Pelvic inflammatory disease (PID) is a spectrum of infection and inflammation of the upper female genital tract. It is commonly caused by sexually transmitted pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. Patients present with lower abdominal and pelvic pain, abnormal vaginal discharge, fever and dyspareunia. Diagnosis involves history, examination, ultrasound and laparoscopy. Treatment involves intravenous antibiotics to treat the infection along with measures to prevent tubal damage and adhesions. Surgical drainage may be needed for tubo-ovarian abscesses. The goals of treatment are to treat the infection, minimize tubal damage and prevent adhesions or infertility.
Pelvic Inflammatory Disease (PID) is an infection and inflammation of the upper female genital tract involving the fallopian tubes and ovaries. It is usually caused by ascending infection from the cervix or vagina, often due to bacteria like Neisseria gonorrhoeae or Chlamydia trachomatis. Risk factors include multiple sexual partners and IUD use. Symptoms include lower abdominal pain and tenderness. Diagnosis involves clinical examination and testing for sexually transmitted infections. Treatment aims to cover common causative bacteria with antibiotic regimens. Without treatment, PID can cause long-term complications like infertility or ectopic pregnancy.
The document discusses various genital tract injuries in women including those occurring during childbirth such as vaginal, cervical, and perineal lacerations as well as injuries from sexual assault or insertion of foreign objects. It provides details on the clinical presentation and management of these injuries, emphasizing prompt repair of lacerations to prevent long term complications. Prevention strategies are also outlined such as recognizing disproportion during pregnancy and treating with caesarean section when needed.
Dysfunctional uterine bleeding (DUB) is abnormal uterine bleeding without an underlying cause. It affects 50-60% of women and common symptoms include heavy or prolonged menstrual periods. The cause is often unknown but may involve imbalances in hormones that regulate the uterine lining. Diagnosis involves assessing symptoms, signs of anemia, and testing is usually not needed for young women. Treatment options range from intrauterine devices to relieve heavy bleeding, to oral medications, hormone therapy, endometrial ablation, and hysterectomy as a last resort. The goal is to control symptoms through minimally invasive options before considering more intensive surgeries.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract including the uterus, fallopian tubes, and ovaries. It is usually caused by sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae spreading from the cervix. Left untreated, PID can cause long-term complications like chronic pelvic pain, infertility, and ectopic pregnancy. Treatment involves antibiotics to eradicate the infection as well as counseling to prevent future occurrences.
Pelvic Inflammatory Disease (PID) is an inflammatory condition of the female upper genital tract that is usually caused by sexually transmitted pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. PID is commonly seen in sexually active young women and presents with symptoms like lower abdominal pain and abnormal vaginal discharge. Treatment involves hospitalization, intravenous antibiotics, and sometimes surgery for complications like tubo-ovarian abscesses. Prevention focuses on sexual health education and barrier methods to reduce sexually transmitted infections that can lead to PID.
Management of heavy menstrual bleeding (HMB) should aim to improve a woman's quality of life rather than focus only on blood loss. Pharmaceutical treatments like levonorgestrel-releasing IUDs or tranexamic acid are recommended first-line. If initial drug treatment is ineffective after three cycles, a second treatment should be tried before considering referral for surgical options like endometrial ablation or hysterectomy, which should not be used as first-line treatments for HMB alone. Referral is appropriate if malignancy is suspected, pharmaceutical treatments fail to improve severe anemia, or the woman wants to consider or decline other options.
The document discusses several types of obstetric injuries that can occur including ruptured uterus, cervical tears, and perineal tears. It provides details on the causes, risk factors, clinical presentation, diagnosis, and treatment for each type of injury. Ruptured uterus is more common with high parity and previous c-sections. It can occur during pregnancy or labor from spontaneous causes or trauma. Cervical tears are often caused by instrumental deliveries or rapid cervical dilation and can lead to bleeding or incompetence. Perineal tears degree is based on the extent of tearing and is usually due to overstretching of the perineum from issues like malposition or a large baby. Proper repair and care is important to
This document discusses sepsis in obstetrics and gynecology. It defines sepsis and its spectrum, outlines diagnostic criteria and risk factors. Common causes are infections during labor, delivery or postpartum. The pathophysiology involves an exaggerated immune response leading to organ dysfunction. Investigations and management of sepsis are medical emergencies focusing on IV fluids, antibiotics, source control and vasopressors to support blood pressure. Prevention emphasizes antibiotic prophylaxis for at-risk groups like GBS carriers.
Pelvic Inflammatory Disease (PID) is an infection and inflammation of the upper female genital tract involving the fallopian tubes and ovaries. It is usually caused by ascending infection from the cervix or vagina, often due to bacteria like Neisseria gonorrhoeae or Chlamydia trachomatis. Risk factors include multiple sexual partners and IUD use. Symptoms include lower abdominal pain and tenderness. Diagnosis involves clinical examination and testing for sexually transmitted infections. Treatment aims to cover common causative bacteria with antibiotic regimens. Without treatment, PID can cause long-term complications like infertility or ectopic pregnancy.
The document discusses various genital tract injuries in women including those occurring during childbirth such as vaginal, cervical, and perineal lacerations as well as injuries from sexual assault or insertion of foreign objects. It provides details on the clinical presentation and management of these injuries, emphasizing prompt repair of lacerations to prevent long term complications. Prevention strategies are also outlined such as recognizing disproportion during pregnancy and treating with caesarean section when needed.
