Laparoscopic management of adnexal abscesses: consequences for fertility.
OBJECTIVE
To study fertility of patients with adnexal abscesses treated by laparoscopy, antibiotic therapy, and second-look laparoscopy.


METHODS
A retrospective clinical study.


METHODS
Department of Obstetrics Gynecology and Reproductive Medicine, University of Auvergne, University Hospital of Clermont Ferrand, France.


METHODS
Thirty-nine patients treated for adnexal abscesses between January 1983 and December 1992.


METHODS
Laparoscopic drainage of adnexal abscesses was performed in all patients; 35 patients underwent a second laparoscopy 3 to 6 months later.


METHODS
Immediate and long-term clinical results, anatomical data obtained at second-look laparoscopy, spontaneous fertility.


RESULTS
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%).


CONCLUSIONS
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.
Department of Obstetrics Gynecology and Reproductive Medicine, Centre Hospitalier Universitaire (CHU), Clermont Ferrand, France.
J
J
Raiga
M
M
Canis
G
G
Le Bouëdec
E
E
Glowaczower
J L
JL
Pouly
G
G
Mage
M A
MA
Bruhat
D000038:Abscess / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D000291:Adnexal Diseases / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D010535:Laparoscopy; D011247:Pregnancy; D012086:Reoperation; D012189:Retrospective Studies