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

Combined histological and bacteriological investigations of 800 specimens of nonpregnant endometrial curettings of 15 to 60 years age group of hill women of Darjeeling District were carried out for detection of tuberculous endometritis. The principal complaints were infertility (47.5 per cent), abnormal uterine bleeding (30.75 per cent), amenorrhoea (11.25 per cent), leucorrhoea (6.25 per cent), and miscellaneous conditions (pelvic pain and pyometra) (4.25 per cent) cases. By histological examination alone, only 10.9 per cent cases could be diagnosed while by combined study the incidence rate was 11.8 percent, an increase in the diagnostic acumen by more than 10.3 per cent. Bacteriological study was of greater value in doubtful cases where there was absence of tuberculous granuloma or epithelioid cell but presence of nonspecific inflammatory cells along with variable degree of necrosis of glandular epithelia. The incidence of M.tuberculosis was 97.7 percent while that of atypical mycobacteria was 2.3 per cent. Thus simultaneous use of culture and biopsy yielded better results. Our prevalence is a little higher than other reports from India. In cold weather at a high altitude, the tubercle bacilli survive longer in fomites which serve as important sources of infection in Darjeeling. Women of third decade are more frequently affected (43.2 per cent).
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PMID:Tuberculous endometritis in hills of Darjeeling: a clinicopathological and bacteriological study. 815 2

Cryoneuroablation, also known as cryoanalgesia or cryoneurolysis, is a specialized technique for providing long-term pain relief in interventional pain management settings. Modern cryoanalgesia traces its roots to Cooper et al who developed in 1961, a device that used liquid nitrogen in a hollow tube that was insulated at the tip and achieved a temperature of - 190 degrees C. Lloyd et al proposed that cryoanalgesia was superior to other methods of peripheral nerve destruction, including alcohol neurolysis, phenol neurolysis, or surgical lesions. The application of cold to tissues creates a conduction block, similar to the effect of local anesthetics. Long-term pain relief from nerve freezing occurs because ice crystals create vascular damage to the vasonervorum, which produces severe endoneural edema. Cryoanalgesia disrupts the nerve structure and creates wallerian degeneration, but leaves the myelin sheath and endoneurium intact. Clinical applications of cryoanalgesia extend from its use in craniofacial pain secondary to trigeminal neuralgia, posterior auricular neuralgia, and glossopharyngeal neuralgia; chest wall pain with multiple conditions including post-thoracotomy neuromas, persistent pain after rib fractures, and post herpetic neuralgia in thoracic distribution; abdominal and pelvic pain secondary to ilioinguinal, iliohypogastric, genitofemoral, subgastric neuralgia; pudendal neuralgia; low back pain and lower extremity pain secondary to lumbar facet joint pathology, pseudosciatica, pain involving intraspinous ligament or supragluteal nerve, sacroiliac joint pain, cluneal neuralgia, obturator neuritis, and various types of peripheral neuropathy; and upper extremity pain secondary to suprascapular neuritis and other conditions of peripheral neuritis. This review describes historical concepts, physics and equipment, various clinical aspects, along with technical features, indications and contraindications, with clinical description of multiple conditions amenable to cryoanalgesia in interventional pain management settings.
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PMID:Cryoanalgesia in interventional pain management. 1688 Aug 82

The term prostatitis syndrome refers to a number of conditions affecting the prostate. Prostatitis syndrome is clinically manifested through symptoms of the lower urogenital tract and perineum. Basic factors in the classification of prostatitis syndrome are clinical symptoms and signs, and the presence of leukocytes and bacteria in selectivelly collected urine samples and in expressed prostatic secretion obtained by the Meares and Stamey localization technique. Antimicrobial therapy is indicated in patients with acute bacterial prostatitis, chronic bacterial prostatitis and chronic inflammatory nonbacterial prostatitis, which also includes bacterial prostatitis unproved by classical methods. Empirical antimicrobial treatment should be initiated immediately in patients with acute bacterial prostatitis and in patients with acute exacerbation of chronic bacterial prostatitis. Targeted antimicrobial therapy is administered in patients with chronic bacterial prostatitis after obtained microbiological results, and empirical antimicrobial therapy lasting for 2-6 weeks in patients with chronic inflammatory nonbacterial prostatitis. Because of their broad spectrum of activity and pharmacodynamic and pharmacokinetic characteristics, fluoroquinolones, ciprofloxacin and ofloxacin are first choice antimicrobial drugs for the treatment of prostatic inflammatory diseases. The efficacy of administered antimicrobial treatment should be followed up 4-6 weeks (early follow-up) and 6 months (late follow up) after the end of antimicrobial therapy. The treatment of a noninflammatory chronic pelvic pain syndrome without proved infection includes phytotherapy, hygienic-dietetic measures, microwave thermotherapy, alpha-adrenergic blocking agents, muscle relaxants, analgesics, non-steroidal antiflogistics, 5-alpha-reductase inhibitors, modified living habits, psychotherapy and antispasmodic analgesics. All patients with chronic types of prostatitis syndrome should avoid drinking alcohol, carbonated beverages, spices, cycling, colds, especially sitting on cold surfaces.
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PMID:[Classification, diagnosis and treatment of prostatitis syndrome]. 1895 27