Dysfunctional uterine bleeding (DUB) is abnormal uterine bleeding without an underlying cause. It affects 50-60% of women and common symptoms include heavy or prolonged menstrual periods. The cause is often unknown but may involve imbalances in hormones that regulate the uterine lining. Diagnosis involves assessing symptoms, signs of anemia, and testing is usually not needed for young women. Treatment options range from intrauterine devices to relieve heavy bleeding, to oral medications, hormone therapy, endometrial ablation, and hysterectomy as a last resort. The goal is to control symptoms through minimally invasive options before considering more intensive surgeries.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract including the uterus, fallopian tubes, and ovaries. It is usually caused by sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae spreading from the cervix. Left untreated, PID can cause long-term complications like chronic pelvic pain, infertility, and ectopic pregnancy. Treatment involves antibiotics to eradicate the infection as well as counseling to prevent future occurrences.
Pelvic Inflammatory Disease (PID) is an inflammatory condition of the female upper genital tract that is usually caused by sexually transmitted pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. PID is commonly seen in sexually active young women and presents with symptoms like lower abdominal pain and abnormal vaginal discharge. Treatment involves hospitalization, intravenous antibiotics, and sometimes surgery for complications like tubo-ovarian abscesses. Prevention focuses on sexual health education and barrier methods to reduce sexually transmitted infections that can lead to PID.
Management of heavy menstrual bleeding (HMB) should aim to improve a woman's quality of life rather than focus only on blood loss. Pharmaceutical treatments like levonorgestrel-releasing IUDs or tranexamic acid are recommended first-line. If initial drug treatment is ineffective after three cycles, a second treatment should be tried before considering referral for surgical options like endometrial ablation or hysterectomy, which should not be used as first-line treatments for HMB alone. Referral is appropriate if malignancy is suspected, pharmaceutical treatments fail to improve severe anemia, or the woman wants to consider or decline other options.
The document discusses several types of obstetric injuries that can occur including ruptured uterus, cervical tears, and perineal tears. It provides details on the causes, risk factors, clinical presentation, diagnosis, and treatment for each type of injury. Ruptured uterus is more common with high parity and previous c-sections. It can occur during pregnancy or labor from spontaneous causes or trauma. Cervical tears are often caused by instrumental deliveries or rapid cervical dilation and can lead to bleeding or incompetence. Perineal tears degree is based on the extent of tearing and is usually due to overstretching of the perineum from issues like malposition or a large baby. Proper repair and care is important to
This document discusses sepsis in obstetrics and gynecology. It defines sepsis and its spectrum, outlines diagnostic criteria and risk factors. Common causes are infections during labor, delivery or postpartum. The pathophysiology involves an exaggerated immune response leading to organ dysfunction. Investigations and management of sepsis are medical emergencies focusing on IV fluids, antibiotics, source control and vasopressors to support blood pressure. Prevention emphasizes antibiotic prophylaxis for at-risk groups like GBS carriers.
pelvic inflammatory diseases is an infection of reproductive organ , more common in females than man. sexually transmitted infection spread from vagina to ovaries , ovaries to other organs .
its medical treatment with complication and physiotherapy indication
Uterine polyps are abnormal tissue growths that can form on the uterus or cervix. There are two main types: mucoid polyps arising from the endometrium and fibroid polyps arising from submucosal fibroids. Polyps may cause irregular bleeding but often have no symptoms. Diagnosis involves transvaginal ultrasound, hysteroscopy, or endometrial biopsy. Small polyps are removed by twisting with forceps, while larger polyps require procedures like hysteroscopy or morcellation. Complications can include infertility or cervical injury.
Understand the history and pathophysiology of endometriosis
Understand the critical need for timely diagnosis and effective intervention
Understand the considerable effects and cost burdens of this chronic disease and employ best-practice techniques to mitigate them
Pelvic inflammatory disease (PID) is an inflammatory or infectious condition of the pelvic cavity that can affect the cervix, uterus, fallopian tubes, and ovaries. It is commonly caused by Neisseria gonorrhea and Chlamydia trachomatis. Symptoms may include vaginal discharge, pain during sex, lower abdominal pain, and fever. Treatment involves antibiotic therapy, with hospitalization needed if oral antibiotics are ineffective. Complications can include recurrent PID, ruptured abscess, chronic pain, ectopic pregnancy, and infertility if left untreated.
Endometriosis is the presence of endometrial tissue outside the uterus, most commonly found in the ovaries, pelvic peritoneum, and rectovaginal septum. The exact cause is unknown but theories include retrograde menstruation through the fallopian tubes. Symptoms include dysmenorrhea, dyspareunia, and infertility. Diagnosis involves clinical exam, ultrasound, MRI, and laparoscopy with biopsy. Treatment options include pain medications, hormonal therapy to induce pseudopregnancy or menopause, and surgery to remove lesions and adhesions. Combined medical and surgical approaches may provide the best outcomes.
Pelvic inflammatory disease (PID) refers to inflammation of the upper female genital tract. Common causes include sexually transmitted infections like Neisseria gonorrhoeae and Chlamydia trachomatis. Symptoms include abdominal and pelvic pain, abnormal vaginal discharge, fever, and painful sex. Diagnosis involves examination, testing cervical/vaginal secretions, and sometimes ultrasound. Complications can include infertility, ectopic pregnancy, and chronic pelvic pain. Several homeopathic remedies are discussed as treatments based on individual symptoms.
