Salpingitis: a frequent response to intrauterine contraception

Abstract

Nonbacterial, chronic salpingitis was found in less than 1% of non-IUD users undergoing elective tubal sterilization, Nonbacterial, chronic salpingitis was found in 47% of IUD users undergoing elective sterilization. Speculation about the influence of this finding on inflammatory morbidity is presented.

PIP: Histologic specimens from both IUD-wearing and non-IUD-wearing women undergoing translaparoscopic tubal sterilization were examined for inflammatory changes. Among 1500 non-IUD wearers salpingitis was noted histologically in 10, less than 1%. At laparoscopy 3 of these had signs of old gonococcal infection, including peritubal adhesions. In 1 case perihepatic adhesions were observed. In 49 patients undergoing simultaneous IUD removal and sterilization, 23 (47%) had chronic salpingitis histologically similar to the inflammatory response previously reported in the endometrium among IUD wearers. The majority of IUDs were Dalkon shields, a reflection of IUD use in the Seattle community. Infectious morbidity did not complicate the poststerilization convalescence. Bacteriological investigation gave negative results. It seems likely that chronic nonbacterial tubal inflammation explains some of the symptoms commonly associated with the IUD. This study also lends histologic support to the theory that decrea sed host resistance to bacterial infection is an explanation for IUD-rel ated inflammatory morbidity.