Laparoscopy Management Medical Surgical COCP Conservative excisision and Progestogens adhesion dissection Radical hysterectomy + bilateral GnRH analogues Gestrinone salpingo-oophrectomy Danazol Pelvic Inflammatory Disease Clinical syndrome associated with ascending spread of microorganisms from vagina/cervix to endometrium, fallopian tubes and contiguous structures Most common causes are : Chlamydia trachomatis Nisseria Gonorrhoeae Risk factors < 25 yrs of age Hx f STD’s Single Hx of PID Multiple sexual partners Recent instrumentation of uterus Young at first intercourse IUCD High frequency of sex Features Pelvic/lower abdo pain Tachycardia Deep dyspareunia Abdo tenderness Dysmenorrhoea Cervical excitation Abnormal/increased vaginal d/c Adnexal swelling & tenderness Fever Investigations WCC, CRP, ESR MSU Laparoscopy cultures Pregnancy test STD screen TV USS Management Antibiotic Therapy Contact tracing Surgery (rare) Complications Pelvic abscess Infertility Dyspareunia Septicaemia Ectopic pregnancy Menstrual disturbance Septic shock Chronic pelvic pain Psychological effects Urogynaecology Causes Features Investigations Treatment Stress Neurological injury, Involuntary loss of Lifestyle changes, Incontinence urethral injury, urine during physical pelvic floor exercises, pelvic trauma activity TVT,
Laparoscopy Management Medical COCP Progestogens GnRH analogues Gestrinone Danazol Surgical Conservative excisision and adhesion dissection Radical hysterectomy + bilateral salpingo-oophrectomy Pelvic Inflammatory Disease Clinical syndrome associated with ascending spread of microorganisms from vagina/cervix to endometrium, fallopian tubes and contiguous structures Most common causes are : Chlamydia trachomatis Nisseria Gonorrhoeae Risk factors < 25 yrs of age Single Multiple sexual partners Young at first intercourse High frequency of sex Hx f STD’s Hx of PID Recent instrumentation of uterus IUCD Features Pelvic/lower abdo pain Deep dyspareunia Dysmenorrhoea Abnormal/increased vaginal d/c Fever Tachycardia Abdo tenderness Cervical excitation Adnexal swelling & tenderness Investigations WCC, CRP, ESR cultures STD screen MSU Pregnancy test TV USS Laparoscopy Management Antibiotic Therapy Contact tracing Surgery (rare) Complications Pelvic abscess Septicaemia Septic shock Infertility Ectopic pregnancy Chronic pelvic pain Dyspareunia Menstrual disturbance Psychological effects Urogynaecology Causes Features Investigations Treatment Stress Incontinence Neurological injury, urethral injury, pelvic trauma Involuntary loss of urine during physical activity Lifestyle changes, pelvic floor exercises, TVT,
OG-Revision-Notes.docx