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

Endometriosis is one of the most frequent gynecological diseases. In its development take a part genetical, mechanical and immunological factors. Main symptoms are cycle-dependent pelvic pain, infertility and characteristic morphological alterations ("pelvic mass"). For the diagnosis the laparoscopy plays the leading role. Therapy is based either on the hormonal inhibition of ovarian function (danazol, GnRH agonists), or surgical interventions (operative laparoscopy), as well as the combination of both methods.
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PMID:[Etiology, pathophysiology and clinical aspect of endometriosis]. 155 19

Seventy-five consecutive patients undergoing laparoscopy for chronic pelvic pain and/or infertility were studied to test whether beta-endorphin concentrations in peripheral mononuclear cells differed according to the presence or absence of endometriosis. Endometriosis was diagnosed in 45 subjects (minimal in 24, mild in 11, moderate in four, and severe in six). Twenty-eight women (62%) with endometriosis and ten (33%) without the disease reported moderate or severe pelvic pain. beta-Endorphin levels were lower in the endometriosis group than in the controls (16.6 +/- 11.2 versus 21.9 +/- 10.5 pg/10(6) cells; P less than .01). This decrease was attributable to reduced beta-endorphin concentrations in the endometriosis patients with moderate or severe pain compared with symptomatic controls (15.5 +/- 10.0 versus 26.3 +/- 7.0 pg/10(6) cells; P less than .01). A significant difference was also found in relation to the cycle phase: The opioid concentration was reduced in the luteal phase in the endometriosis group compared with controls (14.4 +/- 8.4 versus 23.8 +/- 7.5 pg/10(6) cells; P less than .01), but no differences were demonstrated in the follicular and periovulatory phases. beta-Endorphin is capable of modulating the immune response and can be considered as a classical cytokine. Low beta-endorphin production during the luteal phase may have implications in the development and/or maintenance of endometriosis.
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PMID:Mononuclear cell beta-endorphin concentration in women with and without endometriosis. 156 59

We evaluated the prevalence and severity of dysmenorrhea, pelvic pain, and deep dyspareunia and their relation to disease stage and site in 124 infertile women with endometriosis and 67 infertile women with normal findings. Seventy-eight endometriosis patients had stages I-II disease and 46 had stages III-IV. The frequency of dysmenorrhea was similar in patients and controls; pelvic pain was more frequent only in patients with stages III-IV, whereas deep dyspareunia was more prevalent regardless of disease stage. Dysmenorrhea was significantly more severe in stages III-IV patients than in either stages I-II patients or controls. Pelvic pain was more severe in stages III-IV, but we observed a statistically significant difference only in comparison with stages I-II. An association of two or more pain symptoms was more frequent in women with endometriosis than in those with normal pelves (relative risk = 3.1, 95% confidence interval 1.52-6.46). Ovarian endometriomas were the only lesions significantly associated with severe dysmenorrhea and pelvic pain. We conclude that endometriosis in infertile women causes pelvic pain, the severity of which is related to the extent of the disease.
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PMID:Pain symptoms associated with endometriosis. 156 63

Endometriosis is a commonly encountered disease, yet most aspects of its pathogenesis, pathophysiology, and treatment remain controversial. Recent advances, however, have increased our understanding of this enigmatic disorder. While many theories persist regarding the pathogenesis of endometriosis, the transplantation hypothesis is by far the most widely accepted. Evidence continues to accumulate in support of this theory as the primary mode of generating ectopic endometrium. In addition, recent work has begun to uncover factors critical to the growth and maintenance of such implants. Advances in pathophysiology have strongly suggested a cause-effect relationship between endometriosis and pelvic pain; conversely, such a relationship between implants and infertility is becoming more tenuous. Treatment trials, in both animals and humans, have begun to clarify the role of specific interventions in combating endometriosis. In addition, as new pathophysiologic mechanisms have been proposed, an intriguing array of new modalities have been developed as treatment options.
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PMID:Endometriosis: advances in understanding and management. 162 49

The easy access to the pelvis via laparoscopy has led to an appreciable increase in the diagnosis of endometriosis in women with infertility or chronic pelvic pain. This could suggest a rising incidence of the disease but is probably largely related to the recently acquired ability to demonstrate minimal and mild lesions. However, estimates of the distribution of endometriosis in the female population might be unreliable due to lack of control of the variables which influence diagnosis of the disease in the initial stages. Analysis of data from prospective studies on asymptomatic women undergoing tubal sterilization reveals a markedly higher than expected frequency of endometriosis. This raises doubts on the clinical significance of the minimal lesions that are often found. The concept that initial endometriosis should always be treated to avoid worsening of the condition seems to lack a convincing rational basis and is not supported by definitive scientific evidence. Minimal/mild endometriosis could represent a temporary phase in an on-going process that usually results in cytolysis of recently implanted endometrial cells, whereas in a few immunologically 'tolerant' subjects, nodular, cystic and infiltrating lesions develop, with eventual progression to moderate and severe stages.
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PMID:Is mild endometriosis always a disease? 163 81

