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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The knowledge needed to formulate proper indications for hysterectomy include a thorough understanding of the physiology and pathology of the female reproductive organs, the clinical manifestations of pelvic disease, and normal and abnormal psycho/social/sexual development. This basic and thorough knowledge and understanding is the absolute foundation on which to base the practice of gynecologic surgery. After the right operation has been selected for operation, the right operation must be selected for the patient. The successful practice of gynecologic surgery also requires proper preparation of the patient for the operation, proper performance of the operation, and proper postoperative care. A competent gynecologist who has followed a patient for several years, has kept careful records of findings and treatment, and has the patient's full confidence is most likely able to make the most accurate judgment about the necessity for hysterectomy. Yet, in most circumstances a 2nd opinion should still be sought. Apprpriate indications for hysterectomy include benign uterine disease and/or symptoms -- dysfunctional uterine bleeding; uterine pain, bleeding, and enlargement; uterine descensus and prolaspe; uterine leiomyomas; septic abortions; and obstetric catastrophs. Other indications include benign diseases of the tubes and ovaries in which the uterus is not primarily involved -- pelvic inflammatory disease, pelvic endometriosis, and ectopic pregnancy -- and neoplastic disease, namely, cervical intraepithelial carcinoma (carcinoma in situ), early invasive cervical cancer, endometrial adenocarcinoma and sarcoma, trophoblastic disease, ovarian and fallopian tube neoplasms, and malignant disease of other adjacent organs. Miscellaneous and usual indications for hysterectomy include cervical problems such as servical stenosis with recurring pyometra following unsuccessful attempts to keep the cervix open, chronic pelvic pain, pelvic congestion syndrome, and surgical sterilization. A partial list of inappropriate indications for hysterectomy includes prophylaxis against uterine cancer, contraception in a gynecologically normal patient, management of the menopause, leukorrhea and chronic cervictis, primary dysmenorrhea and premenstrual tension, mild urinary incontinence, postmenopausal bleeding, abnormal vaginal/cervical cytology, and cervical dysplasia.
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PMID:Indications of hysterectomy. 733 47

Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease characterized by pelvic pain urgency and frequency. Patients with severe symptoms lead a very miserable life. North American, European and Asian guidelines have been recently promulgated but they differ on many important issues. There is no consensus on its name, definition, investigations and management. Indian guidelines have also been developed and they give more importance to the symptoms in relation to micturition. Though initially believed to be rare or non-existent in India the situation has changed. In Indian patients the presentation is more or less same as the rest of the world but a large percentage have obstructive symptoms and unusual urinary symptoms. Anal discomfort is also common. In India the commonest investigation in all cases of lower urinary tract (LUT) dysfunction is ultrasonography of kidney ureter and bladder with measurement of the post void residual urine volume. Cystoscopy is also done in all the cases to rule out presence of tuberculosis or carcinoma in situ. Bladder pain syndrome/interstitial cystitis (BPS/IC) is not considered to be a clinical disease as it is difficult to rule out all differential diagnosis only from history. Hunner's lesion is very rare. Cystoscopy with hydro distension, oral therapy, intravesical therapy and surgical therapy form the back bone of management. It is difficult to know which treatment is best for a given patient. A staged protocol is followed and all the treatment modalities are applied to the patients in a sequential fashion-starting from the non-invasive to more invasive. Intravesical botox has not been found to be effective and there is no experience with interstim neuromodulation.
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PMID:Clinical presentation and treatment of bladder pain syndrome/interstitial cystitis (BPS/IC) in India. 2681 51