Pelvic inflammatory disease

Overview

Pelvic inflammatory disease is an infection involving any or all of the upper genital tract. Uterus, fallopian tubes, and ovaries are the organs of the upper genital tract.

The infection usually occurs when bacteria spread from vagina to uterus, fallopian tubes or ovaries. The majority of the pathogens causing pelvic inflammatory disease are sexually transmitted. Gonorrhea or chlamydia infections are the most common.

 

Symptoms

  • Lower abdominal pain
  • Abdominal pain that worsens with sexual intercourse
  • Abnormal uterine bleeding (bleeding during sexual intercourse, intermenstrual bleeding, heavy or prolonged menstrual bleeding)
  • Fever
  • Pain during urination
  • Infertility in some women
  • Urinary frequency
  • Unpleasant smelling and heavy vaginal discharge

 

Complications

  • Ectopic pregnancy or tubal pregnancy – The fertilized egg is prevented from making its way through the fallopian tube to implant in the uterus because of the scar tissue from pelvic inflammatory disease.
  • Infertility – Pelvic inflammatory disease may damage the reproductive organs causing infertility.
  • Tubo-ovarian abscess – There is collection of pus in the uterine tubes and ovaries.
  • Perihepatitis – Perihepatitis also called Fitz-Hugh Curtis Syndrome occurs due to inflammation of the liver capsule caused by the infection.

 

Diagnosis

  • Diagnosis is done by an analysis of vaginal discharge and cervical cultures or urine tests.
  • Blood tests, ultrasound, and laparoscopy may be done to determine how widespread the infection is, and to test for sexually transmitted infections.

 

Lifestyle management

  • The risk of pelvic inflammatory disease can be reduced by practicing safe sex and using barrier methods of contraception, such as a condom.
  • If you are at risk of developing sexually transmitted infections talk to your doctor about screening tests.
  • Douching upsets the balance of bacteria in the vagina. Do not douche.

 

Medical management

  • You may be hospitalized if you are seriously ill, or suspected of a tubo-ovarian abscess, pregnancy, or if there is a concern for nonadherence to therapy.
  • Antibiotics – The following regimen may be used for the treatment of pelvic inflammatory disease – cefoxitin, cefotetan and doxycycline, clindamycin and gentamicin, ampicillin-sulbactam and doxycycline, azithromycin and metronidazole.
  • Your sexual partner may be examined and treated to prevent reinfection.
  • Avoid sexual intercourse until treatment is completed and all sexual partners are cleared of infection as indicated by the tests.

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