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Journal of Women's Health (2002) Jan 2024Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general... (Meta-Analysis)
Meta-Analysis
Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general female population. However, the etiology of endometriosis remained unclear. We aimed to systematically assess the association between pelvic inflammatory disease (PID) and the risk of endometriosis. Eligible studies published until May 21, 2022, were retrieved from the PubMed, EMBASE, and Web of Science databases. The studies were included based on the following criteria: (1) original articles on the association between PID and risk of endometriosis; (2) randomized controlled trials and cross-sectional, case-control, and cohort studies; and (3) studies involving humans. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the studies included in this systematic review. The association between PID and risk of endometriosis was evaluated using the overall odds ratio (OR) and correlative 95% confidence interval (CI). The meta-analysis included 14 studies with 747,733 patients. The mean prevalence of PID in women with endometriosis was 33.80%. Our quantitative synthesis revealed that endometritis was associated with a significantly increased risk of endometriosis (OR: 1.63, 95% CI: 1.53-1.74, = 59%). We study a statistically significant association between PID and the risk of endometriosis. In particular, endometritis might play an important role in endometriosis, based on the lower heterogeneity of the subgroup analysis. This finding suggests that reducing the incidence of endometritis might aid in the prevention and treatment of endometriosis.
Topics: Female; Humans; Endometriosis; Pelvic Inflammatory Disease; Endometritis; Cross-Sectional Studies; Pelvic Pain
PubMed: 37851499
DOI: 10.1089/jwh.2023.0300 -
Radiographics : a Review Publication of... 2016Pelvic inflammatory disease (PID) is a common medical problem, with almost 1 million cases diagnosed annually. Historically, PID has been a clinical diagnosis... (Review)
Review
Pelvic inflammatory disease (PID) is a common medical problem, with almost 1 million cases diagnosed annually. Historically, PID has been a clinical diagnosis supplemented with the findings from ultrasonography (US) or magnetic resonance (MR) imaging. However, the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. Given the nonspecific clinical manifestations, computed tomography (CT) is commonly the first imaging examination performed. General CT findings of early- and late-stage PID include thickening of the uterosacral ligaments, pelvic fat stranding with obscuration of fascial planes, reactive lymphadenopathy, and pelvic free fluid. Recognition of these findings, as well as those seen with cervicitis, endometritis, acute salpingitis, oophoritis, pyosalpinx, hydrosalpinx, tubo-ovarian abscess, and pyometra, is crucial in allowing prompt and accurate diagnosis. Late complications of PID include tubal damage resulting in infertility and ectopic pregnancy, peritonitis caused by uterine and/or tubo-ovarian abscess rupture, development of peritoneal adhesions resulting in bowel obstruction and/or hydroureteronephrosis, right upper abdominal inflammation (Fitz-Hugh-Curtis syndrome), and septic thrombophlebitis. Recognition of these late manifestations at CT can also aid in proper patient management. At CT, careful assessment of common PID mimics, such as endometriosis, adnexal torsion, ruptured hemorrhagic ovarian cyst, adnexal neoplasms, appendicitis, and diverticulitis, is important to avoid misinterpretation, delay in management, and unnecessary surgery. Correlation with the findings from complementary imaging examinations, such as US and MR imaging, is useful for establishing a definitive diagnosis. (©)RSNA, 2016.
Topics: Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Pelvic Inflammatory Disease; Tomography, X-Ray Computed; Ultrasonography
PubMed: 27618331
DOI: 10.1148/rg.2016150202 -
The Journal of Infectious Diseases Aug 2021While infection by Neisseria gonorrhoeae is often asymptomatic in women, undetected infections can ascend into the upper genital tract to elicit an inflammatory response... (Review)
Review
While infection by Neisseria gonorrhoeae is often asymptomatic in women, undetected infections can ascend into the upper genital tract to elicit an inflammatory response that manifests as pelvic inflammatory disease, with the outcomes depending on the intensity and duration of inflammation and whether it is localized to the endometrial, fallopian tube, ovarian, and/or other tissues. This review examines the contribution of N. gonorrhoeae versus other potential causes of pelvic inflammatory disease by considering new insights gained through molecular, immunological, and microbiome-based analyses, and the current epidemiological burden of infection, with an aim to highlighting key areas for future study.