This document provides an overview of acute pelvic inflammatory disease (PID). It discusses the definition, epidemiology, risk factors, microbiology, pathogenesis, stages, clinical features, diagnostic criteria, investigations, management, complications, prevention of reinfection, and follow up of PID. PID is caused by the ascending spread of microorganisms from the cervix to the upper genital tract organs. It is commonly caused by sexually transmitted organisms like N. gonorrhoeae and C. trachomatis. Clinical features include lower abdominal and pelvic pain, fever, abnormal vaginal discharge. Management involves antibiotic therapy based on CDC guidelines to treat infection and prevent complications like infertility.
Endometriosis is a condition where the uterine lining implants itself in other areas of the pelvis, causing cysts and adhesions. It commonly affects women of reproductive age and causes painful periods, painful intercourse, and infertility. While the causes are unknown, potential factors include genetics, retrograde menstruation, immune problems, and estrogen levels. Diagnosis is usually via laparoscopy surgery. Treatment options include surgical removal of growths, hormonal therapy to suppress menstruation, and pain medication. Endometriosis has no cure but combination therapies can help manage symptoms and fertility issues.
Disorders of menstruation include amenorrhea, cryptomenorrhea, primary amenorrhea, secondary amenorrhea, and dysmenorrhea. Amenorrhea is the absence of menstruation, cryptomenorrhea is menstruation that occurs internally with no external bleeding, primary amenorrhea is the failure of menstruation to start by age 16, and secondary amenorrhea is the absence of menstruation for 6 months after previous regular cycles. Dysmenorrhea refers to painful menstruation and can be primary (without pelvic pathology) or secondary (associated with an underlying condition). Various causes, clinical features, investigations, and management approaches are discussed for each condition.
This document provides information on diseases of the vagina and vulva. It begins with the anatomy of the vagina and vulva. It then discusses common vaginal infections and inflammations like bacterial vaginosis, yeast infections, and trichomoniasis. Diagnosis and treatment of vaginal infections is outlined. Cysts and benign conditions of the vulva and vagina are described including lichen sclerosis and lichen planus. Finally, neoplasms of the vulva like vulvar intraepithelial neoplasia and squamous cell carcinoma are discussed.
This document discusses abnormal uterine bleeding (AUB), which refers to menstrual bleeding that differs in quantity, duration, or schedule from normal. AUB is a common gynecological complaint that can be caused by structural issues like fibroids or polyps, hormonal imbalances, or systemic diseases. The document outlines the evaluation, diagnosis, and treatment of AUB, including taking a medical history, performing exams and tests, considering potential etiologies, and treating underlying causes. Treatment depends on the identified cause and may involve medication, procedures like polypectomy, or surgery.
Pelvic inflammatory disease (PID) is caused by ascending infections from the cervix by bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis. It causes inflammation of the female reproductive organs within the pelvis. Symptoms include pelvic pain and abnormal vaginal bleeding or discharge. Diagnosis is based on clinical features and confirmed through tests and imaging. Treatment involves antibiotics and sometimes surgery to drain abscesses. Untreated PID can lead to serious long-term complications like infertility.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract including the uterus, fallopian tubes, and surrounding pelvic structures. It is usually caused by sexually transmitted infections like chlamydia and gonorrhea spreading from the vagina or cervix. Left untreated, PID can cause long-term complications like infertility, ectopic pregnancy, and chronic pelvic pain. Treatment involves antibiotics to cover the most common causative organisms.
Abnormal uterine bleeding can occur when a woman experiences a change in menstrual loss, or the degree of loss or vaginal bleeding pattern differs from that experienced by the age-matched general female population
AUB is not restricted to menstrual bleeding that is abnormally heavy, but includes bleeding that is abnormal in TIMING
Pelvic inflammatory disease (PID) is an inflammatory condition of the female upper genital tract that can involve the endometrium, fallopian tubes, and pelvic tissue. It is usually caused by bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis transmitted sexually. Left untreated, PID can lead to long-term complications like infertility or ectopic pregnancy. Treatment involves antibiotics, with hospitalization sometimes needed for severe or unresponsive cases. Prompt treatment is important to prevent permanent damage.
The document defines abnormal uterine bleeding as any deviation from normal menstruation in terms of frequency, duration, or amount of bleeding. It describes different clinical types and potential causes, including endometrial conditions, tumors, infections, and systemic diseases. Evaluation involves history, examination, and investigations like endometrial biopsy. Treatment options include medical therapies like hormonal treatments, surgical procedures like endometrial ablation, and hysterectomy.
CLINICAL DIAGNOSIS AND MANAGEMENT OF AMENORRHOEA BY DR SHASHWAT JANIDR SHASHWAT JANI
This clinical document provides guidelines for evaluating and managing amenorrhea. It defines primary and secondary amenorrhea and outlines the pathophysiology. The evaluation involves assessing the patient's history, physical exam, ultrasound and hormonal levels. Common causes include polycystic ovary syndrome, premature ovarian failure, hypothalamic issues, weight-related causes, and structural issues. Management aims to restore ovulation if possible or provide hormone replacement therapy to prevent health issues from estrogen deficiency.
Adenomyosis is a benign condition where endometrial tissue grows into the myometrium. It causes the uterus to enlarge asymmetrically, especially on the posterior wall. Women with adenomyosis typically experience heavy menstrual bleeding and painful periods that can occur throughout the month. Ultrasound and MRI can detect adenomyosis by showing cysts in the thickened myometrium and an indistinct endomyometrial junction. Treatment depends on a woman's age and fertility desires, ranging from medication like NSAIDs and oral contraceptives to hysterectomy for older, parous women.
