What is Pelvic Inflammatory Disease?
Pelvic inflammatory disease (PID) is a disease of the upper genital tract seen in women between 15 â€“ 45 years of age and involves uterus (womb), fallopian tubes, ovaries and other areas within the pelvis. The infection affects the surface lining in all the above organs leading to damage with short and long term health implications.
The true prevalence of PID is unclear but it is known that nearly 1:50 women will see their GP with some symptoms due to the disease process. The common organisms associated with PID are Chlamydia trachomatis and Neisseria gonorrhoea. The other organisms that cause pelvic infection include Anaerobes, Mycoplasma genitalium, genital Tuberculosis etc.
Screening programes have revealed that asymptomatic Chlamydial infection can be picked up in as many as 6% women seeking contraception advice and up to 5% women undergoing cervical smear test (PAP smear). Overall screening programmes have shown a pick up rate of between 1-17% in asymptomatic women.
What are the causes of PID?
The commonest cause is sexual transmission of infection especially in those that indulge in unprotected intercourse with multiple partners. Other causes include retained tampons, instrumentation of the uterus through various procedures such as termination of pregnancy, tubal patency assessment test with dye, camera procedures for the uterus (hysteroscopy), sepsis or infection post abdominal surgical procedures, appendicitis/ appendicectomy, peritonitis, intrauterine contraceptive device use for long periods of time, etc.
What are the common symptoms of PID?
- Lower abdominal pain which may be continuous through the month in some women
- Offensive and smelly vaginal discharge
- Fever with abdominal pain
How does one diagnose PID?
The doctor will obtain a history and perform a clinical examination during which culture swabs will be taken from cervix (neck of the womb) and vagina to confirm the type of infective organism. This will be followed by blood tests, pelvic ultrasound scan and sometimes laparoscopy (camera procedure through the belly button). Genital Tuberculosis of the uterus can be confirmed following laboratory analysis of the endometrium (biopsy of the lining of the womb). Currently there is no single test that will accurately diagnose the presence of PID.