Topics: Chlamydia Infections; Endometritis; Endometrium; Fallopian Tubes; Female; Gonorrhea; Humans; Neisseria gonorrhoeae; Pelvic Inflammatory Disease
PubMed: 34396410
DOI: 10.1093/infdis/jiab227 -
International Journal of Gynaecology... Aug 2016Pelvic inflammatory disease (PID) is commonly encountered in clinical practice. (Review)
Review
BACKGROUND
Pelvic inflammatory disease (PID) is commonly encountered in clinical practice.
OBJECTIVES
To provide up-to-date guidelines on management of PID.
SEARCH STRATEGY
An initial search of the Cochrane database, PubMed, and Embase was performed using keywords related to PID to identify reports in any language published between January 1990 and January 2012, with an update in May 2015.
SELECTION CRITERIA
All identified reports relevant to the areas of focus were included.
DATA COLLECTION AND ANALYSIS
A level of evidence based on the quality of the data available was applied for each area of focus and used for the guidelines.
MAIN RESULTS
PID must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade C). Pelvic ultrasonography is necessary to exclude tubo-ovarian abscess (grade B). Microbiological diagnosis requires vaginal and endocervical sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ofloxacin and metronidazole for 14days (grade B). Treatment of tubo-ovarian abscess is based on drainage if the collection measures more than 3cm (grade B), with combined ceftriaxone, metronidazole, and doxycycline for 14-21days.
CONCLUSIONS
Current management of PID requires easily reproducible investigations and treatment, and thus can be applied worldwide.
Topics: Anti-Infective Agents; Ceftriaxone; Disease Management; Drug Therapy, Combination; Female; France; Humans; Metronidazole; Ofloxacin; Pelvic Inflammatory Disease; Pelvis; Practice Guidelines as Topic; Societies, Medical; Ultrasonography
PubMed: 27170602
DOI: 10.1016/j.ijgo.2015.11.028 -
BMJ Case Reports Feb 2019
Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Hepatitis; Humans; Liver; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed
PubMed: 30765452
DOI: 10.1136/bcr-2019-229326 -
European Journal of Obstetrics,... Jan 2020Pelvic inflammatory disease (PID) is a common infection which can result in severe long term morbidity, such as chronic pelvic pain and infertility. The morbidity...
OBJECTIVE
Pelvic inflammatory disease (PID) is a common infection which can result in severe long term morbidity, such as chronic pelvic pain and infertility. The morbidity increases in correlation to the number of PID events. Our study aim to assess the risk factors for recurrence of pelvic inflammatory disease.
METHODS
A retrospective case control study was conducted using data for all women who were admitted to a tertiary medical center for a recurrent PID over a duration of 15 years. Women who had a recurrent PID were compared to women admitted for PID treatment without further recurrence. Forward stepwise multivariate logistic regression analysis was subsequently carried out.
RESULTS
The study included 133 women of whom 33 had recurrent PID. Women in the recurrent PID group had a higher rate of previous pelvic surgery (12 (36 %) vs. 20 (20 %), adjusted odds ratio [OR] 2.2 (95 % confidence interval CI 1.06-5.4, p = 0.05) and more had intrauterine devices (IUD) still in place if they had been previously present (5 (71.4 %) vs. 9(25.7 %), OR 7.2, (95 % CI 1.18-43.9), p = 0.02). The majority were treated with a combination of Ampicillin and Gentamycin, fewer received Augmentin or a cephalosporin base regimen (28 (84.8 %) vs 56 (56.0 %), OR 4.4, (95 % CI 1.5-12.3, p = 0.02), (1 (3.0 %) vs 27 (27.0 %), OR 0.08, (95 % CI 0.01-0.64), (4 (12.2 %) vs 17 (17.0 %)) respectively. In addition, invasive treatment had been required in more patients who later had a recurrent PID (6 (18.1 %) vs. 4(4.0 %), OR 5.3 (95 % CI 1.1.4-20.2), p = 0.007). Antibiotic regimens and invasive treatment were independently associated with recurrent PID (OR 2.69; 95 % CI 1.13-6.41, OR 2.10; 95 % CI 1.19-3.71, respectively).
CONCLUSION
Among women with PID, special awareness should be given to women with previous pelvic surgery, who required an additional interventional treatment and have an IUD inserted. Efforts should be made to achieve treatment success and optimal prevention to prevent recurrent PID.
