Suppurative salpingitis after laparoscopic tubal cauterization

Laparoscopic tubal electrocoagulation for sterilization: 5000 cases

Five thousand cases of laparoscopic tubal electrocoagulation were performed for voluntary interval sterilization in outpatient Thai women from January 1974 through June 1978. Immediate complications occurring during surgery resulted from mesosalpingeal hemorrhage, which was successfully managed by omental packing with or without repeated electrocoagulation. The overall failure rate was 0.40%. The authors find this method of tubal electrocoagulation for fertility management to be reliable and safe as an outpatient procedure and to provide rapid convalescence.

Sterilization: a comparative review

Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared. Laparoscopic sterilization has the lowest incidence of complication, the morbidity rate being lower than that of laparotomy sterilization or hysterectomy, and the mortality rate lower than that of a single pregnancy or taking oral contraceptives for 1 year.

Pelvic abscess in association with intrauterine contraceptive device

Serious pelvic infection associated with the use of IUDs is of increasing concern to obstetricians and gynecologists. This review of the literature is accompanied by analysis of 5 years' experience at the Arizona Health Sciences Center. Of 169 patients with acute infections, 34% had an IUD in place at the onset of infection. In addition, 24 of the patients were less than 20 years of age and 35% were nulliparous. Of the nulliparous patients, 11 were rendered sterile following surgical extirpative therapy. Sixty-six patients developed pelvic and tubo-ovarian abscesses; 38% of those were related to IUD usage. Six of the pelvic abscesses and eight of the unilateral tubo-ovarian abscesses came to pelvic cleanout. Evidence presented documents the serious infection potential that IUD usage entails, the antibiotic and surgical management, the infertility that results, and the mechanism assumed responsible. In addition, the high-risk patient has been identified (young, nulliparous, sexually active, and, especially, of the lower socioeconomic strata).

The laparoscopist and electrosurgery

A brief discussion of the physics relating to electrosurgical techniques is given, the complications inherent in this technique when used at laparoscopy are discussed, and the treatment and means of preventing these accidents are reviewed.

The intrauterine device and tubo-ovarian abscess

During the past 4 years, 16 patients have been seen who developed a unilateral tubo-ovarian abscess while wearing, or soon after removal of, an IUD. None of the patients had gonorrhea. There appears to be a prodromal syndrome before abscess formation of 2 to 5 weeks during which the patient complains of vague lower abdominal pain, pelvic tenderness, and dyspareunia. A few patients had a rapid onset of symptoms. The device should be removed when prodromal symptoms arise and the patient should be treated with antibiotics. Should a tubo-ovarian abscess develop, surgical intervention is necessary.