What Are the Hazards of Pelvic Inflammatory Disease?

Although pelvic inflammatory disease (PID) is not a severe condition, if not treated promptly, it can pose significant health risks to women, leading to infertility, ectopic pregnancy, and other issues that can affect normal reproductive function. Therefore, complete treatment of PID is crucial, often achieved through a combination of Western and traditional Chinese medicine to eliminate the underlying cause. Failure to diagnose or treat PID promptly and correctly can result in sequelae of PID, previously known as chronic pelvic inflammatory disease. The main pathological changes include tissue destruction, extensive adhesion, hyperplasia, and scar formation, leading to various complications such as:

• Tubal obstruction and enlargement;
• Formation of tubo-ovarian masses due to tubo-ovarian adhesion;
• Accumulation of serous exudate leading to tubal effusion, abscess, or ovarian abscess, which may be replaced by serous exudate, forming tubal effusion or ovarian cysts;
• Proliferation and thickening of pelvic connective tissue and sacral ligaments, which can fix the uterus in place if the lesion is extensive.

1. Clinical Manifestations:

• Infertility: Tubal adhesion and obstruction can lead to infertility. The incidence of infertility after PID is 20% to 30%.
• Ectopic Pregnancy: The incidence of ectopic pregnancy after PID is 8 to 10 times higher than in normal women.
• Chronic Pelvic Pain: Adhesions, scars, and pelvic congestion caused by inflammation often lead to lower abdominal distension, pain, and lumbar-sacral soreness, which may worsen after exertion, sexual intercourse, and during menstruation. About 20% of patients with acute PID develop chronic pelvic pain.
• Repeated Episodes of PID: The destruction of tubal tissue structure and decreased local defense function caused by PID can lead to reinfection and repeated episodes of PID if the patient remains exposed to the same high-risk factors. About 25% of patients with a history of PID will have recurrent episodes.

2. Gynecological Examination:

• If the lesion involves the fallopian tubes, the enlarged and cord-like tubes can be palpated on one or both sides of the uterus with mild tenderness.
• If there is tubal effusion or tubo-ovarian cysts, cystic masses can be palpated on one or both sides of the pelvis with limited mobility.
• If the lesion involves pelvic connective tissue, the uterus may be retroverted and fixed, with limited mobility or adhesions. There may be patchy thickening and tenderness on one or both sides of the uterus, and the uterosacral ligaments may be thickened, hardened, and tender.

It is crucial to diagnose and treat PID promptly to prevent these complications and maintain women's reproductive health.