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

Infections caused by Chlamydia trachomatis are the most common sexually transmitted diseases occurring in developed countries. Among women, chlamydia-mediated diseases include urethritis, cervicitis, endometritis, and salpingitis. Sequelae include infertility, pelvic pain, ectopic pregnancy, and perinatal infection. Aspects of epidemiology, pathogenesis, diagnosis, treatment, and prevention are discussed.
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PMID:Chlamydial infection in women. 268 46

This study analyzed 12-months expulsion rates among women who had Delta IUDs (modifications of the Lippes Loop D and the TCu 220C) inserted immediately after delivery. 122 women received the Delta Loop and 124 received the Delta T IUD. 1 failed insertion and 1 case of mild pelvic pain were reported at insertion for Delta Loop group, whereas 5 women in the Delta T group experienced mild pelvic pain. The proportions of women reporting menstruation-related problems at follow-up were similar for both groups. There were no cases of pelvic inflammatory disease, although 2 women in the Delta Loop group had cervicitis. The 12-month expulsion rate was 3.7 for the Delta Loop and 7.6 for the Delta T. Most expulsions occurred in the 1st month after insertion. The 12-month removal rate for bleeding or pain was 1.1 for the Delta Loop and 1.0 for the Delta T. Continuation rates at 12 months were 93.3 for the Delta LOOP and 90.7 for the Delta T. The 12-month accidental pregnancy rate was 2.1 among Delta Loop users; there were no pregnancies in the Delta T group. These findings suggest that expulsions are minimized and the risks of infection and uterine perforation are not increased when IUD insertion is performed within 10 minutes after delivery of the placenta. The addition of biodegradable suture projections in the Delta devices is considered to signficantly reduce the number of explusions relative to standard loops.
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PMID:A study of delta intrauterine devices in Ankara, Turkey. 286 33

Pelvic inflammatory disease (PID) is a common infection in women of reproductive age. PID is actually a spectrum of disease, beginning with cervicitis and progressing to endometritis and eventually salpingitis. Sequelae include ectopic pregnancy, infertility, chronic pelvic pain, hydrosalpinx, and tubo-ovarian abscess. Neisseria gonorrhoeae and Chlamydia trachomatis are the primary causes of PID. Chlamydial infection may be asymptomatic, and the resulting salpingitis is often referred to as "silent PID." Polymicrobial infection with other organisms (eg, anaerobes, facultative aerobes) may be initiated by gonorrhea, chlamydial infection, or both. Early recognition of infection, prompt institution of appropriate antibiotic therapy, and proper follow-up are important to prevent the sequelae of PID. Patient education is essential to reduce the incidence of PID.
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PMID:Pelvic inflammatory disease. Current diagnostic criteria and treatment guidelines. 843 60

25 patients have involved in this research, who have chronic gynecologic pelvic pain and each of them had normal gynecologic examination. Chronic pelvic pain has been found mostly between 30-39 years age group married, multipar females, associated with 44% dysmenorrhea, 36 p. cent dyspareunaie. Cultures and clinical examinations were all negative as a sign of infection. Experienced intra-abdominal operation or infection were causes of pelvic pain (48%), especially appendectomy has a prominent place (75%). Laparoscopic investigation showed: 16 p. cent adhesions, 28 p. cent chronic annexitis, 16 p. cent experienced pelvic inflammatory disease, 8 p. cent uterine leiomyoma, 4 p. cent each endometriosis, experienced parametritis and haemorrhagic lutein cysts. Instead of making group of lesions, we prefer to describe it, in numbers as infection importance coefficient (IIC), which is developed for this research. IIC 0-2 points presents insufficient organic causes, it does not represent the cause of pain. Non organic and non gynecologic reasons must be the cause of pain. Non organic and non gynecologic reasons must be investigated. IIC 3-5 points presents minor experienced intraabdominal infection. Secondary cases like myoma, ovarian cysts, chronic cervicitis should be considered first as reason. IIC 6 points and more presents direct organic deficiency suitable surgery is the treatment of choice of this group.
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PMID:[25 patients undergoing laparoscopy for pelvic pain]. 844 81