A case of peritonitis as an unusual complication of LLETZ (large loop excision of the transformation zone) for the treatment of CIN III associated with unrecognized iatrogenic posterior colpotomy is presented. After the procedure, the patient developed fever 38.3 degrees C and diffused severe pelvic pain. The contributing factors, prevention and management of this complication are discussed. Also, the complications of cold knife cervical conization and LLETZ procedure are reviewed.
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PMID:Peritonitis due to iatrogenic colpotomy after large loop excision of the transformation zone (LLETZ) in a patient with cervical intraepithelial neoplasia III: our experience of a rare case with review of the literature. 2261 67

This report presents an exceptional case of uterine avulsion following a cold-knife conization, an unprecedented surgical complication of a common gynecological procedure. Furthermore, it describes the outcomes of the conservative laparoscopic reconstruction that was performed. A 30-year-old nulliparous was referred to our department with secondary amenorrhea and cyclic pelvic pain following a cold-knife conization performed 9 months previous in another institution. The patient underwent a diagnostic laparoscopy, which confirmed that the cervix had been completely resected and that the uterine and vaginal cavities were no longer in contact. We performed an end-to-end utero-vaginal anastomosis followed by a prophylactic cerclage. No intraoperative or postoperative complications were observed. One month after surgery the patient was asymptomatic with normal withdrawal bleeding and remained asymptomatic during her 12-month follow-up consult. To our knowledge, this is the first time that this serious complication with a potential for irreversible damage to reproductive function is reported as a complication of cervical conization. Although our conservative surgical correction repaired the anatomy and reestablished menstruation outflow, further follow-up is necessary to confirm the extent to which reproductive function was restored.
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PMID:Laparoscopic re-anastomosis of a uterine avulsion following cold-knife conization. 2453 81

Chronic pain in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), NIH category III is difficult to treat without understanding its cause. The main symptom of chronic prostatitis is pain. In this study, we would like to explain the origin of pain in men with CP/CPPS and its therapy. Forty-five patients with CP/CPPS have received thermobalancing therapy (TT) enabled by Dr Allen's therapeutic device (DATD) for six months as mono-therapy. The control group comprised 45 men with CP/CPPS did not receive TT. Before and after six months the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores, prostatic volume (PV) by ultrasound measurement and uroflowmetry (Qmax) were compared between the groups. Baseline characteristics have shown no difference. After TT, significant improvements in pain score (p < 0.001), quality of life index (QoL) (p < 0.001), decrease of PV (p < 0.001), and increase Qmax (p < 0.001) were determined. There were not noteworthy changes in the control group. Chronic pain due to CP/CPPS happens as a consequence and challenges at the capillary level, namely pathological capillary activity. In response to initial triggers-such as inflammation, cold, psychological and other factors-constriction and spontaneous expansion of capillaries follows, creating a continuous secondary trigger-i.e., the micro-focus of hypothermia-which in turn provokes expansion of capillaries. The additional tissue due to vascular changes into the prostate increases pressure on nociceptors causing pain. TT relieves chronic pelvic pain by eliminating the lasting focus of hypothermia in the affected prostate tissue.
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PMID:The Vascular Factor Plays the Main Role in the Cause of Pain in Men with Chronic Prostatitis and Chronic Pelvic Pain Syndrome: The Results of Clinical Trial on Thermobalancing Therapy. 2911 11

