Pelvic inflammatory disease (PID) and more specifically salpingitis (visually confirmed inflammation) is the primary cause of tubal factor infertility and is an important risk factor for ectopic pregnancy. The risk of these outcomes increases following repeated episodes of PID. We developed a homogenous discrete-time Markov model for the distribution of PID history in the UK. We used a Bayesian framework to fully propagate parameter uncertainty into the model outputs. We estimated the model parameters from routine data, prospective studies, and other sources. We estimated that for women aged 35-44 years, 33·6% and 16·1% have experienced at least one episode of PID and salpingitis, respectively (diagnosed or not) and 10·7% have experienced one salpingitis and no further PID episodes, 3·7% one salpingitis and one further PID episode, and 1·7% one salpingitis and ⩾2 further PID episodes. Results are consistent with numerous external data sources, but not all. Studies of the proportion of PID that is diagnosed, and the proportion of PIDs that are salpingitis together with the severity distribution in different diagnostic settings and of overlap between routine data sources of PID would be valuable.
PMID 27678278 27678278 DOI 10.1017/S0950268816002065 10.1017/S0950268816002065 Price et al. 2016, Price 2016
Cite this article
Price, M., Ades, T., Welton, N. J., Simms, I., & Horner, P. (2017). Pelvic inflammatory disease and salpingitis: incidence of primary and repeat episodes in England. Epidemiology and infection, 145(1), 208-215. https://doi.org/10.1017/S0950268816002065
Price M, Ades T, Welton NJ, Simms I, Horner P. Pelvic inflammatory disease and salpingitis: incidence of primary and repeat episodes in England. Epidemiol Infect. 2017;145(1):208-215. doi:10.1017/S0950268816002065
Price, Malcolm, et al. "Pelvic inflammatory disease and salpingitis: incidence of primary and repeat episodes in England." Epidemiology and infection, vol. 145, no. 1, 2017, pp. 208-215.
From 1960 10 1984, 2,501 women underwent diagnostic laparoscopy (index laparoscopy) because of a clinical suspicion of acute pelvic inflammatory disease (PID). Of these women, 1,844 had abnormal laparoscopic findings (patients) and 657 had normal findings (control subjects). The reproductive events after index laparoscopy of 1,732 patients and 601 control subjects were followed. The patients and control subjects were followed for a total of 13,400 and 3,958 woman-years, respectively. During the follow-up period, 1,309 (75.6%) of the patients and 451 (75.0%) of the control subjects attempted to conceive. Of these women, 209 (16.0%) of the patients and 12 (2.7%) of the control subjects failed to conceive. A total of 141 (10.8%) of the patients and 0 (0%) of the control subjects had confirmed tubal factor infertility, 21 (1.6%) of the patients and 3 (0.7%) control subjects had other causes of infertility, and 47 (3.6%) patients and 9 (2.0%) control subjects did not have a complete infertility evaluation. Additional information on tubal morphology (hysterosalpingography, laparoscopy, or laparotomy) in women from couples for whom evaluation was incomplete indicated that 165 (12.2%) patients and 4 (0.9%) of the control subjects had abnormal tubal function or morphology after index laparoscopy. Tubal factor infertility after PID was associated with number and severity of PID episodes. The ectopic pregnancy rate for first pregnancy after index laparoscopy was 9.1% among the patients and 1.4% among control subjects.
To describe a case of severe infectious complications following ovarian platelet-rich plasma (PRP) injections for ovarian rejuvenation. Case report. A 45-year-old nulligravid woman with a history of uterine fibroids and ovarian cysts presenting to an academic medical center. Ovarian PRP injections were performed at an outside facility. Following presentation, the patient was treated with intravenous antibiotics. Because of persistent symptoms and clinical deterioration, she subsequently underwent image-guided aspiration of bilateral tubo-ovarian abscesses. Resolution of infection and resumption of baseline activity and menstrual cycles. The patient presented with persistent lower abdominal pain, leukocytosis, and complex bilateral adnexal masses on imaging several days after intraovarian PRP injection. Cultures from aspirated abscesses grew Streptococcus anginosus. After treatment, she achieved full clinical recovery, resuming normal menses and activity within four months. Ovarian PRP injections, although increasingly marketed for "rejuvenation," carry risks of severe complications, including infection, such as tubo-ovarian abscess formation. This case underscores the need for caution and further investigation into the safety and efficacy of PRP for reproductive indications.
Pelvic inflammatory disease (PID) remains a major cause of tubal factor infertility. Although in vitro fertilization (IVF) has largely replaced reconstructive surgery, selected patients with mild tubal damage may still achieve natural conception after surgical repair. This case highlights a spontaneous conception following bilateral fimbrioplasty in a patient with mild post-PID distal tubal occlusion. A 33-year-old, gravida 4 para 2, woman presented with three years of secondary infertility. Hysterosalpingogram (HSG) showed mild bilateral hydrosalpinx and distal tubal occlusion, with normal ovarian reserve and hormonal evaluation. The patient underwent robotic fimbrioplasty on July 23, 2025. Operative findings included Fitz-Hugh-Curtis changes, bilateral filmy adhesions, and grade-I distal occlusion. Bilateral adhesiolysis and fimbrioplasty were performed with restoration of tubal patency on chromotubation. The postoperative course was uncomplicated. Ten weeks after surgery, the patient conceived spontaneously with a normal intrauterine pregnancy. Tubal reconstructive surgery remains a valuable fertility-preserving option for selected patients who decline or lack access to IVF. Success depends on careful patient selection, minimal tubal damage, and meticulous microsurgical technique. Tubal reconstruction can offer selected women an affordable, fertility-preserving option, especially in low-resource settings where IVF is inaccessible.