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

Using a study of 306 coelioscopies as a basis, the authors try to define the relationship existing between the observation of lesions of peritoneal endometriosis and the symptom of pain. Certain observations raise the doubt of there being a cause/effect relationship (i.e. high incidence of peritoneal endometriosis in women without symptoms of pain, only 40% of cases of peritoneal endometriosis are associated with pain, very high incidence of associated lesions or psychiatric history in women with painful peritoneal endometriosis). While unable to rule out the responsibility of lesions of peritoneal endometriosis in the genesis of pelvic pain, they nevertheless believe that such an observation should lead the physician to be critical (is the pain psychogenic?) and thorough (investigation of genital or extra-genital associated lesions) before any conclusion is drawn. In certain cases, the reply will be given by the therapeutic test.
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PMID:[Is peritoneal endometriosis painful?]. 214 97

The advent of MRI has improved the ability of the diagnostic radiologist to provide useful clinical information to the practicing gynecologist. Although US remains the screening procedure of choice for evaluation of the uterus and adnexa because of its relative safety and low cost, MRI is now considered the next imaging step. In a woman with pelvic pain, MRI can accurately identify adenomyosis, enumerate and localize uterine fibroids, and provide more accurate identification of endometriosis and cystic teratomas of the ovary than US. Although MRI should not be used as a screening procedure for diagnosing endometrial or cervical carcinoma, it can aid in patient management by determining the extent of myometrial or cervical invasion by endometrial carcinoma and can be used to calculate tumor volume in patients with cervical carcinoma. Early studies suggest that MRI may be helpful in distinguishing between long-term radiation fibrosis and tumor recurrence in such patients. MRI findings may be highly indicative of the presence of ovarian malignancy, but the procedure adds little to CT or US findings. Nevertheless, MRI is superior in the localization of pelvic masses and is often indicated in clarifying the origin of a mass as uterine or ovarian.
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PMID:Applications of magnetic resonance imaging to gynecology. 218 59

Ovarian remnant syndrome should be considered in the differential diagnosis of pelvic pain with a mass in a patient who has had extirpative surgery. Although rarely reported in the literature, it is probably much more prevalent than is suspected. Most commonly, the initial surgery was performed for endometriosis or pelvic inflammatory disease, with incomplete excision of the ovaries. Surgical excision of the ovarian remnant, the definitive treatment, is itself difficult, and is often attended by serious complications. Medical therapy is empiric, and hormonal manipulation may help prevent recrudescence. Three cases are reported, their pathology and the literature is reviewed.
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PMID:Ovarian remnant syndrome: difficulties in diagnosis and management. 219 Jan 28

Endometriosis is an extremely common gynaecological disease, affecting between 1 and 5% of women of reproductive age. Women with endometriosis typically present for medical care with one of more of the following problems: pelvic pain, infertility, or a large adnexal mass (an endometrioma). The primary treatment for an endometrioma is surgical. However, long term postoperative hormone therapy may be necessary to prevent new endometriomas from developing. There is no evidence that hormonal therapy of endometriosis will improve fecundability in women with endometriosis and infertility. Pelvic pain due to endometriosis can be successfully treated with hormonal agents in the majority of patients. Four basic hormonal regimens are currently available for the treatment of endometriosis: (a) danazol; (b) gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH); gonadorelin] agonists; (c) progesterones (progestins); and (d) combined estrogens and progesterones. Randomised, controlled, clinical trials suggest that danazol and the GnRH agonists are equally effective in the treatment of endometriosis. However, the side effects caused by danazol and the GnRH agonists are markedly different. Danazol produces androgenic side effects including weight gain, hirsutism, acne, oily skin and deepening of the voice. GnRH agonists produce side effects due to hypoestrogenism, including hot flushes, osteoporosis and dry vagina. The ideal drug regimen for the treatment of endometriosis remains to be developed.
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PMID:Endometriosis 1990. Current treatment approaches. 219 Jul 93

