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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients have undergone presacral neurectomy at Yale-New Haven hospital over the past 7 years. The patients were separated into three subdivisions according to abnormal findings at the time of surgery: group I, endometriosis; group II, pelvic inflammatory disease (PID); and group III, those patients with neither endometriosis nor pelvic inflammatory disease but with pelvic pain and infertility. At the time of surgery, an attempt was made to correct and repair coexistent pelvic abnormalities. The groups were evaluated for relief of pain and subsequent viable intrauterine pregnancy. A control group of infertility patients complaining of pain who underwent infertility laparotomy without presacral neurectomy was used for comparison. Presacral neurectomy has traditionally been performed for pain associated with endometriosis and has resulted in subsequent pain relief and pregnancy rates of 30% to 60%. Pregnancy rates of 46% to 47% were found in the PID group, the endometriosis group, and the control group. In addition, 75% of the patients with either PID or endometriosis had significant relief of pain following presacral neurectomy as compared with only 26% of the control group undergoing only infertility laparotomy. It is concluded from these findings that presacral neurectomy plus reconstructive pelvic surgery is more effective than infertility laparotomy alone for the treatment of pelvic pain but that presacral neurectomy does not increase the subsequent incidence of pregnancy.
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PMID:Presacral neurectomy for pelvic pain in infertility. 745 74

Medicated IUDs such as copper IUDs and progesterone-releasing IUDs represent a new development in this form of contraception. All IUDs act by causing an inflammatory reaction at the endometrial level. Techniques of insertion vary from one model to the other; insertion always requires an experienced practitioner, and postabortion or midmenstruation insertions are to be preferred. Pregnancy with IUD in situ is a rare occurrence; the IUD must then be immediately removed. Ectopic pregnancies are about 5-10% of all pregnancies with the device in situ. IUD complications are uterine perforation, mostly done at time of insertion, and pelvic infection which, if untreated, can cause infertility; this is the reason why an IUD is never recommended to a nullipara. Pain and bleeding are the most common side effects. When the strings of the device are not visible, translocation of the device inside the uterine cavity must be suspected. The choice of the wrong type of IUD or a bad insertion can cause spontaneous expulsion of the device. IUD wearers must be regularly seen by a doctor; there is no correlation between IUD use and cervical or endometrial carcinoma.
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PMID:[Intrauterine devices]. 745 47

A retrospective analysis of symptomatology, diagnostic procedures, and treatment of all 155 new cases of genital tuberculosis at 47 Swedish gynecology departments in the period 1968-77 was performed. The frequency of genital tuberculosis was 0.002% of all patients admitted for gynecologic disease. Genital tuberculosis occurred more frequently in the postmenopausal period. The most common symptoms were metorrhagia, pain, and infertility. Chemotherapy alone was used in 40% of the cases. Conservative surgery was attempted in 8%, and 38% had radical surgery. No intrauterine and four tubal pregnancies occurred after therapy. We conclude that primary treatment should be conservative, although the chances of having a normal pregnancy are almost nil and the risk of an ectopic pregnancy is great.
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PMID:Genital tuberculosis in women. Analysis of 187 newly diagnosed cases from 47 Swedish hospitals during the ten-year period 1968 to 1977. 746 85

During one year, 120 patients were referred for outpatient diagnostic hysteroscopy. The most common indications were abnormal uterine bleeding (67%), followed by sterility and infertility, respectively (18%). The uterine cavity was visualised in 103 patients, and about half of the patients (50.5%) had demonstrable uterine pathology. 75 patients (72.8%) did not experience any pain during or after the examination and 28 women (27.2%) reported varying levels of pain. In 17 cases (14%) passage through the internal cervical os was either not possible for anatomical reasons or was not tolerated by the patients. However, diagnostic hysteroscopy, combined with directed biopsy where appropriate, is now considered the method of choice for identifying intrauterine pathology. Performed in an outpatient setting, diagnostic hysteroscopy using a fluid distention medium is largely pain-free and hardly accompanied by side effects, provided patients are thoroughly counseled beforehand. Essential preliminaries for a successful examination are careful patient selection, a clear clinical indication and, above all, the skilled coordination between eye and hand. More widespread use of diagnostic hysteroscopy may spare numerous women the stress of curettage while at the same time facilitating optimal selection of those cases really requiring further medical examination or therapy.
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PMID:[Initial experiences with ambulatory irrigation hysteroscopy]. 755 22

