously performed gynecological laparotomy, followed by salpingitis, gonorrhea and complicated appendicitis. We found a gradual decrease in the pregnancy rate with increasing number of risk factors.
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PMID:Pregnancy rates after tubal surgery in different etiological groups of infertility. 383 10

Between the years 1977 and 1982, laparoscopy was performed on 900 patients where the diagnosis of infertility was made in our department. In the patients' histories events which were considered relevant to subsequent tubal pathology were studied in detail. These potential risk factors were further analyzed and related to the finding of tubal pathology at the time of diagnostic laparoscopy. Patients with moderate or severe endometriosis were excluded from this study, because the high incidence of tubal adhesions in these women rendered it impossible to analyse the relationship between potential risk factors in the patients' histories and the incidence of tubal infertility. The incidence of tubal disease in patients with only one risk factor was compared to patients with no such factors in their history. The incidence of tubal pathology was significantly higher in all categories except the group who had undergone only uncomplicated appendicectomy. Highly significant differences were found after salpingitis, ovarian cystectomy or wedge resection and "complicated" appendicitis. The risk of a low-grade salpingitis was increased after induced abortion and IUD usage. The incidence of tubal pathology (33.7%) in patients without risk factors lends support to the assumption that salpingitis can occur without obvious clinical symptoms and appears to justify laparoscopy and use of antibiotic treatment if salpingitis is suspected in young women, even though clinical symptoms are absent.
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PMID:[Etiologic factors in tubal sterility]. 665 3

An analysis was made of the history of 820 patients who underwent diagnostic laparoscopy for reasons of infertility. Events in the patient's history related to abdominal surgery, infection of the genital tract, and endometriosis were compared with the incidence of tubal disease at laparoscopy. Salpingitis, puerperal endometritis, gynecologic operations such as ovarian cystectomy, wedge resection, and operative correction of uterine retroversion and appendicitis complicated by perforation of the appendix, inflammatory mass, or appendiceal abscess, were all associated with a significantly higher incidence of tubal disease. In patients who had undergone an uncomplicated appendectomy, the occurrence of tubal abnormalities was not increased (42%) when they were compared with the group with a completely negative history (37%). Implications of these findings with relation to the prevention of tubal disease are discussed.
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PMID:Etiological factors in tubal infertility. 706 Jul 89


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