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

Clinical experiences with laparoscopy as a diagnostic or therapeutic procedure in 700 female patients are reported. Indications included: Obscure palpatory findings (53 cases), pelvic pain (187 cases), infertility of unknown etiology (109 cases), tubal coagulation (188 cases), and treatment of adhesions, endometriosis, or cysts (104 cases). Complications incuded mild peritoneal emphysema (28 cases) and bleeding (14 cases); the procedure was interrupted in only 2 cases, however. Hemorrhage from the external iliac artery (1 patient), intestinal trauma (3 cases), and a break in the electric needle were also observed. There were no deaths. It is concluded that laparoscopy is an extremely useful procedure for the clarification of pelvic pain and other gynecological symptoms.
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PMID:[A report on the efficiency of gynaecological laparoscopy (author's transl)]. 427 37

Twenty patients with unicornuate uteri were unexpectedly found during operative procedures. Of these, 18 women had unicornuate uteri with concomitant rudimentary horn and only two were without. Suspicion of ectopic pregnancy, chronic pelvic pain, or pelvic tumor, was most frequently the primary reason for admittance to hospital. Endometriosis (20%) was the most common finding in surgical procedures. Only one hematometra of the rudimentary horn was found. Two tubal pregnancies and two pregnancies in the rudimentary horn, one with rupture of the horn and one with placenta accreta in the horn, were observed. Treatment was the simple excision of the rudimentary horn in 12 cases. Fetal survival rate was 71%, prematurity 15%, and perinatal mortality 7.4% in 35 pregnancies and 27 deliveries. High incidence of breech presentation (33%) and cesarean section rate (30%) was observed. Two out of three pregnancies with cervical cerclage ended successfully. Of 15 pyelograms performed, nine (60%) showed abnormalities, the most frequently being the absence of a kidney.
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PMID:Clinical implications of the unicornuate uterus with rudimentary horn. 613 34

The authors report on a retrospective study of 184 laparoscopies carried out assessing the aetiology of chronic pelvic pain. The population that was studied has a mean age of 28.8 years, with most of the patients being between 20 and 30 years of age. The mean length of the history of the pain was 51 1/2 months. 51% of the cases had pain of a rhythmical nature associated with the menstrual cycle, 11.3% of cases had deep dyspareunia and 37.7% of the cases had repeated attacks of pain. Previous gynaecological pathology was found in 30% of cases and previous pelvis surgery in 11.1% of cases. 41.5% of the population were multiparous. Laparoscopy was only performed after a full clinical and paraclinical examination. It showed the presence of: endometriosis in 22.2% of cases, pelvic adhesions in 17.4%, varicose veins in the pelvis in 11.4%, ovarian cysts in 6.5%, ovarian dystrophies in 3.2%, Masters and Allen syndrome in 3.8%, sub-serous fibroids in 2.1%.
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PMID:[The diagnostic value of celioscopy in the evaluation of chronic pelvic pain. Apropos of 184 cases]. 623 46

One hundred twelve females below the age of twenty years underwent laparoscopy at the Medical University of South Carolina over a ten-year period. Pelvic pain followed by primary amenorrhea was the major indication for the procedure. Eighty-nine percent of those with acute pain had identifiable pelvic pathology, whereas 27% of girls presenting with chronic pain had a normal laparoscopic examination. Pelvic inflammatory disease was the most common diagnosis. Ovarian cysts, pregnancy complications, and endometriosis were also found. Endometriosis was not found among black teenage clinic patients. The procedure appears to be a safe and useful diagnostic tool in this age group.
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PMID:Laparoscopy in children and adolescents. 623 18

Laparoscopy was used to evaluate 100 women who consistently reported pelvic pain in the same location for a minimum of six months. These findings were compared with those of 50 asymptomatic women who underwent laparoscopy for tubal ligation. Overall, 83% of the group with pelvic pain had abnormal pelvic organs as compared with 29% of the asymptomatic group. Adhesions were the most common pathology accounting for 38% and pelvic endometriosis accounted for 32% of the symptomatic group. Results of this study suggest that pelvic pain reported to be in the same location for a minimum of six months, is usually associated with organic pathology.
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PMID:Laparoscopy in 100 women with chronic pelvic pain. 623 50

Peritoneal fluid obtained at laparoscopy from 49 women was measured for its content of prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF2 alpha), 6-keto-prostaglandin F1 alpha (6-KF), and thromboxane B2 (TxB2) by specific radioimmunoassays. In normal women (n = 10), the concentrations of prostaglandins in peritoneal fluid were (mean +/- SE): PGE2 = 0.79 +/- 0.26, PGF2 alpha = 0.60 +/- 0.18, 6-KF = 0.48 +/- 0.19, and TxB2 = 0.23 +/- 0.09 ng/ml; in women with endometriosis (n = 16): PGE2 = 1.43 +/- 0.72, PGF2 alpha = 1.52 +/- 0.59, 6-KF = 3.32 +/- 0.71, and TxB2 = 1.14 +/- 0.69 ng/ml; in women with chronic pelvic inflammatory disease and/or obstructed tubes (n = 19): PGE2 = 1.94 +/- 1.04, PGF2 alpha = 1.20 +/- 0.61, 6-KF = 1.55 +/- 0.40, and TxB2 = 0.64 +/- 0.24 ng/ml; in women with pelvic pain without any visible pathologic condition (n = 4): PGE2 = 1.11 +/- 0.66, PGF2 alpha = 0.73 +/- 0.55, 6-KF = 1.35 +/- 0.35, and TxB2 = 0.39 +/- 0.17. The mean volumes of peritoneal fluid recovered were 10 to 16 ml and were not significantly different between the groups. Except for a significantly elevated concentration of 6-KF in the peritoneal fluid of women with endometriosis compared to normal women (p = less than 0.02), the prostaglandins measured did not differ significantly between the groups of women studied. The possible significance of elevated 6-KF in the peritoneal fluid of women with endometriosis is discussed.
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PMID:Peritoneal fluid prostaglandins and prostanoids in women with endometriosis, chronic pelvic inflammatory disease, and pelvic pain. 636 10

