Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is infection of the uterus, fallopian tubes and adjacent pelvic structures that is not associated with surgery or pregnancy. The terminology is not consistent, however, and many other terms are commonly used to describe the different manifestations of pelvic infection, including endometritis, salpingitis, salpingo-oophoritis, adnexitis, parametritis, pyosalpinx, tubo-ovarian abscess, tubo-ovarian complex, pelvic peritonitis, perihepatitis and peri-appendicitis. Long-term sequelae of PID (tubal factor infertility and ectopic pregnancy) are common and cause major reproductive health problems in later life. However, PID and its sequelae are largely preventable. Although the incidence of hospitalization of women with PID has decreased rapidly in many developing countries, this does not necessarily mean that the overall incidence of PID has decreased; it may simply reflect changes in clinical manifestations towards milder disease. Many cases are 'silent' or 'subclinical'. The disease burden of PID in developing countries remains enormous.