Physicians recruited 6 women aged 17-40 years with cyclic pelvic pain due to endometriosis for a prospective open trial conducted at the Clinical Research Center in San Diego, California. They wanted to assess endocrine and clinical responses to daily administration of 100 mg/d of RU-486 for 3 months. They all experienced amenorrhea during treatment. Moreover, urinary ovarian steroid metabolites were acyclic indicating anovulation. Mean luteinizing hormone (LH; p.02) and LH pulse (p.05) amplitude increased after treatment with RU-486, yet the LH pulse frequency did not change. Further, serum cortisol (p.01) and adrenocorticotropic hormone (p.05) also increased indicating that RU- 486 had an antiglucocorticoid effect. Menstrual cyclicity returned immediately after terminating treatment. 2 patients even became pregnant. Further, all patients reported less pelvic pain during treatment yet the extent of endometriosis did not improve. Indeed most received alternative treatment for endometriosis prior to enrollment in this study with no reduction in pain. The researchers could not determine the mechanism of pain relief or chronic anovulation, however. Further studies using lower doses and longer term therapy with RU-486 in patients with endometriosis are needed.
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PMID:Endocrine responses to long-term administration of the antiprogesterone RU486 in patients with pelvic endometriosis. 171 96

During a period of 18 months with a history of chronic pelvic pain symptomatology (severe dysmenorrhea, severe dyspareunia, extramenstrual pain) retroverted or retroflexed uterus, and infertility were subjected to laparoscopy for diagnostic and therapeutic purposes as well. These women were able to follow up this protocol. After informed consent had been presented patient decided, in a case of endometriosis being verified by the tissue pathology intraoperatively, which one mode of therapy (Group I or Group II) would be administered in her case. All women failed to respond to non-steroidal, antiinflammatory medication, as well as to oral contraceptive treatment. Proposed intraoperative staging of pelvic endometriosis that has not yet been published, was utilized by the author. Group I twenty women were subjected to a translaparoscopic CO2 laser excision and (or vaporization of endometriosis implants, CO2 laser uterine nerve ablation, uterine suspension with Falope Rings and intraperitoneally 32% Dextran was installed. Group II twenty women were subjected only to a translaparoscopic CO2 laser endometriosis excision and/or vaporization and intraperitoneally 32% Dextran-70 was installed. In Group I extramenstrually pain was 90%, severe dysmenorrhea 85%, and infertility 90% were cured. Ten per cent of extramenstrual pain, 5% of severe dysmenorrhea, and 15% of severe dyspareunia were improved. Infertility in this group was unchanged in 10%. Patients' symptoms were not worsened during the 18 months of observation. In Group II only 60% infertility was curred. In 60% extramenstrual pain, in 35% severe dysmenorrhea, in 5% severe dyspareunia were improved. Symptoms were noted to worsen in 5% extramenstrual pain, in 5% severe dysmenorrhea, in 10% severe dyspareunia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A new translaparoscopic approach in endometriosis treatment: a. CO2 laser endometriosis excision and/or vaporization. b. CO2 laser uterine nerve ablation. c. Uterine suspension with Falope Rings. d. Intraperitoneally 32% Dextran-70 installation. 172 45

In the case of a 21-year old woman, who complained of chronic pelvic pain and where cystic structures in the adnexal region had been diagnosed ultrasonically and by laparoscopy, a tumour made up of many small cysts was discovered in the pouch of Douglas next to a typical endometrial cyst. Both the endometrial cyst and the cystic tumour were excised by laparotomy. Histology established the tumour as a multicystic peritoneal mesothelioma. Postoperative recurrence was noticed by ultrasound less than one year later. Laparotomy revealed a 5 cm serous cyst of the right ovary and again countless liquid-filled grape-like small cysts in the pouch of Douglas. Histology revealed a multicystic peritoneal mesothelioma identical to the previously excised tumour. Multicystic peritoneal mesothelioma is a rare soft tissue tumour noted for its frequent recurrences. Most authors agree, that it belongs to the morphological spectrum of reactive mesothelial proliferative lesions and not the neoplastic spectrum. It appears mostly in women, often concomitant with endometriosis and pelvic inflammatory disease and frequently in women, who had previous surgical interventions in the abdominal region.
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PMID:[Recurrent multicystic peritoneal mesothelioma in endometriosis of the pelvis]. 176 Nov 78

Transvaginal ultrasonically guided aspiration of pelvic endometriotic cysts was performed on 21 patients with recurrent endometriosis after previous surgical treatment. Their main complaint was pelvic pain and infertility. Further conservative surgery was considered a contraindication. The symptoms improved markedly following aspiration. During a 12 month follow-up, reaccumulation occurred in only six cases (28.5%) and the improvement in symptoms persisted in the majority of cases. The technique is simple, safe and effective in the treatment of selected cases of endometriosis.
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PMID:Ultrasonic transvaginal aspiration of endometriotic cysts: an optional line of treatment in selected cases of endometriosis. 177 Jan 36

According to the method of differentiation of symptom complexes of traditional Chinese medicine (TCM), endometriosis is a disease of blood stasis and mass in the lower portion of abdomen. 76 cases were treated by TCM prescription named endometriotic pill No 1 with rhubarb as the main ingredient. The chief functions of the rhubarb were removing blood stasis, disintegrating mass and purgation. The total effective rate was 80.26%. Among them, the effective rate of dysmenorrhea was 88.89%, that of pelvic pain was 66.72%, that of intercourse pain 72.12%, and diminishing in size of mass or nodule 22.15%; 3 cases of 22 infertility got pregnant (13.63%). The results revealed that the endometriotic pill No 1 yielded distinct improvement in the treatment of endometriosis, including clinical symptoms and signs, laboratory assay of blood rheology, serum Ig, subgroup of T lymphocyte (OKT system) and PG.
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PMID:[Treatment of endometriosis with removing blood stasis and purgation method]. 177 64


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