The peritoneum covering the pelvic viscera is usually smooth and glistening. Defects in the pelvic peritoneum are usually presumed to be acquired. Allen and Masters described such a clinical syndrome, the anatomic cornerstone of which was laceration(s) of uterine supports with resultant defect(s) in the broad and/or uterosacral ligaments. This diagnosis has been made more often recently on the basis of laparoscopic findings alone. Twenty-five cases of pelvic peritoneal defects were documented in a series of 635 consecutive diagnostic laparoscopies done primarily for pelvic pain. None fit the criteria of the Allen-Masters syndrome. Sixty-eight percent had associated endometriosis. It is suggested that pelvic peritoneal defects may be causally related to endometriosis, the disease either attacking presumably previously altered peritoneal surfaces or causing peritoneal scarring, duplication, and reduplication secondary to the cyclic insults of the ectopic endometrium and thereby producing the appearance of traumatic lacerations. Further, it is suggested that when such defects are noted at laparoscopy, the presence of other associated pathologic abnormalities, including endometriosis, should be investigated.
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PMID:Pelvic peritoneal defects and endometriosis: Allen-Masters syndrome revisited. 645 17

Endometriosis was encountered in 66 of 140 patients (47%) who underwent laparoscopy for chronic pelvic pain at Boston Children's Hospital Medical Center. Pelvic pain associated with this diagnosis was both cyclic and acyclic and typically began 2.9 years after menarche. Other symptoms included irregular menses, gastrointestinal and bladder symptoms, and increased vaginal discharge. The diagnosis of endometriosis had not been made preoperatively in the majority of patients despite repeated pelvic examinations and thorough evaluation of the gastrointestinal and urinary tracts. Psychiatric referral had been recommended for 10 patients. The most constant physical finding preoperatively was tenderness with or without cul-de-sac nodularity. Eleven patients (17%) with biopsy-proved endometriosis has normal pelvic examinations. Fifty-eight percent of patients had early and minimal disease (stage I). In the remaining patients, the disease was more extensive, involving the ovaries, tubes, and/or adjacent pelvic structures (stages II-IV). Although in most instances the implants were typical in appearance, in 13 patients (20%) the disease was not recognizable grossly, but was confirmed morphologically. The regimens utilized as primary treatment were based on the stage of the disease and consisted of either ovulation suppression alone or surgery with or without subsequent ovulation suppression. A satisfactory outcome was achieved in 47 patients (71%). The remaining 19 patients (28%) who did not respond to primary treatment were either operated on or treated symptomatically and are being carefully followed.
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PMID:Adolescent endometriosis. 645 89

Few previous studies have examined the relationship between the preoperative and pathologic diagnoses for hysterectomy. To determine the percentage of preoperative diagnoses that were confirmed by pathologic examination, we analyzed data from the Collaborative Review of Sterilization, a multicenter study of hysterectomies and tubal sterilizations in women aged 15 to 44 years. Data were collected from patient interviews and chart reviews. Of the 1851 women included in this study, 1283 (69%) had abdominal hysterectomies and 568 (31%) had vaginal hysterectomies. Overall, 52% of the hysterectomies were performed for a preoperative diagnosis that could potentially be confirmed by pathologic examination. Pathologic examination actually confirmed the preoperative diagnosis of endometrial hyperplasia in 95% of the cases, cervical intraepithelial neoplasia in 89%, leiomyomas in 84%, pelvic inflammatory disease in 75%, adenomyosis in 48%, and endometriosis in 47%. Among all of the potentially confirmable diagnoses, 80% were confirmed. The remaining 48% of the women who had hysterectomies had preoperative diagnoses that were not amenable to confirmation by pathology. Most of these were for one of three diagnoses: menstrual bleeding disorders, pelvic pain, or pelvic relaxation. In 47% of these cases, pathologic examination showed leiomyoma or adenomyosis; no abnormalities were found in 38% of these cases.
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PMID:Confirmation of the preoperative diagnoses for hysterectomy. 648 93

26 women presenting with internal and external endometriosis and 27 women with chronic cystic mastopathy and mastodyny received 400 mg danazol-a 17-ethinyltestosterone derivate-daily for 3 to 6 months. Before, during and after completion of treatment clinical and endocrinological investigation as well haematological examinations and determinations of blood and urinary chemistry were carried out. In cases of mastopathy plate thermography and mammography were performed; in endometriosis the diagnosis was verified by laparoscopy or-tomy. An improvement in, or disappearance of dysmenorrhoea and pelvic pain was observed in the endometriosis group. At laparoscopy or -tomy a decrease in, but not a complete disappearance of endometriotic foci was seen. A most favourable effect of danazol was seen in mastodyny. A change in plate thermographic or mammographic findings was observed on only a few patients. A significant fall in 17 beta-oestradiol after one month and a slight decrease in basal LH levels (statistical trend) were observed. FSH and HPRL levels were not significantly affected. Ovulation was mostly suppressed, but serum progesterone values were found several times to be in the range characteristic of severe luteal insufficiency (100 to 1500 pg/ml). Hence, not only amenorrhoea, but also breakthrough bleeding occurred. The observed side affects can be ascribed to anabolic (weight gain), androgenic (acne, hirsutism) and hypoestronic (atrophic vaginitis, hot flushes, restlessness) symptomatology.
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PMID:[Clinical experience with danazol treatment of endometriosis and mastopathy]. 679 63


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