Doctors Lounge - Gynecology Answers
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Forum Name: Gynecology
Question: TUBAL INFECTION - URGENT
|shandifoster03 - Sat Feb 21, 2004 4:23 am||
I am 19 years old and married for over 1 year. I had a miscarriage and D&C on September 8, 2003. I have always had menstrual cycles that fluctuated but not like this. They were always around 28-35 days in length. Since December they have been 38-45 days in length and have been menstruating up to 10 days long. I went to the emergency room on January 23, 2004 with severe lower abdominal pain and swelling. They gave me an antibiotic and pain pills and sent me home saying it was nothing but a tubal infection. I have been having these symptoms for about 4 years now and they always say that it is a tubal infection. Since the 23rd, I have been experiencing abdominal pain and swelling, hotflashes and night sweats, fatigue, shortness of breath, heartburn, breast pain and itching, constipation, nausea, terrible headaches, frequent urination, mood swings, painful intercourse, and thick dark hair growth on my upper lip, chin and neck. My last cycle lasted 43 days, I began menses at the age of 7. My mother has had cervical cancer, a 25 lb. ovarian cancer and hysterectomy at age 32, and has HPV. What on earth could this be? Everyone keeps telling me that I'm too young to have cancer, but I am extremely worried because day by day the symptoms keep getting worse. I have a doctors appointment for February 25, 2004. Is my doctor just going to send me home again? What do I need to ask him to do?
|Dr. Tamer Fouad - Sat Feb 21, 2004 8:29 am||
Tubal infection is one form of the so called pelvic inflammatory disease (PID). In order to diagnose a PID infection, a physician may perform several tests. A physical examination is typically done first in order for the physician to locate the specific area of the body that is bothering the patient. If the problem is found in the lower abdominal area, a pelvic exam can be performed for further investigation. A sonogram may also be taken to obtain a better idea of what the reproductive organs look like inside the woman's body. To help in determining the cause of the disease, a sample of the woman's vaginal discharge may also be examined. In addition, surgical procedures can be performed to confirm the presence of PID. These include endometrial biopsies and laparoscopies. In an endometrial biopsy, internal tissue samples are removed for analysis. In a laparoscopy, the surgeon inserts a lighted tube into the lower abdomen in order to see a visual image of what the tissue in this area looks like. Laparoscopies can also be used to perform the endometrial biopsies.
A diagnosis of PID is made if the results obtained from several tests are consistent with one another. Frequently when pelvic inflammation is present and the sample of vaginal discharge contains a causative organism, a diagnosis of PID can be made. During the surgical procedures, if there is visual proof of inflamed tissue and the specimen of tissues obtained from such a procedure reveals one or more of the causative organisms; this too can be used to confirm PID.
The above investigations will also exclude the presence of any other conditions such as cancer. They will also be done with the aim of finding a reason for the repeated attacks that you are witnessing.
If confirmed then treatment of PID in a woman your age is mandatory as repeated infections lead to scarring of the tubes. This will ultimately lead to infertility. Aggressive antibiotics is essential.
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