Topics: Adult; Female; Humans; Israel; Pelvic Inflammatory Disease; Retrospective Studies; Risk Factors
PubMed: 31734623
DOI: 10.1016/j.ejogrb.2019.11.004 -
Pediatrics in Review Aug 2020
Review
Topics: Abdominal Pain; Adolescent; Child; Child, Preschool; Diabetic Ketoacidosis; Diagnosis, Differential; Female; Humans; Migraine Disorders; Pain, Referred; Pediatrics; Pelvic Inflammatory Disease; Peptic Ulcer
PubMed: 32737258
DOI: 10.1542/pir.2019-0221 -
The Journal of Infectious Diseases Aug 2021Pelvic inflammatory disease (PID) is an infection of the upper genital tract that has important reproductive consequences to women. We describe the burden of and trends...
BACKGROUND
Pelvic inflammatory disease (PID) is an infection of the upper genital tract that has important reproductive consequences to women. We describe the burden of and trends in PID among reproductive-aged women in the United States during 2006-2016.
METHODS
We used data from 2 nationally representative probability surveys collecting self-reported PID history (National Health and Nutrition Examination Survey, National Survey of Family Growth); 5 datasets containing International Classification of Diseases, Ninth/Tenth Revision codes indicating diagnosed PID (Healthcare Utilization Project; National Hospital Ambulatory Medical Care Survey, emergency department component; National Ambulatory Medical Care Survey; National Disease Therapeutic Index; MarketScan); and data from a network of sexually transmitted infection (STI) clinics (Sexually Transmitted Disease Surveillance Network). Trends during 2006-2016 were estimated overall, by age group and, if available, race/ethnicity, region, and prior STIs.
RESULTS
An estimated 2 million reproductive-aged women self-reported a history of PID. Three of 4 nationally representative data sources showed overall declines in a self-reported PID history, and PID emergency department and physician office visits, with small increases observed in nearly all data sources starting around 2015.
CONCLUSIONS
The burden of PID in the United States is high. Despite declines in burden over time, there is evidence of an increase in recent years.
Topics: Adolescent; Adult; Cost of Illness; Emergency Service, Hospital; Female; Humans; Nutrition Surveys; Pelvic Inflammatory Disease; Sexual Behavior; United States; Young Adult
PubMed: 34396411
DOI: 10.1093/infdis/jiaa771 -
Journal of Pediatric and Adolescent... Apr 2017To evaluate the incidence of pelvic inflammatory disease (PID) in virgin women and investigate the clinical characteristics of the patients. (Review)
Review
STUDY OBJECTIVE
To evaluate the incidence of pelvic inflammatory disease (PID) in virgin women and investigate the clinical characteristics of the patients.
DESIGN
Retrospective chart review and literature review.
SETTING
Tertiary academic center.
PARTICIPANTS
Virgin women who were confirmed to have PID via surgery from 2002 to 2014.
INTERVENTIONS
None.
MAIN OUTCOME MEASURES
The evaluation of medicosurgical history, clinical progress, surgical record, and pathologic reports.
RESULTS
Of 122 patients diagnosed with PID via surgery, 5 women were virgins (4.1%). The median age was 21 years (range, 14-24 years), and all patients presented with abdominal pain. The median diameter of the pelvic abscess pocket on preoperative imaging was 4.5 cm (range, 2.6-15 cm). Only 1 case was preoperatively diagnosed as a tubo-ovarian abscess; the others were expected to be benign ovarian tumors, such as endometrioma and dermoid cysts. No possible source of infection was identified for any patient, except 1 who had a history of an appendectomy because of a ruptured appendix. The results of the histopathological analysis of the excisional biopsy performed during surgery in 4 cases were consistent with acute suppurative inflammation. After postoperative antibiotic use, the conditions of all patients stabilized, and they were discharged from the hospital on median postoperative day 9.
CONCLUSION
PID in virgin women is rare, but it should be considered in all women with abdominal pain, regardless of sexual history.
Topics: Abdominal Pain; Abscess; Adolescent; Anti-Bacterial Agents; Fallopian Tube Diseases; Female; Humans; Ovarian Diseases; Ovarian Neoplasms; Pelvic Inflammatory Disease; Postoperative Complications; Retrospective Studies; Sexual Abstinence; Young Adult
PubMed: 26260586
DOI: 10.1016/j.jpag.2015.08.001 -
The New England Journal of Medicine Nov 2019
Topics: Abdominal Pain; Cholelithiasis; Female; Hepatitis; Humans; Middle Aged; Pelvic Inflammatory Disease; Peritonitis
PubMed: 31774961
DOI: 10.1056/NEJMicm1813625