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PubMed2004

[Analysis of 1006 cases with selective salpingography and fallopian tube recanalization].

OBJECTIVE: To retrospectively analysis of selective salpingography (SSG) and fallopian tube recanalization (FTR) in 1006 infertile women with tube obstruction, to summarize their clinical effect and practical value, to analyze the related factors which can improve treatment effect and pregnancy rate, and give suggestions of their indication and contraindication. METHODS: SSG and FTR using self-made coaxial catheter were carried out in 1006 infertile cases with tube obstruction of various portions and extents confirmed by hysterosalpingography (HSG). The one-year cumulative pregnancy rate and the effective rate by HSG reexamination were calculated, in combination with dynamic observation of preoperative HSG and intraoperative tube imaging. RESULTS: In the complete tubal occlusion group of 601 tubes in 315 cases, the recanalization rate was 87.9% (528/601), among which, 35.4% was only treated by SSG and 64.6% by FTR. Postoperative pregnancy rate and ectopic pregnancy rate were 39.9% and 2.7% respectively, and tubal reocclusion was 1.8% in one-year's follow up. In those failure to recanalization, tubal tuberculosis was in 4 cases, salpingitis isthmica nodosum was in 3 cases, isthmic occlusion was in 9 cases with club-changed terminal, ampullar or fimbrial occlusion was in 6 cases, and tubal fibrosis in 10 cases. In the incomplete tubal occlusion group of 1314 tubes in 691 cases, catheterized hydrotubation was carried out. Fimbrial adhesion diagnosed by HSG was found false positive or negative in 65 cases. The pregnancy rate was 53.6%, 45.7% and 26.8% in the mildly, moderately and severely occluded cases respectively. The ectopic pregnancy rate was 1.4%. The patent rate confirmed by HSG reexamination was 86.9% one year later. Sixteen cases with obvious fimbrial adhesion or enwrapped adnexa in both groups were treated by laparoscopy, with a coincidence rate of 97.1%. CONCLUSIONS: Selective salpingography and fallopian tube recanalization have both effects of diagnosis and treatment on tubal infertility. The techniques are simple, safe, and credible, and worth to be applied clinically. Knowing the shapes of fallopian tube confirmed by preoperative HSG can increase the rates of recanalization.

Adult↗
PubMed1992

[Pharmacokinetic and clinical evaluation of levofloxacin in obstetrical and gynecological field].

Levofloxacin (LVFX, DR-3355) a new synthetic antibacterial agent, was evaluated pharmacokinetic and clinically in the field of obstetrics and gynecology and the following results were obtained. 1. The transport of LVFX into genital tissues (various regions in the uterus, ovary and oviduct) after a single oral administration of 200 mg was found to be good. 2. Sixteen patients with genital infections (endometritis, salpingitis, cervicitis, mastitis) were treated with LVFX at daily doses of 200-300 mg for 5-15 days. The efficacy rate was 100% and no side effect was observed.

Administration, Oral↗
PubMed1978

[Rifamycin chromopertubation under laparoscopic control (author's transl)].

There is an inherent danger of infection or promoting the exacerbation of an as yet incompletely healed inflammatory process when retrograde perfusion of the Fallopian tubes is performed, as in the diagnosis of sterility by laparoscopy and chromopertubation. Hence, the intense-red tuberculostatic drug, rifamycin SV (Rifocin) was instilled by means of the Schultz Instillator, either alone or in combination with indigo carmine, in place of the conventional indicator solutions, to test tubal patency in all patients under investigation for sterility, whether there was a history of acute, subacute or chronic salpingitis or not. This procedure was not followed by exacerbation of preceeding infection in a single case, which is particularly noteworthy in two patients shown to have extensive tubal and peritoneal tuberculosis.

Adnexal Diseases↗
PubMed1978

[Diagnosis and therapy of acute adnexitis using laparoscopy].

