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Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is characterised by infection of the female reproductive organs, such as the

  • uterus,
  • fallopian tubes, and
  • ovaries

It is mostly acquired through unsafe sexual practices and is one of the most serious consequences of sexually transmitted diseases (STD).

PID can cause permanent damage to the female reproductive system, and is one of the leading causes of infertility.

CAUSES OF PELVIC INFLAMMATORY DISEASE (PID)

PID can occur when your cervix is exposed to an STD, such as chlamydia or gonorrhea. The infection eventually spreads to your uterus, ovaries, and fallopian tubes.

Ninety percent of PID occurs as a result of untreated chlamydia and gonorrhoea. Sexual practices that involve multiple partners and unprotected sex increase your chances of acquiring STDs, which can in turn lead to PID. Some of the other causes include:

  • Intrauterine device (IUD) use
  • Giving birth
  • Miscarriage
  • Abortion
  • Endometrial biopsy (procedure to remove a piece of tissue from your uterine lining for examination)
  • Previous history of PID or STD

SYMPTOMS OF PELVIC INFLAMMATORY DISEASE

Pelvic inflammatory disease PID can show minor symptoms or no symptoms at all (common with chlamydial infection). They can often vary, but may include:

  • Dull pain in your stomach and lower abdomen and pelvis
  • Green or yellow vaginal discharge, having a distinct and often unpleasant odor
  • Pain during urination
  • Irregular menses
  • Fever or chills
  • Nausea, vomiting or diarrhoea
  • Pain in the lower back
  • Painful intercourse

If you notice these symptoms, it is important to visit the doctor immediately, as prompt treatment is vital for PID.

COMPLICATIONS WITH PELVIC INFLAMMATORY DISEASE

If left untreated, PID can cause

  • Scarring
  • Collection of abscesses (infected fluid) in the fallopian tubes.

PID can also lead to

  • infertility or
  • ectopic pregnancy (implantation of embryo outside the uterus).

Scarring or damage can occur to other reproductive organs, which can cause chronic pelvic pain that can last for many months.

DIAGNOSIS OF PELVIC INFLAMMATORY DISEASE

Based on your signs and symptoms, Dr Gailani may perform

  • a pelvic examination,
  • obtain a sample of your vaginal discharge, and
  • perform cervical cultures and urine tests.

Samples may be obtained from your cervix and vagina using a cotton swab, and sent to the laboratory to identify the bacteria causing the infection.

Dr Gailani may also recommend the following tests to confirm and determine the extent of your infection.

  • Blood tests,
  • Pelvic ultrasound to check your reproductive organs and exclude any abscesses ( pus collection ).
  • Endometrial biopsy
  • Laparoscopy, where a thin, lighted tube with a camera is inserted through a small cut in your abdomen to examine your pelvic organs

TREATMENT FOR PELVIC INFLAMMATORY DISEASE

Confirmation of PID will be immediately followed by treatment.

Antibiotic Treatment

You will be started on oral antibiotic medications for mild cases of PID.

If More Management Required

For more severe cases, you may be treated with a combination of oral and intravenous medications, or hospitalised for more aggressive management.

It is important that your partner also gets treated, even if he does not have any symptoms, in order to prevent future recurrence of the infection.

Further Treatments

If antibiotics fail to clear the infection, and if the infection forms abscesses in your uterus or ovaries, you may be recommended to undergo:

  • Laparoscopy for removal of abscess and pelvic wash out,
  • Oophorectomy is occasionally necessary (removal of the ovary)
  • Salpingectomy (removal of the Fallopian tube) if filled with pus.

When your infection, abscess, or inflammation has cleared, but you are still experiencing chronic pelvic pain, there are a variety of options to address the pain (see chronic pelvic pain).

PREVENTION OF PELVIC INFLAMMATORY DISEASE

Prevention is the best way to deal with PID.

  • Avoid unsafe sexual practices, multiple partners
  • Use barrier methods such as condoms and spermicides.
  • Avoid IUCDs if you have multiple partners.
  • Watch for symptoms and be prompt to get treatment.
  • Have regular follow up with Dr Gailani, as infections identified during the early stages can be prevented from spreading to your reproductive organs.