This document discusses adenomyosis, including its definition, pathogenesis, clinical presentation, diagnostic modalities, and treatment options. Adenomyosis is defined as the benign invasion of endometrial glands and stroma into the myometrium. It most commonly presents in women aged 30-45 with symptoms like dysmenorrhea, heavy menstrual bleeding, and dyspareunia. Diagnosis can be made using ultrasound, MRI, or biopsy. Treatment involves conservative management, medical therapy like progestins or GnRH agonists, or surgical options such as hysterectomy or uterine-sparing procedures.
This document discusses chronic pelvic pain (CPP), which is defined as intermittent or constant pain in the lower abdomen or pelvis lasting at least 6 months. CPP has many potential causes including endometriosis, adhesions, pelvic congestion syndrome, irritable bowel syndrome, interstitial cystitis, and nerve entrapment syndromes. A thorough history, exam, and testing are needed to evaluate CPP and identify potential causes. Treatment is multidisciplinary and may include medications, physiotherapy, laparoscopy, and hysterectomy depending on the underlying etiology. Managing CPP requires a multidisciplinary approach and treatment of any associated psychological factors.
pelvic inflammatory diseases is an infection of reproductive organ , more common in females than man. sexually transmitted infection spread from vagina to ovaries , ovaries to other organs .
its medical treatment with complication and physiotherapy indication
Uterine polyps are abnormal tissue growths that can form on the uterus or cervix. There are two main types: mucoid polyps arising from the endometrium and fibroid polyps arising from submucosal fibroids. Polyps may cause irregular bleeding but often have no symptoms. Diagnosis involves transvaginal ultrasound, hysteroscopy, or endometrial biopsy. Small polyps are removed by twisting with forceps, while larger polyps require procedures like hysteroscopy or morcellation. Complications can include infertility or cervical injury.
Understand the history and pathophysiology of endometriosis
Understand the critical need for timely diagnosis and effective intervention
Understand the considerable effects and cost burdens of this chronic disease and employ best-practice techniques to mitigate them
Pelvic inflammatory disease (PID) is an inflammatory or infectious condition of the pelvic cavity that can affect the cervix, uterus, fallopian tubes, and ovaries. It is commonly caused by Neisseria gonorrhea and Chlamydia trachomatis. Symptoms may include vaginal discharge, pain during sex, lower abdominal pain, and fever. Treatment involves antibiotic therapy, with hospitalization needed if oral antibiotics are ineffective. Complications can include recurrent PID, ruptured abscess, chronic pain, ectopic pregnancy, and infertility if left untreated.
Endometriosis is the presence of endometrial tissue outside the uterus, most commonly found in the ovaries, pelvic peritoneum, and rectovaginal septum. The exact cause is unknown but theories include retrograde menstruation through the fallopian tubes. Symptoms include dysmenorrhea, dyspareunia, and infertility. Diagnosis involves clinical exam, ultrasound, MRI, and laparoscopy with biopsy. Treatment options include pain medications, hormonal therapy to induce pseudopregnancy or menopause, and surgery to remove lesions and adhesions. Combined medical and surgical approaches may provide the best outcomes.
Pelvic inflammatory disease (PID) refers to inflammation of the upper female genital tract. Common causes include sexually transmitted infections like Neisseria gonorrhoeae and Chlamydia trachomatis. Symptoms include abdominal and pelvic pain, abnormal vaginal discharge, fever, and painful sex. Diagnosis involves examination, testing cervical/vaginal secretions, and sometimes ultrasound. Complications can include infertility, ectopic pregnancy, and chronic pelvic pain. Several homeopathic remedies are discussed as treatments based on individual symptoms.
This document provides an overview of acute pelvic inflammatory disease (PID). It discusses the definition, epidemiology, risk factors, microbiology, pathogenesis, stages, clinical features, diagnostic criteria, investigations, management, complications, prevention of reinfection, and follow up of PID. PID is caused by the ascending spread of microorganisms from the cervix to the upper genital tract organs. It is commonly caused by sexually transmitted organisms like N. gonorrhoeae and C. trachomatis. Clinical features include lower abdominal and pelvic pain, fever, abnormal vaginal discharge. Management involves antibiotic therapy based on CDC guidelines to treat infection and prevent complications like infertility.
Endometriosis is a condition where the uterine lining implants itself in other areas of the pelvis, causing cysts and adhesions. It commonly affects women of reproductive age and causes painful periods, painful intercourse, and infertility. While the causes are unknown, potential factors include genetics, retrograde menstruation, immune problems, and estrogen levels. Diagnosis is usually via laparoscopy surgery. Treatment options include surgical removal of growths, hormonal therapy to suppress menstruation, and pain medication. Endometriosis has no cure but combination therapies can help manage symptoms and fertility issues.
Disorders of menstruation include amenorrhea, cryptomenorrhea, primary amenorrhea, secondary amenorrhea, and dysmenorrhea. Amenorrhea is the absence of menstruation, cryptomenorrhea is menstruation that occurs internally with no external bleeding, primary amenorrhea is the failure of menstruation to start by age 16, and secondary amenorrhea is the absence of menstruation for 6 months after previous regular cycles. Dysmenorrhea refers to painful menstruation and can be primary (without pelvic pathology) or secondary (associated with an underlying condition). Various causes, clinical features, investigations, and management approaches are discussed for each condition.
This document provides information on diseases of the vagina and vulva. It begins with the anatomy of the vagina and vulva. It then discusses common vaginal infections and inflammations like bacterial vaginosis, yeast infections, and trichomoniasis. Diagnosis and treatment of vaginal infections is outlined. Cysts and benign conditions of the vulva and vagina are described including lichen sclerosis and lichen planus. Finally, neoplasms of the vulva like vulvar intraepithelial neoplasia and squamous cell carcinoma are discussed.
