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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Varicocele, an abnormal dilatation of the pampiniform plexus, frequently contributes to male factor infertility. We performed laparoscopic varicocelectomy in 20 patients with varicoceles and abnormal seminal findings. The spermatic artery was identified and preserved in 13 patients and was clipped along with the veins in 7 patients including 1 patient with bilateral varicocele. The time required for the artery-ligating surgery ranged from 90 to 120 minutes with an average of 113.2 minutes, while the time needed for the artery-preserving technique ranged from 90 to 250 minutes with an average of 158.0 minutes. Some analgesics were administered to 11 patients, while the other 9 patients needed no analgesics. All patients were able to walk within 24 hours of the operation. The mean hospitalization period after the operation was 5.9 days. Sperm concentrations significantly improved postoperatively (p < 0.05). No difference in postoperative improvement of seminal findings was observed between artery-ligating and artery-preserving groups. A slight scrotal emphysema developed during the operation in 1 patient. Abdominal pain was experienced in 1 patient, but subsided within a few days. No serious complications were observed. The laparoscopic technique may replace routine open high ligation as the surgical treatment of choice, especially in patients with bilateral varicocele.
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PMID:Laparoscopic varicocele ligation. 873 26

Cervical pregnancy is a very rare, potentially life-threatening type of ectopic pregnancy. The condition is usually difficult to differentiate from the cervical phase of an incomplete abortion or a bleeding cervical fibroid. A 24-year-old Nigerian woman was seen in a private hospital with a history of 2.5 months amenorrhea, followed by irregular, occasionally heavy, vaginal bleeding for 8 days. She denied any history of associated abdominal pain or urinary symptoms. Before this recent period of morbidity, the woman's menses had been regular every 30 days with normal blood loss of 4 days' duration. She had had two prior normal deliveries, most recently 2 years earlier, and had no history of prior abortion, dilatation, and curettage; infertility; or any contraceptive practice before consultation. Vaginal examination found no active bleeding, but a bulky, soft, 1-2 cm dilated cervix. An ultrasound scan obtained by the patient in another private clinic one day earlier identified an empty uterine cavity, but a bulky cervix with a gestational sac and fetal node. The patient was to be admitted for immediate evacuation, but left the hospital in search of money for the operation. The products of conception were evacuated at the hospital the next day. The patient was in satisfactory condition with no complaints at 4 weeks follow-up.
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PMID:Cervical ectopic pregnancy: a case report. 885 77

The analgesic efficacy and duration of action of tenoxicam, an injectable non-steroidal analgesic with a long elimination half-life, were studied in day case laparoscopy in a double-blind randomised prospective parallel placebo-controlled trial. Tenoxicam 20 mg or saline was given intravenously at induction of anaesthesia in 67 women undergoing day case investigative laparoscopy for infertility or abdominal pain. Outcome measures were time to first analgesia, pain levels at 2, 4 and 24 h plus postoperative analgesic consumption in hospital and at home. The study showed no statistically significant difference in any of these measures between the two groups. Tenoxicam 20 mg intravenously immediately pre-operatively cannot be recommended for day case surgery on the basis of this study.
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PMID:The analgesic efficacy of tenoxicam versus placebo in day case laparoscopy: a randomised parallel double-blind trial. 894 4

Female genital schistosomiasis (FGS) is a neglected disease entity which may give rise to considerable suffering among women of child-bearing age in areas where schistosomiasis (especially due to Schistosoma haematobium) is prevalent. The close relation between the vessels in genital organs and the urinary bladder enables the parasite to easily change location to virtually any organs in the female pelvic area. Symptoms concur with the anatomical location of worm pairs and their ova. Lesions of the lower female genital tract can easily be investigated by cytology, histology or direct demonstration of eggs in scrapings or biopsies whereas schistosomiasis of the upper genital tract is clinically indecipherable and less accessible for examination. In the literature there are references to FGS as a cause of infertility, complications of pregnancy, menstrual disorders, problems related to sexual intercourse, diagnostic similarities to STDs and cancer, unspecified complaints related to blood loss, chronic abdominal pain, social segregation and related psychological problems. The diagnosis of female upper genital schistosomiasis is difficult and the authors point out possible diagnostic procedures which might be helpful for further understanding of this complex entity.
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PMID:Schistosomiasis in women: manifestations in the upper reproductive tract. 902 8

Algorithms for the diagnosis of ectopic pregnancy are applied independent of the patient population. However, patients may require care at various times of gestation or for different reasons. To examine the utility of the same diagnostic criteria for identifying an ectopic pregnancy in different patient populations, we evaluated women from the infertility clinic and the residents' gynecology clinic at Yale-New Haven Hospital. Sixty women with nonemergency ectopic pregnancies were identified, 38 from the infertility clinic and 22 from the residents' clinic. Although the most common symptoms were the same in both groups (abdominal pain, spotting/bleeding >3 days, dizziness, shoulder pain), they were significantly more frequent in women form the residents' clinic. Despite care by the same attending physicians, ruptured ectopic pregnancies were more than 3 times as likely to occur in the noninfertility patients, and half as likely to be treated laparoscopically (p<0.01). Patients from the residents' clinic also were more likely to have postoperative complications (p<0.5), and had over a threefold higher risk of receiving a blood transfusion. We conclude that criteria for diagnosis and intervention in ectopic pregnancy may have to be modified on the basis of characteristics of the patient population.
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PMID:Failure of standard criteria to diagnose nonemergency ectopic pregnancies in a noninfertility patient population. 905 Apr 75

