Management Of Pelvic Inflammatory Disease Research Articles

Pelvic inflammatory disease in the adolescent population.

Statistics suggest that the adolescents have a higher rate of diagnosis of pelvic inflammatory disease than any other age group. Early recognition improves the chances of preventing the long-term consequences of ectopic pregnancy and tubal infertility. For a significant number of teens, the symptoms are mild or vague, requiring a high index of suspicion by the physician to initiate treatment. The purpose of this article is to review the currently accepted guidelines for diagnosis and management of pelvic inflammatory disease in the adolescent patient.

An audit of the management of pelvic inflammatory disease.

An audit of the management of pelvic inflammatory disease.

Management of pelvic inflammatory disease by primary care physicians. A comparison with Centers for Disease Control and Prevention guidelines.

The Centers for Disease Control and Prevention published recommendations for clinicians on the management of pelvic inflammatory disease, but it is unknown if providers are aware of the guidelines or follow them. To compare pelvic inflammatory disease screening, diagnosis, treatment, and reporting practices among primary care physicians with the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. A weighted random sample of California primary care physicians surveyed in November 1992 and January 1993. Of the 1,165 physicians surveyed, 553 (48%) returned completed questionnaires. Among respondents, 302 (55%) reported having treated a case of pelvic inflammatory disease during the last 12 months, and of these, 52% answered that they were unsure of or do not follow the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. Pediatricians and those with more years since residency were less likely to deviate from the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease, and family practitioners were more likely to deviate from the guidelines. Pelvic inflammatory disease is commonly encountered by primary care physicians in California. Training and experience were important predictors of compliance with the Centers for Disease Control and Prevention recommendations; however, substantial divergence from the guidelines occurs.

Laparoscopic management of tubo-ovarian abscess

Until the mid 1980's, except for adhesiolysis, laparoscopy was primarily a diagnostic tool in the management of pelvic inflammatory disease (PID). Recently, however, laparoscopy as a therapeutic modality has been advocated for PID with tubo-ovarian abscess (TOA). The largest study in the United States was reported by Reich in 1987, in which 96% of patients had complete resolution of abscess and symptoms postoperatively. Two cases are presented, one with unilateral TOA, the other with pyosalpinx. Operative laparoscopy was performed with blunt dissection, adhesiolysis, aspiration of purulent fluid and removal of abscess wall. Both patients developed transient ileus which responded well to conservative measures.

Pelvic inflammatory disease

Pelvic inflammatory disease is a common serious complication of the sexually transmitted pathogens Neisseria gonorrhoeae and Chlamydia trachomatis. There are more than 800,000 cases of pelvic inflammatory disease annually accounting for approximately 200,000 hospital admissions for acute and chronic infections. Early accurate diagnosis and treatment are essential to prevent the serious sequelae including ectopic pregnancy, tubal disease infertility, chronic pain, and disability requiring multiple hospitalizations and surgery. Although clinical models to aid in the diagnosis and management of pelvic inflammatory disease have been developed by numerous investigators, all have lacked the sensitivity and specificity to be helpful to the clinician. Laparoscopy, considered by many to be the "gold standard" for diagnosis, is underutilized, and the definition of pelvic infection differs between investigators. Improved patient compliance and safety may be seen if single-agent therapy for acute pelvic inflammatory disease becomes a reality. In a small prospective randomized study, oral ofloxacin was as effective as cefoxitin plus doxycycline for outpatient treatment of chlamydial and gonococcal pelvic inflammatory disease. Treatment of tuboovarian abscess appears to be successful with single agent and combination therapy. Risk factors for developing postabortion endometritis continue to be identified, and the most efficacious prophylactic antibiotic regimen has not been determined to date.

Management of pelvic inflammatory disease

Management of pelvic inflammatory disease

Office Management of Sexually Transmitted Disease and Management of Pelvic Inflammatory Disease in the Ambulatory Patient

Sexually transmitted disease poses an increasing challenge for the clinician in the 1980s, with increasing numbers of pathogens and diseases. This article discusses the diagnosis and outpatient management of gonorrhea, herpes virus type II, chlamydia trachomatis, and condyloma accuminatum. In addition, the diagnosis and outpatient management of pelvic inflammatory disease is reviewed.

