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Query: UMLS:C0242172 (pelvic inflammatory disease)
 3,755 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred nineteen Jamaican women who underwent myomectomy from 1964 to 1969 were followed up for 5 to 9 years. Infertility was the most common presenting complaint. Preoperative hysterosalpingograms were performed on 61 patients and were abnormal for the majority of these patients. Surgery revealed submucous fibroids in 41 patients and pelvic inflammatory disease in 51 patients. The pregnancy rate following myomectomy was 18.5%, but successful outcomes occurred in only 9.2% of the cases. Pregnancy was unsuccessful for all patients who underwent both myomectomy and tuboplasty. Twenty-three patients had a recurrence of myoma, and 13 of these underwent subsequent hysterectomy.
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PMID:Myomectomy in infertile Jamaican women. 2 71

A total of 415 women treated for laparoscopically verified pelvic inflammatory disease (PID) were reviewed after 9.5 years. Of these, 88 (21.2 per cent) were involuntarily childless after one or more infection; in 72 cases (17.3 per cent) this was due to tubal obstruction; 263 (63.4 per cent) women became pregnant; 64 (15.4 per cent) were voluntarily childless. Tubal occlusion was diagnosed after one infection in 12.8 per cent, after two infections in 35.5 per cent, and after three or more infections in 75 per cent of the women. Tubal occlusion was more common after nongonorrheal than after gonorrheal salpingitis. Infertility varied with the inflammatory changes seen at laparoscopy. The ratio between ectopic and intrauterine pregnancies after the infections was 1/24. Chronic abdominal pain was reported by 18.1 per cent of the women. Corresponding findings in 100 healthy control subjects were: involuntary childlessness in three despite normal Fallopian tubes, one ectopic in 147 intrauterine pregnancies, and chronic abdominal pain in five cases.
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PMID:Effect of acute pelvic inflammatory disease on fertility. 12 23

The primary use of laparoscopy is as a surgical tool, with sterilizations being the overwhelming indication. The laparoscope is used less frequently as a non-surgical tool, with the major indication being for diagnosing infertility and/or amenorrhea, and for evaluation of obscure pelvic pain. There would seem to be several indications for laparoscopy that have been neglected, these being in confirming the diagnosis of acute pelvic inflammatory disease; in the evaluation of malignancies and abdominal-pelvic trauma; and the surgical treatment of pelvic pain. Lapar-The majority of these contraindications are relative, and depend soley on the laparoscopist's ability and his clinical judgment. The problems of hernias seem to have been over-emphasized. The laparoscopist should be aware of potential problems with umbilical hernia, and he probably can ignore hiatal hernias except when they are large and quite symptomatic. However, generalized abdominal peritonitis, significant hemoperitoneum with intestinal obstruction are felt by most authors to be absolute contraindications. The most frequent complications of laparoscopy involve the physoperitoneum. Except for cardiac arrest the most serious complications involve electrical burns to small bowel.
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PMID:Indications, contraindications and complications of laparoscopy. 12 9

Laproscopic sterilization techniques and the diagnostic use of laparoscopy are discussed. In a series of 1000 laparoscopic sterilizations by the 2-incision technique, there was a total failure rate, surgical and operative, of .4%. In a similar series with the 1-incision technique and electrocagulation only, the total failure rate was 1.6%, though the complication rate was considerably reduced. The high failure rate was attributed to incomplete transection resulting in recanalization. The failure rate with a single-incision, 3-burn technique was .25% in a series of 2000 patients, and complications were few. Tubal occlusion with hemoclips has produced poor results (failure rate: 8-27%). The results with silastic bands, however, have been comparable to those for electrocoagulation, but with fewer complications. Means by which the cost of laparoscopic equipment may be reduced are discussed. Laparoscopy can be helpful in the diagnosis of infertility-endocrinology, ectopic pregnancy, pelvic pain, pelvic inflammatory disease, adnexal masses, and the retrieval of foreign bodies in the pelvic region. Contraindications to laparoscopy are reviewed. It is concluded that laparoscopy is a safe and effective means of sterilization on an outpatient basis, and is of value in the diagnosis of gynecologic disorders.
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PMID:Laparoscopy. 13 20

Laparoscopy was utilized as the final step in the infertility investigation of 155 indigent patients. Unnecessary laparotomy was avoided in 72 (46 per cent) of these patients. Depending upon the endoscopic findings, the presence of additional infertility factor(s) either positively or negatively affected prognosis. With the same anesthetic, 83 (54 per cent) of the 155 patients underwent conservative infertility operations. Unless even greater selectivity can be achieved by prior diagnostic laparoscopy, the postoperative term pregnancy rate (11 per cent) does not justify infertility operations in a population prone to pelvic inflammatory disease, particularly in those individuals with other infertility factors.
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PMID:Diagnostic laparoscopy: a prognostic aid in the surgical management of infertility. 13 12

