Gynaecology › Pelvic Infections
Pelvic Infections
Pelvic infection is inflammation of the reproductive organs. Treated early it resolves completely; left late it can leave permanent damage to the tubes, leading to infertility and persistent pain. Where there is suspicion, therefore, nothing is left to wait.
Symptoms
- Pain in the lower abdomen and pelvis
- Coloured, offensive discharge
- Fever and malaise
- Pain during intercourse
- Bleeding or spotting between periods
- Burning on passing urine
Causes
Most infections arise from bacteria travelling upwards from the cervix; chlamydia and gonorrhoea are the principal organisms. Infection may also follow childbirth, miscarriage or insertion of an intrauterine device.
A substantial proportion of chlamydial infections cause no symptoms at all. Screening in those at risk is therefore carried out without waiting for symptoms.
Diagnosis
Examination findings, tests on discharge and urine samples, and ultrasound are assessed together. Blood tests show the degree of inflammation. Findings such as inflammatory fluid collecting in the tubes may be visible on ultrasound.
Treatment
Treatment is with antibiotics and the full course must be completed — stopping because symptoms have settled allows the infection to persist silently.
The sexual partner should be assessed at the same time and treated if necessary; otherwise the infection is simply reacquired. Intercourse is avoided during treatment.
Why it must be taken seriously
Recurrent or late-treated infection leaves blockage and adhesions in the tubes. The consequences can be infertility, an increased risk of ectopic pregnancy and years of pelvic pain. Early treatment prevents all of these.