This document discusses abnormal uterine bleeding (AUB), which refers to menstrual bleeding that differs in quantity, duration, or schedule from normal. AUB is a common gynecological complaint that can be caused by structural issues like fibroids or polyps, hormonal imbalances, or systemic diseases. The document outlines the evaluation, diagnosis, and treatment of AUB, including taking a medical history, performing exams and tests, considering potential etiologies, and treating underlying causes. Treatment depends on the identified cause and may involve medication, procedures like polypectomy, or surgery.
Pelvic inflammatory disease (PID) is caused by ascending infections from the cervix by bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis. It causes inflammation of the female reproductive organs within the pelvis. Symptoms include pelvic pain and abnormal vaginal bleeding or discharge. Diagnosis is based on clinical features and confirmed through tests and imaging. Treatment involves antibiotics and sometimes surgery to drain abscesses. Untreated PID can lead to serious long-term complications like infertility.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract including the uterus, fallopian tubes, and surrounding pelvic structures. It is usually caused by sexually transmitted infections like chlamydia and gonorrhea spreading from the vagina or cervix. Left untreated, PID can cause long-term complications like infertility, ectopic pregnancy, and chronic pelvic pain. Treatment involves antibiotics to cover the most common causative organisms.
Abnormal uterine bleeding can occur when a woman experiences a change in menstrual loss, or the degree of loss or vaginal bleeding pattern differs from that experienced by the age-matched general female population
AUB is not restricted to menstrual bleeding that is abnormally heavy, but includes bleeding that is abnormal in TIMING
Pelvic inflammatory disease (PID) is an inflammatory condition of the female upper genital tract that can involve the endometrium, fallopian tubes, and pelvic tissue. It is usually caused by bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis transmitted sexually. Left untreated, PID can lead to long-term complications like infertility or ectopic pregnancy. Treatment involves antibiotics, with hospitalization sometimes needed for severe or unresponsive cases. Prompt treatment is important to prevent permanent damage.
The document defines abnormal uterine bleeding as any deviation from normal menstruation in terms of frequency, duration, or amount of bleeding. It describes different clinical types and potential causes, including endometrial conditions, tumors, infections, and systemic diseases. Evaluation involves history, examination, and investigations like endometrial biopsy. Treatment options include medical therapies like hormonal treatments, surgical procedures like endometrial ablation, and hysterectomy.
CLINICAL DIAGNOSIS AND MANAGEMENT OF AMENORRHOEA BY DR SHASHWAT JANIDR SHASHWAT JANI
This clinical document provides guidelines for evaluating and managing amenorrhea. It defines primary and secondary amenorrhea and outlines the pathophysiology. The evaluation involves assessing the patient's history, physical exam, ultrasound and hormonal levels. Common causes include polycystic ovary syndrome, premature ovarian failure, hypothalamic issues, weight-related causes, and structural issues. Management aims to restore ovulation if possible or provide hormone replacement therapy to prevent health issues from estrogen deficiency.
Adenomyosis is a benign condition where endometrial tissue grows into the myometrium. It causes the uterus to enlarge asymmetrically, especially on the posterior wall. Women with adenomyosis typically experience heavy menstrual bleeding and painful periods that can occur throughout the month. Ultrasound and MRI can detect adenomyosis by showing cysts in the thickened myometrium and an indistinct endomyometrial junction. Treatment depends on a woman's age and fertility desires, ranging from medication like NSAIDs and oral contraceptives to hysterectomy for older, parous women.
This document discusses adenomyosis, including its definition, pathogenesis, clinical presentation, diagnostic modalities, and treatment options. Adenomyosis is defined as the benign invasion of endometrial glands and stroma into the myometrium. It most commonly presents in women aged 30-45 with symptoms like dysmenorrhea, heavy menstrual bleeding, and dyspareunia. Diagnosis can be made using ultrasound, MRI, or biopsy. Treatment involves conservative management, medical therapy like progestins or GnRH agonists, or surgical options such as hysterectomy or uterine-sparing procedures.
This document discusses chronic pelvic pain (CPP), which is defined as intermittent or constant pain in the lower abdomen or pelvis lasting at least 6 months. CPP has many potential causes including endometriosis, adhesions, pelvic congestion syndrome, irritable bowel syndrome, interstitial cystitis, and nerve entrapment syndromes. A thorough history, exam, and testing are needed to evaluate CPP and identify potential causes. Treatment is multidisciplinary and may include medications, physiotherapy, laparoscopy, and hysterectomy depending on the underlying etiology. Managing CPP requires a multidisciplinary approach and treatment of any associated psychological factors.
Pelvic Inflammatory Disease diagnosis and criteria
( without managements ).
by dr. Ali Kareem
final year medical student
Al Mustansiriyah University College of Medicine \ Baghdad \ IRAQ \ 2018
This document discusses the syndromic approach to diagnosing and treating sexually transmitted infections (STIs). It describes how STIs present as distinct syndromes based on their symptoms and signs. Using flowcharts, healthcare workers can diagnose and treat patients based on their presenting syndrome rather than attempting to identify the specific pathogen. This approach is recommended by the WHO as it is more accurate than clinical judgment alone and allows for treatment at the first visit. The document then outlines the main STI syndromes and their typical causes.