In cases of acute adnexitis laparoscopy is an excellent diagnostic method. By this way we found in 182 patients with clinical symptoms only 50,5% acute inflammatory diseases of adnexa. On the other hand there was a normal genital status in 18,1%, acute appendicitis in 9,9%, ectopic pregnancy in 7,7% etc. Clinical examinations and second-look-laparoscopy 6--8 weeks after ending the treatment cases of salpingitis alone showed the best results. Patients with more extensive inflammatory reactions had more adhesions too. An early diagnosis and treatment under hospital conditions is recommended. We have good experiences with immediately operation in cases of suppurative inflammation of the adnexa, which are only diagnosticate by laparoscopy.

Acute Disease↗
PubMed1992

[Primary adenocarcinoma of the fallopian tube. Retrospective study of 16 cases. Prognostic factors].

The authors report the result of a study carried out on 16 cases of tubal adenocarcinoma treated between the years 1975 and 1988. This is a rare gynaecological cancer with a poor prognosis. The mean age of the patients was 57 years, 64.5% of them were menopausal. 25% had had a history of sterility. 29% were nulliparous and 37.5% had previous salpingitis. In 44% of cases the principal clinical signs were a watery discharge and a blood stained discharge. Pelvic pain occurred in 37% of the cases and CT scan showed a pelvic mass in 50% of cases. Hysterosalpingography and ultrasound were two complimentary investigations. The relatively early stage at which first signs of the condition were noted, show the stages of the disease: stage I 68.7%, stage II 25%, stage III 6.2%, stage IV 0%. Surgery above all was the basis of treatment carried out in all cases, and supplemented in 15 out of the 16 cases by added treatment (radiotherapy, chemotherapy of hormone therapy). As far as histology was concerned, well or moderately well differentiated forms were found to predominate (there were 37.5% grade I and 37.5% grade II) against only 26% for grade III. More than half of the tube wall was infiltrated in 50% of cases. The actuarial survival rate after 5 years was 33%. The authors examine the principal factors responsible for the prognosis, the tissue, the early diagnosis and the possibility of removing the tumour completely at the first operation as well as the histological grading and above all the degree of depth of infiltration of the wall of the tube.

Adenocarcinoma↗
PubMed2005

[The risk of pelvic inflammatory disease associated with urogenital infection with Chlamydia trachomatis; literature review].

OBJECTIVE: To determine the rate of PID in women with genital Chlamydia trachomatis infection. DESIGN: Systematic literature review. METHOD: MEDLINE and EMBASE were searched over the years 1975-2003 using the keywords 'Chlamydia trachomatis', 'complication', 'pelvic (inflammatory disease)', 'PID', 'endometritis', 'adnexitis', and 'salpingitis'. The reference lists ofthe articles retrieved were checked for other relevant publications. The PID complication rate was determined, as were the characteristics of the study populations and the validity of the diagnostic methods and outcome measures used. RESULTS: 9 prospective studies were identified. The rate of PID in women with a genital C. trachomatis infection varied between o and 72%. Asymptomatic women who were diagnosed with C. trachomatis infection in general screening had the lowest rate of PID: 0-4%. PID occurred in 12-30% of symptomatic women or women with a higher risk of having an STD (e.g. visitor of an STD clinic, double-infection with gonorrhoea, high risk assessed by questionnaire, having a partner with symptomatic C. trachomatis infection). Women who underwent legal abortion had the highest rate of PID (27-72%). CONCLUSION: The PID rate in women with C. trachomatis varied considerably. Risk depended on whether the infection was symptomatic and the prior probability of having an STD.

Adult↗
PubMed2005

[Chlamydia: diagnostic and treatment].

