PELVIC INFLAMMATORY DISEASE

What is Pelvic Inflammatory Disease

Inflammatory diseases of the pelvic organs are characterized by various manifestations depending on the level of damage and the strength of the inflammatory reaction. The disease develops due to pathogens entering the genital tract (enterococci, bacteroides, chlamydia, mycoplasmas, ureaplasmas, trichomonads) and in the presence of favorable conditions for its development and reproduction. Such conditions are created in the postnatal, postabortion period or during menstruation. The infection affects organs of female genital system: the uterus, fallopian tubes, ovaries.

Natural defense mechanisms, such as anatomical features, local immunity, acidic environment of vaginal contents can prevent the development of genital infection in most cases. But if pelvic inflammatory disease is caused by sexually transmitted infections occur and left untreated, it may result in severe complications including ectopic pregnancy and infertility.

What are the causes of Pelvic Inflammatory Disease occurrence?

Inflammation of the pelvic organs usually occurs when the infection spreads from the vagina, the uterine cavity due to abortions or complicated childbirth, diagnostic or therapeutic curettage. The infection can also come from neighboring organs: the appendix, the sigmoid colon, as well as through hematogenous way.

The factors for the development of Pelvic Inflammatory Disease are:

• Any intrauterine intervention: intrauterine device insertion, abortion, curettage;
• promiscuous sexual behavior;
• past inflammatory diseases of female genital organs;
• complicated childbirth;
• hypothermia;
• poor personal hygiene

How may Pelvic Inflammatory Disease be caught?

Pelvic Inflammatory Disease is mostly caused by STD like clamidiosis, trichomoniasis, gonnorhea and others.

Risk groups for inflammatory processes in the pelvic organs are:

• Women who are carriers of sexually transmitted diseases, and who are suffering from these diseases.
• Women who already had previous inflammation are also at risk of recurrence;
• Sexually active teenage girls are much more susceptible to the disease than adult women;
• Women who have constantly many sexual partners are also at high risk of “catching” inflammation transmitted through sex.

Symptoms of Pelvic Inflammatory Disease

Symptoms of the Pelvic Inflammatory Disease in different cases may differ or may be asymptomatic at all, but usually they are as follows:

• Redness, swelling, itching of the vulvar and vaginal mucosa;
• Drawing pains in the lower abdomen or lower back;
• Pain during sexual intercourse;
• Vaginal discharge: abundant mucous or mucopurulentdischarge with an unpleasant smell and a yellowish tinge;
• Yellowish, turbid discharge with gas bubbles and an unpleasant smell;
• tyroid discharge accompanied by itching or burning;
• bloody discharge;
• Mucopurulent discharge with pain in the lower abdomen;
• Irregular menstruation;
• mainfull or difficulty urinating.
• Additionally, general symptoms may occur: fever, fatigue, weakness, malaise, diarrhea, vomiting.

If symptoms of inflammation occur, you need to undergo a checkup. Inflammation is also indicated by painful sensations during the palpation of the uterus and appendages

Diagnosis of Pelvic Inflammatory Disease

Since pelvic inflammatory disease can have mild symptoms or can be asymptomatic at all it is necessary to consult a gynecologist regularly especially if you are sexually active and have unprotected sex. Unfortunately, there are no specific tests and analysis to diagnose PID, but a doctor can reveal the infection with the help of the combined examination of the patient.

The gynecologist can suspect an inflammatory disease of the pelvis when the patient is questioned and examined. The patient feels pain when being palpated at the area of the uterus and appendages. The doctor should take smears from the vagina and the cervical canal for bacteriological examination – so that causative agent of the disease can be identified. The main of them are: staphylococcus, E. coli, gardnerella, fungi, chlamydia, viruses, trichomonads, gonococci, ureaplasma, mycoplasma.

Also, general analysis of the blood can be carried out to reveal inflammatory changes: leukocytosis with a shift to the left, increased ESR.

Ultrasound can also be advised to reveal an increase in the size of the appendages and ovaries, the formation of suppurative focuses

Treatment of PID. Is PID curable?

After PID is diagnosed, antibiotics are usually prescribed. Antibiotics usually provide full recovery. If the prescribed antibiotics are ineffective, the patient should be hospitalized. In hospital, more intensive therapy with intravenous administration of two or more antibiotics is prescribed to eliminate the infection as quickly and effectively as possible. The longer and more severe the inflammatory process is, the higher the probability and frequency of various complications, including infertility is.

In the fallopian tubes, ovaries and the pelvic cavity abscesses (accumulations of pus) can develop. If the use of antibiotics is ineffective, then surgical intervention (opening of abscess, removal of pus) is necessary. If the abscess ruptures, pus enters the abdominal cavity, the symptoms quickly rise – severe pains in the lower abdominal cavity, nausea, vomiting and a sharp decrease in blood pressure (bacterial-septic shock) occur and develop. If the infection enters the blood and spreads with the bloodstream, the condition is called sepsis, which can lead to death. When the abscess breaks, an emergency operation is required.

FAQ on PID

Is PID curable?

Yes, in most cases taking of antibiotics provide complete recovery. If they turned out to be ineffective, surgery is necessary. However, it should be pointed out that the earlier the disease state is, the easier the treatment is. If PID is diagnosed at early state, the disease is treated easily and quickly by taking antibiotics.

How may PID be prevented?

PID is caused by sexually transmitted diseases which are usually caught during sexual intercourse. Thus, to avoid PID infection it is better to have only one sexual partner whom you can trust or have protected sex. It is also important to be checked up regularly. You shouldn’t leave any of contracted infection untreated because it can cause PID and many other serious complications.

What consequence can be caused by PID?

PID can lead not only to loss of ability to work, but often can hinter from happiness of motherhood, which is associated with the development of both primary and secondary infertility. This is caused by the appearance of adhesions between the ovaries and uterine tubes, disappearance of the lumen of the latter, as a result of which spermatozoa can not penetrate into the abdominal cavity and fertilize the ovum. Past inflammation of the uterus and appendages can cause chronic pelvic pain, ectopic pregnancy and other dangerous complications. Sometimes the infectious process spreads from the uterus and its appendages into the abdominal cavity, causing the formation of adhesions on the external surface of the liver, which leads to the development of perihepatitis, accompanied by pain in the right hypochondrium. The later treatment is started, the higher the risk of complications development is.