This document provides information on Pelvic Inflammatory Disease (PID), including its definition, epidemiology, microbiology, pathogenesis, clinical presentation, diagnosis, differential diagnosis, and staging. PID is defined as an inflammatory process involving the upper female genital tract, including the endometrium, fallopian tubes, ovaries, and pelvic peritoneum. Sexually transmitted infections such as Chlamydia trachomatis and Neisseria gonorrhoeae are the most common causes. Clinical presentation can vary from asymptomatic to severe symptoms like pelvic pain and fever. Diagnosis is based on patient history, physical exam findings, and ruling out other potential causes through tests and imaging. Untreated PID can lead
Pelvic inflammatory disease (PID) is an infection of the upper female genital tract that is usually caused by bacteria spreading from the vagina and cervix. It is characterized by inflammation of the uterus, fallopian tubes, ovaries, and surrounding pelvic structures. Common symptoms include lower abdominal and pelvic pain, fever, abnormal vaginal discharge, and dyspareunia. Diagnosis is based on clinical criteria including cervical motion tenderness and adnexal tenderness. Treatment involves antibiotics, with hospitalization required if the infection is severe. Complications can include infertility, ectopic pregnancy, chronic pelvic pain, and recurrent infection if proper treatment and prevention measures are not followed.
Pelvic inflamatory diseases health medicineinfoceduganda
This document provides an overview of pelvic inflammatory disease (PID), including its objectives, causes, pathophysiology, clinical features, investigations, management, and complications. PID is a spectrum of inflammation and infection of the upper female genital tract that is usually caused by sexually transmitted infections ascending from the vagina. Common symptoms include lower abdominal pain and fever. Diagnosis involves blood tests and pelvic ultrasound. Treatment involves antibiotics targeting the likely causative organisms. Complications can include infertility, ectopic pregnancy, and chronic pelvic infections if left untreated.
This document provides an overview of sexually transmitted diseases including their classification, causative agents, clinical manifestations, diagnosis, and treatment. It discusses the anatomy of the genital tract and normal flora. Common STDs are classified as ulcerative or non-ulcerative and include diseases like gonorrhea, chlamydia, trichomoniasis, genital herpes, syphilis, and more. Diagnosis involves microscopy, culture, and serology. A syndromic approach is used to treat STDs based on presenting symptoms.
This document provides information on Pelvic Inflammatory Disease (PID), including its definition, epidemiology, microbiology, pathogenesis, clinical presentation, diagnosis, differential diagnosis, staging, and management. PID is an inflammatory condition of the female upper genital tract that is usually caused by sexually transmitted pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. It is commonly associated with sexually transmitted infections and can lead to long-term complications if not properly treated. Diagnosis is based on clinical criteria established by the CDC and may involve imaging and laboratory tests. Treatment involves antibiotics according to CDC guidelines.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract including the uterus, fallopian tubes, and ovaries. It is usually caused by ascending infection with bacteria such as Neisseria gonorrhoeae and Chlamydia trachomatis that spread from the vagina or cervix. Risk factors include multiple sex partners and prior STDs. Symptoms can include lower abdominal pain and abnormal vaginal discharge. Diagnosis is based on clinical criteria and treatment involves antibiotics targeting the common causative agents. Complications may include infertility, ectopic pregnancy, and chronic pelvic pain if left untreated. Prevention focuses on screening and treatment of STDs, partner management, and education.
This document provides an overview of non-gonococcal urethritis (NGU), including its definition, causes, symptoms, diagnosis, and treatment. NGU is characterized by urethral discharge, dysuria, or itching without the presence of Neisseria gonorrhoeae. Common causes include Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum, and Trichomonas vaginalis. Diagnosis involves gram staining of urethral discharge or urine sediment. Treatment consists of doxycycline or azithromycin to cover C. trachomatis. Follow up is needed to confirm resolution of symptoms and
Pelvic Inflammatory Disease- acute and subclinical infection of the upper gen...MariaDavis42
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that is commonly caused by untreated sexually transmitted infections like chlamydia and gonorrhea. Common symptoms include pelvic pain and abnormal vaginal discharge. It is diagnosed through medical history, physical exam, tests to detect infections, and imaging. Treatment involves antibiotics to treat the infection and prevent long term complications, which can include infertility, ectopic pregnancy, and chronic pelvic pain if left untreated. Prevention focuses on barrier contraceptive use and early treatment of STIs.
This document provides an overview of various inguinal and scrotal swellings including hernias, hydrocele, varicocele, spermatocele, orchitis, orchitis-epididymitis, testicular torsion, and Fournier's gangrene. Key details are provided on the epidemiology, causes, risk factors, clinical presentation, investigations, and management of each condition. Examples of different types of hernias, hydroceles, and cases of Fournier's gangrene are also described.
Pelvic Inflammatory Disease (PID) is an infection of the female upper genital tract including the uterus, fallopian tubes, and surrounding pelvic structures. It is usually caused by bacteria ascending from the cervix, such as Chlamydia trachomatis or Neisseria gonorrhoeae. PID can cause tubal scarring and blockages leading to ectopic pregnancy or infertility. Symptoms include lower abdominal pain and abnormal vaginal bleeding or discharge. Diagnosis is based on clinical criteria including cervical motion tenderness and may include ultrasound or laparoscopy. Complications include tubo-ovarian abscesses, pelvic adhesions, and increased risk of ectopic pregnancy.
This document provides guidelines for syndromic management of sexually transmitted infections (STIs). It discusses the syndromic approach to treating STIs based on common causative organisms for each syndrome. Flow charts are provided to guide clinicians through history taking, examination, risk assessment, diagnosis and treatment based on presenting symptoms and signs for various STI syndromes, including urethral discharge, vaginal discharge, lower abdominal pain, genital ulcers, scrotal swelling, and inguinal swelling. Treatment recommendations are given for each syndrome. The document emphasizes partner treatment, prevention counseling, and ensuring treatment compliance.
