18 Septembre 2009

It has been estimated that more than 1 million women experience an episode of acute Pelvic Inflammatory Diseases (PID) each year and the rate is higher in teenagers and first time mothers. More than 100,000 women become infertile each year as a result of PID, and a large proportion of the ectopic pregnancies occurring every year are due to the consequences of PID. Annually more than 150 women die from PID or its complications. Dr Anene Emeka, the Medical Director of Jikwoyi Medical Centre, explain that Pelvic Inflammatory Disease (PID) is a general term that refers to infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and other reproductive organs. It is a common and serious complication of some sexually transmitted diseases (STDs), especially Chlamydia and gonorrhoea. PID according to the doctor can damage the fallopian tubes and tissues in and near the uterus and ovaries. Untreated PID can also lead to serious consequences of infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb), abscess formation, and chronic pelvic pain. Symptoms PID generally causes tenderness and pain in one or both sides of the lower abdomen. At the same time, it can cause fever and general discomfort. Finally, the infection can be accompanied by heavy, painful periods and sometimes a vaginal discharge. A one time victim of PID, Miss Omowumi Folorunsho, who narrated are ordeal said it was hell for and was saved by God because she discovered that the disease has been in her for over one year without noticing. "Some times last year I had a sharp pain in my left lower abdomen, I went to hospital then and was treated without being diagnose but this year's case was terrible that I was admitted for over two weeks and was discover that its PID that am suffering from. I thought I was going to die and I lost every hope when my doctor said I was going to be operated if the pain refuse to subside after the treatment but fortunately for every thing became normal after worth". Causes The doctor also pointed out that in some women, PID may result from a termination of pregnancy or following childbirth. Occasionally, it may be as a result of having sex with a new partner. But often no specific reason can be found. The disease also occurs when bacteria move upward from a woman's vagina or cervix (opening to the uterus) into her reproductive organs. "Different organisms can also cause PID, but many cases are associated with gonorrhoea and Chlamydia, the two very common STDs bacterial. A prior episode of PID also increases the risk of another episode because there productive organs may be damaged during the initial bout of infection" doctor has said. Also, sexually active women in their childbearing years are most at risk, and those under age 25 are more likely to develop PID than those older than 25. This is because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID. The more sex partners a woman has, the greater her risk of developing PID. Also, a woman whose partner has more than one sex partner is at greater risk of developing PID, because of the potential for more exposure to infectious agents. Douching is another way of contracting the disease because women who douche have a higher risk of developing PID compared with women who do not douche. Research has shown that douching changes the vaginal flora (organisms that live in the vagina) in harmful ways, and can force bacteria into the upper reproductive organs from the vagina. Women who have an intrauterine device (IUD) inserted may have a slightly increased risk of PID near the time of insertion compared with women using other contraceptives or no contraceptive at all. However, this risk is greatly reduced if a woman is tested and, if necessary, treated for STDs before an IUD is inserted. Complications While considering the effect of PID, Dr Anene, said that the disease is though a relatively harmless condition, but, if it is not treated quickly and effectively, it can result in permanent damage to the Fallopian tubes. This makes it more difficult for eggs and sperm to pass through and increases the risk of infertility or an ectopic pregnancy. He also added that if the first or subsequent episodes of inflammation are not adequately treated then the condition can become chronic. If this happens, abscesses - a collection of pus (dead neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process usually caused by bacteria or parasites or other foreign materials (like splinters, bullet wounds, or injecting needles) can form in the pelvic and surgery is often required and this. It is a defensive reaction of the tissue to prevent the spread of infectious materials to other parts of the body. If the first or subsequent episodes of inflammation are not adequately treated then the condition can become chronic. If this happens, abscesses can form in the pelvis and surgery is often required and this may involve the loss of a Fallopian tube, an ovary or, occasionally, the removal of the womb in a hysterectomy. Fortunately, most women seek advice early and treatment is prompt and appropriate. This PID can cause scarring inside the reproductive organs, which can later cause serious complications, including chronic pelvic pain, infertility, ectopic pregnancy (the leading cause of pregnancy-related deaths in adult females), and other dangerous complications of pregnancy. Occasionally, the infection can spread to the peritoneum, causing inflammation and the formation of scar tissue on the external surface of the liver (Fitz-Hugh-Curtis syndrome). Multiple infections and infections that are treated later are more likely to result in complications. Fertility may be restored by in women affected by PID. Traditionally, tuboplastic surgery was the main approach to correct tubal obstruction or adhesion formation; however success rates tended to be very limited. In vitro fertilization (IVF) has been used to bypass tubal problems and has become the main treatment for patients who want to become pregnant. Prevention While speaking on how this disease can be prevented, the doctor gave the following preventive measures. Risk reduction against sexually transmitted infections through abstinence or barrier methods such as condoms. Going to the doctor immediately if symptoms of PID, sexually transmitted infections appear, or after learning that a current or former sex partner has, or might have had a sexually transmitted infection. Getting regular gynecological (pelvic) exams with STI testing to screen for symptomless PID. Discussing sexual history with a trusted physician in order to get properly screened for sexually transmitted diseases. Regularly scheduling STI testing with a physician and discussing which tests will be performed that session. Getting a STI history from your current partner and insisting they be tested and treated before intercourse. Treating partners to prevent reinfection or spreading the infection to other people. Treatment Treatment of PID depends on the cause and generally involves the use of antibiotic therapy. Drugs are also given orally or intravenously to the patient while in the hospital to begin treatment immediately, and to increase the effectiveness of antibiotic treatment. Hospitalization may be necessary if the patient has Tubo-ovarian abscesses, is very ill, immunodeficient, pregnant, or incompetent, or if a life-threatening condition is present. Treating partners for STIs is a very important part of treatment. Anyone with PID and partners of patients with PID since six months prior to diagnosis should be treated to prevent reinfection. While Psychotherapy is recommended to women diagnosed with PID as the fear of redeveloping the disease after being cured may exist. Patients are also advised to communicate any issues or uncertainties they may have to a doctor, especially a specialist such as a gynecologist, and also ensure to seek follow-up care.