2009, pp 1719-1730

Surgical Management of Pelvic Inflammatory Disease

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Pearls and Pitfalls

  • Clinicians should have a low threshold for diagnosing and treating pelvic inflammatory disease (PID) in young women; empiric treatment of PID should be initiated in the presence of uterine and/or adnexal tenderness or cervical motion tenderness when other etiologies are not obvious.

  • Patients infected with Chlamydia trachomatis may present with vague symptoms as compared to patients infected with Neisseria gonorrhoeae; C. trachomatis often results in a higher rate of infertility.

  • Antibiotic treatment for PID should be consistent with those recommended in the most recent CDC “Sexually Transmitted Diseases Treatment Guidelines.”

  • The most severe form of PID is the development of a tubo-ovarian abscess (TOA) which has the potential of progression to sepsis and death if diagnosis and treatment do not occur in a timely manner.

  • For pelvic abscesses, treatments include transvaginal and transcutaneous drainage; laparoscopy with irrigation and drainage or excisio ...