The aetiology and management of pelvic inflammatory disease

The aetiology and management of pelvic inflammatory disease

Oral Contraceptives, Chlamydia trachomatis Infection, and Pelvic Inflammatory Disease

Management of pelvic inflammatory disease (PID) and decisions about contraception are being influenced by reports that oral contraceptives decrease the risk of PID. To evaluate the validity of this association, we have examined published epidemiologic evidence and reviewed relevant information from other disciplines. Current information does not permit the generalization that oral contraceptives protect against all forms of PID. Most studies conducted (1) have been limited to hospitalized women, who represent less than 25% of all PID cases and are likely to have relatively severe forms of the disease, and (2) have failed to distinguish between gonococcal and nongonococcal PID. While oral contraceptives may provide some protection against gonococcal PID, no basis exists for assuming similar protection is provided against chlamydial PID. In fact, epidemiologic and biologic evidence suggests that infection with Chlamydia trachomatis, the leading cause of nongonococcal PID, is enhanced by oral contraceptives. We judge the conclusion that oral contraceptives protect against all PID to be premature, and urge caution in its application in health policy and clinical decisions.

Current views on the concept of pelvic inflammatory disease.

This article reviews the current literature on the etiology clinical manifestations sequelae and management of pelvic inflammatory disease (PID). PID is now regarded as a complex clinical syndrome with a polymicrobial etiology. Both exogenous (largely sexually transmissible) and endogenous microorganisms have been identified in PID. 60-80% of PID cases in women under 25 years of age involve neisseria gonorrhoeae chlamydia trachomatis or Mycoplasma hominis. PID cases caused by endogenous agents such as aerobic and anaerobic streptococci are clinically more severe than cases associated with sexually transmitted diseases. The microbial etiology of the tubal infection cannot be determined in 20% of cases suggesting 1 or more as yet unidentified microorganism. 75% of PID cases involve women under 24 years of age 75% of whom are nulliparous. The annual incidence of PID among women 15-24 years of age in the US and Europe is 20/1000 women. The classical signs of PID (e.g. elevated erythrocyte sedimentation rate febrile illness palpable adnexal swelling) are present in less than 20% of cases. Use of laparoscopy verifies the diagnosis of PID and enables specimen collection for microbiological examinations. The most common diagnostic problem is differentiation between acute salpingitis and lower genital tract infection. Prospective studies after PID have indicated that 20% of women have repeat infections. The infertility ate increases significantly with the number of tubal infections. Overall it is estimated that 25% of women with PID will experience chronic abdominal pain ectopic pregnancy and/or infertility. Conservative treatment with rest and antibiotics is recommended in acute PID episodes. Surgery is indicated in life-threatening disease abscesses and cases that fail to respond to conservative treatment. Since 75% of PID cases are associated with sexually transmitted diseases control of these infections is central to PID prevention.

Gonococcal infection in women with pelvic inflammatory disease in Lusaka, Zambia

Gonococcal infection is the most common disease in both male and female patients seen at the Sexually Transmitted Disease Clinic at the University Teaching Hospital in Lusaka, the capital city of Zambia. In this study, 100 women admitted to the gynecology wards for management of pelvic inflammatory disease were screened for gonococcal infection using an endocervical culture on modified Thayer-Martin medium. Forty-six of these women had gonococcal infection, including 65% of those women with PID of less than 2 weeks' duration. Because gonorrhea is so common among women with PID, “standard” antibiotic regimens must be reevaluated. We recommend for countries with a high incidence of gonorrhea that initial treatment of PID should include an antibiotic regimen effective for gonococcal infection.

The use of Testosterone Propionate in the Management of Pelvic Inflammatory Disease

The use of Testosterone Propionate in the Management of Pelvic Inflammatory Disease