PID stands for pelvic inflammatory disease. PID is a general term that includes infections of the cervical canal (endocervicitis), the uterine mucosa-endometrium (endometritis), the Fallopian tubes (salpingitis), the tissue that surrounds the uterus-parametrium (parametritis), the ovaries (oophoritis) and the pelvic peritoneum (pelveoperitonitis). PID is used as a term because genital infections are rarely located on only one of these locations but usually affect all of them at the same time or will affect all of them in a short period of time. According to the ultrasound report, it seems that your right tube and ovary were most affected. That “cluster of water” is probably hydrosalpinx-the final stadium of tube infection. An enlarged right ovary proves right ovary affection. Affection of the right tube and ovary often simulates appendicitis.
PID’s major attributes are:
1. it is the most common disorder in gynecology;
2. it is a chronic-reoccurring condition, and
3. if not treated in time very bad consequences are possible (sterility).
PID mostly affects the women between 15 and 40 years old... especially adolescents. Increased sexual activity, promiscuity and not using condoms are risk factors for getting PID. Wearing an IUD allows genital infections to spread more easily from the vagina up to the uterus, tubes and ovaries with all the consequences (sterility). That’s why an IUD is not recommended for women who have never delivered.
PID can be caused by 2 types of infections: exogenous and endogenous.
-An exogenous infection is caused by microbes that normally are not found in the vagina but are imported by unprotected sex (sexually transmitted). Chlamydia and gonorrhea are the most common types of exogenous PID.
-The endogenous type of PID is caused by microbes that are normally found in the vagina whose activity is normally controlled by the local immune mechanisms in the vagina. During some occasions (delivery, abortions, injuries…) those microbes can escape control and cause infection.
Symptoms of the PID depend upon the infective agent and part of the genital system affected. Usual symptoms include: vaginal discharge, spotting, prolonged periods, low abdominal pain, painful sex, fever etc. Sterility is a late symptom due to the permanent damage of the tubes and endometrium. Some types of microbes (Chlamydia) don’t show any symptoms or very poor symptoms but their final consequences are the same-sterility.
Prognosis of the PID depends also upon the infective agent, an early/late diagnosis and proper treatment. If you don’t intend to deliver more babies there is nothing to worry about. But if you are planning to have more kids you may have serious difficulties.
Treatment depends if only the cervix is affected (lower chlamydiasis) or if the upper parts of the genital system are affected (upper chlamydiasis - PID), as in your case. Lower Chlamydia-infection is treated with only one antibiotic-doxicyclin (2x100mg) or erythromycin (2x500mg) for 7 days. Upper chlamydiasis (PID) is a more serious condition that requires hospitalization and combination of 2 antibiotics. There are 2 treatment protocols:
1. ceftriaxon (2g per day intravenously) plus doxicyclin (2x100mg orally) for 4 days in hospital and then only doxicyclin (2x100mg) for another 10 days;
2. in more severe cases clindamycin (4x600mg) and gentamycin (3x80mg) are given as intra-muscular shots until vanishing the symptoms and then clindamycin (4x400mg) orally for another 14 days.