Surgery

Surgery is not usually done to treat pelvic inflammatory disease (PID) unless it is needed to:

• Drain or remove an abscess, such as a tubo-ovarian abscess.
• Cut scar tissue (adhesions) that is causing pain.

Surgery is sometimes used when a diagnosis is still unclear after other tests are done or when antibiotic treatment is not working. Diagnostic laparoscopy is usually used.

Surgery Choices

Procedures that may be used to diagnose and treat the complications of pelvic inflammatory disease (PID) include:

• Laparoscopy, which allows the surgeon to insert a lighted viewing instrument through a very small abdominal incision, look for signs of ectopic pregnancy or infection and scar tissue, and make repairs if necessary.
• Laparotomy, which allows the surgeon to directly inspect the abdominal cavity through a small incision in the abdomen and make repairs if necessary.
• Drainage of an abscess using a needle and syringe. The doctor usually uses ultrasound to clearly see where the needle is going, which makes an incision unnecessary.

What To Think About

Surgery to remove adhesions caused by pelvic inflammatory disease has not been proved to relieve pain unless adhesions are severe (referred to as stage IV adhesions).⁶

The need for surgical treatment of PID has decreased over the past several years because of earlier diagnosis and better antibiotic treatment.

Laparoscopy or laparotomy may be done for diagnosis of pelvic symptoms, and treatment can be done at the same time. Laparoscopy is used more often. Laparotomy typically requires a longer recovery period.