Encyclopedia of Health and Medicine

penis 317
procedures. The doctor closes the speculum’s
blade to withdraw the speculum.
See also KEGEL EXERCISES; PREVENTIVE HEALTH CARE
AND IMMUNIZATIONS.
pelvic inflammatory disease (PID) A bacterial
INFECTION involving the UTERUS, FALLOPIAN TUBES,
CERVIX, and VAGINA. Untreated PID has the potential
to become life threatening if it spreads to
involve the peritoneal membrane (PERITONITIS), the
tissue that encloses the abdominal cavity. Because
PID can cause scarring within the fallopian tubes
that occludes them (blocks the tubes’ openings),
chronic or recurrent PID is a leading cause of
INFERTILITY in women. PID is a significant health
concern in the United States with doctors diagnosing
more than one million women with it each
year, about half of whom have permanently
impaired FERTILITY as a consequence.
The most common cause of PID is recurrent or
untreated infection with SEXUALLY TRANSMITTED DIS-
EASES (STDS) such as CHLAMYDIA and GONORRHEA.
Other causes include infection that occurs as a
postoperative complication after a surgical procedure
such as DILATION AND CURETTAGE (D&C) or elective
ABORTION. A less common cause of PID is
infection resulting from an intrauterine device
(IUD), a form of long-term birth control.
Symptoms and Diagnostic Path
It is possible to have PID, especially chronic PID,
with few or no symptoms. Many women who
have PID typically appear quite ill, however, and
may have FEVER and chills in addition to other
symptoms. Such symptoms may include
• yellowish or greenish malodorous (foulsmelling)
vaginal discharge
• lower abdominal tenderness, cramping, or PAIN
• NAUSEA, VOMITING, and DIARRHEA
• vaginal bleeding between menstrual periods
• irregular or unusually heavy menstrual periods
The diagnostic path includes PELVIC EXAMINATION
with vaginal discharge and tissue samples for laboratory
analysis and BLOOD tests to evaluate the
presence of infection or INFLAMMATION within the
body (such as elevated sedimentation rate, white
blood cell count, and C-REACTIVE PROTEIN). The
cervix and uterus are generally very tender to palpation
during the pelvic exam, which is a key
diagnostic criterion.
Treatment Options and Outlook
Treatment is prompt administration of ANTIBIOTIC
MEDICATIONS, by intravenous (IV) or intramuscular
injection for severe symptoms and orally otherwise.
Antibiotic therapy may include two or more
antibiotic medications, depending on the identified
BACTERIA present in the vaginal and cervical
cultures. It is essential to take the full course of all
antibiotics as prescribed to completely eradicate
the infection, which cures the PID. ANALGESIC MED-
ICATIONS relieve pain and reduce fever to improve
comfort. Possible complications of PID include
infertility, increased risk for ECTOPIC PREGNANCY,
and chronic pelvic pain. The likelihood of these
complications increases with each episode of PID,
though prompt diagnosis and treatment helps mitigate
their risk.
ANTIBIOTICS TO TREAT
PELVIC INFLAMMATORY DISEASE (PID)
ampicillin/sulbactam
cefotetan
cefoxitin
ceftriaxone
ciprofloxacin
clindamycin
doxycycline
gentamicin
metronidazole
ofloxacin
Risk Factors and Preventive Measures
The primary risk factor for PID is untreated STD
infection. Many people do not have symptoms of
STDs yet are infected and pass the infections to
their sex partners. Multiple sex partners and
unprotected sex are high-risk behaviors for STDs
and PID. Measures to prevent infection among
sexually active adults include mutual monogamy
and latex condom use with every sexual act.
See also HIV/AIDS; MENSTRUATION; SEXUALLY TRANS-
MITTED DISEASE (STD) PREVENTION.
penis The male organ for URINATION and SEXUAL
INTERCOURSE. The penis is an elongated, cylindrical
structure made of connective and erectile tissue
that extends outside the body from the base of the
pelvis. Ligaments attach the root of the penis (segment
within the body) to the pubic bone at the