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

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

During the last years tremendous changes have occurred in the epidemiologic knowledge and the diagnostic process of the prostatitis syndrome. A new worldwide-accepted classification system has become the gold standard in contemporary literature. The aim of this study was to compare the inflammatory and infectious status of men with prostatitis syndrome with results from our study cohort from 1992. A total of 168 symptomatic men (mean age 43.2 years; range 18-79) attending the Giessen prostatitis outpatient department were included. All men underwent a standard four-glass-test including leucocyte analysis in all specimens. A routine search for Ureaplasma urealyticum and Chlamydia trachomatis was performed. Ejaculate analysis following World Health Organization (WHO) criteria has been performed including the evaluation of increased number of peroxidase-positive leucocytes (PPL). Men were classified according to the National Institutes of Health (NIH) prostatitis classification. The distribution of patients according to NIH criteria is as follows: NIH II (4.2%), NIH IIIA (31.5%), NIH IIIB (50.0%) and urethroprostatitis (14.3%). Chlamydial infection was present in one man (0.6%). Only two men with increased leucocytes in prostatic secretions demonstrated > or =106 million ml-1 PPL in semen. As compared with our cohort study 10 years ago, the proportion of the different subtypes of the prostatitis syndrome have remained stable. The aetiological spectrum of chronic bacterial prostatitis has not changed whereas, in contrast, the prevalence of C. trachomatis now is found to be strikingly reduced. Using the WHO cutpoints for leucocytospermia the inclusion of seminal leucocytes to the diagnostic process has not influenced the distribution between inflammatory (type NIH IIIA) and noninflammatory (type NIH IIIB) chronic pelvic pain syndrome.
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PMID:The 2001 Giessen Cohort Study on patients with prostatitis syndrome--an evaluation of inflammatory status and search for microorganisms 10 years after a first analysis. 1453 51

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

Chlamydia trachomatis is a widespread, sexually transmitted infection causing pelvic inflammatory disease, infertility, ectopic pregnancy and chronic pelvic pain among women. Asymptomatic infections among men contribute significantly to maintaining the spread of the infection. In a 1-y intervention study in general practices we aimed to evaluate an opportunistic screening programme targeting 16-25-y-old men. When the young men saw their general practitioner (GP) for the first time during the intervention y, they were offered a test for C. trachomatis based on a first catch urine sample. Main outcome measures were percentage of tested men and prevalence of infection in the intervention practices compared with the test activity in the rest of the county during the intervention y and the y before. GPs in the intervention practices saw 617 (75.6%) of the 814 registered young men during the intervention period. Screening was offered to 300 (48.6%) and 219 (26.9% of the target population) accepted the invitation. The prevalence of infection among screened men was 5.0%. We conclude that opportunistic screening for urogenital C. trachomatis infection in general practice is feasible.
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PMID:Opportunistic screening of young men for urogenital Chlamydia trachomatis infection in general practice. 1576 88

Chlamydia trachomatis infection is the most commonly reported sexually transmitted disease (STD) in the United States. An estimated 2.8 million infections occur annually. In 2002, a total of 834,555 cases in the United States, including 10,914 cases in Massachusetts, were reported through the National Notifiable Disease Surveillance System (NNDSS). Chlamydial infection is most often reported in females, particularly those aged 15-24 years, reflecting a higher level of screening in females but also important risk factors. Although the majority of infections are asymptomatic, complications are potentially severe in women and include pelvic inflammatory disease, which can lead to tubal pregnancy, infertility, and chronic pelvic pain. Chlamydial infection during pregnancy can cause illness in the infant (e.g., conjunctivitis and pneumonia). Infection in men can manifest as urethritis and epididymitis. Timely, documented diagnosis and treatment of chlamydial infection are critical to prevent both complications and transmission. Since 1996, a progressive increase has occurred in the number of reported cases of chlamydial infection in Massachusetts, in part because of an increase in screening and use of more sensitive tests. This report summarizes an evaluation of chlamydial-infection reporting in Massachusetts during January-June 2003. The results underscore the need for improvement in both completeness and timeliness of reporting chlamydial infection in Massachusetts.
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PMID:Reporting of chlamydial infection--Massachusetts, January-June 2003. 1594 26

Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. The spectrum of disease ranges from subclinical, asymptomatic infection to severe, life-threatening illness; sequelae include chronic pelvic pain, ectopic pregnancy, and infertility. PID is diagnosed clinically, with laboratory and imaging studies reserved for patients who have an uncertain diagnosis, are severely ill, or do not respond to initial therapy. The Centers for Disease Control and Prevention diagnostic criteria include uterine, adnexal, or cervical motion tenderness with no other obvious cause in women at risk of PID. Empiric treatment should be initiated promptly and must cover Chlamydia trachomatis and Neisseria gonorrhoeae; the possibility of fluoroquinolone-resistant N. gonorrhoeae also should be considered. Hospitalization for initial parenteral therapy is necessary for patients with tubo-ovarian abscess and for those who are pregnant, severely ill, unable to follow a prescribed treatment plan, or unable to tolerate oral antibiotics. Patients also should be hospitalized if a surgical emergency cannot be excluded or if no clinical improvement occurs after three days. Routine screening for asymptomatic chlamydial infection can help prevent PID and its sequelae.
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PMID:The challenge of pelvic inflammatory disease. 1652 95