Tubal factors account for 50% of the causes of female sterility. Laparoscopic tubal surgery to correct infertility is absolutely contraindicated when tubal occlusion is due to genital tuberculosis, in the presence of thickened sclerotic tubes, in the presence of pelvic inflammatory disease, and in women over 37. Results of reconstructive tubal surgery for infertility have not been very successful in the past; however, improvement in technique and in the selection of patients have recently made the procedure more successful. Interventions to cure sterility include salpingolysis and ovairolysis, dilatation of fimbrial phimosis, salpingotomy, and tubouterine anastomosis for cornual occlusion of the tubes. Intrauterine pregnancy rates after such interventions vary greatly among the different authors. Tubal reanastomosis, and tubouterine implantation are becoming almost a common intervention, since the number of women seeking reversal of sterilization is definitely on the increase. In this case also, pregnancy rates vary greatly. It is very important to closely follow patients after reconstructive tubal surgery, and to keep in mind the possibility of ectopic pregnancy after any type of tubal surgery.
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PMID:Reconstructive surgery of the oviduct. 14 Feb 42

From June 1974 to March 1975, 138 patients in Malawi who were suffering from infertility were examined for schistosoma ova by rectal biopsy. 42 control patients who had incomplete abortions were also examined for bilharziasis. S. haematobium was discovered in 41.3% of the infertile group and in 21.4% of the control group. Although pregnancies were not required to be reported 4 patients with primary infertility were treated for bilharziasis and became pregnant. There seems to be a relationship between primary infertility and asymtomatic bilharziasis caused by S. haematobium. There is a lack of association between secondary infertility possibly due to other forms of pelvic inflammatory disease.
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PMID:Infertility and bilharziasis of the female genital tract. 79 50

Three cases of coccidioidomycosis of the female genital tract are reviewed. The diagnosis was made by laparotomy in 2 patients who presented with tender adnexal masses, and by endometrical curettage in a third patient with disseminated coccidioidomycosis. Hysterectomies were performed in all 3 patients; 1 had a bilateral salpingo-oophorectomy and the others a bilteral salpingectomy and unilateral oophorectomy. Two patients received chemotherapy with amphotericin B. One patient died 4 years after her operation from disseminated and meningeal coccidioidomycosis. In a female patient who has resided in an endemic region and who presents with pelvic pain of obscure origin, unexplained infertility, a menstrual disorder, or a chronic, refractory pelvic inflammatory disease, genital coccidioidomycosis should be considered in the differential diagnosis.
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PMID:Female genital coccidioidomycosis. 111 94

Current methods used for the laboratory diagnosis of a Chlamydia trachomatis disease control program for a developing country are reviewed to guide clinical microbiology laboratories to develop criteria for testing. Human chlamydia infections are a major public health problem in both developed and developing countries. Worldwide an estimated 360 million persons are infected by the ocular serovars of Chlamydia trachomatis and 6.4 million are blind from the scarring, sequelae. The genital strains of Chlamydia trachomatis cause cervical, endometrial or tubal infections in women, resulting in pelvic inflammatory disease (PID) or ectopic pregnancy, and infertility. Over 50% of chlamydia infections in women are asymptomatic and progress to silent PID and infertility. In industrialized countries chlamydia infections are the major cause of sexually transmitted disease-related infertility. Infants born to infected mothers are at risk for chlamydia pneumonia and ophthalmia neonatorum. More tentative associations of chlamydia infections exist with Reiter's Syndrome. Early diagnosis of chlamydia infections is the most cost effective means of preventing the longterm sequelae of trachoma, pelvic inflammatory disease, ectopic pregnancy and infertility, which are a major public health liability in developing countries. In many developed and developing countries, public health decision maker are not aware of the extent of chlamydia infections in the community. One of the priorities of the disease control program is to provide accurate epidemiologic data through seroprevalence studies. This includes estimates of persons infected, the severity of complications and sequelae. Public health strategies are required to establish laboratory services and to diagnose and treat the disease. The diagnostic methods for C. trachomatis include specimen collection, cytologic methods, serologic methods, cell culture method, antigen detection methods, and nucleic acid hybridization tests that should be available at the national reference laboratory.
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PMID:The role of the laboratory in a Chlamydia control programme in a developing country. 128 34

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


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