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Pelvic Inflammatory Disease (PID): Causes, Symptoms and Treatment

Home » Pelvic Inflammatory

Introduction

The pelvic inflammatory disease  or PID  occurs when the reproductive organs in a female get infected by a disease. The reproductive organs include the fallopian tube, vagina as well as ovaries. It should be treated as early as possible so as to avoid serious complications in the future.

ICD-10 Codes for Pelvic Inflammatory Disease (PID):

Pelvic Inflammatory Disease is an infection of the female reproductive organs. The ICD-10 codes for PID are:

  • N70.: Inflammatory disease of the fallopian tubes
    • N70.0: Acute salpingitis
    • N70.1: Chronic salpingitis
    • N70.9: Salpingitis, unspecified
  • N71.: Inflammatory disease of the uterus
    • N71.0: Acute endometritis
    • N71.1: Chronic endometritis
    • N71.9: Endometritis, unspecified
  • N72: Inflammatory disease of the cervix
    • N72.0: Acute cervicitis
    • N72.1: Chronic cervicitis
    • N72.9: Cervicitis, unspecified
  • N73.9: Female pelvic inflammatory disease, unspecified (for cases where the exact location is not specified)

CPT Codes for Diagnosis and Treatment of PID:

Management and treatment of PID may involve various procedures. Common CPT codes include:

  1. 99201 – 99215: Office or other outpatient visits (for initial diagnosis and follow-up care of PID)
  2. 76830: Ultrasound, transvaginal (used to evaluate the pelvic organs and assess for inflammation or other abnormalities)
  3. 58300: Endometrial biopsy (if there is a need to sample the endometrial lining for diagnostic purposes)
  4. 58662: Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface (if surgical intervention is needed)
  5. 58660: Laparoscopy, surgical; with lysis of adhesions (if PID has caused adhesions that need to be addressed)

pelvic inflammatory

Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.

The PID occurs worldwide and has more prevalence, especially in Sub-Saharan Africa at 70% followed by 34% in Asians and 31% in developed countries. In India, the incidence usually falls in-between 3% to 10%.

The reasons for pelvic inflammatory disease can be attributed to a number of factors which are
  • Gonorrhea
  • Chlamydia
  • Pelvic tuberculosis
  • Insertion of Copper T or a hormone-containing Intrauterine device.
  • Termination of pregnancy
  • Giving birth to a new child

PID can sometimes escape detection and you may remain in darkness while it still exists. But it can also begin abruptly and rapidly

  • Agony and pain around the region of the belly
  • Vaginal discharge is mysterious and has bizarre colors such as green or yellow
  • Fever and/or chills
  • Nausea and vomiting
  • Having sex is painful
  • Improper periods
  • Passing urine gives a burning sensation

  1. Conservative treatment:

    1. Medicines to control the pain
    2. Medicines to control bleeding like trenaxamic acid
    3. Hormonal injections like leuprolide acetate which correct the high estrogen levels thereby help in ameliotrating adenomyosis
    4. Medicines like hormonal intrauterine devices e.g. mirena; or tablets containing progesterone hormone.

If you see any symptoms of PID then you should visit a gynecologist as soon as possible. Your gynecologist will diagnose whether you have the pelvic inflammatory disease by any of the following parameters

  • By examining your medical history, and asking questions about your general health and sexual health.
  • Blood examination
  • Pelvic examination
  • Urine test: So as to strike out urinary tract infection
  • Ultrasound: To obtain a lucid image of the reproductive system
  • Vaginal culture if in case any infection is detected

In rare cases, your gynecologist will do other tests such as 

  • Endometrial biopsy: A tiny amount of sample is excised and sent to a laboratory for testing from the endometrium which is the lining of the uterus
  • Laparoscopy: Surgery is performed using a tiny incision and a light attached device is utilized to have a close-up view of reproductive organs.

If you contract pelvic inflammatory disease many times then your fallopian tubes can become scarred. This can lead to some serious complications such as 

  • Infertility
  • Ectopic pregnancy
  • Development of long-term pelvic pain

Pelvic inflammatory disease(PID) can be treated with the help of medicines such as antibiotics in case of infection. However it should be noted that medicines cannot undo the harm already caused by the infection, so it becomes critical that you report to your gynecologist as early as you can when you notice any symptoms of PID

Your gynecologist will prescribe you oral antibiotics. It is highly mandatory that you take some steps such as

  • Strictly follow the course of antibiotics and not skip any dose.
  • Finish the course of antibiotics even if you begin to see improvement in your symptoms
  • Make sure you do a follow-up visit to your gynecologist so that she can check whether your treatment is working the way it should or not.

Sometimes it may happen that even though antibiotics are taken by the oral route they show limited efficacy so in that case you should go to the hospital and start Intravenous (IV) treatment.IV treatment also becomes mandatory if you are

  • In gestation period
  • Having extreme infection
  • Your fallopian tubes and ovaries are filled with pus

It is not necessary that PID can occur due to sexually transmitted diseases (STDs) only. In a small percentage of cases when normal bacteria reach your reproductive organs pelvic inflammatory disease can occur. However, in the majority of cases, STDs are responsible for pelvic inflammatory disease. You can take the following measures

  • Don’t have many sexual partners
  • Keep barriers to birth control
  • Go for treatment if you observe any symptoms
  • Go for frequent and constant health checkups.