Symptoms of Pelvic Inflammatory Disease

Pathological changes of pelvic inflammatory disease:

Symptoms of endometritis: frequent occurrence of edema and exudation in the whole uterine cavity.

Patients with acute PID may suffer from fever, chill, white blood cell increase, lower abdominal pain, vaginal discharge increase sometimes with bloody and foul-smelling vaginal discharge, and mild uterus enlargement with tenderness in the uterus, while patients with chronic PID may suffer from excessive menstruation, lower abdominal pain and obvious lumbosacral enlargement. Endometritis, acute or chronic, can lead to tubal obstruction which may stop or block the outflow of inflammatory discharge in the uterine cavity, and this results in the occurrence of pyometra. Chronic endometritis may have no obvious symptoms, but uterus enlargement, tenderness and obvious proliferation of the connective tissue beside the uterus may be discovered when gynecologial examination is conducted.

1. Salpingitis: the thickening and fibrosis of salpinx lead to streak salpinx. Salpingitis causes the adhesion of the ovary and salpinx with surrounding organs, which leads to the appearance of hard and stationary lumps, and it causes the thickening and adhesion of salpinx, which also leads to the appearance of lumps. Partial or complete blockage of the opening of the salpinx, especially the fimbrial end may lead to the adhesion of endosalpinx due to inflammation, which makes the salpinx narrower or blocked. Thus the passage of the egg, the sperm and the oosperm may be blocked, which leads to infertility.

2. Hydrosalpinx: after the occurrence of hydrosalpinx, the fimbrial end adhesion is blocked, and serous fluid exudes from through the salpinx. Then the retention of the fluid in the salpinx leads to hydrosalpinx or pyosalpinx which may develop into hydrosalpinx when the fester is absorbed. If the ovary is affected in the meantime, tubo-ovarian cyst will occur.

3. Chronic pelvic paramitritis：with the inflammation spreading to parametrium and utero-sacral ligament, local tissue becomes thicker and harder and fans out to the pelvic wall, and the uterus stays where it is or is pulled to where the inflammation occurs

4. Pelvic hydrops, namely pelvic effusion and mostly connected with PID, is the inflammatory exudate caused by PID. This may occur after endometritis. And if the slightly liquid exudated from the cells swelled in endometria tissue is wrapped up by surrounding tissues, cystic mass will appear. Therefore, pelvic effusion shall be timely discovered and thoroughly cured.

5. Pelvic cavity spindylosis: it occurs when a failure to cure PID timely leads to further infection of mycoplasma and chlamydia. For example, the infection of mycoplasma and chlamydia in organs like the uterus, salpinx and ovary invites the occurrence of endometritis, salpingitis and ovaritis which causes hyperemia of tissues, edema, discharge increase, metrosynizesis, tubal adhesion and the adhesion of the ovary and the salpinx. Consequently the salpinx may be blocked, uplifted and curved, and the peristalsis of the salpinx may also be affected. Besides, the adhesion of these organs may affect the normal process of a sperm fertilizing an egg, and inflammation or infection will increase the discharge which will kill or wound the sperm and affect sperm motility. In this way, cases like female sterility, fetal anomaly, miscarriage and exfetation will appear.