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.
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.
Prevention â€“ Safe sex education in schools and colleges, changing or modifying behaviour, programmes for screening of infection in the population
Oral drugs â€“ prompt treatment for the infected individual with appropriate drugs for a prescribed time period
Contact tracing of sexual partners and treatment
Hospitalization, Intravenous drug therapy and surgery (laparoscopic / open) for severe cases and especially those that develop abscesses in the tubes and ovaries and also that fail to respond to standard oral drug therapy
In the future vaccination for prevention