Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-six patients with ovarian endometriosis were treated with Nd:YAG laser contact irradiation under laparoscopic control. Indications for laparoscopy were infertility (n = 20) and dysmenorrhea (n = 16). The laparoscopic procedures so far undertaken in our clinic include: Aspiration of chocolate cyst, removal of ovarian endometriosis, adhesion-lysis, uterine nerve ablation, coagulation of peritoneal endometriosis and irrigation. No complications were seen. After undergoing this procedure, eight of 20 patients achieved pregnancy and 15 of 16 patients obtained pain relief. Serum CA125 levels were significantly decreased postoperatively. We confirmed that contact irradiation with a cone-shaped sapphire probe provides adequate incision and lysis at lower power levels, and that this method is an effective treatment for ovarian endometriosis.
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PMID:[YAG laser contact therapy of ovarian endometriosis under laparoscopy]. 182 81

Of 903 surgically treated patients with endometriosis the disease recurred in 132 cases (14.6%) during the follow-up period of 6-10 years. The re-operation was performed within 1 year after the primary operation for 7 patients, within 1-5 years for 91 patients and more than 5 years after the primary surgery for 34 patients. The most common complaints were pain in the lower abdomen and dysmenorrhoea and the most common sites for the recurrence the ovaries and retrocervix. Endometrioma of the rectum was surgically treated in 10 patients and endometrioma of the urinary bladder in 3. Gestagen therapy after the primary surgery had no effect on the recurrence rate.
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PMID:Recurrent endometriosis. 745 May 70

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

Endometriosis is ectopic endometrial tissue that responds to hormonal stimulation and is found in 8 to 15 per cent of all menstruating women. Endometrioma in a surgical scar is rare and appears in 0.1 per cent of women who have undergone cesarean section; 25 per cent of these women have concomitant pelvic endometriosis. Endometrioma in a scar can present as a painful swelling on the scar that worsens during cough and effort, with the patient's complaints resembling those of a postoperative hernia occurring in a scar. It can also mimic other lesions of the abdominal wall, such as hematomas, granulomas, abscesses, and tumors. Four cases of endometriomas in a cesarean section scar are described. Two were diagnosed preoperatively as postoperative ventral hernias, and the other two presented with an abdominal wall mass causing pain and discomfort. All patients underwent surgery, and the error of their preoperative diagnosis was revealed by histology, which confirmed endometrioma. We contend that endometrioma in scarring is a diagnostic pitfall that should be considered in the differential diagnosis of postoperative ventral hernias and various abdominal wall masses.
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PMID:Endometriosis in abdominal scars: a diagnostic pitfall. 895 45

Endometriosis is a condition in which uterine mucosal tissue is located outside the uterus. Endometriosis may be pelvic or extrapelvic. The term endometrioma is used when endometriosis appears as a circumscribed mass. Abdominal wall endometriomas are usually a secondary process in scars after surgical procedures. A retrospective study of abdominal wall endometrioma, from March 1992 through April 1999 at our institution was done. The mean age of the patients was 28.4 years. Twelve of these reported cases were secondary to previous surgery. One patient presented primarily with an abdominal wall mass without previous surgical history. The most common presentation was an abdominal wall mass associated with pain during the menstrual cycle. Endometrioma was considered as a differential diagnosis in seven patients. All patients underwent surgery. Along with the literature review on endometrioma, the importance of considering it in the differential diagnosis for patients of child-bearing age is discussed.
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PMID:Abdominal wall endometriomas. 1185 68

This article presents two cases of abdominal wall endometrioma. Endometrioma develops after surgery due to transportation and subsequent implantation of endometrial cells. Abdominal wall endometrioma can cause pain, anxiety, and morbidity. Therefore implementation of preventative measures during surgery is paramount to avoid extraneous surgery and hospital expenses. Diagnoses are rarely established prior to surgery, but surgeons often suspect the syndrome in women who have a history of a mass associated with cyclical pain. Radiological examination is useful to exclude hernia and metastatic malignancy, and to delineate the extent of the mass. Wide excision of endometrioma is usually curative.
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PMID:Scar endometrioma: awareness and prevention. 1202 55

Scar endometrioma is an uncommon condition following caesarean section. It presents as a lump on the caesarean scar and can often be painful. Endometrioma is referred to the general surgeon as an incisional hernia. We present six such patients referred to the general surgical department by either the general practitioner or the gynaecologist. Scar endometrioma is believed to arise due to implantation of endometrial tissue during caesarean section. Cyclical pain, as in endometriosis, is characteristic but uncommon. Local wide excision remains the treatment of choice.
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PMID:Post-caesarean incisional hernia or scar endometrioma? 1745 Jun 97

Endometrioma of the abdominal wall is a not well-recognized disease and usually develops after pelvic surgery. The most common presentation is a mass of the abdominal wall associated with pain during menstruation. We report six cases of parietal endometriomas studied with ultrasonography, CT, and in one case with MRI. Our results are compared with recent findings in the literature. The purpose of this study was to describe the clinical and imaging findings in abdominal wall endometriomas that can help reach a presurgical diagnosis.
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PMID:[Endometriomas of the abdominal wall: Imaging findings]. 1709 64

Endometrioma is one of the most frequent pathologies in gynecologic surgery. Laparoscopic cyst excision is considered the best treatment in terms of lower recurrence and improved fertility. However, it was recently questioned whether the excision of the endometrioma could decrease the function of the operated ovary and if it could affect the subsequent fertility. Even if a consistent amount of ovarian tissue is unintentionally removed together with the capsule of the cyst, resulting in does not show the follicular pattern observed in working ovaries. Currently, no definitive data clarify whether the damage to the ovarian reserve, observed in patient with endometrioma, is related to the surgical procedure, to the previous presence of the cyst, or both. Electrosurgial coagulation during hemostasis could play an important role in terms of damage to ovarian stroma and vascularization. Particular attention must be paid in presence of bilateral endometriotic cysts. In fact, an increase in premature ovarian failure rate was reported when both the ovaries are involved in surgery. Incase of assisted reproductive techniques, no clear evidence indicates which is the best approach for concomitant endometriotic cyst. On the base of these considerations endometriomas Should be treated only in case of pain, infertility, and in asymptomatic patients if the cyst diameter is greater than 4 cm.
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PMID:Endometrioma excision and ovarian reserve: a dangerous relation. 1924 2

Endometrioma formation is an uncommon complication of caesarean sections. Frequently the diagnosis is delayed, due to a failure to include it in the differential diagnosis for an abdominal wall mass. The case of a thirty-six year-old female, presenting with the classical triad of a mass and cyclical pain arising in a caesarean section scar, is reported. Wide excision was performed via a transverse lower abdominal ellipse, similar to that used for abdominoplasty. The involved rectus muscle was excised and the abdominal wall was reconstructed using polypropylene mesh. An abdominoplasty-like approach affords clear margins for large caesarean section scar endometriomas thus reducing the recurrence risk. Abdominal wall reconstruction may be required for extensive lesions.
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PMID:Abdominal wall reconstruction for a large caesarean scar endometrioma. 1973 96


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