[Silent salpingitis. Does it exist?]

The diagnosis of salpingitis based solely on clinical criteria is inaccurate, with both low specificity and sensitivity. Laparoscopy has therefore become a valuable diagnostic tool in clinical practice and essential in clinical research on salpingitis. Different types of evidence indicate that atypical salpingitis without abdominal pain and discrete or absent symptoms is a common etiology of tubal factor infertility. A low threshold for suspecting salpingitis has been recommended to augment the sensitivity of clinical diagnosis. This leads to lower specificity and thereby a greater number of false positive diagnoses and unnecessary antibiotic treatment. Outpatient biopsy from the endometrium for histopathology and chlamydia testing might augment the specificity in cases with discrete symptoms, and should be investigated further. The sensitivity of laparoscopy is low for endosalpingitis without affection of the serosa, and might be augmented by using minibiopsies and chlamydia PCR from the tubal mucosa. The most significant measure toward reducing the sequelae of salpingitis is the combatting of chlamydia infection through screening programs and qualified partner management.