Zur Behandlung der akuten Salpingitis mit Tetracyclin/Metronidazol mit oder ohne zusätzliche Heilbadkur, Augmentan oder Ciprofloxacin/Metronidazol: Eine second look-Laparoskopie-Studie

Abstract

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Vaginale Mooranwendungen bei chronischer Salpingitis

“…Wenn auch nach second-look-Chromolaparoskopie keine Befundänderung festzuste!len ist, so konnte nur bei 2 der 34 Patientinnen nach Balneotherapie in der Nachbehandlung einer Salpingitis keine subjektive und objektive Befundbesserung festgestellt werden (Gerber et al 1992). Nach Abklingen der entzünd!ichen Erscheinungen wird eine Nachbehandlung von 4-6 Wochen empfohlen (Baatz 1966).…”