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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

A hospital-based, prospective study was done in 350 women of 20-50 years to compare VIA with Pap smear for early detection of cervical dysplasia at Maternity Hospital, Thapathali, from May 2004 to December 2004. Pap smear was taken from each woman followed by VIA. Women with positive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. The variables studied were age group, presenting complaint, age of marriage, parity, smoking habit and appearance of cervix. The incidence of positive VIA and Pap smear was 2.86 and 0.57 respectively. Pelvic pain was the most common presenting complaint. The majority of the women were married before 20 years of age. All women with either positive VIA and/or Pap smear were of parity two or above. There was no significant association between smoking and positive VIA (P=0.699) or Pap smear (P=0.397). Approximately 36.57% of the women screened had abnormal looking cervix. There were two women with high grade intraepithelial lesion (HSIL) and both were VIA positive and this was statistically significant (Fischer exact P=0.0007). Of the ten VIA positive women, on histopathological examination six showed chronic cervicitis, one acute cervicitis, one showed cervical intraepithelial neoplasia (CIN) II, one had normal finding and one was lost to follow up. VIA as a screening test for cervical neoplasia did not miss any lesion detected by Pap smear and confirmed by cervical biopsy.
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PMID:Early detection of precursors of cervical cancer with cervical cytology and visual inspection of cervix with acetic Acid. 1870 35