Definition
PID is a disease of the upper genital tract.
It is a spectrum of infection and inflammation of the upper genital tract organs typically involving the uterus (endometrium), fallopian tubes, ovaries, pelvic peritoneum and surrounding structures.
Epidemiology
Occurs both in the developed and developing
countries.
85 per cent are spontaneous infection in sexually active females of reproductive age.
The remaining 15 per cent follow procedures, which favors the organisms to ascend up.
Two-thirds are restricted to young women of less than 25 years and the remaining one-third limited among 30 years or older.
Risk factors
Menstruating teenagers.
Multiple sexual partners.
Absence of contraceptive pill use.
Previous history of acute PID.
IUD users.
Area with high prevalence of sexually transmitted diseases.
Protective factors
Contraceptive practice
Barrier methods
Oral steroidal contraceptives
Monogamy / Vasectomy
Others
Pregnancy
Menopause
Vaccines
CLINICAL FEATURES
Bilateral lower abdominal and pelvic pain dull in nature.
Fever, lassitude and headache.
Irregular and excessive vaginal bleeding .
Abnormal vaginal discharge (purulent or copious)
Nausea and vomiting.
Dyspareunia.
Pain and discomfort in the right hypochondrium.
Signs
Temperature >38.3°C.
Abdominal palpation
(1) Tenderness on both the quadrants of lower abdomen.
(2) The liver may be enlarged and tender.
Vaginal examination
(1) Abnormal vaginal discharge (purulent).
(2) Congested external urethral meatus or openings of Bartholin’s ducts through which pus may be seen escaping out on pressure.
(3) Speculum examination shows congested cervix with purulent discharge from the canal.
Clinical diagnostic criteria of PID (CDC-2006)
Minimum Criteria
Lower abdominal tenderness.
Adnexal tenderness.
Cervical motion tenderness.
Additional Criteria
Oral temperature > 38.3°C.
Mucopurulent cervical or vaginal discharge.
Raised C-reactive protein and/or ESR.
Definitive Criteria
Histopathologic evidence of endometritis on biopsy.
Imaging study (TVS/MRI) evidence of tubo-ovarian complex.
Laparoscopic evidence of PID
Investigations
Identification of organisms
Blood: Leucocyte count shows leucocytosis to more than 10,000 per cu mm and an elevated ESR value of more than 15 mm per hour.
Laparoscopy
Complications Of Pid
Immediate
Pelvic peritonitis or even generalized
Septicemia
Late
Dyspareunia
Infertility
Chronic pelvic inflammation
Formation of adhesions or hydrosalpinx or pyosalpinx and tubo-ovarian abscess.
Chronic pelvic pain and ill health.
Ambulatory Management Of Acute PID (CDC-2006)
Patient should have oral therapy for 14 days
Regimen A
Levofloxacin 500 mg (or, ofloxacin 400 mg) PO
Metronidazole 500 PO bid
Regimen B
Ceftriaxone 250 mg IM single dose
Doxycycline 100 mg PO BID with or without
Metronidazole 500 mg PO BID for 14
Pelvic inflammatory disease (PID) is an infection and inflammation of the upper female genital tract affecting the uterus, fallopian tubes, ovaries and surrounding structures. It occurs most often in sexually active young women under 25 years old and risk factors include multiple sexual partners and lack of contraceptive use. Common symptoms include lower abdominal pain and fever. Diagnosis is based on clinical criteria such as abdominal and adnexal tenderness. Treatment involves oral or intravenous antibiotics for 14 days to prevent complications like infertility, chronic pelvic pain and tubo-ovarian abscesses.
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2. Etiology
Anatom
y
Staging
Sympto
ms
Signs
DD’s
PID is a spectrum of infection and inflammation
of the upper genital tract organs ,typically
involving :
The uterus (endometrium),
Fallopian tubes,
Ovaries,
Pelvic peritoneum and
Surrounding structures
Definition
8. Etiology
Anatom
y
Staging
Sympto
ms
Signs
DD’s
Contraceptive practice
● Barrier methods, specially condom, diaphragm
with spermicides.
● Oral steroidal contraceptives have got two
preventive aspects.
○ Produce thick mucus plug preventing
ascent of sperm and bacterial penetration.
○ Decrease in duration of menstruation, creates a
shorter interval of bacterial colo- nization of the
upper tract.
Protective and preventive factors
9. Etiology
Anatom
y
Patholog
y
Sympto
ms
Signs
DD’s
Acute salpingitis
Surest sign of salpingitis is the discharge of seropurulent fluid
from the fimbrial end .
The inflammatory exudate –mainly at the ampullary end.
The mucous membrane – first affected
Mucous membrane - oedematous,
ulceration
The ulceration
Adhesion
Tubal blockage
Pelvic abscess
Pyosalpinx
15. Etiology
Anatom
y
Sympto
ms
Signs
DD’s
Symptoms
● Patients with acute PID present with a wide range of
non-specific clinical symptoms.
● Symptoms usually appear at the time and
immediately after the menstruation.
● Bilateral lower abdominal and pelvic pain which is
dull in nature. The onset of pain is more rapid and
acute in gonococcal infection (3 days) than in
chlamydial infection (5–7 days).
● There is fever, lassitude and headache.
● Irregular and excessive vaginal bleeding is usually
due to associated endometritis.
