Pelvic

Pelvic Inflammatory Disease

What is Pelvic Inflammatory Disease? (PID)
Pelvic Inflammatory Disease is an infection of a woman’s pelvic organs.  These include the uterus (womb), Fallopian tubes, and ovaries.  It can exist without symptoms but usually causes much pain and illness.

What causes PID?
PID is an infection caused by germs.  Sometimes the pus seems to be sterile because we cannot culture the germ.  Most infections are caused by Chlamydia or Gonococcus (which produces the disease of gonorrhoea). 

Who gets PID?
It is extremely unlikely that you will develop PID if you do not have sexual intercourse. 

  • - More than one partner increases the risk. 
  • - Patients are commonly under 25 years of age. 
  • - An Intra-Uterine Contraceptive Device (IUCD) increases the risk. 
  • - Douching is also thought to be a risk factor.

Why should I worry about PID?
The infection damages the Fallopian Tubes.  This might be slight with no discernable loss of function.  This is particularly if it is treated quickly.  A bit more damage can slow the flow of fluid along the tubes (due to damage to cilia) so slowing passage of a fertilised egg which can cause Ectopic Pregnancy.  There is a risk, particularly with repeated infection, of complete blockage of the Fallopian Tubes and sterility.

How common is PID?
No one knows exactly as some disease goes unreported.  The woman may be treated with antibiotics without a diagnosis being made.  However, we know that there are around a million reported cases each year in the USA of whom about 10% become infertile [1]. 

How is PID diagnosed?
Symptoms may include

  • - Lower abdominal pain on both sides.
  • - An unusual discharge from your vagina.
  • - Fever.

Signs (the things which the doctor discovers)

  • - Bilateral lower abdominal tenderness
  • - Cervical excitation pain (pain on moving the neck of the womb during an internal examination)
  • - Bilateral adnexal (the bits beside the womb) tenderness during an internal examination
  • - Culture of swabs from cervix and urethra
  • - Culture of urine (to exclude urinary tract infection)

An ultrasound scan may show a typical picture
BUT definitive diagnosis is by Laparoscopy

How is PID treated?
PID is treated with antibiotics.  It is often treated without knowing the exact micro-organism that is causing the infection.  Therefore two or more antibiotics may be used to kill the widest possible range of bacteria.  Hopefully the pain goes away quickly but it is important to take the whole course or a few remaining germs might grow and the pain return.

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