Endometriosis may result in pain and/or infertility in some patients, while others may remain asymptomatic. The disease appears to progress and regress somewhat unpredictably, making it difficult to determine the appropriate treatment. Progression of the disease can be altered by medical and surgical treatments used according to general guidelines but selected for the individual. Coagulation, medical suppression and observation are frequently the first approaches to infertility or pain resulting from endometriosis. Deep dissection and excision may be indicated with deep disease, persistent pain or persistent tenderness.
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PMID:Pain and infertility--a rationale for different treatment approaches. 757 51

A series of 200 cases of endometriosis were treated laparoscopically by Nd: YAG laser and microwave at Peking Union Medical College Hospital. All the operations were performed under local and topical anesthesia follow-up for 10-48 months revealed good results. Of 76 cases with infertility, 46 (60.5%) conceived after treatment. Of 114 cases with ovarian endometriomas, the cysts were no longer found in 81 cases (71.1%), decreased in size in 24 cases (21.0%). Of 180 cases with pain symptoms, 105 patients (58.3%) were achieved complete relief, Partial relief in 61 cases (33.9%). It has been found that laparoscopic surgery is effective to improve fertile rate for the patients with all the stages of endometriosis. The results showed that the microwave and Nd: YAG laser can be achieved with safety and success. The microwave is safer than Nd: YAG laser and is easier to operate and less expensive.
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PMID:[Laparoscopic treatment of endometriosis with Nd: YAG laser and microwave]. 779 44

New data on the pathophysiology of pain associated with endometriosis are available. The predominant role of deep endometriosis has been stressed. In multivariate analysis, superficial endometriosis and even adhesions and ovarian cysts do not appear to be related with pain. Deep endometriosis is usually located posterior to the vagina and cervix, involving the pouch of Douglas, the rectovaginal septum and the uterosacral ligaments. In such cases, pelvic examination shows a painful induration or a nodule in this area. The anterior cul-de-sac and the lateral pelvic wall may also be involved. Two histological and clinical aspects may be observed: deep endometriosis arising under the peritoneal surface, or adenomyosis arising from the uterine cervix. Only complete surgical excision may be curative, but recurrences may occur after surgery. Hormonal therapy is only suspensive. However, surgical therapy involves a significant risk of complication. Surgery for deep endometriosis may be one of the most difficult gynecologic operations. It should be performed only by experienced surgeons, with skills in oncological dissections of the pelvis. The guidelines for therapy are thus clear. Superficial endometriosis does not cause pain and should not be treated by itself; symptomatic relief of pain may be obtained by therapeutic amenorrhea or by the placebo effect of surgery. Endometriomas are managed in the same way as all organic ovarian cysts. Adhesions are lysed if infertility is associated with pain, or to gain access to the retroperitoneal area. Etiologic therapy is acceptable only in case of deep endometriosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pelvic pain and external endometriosis. Physiopathology and treatment]. 788 88

Infertility is experienced by 5 million U.S. couples, some of whom perceive it a stigmatizing condition. Recent technological innovations have created a multitude of medical interventions for those infertile individuals who can financially afford them. For some infertile women, those interventions also transform infertility from a private pain to a public, prolonged crisis. Our research focuses on 25 U.S. women who sought medical treatment for infertility and describes their perception of the stigma associated with infertility. We apply a critical, feminist perspective to our analysis of the women's lived experiences within the social and medical contexts in which they occur.
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PMID:Stigma: the hidden burden of infertility. 789 19

Endometriosis is a disease observed in women in fertile age, it causes pelvic pain characterized by dysmenorrea and dyspareunia. Moreover, there is an association with infertility. Between the alternative of the medical therapeutics of endometriosis drugs with hipogonadotrofic and hypoestrogenic effects, as the danazol and gestrinona has been used. At present, there are analogies of GnRH factor where leuprolide acetate allow a continue liberation in a monthly administration. This is a case of a woman with extensive endometriosis that has hepatitis due to danazol and subsequently was treated with leuprolide acetate. The effectiveness of leuprolide acetate is analyzed in relation with the relief of pain and the laparoscopic evaluation of the endometriosis focus.
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PMID:[Advanced endometriosis treatment with leuprolide acetate]. 799 63

Varicocele may cause scrotal pain and swelling, and may be associated with retardation of testicular growth, impaired sperm quality and infertility. Imaging methods may reveal subclinical varicocele. The condition may be treated with high or low ligation of the testicular veins or occlusion via catheter. The occluding material can consist of metal coils or various liquids such as sclerosing agents, glue or heated contrast medium. Good results are reported for clinical symptoms and sperm quality, while the effect on pregnancy rates varies considerably. The rate of complications is low in large series.
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PMID:[Treatment of varicocele]. 799 34


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