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| Pelvic inflammatory disease (PID) |
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Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist
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What is pelvic inflammatory disease?
Pelvic inflammatory disease (PID) is an infection that passes
from the vagina through neck of the womb (cervix), the womb (uterus) and up to
the Fallopian tubes. The ovaries are sometimes also involved.
Bacteria and other
micro-organisms can find their way through the vagina and the cervix to the
internal reproductive organs. A bacterial infection can cause inflammation in
these organs and their surroundings. This most commonly occurs in the Fallopian
tubes.
What causes PID?
In some women, PID may result from a
termination of
pregnancy or following
childbirth.
Occasionally, it may be as a result of having sex with a new partner. But often
no specific reason can be found. In the UK the 'bug' most commonly
responsible for PID is
Chlamydia.
What are the symptoms of PID?
PID causes tenderness and
pain in one or both sides of
the lower abdomen. At the same time, it can cause fever and general
discomfort. Finally, the infection can be accompanied by
heavy, painful
periods and sometimes a
vaginal discharge.
How does the doctor make a diagnosis?
If, in a
pelvic examination,
the doctor detects tenderness and perhaps even a lump next to the uterus, then
PID is a possible cause.
Blood tests can also
be used to detect signs of infection.
Usually these symptoms and signs of infection are sufficient for
the doctor to make a diagnosis of PID but, sometimes, it may be necessary to
also examine the inside of the pelvis using
laparoscopy to detect
any inflammatory changes.
Samples are also taken from the neck of the womb to try to
identify the organism responsible for the infection.
How is PID treated?
The doctor will normally prescribe
antibiotics and advise the patient to
keep warm and rest at home - hospitalisation is not usually necessary. In most
cases, the inflammation will subside in a week or two. However, if the pain and
soreness remain, this could be a sign that the infection has not gone away and
might even have returned.
Fortunately, with proper treatment, this is uncommon. If
Chlamydia is detected then the woman's sexual partner
should also be tested. If he is infected, he will also require
treatment.
What complications may arise from PID?
Even though PID is a relatively harmless condition, if it is not
treated quickly and effectively, it can result in permanent damage to the
Fallopian tubes. This makes it more difficult for eggs and sperm to pass
through and increases the risk of infertility or an
ectopic pregnancy.
If the first or subsequent episodes of inflammation are not
adequately treated then the condition can become chronic. If this happens,
abscesses can form in the pelvis and surgery is often required. This may
involve the loss of a Fallopian tube, an ovary or, occasionally, the removal of
the womb in a
hysterectomy.
Fortunately, most women seek advice early and treatment is prompt and
appropriate.
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Based on a text by Dr Erik Fangel Poulsen, gynaecologist
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Last updated 02.06.2005
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