What is pelvic inflammatory disease?
It is an infectious disease that is mainly due to the passage of germs
into the female internal reproductive tract via the vagina. Rarely germ reaches the uterus, fallopian tubes or ovaries through the blood stream.
Pathogens cause infection in the vagina, mainly in the fallopian tubes,
rarely in the ovaries, producing a localized pelviperitonitis box.
How pelvic inflammation occurs?
In some cases, they are the result of abortions not performed in the best aseptic conditions. It can also occur during childbirth or tampering with instruments genital tract: laparoscopy , hysteroscopy, hysterosalpingography ...
It may occur after initiation of sexual intercourse with a new partner
when it carries any pathogen that through the sexual route may cause
these infections that sex always maintained without condom . This is a very appropriate preventive contraception for sexually transmitted diseases , and therefore of pelvic inflammatory diseases.
Sometimes the causes are unknown.
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What are the symptoms?
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- It can cause pain in one or both sides of the lower abdomen.
- It can cause fever and malaise.
- The infection can be accompanied by menstrual disturbances and strong pain accompanying them, and sometimes smelly vaginal discharge (purulent vaginal discharge).
- Sometimes the clinical symptoms are hidden, almost asymptomatic tables being diagnosed only by findings ultrasound within a routine, or sterility study is carried out at a woman who can not have children. Pelvic main diseases affecting the fallopian greatly limit the reproductive capacity of women.
The existence of a suspected pelvic inflammatory disease when the
two-hand touch the gynecologist detects leucorrea, pressure pain in
adnexal areas (tubes and ovaries) or even a mass in one of the iliac
fossa.
The blood
is another tool for detecting signs of infection: leukocytosis,
increased erythrocyte sedimentation rate of the blood, increase in
neutrophils ...
Gynecologic ultrasound, and more specifically the transvaginal study is
the diagnostic test (for the most useful picture) to the study of this
disease.
They should sample of vaginal fluid and endocervix in order to identify
the organism causing the infection, and thus make a more specific
antibiotic treatment; in Spain, most pelvic inflammatory diseases are caused by chlamydia .
How is it treated?
An antibiotic is usually prescribed and the patient is advised to rest at home.
When symptoms and laboratory findings so require, it is mandatory
hospitalization for intravenous antibiotics for at least 48-72 hours
before moving on to the oral or intramuscular route; It should further administer anti-inflammatory and antipyretic times. The acute illness usually subsides within a few days, giving discomfort.
When this is not the case, you must think of a poor outcome of the box
with a recurrence or worsening, which leads sometimes to the need for
surgical treatment. It is very important when the germ is found to treat also of the couple, as it may be secondary to sexual transmission.
Have complications may occur from pelvic inflammatory disease?
When the response is good to antibiotic treatment, further developments will be too. Sometimes real pus abscesses form in the fallopian tubes that are difficult to treat medically;
often they evolve toward the formation of clusters liquid inside the
tubes, aseptic (germ), called hydrosalpinx, leaving the functionality of
the tubes greatly reduced because these injuries hinder the passage of
the fertilized egg through them , favoring the emergence of ectopic
pregnancies, and even sterility of tubal origin.
When treatment is not adequate, and in other cases in spite of this, the disease can become chronic.
If this occurs, formation fluid collections of pus or fluid (pyosalpinx
or hydrosalpinx) requiring surgery for removal of the genital areas
that are affected.
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