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Laparoscopic management of adnexal abscesses: consequences for fertility
J Raiga1, M Canis, G Le Bouëdec
1Department of Obstetrics Gynecology and Reproductive Medicine, Centre Hospitalier Universitaire (CHU), Clermont Ferrand, France.
Objective:
To study fertility of patients with adnexal abscesses treated by laparoscopy, antibiotic therapy, and second-look laparoscopy.
Design:
A retrospective clinical study.
Setting:
Department of Obstetrics Gynecology and Reproductive Medicine, University of Auvergne, University Hospital of Clermont Ferrand, France.
Patient(S):
Thirty-nine patients treated for adnexal abscesses between January 1983 and December 1992.
Intervention(S):
Laparoscopic drainage of adnexal abscesses was performed in all patients; 35 patients underwent a second laparoscopy 3 to 6 months later.
Main Outcome Measure(S):
Immediate and long-term clinical results, anatomical data obtained at second-look laparoscopy, spontaneous fertility.
Result(S):
No immediate reoperation was necessary within the first 2 months after the initial laparoscopic surgery. At second-look laparoscopy, an adhesiolysis was necessary in all cases. A distal tuboplasty was performed in 17 patients and 6 patients were referred to IVF-ET. Subsequently, 12 of 19 patients not using any contraception obtained a spontaneous intrauterine pregnancy (63%).
Conclusion(S):
This study confirms that laparoscopic surgery is a safe and efficient technique for treating adnexal abscesses. Anatomical results observed at second-look laparoscopy suggest that this second surgical step is essential for patients desiring future pregnancy.