A retrospective study evaluated the feasibility and safety of operative gynecologic procedures performed in an ambulatory surgical center. Between July 1993 and December 1995, 5766 women (mean age 36.9 yrs, range 13-95 yrs) who were referred to our center underwent surgery. The most common preoperative diagnoses were dysfunctional bleeding, missed abortion, postmenopausal bleeding, cervical dysplasia, mullerian duct malformation, infertility, endometriosis, adhesions, desire for sterilization, adnexal mass, lower abdominal pain, ectopic pregnancy, and fibroids. A total of 2351 laparoscopies, 2 laparotomies, and 3415 vaginal procedures were performed. The most common procedures were dilatation and curettage, 1455; hysteroscopy, 1051; adnexal surgery, 810; tubal ligation, 679; abdominal myomectomy, 186; operative hysteroscopy, 145; and cone biopsy, 118. The duration of surgery was 10 to 210 minutes. Most patients (99.51%) were discharged between 2 and 8 hours after surgery. Only 28 (0.49%) had to be admitted to the hospital; 18 women had preoperatively planned admissions and 10 were unexpectedly admitted postoperatively. The intraoperative and postoperative complication rate was 0.50% (29). We believe that ambulatory surgery is safe and efficient with proper patient selection and when the surgeon and the anesthetist have significant expertise.
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PMID:Ambulatory Gynecologic Surgery 907 98

Tuboovarian abscess is a serious consequence of pelvic inflammatory disease, especially in the adolescent population. Early diagnosis and treatment are essential to prevent further sequelae including infertility, ectopic pregnancy, and chronic pelvic pain. Not all patients, however, present with pelvic pain, pelvic mass, fever, and leukocytosis. We present the case of a sexually active 15-year-old black girl who presented with mild abdominal pain and excessive vaginal bleeding without pelvic mass, fever, or leukocytosis. Erythrocyte sedimentation rate was 66 mm/h. Pelvic ultrasound revealed bilateral complex ovarian masses. At laparoscopy, the patient had bilateral tuboovarian abscesses with extensive adhesions to the pelvic side walls. This case illustrates the need for a high index of suspicion of tuboovarian abscess in sexually active adolescents.
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PMID:Tuboovarian abscess in the adolescent. 917 5

During the five years from 1990-1994, 98 women underwent surgery for ectopic pregnancy. For every 167 deliveries, one patient underwent surgery for ectopic pregnancy. The incidence is 0.59 per cent with a rising trend. The commonest presenting symptom was abdominal pain (97%) followed by vaginal bleeding (79%). Four patients were asymptomatic and were diagnosed at routine antenatal ultrasound scan. The most frequent physical findings were abdominal tenderness (91%), followed by adnexal tenderness (54%). Histories of infertility (15%), use of intrauterine contraceptive devices (14%), and previous ectopic pregnancy (11%) were elicited. Five patients had a false negative urinary pregnancy test and subsequently required surgery. The ectopic pregnancies were tubal in 98 per cent of the cases. The diagnosis and management of ectopic pregnancy has changed significantly over the last decade. The increasing use of quantitative BHCG assay and vaginal ultrasonography have made early diagnosis possible, allowing conservative tubal surgery when indicated.
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PMID:A five-year review of ectopic pregnancy. 947 94

During the nine years (1986-1994), 138 women underwent surgery for ectopic pregnancies (One for every 213 deliveries). The commonest presenting symptom was abdominal pain (96%) followed by vaginal bleeding (83%). Four patients were asymptomatic and were diagnosed at a routine antenatal ultrasound scan. The most frequent physical findings were abdominal tenderness (87%) and followed by adnexal tenderness (57%). Histories of infertility in 17%, use of intrauterine contraceptive device (13%), and previous ectopic pregnancy in 11% were elicited. Eleven patients (8%) had a false negative urinary pregnancy test and subsequently required surgery. The ectopic pregnancies were tubal in 97% of the cases. There were 3 ovarian ectopics and one cervical ectopic.
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PMID:Nine year survey of 138 ectopic pregnancies. 954 73

A 31-year old woman with secondary infertility after a previous Cesarean delivery underwent in vitro fertilization and embryo transfer (IVF-ET). She was pregnant by IVF-ET. In the first trimester, however, she began to have genital bleeding and lower abdominal pain. This led to intrauterine fetal death, which was terminated by curettage of the uterine cavity. Later, magnetic resonance imaging (MRI) showed the uterine pregnancy on the lower segment scar and the rupture, which was abdominally repaired. It is very likely that the uterine rupture was associated with the implantation in the Cesarean section's scar in this case.
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PMID:Lower segment uterine rupture related to early pregnancy by in vitro fertilization and embryo transfer after a previous cesarean delivery. 970 95


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