Chlamydia are obligate intracellular bacteria. Three species are considered human pathogens. Chlamydophila pneumoniae is one of the most common agents of atypical community-acquired pneumonia. Chlamydophila psittaci causes psittacosis, a severe zoonotic pneumonia transmitted by birds. Finally, Chlamydia trachomatis is the etiologic agent of trachoma and urogenital infections. The latter are commonly asymptomatic or paucisymptomatic. Thus, they may remain undiagnosed for years, leading to serious late complications such as salpingitis, ectopic pregnancy and infertility. Currently, the diagnosis of chlamydial infections is essentially based on molecular methods. Treatment should use an antibiotic with good intracellular bioavailability such as tetracycline, macrolides and new generation fluoroquinolones.

Adult↗
PubMed1992

Clamydial antibody in sera of patients with trachoma.

Serum samples were taken in 1987 from 118 patients with trachoma seen in the Department of Opthalmology of the Gonder College of Medical Sciences, Gonder, Ethiopia, patients being staged according to MacCallan (II, III, IV), and classified in categories of different degrees of inflammation according to Dawson et al. Sera were investigated with the microIF test, using Chlamydia trachomatis serotypes A, B, C and partially D as antigens. Healthy Ethiopian students (n = 14), patients with chlamydial urogenital infections (n = 100), salpingitis (n = 47), and D-seronegative individuals (n = 574) served as controls. Patients with trachoma with severe inflammation showed significantly higher chlamydial antibody titres (greater than or equal to 1:128) against serotype A (p less than 0.05), B (p less than 0.01), and C (p less than 0.01) than patients with trivial, mild or moderate inflammatory symptoms. There was little correlation between MacCallan stages and chlamydial antibody titres, probably due to persistence of antibodies. In the control group of Ethiopian students only single persons were found to react with C. trachomatis serotypes A, B, and C in high titres; the geometric mean varied from x = 1:17 to x = 1:25 and distinctly differed from trachoma patients (x = 1:65). The individuals of other control groups showed high antibody titres against serotype C only in single cases and low geometric mean values.

Adolescent↗
PubMedDate not supplied

The PCR assessed prevalence of Chlamydia trachomatis in aborted tissues.

BACKGROUND: Infections caused by Chlamydia trachomatis (ChT) are the most prevalent sexually transmitted bacterial infections worldwide. ChT is a cause of cervicitis, endometritis, salpingitis, tubal infertility and ectopic pregnancy. Perinatal infections with ChT have been associated with premature rupture of membranes, stillbirth, preterm delivery, and in newborns with conjunctivitis and pneumonia. There are controversial data referring to the association between colonisation by ChT and the risk of spontaneous abortion. Only few studies investigated the prevalence of ChT antigens in aborted tissues. AIM: To determine the prevalence of ChT in patients with spontaneous pregnancy loss using Polymerase Chain Reaction (PCR). MATERIALS AND METHOD: We completed prospective analysis of 50 patients after spontaneous abortions. The prevalence of ChT infections was assessed by PCR performed in samples taken during curettage following miscarriage. RESULTS: ChT was present in 16 (32%) of samples. Other pathogens of the lower genital tract were found in cultures from 11 patients. CONCLUSIONS: The prevalence of ChT infections in early abortions in this study was found to be surprisingly high. It implies the importance of screening of women planning pregnancy and pregnant women for this disease.

Aborted Fetus↗
PubMed2005

[Mycoplasma genitalium--a new challenge in sexually transmitted diseases].

Although Mycoplasma genitalium was described 20 years ago, the knowledge concerning it is still limited. The publications in the area are surprisingly few in number, especially considering that the pathogen is rather common and has been connected with a number of different urogenital diseases. The PCR technique has made it possible to perform investigations on a large scale, which might elucidate the pathogenic role of M. genitalium in the urogenital tract. However, it seems well established that M. genitalium causes non-gonococcal urethritis (NGU). The mycoplasma behaves almost identically to Chlamydia trachomatis with respect to routes of infection and inflammatory response, but no further relationship between the two organisms seems obvious. M. genitalium is believed to produce urethritis with almost the same frequency as C. trachomatis. In the female genital tract, M. genitalium is strongly incriminated as a primary cause of cervicitis, endometritis and salpingitis, the latter complicated by tubal damage. The role of the organisms in epididymitis, prostatitis and neonatal infections is unclear. In the case of urethritis and upper genital tract infections in the female, it is recommended to test for M. genitalium using molecular biological assays and in the event of a positive result institute antimicrobial therapy.

