Second-look laparoscopy after acute salpingitis

Patients with a laparoscopically verified first episode of acute salpingitis were offered a second-look laparoscopy to determine the effectiveness of the treatment regimen in terms of anatomic end result as well as to correlate the anatomic end result with future fertility. Until now, 13 women have been subjected to such relaparoscopy 16 to 33 weeks after the acute illness. At the acute stage of the disease, 11 of the women had serologic and/or cultural evidence of genital infection with Chlamydia trachomatis, three of whom also had Neisseria gonorrhoeae. All were culture-negative after treatment. In eight patients relaparoscopy showed that previously adherent adnexa were apparently normal, whereas in two patients a deterioration of the laparoscopic findings was found. Two patients had bilateral occluded tubes, for a preliminary infertility rate of 15%. These preliminary observations suggest that second-look laparoscopy after acute salpingitis might be a useful method for early objective evaluation of treatment results.