ABSTRACT
A prospective study of 210 infertile patients, investigating the role of chlamydia serology as a screening test for tubal infertility with comparison of results with hysterosalpingography and laparoscopy, showed that Chlamydia serology is an inexpensive, noninvasive test that matches or surpasses the predictive value of most standard infertility tests.
Subject(s)
Chlamydia Infections/diagnosis , Chlamydia trachomatis , Infertility, Female/diagnosis , Mass Screening , Serologic Tests , Adult , Chlamydia Infections/immunology , Chlamydia trachomatis/immunology , Fallopian Tube Diseases/complications , Fallopian Tube Diseases/diagnosis , Female , Fluorescent Antibody Technique , Humans , Hysterosalpingography , Immunoglobulin G/analysis , Infertility, Female/etiology , Infertility, Female/microbiology , Infertility, Female/physiopathology , Laparoscopy , Predictive Value of Tests , Pregnancy , Pregnancy Rate , Prospective Studies , Sensitivity and Specificity , Serologic Tests/standardsABSTRACT
BACKGROUND: Prior study has shown that right paracolic adhesions are found in 90% of patients with chronic pelvic pain and less frequently in pain-free patients. We set out to determine whether paracolic adhesiolysis will reduce site-specific pain. METHODS: This was a prospective, randomized trial of right paracolic adhesiolysis at the time of diagnostic and operative laparoscopy for chronic pelvic pain. Twenty-five patients with a diagnosis of chronic pelvic pain were randomized to either undergo or withhold lysis of right paracolic adhesions at the time of operative laparoscopy. RESULTS: Right paracolic adhesions were found in 100% of our patients. For all subjects, there was a significant reduction of right and left lower quadrant pain (P<0.001) following the operative laparoscopy. Those who underwent right paracolic adhesiolysis had significantly greater right pelvic pain reduction than those who did not (P=0.014). There was no difference in the reduction of left or mid pelvic pain between the treatment and control groups. CONCLUSIONS: Right paracolic adhesiolysis reduces short-term site-specific tenderness in patients with chronic pelvic pain. Patients who would benefit from diagnostic or operative laparoscopy are likely to benefit further from paracolic adhesiolysis.
