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Silent pelvic inflammatory disease: is it overstated?

P Wølner-Hanssen1

  • 1Department of Obstetrics and Gynecology, University Hospital of Lund, Sweden.

Obstetrics and Gynecology
|September 1, 1995
PubMed
Summary

A history of lower abdominal pain is strongly associated with laparoscopic findings in infertile women, suggesting silent pelvic inflammatory disease (PID) is less common than believed. Further medical history questioning is recommended for improved diagnosis.

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Area of Science:

  • Reproductive Medicine
  • Gynecology
  • Surgical Endoscopy

Background:

  • Infertility affects numerous women globally.
  • Pelvic inflammatory disease (PID) is a known cause of infertility.
  • Silent PID, without clear symptoms, is suspected but poorly understood.

Purpose of the Study:

  • To investigate the correlation between reported abdominal pain history and actual laparoscopic findings in infertile women.
  • To assess the prevalence of silent PID in this population.

Main Methods:

  • Prospective study of 112 infertile women before diagnostic laparoscopy.
  • Standardized questionnaires collected medical and pain history.
  • Laparoscopic findings meticulously recorded.

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Main Results:

  • 32.1% of women had adhesions or tubal occlusions.
  • History of pelvic inflammatory disease (PID) showed varied associations with findings.
  • A history of lower abdominal pain was significantly linked to adhesions and/or distal tubal occlusion (OR 5.7).
  • Only 4 women met criteria for possible silent PID.

Conclusions:

  • Silent PID appears less prevalent in infertile women than previously assumed.
  • The study highlights the diagnostic value of detailed abdominal pain history.
  • Enhanced medical history questioning is crucial for future infertility evaluations.