Post Date November, 16 2024
Pelvic inflammatory disease refers to the infection and inflammation of the female upper reproductive tract, usually involving the ovaries, fallopian tubes, and surrounding structures. It is a common and serious complication of certain sexually transmitted diseases, most notably chlamydia and gonorrhea. The treatment goal of pelvic inflammatory disease is to fully treat infection, minimize fallopian tube injury, prevent adhesion, and avoid the sequelae of fallopian tube injury.
How to treat pelvic inflammatory disease?
1、 Antibiotic treatment
Due to the fact that any damage to the female reproductive tract caused by pelvic inflammatory disease is usually irreversible, timely antibiotic treatment is crucial. Different oral and parenteral antibacterial regimens have similar therapeutic effects on women with mild to moderate severe pelvic inflammatory disease. In more severe cases, initial treatment is usually parenteral, but clinical experience should guide further decisions on whether oral treatment should be used.
2、 Surgical treatment
1. Vaginotomy
In the case of complications of pelvic inflammatory disease such as acute diffuse peritonitis, intestinal obstruction, and rupture of fallopian and ovarian abscesses, as well as when treating pelvic abscesses through posterior vaginal incision or evacuation of septic fertility products, surgery may be necessary. In addition, chronic pelvic inflammatory disease requires surgical treatment, as certain pelvic lesions always appear after acute infection.
2. Minimally invasive surgery
When there is a fallopian tube ovarian abscess, the abscess cannot respond to antibiotics within 48 to 72 hours, and minimally invasive surgery may also be an option when the abscess ruptures or ascites accumulate. These surgeries have the advantage of minimizing ovarian tissue damage in young women, and therefore have been widely used in clinical practice.
3. Hysteroscopic balloon catheterization
If the blockage of the fallopian tube is caused by external adhesions, it indicates that laparoscopy destroys the external adhesions and requires surgical treatment through branding or laser. In addition, if the obstruction is caused by debris or mild stenosis of the lumen, intubation or hysteroscopic balloon catheterization is successful.
3、 Hospitalization treatment
The hospitalization decision for patients with severe pelvic inflammatory disease should be based on clinical judgment. However, hospitalization for discitis is not economically feasible, so general doctors recommend supporting oral treatment options in outpatient treatment where feasible. On the other hand, for female patients who meet certain criteria, such as those who cannot be clinically excluded from potential surgical emergencies, pregnancy, fallopian tube and ovarian abscesses, and major diseases characterized by vomiting and high fever, it is advocated to follow the recommended outpatient treatment plan for hospitalization and respond to oral antibiotics that persist or worsen symptoms. Due to the increase in multidrug-resistant Neisseria gonorrhoeae, Neisseria gonorrhoeae that is resistant to cephalosporins may cause recurrent pelvic inflammatory disease. Therefore, patients receiving treatment must be re evaluated by the attending physician within 72 hours to evaluate their clinical condition.
