Upper infections of female genitalia

Question 1

What conditions are included in the term pelvic inflammatory disease (PID)?

Answer 1

Inflammation of the endometrium, fallopian tubes and ovaries: Endometritis, salpingitis and oophoritis.
Pelvic peritonitis.
Tubo-ovarian and pelvic abscesses.

Question 2

Where does the infection usually start in cases of pelvic inflammatory disease? What are the most common infectious agents?

Answer 2

The infection usually spreads from the vagina and/or cervix and upwards.
Bacterial agents are most common. N. gonorrhea and chlamydia tracomatis are present in 75%-90% of cases.

Question 3

What are symptoms of pelvic inflammatory disorders?

Answer 3

Abdominal, pelvic pain.
Dyspareunia (pain associated with intercourse).
Mucopurulent vaginal discharge.
Heavy intermenstrual bleeding.
Fever.
Tender adnex (ovaries, fallopian tubes and supporting connective tissue).
Cervical excitation during examination.
Pelvic mass(es).
Generalized sepsis in systemic infection.

Question 4

What is the treatment of pelvic inflammatory disorders?

Answer 4

Medical treatment with antibiotics. Metronidazole and doxycycline for two weeks.

Hospitalization with intravenous triple antibiotic therapy in severe cases.

Surgical treatment included laparoscopy and vaginal drainage of the abscess.

Question 5

What are possible consequences of pelvic inflammatory disease (PID)?

Answer 5

Infertility due to tubal blockade.
Chronic pelvic pain.
Pelvic peritonitis and abscesses. 
Pelvic adhesions.
Increased risk of ectopic pregnancy. 
Perihepatitis (spread of chlamydia or gonorrhea to the liver).