11.1. GENERAL INFORMATION
Pelvic inflammatory disease is a group of morbidities marked by inflammation affecting the genitals as one nosologic entity or any combination of these.
11.1.1. Clinical Information
Pelvic inflammatory disease is an urgent issue in gynecology nowadays: the incidence rate is growing, the average patient is becoming younger, on the whole women of reproductive age show inferior reproductive health. Pelvic inflammatory disease (PID) is called "a problem inside a problem". Clinical importance of PID is related to its wide occurrence, difficulty of diagnosis and treatment, high rate of chronicity, and its negative impact on the woman's reproductive health. PID increases the risk of infertility, obstetric complications (pregnancy loss, fetal infection, post-partum purulent complications), ectopic pregnancy, syndrome of chronic pelvic pain.
NB! In the structure of gynecologic morbidity PID comes first accounting for 60-65%; of these, 30% of patients are hospitalized.
There are several age-specific peaks of genital inflammation in women: the age of 3-5, 11-13, 18-20, 55-60. The first two peaks coincide with the age of maximum appendicitis incidence (appendicular genital syndrome), the next one is due to sexual activity, and the last one is due to considerable decrease in estrogen impact on the female body (see Chapter 26).
The highest primary incidence of PID is noted in individuals aged 15-24; after the age of 30 the rate of PID declines somewhat, which can be due to both a change in sexual behavior and emergence of protective antibodies in the cervical canal.
The high incidence of PID follows from such social phenomena as:
• migration increasing worldwide; it promotes a rapid spread of infection;