Encourage use of condoms, barriers after PID: fewer recurrences.(Gynecology)

OTTAWA -- All women who experience an episode of pelvic inflammatory disease should be encouraged to use condoms consistently, Dr. Roberta B. Ness said at a congress of the International Society for Sexually Transmitted Disease Research.

Condom use reduces the likelihood of recurrences of pelvic inflammatory disease (PID), and also lessens the risk for sequelae such as 'chronic pelvic pain and infertility, she said.

In a study that included 684 women with clinical signs and symptoms of mild-to-moderate PID who were followed for 35 months, recurrent disease developed in 11.9% of women using barrier methods of contraception, and in 8.8% of those who reported using condoms consistently (during at least 75% of visits). Among those who did not use barrier contraception, PID recurrences occurred in 16.7%, Dr. Ness said.

Chronic pelvic pain developed in 28.6% of barrier users and 26.7% of consistent condom users, compared with 36.7% of nonusers.

Infertility resulted in 40.9% of barrier users and 34.8% of consistent condom users. Among nonusers, infertility resulted in 54.5%, she said.

These findings are part of the ongoing Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) study, which began as a randomized trial comparing the efficacy of inpatient and outpatient treatment. PEACH is now continuing as a cohort study evaluating long-term outcomes after PID, said Dr. Ness of the department of epidemiology, University of Pittsburgh.

The study initially enrolled 831 women With signs and symptoms of PID from 13 clinical sites between March 1996 and February 1999. All had a history of mild-to-moderate pelvic discomfort for 30 days or less, uterine or adnexal tenderness, and leukorrhea, mucopurulent cervicitis, or untreated gonococcal or chlamydial cervicitis.