Pyometra

Pyometra is an uterine condition that involves accumulation of pus in uterine cavity, caused by interference with natural drainage of uterus. It is a rare disorder that normally occurs in post-menopausal woman with concurrent medical conditions. Most pyometra cases are associated with malignant disease of the uterus. Other causes include:

• Foreign bodies
  
  
• Puerperal infections or Postpartum infections
  
  
• Uterine anomalies
  
  
• Fibroid degeneration
  
  
• Senile Cervicitis
  
  
• Uterine compression sutures used for postpartum hemorrhage to avoid hysterectomy
  
  
• Genital tuberculosis.
  

Symptoms

Most often, Pyometra does not present with any symptoms and the condition could be incidentally found through imaging performed for different purpose. Some of the symptoms of Pyometra include

• Blood-stained purulent vaginal discharge
  
  
• Symmetrical uterine enlargement
  
  
• Post menopausal bleeding
  
  
• Lower abdominal pain
  
  
• Nausea and vomiting
  
  
• Diarrhea
  
  
• Pyrexia (rarely)
  

Very rarely, pyometra leads to spontaneous perforation. It is a medical emergency and requires an immediate attention and treatment.

Diagnosis

Diagnostic tests are planned and performed on the lines of underlying condition that has resulted in Pyometra. If prevailing tuberculosis is causing symptoms of pyometra, diagnosis can be confirmed by tuberculin testing, histology, Hysterosalpingogram or PCR. Ultrasound scan, CT scan and MRI are generally recommended to diagnose the condition. Doppler scanning is used when pyometra has occurred due to endometrial cancer. X-ray shows the presence of spontaneous perforation of the uterus.

Treatment

Dilatation of the cervix and pus drainage is the treatment of choice, and it is important to rule out the possibility of cancer and differentiate the malignancy. However regular monitoring is necessary to look for recurrence. In few cases, Hysterectomy may be advised to avoid future complications. Medicine therapy with antibiotics becomes necessary if there is an infection. Tubercular pyometra should is treated with appropriate anti-tubercular chemotherapy.