This is the first reported case of simultaneously occurring pelvic splenosis and Mayer-Rokitansky-Kuster-Hauser syndrome. No other congenital or anatomic abnormalities were observed in the patient, and she had no history of abdominal trauma or surgery. Endometriosis was suspected initially during laparoscopy for pelvic pain. After tissue removal at laparotomy, the histologic evaluation established the diagnosis of splenosis. Biopsy at laparoscopy should be considered to confirm the diagnosis in the presence of a congenital anomaly and lesions suspected of being endometriotic.
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PMID:Mayer-Rokitansky-Kuster-Hauser syndrome with splenosis. A case report. 221 46

Cyclic pelvic pain is a common gynecologic problem caused by relatively few diseases, which usually can be diagnosed and remedied quickly. Some complaints reflect normal physiologic aspects of the menstrual cycle (mittelschmerz, menstrual awareness). Premenstrual syndrome can be diagnosed, but an effective and convenient treatment is lacking. Dysmenorrhea is the commonest source of cyclic pain, diagnosed by its characteristic history and rapid relief on administration of antiprostaglandin agents. Endometriosis is diagnosed surgically and best treated either surgically then, or medically by danazol or GnRH agonists. In contrast, adenomyosis is a problem commonly encountered in later life, and hysterectomy is usually needed for both definitive diagnosis and treatment.
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PMID:Cyclic pelvic pain. 223 52

Between 1977-1989, 29 women with symptomatic endometriosis were treated with megestrol acetate by the Johns Hopkins Division of Reproductive Endocrinology. All had previously received one or more alternative medical treatments for endometriosis, in each case discontinued because of poor response or development of unacceptable side effects. Treatment consisted of a daily dose of 40 mg megestrol acetate orally for up to 24 months. Disease-related symptoms (dysmenorrhea, noncyclic pelvic pain, and dyspareunia) were relieved in 86% of the subjects treated with an adequate course of therapy. Side effects were fairly well tolerated, although eight women discontinued treatment within 2 months and two others stopped the drug by 4 months. These preliminary findings suggest that megestrol acetate may be an effective treatment for patients with endometriosis, even those who have been unresponsive to other modes of therapy.
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PMID:Megestrol acetate for treatment of endometriosis. 231 84

We analyzed the prevalence of dysmenorrhea, pelvic pain, and dyspareunia in relation to the disease stage in 160 women with endometriosis but no other associated pelvic disease who underwent their first gynecologic surgery (laparoscopy or laparotomy) at the First Obstetric and Gynecology Clinic of the University of Milan between 1985 and 1987. Dysmenorrhea was reported by 78% of the patients, pelvic pain by 39%; and deep dyspareunia by 32%. No relation was found between severity of the pain symptoms and stage of the disease or site of the endometriotic lesions.
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PMID:Stage and localization of pelvic endometriosis and pain. 235 89

The neodymium:yttrium-aluminum garnet (Nd:YAG) laser was used via laparoscopy in 84 patients complaining of infertility and/or pelvic pain. All patients in the study had biopsy-proven or visually confirmed pelvic endometriosis. The Nd:YAG laser was used in conjunction with sapphire probes as a touch technique on tissue. Problems usually encountered, such as mirror alignment, beam focus, and smoke plume, with carbon dioxide laser systems were avoided, and use of the laser in a liquid environment was possible. Restoration of fertility was seen in 39.7% with short follow-up; pain relief was excellent, especially in conjunction with uterosacral denervation.
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PMID:Treatment of endometriosis with a Nd:YAG tissue-contact laser probe via laparoscopy. 247 10

In a pilot study, chronic pelvic pain associated with endometriosis, dysmenorrhoea or menorrhagia has been treated for prolonged periods with low dose buserelin (daily) and medroxy-progesterone (monthly). The partial inhibition of ovarian function was effective in relieving pain and controlling uterine bleeding, with few side effects. There was no change in serum cholesterol level. A possible small bone demineralisation effect has been observed.
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PMID:Long-term use of the low dose LHRH analogue combined with monthly medroxy-progesterone administration. 251 46


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