The prevalence of sexually transmitted diseases (STDs) and the frequency of genitourinary symptoms and signs were assessed in 1233 female prostitutes aged 18-45 years, of mean age 26, in Yaounde and Douala. Researchers recorded the physical signs and symptoms experienced by the study subjects within 14 days prior to the physical examination provided as part of the study. The women were tested for gonorrhea, chlamydia infection, and trichomoniasis, with doctors' clinical impressions compared to laboratory test findings. 20% had cervicitis; gonorrhea (11%), chlamydia (12%), or both (3%). 20% had a positive wet mount test for trichomoniasis; 10 subjects were diagnosed with gonorrhea, chlamydia, and trichomoniasis; 65.1% reported abnormal vaginal discharge; and 44.7% reported pelvic pain. Clinical diagnosis for cervicitis and trichomoniasis in this study had sensitivities of less than 50% and specificities of greater than 65%. STDs are therefore common among prostitutes in Cameroon and clinical diagnosis was not an accurate predictor of infection at the individual level.
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PMID:Prevalence and prediction of sexually transmitted diseases among sex workers in Cameroon. 969 96

Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections (STI) recognized throughout the world. Worldwide, the magnitude of morbidity associated with sexually transmitted chlamydial infections is enormous. C.trachomatis is a common cause of urethritis and cervicitis, and sequelae include pelvic inflammatory disease (PID), ectopic pregnancy, tubal factor infertility, epididymitis, proctitis and reactive arthritis. The sharp worldwide increase in the incidence of PID during the past two decades has led to the secondary epidemics of tubal factor infertility and ectopic pregnancy. Chlamydial PID is the most important preventable cause of infertility and adverse pregnancy outcome. Chlamydial infections, like STI in general, are primarily a woman's health care issue since the manifestations and consequences are more damaging to the reproductive health in women than in men. Based on the available evidence, approximately 20% of women with chlamydial lower genital tract infection will develop PID, approximately 4% develop chronic pelvic pain, 3% infertility, and 2% adverse pregnancy outcome. However, these estimates are based on relatively weak evidence. Research on the link between C.trachomatis and male aspects of infertility has been much more limited. Currently recommended treatment regimens include azithromycin in a single dose or doxycycline for 7 days. These therapies are highly efficacious. Timely management of sex partners is essential for decreasing the risk for re-infection. Immunopathogenesis of C.trachomatis infection is one of the main focal points of current research into Chlamydia. Chlamydial infection fills the general prerequisites for disease prevention by screening, i.e. chlamydial infections are highly prevalent, usually asymptomatic, are associated with significant morbidity, can be reliably diagnosed, and are treatable. Screening programmes for C.trachomatis will be of paramount importance in the prevention of long-term sequelae. The cost of screening is only a fraction of the health care costs incurred due to complications resulting from undiagnosed and untreated chlamydial infections. Current strategies to control C.trachomatis still largely depend on clinic-based screening of symptomatic patients, and have not been successful. The development of highly sensitive and specific nucleic acid amplification tests for the diagnosis of chlamydial infections has been an important advance in the ability to conduct population-based screening programmes to prevent complications. Thus, the case for screening is clearly made, but much detail remains to be worked out.
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PMID:Chlamydia trachomatis: impact on human reproduction. 1058 82

The purpose of this report is to evaluate the association between lower genital tract inflammation and objectively diagnosed endometritis. We analyzed the first 157 patients enrolled in the PEACH study, a multicenter randomized clinical trial designed to compare the effectiveness of outpatient and inpatient therapy for PID. Women less than 38 years of age, who presented with a history of pelvic discomfort for 30 days or less and who were found to have pelvic organ tenderness (uterine or adnexal tenderness) on bimanual examination, were initially invited to participate. After recruitment of the first 58 patients (group 1) we added the presence of leukorrhea, mucopurulent cervicitis, or untreated positive test for N. gonorrhoeae or C. trachomatis to the inclusion criteria (group 2, N = 99). We compared rates of endometritis in the two groups and calculated the sensitivity, specificity, and predicted values of the presence of white blood cells in the vaginal wet preparation. The rate of upper genital tract infection in group 1 was 46.5% (27/58) compared to 49.5% (49/99) in group 2. Microbiologic evidence of either N. gonorrhoeae or C. trachomatis increased from 22.4% in group 1 to 38.3% in group 2. The presence of vaginal white blood cells or mucopus has a high sensitivity (88.9%), but a low specificity (19.4%) for the diagnosis of upper genital-tract infection. Assessment of the lower genital tract for evidence of infection or inflammation is a valuable component of the diagnostic evaluation of pelvic inflammatory disease. The presence of either mucopus or vaginal white blood cells is a highly sensitive test for endometritis in patients with pelvic pain and tenderness.
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PMID:Association of lower genital tract inflammation with objective evidence of endometritis. 1080 62

