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

Of the first 500 women in Oxford to undergo transcervical resection of the endometrium, 101 (20%) have subsequently undergone hysterectomy. This study was undertaken to assess the reasons for failure of endometrial resection. An audit of the case notes of the 101 women requiring hysterectomy was performed. Data collection included the patient's age, weight, parity, reasons for endometrial resection, details of the endometrial resection, reasons for hysterectomy, hysterectomy findings and uterine histology. Six (6%) hysterectomies were performed as emergency operations during endometrial resection, 33 (33%) were performed for persistent menorrhagia, 39 (39%) for recurrent menorrhagia and in 18 women (18%) for pelvic pain. The duration of success following endometrial resection ranged from 0 to 21 months. Hysterectomy was significantly more common in older women under 40 years of age, in the presence of an enlarged fibroid uterus, when complications at endometrial resection had occurred and in women operated on by relatively inexperienced surgeons. Endometrium ws present in 96% of hysterectomy specimens. Uterine malignancy that had not been diagnosed at transcervical resection of the endometrium was present at hysterectomy in two women. Hysterectomy should be considered in preference to endometrial resection for treatment of menorrhagia in women who are less than 40 years old and in the presence of large intramural fibroids.
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PMID:Hysterectomy following failed endometrial resection. 1551 76

The denervation-reinnervation view proposes that retrograde menstruation results from loss of normal, fundocervical polarity caused by injuries to uterine nerves. Injuries may be sporadic (following vaginal delivery) or recurrent (after persistent straining during defaecation) creating very different appearances at laparoscopy. Clinical symptoms of pelvic pain, menstrual problems, dyspareunia, and dysmenorrhoea result from aberrant reinnervation that may occur with, or without deposits of pelvic endometriosis. Endometrium, delivered by retrograde menstruation, adheres to any injured tissues in the lower pelvis. Classical 'endometriosis' is largely an epiphenomenon to underlying processes of denervation and reinnervation.
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PMID:Endometriosis: the elusive epiphenomenon. 1975 60