The incidence and prevalence of pelvic inflammatory disease and its impact in infertility, pelvialgy and surgical interventions

Abstract

Introduction. Pelvic inflammatory disease (PID) is considered a major cause of morbidity in women, but its epidemiology is little known in Albania. Purpose. Investigation of the incidence and prevalence of pelvic inflammatory disease and its impact on infertility, pelvialgia and surgical interventions. Objectives. The study is based on cases with acute and chronic PID, and not on asymptomatic ones. The literature review is based on studies and data from PubMed and Cochrane. We must emphasize the fact that the literature provides different data between developed and developing countries in terms of PID incidence. Data in Albania show that in addition to C. trachomatis, N. gonorrhoeae is also observed, which has a high incidence associated with PID. Other characteristics such as the age of the first relationship, having or not having many partners are similar to those of European Community countries. Results. The highest incidence of patients diagnosed with PID was in women of reproductive age (1.7%). The diagnostic criteria were: the presence of abdominal pain and the exclusion of competitive diagnoses. The combined case-control and retrospective study showed that PID has the characteristics of a sexually transmitted disease. When compared with a control group who had undergone tubular ligation or the presence of IUD, the increased risk for PID was associated with: age group < 25 years; age at first sexual intercourse < 20 years; Roma or Egyptian population; parity; a previous history with SST and the presence of C. trachomatis. When the comparison was performed with the data obtained in the general population randomly, the increased risk is related to: age group < 25 years; age at first sexual intercourse < 15 years; low socio-economic status; having many partners; abortion; previous history of SSTs and exposure to C. trachomatis. Of the cases, 64% were not associated with any of the infectious agents measured in this study (idiopathic). Several idiopathic cases were associated with Mycoplasma genitalium.

Keywords

• pelvic inflammatory disease (pid)
• infertility
• pelvialgy
• surgical interventions