Your doctor will begin with a detailed history of your general health and sexual activity. He or she will perform a pelvic exam to check the health of your reproductive organs, and look for evidence of gonorrhea and chlamydia infection. Your doctor may find the abnormal cervical discharge and tenderness of the cervix, fallopian tubes and cervix on examination. This discharge will be tested to determine the cause of the infection, including cultures for gonorrhea and chlamydia.
If your doctor suspects PID, he or she may order other tests, including:
Blood tests to analyze blood for evidence of infection.
Ultrasound (sonogram) to view the reproductive organs.
Other tests less commonly performed include:
Endometrial biopsy, a procedure in which a small sample of tissue from the lining of the uterus (endometrium) is removed for evaluation and testing
Laparoscopy, a procedure during which a thin, lighted instrument (laparoscope) is inserted through a small cut in the lower abdomen to allow the doctor to examine the internal reproductive organs
What Is the Treatment for PID?
If the findings of your exam or tests suggest PID, treatment is started immediately.
Antibiotics. The initial treatment for mild cases of PID usually consists of one or more antibiotic medications taken by mouth. More significant cases can be treated with a combination of intravenous and oral antibiotics. If treatment is not effective, if you cannot take antibiotics by mouth, or if the infection is severe, you may need to be hospitalized to receive medication intravenously (directly into a vein).
If you are diagnosed with PID, your sexual partner(s) also must be treated even if they do not have any symptoms. Otherwise, the infection will likely recur when you have sex again.
Surgery. When PID causes an abscess (when the inflamed tissue forms a collection of pus), antibiotics are no longer as effective. Surgery is often needed to remove the abscesses (or the organ with the abscess) to prevent them from rupturing and causing widespread infection throughout the pelvis and abdomen. Depending on the conditions, this may be done with a laparoscope (a thin, lighted instrument) or with a procedure in which the doctor opens the abdomen to view the internal organs (laparotomy). Both techniques are major surgical procedures and are performed under general anesthesia (you are put to sleep).
If abscesses have formed on the uterus or ovaries, your doctor may recommend hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries).
Another surgical procedure that could be recommended to treat chronic pain when there is no infection, inflammation, or abscess present are those that involve nerve ablation (destruction) surgeries. In these types of surgeries the nerves which provide sensation to the organs in the pelvis are removed or destroyed. In the hands of an experienced surgeon, these procedures can be effective in eliminating pain.