Synonyms in a broader sense
Inflammation of the uterine appendages such as ovaries and fallopian tubes Fallopian tube inflammation, ovarian inflammation English: adnexitisThe task of the uterine appendages is to allow the fertilisable egg to mature (ovary) and then to transport it into the uterus, which happens via the fallopian tube. The term pelvic inflammatory disease is now used to describe the inflammation of the ovary and the fallopian tube (tuba uterina). Of course, both organs, ovaries (ovary) and fallopian tube (tuba uterina), can also be inflamed separately.
However, such an isolated inflammation is extremely rare, as the pathogens usually reach the ovary via the fallopian tube and the inflammation thus spreads to both organs. There is one fallopian tube and one ovary on both sides of the uterus, so that the pelvic inflammatory disease can occur on one or both sides. The inflammation leads to pain in the ovaries, but this can also have many other causes and occurs more frequently during pregnancy.
You can read more about this topic under Pain in the ovaries during pregnancy. The World Health Organization (WHO) coined an internationally recognized collective term that includes various chronic and acute inflammations in the pelvis. Pelvic inflammatory disease (PID) is the collective term and includes inflammation of the fallopian tube (salpingitis = inflammation of the fallopian tubes), inflammation of the ovary (salpingoophoritis = inflammation of the ovaries) and, as complications, inflammation of the peritoneum (pelveoperitonitis = peritonitis) and inflammation of the suspension ligaments of the uterus (parametritis). Pelvic inflammatory disease belongs to the serious gynaecological diseases. Despite successful treatment, it can also lead to chronic progressions or late effects, such as adhesions, a pregnancy outside the uterus (extra-lower pregnancy, such as an ectopic pregnancy) or infertility (sterility).
Epidemiology
An acute inflammation of the ovary occurs in young women who are not pregnant but are sexually active. Especially women who have a high number of different sexual partners, whose sexual activity started early and whose hygiene is inadequate have an increased risk of disease. Every year 11-13 out of every 1000 women fall ill, whereby the new cases are mainly found in patients between 16 and 20 years of age.
Cause
The triggers of the pelvic inflammatory disease are in most cases bacteria. These either come from the lower genitals, through the vagina and uterus up to the fallopian tubes and ovaries. This path of infection is only permeable for bacteria if the normal protective barriers, such as the closed cervix, are lifted.
This is the case, for example, during menstruation (menstruation), after births or miscarriages and after vaginal surgery, such as the insertion of a coil or a scrape of the uterus. This form of inflammation ascending from below (ascending) is found almost exclusively in sexually mature and sexually active women. Another possibility for the inflammation to spread is the descent (descending infection) of the bacteria from the abdominal organs.
If a neighbouring abdominal organ is inflamed, the bacteria reach the fallopian tube or ovary directly and cause pelvic inflammation there, or the bacteria are transported to the organs via the lymphatic system and cause pelvic inflammation. If an infection occurs in the operating area after an abdominal operation such as the removal of the appendix in the case of appendicitis (appendectomy), the bacteria that have penetrated here can also cause pelvic inflammation. Chlamydia, gonococcus (gonorrhea pathogen) and mycoplasma are known to be the triggering bacteria in more than 75% of cases. In very rare cases, the infection can also originate from tuberculosis.
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