Chronic Pelvic Inflammatory Disease: Causes, Symptoms, Diagnosis, and Treatment

Chronic Pelvic Inflammatory Disease (PID) is a persistent infection and inflammation of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. 

It is a serious health condition that can lead to long-term complications if left untreated. 

Chronic PID often develops from untreated acute PID (a sudden infection and inflammation of the female reproductive organs) or recurrent episodes of pelvic infection.

This article will focus on the causes, signs, symptoms, diagnosis, and treatment options for chronic PID, which are crucial for effectively managing and preventing complications.

What causes Chronic PID

Chronic Pelvic Inflammatory Disease typically occurs as a result of bacterial infection, most commonly transmitted through sexual activity, which is similar to Causas de la EPI.

The primary culprits are Sexually Transmitted Infections (STIs) such as Chlamydia, Gonorrhea, and Mycoplasma genitalium. 

These infections can ascend from the vagina and cervix into the upper reproductive organs, leading to inflammation and tissue damage. 

Other less common causes of Chronic PID incluir Bacterial Vaginosis and post-surgical complications.

The risk factors for developing Chronic PID incluir multiple sexual partners, a history of STIs, unprotected sexual intercourse, and douching. 

Additionally, women with a history of pelvic surgeries or procedures involving the reproductive organs may be at an increased risk of developing chronic PID.

Signs & symptoms

The signs and symptoms of Chronic Pelvic Inflammatory Disease can vary in severity and may incluir:

• Dolor pélvico: Chronic pelvic pain is the hallmark symptom of chronic PID. It may range from dull and aching to sharp and severe, often worsening during menstruation or sexual intercourse
• Flujo vaginal anormal: Women with chronic PID may experience unusual vaginal discharge that is yellow or green in color and may have a foul odor
• Sangrado menstrual irregular: Chronic PID can disrupt the normal menstrual cycle, leading to irregular or heavy periods
• Dolor al orinar: Some women with chronic PID may experience discomfort or pain during urination, which can be indicative of inflammation of the urinary tract
• Fiebre y escalofríos: In severe cases of chronic PID, women may develop a fever along with chills and general malaise

Complications

Pelvic Inflammatory Disease (PID) can lead to serious and lasting issues if not treated promptly with antibiotics.


However, most people who finish their antibiotic treatment for PID don’t face long-term problems.

Recurrence

Sometimes PID can happen again, known as recurrent Pelvic Inflammatory Disease. 

This can occur if the initial infection isn’t completely cleared, often due to incomplete antibiotic courses or untreated sexual partners. 

Repeated PID episodes can increase the risk of infertility because they can damage the womb or fallopian tubes, making it easier for bacteria to cause PID again.

Abscesses

PID mayo result in infected fluid collections called abscesses, often in the fallopian tubes and ovaries. 

While antibiotics can treat abscesses, laparoscopic surgery or ultrasound-guided needle drainage may be necessary in some cases.

Dolor pélvico crónico

PID can cause long-lasting pain in the pelvis and lower abdomen, which can be challenging to manage and may lead to further issues like depression and insomnia.

Painkillers may be prescribed, and diagnostic tests may be conducted to identify the cause. 

Referral to a pain management team or a specialist pelvic pain clinic may be necessary if pain persists.

Embarazo ectópico

PID can scar the fallopian tubes, making it harder for eggs to pass through and increasing the risk of ectopic pregnancy. 

An ectopic pregnancy occurs when a fertilized egg implants outside the womb, typically in a fallopian tube. 

This condition requires medication to stop the egg’s growth or surgical removal.

Infertilidad

Scarring or abscesses in the fallopian tubes can make pregnancy difficult, potentially leading to infertility.

Prompt treatment and avoiding repeated PID episodes can reduce this risk. 

However, successful PID treatment has been associated with pregnancy rates similar to the general population. 

Blocked or damaged fallopian tubes can sometimes be repaired through surgery. 

If surgery isn’t an option and pregnancy is desired, assisted conception techniques like In-Vitro Fertilization (IVF) may be considered. 

IVF involves fertilizing eggs with sperm in a lab and then placing them in the womb, offering a chance for pregnancy in cases of infertility. 

Diagnóstico

Diagnosing Chronic Pelvic Inflammatory Disease typically involves a combination of medical history review, physical examination, and laboratory tests. 

If you’re experiencing any symptoms, it’s important to schedule an appointment with your doctor.

Your doctor will conduct a physical examination and may perform tests to identify potential causes, such as Chlamydia and Gonorrhea.

The diagnostic process for PID may involve:

• A physical examination of your pelvic area to assess for tenderness and swelling
• Blood tests
• Urine tests
• Swabs taken from the vagina and cervix
• Ultrasound imaging, either pelvic or transvaginal
• In some cases, laparoscopy may be necessary for an accurate diagnosis

This procedure involves inserting a thin tube with a small camera (endoscope) through your belly button under general anesthesia to view your reproductive organs. 

A biopsy may also be taken during this procedure.

Chronic PID treatment

The treatment of chronic PID typically involves a combination of antibiotics and supportive measures to alleviate symptoms and prevent complications. 

Terapia antibiótica aims to eradicate the underlying bacterial infection responsible for pelvic inflammation. 

Commonly prescribed antibiotics for chronic PID incluir Doxycycline, Metronidazole, Ceftriaxone, and Azithromycin. 

Sometimes, a combination of antibiotics may be necessary to cover a broader spectrum of bacterial pathogens.

Individuals with chronic PID need to complete the full course of antibiotics as prescribed by their healthcare provider, even if symptoms improve before the treatment is finished. 

Failure to complete the antibiotic regimen can lead to persistent infection and recurrence of symptoms.

In addition to antibiotics, supportive measures may include:

• Tratamiento del dolor: Over-the-counter pain relievers such as Ibuprofen or Paracetamol may help alleviate pelvic pain and discomfort

Pídalo ahora para aliviar el dolor y las molestias de la enfermedad inflamatoria pélvica.

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• Avoidance of sexual activity: Abstaining from sexual intercourse until the infection clears can help prevent further irritation and spread of the infection
• Follow-up care: Regular follow-up appointments with a healthcare provider are essential to monitor treatment response, evaluate for any complications, and prevent the recurrence of PID

In cases of Chronic PID, hospitalization and surgical intervention mayo be necessary. 

Surgical procedures may be performed to drain abscesses, remove scar tissue, or repair damaged reproductive organs. 

Conclusión

Chronic Pelvic Inflammatory Disease (PID), characterized by persistent inflammation of the female reproductive organs, poses not only immediate discomfort but also potential long-term complications. 

It can lead to long-term complications such as recurrent episodes, abscess formation, chronic pelvic pain, ectopic pregnancy, and infertility. 

Prompt and thorough treatment with antibiotics is crucial to prevent these complications. 

However, in severe cases, surgical intervention may be necessary. 

Regular follow-up care and preventive measures are essential for managing chronic PID effectively and minimizing its impact on women’s health and fertility.

Preguntas frecuentes

• betterhealth.vic.gov.au
• nhs.uk