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  • Title: [Severe acute genital infections (Based on 100 cases). A clinical study and the contribution of laparoscopy (author's transl)].
    Author: Blum F, Pathier D, Treisser A, Faguer C, Barrat J.
    Journal: J Gynecol Obstet Biol Reprod (Paris); 1979; 8(8):711-21. PubMed ID: 162292.
    Abstract:
    A continuous prospective series of 100 cases of severe acute genital infections which were collected over a period of 16 months at the Gynaecological and Obstetrical Clinic of the Saint Antoine Hospital has been studies using the same protocol. Analysing the history given by these patients before the onset of the illness shows how young they were and how frequently they were nulliparous, as well as the role of intra-uterine contraceptive devices. The correlation between the clinical features and those found on laparoscopy which was carried out almost routinely shows the great advantages of this examination. The authors in their discussion have tried, by analysing groups of symptoms, to show that to make an early correct diagnosis laparoscopy has to be used in a majority of cases. It allows treatment to be instituted quickly and unhesitatingly. Furthermore, it is justified because: It is necessary to find out all lesions that are present and which are unpredictable clinically. It renders it possible to carry out therapeutic manoeuvres (such as cutting adhesions and giving antibiotics locally) and to take swabs for bacteriological examination (this will be discussed in the second part of this article). 124 women were observed for supposed genital infection; the same protocol was used for all patients who were examined before and after celioscopy. Celioscopy revealed that there had been 32 false diagnoses; it also revealed 8 cases of infection not previously suspected. 59 patients were nulliparous, a percentage to take into consideration since it is well known that genital infection can cause sterility. Most patients were between 21-25, and for 24 of them the infection had been caused by an IUD. Revealing symptoms were, always, pain, and sometimes fever and methorrhagia. The study shows that prompt and exact diagnosis often rests on celioscopy, which not only allows for correction of false diagnoses, but permits initiation of the proper treatment as soon as possible.
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