Causes of pelvic inflammatory disease

Pelvic inflammatory disease refers to inflammation of the female upper reproductive tract and surrounding tissues. The inflammation can be confined to one part or involve several parts at the same time. The most common are salpingitis and salpingo-oophoritis. Let's take a look at the causes of pelvic inflammatory disease.

Basic pathology:

The main pathogens that cause pelvic inflammatory disease are: Staphylococcus, Escherichia coli, anaerobic bacteria, sexually transmitted pathogens (such as gonococci, Chlamydia trachomatis, Mycoplasma, herpes virus). The main causes of acute pelvic inflammatory disease are postpartum or abortion infection, postoperative infection after intrauterine surgery, poor menstrual hygiene, and direct spread of inflammation of adjacent organs. Acute pelvic inflammatory disease can cause the body to develop acute endometritis and acute myometritis, acute salpingitis, pyosalpingitis, tubo-ovarian abscess, acute pelvic connective tissue inflammation, acute pelvic peritonitis, sepsis and sepsis. Chronic pelvic inflammatory disease is often caused by the failure to thoroughly treat acute pelvic inflammatory disease, or the patient's poor physical condition and prolonged course of the disease. It can cause the body to develop chronic salpingitis and hydrosalpingitis, salpingo-oophoritis and tubo-ovarian cysts, and chronic pelvic connective tissue inflammation.

1. Chronic salpingitis and hydrosalpinx Chronic salpingitis is mostly bilateral, with mild or moderate enlargement of the fallopian tubes, and the fimbriae may be partially or completely closed and adhere to the surrounding tissues. In addition, sometimes the mucosal epithelium and fibrous tissue in the isthmus of the fallopian tube proliferate and adhere, making the fallopian tube nodular and thickened, which is called nodular salpingitis. When the inflammation of the fallopian tube is mild, the fimbriae and isthmus are adhered and closed, and serous exudates accumulate to form hydrosalpinx; sometimes, the fallopian tube pus becomes chronic, the pus is gradually absorbed, and the serous fluid continues to seep out from the tube wall and fill the lumen, which can also form hydrosalpinx. The surface of the hydrosalpinx fallopian tube is smooth, the tube wall is very thin, and it is shaped like a sausage or a retort with a curved neck, curled backwards, and can be free or have membrane-like adhesions with the surrounding tissues.

2. Tubal oophoritis and tubo-ovarian cysts When the fallopian tubes become inflamed, they may spread to the ovaries and may adhere to each other to form inflammatory masses, or the fimbria of the fallopian tubes may adhere to the ovaries and cause fluid to seep out to form tubo-ovarian cysts. It may also be formed by the absorption of pus from tubal ovarian abscesses.

3. Chronic pelvic connective tissue inflammation: The inflammation spreads to the uterosacral ligament, causing the fibrous tissue to proliferate and harden. If the spread is wide, the uterus may be fixed and the paracervical tissue may also thicken.

Causes:

The main causes of pelvic inflammatory disease are:

1. Postpartum or post-abortion infection: After delivery, the mother is weak, the cervix fails to close in time due to the outflow of residual blood and turbid fluid, there is a placental detachment surface in the uterine cavity, or the birth canal is damaged during delivery, or there are residual placenta and fetal membranes, or there is sexual intercourse too early after delivery, pathogens take advantage of the opportunity to invade the uterine cavity, which can easily cause infection; vaginal bleeding lasts too long during spontaneous abortion or medical abortion, or there are tissues remaining in the uterine cavity, or the aseptic operation of the artificial abortion operation is not strict, etc., all of which can cause post-abortion infection.

2. Infection after intrauterine surgical operation: such as placement or removal of intrauterine contraceptive ring, curettage, tubal insufflation, hysterosalpingography, hysteroscopy, submucosal myomectomy, etc. Due to sexual life before operation or lax surgical disinfection or inappropriate selection of preoperative indications, the original chronic inflammation of the reproductive tract may cause acute attack and spread due to surgical interference; some patients do not pay attention to personal hygiene after operation, or do not follow the doctor's orders after operation, which may also cause bacterial ascending infection and cause pelvic inflammatory disease.

3. Poor menstrual hygiene: If you do not pay attention to menstrual hygiene, use unclean sanitary napkins and panty liners, take a bath during menstruation, have sexual intercourse during menstruation, etc., pathogens may invade and cause inflammation.

4. Direct spread of inflammation from adjacent organs: The most common cases are appendicitis and peritonitis. Since they are adjacent to the female internal reproductive organs, inflammation can spread directly and cause pelvic inflammation. In chronic cervicitis, inflammation can also spread through the lymphatic circulation and cause pelvic connective tissue inflammation.

5. Acute attacks of chronic pelvic inflammatory disease, etc.

Infection route:

A group of infectious diseases of the female upper reproductive tract is called pelvic inflammatory disease, which is a common gynecological disease. The inflammation can be confined to one part or several parts at the same time. It can be divided into acute and chronic according to its course of disease and clinical manifestations.

1. Spread through the lymphatic system

Bacteria and pathogens invade the pelvic connective tissue and other parts of the internal reproductive organs through the lymphatic vessels of the vulva, vagina, cervix and uterine body trauma. They are the main transmission route for puerperal infection, post-abortion infection and infection after intrauterine contraceptive device placement, and are most common in infections with streptococci, Escherichia coli and anaerobic bacteria.

2. Spreading upward along the genital mucosa

After the pathogens invade the vulva and vagina, they spread along the mucosal surface through the cervix, endometrium, and fallopian tube mucosa to the ovaries and abdominal cavity. Neisseria gonorrhoeae, Chlamydia trachomatis, and Staphylococcus aureus spread along this route.

3. Transmission through blood circulation

The pathogen first invades other systems of the human body and then infects the genitals through the blood circulation. This is the main route of tuberculosis infection.

4. Direct spread

After other organs in the abdominal cavity are infected, they spread directly to the internal reproductive organs. For example, appendicitis can cause right-sided salpingitis.

harm:

1. Infertility

The biggest harm of pelvic inflammatory disease is infertility. Inflammation of any part of the uterus, fallopian tubes, ovaries or surrounding tissues in the pelvic cavity, including the peritoneum in the pelvic cavity, can cause infertility. When acute inflammation is not completely treated and turns into chronic inflammation, or when pelvic inflammatory disease is not treated in time and becomes chronic, it often causes infertility.

2. Kidney disease

Because the pelvic connective tissue is connected to the retroperitoneal connective tissue and can reach around the kidneys, if acute pelvic connective tissue inflammation is not treated, the inflammation can not only spread to the fallopian tubes, pelvic peritoneum and other tissues and organs, causing pelvic abscesses, but can also spread upwards and lead to perirenal abscesses.

3. Mental and psychological impact

Chronic inflammation can affect normal work and life as well as physical and mental health due to its long-term treatment and repeated attacks.

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