Animals↗
PubMedDate not supplied

[Prevalence of cervicovaginal infections caused by Chlamydia trachomatis among female population of the city of Cuernavaca, Morelos].

The chlamydiae are a genetically diverse group of bacteria with a unique intracellular development cycle. The spectrum of clinical manifestations of Chlamydia trachomatis infections in the female includes cervicitis, acute urethral syndrome, pelvic inflammatory disease, salpingitis and the risk of exposure of infants born through an infected birth canal who may develop inclusion conjunctivitis and/or pneumonia. In order to determine the prevalence of cervicovaginal infections caused by C. trachomatis in female population in Cuernavaca, Morelos, we studied 2,407 sexually active women from a suburban area. Genital specimens were collected from each woman and cultured in McCoy cell monolayers. Detection of the bacteria was done by staining with fluorescein-conjugated monoclonal antibodies (Syva Microtrak, Palo Alto CA). 97 of them were culture-positive for C. trachomatis, with and overall prevalence of 4.02 per cent. The most important clinical symptom observed in 47 of the infected patients was an increased or altered vaginal discharge.

Adolescent↗
PubMedDate not supplied

[Mycoplasma genitalium should be suspected in unspecific urethritis and cervicitis. A study from Vasterbotten confirms the high prevalence of the bacteria].

The microbe Mycoplasma genitalium has in several studies been proposed as an individual cause of non-gonococcal urethritis (NGU) in men, and has been associated with pelvic inflammatory disease (PID) and salpingitis. The prevalence of M genitalium has generally been 50-90% of the prevalence of C trachomatis, and this seems to be the case in Sweden as well. This is the first study of the pathogenesis and prevalence of M genitalium in northern Sweden. In total 823 samples, 340 from women and 483 from men, were screened for M genitalium by using a PCR method. Thirtythree (4.0%) patients, 13 (3.8%) women and 20 (4.1%) men, were infected by M genitalium. In the same group 60 (7.3%) patients, 16 (4.7%) women and 44 (9.1%) men, were infected by Chlamydia trachomatis. None of the 22 patients that were tested after treatment with azitromycin was still infected.

Adult↗
PubMed2006

The challenge of pelvic inflammatory disease.

Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. The spectrum of disease ranges from subclinical, asymptomatic infection to severe, life-threatening illness; sequelae include chronic pelvic pain, ectopic pregnancy, and infertility. PID is diagnosed clinically, with laboratory and imaging studies reserved for patients who have an uncertain diagnosis, are severely ill, or do not respond to initial therapy. The Centers for Disease Control and Prevention diagnostic criteria include uterine, adnexal, or cervical motion tenderness with no other obvious cause in women at risk of PID. Empiric treatment should be initiated promptly and must cover Chlamydia trachomatis and Neisseria gonorrhoeae; the possibility of fluoroquinolone-resistant N. gonorrhoeae also should be considered. Hospitalization for initial parenteral therapy is necessary for patients with tubo-ovarian abscess and for those who are pregnant, severely ill, unable to follow a prescribed treatment plan, or unable to tolerate oral antibiotics. Patients also should be hospitalized if a surgical emergency cannot be excluded or if no clinical improvement occurs after three days. Routine screening for asymptomatic chlamydial infection can help prevent PID and its sequelae.

Anti-Bacterial Agents↗
PubMedDate not supplied

Culturing tubal pregnancies for Chlamydia trachomatis: is it beneficial?