Women who develop bladder pain syndrome (BPS), irritable bowel syndrome, or dyspareunia frequently have an antecedent history of dysmenorrhea. Despite the high prevalence of menstrual pain, its role in chronic pelvic pain emergence remains understudied. We systematically characterized bladder, body, and vaginal mechanical sensitivity with quantitative sensory testing in women with dysmenorrhea (DYS, n = 147), healthy controls (HCs) (n = 37), and women with BPS (n = 25). Previously, we have shown that a noninvasive, bladder-filling task identified a subset of women with both dysmenorrhea and silent bladder pain hypersensitivity, and we repeated this to subtype dysmenorrhea sufferers in this study (DYSB; n = 49). DYS, DYSB, and BPS participants had lower vaginal mechanical thresholds and reported more pain to a cold stimulus during a conditioned pain modulation task and greater pelvic examination after-pain than HCs (P's < 0.05). DYSB participants also had reduced body mechanical thresholds and less conditioned pain modulation compared to HCs and DYS participants (P's < 0.05). Comparing quantitative sensory testing results among the DYS and HC groups only, provoked bladder pain was the only significant predictor of self-reported menstrual pain (r = 0.26), bladder pain (r = 0.57), dyspareunia (r = 0.39), and bowel pain (r = 0.45). Our findings of widespread sensory sensitivity in women with dysmenorrhea and provoked bladder pain, much like that observed in chronic pain, suggest a need to study the trajectory of altered mechanisms of pain processing in preclinical silent visceral pain phenotypes to understand which features convey inexorable vs modifiable risk.
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PMID:Dysmenorrhea subtypes exhibit differential quantitative sensory assessment profiles. 3216 5

Background and aims Psychological traits such as pain catastrophizing may play a role in the development of chronic pelvic pain (CPP). Pain catastrophizing is the tendency to amplify negative cognitive and emotional pain processes. The Pain Catastrophizing Scale (PCS) assesses elements of pain catastrophizing divided into three subgroups of factors (rumination, helplessness and magnification). Previous studies have shown associations between CPP and increased pain sensitivity, widespread generalized hyperalgesia, and decreased pain thresholds, but the relation between pain catastrophizing and specific pain thresholds has not yet been widely examined in this patient group. The aims of this study were (a) to determine if catastrophizing is increased in women with CPP compared with pain-free women, (b) to assess the importance of pain catastrophizing, psychological distress variables, and subjective pain sensitivity for pain thresholds of heat, cold and pressure in these two groups, and (c) to determine whether psychological variables or pain thresholds best contribute to the differentiation between CPP and controls. Methods Thirty-seven women with chronic pelvic pain who underwent diagnostic laparoscopy on the suspicion of endometriosis participated along with 55 healthy and pain-free controls. All underwent quantitative sensory testing on six locations on the body to determine heat (HPT), cold (CPT) and pressure (PPT) pain thresholds. The PCS, the Pain Sensitivity Questionnaire (PSQ), the Hospital Anxiety Depression Scale, (HADS) demographics and clinical data were collected prospectively. Principal component analysis and orthogonal partial least square regressions were used to assess the associations between PCS scores and pain thresholds. Results The women with CPP scored significantly higher on PCS than the healthy controls. PCS-helplessness, PCS-rumination and HADS-depression were significantly associated with pain thresholds for the whole group. In the CPP group, PCS-rumination, body mass index and PSQ were significant regressors for HPT and CPT. The PCS and the HADS subscales were strongly intercorrelated in women with CPP and were stronger regressors of group membership than the three pain thresholds. In the group of healthy control women, no relationships were found to be significant. The psychological variables were somewhat stronger significant regressors than pain thresholds (also significant) for group membership. Conclusions Women with CPP have significantly higher pain catastrophizing scores than women without CPP. The pain catastrophizing rumination factor is significantly associated with pain thresholds of heat and cold in CPP women. PCS and HADS are strongly intercorrelated and PSQ correlates positively with these variables. It seems that the psychological variables are important for group differentiation. Implications The results clearly indicate the need for a multimodal assessment (bio-psycho-social) of CPP patients including psychological symptoms such as catastrophizing, anxiety and depression. The registration of semi-objective pain thresholds captures both specific pain sensitivity information (mechanical pressure, cold or heat) and the degree of wide spread pain hypersensitivity. There is a need for future larger studies investigating whether certain profiles in the clinical presentations (including pain thresholds and psychological variables) are associated with outcomes after different types of interventions.
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PMID:Pain catastrophizing is associated with pain thresholds for heat, cold and pressure in women with chronic pelvic pain. 3238 92