The objective of the study was to determine the clinical manifestations and diagnostic criteria used to diagnose presumptive pelvic inflammatory disease (PID) at the Sydney Sexual Health Centre (SSHC). The study was a retrospective, case-note review of all women diagnosed with presumptive PID between April 1991 and December 1997. Seven hundred and thirteen women were included. The commonest recorded symptoms were vaginal discharge (68%), lower abdominal pain (65%) and dyspareunia (57%), while adnexal tenderness (83%), cervical motion tenderness (75%) and cervicitis (56%) were the most frequently recorded examination findings. Sixty-two per cent were prescribed doxycycline and metronidazole. The recording of signs and symptoms in women with presumptive PID was poor and only 22% met the current Centers for Disease Control (CDC) diagnostic criteria. It is likely that PID is over diagnosed in this group of women. This may lead to under diagnosis of other conditions causing pelvic pain and may be detrimental to reproductive health.
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PMID:Diagnosing PID--getting the balance right. 1099 Mar 40

The authors examined using the polymerase chain reaction (PCR) more than 2700 gynaecological patients for the presence of Ch. tracheomatis. The patients were mostly from Bratislava and surroundings. The material used were cervical smears or morning urine. The most frequent diagnoses associated with Chlamydia infection were adnexitis (38%), cervicitis (22%), pelvic pain (9%), sterility (9%), cystitis and ureteritis (3%) abortus imminenes (4%) partus prematurus imminenes (9%). There was a marked seasonal character of chlamydias with the peak during the summer period. The mean age of the patients was 29.2 years and thus the assumed higher incidence of younger age groups was not confirmed. PCR proved to be an accurate, reliable and perspective method for the detection of Ch. trachomatis in Slovak gynaecological patients.
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PMID:[Diagnosis of Chlamydia trachomatis using PCR in gynecology patients in Slovakia]. 1266 79

Douching has been linked to gonococcal or chlamydial cervicitis and pelvic inflammatory disease (PID) in retrospective studies. The authors conducted a 1999-2004 prospective observational study of 1,199 US women who were at high risk of acquiring chlamydia and were followed for up to 4 years. Cervical Neisseria gonorrhoeae and Chlamydia trachomatis were detected from vaginal swabs by nucleic acid amplification. PID was characterized by histologic endometritis or pelvic pain and tenderness plus one of the following: oral temperature >38.3 degrees C, leukorrhea or mucopus, erythrocyte sedimentation rate >15 mm/hour, white blood cell count >10,000, or gonococcal/chlamydial lower genital tract infection. Associations between douching and PID or gonococcal/chlamydial genital infections were assessed by proportional hazards models. The 4-year incidence rate of PID was 10.9% and of gonococcal and/or chlamydial cervicitis was 21.9%. After adjustment for confounding factors, douching two or more times per month at baseline was associated with neither PID (adjusted hazard ratio = 0.76, 95% confidence interval: 0.42, 1.38) nor gonococcal/chlamydial genital infection (adjusted hazard ratio = 1.16, 95% confidence interval: 0.76, 1.78). Frequency of douching immediately preceding PID or gonococcal/chlamydial genital infection was not different between women who developed versus did not develop outcomes. These data do not support an association between douching and development of PID or gonococcal/chlamydial genital infection among predominantly young, African-American women.
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PMID:Douching, pelvic inflammatory disease, and incident gonococcal and chlamydial genital infection in a cohort of high-risk women. 1563 69


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