Chronic Chlamydia trachomatis infection has been demonstrated in the fallopian tubes of asymptomatic infertile women. These women have a significantly increased risk of ectopic pregnancies. The purpose of our study was to determine the efficacy of culturing the ectopic site for C. trachomatis, the likely cause of asymptomatic salpingitis in association with a tubal pregnancy. We cultured the fallopian tubes of 21 patients undergoing surgery for tubal pregnancy, all 21 cultures were negative for C. trachomatis. Although infection with this organism is one of the causes of ectopic pregnancy, we were unable to demonstrate the presence of a concomitant chlamydial infection at the time of surgery. Combining chlamydial cultures with nonculture techniques may be more beneficial in further attempts to demonstrate such an association.

Adolescent↗
PubMed2006

[Acute abdomen caused by Salmonella typhi acute appendicitis].

Salmonella infections can manifest themselves as acute abdominal problems and lead to emergency surgery. Some examples are: salmonella-related intestinal perforations, gallbladder involments, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with salmonella mimics acute appendicitis and it is often difficult to establish a timely and tempestive diagnosis in children with right lower abdominal pain. Because of the difficult diagnostic process, a significant number of patients with salmonella infections present acute abdomen and undergo needless operations. Instead, in our case of salmonella-related acute abdomen, laparotomy was the right therapeutic choice. The conclusion is drawn that, even if there is not a precise diagnosis, in salmonella-related acute abdomen the surgical approach is the right choice, considering the high morbidity and mortality associated with untreated appendicitis and intestinal perforations.

Abdomen, Acute↗
PubMed1991

[Chlamydial infection in women with ectopic pregnancy].

A study was carried out on the presence of antibodies to C. trachomatis in women with ectopic pregnancy, established during laparotomy. Pathohistological examination discovered that ectopic pregnancy occurred due to chronic salpingitis in a larger part of the women. The presence of antibodies to C. trachomatis was found in women with more sexual partners more frequently. Serum data for infection to C. trachomatis did not correlate with inflammatory gynecological diseases, undergone in the past. From the obtained results the authors could conclude that the endured subclinical chlamydial infection has caused damage of the Fallopian tubes, which is the cause for occurrence of ectopic pregnancy.

Antibodies, Bacterial↗
PubMedDate not supplied

[Characteristics of patients with laparoscopically verified pelvic inflammation].

Comparing the characteristics of the two groups young women: one with laparoscopically confirmed pelvic inflammatory disease (PID) and the other with no PID (control group) but corresponding to the first group by age, marital status and number of pregnancies, it has been found that the patients with PID are below 25 years of age, have a lower degree of education (p less than 0.05), and 25.5% of them do not use any contraceptive method (p less than 0.01). It has also been observed that in their gynecologic history they mention an episode of lower abdominal pain (p less than 0.01). A further comparison of this finding with laparoscopically confirmed adnexal changes has shown that in 50% of the study group patients there exist sequelae of an earlier PID episode (asymptomatic salpingitis). The results obtained point to the need for carefully connecting the characteristics of the population regarding the risk of PID and the minimal clinical symptoms in diagnosing PID.

Abortion, Spontaneous↗
PubMed1991

[Morbidity from bilateral tubal ligation, via laparoscopy].

From January 1, 1987 January 30, 1990, 374 laparoscopic sterilizations using silastic rings (Falope), were carried out. Morbidity and main risk factors, were analyzed. More frequent surgical complications were: mesosalpinx rupture, and fallopian tube rupture in 22 cases (5.8%); abdominal wall emphysema, three cases (0.8%), uterine perforation, two cases (0.5%); other pelvic structures lesions, three cases (0.8%). Morbidity risk factors were: previous abdominal surgery, obesity, salpingitis, use of an uterine mobilizer in a puerperal uterus, and practice of tubal occlusion during the luteal phase of cycle, due to possibility of luteal phase pregnancy; therefore, if a risk factor is present, it is advisable to use other contraceptive technique.

Adolescent↗