● Abnormal vaginal discharge which becomes purulent
and or copious
17. Etiology
Anatom
y
Sympto
ms
Signs
DD’s
Symptoms
● Nausea and vomiting.
● Dyspareunia.
● Pain and discomfort in the right
hypochondrium due to concomitant
perihepatitis (Fitz-Hugh-Curtis syndrome)
may occur in 5–10% of cases of acute
salpingitis.
● The liver is involved due to transperitoneal
or vascular
dissemination of either gonococcal or
chlamydial
infection.
18. Etiology
Anatom
y
Signs
Staging
DD’s
18
Signs
● The temperature >38.3°C.
● Abdominal palpation reveals tenderness on both the
quadrants of lower abdomen. The liver may be enlarged
and tender.
● Vaginal examination reveals:
(1)Abnormal vaginal discharge which may be of purulent.
(2)Congested external urethral meatus or openings of
Bartholin’s ducts through which pus may be seen
escaping out on pressure.
(3)Speculum examination shows congested cervix with
purulent discharge from the canal.
(4)Bimanual examination reveals bilateral tenderness
on fornix palpation.
22. Etiology
Anatom
y
Staging
Sympto
ms
Signs
DD’s
AcutepiddIagnosticapproach
History, physical examination,
& pregnancy test
abdominal pain or pain
migration from periumbilical
area to right lower quadrant
of abdomen?
Cervical motion, uterine, or
adnexal tenderness?
Evaluate for ectopic pregnancy with
quantitative beta-subunit of HCG test
and transvaginal USG
Consider surgical consultation and
laparotomy for appendicitis; if
diagnosis in doubt, consider USG or
abdominal and pelvic CT with
intravenous contrast media
Consider PID; obtain transvaginal USG
to evaluate for tubo-ovarian abscess
Pregnancy
Yes
Yes
Yes
No
Right lower quadrant
No
No
23. Etiology
Anatom
y
Staging
Sympto
ms
Signs
DD’s
Pelvic mass on examination?
Dysuria and white blood cells
on urine analysis?
Consider ovarian cyst, ovarian
torsion, degenerating uterine fibroid,
or endometriosis; obtain transvaginal
USG
Evaluate for urinary tract infection or
pyelonephritis; obtain urine culture
Yes
Yes
No
No
Transvaginal USG to
evaluate for other
diagnosis
25. Etiology
Anatom
y
Staging
Sympto
ms
Signs
Investigatio
ns
● A pregnancy test should always be performed to
exclude the important differential diagnosis of ectopic
pregnancy.
● High vaginal and endocervical swabs (high vaginal
for Trichomonas vaginalis, Candida and bacterial
vaginosis, endocervical for gonorrhoea and Chlamydia)
should be taken.
● Midstream specimen of urine should be sent for
microscopy and culture.
● Full blood count and C-reactive protein are important
if the woman is systemically unwell, and urea and
electrolytes should be analysed if she is vomiting.
● Serological test for syphilis should be carried out for
both the partners in all cases.
investigations
26. Etiology
Anatom
y
Staging
Sympto
ms
Signs
Investigatio
ns
investigations
Ultrasound scan will exclude a large tubo-ovarian
collection, but is usually normal with PID except for
possible free peritoneal fluid, which is a non-
specific finding.
Culdocentesis: Aspiration of peritoneal fluid and
its white cell count, if exceeds 30,000 per mL. is
significant in acute PID. Bacterial culture from the
fluid is not informative because of vaginal
contamination.
Laparoscopy is indicated if the diagnosis is
unclear or there is no response to treatment
after 48 hours.
29. Etiology
Anatom
y
Staging
Sympto
ms
Signs
Investigatio
ns
laproscopy
Laparoscopic findings and severity of PID:
● Mild: Tubes: edema, erythema,
no purulent exudates and
mobile.
● Moderate: Purulent exudates
from the fimbrial ends, tubes
not freely movable.
● Severe: Pyosalpinx,
inflammatory complex, abscess.
● ‘Violin string’ like adhesions in
the pelvis and around the liver
suggests chlamydial infection.
35. Etiology
Anatom
y
Staging
Sympto
ms
Investigatio
ns
Treatme
nt
Treatment
The following are the newer antibiotic regimens:
1. Cefoxitin 2 g IV 6-hourly + Doxycycline, 100 mg IV
followed by oral route.
2. Azithromycin 500 mg IV 6-hourly for 2 days, then orally
for chlamydia.
4. Levofloxacin 500 mg bd for 14 days with or without
metronidazole.
5. Clindamycin 900 mg intravenously every 8-hourly +
gentamicin loading dose IV or IM (2 mg/kg) followed by
maintenance dose (1.5 mg/kg) 8-hourly
Placentrex (aqueous extract of fresh placenta) -multipronged
anti-inflammatory action. It also causes tissue regeneration,
wound healing, and has significant immunotropic action
involving both humoral and cellular immunity.
37. Etiology
Anatom
y
Staging
Sympto
ms
Investigatio
ns
Treatme
nt
Minimal invasive surgery
Indications:
1. The size of the abscess is more than 10 cm.
2. The abscess fails to respond to antibiotics in 48–72 h.
3. Abscess ruptures.
4. Pyoperitoneum.
Minimal invasive surgery is done by posterior colpotomy.
Ultrasound-guided vaginal aspiration of pelvic abscess.
Percutaneous abscess drainage (PAD) under CT.
Disadvantages of PAD:
Septicaemia,
Bladder and bowel injury,
Haemorrhage and recurrence.
late complicatios:
Recurrence, chronic PID, tubal blockage, chronic pelvic pain.