Article Text
Abstract
Background The aim of our study was to investigate the presence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG) and non-sexual transmitted infection (STI) microorganisms in Fallopian tubes of patients with tubo-peritoneal factor of infertility diagnosed during laparoscopy or with normal tubes.
Methods 12 of 22 infertile women included in investigation had tubal-peritoneal pathology and 10 women were without tubal pathology as assessed by laparoscopy. During laparoscopy the tubes were flushed with 2–4 ml 0.9%-saline solution, immediately after the laparoscope and auxiliary instruments were introduced. The tubes were flushed by gently grasping the tubal ampulla near the fimbria portion with atraumatic tubal forceps and introducing an epidural catheter inside the ampulla through the abdominal tubal ostium via a suprapubic puncture. We also took material from tubes with microbiological loop in aim to do bacteriological investigation.
Results The mean age in first group was 25±0,5 years, in control group was 31±1 years. Included criteria for both groups was infertility and absence of STI in endocervix. In case group all patients had pelvic inflammatory disease in anamnesis, high level of CT antibodies (MOMP and HSP), severe tubal pathology and adhesive process revealed during laparoscopy. We did not find CT, NG or any non STI microorganisms in tubes in both groups. We found twice Ureaplasma urealyticum (UU) in tubes in control group.
Conclusion The principal feature of salpingitis is extensive tissue remodeling that produces chronic sequelae such as scars and lumen obstruction and during this process the STIs and non STIs are cleared by the immune system. So, in spite of severe tubal pathology we did not find STI in Fallopian tubes. UU do not injure tubes (as we can see in control group), it could be a co-infecting pathogen, persists after antibiotics therapy and selective elimination of main pathogen.
Disclosure No significant relationships.