We investigated the seminal micro-flora of 116 men. Eighty-four men had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and 34 of them were also leukocytospermic. Thirty-two asymptomatic men formed the control group. Micro-organisms were found in all of the 116 seminal fluid specimens. More than 20 different micro-organisms were found in both groups. Neisseria gonorrhoeae and Chlamydia trachomatis were not found. A high frequency of anaerobic bacteria was found in all groups (68-79%), and in most of the specimens, anaerobic micro-organisms were equal to or outnumbered the aerobic strains. We found 1-8 different micro-organisms in each semen sample, the total count of micro-organisms ranged from 10(2) to 10(7)/mL of semen. Both parameters were significantly higher in leukocytospermic CP/CPPS (NIH IIIA category) patients (median=5 different micro-organisms; total median count 5 x 10(4)) than in the control group (median=3 different micro-organisms; total median count 10(3)). In the CP/CPPS patients, the prevalence and/or count of some opportunistic bacteria was higher than in the control group. To show that the micro-organisms do not originate from the urethra, first voided urine was also investigated in 17 prostatitis patients and 15 controls. One patient had significantly fewer micro-organisms (median 1 vs. 4) and a lower total count of micro-organisms (median 10(2) vs. 10(4)/mL) in the first-catch urine than in the seminal fluid. We found only one third of the micro-organisms to be similar in urine and semen while anaerobic bacteria and some aerobic opportunists were infrequent in urine. Semen is a suitable specimen for the diagnosis of prostatitis.
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PMID:Anaerobic seminal fluid micro-flora in chronic prostatitis/chronic pelvic pain syndrome patients. 1688 98

Infection with Chlamydia trachomatis accounts for the most common bacterial sexually transmitted infection in the UK. Men between 20 and 24 years and women between 16 and 19 years have the highest prevalence of chlamydial infection. Because the majority of women with chlamydial infection are asymptomatic, a proportion remains untreated and eventually develops pelvic inflammatory disease (PID). PID can result in ectopic pregnancy, infertility and chronic pelvic pain. Screening for chlamydial infection might reduce the incidence of complications of PID. The advent of nucleic acid amplification tests and single-dose therapy for chlamydial infection has made home testing and easy treatment possible.
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PMID:A review on infection with Chlamydia trachomatis. 1693 31

Pelvic inflammatory disease (PID) is a frequent condition of young women, often resulting in reproductive morbidity. Although Neisseria gonorrhoeae and/or Chlamydia trachomatis are/is recovered from approximately a third to a half of women with PID, the etiologic agent is often unidentified. We need PCR to test for M genitalium among a pilot sample of 50 women with nongonococcal, nonchlamydial endometritis enrolled in the PID evaluation and clinical health (PEACH) study. All participants had pelvic pain, pelvic organ tenderness, and leukorrhea, mucopurulent cervicitis, or untreated cervicitis. Endometritis was defined as > or =5 surface epithelium neutrophils per x400 field absent of menstrual endometrium and/or > or =2 stromal plasma cells per x120 field. We detected M genitalium in 7 (14%) of the women tested: 6 (12%) in cervical specimens and 4 (8%) in endometrial specimens. We conclude that M genitalium is prevalent in the endometrium of women with nongonococcal, nonchlamydial PID.
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PMID:Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease. 1748 98

The evaluation of acute and chronic bacterial prostatitis and the diagnostic management of chronic prostatitis/chronic pelvic pain syndrome with special reference to infection and inflammation is well defined. Men with symptoms of acute bacterial prostatitis (NIH I) have to undergo urine analysis and culture of the urine. An initial imaging of the prostate is suggested to exclude prostatic abscess. In chronic bacterial prostatitis (NIH II) the 4- and/or the 2-glass test for white blood cell counts and culture are necessary. Culture of semen has a lower sensitivity but is recommended for evaluation in selected men with problems with infertility. Imaging of the prostate is indicated to exclude abscess formations. In patients with chronic prostatitis/chronic pelvic pain syndrome (NIH III) symptom scoring is mandatory using the NIH-CPSI. The 4- and/or the 2-glass test are suggested to rule out bacterial infections. The routinely done analysis of urine and expressed prostatic secretions for leukocytes is debatable, especially due to the fact that the differentiation between patients with inflammatory and non-inflammatory subgroups of CP/CPPS may not be useful for the daily praxis. Optional investigations include the analysis for leukocytes in the ejaculate. Histopathological and molecular microbiological evaluation of prostatic tissue are investigational tests requiring for evaluation. Routine done serum PSA, routine imaging of the prostate and tests for Chlamydia trachomatis and Ureaplasma are not really proven to provide benefit for the patient. In patients with asymptomatic prostatitis (NIH IV) is no evaluation necessary unless considering antimicrobial therapy for elevated PSA or infertility.
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PMID:Evaluation of acute and chronic bacterial prostatitis and diagnostic management of chronic prostatitis/chronic pelvic pain syndrome with special reference to infection/inflammation. 1816 76


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