Patient's question:
Since last year, occasional left lower abdominal pain and dyspareunia. Gynecological examination revealed tenderness upon palpation, reduced menstrual flow, and dark-colored discharge.Doctor's answer:
Hello: Pelvic inflammatory disease (PID) and pelvic endometriosis share some similarities and differences in clinical manifestations and symptoms. Regarding PID: A history of vaginal infections or pelvic inflammatory disease, such as abnormal vaginal discharge, odor, and bacterial infections confirmed by secretion tests, previous lower abdominal pain, or fever with leukocytosis, along with reference to CRP and other tests. Gynecological examination: tenderness in the uterus and adnexa, or palpable masses, which improve after anti-inflammatory treatment~.Pelvic endometriosis, on the other hand, primarily manifests as lower abdominal pain before or after menstruation, which progressively worsens, along with dyspareunia. During gynecological examination, nodular tenderness may be felt on the posterior uterus, and adnexal masses may be palpable. Ultrasound can aid in diagnosis, and blood CA125 levels may slightly increase. These are the typical symptoms and signs observed in most patients, though some atypical presentations may occur, requiring further clinical evaluation~.
Regarding treatment plans, the first step is to conduct a thorough examination and confirm the diagnosis. If PID is diagnosed, antibiotic treatment is necessary. For endometriosis, the treatment plan should be tailored based on examination results, including medication, laparoscopic diagnosis and treatment, or abdominal surgery (such as conservative surgery~). High-quality hospitals in Beijing include:
Peking Union Medical College Hospital (PUMCH)
Renji Hospital, Peking University
Peking University Third Hospital